CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Warner Hospital and Health Services

Billing Code: 72131 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$414

about 3.9× the $107 Medicare rate · typically $113–$1,061

modeled estimate · not a bill or quote

What this hospital charges insurers

$405

About the fair price

about $9 under the fair price · 3.8× Medicare

Medicare pays $107 Fair price $414 This hospital $405 Cash price $3,264 Hospital's list price $3,264

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

Highest price of the 9 IL hospitals we have prices for — worth calling around.

Cheapest $75 Priciest $405

Black dot = this hospital, among the 9 IL hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, lower back (lumbar spine) is about $414 (about 3.9× the $107 Medicare rate). Warner Hospital and Health Services charges insurers about $405, or about $3,264 in cash — about the fair price. Located in Clinton, IL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$1,338 - $2,774	1253%
Blue Cross Blue Shieldmajor	$405 - $3,199	379%
Aetnamajor	$405 - $2,774	379%
Cignamajor	$2,709	2536%
Humanamajor	$1,338 - $2,774	1253%
HealthLink	$2,546	2384%
Meridian	$405	379%
Molina	$405 - $1,338	379%
WellCare	$1,338	1253%
+ 5 smaller / regional plans	$405 - $2,872

Government programs also on file: Medicaid.

Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 3,264), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72131.

Insurance Before you use insurance

Call your insurance company to confirm Warner Hospital and Health Services is in-network.
Ask your insurer whether prior approval is required for CPT code 72131.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Warner Hospital and Health Services

Compare: CT scan, lower back (lumbar spine) at other IL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.