CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: The East Alabama Healthcare Authority

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $123
Cash Discount Price: $135
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at The East Alabama Healthcare Authority is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $135. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.15x the Medicare baseline. Located in 2000 Pepperell Parkway, Opelika, AL.

Cash / Self-Pay

$135

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $135 (126%)

Insurance Median: $123 (115%)

Cash: $135 (126% of Medicare)

Ins. Median: $123 (115% 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
Novanet	$37	35%
Aetna	$43 - $246	40%
Blue Cross Blue Shield	$43 - $188	40%
Cigna	$43 - $190	40%
Humana	$43 - $195	40%
Simpra	$43 - $96	40%
Viva	$43 - $239	40%
Beechstreet	$92 - $209	86%
Alabama Crime Victims	$123	115%
Mcm Maxcare	$197	184%
Mega Life	$197	184%
UnitedHealthcare	$197	184%
Coventry First Health	$209	196%
Geha	$209	196%
Multiplan	$209	196%
Workers Comp	$209	196%
Trpn	$221	207%

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 $135.
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 The East Alabama Healthcare Authority 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.