CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: St. Vincent's East

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $167
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.56x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at St. Vincent's East is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.56x the Medicare baseline. Located in 50 Medical Park East Drive, Birmingham, AL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$167

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%)

Insurance Median: $167 (156%)

Ins. Median: $167 (156% 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.

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	$92	86%
Cooper Green	$96	90%
UnitedHealthcare	$96 - $218	90%
Viva	$96 - $1,736	90%
Humana	$97 - $248	91%
Aetna	$98 - $750	92%
Cigna	$98 - $206	92%
Prime Health Services	$100 - $2,435	94%
Ambetter / Centene	$117 - $131	110%
Seven Corners	$129	121%
Construction Claims Management	$2,091	1958%
Corvel	$2,091	1958%
Alamed	$2,214	2073%
Multiplan	$2,315	2167%
Pnoa	$2,315	2167%

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 $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72131.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St. Vincent's East is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72131.
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.