CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: North Austin Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $434
  • Cash Discount Price: $921
  • vs. Medicare Baseline: 4.06x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at North Austin Medical Center is $434. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $921. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.06x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$921

Average discount available for prompt cash payment at this facility.

Insurance Median
$434

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: $921 (862%)
Insurance Median: $434 (406%)
Cash: $921 (862% of Medicare)
Ins. Median: $434 (406% 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 406% of the Medicare baseline (a markup of 306%). 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
Superior Health Plan $28 - $537 26%
St David’S Hospice $105 98%
United $109 - $1,422 102%
Blue Cross Blue Shield $110 - $932 103%
Molina Healthcare $115 108%
Humana $131 123%
Sendero $131 123%
Aetna $132 - $2,612 124%
Imo Med - Select Network $168 - $948 157%
Texas Healthcare Foundation Heb $207 - $1,169 194%
Amerigroup $218 204%
Texas Workforce Commission $218 - $1,232 204%
Averde Health $252 - $1,422 236%
UnitedHealthcare $252 - $1,422 236%
Comanche County $280 - $1,580 262%
National Choicecare $280 - $1,580 262%
Healthsmart Preferred Care $308 - $2,528 288%
Independent Medical Systems $308 - $1,738 288%
Physicians Cooperative Of Texas $308 - $1,738 288%
Prime Health $336 - $1,896 315%
First Health $350 - $2,244 328%
Coastal Comp Health Networks $364 - $2,054 341%
National Health Care $364 - $2,054 341%
Texas Municipal League $392 - $2,212 367%
Medcorp Southwest $420 - $2,370 393%
Rockport Healthcare Group $448 - $2,844 419%
Bce Emergis Corporation $504 - $2,844 472%
Beech Street $504 - $2,844 472%
Medical Control Network Solutions $504 - $2,844 472%
Multiplan $504 - $2,844 472%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals