CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Forks Community Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $942
Cash Discount Price: $2,104
vs. Medicare Baseline: 8.82x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Forks Community Hospital is $942. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,104. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.82x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$2,104

Average discount available for prompt cash payment at this facility.

Insurance Median

$942

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: $2,104 (1970%)

Insurance Median: $942 (882%)

Cash: $2,104 (1970% of Medicare)

Ins. Median: $942 (882% 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 882% of the Medicare baseline (a markup of 782%). 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
Medicare (plans)	$318	298%
Medicaid / KanCare	$326 - $1,583	305%
Coordinated Care (Mco) Mcd-All Plans	$352 - $1,613	330%
UnitedHealthcare	$419 - $3,670	392%
Community Health Network Mcr-All Other Plans	$424 - $1,943	397%
Humana	$424 - $1,943	397%
Tricare	$424 - $1,943	397%
Triwest-All Plans	$424 - $1,943	397%
Ambetter / Centene	$492 - $2,254	461%
Wellcare Med Adv - All Plans	$492 - $2,254	461%
Regence-All Other Plans	$542 - $2,486	507%
Community Health Exchange	$612 - $2,807	573%
Molina Commercial-All Other Plans	$867 - $3,973	812%
Aetna	$895 - $4,102	838%
Blue Cross Blue Shield	$895 - $4,102	838%
Cigna	$942 - $4,318	882%
First Choice-All Plans	$942 - $4,318	882%

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 $2,104.
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 Forks Community Hospital 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.