CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: St Joseph's Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $2,209
  • Cash Discount Price: $2,484
  • vs. Medicare Baseline: 20.68x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at St Joseph's Hospital is $2,209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,484. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.68x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$2,484

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,209

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: $2,484 (2326%)
Insurance Median: $2,209 (2068%)
Cash: $2,484 (2326% of Medicare)
Ins. Median: $2,209 (2068% 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 2068% of the Medicare baseline (a markup of 1968%). 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
Molina Healthcare $215 - $690 201%
Meridian Health Plan $226 212%
UnitedHealthcare $690 - $3,450 646%
Blue Cross Blue Shield $690 646%
Aetna $690 - $2,412 646%
Clear Spring Health of Illinois $690 646%
Humana $690 646%
Sae Hospice $690 646%
Amish Community $966 904%
Cigna $1,190 1114%
Caterpillar, Inc. $1,315 1231%
Naphcare $1,449 1357%
Celtic Insurance Company $1,518 1421%
Hopetrust $1,725 1615%
Claim Doc $1,725 1615%
Wellfirst $2,209 2068%
First Health $2,550 2387%
Multiplan/Phcs $2,932 2745%
Healthlink $2,932 2745%
Provider Network of America $3,105 2907%
Healthcare Finest Network (Hfn) $3,105 2907%
Qtc Medical Group of Illinois $3,450 3230%
Interplan $3,450 3230%
Healthscope $3,450 3230%
Mental Health Network $3,450 3230%
Consociate Group $3,450 3230%
Current Health Solutions $3,450 3230%
Health Alliance Medical Plans $3,450 3230%
Illinois Breast and Cervical Cancer Program $3,450 3230%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals