CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Doctors Center Hospital Carolina LLC

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $275
  • Cash Discount Price: $250
  • vs. Medicare Baseline: 2.57x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Doctors Center Hospital Carolina LLC is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $250. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.57x the Medicare baseline. Located in Edif Jesus T Pineiro Ave Fernandez Juncos Bo Puebl, Carolina, PR.
Cash / Self-Pay
$250

Average discount available for prompt cash payment at this facility.

Insurance Median
$275

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: $250 (234%)
Insurance Median: $275 (257%)
Cash: $250 (234% of Medicare)
Ins. Median: $275 (257% 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 257% of the Medicare baseline (a markup of 157%). 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
Medicare (plans) $102 95%
Mcs Life Insurance $225 211%
Humana $275 257%
International Medical Card $275 257%
Triple-S $275 257%
Mapfre $300 281%
Plan De Salud Menonita $300 281%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Edif Jesus T Pineiro Ave Fernandez Juncos Bo Puebl, Carolina, PR 00979
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals