CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Southeast Georgia Health System -- Camden Campus

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $1,975
Cash Discount Price: Unavailable
vs. Medicare Baseline: 18.49x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Southeast Georgia Health System -- Camden Campus is $1,975. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 18.49x the Medicare baseline. Located in 2000 Dan Proctor Drive, Saint Marys, GA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,975

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%)

Insurance Median: $1,975 (1849%)

Ins. Median: $1,975 (1849% 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 1849% of the Medicare baseline (a markup of 1749%). 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
Amerigroup_Community_Care	$52	49%
Caresource_Georgia_Families	$52	49%
Peachstate_Health_Plan	$52	49%
Blue Cross Blue Shield	$81 - $2,337	76%
Caresource	$81 - $121	76%
Humana	$81 - $2,929	76%
UnitedHealthcare	$81	76%
United_Healthcare_Veterans_Administration	$81	76%
Aetna	$82 - $2,797	77%
Clover_Health	$82	77%
Devoted_Health	$84	79%
Pruitthealth	$85	80%
Ambetter / Centene	$129	121%
Sea_Island	$2,337	2188%
Sghs_Meritain	$2,337	2188%
Coventryone_Hix	$2,501	2342%
United_Healthcare	$2,541	2379%
Medishare	$2,797	2619%
Choicecare	$2,929	2742%
Cigna	$2,929	2742%
Industry_Buying_Group_Ibg	$2,929	2742%
First_Health_Southcare	$2,962	2773%
One_Health_Great_West	$2,962	2773%
Pponext	$3,126	2927%

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 $X.
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 Southeast Georgia Health System -- Camden Campus 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.