CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Intermountain Health St. Mary's Regional Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $1,321
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 12.37x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Intermountain Health St. Mary's Regional Hospital is $1,321. 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 12.37x the Medicare baseline. Located in 2635 N 7Th St, Grand Junction, CO.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,321

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: $1,321 (1237%)
Ins. Median: $1,321 (1237% 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 1237% of the Medicare baseline (a markup of 1137%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Select Health $107 100%
UnitedHealthcare $107 - $1,414 100%
Blue Cross Blue Shield $558 - $1,446 522%
Monument Health $803 752%
Cigna $989 - $1,147 926%
Allegiance $1,147 1074%
Aetna $1,209 - $1,417 1132%
Kaiser Perm Ppo/Pos $1,301 1218%
Geha $1,342 - $1,414 1256%
Meritain Health $1,342 1256%
Humana $1,411 1321%
Cofinity $1,417 1327%
First Health Network $1,417 1327%
Private Hlthcare Sys $1,491 1396%
Public Employees Health $1,555 1456%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2635 N 7Th St, Grand Junction, CO 81501
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals