CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Kaleida Health

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $101
  • Cash Discount Price: $473
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Kaleida Health is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $473. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.95x the Medicare baseline. Located in 100 High Street, Buffalo, NY.
Cash / Self-Pay
$473

Average discount available for prompt cash payment at this facility.

Insurance Median
$101

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: $473 (443%)
Insurance Median: $101 (95%)
Cash: $473 (443% of Medicare)
Ins. Median: $101 (95% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Highmark Wny $31 - $57 29%
American Progressive Life & Health $36 - $45 34%
UnitedHealthcare $37 - $142 35%
Univera Healthcare $39 - $77 37%
Molina Healthcare Of New York, Inc. $40 - $42 37%
Fidelis Care $42 - $77 39%
Vns Choice $48 45%
Wellcare $48 - $136 45%
Independent Health Association $76 - $249 71%
Independent Health Association - Wchob $79 - $249 74%
Blue Cross Blue Shield $89 - $487 83%
Ghi/Emblem Health $94 - $176 88%
Ghi/Emblem Health - Wchob $94 - $118 88%
Aetna $98 - $138 92%
Magnacare $98 - $126 92%
Magnacare - Wchob $98 - $126 92%
Tricare $124 116%
Univera $128 - $594 120%
Fidelis $141 132%
Cigna $153 - $185 143%
Univera - Wchob $177 - $594 166%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 High Street, Buffalo, NY 14210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals