CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Cleveland Clinic

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $244
  • Cash Discount Price: $441
  • vs. Medicare Baseline: 2.28x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Cleveland Clinic is $244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $441. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.28x the Medicare baseline. Located in 9500 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$441

Average discount available for prompt cash payment at this facility.

Insurance Median
$244

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: $441 (413%)
Insurance Median: $244 (228%)
Cash: $441 (413% of Medicare)
Ins. Median: $244 (228% 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 228% of the Medicare baseline (a markup of 128%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Summacare $29 - $366 27%
Aetna $44 - $1,110 41%
Blue Cross Blue Shield $44 - $577 41%
Devoted Health $44 - $120 41%
Humana $44 - $577 41%
The Health Plan $44 - $610 41%
United $44 - $319 41%
UnitedHealthcare $44 - $710 41%
Upmc $44 - $666 41%
Valor $44 - $120 41%
Cigna $46 - $888 43%
Communicare $46 - $126 43%
Perennial Health $48 - $129 45%
Pphp $48 - $132 45%
Zing Health $49 - $132 46%
Cc Ehp $84 - $424 79%
Mmo $99 - $1,170 93%
Oscar $115 - $296 108%
Paramount $131 - $198 123%
Buckeye $134 - $201 125%
Caresource $134 - $192 125%
Amerihealth $140 131%
Molina $140 - $201 131%
Ohcp $168 - $432 157%
Ohio Healthy $172 - $475 161%
Aultcare $185 - $477 173%
Amish Community Aid Plan $194 - $500 182%
United Bh $211 198%
Omas $216 - $555 202%
Healthsmart $237 - $610 222%
Phphi $259 - $666 242%
Clarity Health $280 - $722 262%
Gms $302 - $777 283%
Quality Care Partners $302 - $777 283%
Consociate Health $323 - $832 302%
Multiplan $388 - $999 363%
Three Rivers $388 - $999 363%
Usa Managed Care $388 - $999 363%
Php $407 381%
Medical Benefit Corp $475 445%
Parkview Health Plan $475 445%
Community Health Alliance $543 508%
Frontpath $611 572%
Managed Care Services $611 572%
Tertiary Care Network $611 572%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9500 Euclid Avenue, Cleveland, OH 44195
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals