CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Sterling Regional Medcenter

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $2,306
Cash Discount Price: $844
vs. Medicare Baseline: 21.59x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Sterling Regional Medcenter is $2,306. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $844. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 21.59x the Medicare baseline. Located in 615 Fairhurst St, Sterling, CO.

Cash / Self-Pay

$844

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,306

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: $844 (790%)

Insurance Median: $2,306 (2159%)

Cash: $844 (790% of Medicare)

Ins. Median: $2,306 (2159% 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 2159% of the Medicare baseline (a markup of 2059%). 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
Clear Spring Health	$107	100%
UnitedHealthcare	$107 - $2,963	100%
Longevity	$110	103%
Humana	$113	106%
Devoted Health Services	$118	110%
Pinnacol Assurance Workers Comp	$168 - $1,520	157%
Aetna	$872 - $2,907	816%
Banner Health	$969	907%
Blue Cross Blue Shield	$969 - $2,375	907%
Healthspring Life & Health Insurance Company, Inc.	$969	907%
Medica	$969 - $2,604	907%
Medicare (plans)	$969	907%
Assist Health Group	$1,163	1089%
Denver Health Medical Plan	$1,893	1772%
Apostrophe, Inc.	$2,813	2634%
First Choice Health Network	$2,813	2634%
First Choice Of The Midwest	$2,970	2781%
Hue Health, Inc	$2,970	2781%
Rocky Mountain Health Plans	$2,970	2781%
Multiplan	$3,032	2839%

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 $844.
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 Sterling Regional Medcenter 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.