CT scan, lower back (lumbar spine)
Facility: Northside Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $1,135
- Cash Discount Price: $3,319
- vs. Medicare Baseline: 10.63x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 1063% of the Medicare baseline (a markup of 963%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Champus Va | $82 | 77% |
| Blue Cross Blue Shield | $104 - $3,084 | 97% |
| Clear Springs Eon Health | $104 | 97% |
| Medicare (plans) | $104 - $127 | 97% |
| UnitedHealthcare | $104 - $1,307 | 97% |
| Va Ccn | $104 | 97% |
| Bccp | $106 | 99% |
| Cbww | $106 | 99% |
| Humana | $106 - $109 | 99% |
| Tricare | $106 | 99% |
| Aetna | $107 - $1,455 | 100% |
| Coventry | $107 - $3,009 | 100% |
| Caresource | $108 - $1,646 | 101% |
| Kaiser | $108 - $1,483 | 101% |
| Wellcare | $108 | 101% |
| Clover Health | $110 | 103% |
| Pruitt Health Premier | $110 | 103% |
| Us Dept Of Labor Wc | $133 | 125% |
| Streamline Imaging | $138 | 129% |
| One Call Diagnostics | $194 | 182% |
| Mti | $204 | 191% |
| Homelink | $216 | 202% |
| Genex/Priority Care Solutions | $223 | 209% |
| Spreemo | $223 | 209% |
| Fairly Group | $237 | 222% |
| Authentic 4D | $251 | 235% |
| Direct Pay Provider Network Llc | $251 | 235% |
| Corvel Workers Comp | $265 | 248% |
| Employers Choice Network | $265 | 248% |
| Fieldale Farms Wc | $279 | 261% |
| Georgia Workers Compensation | $279 | 261% |
| Truths Community | $379 | 355% |
| Med Care Solutions | $430 | 403% |
| Medlien Healthcare Services | $430 | 403% |
| Health One Alliance_Ppo | $450 | 421% |
| Oscar | $695 | 651% |
| Amerigroup | $715 - $804 | 669% |
| Ambetter / Centene | $719 - $906 | 673% |
| Cigna | $722 - $1,387 | 676% |
| Medicaid / KanCare | $804 - $925 | 753% |
| Good Samaritan Radiology | $884 | 828% |
| Northside Health Network | $1,448 | 1356% |
| Georgia Reproductive Specialists | $1,770 | 1657% |
| Quick Trip | $2,434 | 2279% |
| Novanet_Ppo | $3,098 | 2900% |
| Phcs | $3,319 | 3107% |
| Beech Steet | $3,761 | 3521% |
| Multiplan | $3,761 | 3521% |
| Multiplan Workers Comp | $3,761 | 3521% |
| Careiq | $4,425 | 4143% |
| Dekalb_Department Of Health | $4,425 | 4143% |
| Fifa | $4,425 | 4143% |
| Institutional Marietta Surgery Center | $4,425 | 4143% |
| Institutional Veterans Evaluation Services | $4,425 | 4143% |
| Rabun County Boc | $4,425 | 4143% |