CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Straub Clinic and Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $466
Cash Discount Price: $1,210
vs. Medicare Baseline: 4.36x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Straub Clinic and Hospital is $466. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,210. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.36x the Medicare baseline. Located in 888 S King Street, Honolulu, HI.

Cash / Self-Pay

$1,210

Average discount available for prompt cash payment at this facility.

Insurance Median

$466

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: $1,210 (1133%)

Insurance Median: $466 (436%)

Cash: $1,210 (1133% of Medicare)

Ins. Median: $466 (436% 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 436% of the Medicare baseline (a markup of 336%). 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
Ohana	$93 - $473	87%
Alohacare	$126 - $717	118%
Hmsa	$126 - $389	118%
Mdx	$126 - $1,270	118%
Devoted	$132	124%
UnitedHealthcare	$178 - $365	167%
Hwmg/Hmaa	$273 - $1,267	256%
Pac Admin	$371	347%
Verdegard	$410 - $1,270	384%
Calvos	$1,191 - $1,834	1115%
Mimoh	$1,191 - $1,834	1115%
Hcha	$1,270 - $1,957	1189%
Kaiser	$1,270 - $1,957	1189%
Multiplan	$1,270 - $2,079	1189%

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 $1,210.
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 Straub Clinic and Hospital 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.