CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: HCA Healthone Mountain Ridge

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $4,968
Cash Discount Price: $12,999
vs. Medicare Baseline: 46.51x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at HCA Healthone Mountain Ridge is $4,968. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,999. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 46.51x the Medicare baseline. Located in 9191 Grant St, Thornton, CO.

Cash / Self-Pay

$12,999

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,968

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: $12,999 (12170%)

Insurance Median: $4,968 (4651%)

Cash: $12,999 (12170% of Medicare)

Ins. Median: $4,968 (4651% 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 4651% of the Medicare baseline (a markup of 4551%). 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 - $9,641	108%
Pinnacol Workers Comp	$169	158%
Multiplan	$176 - $11,726	165%
United	$185 - $5,863	173%
Rocky Mountain Health Plan	$245	229%
Life Source Services	$350	328%
Aetna	$1,164 - $1,763	1090%
Vail Health	$1,180 - $1,980	1105%
Kaiser	$1,467 - $2,462	1373%
Bright Health	$2,329 - $3,909	2181%
Colorado Program For Children With Special Needs	$2,639 - $4,430	2471%
Cigna	$4,968 - $8,338	4651%
Western Plains Community Health	$5,046 - $8,469	4724%
Northcare	$5,434 - $9,120	5088%
Physician Health Partners	$5,434 - $9,120	5088%
Medical Development International	$6,211 - $10,423	5815%
Prime Health	$6,987 - $11,726	6542%

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 $12,999.
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 Mountain Ridge 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.