CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Mercy Hospital of Buffalo

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $99
  • Cash Discount Price: $312
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Mercy Hospital of Buffalo is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $312. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.93x the Medicare baseline. Located in 565 Abbott Road, Buffalo, NY.
Cash / Self-Pay
$312

Average discount available for prompt cash payment at this facility.

Insurance Median
$99

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: $312 (292%)
Insurance Median: $99 (93%)
Cash: $312 (292% of Medicare)
Ins. Median: $99 (93% 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
UnitedHealthcare $32 - $173 30%
Medicaid / KanCare $37 - $199 35%
VA Veterans Affairs [700001] $39 - $128 37%
Univera Healthcare [100169] $40 - $157 37%
Univera Healthcare Essential [100170] $40 - $170 37%
Beacon Essential [350122] $41 - $153 38%
Fidelis Essential [100163] $41 - $318 38%
Excellus Rochester McD [350117] $42 - $199 39%
Tuscarora Nation [550120] $42 - $199 39%
Vna Option Mltc [350110] $42 - $199 39%
Amerigroup [350102] $42 - $242 39%
Blue Cross Blue Shield $42 - $318 39%
Crime Victims [100176] $42 - $199 39%
Independent Health Essential [100166] $42 - $199 39%
Ghi [100153] $43 - $121 40%
Medicare (plans) $45 - $183 42%
Tricare $46 - $128 43%
Covid19 Hrsa [45013] $46 - $128 43%
Magnacare [100142] $46 - $128 43%
Humana $46 - $134 43%
Aetna $46 - $134 43%
Hospice [550001] $46 - $128 43%
Meritain [100063] $46 - $128 43%
Catholic Health Life Pace [400005] $46 - $128 43%
Fallon Health [450115] $46 - $128 43%
Seneca Nation [450119] $46 - $128 43%
Champ VA [700002] $46 - $128 43%
Cigna $46 - $185 43%
Wellcare Fidelis Dual [450451] $47 - $134 44%
Fidelis Dual Advantage [450120] $47 - $134 44%
Wellcare [450129] $50 - $140 47%
Iha First Choice [800001] $50 - $312 47%
Independent Health [100165] $50 - $303 47%
Fidelis Exchange [100164] $55 - $153 51%
Beacon Health Options [100023] $55 - $153 51%
UPMC Health Plan [100181] $62 - $289 58%
Mvp Healthcare [100168] $62 - $189 58%
Molina Essential [100167] $94 - $448 88%
Federal Workers Compensation [500100] $129 - $514 121%
No Fault [114001] $129 - $514 121%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 565 Abbott Road, Buffalo, NY 14220
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals