CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Flagstaff Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $199
  • Cash Discount Price: $1,398
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Flagstaff Medical Center is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,398. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.86x the Medicare baseline. Located in 1200 North Beaver Street, Flagstaff, AZ.
Cash / Self-Pay
$1,398

Average discount available for prompt cash payment at this facility.

Insurance Median
$199

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: $1,398 (1309%)
Insurance Median: $199 (186%)
Cash: $1,398 (1309% of Medicare)
Ins. Median: $199 (186% 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.

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
Carefirst $106 99%
Mercy Care Rhba $106 99%
Ahcccs $109 102%
Ahcccs Other $109 102%
Fmc Jail $109 102%
Health Choice $109 - $229 102%
Health Choice Arizona $109 102%
Health Choice Integrated Care $109 102%
Health Net Of Arizona $109 102%
Mercy Care $109 102%
Nhi Out Of State Ahcccs $109 102%
UnitedHealthcare $109 - $2,586 102%
Health Net Federal $112 105%
University Of Arizona Health Plans $116 - $129 109%
Aetna $118 - $2,379 110%
Fmc 30/70 $118 110%
Humana $118 - $2,656 110%
Medicare (plans) $118 110%
Mercy Care Advantage $118 110%
Rehabilitation Hospital Of Northern Arizona $118 110%
Snf Fmc $118 110%
Wellcare $118 110%
Wellcare By Allwell $118 110%
Fmc Ihs $119 111%
Va Pccc Triwest $119 - $127 111%
Devoted $123 - $125 115%
Ambetter / Centene $135 126%
Pnoa $176 165%
Naphcare $222 - $239 208%
Nau Athletic Department $250 - $2,237 234%
Self Pay $1,398 - $2,796 1309%
Self-Pay 50% Discount $1,398 1309%
Blue Cross Blue Shield $1,640 - $2,049 1535%
Workers Comp $1,817 1701%
Copperpoint $2,049 1918%
Cigna $2,516 2356%
Fmc 90/10 $2,516 2356%
Rural Arizona Network Multiplan $2,516 2356%
United Behavioral Health $2,796 2618%
Auto Insurance $5,000 4681%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 North Beaver Street, Flagstaff, AZ 86001
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals