CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Eastern Idaho Regional Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $1,272
Cash Discount Price: $2,456
vs. Medicare Baseline: 11.91x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Eastern Idaho Regional Medical Center is $1,272. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,456. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.91x the Medicare baseline. Located in 3100 Channing Way, Idaho Falls, ID.

Cash / Self-Pay

$2,456

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,272

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: $2,456 (2299%)

Insurance Median: $1,272 (1191%)

Cash: $2,456 (2299% of Medicare)

Ins. Median: $1,272 (1191% 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 1191% of the Medicare baseline (a markup of 1091%). 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
Blue Cross Blue Shield	$38 - $2,333	36%
Molina	$38 - $64	36%
Interwest Health	$151 - $2,210	141%
Regence	$225	211%
United	$245 - $1,419	229%
Select Health	$744	697%
Select Health Ichn Brightpath	$744 - $830	697%
Select Health Idaho (Eirmc Only)	$783	733%
Aetna	$968 - $1,196	906%
Doug Andrus Distributing	$982	919%
University Of Utah	$1,031	965%
Mountain Health Co-Op	$1,228 - $1,842	1150%
Pacificsource Health	$1,316	1232%
Cigna	$1,351	1265%
First Choice Health Of Washington	$1,474	1380%
Moda	$1,530	1432%
Dmba	$1,582	1481%
Prime Health	$1,842 - $2,087	1725%
Geha Ppo Usa	$1,965	1840%
Humana	$2,063	1931%
Multiplan	$2,063 - $2,210	1931%
First Choice Of The Midwest	$2,210	2069%
St. John'S Health Network	$2,210	2069%
Coventry First Health	$2,235	2093%
Shashone-Bannock Tribal Health	$2,456	2299%

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 $2,456.
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 Eastern Idaho Regional Medical Center 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.