CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Capital Health Regional Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $1,902
Cash Discount Price: $20,028
vs. Medicare Baseline: 17.81x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Capital Health Regional Medical Center is $1,902. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,028. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 17.81x the Medicare baseline. Located in 750 Brunswick Ave, Trenton, NJ.

Cash / Self-Pay

$20,028

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,902

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $20,028 (18751%)

Insurance Median: $1,902 (1781%)

Cash: $20,028 (18751% of Medicare)

Ins. Median: $1,902 (1781% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1781% of the Medicare baseline (a markup of 1681%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Fidelis	$116	109%
Clover	$118	110%
Wellpoint	$118 - $906	110%
Humana	$120	112%
Medicare (plans)	$120	112%
Oxford Benefit Plan	$252	236%
UnitedHealthcare	$287 - $839	269%
Cigna	$328 - $15,736	307%
Medicaid / KanCare	$814 - $896	762%
Aetna	$1,030 - $7,448	964%
Blue Cross Blue Shield	$1,902 - $2,509	1781%
Multiplan	$16,213 - $17,834	15179%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $20,028.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72125.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Capital Health Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72125.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.