CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Medical Center Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $422
Cash Discount Price: $1,901
vs. Medicare Baseline: 3.95x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Medical Center Hospital is $422. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,901. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.95x the Medicare baseline. Located in 500 W 4Th Street, Odessa, TX.

Cash / Self-Pay

$1,901

Average discount available for prompt cash payment at this facility.

Insurance Median

$422

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: $1,901 (1780%)

Insurance Median: $422 (395%)

Cash: $1,901 (1780% of Medicare)

Ins. Median: $422 (395% 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 395% of the Medicare baseline (a markup of 295%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$100 - $1,961	94%
Corvel Wc	$100 - $107	94%
Humana	$100	94%
UnitedHealthcare	$100 - $2,971	94%
Novitas Solutions	$103	96%
Triwest Va Ccn	$103	96%
Care Improvement Plus	$105	98%
Medicaid / KanCare	$105 - $110	98%
Superior Chips	$105	98%
Ambetter / Centene	$109 - $118	102%
Wellcare By Allwell	$109	102%
Amerigroup	$118	110%
Blue Cross Blue Shield	$118 - $1,278	110%
Community Health Choice	$118	110%
First Care Health Plan	$118	110%
Superior Health Plan	$118	110%
Group Resources	$126	118%
Workers Comp	$210	197%
Caprock	$386 - $1,426	361%
Health Select	$391 - $1,278	366%
Healthsmart Preferred Care	$422 - $1,783	395%
Geha	$700	655%
Firstcare	$850 - $2,080	796%
Cigna	$1,082 - $1,503	1013%
90 Degree Benefits	$1,426	1335%
State Comptroller	$1,486	1391%
Texas Mutual Wc	$1,961	1836%

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 $1,901.
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 Medical Center Hospital 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.