CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Clarion Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $185
  • Cash Discount Price: $305
  • vs. Medicare Baseline: 1.73x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Clarion Hospital is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $305. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.73x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$305

Average discount available for prompt cash payment at this facility.

Insurance Median
$185

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: $305 (286%)
Insurance Median: $185 (173%)
Cash: $305 (286% of Medicare)
Ins. Median: $185 (173% 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
Highmark $101 - $185 95%
Amerihealth $102 - $147 95%
Cigna $102 - $272 95%
Highmark Community Blue $102 95%
Martin'S Point - Usfhp $102 - $191 95%
Medicare (plans) $102 95%
Tricare $102 95%
UnitedHealthcare $102 95%
Upmc $104 - $808 97%
Aetna $105 - $485 98%
Geisinger $107 - $160 100%
Devoted Health Plan $108 - $218 101%
The Health Plan $108 - $240 101%
Gateway $109 - $202 102%
Pa Health & Wellness $109 102%
American Health Plan $113 106%
Medicaid / KanCare $134 125%
Jefferson Health Plan $147 138%
Highmark - Ind.& Managed Care $185 - $230 173%
Peak Health $240 - $382 225%
Devon $409 383%
Workers Comp $667 624%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals