CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Sheridan Memorial Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $1,244
Cash Discount Price: $709
vs. Medicare Baseline: 11.65x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Sheridan Memorial Hospital is $1,244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $709. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.65x the Medicare baseline. Located in 1401 W 5Th St, Sheridan, WY.

Cash / Self-Pay

$709

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,244

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: $709 (664%)

Insurance Median: $1,244 (1165%)

Cash: $709 (664% of Medicare)

Ins. Median: $1,244 (1165% 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 1165% of the Medicare baseline (a markup of 1065%). 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
Humana	$46 - $114	43%
Blue Cross Blue Shield	$80 - $1,220	75%
Pacificsource-All Plans	$267 - $1,294	250%
Wise Provider Network-All Plans	$267 - $1,367	250%
Medi-Share Profee Only - All Plans	$273	256%
Miscellaneous-All Plans	$273 - $1,323	256%
Cigna	$282 - $1,367	264%
First Choice Comm - All Plans	$288 - $1,396	270%
Phcs Multiplan-All Plans	$288 - $1,396	270%
Three Rivers-All Plans	$288 - $1,396	270%
Wy School Boards-All Plans	$1,227	1149%
UnitedHealthcare	$1,260	1180%
C1 Employee - All Plans	$1,323	1239%
Casper Opco Llc - All Plans	$1,323	1239%
First Health Comm - All Plans	$1,323	1239%
Ebms - All Plans	$1,396	1307%

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 $709.
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 Sheridan Memorial 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.