CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Bellin Health Oconto Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $497
Cash Discount Price: $422
vs. Medicare Baseline: 4.65x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Bellin Health Oconto Hospital is $497. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $422. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.65x the Medicare baseline. Located in 820 Arbutus Ave, Oconto, WI.

Cash / Self-Pay

$422

Average discount available for prompt cash payment at this facility.

Insurance Median

$497

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: $422 (395%)

Insurance Median: $497 (465%)

Cash: $422 (395% of Medicare)

Ins. Median: $497 (465% 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 465% of the Medicare baseline (a markup of 365%). 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	$221 - $1,424	207%
Community Care	$221	207%
Humana	$221	207%
My Choice	$221	207%
Network Health	$221 - $552	207%
UnitedHealthcare	$266 - $454	249%
Aetna	$324	303%
Cigna	$459 - $467	430%
Common Ground	$472 - $486	442%
Chorus Community Health Plan	$487	456%
Aspirus Arise	$508	476%
Healthsmart	$519	486%
Ihs(Claimsbridge)	$519	486%
Medical College Of Wi	$519	486%
Hps/Paymedix	$532 - $578	498%
Wps Insurance	$545	510%
Allied National	$552	517%
First Health	$552	517%
Galaxy Health	$552	517%
Three Rivers Provider Network	$584	547%
Trilogy	$584	547%

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 $422.
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 Bellin Health Oconto 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.