CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Atrium Health Navicent Rehabilitation Hopsital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $117
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Atrium Health Navicent Rehabilitation Hopsital is $117. 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 1.10x the Medicare baseline. Located in 3351 Northside Dr, Macon, GA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$117

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: $117 (110%)

Ins. Median: $117 (110% 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.

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
Aetna	$44 - $684	41%
Blue Cross Blue Shield	$44 - $117	41%
Georgia Health Advantage	$44 - $117	41%
Humana	$44 - $614	41%
UnitedHealthcare	$44 - $718	41%
Care Source	$45 - $119	42%
Clover	$45 - $119	42%
Eon Health	$45 - $119	42%
Pruitt Health	$46 - $123	43%
Alliant	$53 - $140	50%
Ambetter / Centene	$60 - $158	56%
Securehealth	$137 - $571	128%
Cigna	$175 - $524	164%
Ibg	$205 - $684	192%
Kaiser	$234 - $766	219%

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 Atrium Health Navicent Rehabilitation Hopsital 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.