CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Prisma Health Laurens County Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $408
  • Cash Discount Price: $1,722
  • vs. Medicare Baseline: 3.82x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Prisma Health Laurens County Hospital is $408. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,722. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.82x the Medicare baseline. Located in 22725 Highway 76 East, Clinton, SC.
Cash / Self-Pay
$1,722

Average discount available for prompt cash payment at this facility.

Insurance Median
$408

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: $1,722 (1612%)
Insurance Median: $408 (382%)
Cash: $1,722 (1612% of Medicare)
Ins. Median: $408 (382% 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 382% of the Medicare baseline (a markup of 282%). 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) $78 - $686 73%
Tricare $99 93%
Blue Cross Blue Shield $106 - $1,101 99%
Champva [3049] $106 99%
Cigna $106 - $2,365 99%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $106 99%
Deseret Mutual Ins Co [3066] $106 99%
Generic Skilled Nursing [3196] $106 99%
Hospice Contracted [1500] $106 99%
Hospice Non Contracted [3190] $106 99%
Triwest Healthcare Alliance Vcp [902] $106 99%
Va Community Care Network-Vaccn [903] $106 99%
Veterans Administration [3194] $106 99%
Humana $108 - $734 101%
UnitedHealthcare $110 - $408 103%
Aetna $111 - $2,093 104%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $111 104%
Healthy Conn Prime-First Choice Vip Care [5300] $113 106%
Healthy Conn Prime-Molina Healthcare [5330] $117 110%
Workers Comp [600] $149 140%
Ambetter / Centene $195 183%
Golden Rule Insurance Company [2991] $240 225%
Oxford Health Plans [2992] $240 225%
Zzumr-Salt Lake City Ut [3169] $240 225%
Medicaid / KanCare $408 - $720 382%
Sc Dept Of Corrections [2998] $491 460%
Scdc-Sc Dept Of Corrections [7232] $491 460%
Bluechoice [810] $604 - $1,160 565%
Prisma Health Seniorcare Pace - Midlands [5400] $615 576%
Prisma Health Seniorcare Pace-Upstate [5200] $615 576%
First Choice Benefits Mgmt [3074] $686 642%
Bob Jones Univ-Pai [821] $915 857%
Promise Health Plan Contracted [2401] $927 - $1,875 868%
Orangeburg Senior Helping Center Pace [5401] $1,060 992%
Planned Administrators [820] $1,101 1031%
Meritain Health Contracted [2200] $1,695 - $2,093 1587%
Preferred Administrators Contracted [2839] $1,854 1736%
Medcost [2940] $1,960 - $2,199 1835%
Atlantic Packaging Contracted [4833] $1,987 1860%
Aps Healthcare System [2981] $2,119 1984%
Multiplan/Phcs Contracted [2950] $2,358 2208%
Evernorth Behavioral Contracted [2982] $2,365 2214%
Mvp Health Care [3037] $2,365 2214%
Vsp Vision Care [2986] $2,384 2232%
First Health Contracted [2952] $2,464 2307%
Furman Int/Allen University Student [2951] $2,464 2307%
Quiktrip-First Health [3067] $2,464 2307%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 22725 Highway 76 East, Clinton, SC 29325
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals