CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Madison County Memorial Hospital

Billing Code: 72131 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$115

about 1.1× the $107 Medicare rate · typically $55–$912

modeled estimate · not a bill or quote

What this hospital charges insurers

$93

Below the fair price — a good deal

about $22 under the fair price · 0.9× Medicare

Medicare pays $107 Fair price $115 This hospital $93 Cash price $425 Hospital's list price $850

How we calculate the fair BaseRate →

How this hospital compares to other FL hospitals

On the higher side — 6 of 8 other FL hospitals charge less.

Cheapest $68 Priciest $106

Black dot = this hospital, among the 9 FL hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, lower back (lumbar spine) is about $115 (about 1.1× the $107 Medicare rate). Madison County Memorial Hospital charges insurers about $93, or about $425 in cash — below the fair price — a good deal. Located in Madison, FL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$47 - $399	44%
Blue Cross Blue Shieldmajor	$197	184%
Aetnamajor	$148 - $578	139%
Humanamajor	$93 - $322	87%
Molina	$93	87%
WellCare	$93	87%
+ 4 smaller / regional plans	$93

Government programs also on file: Medicaid.

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 425), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72131.

Insurance Before you use insurance

Call your insurance company to confirm Madison County Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 72131.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Madison County Memorial Hospital

Compare: CT scan, lower back (lumbar spine) at other FL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.