CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Stephens County Hospital

Billing Code: 72131 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$103

about 1.0× the $107 Medicare rate · typically $103–$390

modeled estimate · not a bill or quote

What this hospital charges insurers

$103

About the fair price

1.0× Medicare

Medicare pays $107 Fair price $103 This hospital $103 Cash price $448 Hospital's list price $746

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

Highest price of the 9 GA hospitals we have prices for — worth calling around.

Cheapest $70 Priciest $103

Black dot = this hospital, among the 9 GA 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 $103 (about 1.0× the $107 Medicare rate). Stephens County Hospital charges insurers about $103, or about $448 in cash — about the fair price. Located in Toccoa, GA.

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✓ Cigna HumanaKaiser 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	$656 - $1,254	614%
Blue Cross Blue Shieldmajor	$597 - $1,141	559%
Aetnamajor	$634 - $1,211	594%
Cignamajor	$671 - $1,283	628%
Amerigroup	$240 - $458	225%
CareSource	$103	96%

Government programs also on file: Medicare, Medicaid.

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 448), 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 Stephens County 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 Stephens County Hospital

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

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