CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $215
  • Cash Discount Price: $693
  • vs. Medicare Baseline: 2.01x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Cincinnati Children's Hospital Medical Center is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $693. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.01x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.
Cash / Self-Pay
$693

Average discount available for prompt cash payment at this facility.

Insurance Median
$215

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: $693 (649%)
Insurance Median: $215 (201%)
Cash: $693 (649% of Medicare)
Ins. Median: $215 (201% 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 201% of the Medicare baseline (a markup of 101%). 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
Blue Cross Blue Shield $31 - $2,420 29%
Mhs_In $32 - $129 30%
Caresource_In $33 - $135 31%
Aetna $37 - $2,339 35%
Humana $39 - $616 37%
Passport_Ky $39 - $640 37%
United_Health_Care_Ky $39 - $650 37%
Wellcare_Ky $39 - $648 37%
Caresource_Oh $68 - $274 64%
Amerihealth_Caritas_Oh $70 - $296 66%
Molina_Oh $72 - $302 67%
Buckeye_Oh $75 - $315 70%
United_Health_Care_Oh $81 - $289 76%
Caresource_Oh_Insurance $123 - $1,182 115%
Medical_Mutual_Of_Ohio_Insurance $138 - $2,339 129%
Parkview_Signature_Care_Insurance $158 - $1,920 148%
Point_Comfort_Insurance $167 - $1,600 156%
Margaret_Mary_Health_Insurance $170 - $1,920 159%
United_Health_Care_Insurance $196 - $2,206 184%
Beechstreet_Insurance $208 - $2,413 195%
Cigna $208 - $2,339 195%
Health_Ohio_Network_Insurance $234 - $2,339 219%
Custom_Design_Benefits_Insurance $244 - $2,339 228%
Health_Smart_Preferred_Insurance $244 - $2,339 228%
Medical_Benefit_Administrators_Insurance $244 - $2,339 228%
Ohio_Health_Choice_Insurance $244 - $2,339 228%
Private_Health_Care_Systems_Insurance $247 - $2,364 231%
First_Health_Group_Insurance $252 - $2,413 236%
Health_Link_Insurance $252 - $2,413 236%
Evolutions_Health_Care_Systems $257 - $2,462 241%
Galaxy_Health_Insurance $257 - $2,462 241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Burnet Avenue, Cincinnati, OH 45229
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens