CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Banner Lassen Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $2,308
Cash Discount Price: $1,397
vs. Medicare Baseline: 21.61x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Banner Lassen Medical Center is $2,308. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,397. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 21.61x the Medicare baseline. Located in 1800 Spring Ridge Drive, Susanville, CA.

Cash / Self-Pay

$1,397

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,308

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: $1,397 (1308%)

Insurance Median: $2,308 (2161%)

Cash: $1,397 (1308% of Medicare)

Ins. Median: $2,308 (2161% 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 2161% of the Medicare baseline (a markup of 2061%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$21	20%
Partnership Healthplan Of Ca	$205	192%
Banner Health	$1,007	943%
UnitedHealthcare	$1,007 - $2,283	943%
Network Providers, Llc	$1,309	1226%
Imperial Health Plan Of California, Inc	$1,359	1272%
Blue Shield Of California	$2,136	2000%
Multiplan	$2,210	2069%
Cigna	$2,332	2183%
Coventry	$2,357	2207%
First Health	$2,357	2207%
Health Net	$2,381	2229%

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 $1,397.
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 Banner Lassen Medical Center 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.