CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Hospital Metropolitano Dr Pila

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $123
Cash Discount Price: $300
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Hospital Metropolitano Dr Pila is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $300. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.15x the Medicare baseline. Located in 2435 Boulevard Luis A Ferre, Ponce, PR.

Cash / Self-Pay

$300

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $300 (281%)

Insurance Median: $123 (115%)

Cash: $300 (281% of Medicare)

Ins. Median: $123 (115% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
First Medical	$45 - $162	42%
Triple S	$45 - $138	42%
Privado	$55	51%
Mso	$58 - $70	54%
Va	$74	69%
Acaa	$82	77%
Hospicio	$86	81%
Mcs	$91 - $131	85%
Tricare	$91	85%
Humana	$102 - $206	95%
Ch	$113	106%
Salud Correccional	$113	106%
Fondo Del Seguro Estado	$120	112%
Plan De Salud Menonita	$126 - $150	118%
Prossam	$131	123%
Bl	$138	129%
Cigna	$139	130%
Comerciales	$150	140%
Life Link	$150	140%
Mc	$150	140%
Wellcare	$150	140%
Aarp	$275	257%
Mapfre	$300	281%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $300.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72125.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Hospital Metropolitano Dr Pila is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72125.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.