CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: St Luke's Hospital - Monroe Campus

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $228
  • Cash Discount Price: $3,527
  • vs. Medicare Baseline: 2.13x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at St Luke's Hospital - Monroe Campus is $228. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,527. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.13x the Medicare baseline. Located in 100 St Luke's Lane, Stroudsburg, PA.
Cash / Self-Pay
$3,527

Average discount available for prompt cash payment at this facility.

Insurance Median
$228

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: $3,527 (3302%)
Insurance Median: $228 (213%)
Cash: $3,527 (3302% of Medicare)
Ins. Median: $228 (213% 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 213% of the Medicare baseline (a markup of 113%). 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 $109 - $1,357 102%
Highmark $109 - $264 102%
Aetna $111 - $1,483 104%
Geisinger $111 - $1,195 104%
Humana $113 106%
Upmc Health Plan $114 - $1,165 107%
UnitedHealthcare $118 - $1,228 110%
Highmark Wholecare $154 144%
Amerihealth Caritas $160 150%
Jefferson Health Plan $192 180%
Oscar $1,103 1033%
Cigna $1,163 1089%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 St Luke's Lane, Stroudsburg, PA 18360
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals