CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: The Women's Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $98
  • Cash Discount Price: $1,394
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at The Women's Hospital is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,394. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.92x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.
Cash / Self-Pay
$1,394

Average discount available for prompt cash payment at this facility.

Insurance Median
$98

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: $1,394 (1305%)
Insurance Median: $98 (92%)
Cash: $1,394 (1305% of Medicare)
Ins. Median: $98 (92% 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.

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
Amish $39 - $272 37%
Aetna $44 - $1,573 41%
Blue Cross Blue Shield $44 - $359 41%
Caresource $44 - $98 41%
Caresource Hip $44 - $98 41%
Caresource In $44 - $98 41%
Chamber Care $44 - $1,653 41%
Humana $44 - $543 41%
Iu Health $44 - $1,181 41%
Mdwise Hip $44 - $98 41%
Meridian Health Il $44 - $98 41%
Mhs $44 - $98 41%
Mhs Behavioral $44 - $98 41%
Molina Il $44 - $98 41%
Molina Ky $44 - $98 41%
Molina Ky Dual $44 - $98 41%
Patoka Valley Health Care (80/20 Plan) $44 - $1,464 41%
Patoka Valley Health Care (90/10 Plan) $44 - $1,417 41%
UnitedHealthcare $44 - $1,890 41%
Wellcare Ky $44 - $543 41%
Ambetter / Centene $50 - $152 47%
Passport Molina Ky $50 - $543 47%
Immergrun $53 - $987 50%
Caresource Marketplace (Just4Me) $57 - $147 53%
One Care $57 - $1,653 53%
Hst $59 - $147 55%
Alliance Coal $60 - $1,637 56%
Allied National/Zelis - Freedom Plan $61 - $240 57%
Claimdoc $63 - $142 59%
Encorecombined $70 - $1,653 66%
Encoreprime $70 - $1,606 66%
Hope Trust $70 - $162 66%
Noncontracted $70 - $157 66%
Self Pay $100 - $1,394 94%
Cigna $154 - $1,341 144%
Claritev (Formerly Phcs/Mulitplan) $154 - $1,630 144%
First Health/Coventry $154 - $1,748 144%
Healthlink $154 - $2,008 144%
Sagamore $154 - $1,341 144%
Center Care $172 - $1,842 161%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4199 Gateway Blvd, Newburgh, IN 47630
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals