CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: St David's South Austin Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $2,849
  • Cash Discount Price: $7,501
  • vs. Medicare Baseline: 26.67x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at St David's South Austin Medical Center is $2,849. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,501. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 26.67x the Medicare baseline. Located in 901 West Ben White Blvd, Austin, TX.
Cash / Self-Pay
$7,501

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,849

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: $7,501 (7023%)
Insurance Median: $2,849 (2667%)
Cash: $7,501 (7023% of Medicare)
Ins. Median: $2,849 (2667% 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 2667% of the Medicare baseline (a markup of 2567%). 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
St David’S Hospice $105 98%
United $109 - $3,441 102%
Blue Cross Blue Shield $110 - $2,439 103%
Molina Healthcare $115 108%
Humana $131 123%
Sendero $131 123%
Aetna $132 - $2,612 124%
Amerigroup $218 204%
Superior Health Plan $368 - $1,300 345%
Cigna $2,133 - $2,218 1997%
Imo Med - Select Network $2,206 - $2,294 2065%
Texas Healthcare Foundation Heb $2,721 - $2,829 2548%
Texas Workforce Commission $2,868 - $2,982 2685%
Averde Health $3,309 - $3,441 3098%
Comanche County $3,677 - $3,824 3443%
Emerging Therapy Solutions $3,677 - $5,276 3443%
National Choicecare $3,677 - $3,824 3443%
Healthsmart Preferred Care $4,045 - $6,118 3787%
Independent Medical Systems $4,045 - $4,206 3787%
Physicians Cooperative Of Texas $4,045 - $4,206 3787%
Prime Health $4,412 - $4,588 4131%
First Health $4,633 - $5,498 4338%
Coastal Comp Health Networks $4,780 - $4,971 4475%
National Health Care $4,780 - $4,971 4475%
Texas Municipal League $5,148 - $5,353 4820%
Medcorp Southwest $5,516 - $5,735 5164%
Preferred Health Arrangement $5,516 - $5,735 5164%
Rockport Healthcare Group $5,883 - $6,882 5508%
Bce Emergis Corporation $6,619 - $6,882 6197%
Beech Street $6,619 - $6,882 6197%
Medical Control Network Solutions $6,619 - $6,882 6197%
Multiplan $6,619 - $6,882 6197%
UnitedHealthcare $7,354 - $7,647 6885%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 West Ben White Blvd, Austin, TX 78704
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals