CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Memorial Health Meadows Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $610
Cash Discount Price: $3,191
vs. Medicare Baseline: 5.71x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Memorial Health Meadows Hospital is $610. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,191. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.71x the Medicare baseline. Located in One Meadows Parkway, Vidalia, GA.

Cash / Self-Pay

$3,191

Average discount available for prompt cash payment at this facility.

Insurance Median

$610

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: $3,191 (2988%)

Insurance Median: $610 (571%)

Cash: $3,191 (2988% of Medicare)

Ins. Median: $610 (571% 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 571% of the Medicare baseline (a markup of 471%). 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
Ambetter / Centene	$125	117%
Health One Alliance	$148	139%
Aetna	$167	156%
Amerigroup	$181 - $610	169%
Blue Cross Blue Shield	$238 - $2,543	223%
United	$245 - $2,214	229%
Prime Health	$267	250%
Employer'S Health Network	$273	256%
Pruitt Health	$278 - $935	260%
Peach State	$292 - $984	273%
Memorial Health Plan	$322 - $1,082	301%
Multiplan	$1,316 - $4,427	1232%

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 $3,191.
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 Memorial Health Meadows 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.