CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Ann & Robert H Lurie Childrens Hospital of Chicago

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $2,750
  • Cash Discount Price: $2,407
  • vs. Medicare Baseline: 25.75x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Ann & Robert H Lurie Childrens Hospital of Chicago is $2,750. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,407. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 25.75x the Medicare baseline. Located in 225 E Chicago Ave, Box 140, Chicago, IL.
Cash / Self-Pay
$2,407

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,750

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: $2,407 (2254%)
Insurance Median: $2,750 (2575%)
Cash: $2,407 (2254% of Medicare)
Ins. Median: $2,750 (2575% 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 2575% of the Medicare baseline (a markup of 2475%). 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
Medicare (plans) $584 - $2,656 547%
Magellan $900 - $2,750 843%
UnitedHealthcare $1,126 - $1,210 1054%
Mercycare Health $1,272 1191%
Cigna $1,444 - $2,441 1352%
Blue Cross Blue Shield $1,489 - $2,750 1394%
Aetna $1,719 - $2,614 1609%
Beacon Health Options $1,719 1609%
La Rabida Childrens Hospital $1,719 1609%
Centegra $2,063 1931%
Independent Physicians At Mercy $2,063 1931%
Advanced Physicians Association Ipa $2,407 2254%
Health Plus $2,407 2254%
Imagine Health $2,407 2254%
Methodist First Choice $2,407 2254%
Northwest Community Healthcare $2,407 2254%
Presence Health Partners $2,407 2254%
St. Francis $2,407 2254%
Ui Health $2,407 2254%
West Suburban Health Providers $2,407 2254%
Shriners Hospital $2,578 2414%
Swedish Covenant Physician Partners $2,578 2414%
American Psych Systems $2,750 2575%
Health Alliance $2,750 2575%
Macneal Health $2,750 2575%
Healthlink Inc. $2,836 2655%
Cofinity $2,922 2736%
Hfn Inc $2,922 - $3,094 2736%
Humana $2,922 2736%
Principal Healthcare $2,922 2736%
St. Elizabeth $2,922 2736%
First Health $3,025 2832%
Healthstar $3,025 2832%
Preferred Health Network $3,025 2832%
Sagamore Health Network $3,025 2832%
Beech Street $3,094 2897%
Benchmark Health $3,094 2897%
Employer'S Coalition On Health $3,094 2897%
Private Health Care System $3,094 2897%
Security Health Plan $3,094 2897%
Swedish American $3,094 2897%
Wellmark/Healthnetwork $3,163 2961%
Health Smart $3,266 3058%
Integrated Health Plan $3,266 3058%
Multiplan $3,266 3058%
National Provider Network $3,266 3058%
Wea Insurance Group $3,266 3058%
Unicare $3,678 - $8,500 3443%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 225 E Chicago Ave, Box 140, Chicago, IL 60611
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens