CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Southern Ocean Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $556
Cash Discount Price: $116
vs. Medicare Baseline: 5.21x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Southern Ocean Medical Center is $556. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.21x the Medicare baseline. Located in 1140 Rt 72 W, Manahawkin, NJ.

Cash / Self-Pay

$116

Average discount available for prompt cash payment at this facility.

Insurance Median

$556

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: $116 (109%)

Insurance Median: $556 (521%)

Cash: $116 (109% of Medicare)

Ins. Median: $556 (521% 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 521% of the Medicare baseline (a markup of 421%). 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
Karna	$83 - $244	78%
Blue Cross Blue Shield	$116	109%
Vaccn	$116	109%
Wellcare	$116	109%
United Community/Americhoice	$122	114%
Aetna	$127 - $2,326	119%
UnitedHealthcare	$139 - $714	130%
Cigna	$258 - $2,376	242%
Oxford	$265 - $1,607	248%
Clover	$535	501%
Amerihealth	$551 - $561	516%
Seoul Medical Group	$609	570%
Horizon	$1,933 - $2,715	1810%
Brighton Health Plan	$2,049	1918%
Bergen Risk	$2,228	2086%
Multiplan - PHCS	$2,524	2363%
Qualcare	$2,697	2525%

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 $116.
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 Southern Ocean 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.