CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Lodi Community Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $367
Cash Discount Price: $441
vs. Medicare Baseline: 3.44x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Lodi Community Hospital is $367. 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 3.44x the Medicare baseline. Located in 225 Elyria Street, Lodi, OH.

Cash / Self-Pay

$441

Average discount available for prompt cash payment at this facility.

Insurance Median

$367

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: $367 (344%)

Cash: $441 (413% of Medicare)

Ins. Median: $367 (344% 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 344% of the Medicare baseline (a markup of 244%). 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
Blue Cross Blue Shield	$106 - $556	99%
UnitedHealthcare	$106 - $421	99%
Humana	$204	191%
Mmo	$204 - $1,170	191%
Summacare	$204 - $416	191%
United	$204 - $485	191%
Oscar	$205 - $261	192%
Buckeye	$226	212%
Caresource	$226	212%
Aetna	$231 - $679	216%
Molina	$237	222%
Amerihealth	$248	232%
The Health Plan	$272 - $543	255%
Amish Community Aid Plan	$306 - $340	286%
Ohcp	$330	309%
Aultcare	$340	318%
Omas	$340	318%
Ohio Healthy	$367	344%
Php	$407	381%
Phphi	$407	381%
Upmc	$407	381%
Cigna	$438	410%
Cc Ehp	$456	427%
Gms	$475	445%
Medical Benefit Corp	$475	445%
Consociate Health	$509	477%
Frontpath	$611	572%
Managed Care Services	$611	572%
Multiplan	$611	572%
Tertiary Care Network	$611	572%

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 $441.
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 Lodi Community 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.