CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $1,641
Cash Discount Price: $1,834
vs. Medicare Baseline: 15.36x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $1,641. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,834. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.36x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$1,834

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,641

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: $1,834 (1717%)

Insurance Median: $1,641 (1536%)

Cash: $1,834 (1717% of Medicare)

Ins. Median: $1,641 (1536% 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 1536% of the Medicare baseline (a markup of 1436%). 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
Wps Health Insurance	$406 - $1,300	380%
UnitedHealthcare	$588	551%
The Alliance	$981	918%
Security Health Plan (Shp)	$1,004 - $1,115	940%
Amish/Mennonite	$1,062	994%
Quartz	$1,101	1031%
Cigna	$1,313 - $1,429	1229%
Health Payment Systems	$1,344	1258%
Humana	$1,525 - $1,719	1428%
Group Health Cooperative Of Eau Claire	$1,583 - $1,834	1482%
Network Health Plan	$1,612	1509%
First Health	$1,641	1536%
Molina Healthcare Of Wi	$1,641	1536%
Trilogy	$1,738	1627%
Healtheos By Multiplan Inc.	$1,796 - $1,834	1681%
Health Partners	$1,834	1717%
Coventry	$1,854	1736%
Blue Cross Blue Shield	$3,449 - $5,836	3229%

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 $1,834.
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 Marshfield Medical Center - Beaver Dam (Mmc-Bd) 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.