CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: HCA Healthone Rose

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $1,503
Cash Discount Price: $10,439
vs. Medicare Baseline: 14.07x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at HCA Healthone Rose is $1,503. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,439. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 14.07x the Medicare baseline. Located in 4567 E 9Th Ave, Denver, CO.

Cash / Self-Pay

$10,439

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,503

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: $10,439 (9773%)

Insurance Median: $1,503 (1407%)

Cash: $10,439 (9773% of Medicare)

Ins. Median: $1,503 (1407% 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 1407% of the Medicare baseline (a markup of 1307%). 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	$115 - $7,725	108%
Pinnacol Workers Comp	$169	158%
Multiplan	$176 - $9,395	165%
United	$185 - $4,698	173%
Rocky Mountain Health Plan	$245	229%
Aetna	$1,164 - $1,763	1090%
Vail Health	$1,587	1486%
Bright Health	$3,132	2932%
Colorado Program For Children With Special Needs	$4,698	4398%
Cigna	$6,681	6255%
Western Plains Community Health	$6,785	6352%
Northcare	$7,307	6841%
Physician Health Partners	$7,307	6841%
Medical Development International	$8,351	7819%
Rocky Mtn Planned Parenthood	$8,873	8307%
Prime Health	$9,395	8796%

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 $10,439.
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 HCA Healthone Rose 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.