CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $240
  • Cash Discount Price: $1,357
  • vs. Medicare Baseline: 2.25x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Independence Health System Butler Memorial Hospita is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,357. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.25x the Medicare baseline. Located in One Hospital Way, Butler, PA.
Cash / Self-Pay
$1,357

Average discount available for prompt cash payment at this facility.

Insurance Median
$240

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: $1,357 (1270%)
Insurance Median: $240 (225%)
Cash: $1,357 (1270% of Medicare)
Ins. Median: $240 (225% 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 225% of the Medicare baseline (a markup of 125%). 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
Highmark $100 - $362 94%
Life Butler County $102 95%
Martin'S Point - Usfhp $102 - $678 95%
Medicare (plans) $102 95%
Peak Health $102 - $1,357 95%
Provider Partners $102 95%
Tricare $102 95%
UnitedHealthcare $102 - $262 95%
Aetna $105 - $1,550 98%
Humana $106 99%
Amerihealth $107 - $147 100%
Geisinger $107 - $1,938 100%
Devoted Health Plan $108 - $775 101%
The Health Plan $108 - $240 101%
Pa Health & Wellness $109 102%
American Health Plan $113 106%
Pnoa $113 - $1,550 106%
Workers Comp $113 106%
Gateway $115 - $2,035 108%
Medicaid / KanCare $134 125%
Highmark Aca - Direct Blue $135 - $362 126%
Upmc $139 - $2,035 130%
Jefferson Health Plan $147 138%
Ellwood Group $205 - $833 192%
Highmark Community Blue $212 - $362 198%
Cigna $234 - $969 219%
Highmark - Ind.& Managed Care $240 - $362 225%
Ccbh - Behavioral Health $758 - $969 710%
Private Healthcare Systems $1,357 - $1,647 1270%
Devon $1,454 1361%
Intergroup $1,550 1451%
Multiplan $1,744 1633%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Way, Butler, PA 16001
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals