CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Lewisgale Hospital Pulaski

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $3,741
Cash Discount Price: $7,125
vs. Medicare Baseline: 35.02x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Lewisgale Hospital Pulaski is $3,741. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,125. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 35.02x the Medicare baseline. Located in 2400 Lee Highway, Pulaski, VA.

Cash / Self-Pay

$7,125

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,741

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: $7,125 (6671%)

Insurance Median: $3,741 (3502%)

Cash: $7,125 (6671% of Medicare)

Ins. Median: $3,741 (3502% 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 3502% of the Medicare baseline (a markup of 3402%). 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
Blue Cross Blue Shield	$162 - $521	152%
United	$245 - $3,206	229%
Lifeworks	$1,354	1268%
Universal Healthcare Group	$1,568	1468%
Virginia Health Network	$2,494 - $5,059	2335%
Aetna	$2,807 - $3,206	2628%
Greenvbrier Sporting Club	$4,275	4002%
Corvel	$5,130	4803%
Richfield Nursing Center	$5,344	5003%
Richfield Retirement Community	$5,344	5003%
Multiplan	$5,486	5136%
Community Care Network	$5,700	5337%
Graham-White Manufacturing	$5,700	5337%
Occunet Workers Comp	$5,700	5337%
One Health Plan	$5,700	5337%
Patients Choice	$6,270	5870%
4Most	$6,412	6003%
American Postal Workers Union	$6,412	6003%
Phcs	$6,412	6003%
Star Transportation	$6,412	6003%

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 $7,125.
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 Lewisgale Hospital Pulaski 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.