CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Cascade Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $864
Cash Discount Price: $1,242
vs. Medicare Baseline: 8.09x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Cascade Medical Center is $864. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,242. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.09x the Medicare baseline. Located in 817 Commercial Street, Leavenworth, WA.

Cash / Self-Pay

$1,242

Average discount available for prompt cash payment at this facility.

Insurance Median

$864

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: $1,242 (1163%)

Insurance Median: $864 (809%)

Cash: $1,242 (1163% of Medicare)

Ins. Median: $864 (809% 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 809% of the Medicare baseline (a markup of 709%). 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
Aetna	$53 - $1,398	50%
Asuris Northwest Health	$53 - $1,398	50%
Blue Cross Blue Shield	$53 - $1,180	50%
Humana	$53 - $898	50%
Medicare (plans)	$53 - $898	50%
Molina Healthcare Of Washington Mcr Adv	$53 - $907	50%
Wellcare Health Plan Inc Mcr Adv	$57 - $970	53%
Tricare	$137	128%
Medicaid / KanCare	$232 - $830	217%
Community Health Plan Of Wa Mcd Rep	$241 - $864	226%
Coordinated Care Of Wa Mcd Rep	$241 - $864	226%
Molina Healthcare Of Washington Mcd Rep	$241 - $864	226%
First Choice Health Network	$246	230%
Pacificsource Health Plans	$246	230%
Washington Department Of Labor And Industry	$253	237%
Ambetter / Centene	$272 - $974	255%
Community Health Plan Of Wa	$282 - $1,009	264%
Cigna	$363 - $1,298	340%

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 $1,242.
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 Cascade Medical Center 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.