CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Saratoga Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $52
Cash Discount Price: $1,664
vs. Medicare Baseline: 0.49x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Saratoga Hospital is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,664. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.49x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.

Cash / Self-Pay

$1,664

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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: $1,664 (1558%)

Insurance Median: $52 (49%)

Cash: $1,664 (1558% of Medicare)

Ins. Median: $52 (49% 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.

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
Cdphp	$30 - $825	28%
Blue Cross Blue Shield	$33 - $1,997	31%
Fidelis	$33 - $825	31%
Medicare (plans)	$33 - $44	31%
Tricare	$38 - $44	36%
Hamaspik	$41 - $861	38%
Medicaid / KanCare	$42	39%
Emblem Health Ghi	$44 - $49	41%
UnitedHealthcare	$44 - $2,995	41%
Aetna	$45 - $1,631	42%
Mvp	$45 - $85	42%
Blue Shield Highmark	$53 - $60	50%
Mvp Commercial	$65 - $2,330	61%
Cigna	$70 - $85	66%
Emblem	$126 - $190	118%
Blue Shield	$167 - $477	156%
Nascentia Health Options	$185	173%
Mvp Essential Plan	$367 - $733	344%
Mvp Govt Programs	$367	344%
Empire Plan Nyship	$2,330	2181%
Multiplan	$2,496 - $2,829	2337%
Magnacare	$2,995 - $3,162	2804%

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 $1,664.
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 Saratoga Hospital 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.