CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $1,183
  • Cash Discount Price: $767
  • vs. Medicare Baseline: 11.08x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Childrens Hospital of Wisconsin Fox Valley is $1,183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $767. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.08x the Medicare baseline. Located in 130 Second St, Neenah, WI.
Cash / Self-Pay
$767

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,183

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: $767 (718%)
Insurance Median: $1,183 (1108%)
Cash: $767 (718% of Medicare)
Ins. Median: $1,183 (1108% 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 1108% of the Medicare baseline (a markup of 1008%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Froedtert Health $976 - $1,186 914%
Medical College Of Wisconsin $976 914%
Network Health Plan $993 930%
UnitedHealthcare $1,025 - $1,061 960%
Aspirus Health Plan $1,046 979%
Common Ground Healthcare Cooperative $1,046 - $1,186 979%
Trilogy Health Solutions $1,046 - $1,186 979%
Wps Health Plan $1,060 - $1,255 992%
Advocate Aurora Healthcare $1,074 1006%
Blue Cross Blue Shield $1,088 - $1,325 1019%
Centivo $1,088 1019%
Health Partners $1,088 - $1,227 1019%
Employer Health Care Alliance Cooperative $1,095 1025%
Dean Health Plan $1,116 1045%
Group Health Cooperative Of Eau Claire $1,116 1045%
Oan Llc $1,116 1045%
Security Health Plan $1,158 1084%
Health Payment Systems $1,180 1105%
Praire States $1,186 1110%
Quartz Health Insurance $1,186 1110%
Sheboygan Employer'S Health Network $1,186 1110%
America'S Ppo $1,213 1136%
Aetna $1,227 - $1,241 1149%
Bellin Thedacare $1,255 1175%
Cigna $1,255 1175%
Group Health Cooperative Of South Central Wisconsin $1,255 1175%
Healthsmart $1,255 1175%
Prevea Health Network $1,255 1175%
Multiplan $1,269 - $1,325 1188%
Coventry Health Care $1,325 1241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 130 Second St, Neenah, WI 54956
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens