CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Oroville Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $175
Cash Discount Price: $507
vs. Medicare Baseline: 1.64x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Oroville Hospital is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $507. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.64x the Medicare baseline. Located in 2767 Olive Highway, Oroville, CA.

Cash / Self-Pay

$507

Average discount available for prompt cash payment at this facility.

Insurance Median

$175

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: $507 (475%)

Insurance Median: $175 (164%)

Cash: $507 (475% of Medicare)

Ins. Median: $175 (164% 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	$50 - $2,027	47%
Butte County	$64 - $642	60%
Aetna	$105	98%
Community Care	$105	98%
Nivano Physicians Inc	$105	98%
UnitedHealthcare	$105 - $1,567	98%
River City Medical Group	$115	108%
Cigna	$147 - $1,474	138%
Coventry Health Care	$147 - $1,474	138%
Health Net	$147 - $1,474	138%
Multiplan	$147 - $1,474	138%
Interplan	$156 - $1,567	146%
Three Rivers Provider Network	$156 - $1,567	146%
Beech Street	$166 - $1,659	155%
Healthstar	$166 - $1,659	155%
Partnership Healthplan Of California	$173	162%
Health Payors Organization	$175 - $1,751	164%
Blue Shield Of California	$178 - $1,788	167%
Blue Shield Value Network	$364	341%

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 $507.
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 Oroville Hospital 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.