CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $2,234
  • Cash Discount Price: $4,764
  • vs. Medicare Baseline: 20.92x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Hospital of Univ of Pennsylvania is $2,234. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,764. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.92x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$4,764

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,234

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: $4,764 (4460%)
Insurance Median: $2,234 (2092%)
Cash: $4,764 (4460% of Medicare)
Ins. Median: $2,234 (2092% 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 2092% of the Medicare baseline (a markup of 1992%). 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
Gspp And Wissahickon Hospice $55 51%
Medicaid / KanCare $83 - $4,995 78%
Kaiser Permanente $87 - $4,995 81%
UnitedHealthcare $97 - $4,995 91%
Keystone Mercy Health Plan $106 - $4,995 99%
Blue Cross Blue Shield $110 - $3,832 103%
Medicare (plans) $110 - $112 103%
Philadelphia Va Medical Center $110 103%
Tricare $110 103%
Upmc $110 - $4,995 103%
Ibc $112 105%
Cigna $113 - $2,248 106%
Geisinger Health Plan $113 - $349 106%
Health Partners $113 - $4,995 106%
Humana $113 - $3,996 106%
Devoted Health $115 108%
Pa Health And Wellness $115 - $181 108%
Penn Life (Living Independently For Elders) $115 108%
Aetna $116 - $4,995 109%
Clover Health Plan $119 111%
Keystone First $122 114%
Us Family Health Plan $126 118%
Pa Medical Assistance $134 - $4,995 125%
Gateway Health Plan $136 127%
Paired Kidney Exchange $136 - $150 127%
Elap $156 146%
Claims Watcher $176 - $198 165%
Oscar Health Plan $187 175%
Centivo $198 185%
Elap Services $204 191%
Highmark $231 216%
Penn Global Medicine $291 272%
Keystone Hmo Proactive $304 285%
Ibc Commercial Hpn $314 294%
Horizon Nj Health $766 - $878 717%
Preferred Health Care Eliance $997 - $1,099 933%
Pgm - Regie De L'Assurance Maladie Quebec $1,042 - $1,149 976%
Pgm - Kuwait Defense $1,586 - $2,248 1485%
Qualcare $1,722 - $1,898 1612%
Olympus $1,781 - $1,963 1667%
Coventry $1,813 - $2,547 1697%
Pgm - Chop $1,813 - $1,998 1697%
Wissahickon Hospice $1,813 - $1,998 1697%
Healthamerica/Coventry $2,039 - $2,448 1909%
First Health Global $2,266 - $2,498 2122%
Health Net $2,719 - $2,997 2546%
Pgm - Royal Embassy Of Saudi Arabia $2,719 - $2,997 2546%
Pgm - Embassy Of Qatar $2,946 - $3,247 2758%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $2,946 - $3,247 2758%
Interlink $3,036 - $3,347 2842%
Pgm - Embassy Of The United Emirates/Ipc $3,172 - $3,496 2970%
Health America/Ccn $3,626 - $3,996 3395%
Intergroup $3,626 - $3,996 3395%
Pgm - Kuwait Health Division $3,626 - $3,996 3395%
Pgm - Kuwait Oil $3,626 - $3,996 3395%
Preferred Care $3,626 - $3,996 3395%
Blue Quality Centers For Transplant (Bqct) $4,532 - $4,995 4243%
City Of Philadelphia Behavioral Health $4,532 - $4,995 4243%
Commercial Other $4,532 - $4,995 4243%
International Pfs $4,532 - $4,995 4243%
United Behavioral Health $4,532 - $4,995 4243%
Workers Compensation $4,532 - $4,995 4243%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals