CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Memorial Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $354
  • Cash Discount Price: $855
  • vs. Medicare Baseline: 3.31x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Memorial Medical Center is $354. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $855. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.31x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$855

Average discount available for prompt cash payment at this facility.

Insurance Median
$354

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: $855 (800%)
Insurance Median: $354 (331%)
Cash: $855 (800% of Medicare)
Ins. Median: $354 (331% 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 331% of the Medicare baseline (a markup of 231%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Triwest Va Pccc-All Plans $45 - $620 42%
Amerigroup Mcr Adv-All Other Plans $46 - $632 43%
Care Improvement Plus - All Other Plans $46 - $632 43%
Care Improvement Plus Mcr $46 - $639 43%
Superior Allwell Mcr Adv-All Other Plans $46 - $632 43%
UnitedHealthcare $46 - $1,806 43%
Universal American Mcr-All Other Plans $46 - $632 43%
Universal American Snp $48 - $664 45%
Coventry First Hlth Hmo Ppo-All Other Plans $57 - $1,806 53%
Coventry First Hlth Mcr Adv $57 - $632 53%
Ambetter / Centene $59 - $759 55%
Galaxy Health Network-All Plans $66 - $1,919 62%
Capstar Health Network-All Plans $82 - $1,806 77%
Cigna $82 - $1,694 77%
Healthcare Highways-All Plans $119 - $1,806 111%
Prime Healthcare Services-All Plans $129 - $1,581 121%
Blue Cross Blue Shield $138 - $384 129%
Humana $147 - $1,806 138%
Corvel Work Comp-All Plans $156 - $1,919 146%
Independent Med Sys Ppo-All Plans $156 - $1,919 146%
Multiplan Mcr Adv $156 - $632 146%
Multiplan Phcs Ppo-All Other Plans $156 - $1,919 146%
Provider Select Ppo-All Plans $156 - $1,919 146%
Three Rivers Ppo-All Plans $156 - $1,919 146%
Usa Mso - All Plans $156 - $1,919 146%
Amerigroup Chip $184 - $1,084 172%
Amerigroup Star $184 - $1,084 172%
Amerigroup Star Kids $184 - $1,084 172%
Amerigroup Star Plus $184 - $1,084 172%
Comm Health Chip $184 - $1,084 172%
Comm Health Perinatal-All Other Plans $184 - $1,084 172%
Molina Chip/Star-All Plans $184 - $1,084 172%
Scott & White Chip/Star-All Plans $184 - $1,084 172%
Superior Chip/Star $184 - $1,084 172%
Texas Childrens Hp - All Plans $184 - $1,084 172%
Comm Health Mcaid Hmo $193 - $1,138 181%
Comm Health Star $193 - $1,138 181%
Aetna $1,806 1691%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals