CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Shepherd Center, Inc.

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $211
  • Cash Discount Price: $1,891
  • vs. Medicare Baseline: 1.98x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Shepherd Center, Inc. is $211. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,891. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.98x the Medicare baseline. Located in 2020 Peachtree Rd Nw, Atlanta, GA.
Cash / Self-Pay
$1,891

Average discount available for prompt cash payment at this facility.

Insurance Median
$211

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: $1,891 (1770%)
Insurance Median: $211 (198%)
Cash: $1,891 (1770% of Medicare)
Ins. Median: $211 (198% 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.

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
Blue Cross Blue Shield $37 - $265 35%
Medicare (plans) $47 - $104 44%
Humana $51 - $102 48%
Kaiser $55 - $101 51%
Coventry $71 - $2,458 66%
Aetna $72 - $3,214 67%
UnitedHealthcare $112 - $310 105%
Cigna $230 215%
Paradigm Wc $1,853 1735%
Secure Health $2,269 2124%
Coventry Wc $2,458 2301%
Alamed Wc $2,647 2478%
Fcci Wc $2,647 2478%
Multiplan $2,836 2655%
Evolution Wc $3,025 2832%
Prime Health Wc $3,025 - $3,403 2832%
Corvel Wc $3,214 3009%
Novanet Wc $3,214 3009%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2020 Peachtree Rd Nw, Atlanta, GA 30309
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL