CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Franciscan Health Olympia & Chicago Heights

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $1,827
Cash Discount Price: $818
vs. Medicare Baseline: 17.11x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Franciscan Health Olympia & Chicago Heights is $1,827. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $818. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 17.11x the Medicare baseline. Located in 20201 S Crawford Avenue, Olympia Fields, IL.

Cash / Self-Pay

$818

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,827

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: $818 (766%)

Insurance Median: $1,827 (1711%)

Cash: $818 (766% of Medicare)

Ins. Median: $1,827 (1711% 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 1711% of the Medicare baseline (a markup of 1611%). 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
Managed Health Services [1302]	$98	92%
Mdwise [1175]	$98	92%
Medicaid / KanCare	$98	92%
Medicare (plans)	$112 - $3,683	105%
Workers Comp [1172]	$224	210%
Blue Cross Blue Shield	$267 - $817	250%
Commercial [2001]	$481 - $2,210	450%
Managed Care [2000]	$481 - $2,210	450%
United Medical Resources [1158]	$1,827 - $2,008	1711%
United Medical Resources [1301]	$1,827 - $2,008	1711%
UnitedHealthcare	$1,827 - $2,008	1711%

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 $818.
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 Franciscan Health Olympia & Chicago Heights 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.