CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: St Francis Hospital - Interquest

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $310
Cash Discount Price: $2,302
vs. Medicare Baseline: 2.90x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at St Francis Hospital - Interquest is $310. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,302. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.90x the Medicare baseline. Located in 10860 New Allegiance Dr, Colorado Springs, CO.

Cash / Self-Pay

$2,302

Average discount available for prompt cash payment at this facility.

Insurance Median

$310

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: $2,302 (2155%)

Insurance Median: $310 (290%)

Cash: $2,302 (2155% of Medicare)

Ins. Median: $310 (290% 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 290% of the Medicare baseline (a markup of 190%). 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
Aetna	$85 - $439	80%
Blue Cross Blue Shield	$85 - $5,065	80%
Cigna	$85 - $310	80%
Devoted Health	$85	80%
Humana	$85	80%
Innovage	$85	80%
Kaiser	$85 - $2,619	80%
Medicare (plans)	$85	80%
Rocky Mountain Pace	$85	80%
UnitedHealthcare	$85 - $245	80%
United Colorado Doctor'S Plan	$245	229%
Direct To Employer	$322 - $1,554	301%
Centura Employee Plan	$337	316%
Multiplan	$592 - $4,892	554%

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 $2,302.
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 St Francis Hospital - Interquest 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.