CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Gunnison Valley Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $323
Cash Discount Price: $984
vs. Medicare Baseline: 3.02x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Gunnison Valley Hospital is $323. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $984. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.02x the Medicare baseline. Located in 711 N Taylor St, Gunnison, CO.

Cash / Self-Pay

$984

Average discount available for prompt cash payment at this facility.

Insurance Median

$323

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: $984 (921%)

Insurance Median: $323 (302%)

Cash: $984 (921% of Medicare)

Ins. Median: $323 (302% 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 302% of the Medicare baseline (a markup of 202%). 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
Cigna	$41 - $1,939	38%
Medicare (plans)	$46 - $970	43%
Aetna	$67 - $1,900	63%
Apostrophe-All Plans	$76 - $1,781	71%
Medicaid / KanCare	$143 - $145	134%
Gunnison County Sheriff Op & Profee Only	$173 - $1,016	162%
Ebms Hdhp	$202 - $1,187	189%
Tetwp Op & Profee Only-All Plans	$202 - $1,187	189%
U Of Co Transplant-All Plans	$202 - $1,187	189%
Ebms Ppo Plan-All Other Plans	$236 - $1,385	221%
Gunnison County Employees-All Other Plans	$269 - $1,583	252%
Scottish Rites-All Plans	$269 - $1,583	252%
Elap Employers-All Plans	$286 - $1,682	268%
Blue Cross Blue Shield	$295 - $1,735	276%
Multiplan-All Plans	$303 - $1,840	284%
Rocky Mountain Health-All Plans	$320 - $1,880	300%
UnitedHealthcare	$320 - $1,880	300%
Cofinity-All Plans	$323 - $1,900	302%
Gunnison County Coroner Op Only	$1,016	951%

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 $984.
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 Gunnison Valley Hospital 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.