CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Shirley Ryan Abilitylab

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $2,705
  • Cash Discount Price: $2,497
  • vs. Medicare Baseline: 25.33x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Shirley Ryan Abilitylab is $2,705. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,497. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 25.33x the Medicare baseline. Located in 355 E Erie St, Chicago, IL.
Cash / Self-Pay
$2,497

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,705

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: $2,497 (2338%)
Insurance Median: $2,705 (2533%)
Cash: $2,497 (2338% of Medicare)
Ins. Median: $2,705 (2533% 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 2533% of the Medicare baseline (a markup of 2433%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $110 - $787 103%
Health Care Services Corporation $110 - $1,997 103%
Humana $110 103%
Tricare $110 103%
UnitedHealthcare $110 - $2,397 103%
Wellcare Meridian Fide $110 103%
Advocate Health Partners $112 105%
Blue Cross Blue Shield $224 - $475 210%
County Care $224 210%
Meridian Health Plan $224 210%
Cigna $1,477 1383%
Hfn $1,621 - $3,964 1518%
Corvel Corporation $1,672 1565%
Coventry Workers Comp $1,672 1565%
Multiplan $1,672 1565%
Paradigm Health Corporation $1,707 1598%
Personalcare Insurance Of Il/Firsthealth Grp Corp/Coventryhealth And Life Insurance Co $1,707 - $3,744 1598%
State Of Illinois $1,707 - $2,343 1598%
Uic Physician Group-Campuscare $2,080 - $2,289 1947%
Uic Physician Group $2,289 - $3,568 2143%
Union Health Service $2,330 2181%
Affordable Health Care Concepts $2,501 - $2,647 2342%
Loyola University Physician Foundation $2,705 2533%
University Of Chicago Practice Plan $2,705 - $2,863 2533%
Health Care Services Corporation Dba Managed Care Network Preferred $2,834 - $3,703 2653%
Advocate And Advocate Health Partners $2,913 2727%
Gallagher Benefit Administrators $3,121 - $3,304 2922%
Health Care Services Corporation D/B/A Hmo Illinois $3,246 3039%
Unicare Life And Health Insurance $3,246 - $3,436 3039%
Private Healthcare Systems $3,329 - $3,524 3117%
Resurrection Health Care Preferred $3,329 - $3,524 3117%
Cofinity Aka Ppom $3,537 - $3,744 3311%
Health Payors Organization $3,537 - $3,744 3311%
Healthnetwork $3,662 - $3,953 3429%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 355 E Erie St, Chicago, IL 60611
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL