CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Fairview Park Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $273
Cash Discount Price: $5,760
vs. Medicare Baseline: 2.56x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Fairview Park Hospital is $273. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,760. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.56x the Medicare baseline. Located in 200 Industrial Boulevard, Dublin, GA.

Cash / Self-Pay

$5,760

Average discount available for prompt cash payment at this facility.

Insurance Median

$273

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: $5,760 (5393%)

Insurance Median: $273 (256%)

Cash: $5,760 (5393% of Medicare)

Ins. Median: $273 (256% 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 256% of the Medicare baseline (a markup of 156%). 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
Blue Cross Blue Shield	$63 - $220	59%
Ambetter / Centene	$125	117%
Health One Alliance	$148	139%
Aetna	$172 - $3,175	161%
United	$245 - $2,592	229%
Core Resources	$250	234%
Prime Health	$267	250%
Employer'S Health Network	$273	256%
Rockport United Network	$273	256%
Identity Mco	$279	261%
Synergy Health Network	$279	261%
Amerigroup	$772	723%
Nhc Advantage	$1,094	1024%
Pruitt Health	$1,094	1024%
Peach State	$1,152	1079%
Wellcare	$1,152	1079%
Memorial Health Plan	$1,267	1186%
Americas 1St Choice	$1,613	1510%
Leavitt Risk Partners	$1,728	1618%
Dodge County Hospital	$2,880	2696%
American Steel Products	$4,896	4584%
City Of Eastman	$4,896	4584%
Dodge Co Board Of Commissioners	$4,896	4584%
Graham Brothers Construction	$4,896	4584%
Multiplan	$5,184	4853%
Novanet	$5,184	4853%

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 $5,760.
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 Fairview Park 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.