CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Texas Orthopedic Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $989
  • Cash Discount Price: $8,692
  • vs. Medicare Baseline: 9.26x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Texas Orthopedic Hospital is $989. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,692. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.26x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
$8,692

Average discount available for prompt cash payment at this facility.

Insurance Median
$989

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: $8,692 (8138%)
Insurance Median: $989 (926%)
Cash: $8,692 (8138% of Medicare)
Ins. Median: $989 (926% 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 926% of the Medicare baseline (a markup of 826%). 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
Texas Health Network $103 96%
Amerigroup $105 98%
Texas Childrens Health Plans $105 - $1,443 98%
Community Health Choice Mcd $107 100%
United $109 - $3,911 102%
Aetna $115 - $1,322 108%
Molina Healthcare $115 108%
Humana $131 - $2,298 123%
Blue Cross Blue Shield $224 - $3,042 210%
Superior Health Plan $522 489%
Cigna $1,635 - $2,106 1531%
Texas Workforce Commission $2,086 1953%
Christus (Usfhp) $3,477 3255%
Healthsmart Preferred Care $3,738 - $7,388 3500%
Fidelis Securecare Of Tx $3,911 3662%
Coventry National First Health $4,633 4338%
Physicians Cooperative Of Texas $4,781 4476%
Rockport Workers Comp $4,781 4476%
Independent Medical System $5,215 4883%
National Healthcare Solutions $5,215 4883%
Southwest Medical $5,215 4883%
Coastal Comp $5,650 5290%
Multiplan $6,519 - $7,388 6103%
International Health Insurance $6,954 6511%
Physicians, Inc $7,388 6917%
Affiliated Ppo $7,823 7324%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals