CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Atrium Health Navicent Peach

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $323
  • Cash Discount Price: $769
  • vs. Medicare Baseline: 3.02x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Atrium Health Navicent Peach is $323. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $769. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.02x the Medicare baseline. Located in 1960 Highway 247 Connector, Byron, GA.
Cash / Self-Pay
$769

Average discount available for prompt cash payment at this facility.

Insurance Median
$323

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: $769 (720%)
Insurance Median: $323 (302%)
Cash: $769 (720% of Medicare)
Ins. Median: $323 (302% 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 302% of the Medicare baseline (a markup of 202%). 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.

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
Aetna $51 - $907 48%
Blue Cross Blue Shield $51 - $323 48%
Georgia Health Advantage $51 - $323 48%
Humana $51 - $1,306 48%
UnitedHealthcare $51 - $968 48%
Care Source $52 - $329 49%
Clover $52 - $329 49%
Eon Health $52 - $329 49%
Alliant $53 - $753 50%
Pruitt Health $53 - $323 50%
Ambetter / Centene $57 - $784 53%
Securehealth $137 - $999 128%
Cigna $175 - $1,119 164%
Multiplan $999 - $1,230 935%
Novanet $1,230 1152%
Three Rivers Provider Network $1,306 1223%
Beechstreet $1,429 1338%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1960 Highway 247 Connector, Byron, GA 31008
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals