CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Uofl Health - Shelbyville Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $724
Cash Discount Price: $774
vs. Medicare Baseline: 6.78x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Uofl Health - Shelbyville Hospital is $724. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $774. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.78x the Medicare baseline. Located in 727 Hospital Drive, Shelbyville, KY.

Cash / Self-Pay

$774

Average discount available for prompt cash payment at this facility.

Insurance Median

$724

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: $774 (725%)

Insurance Median: $724 (678%)

Cash: $774 (725% of Medicare)

Ins. Median: $724 (678% 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 678% of the Medicare baseline (a markup of 578%). 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
Humana	$91 - $343	85%
Senior Care Communty Of Ky	$96	90%
Blue Cross Blue Shield	$100 - $876	94%
Cigna	$100	94%
Essence Health	$100	94%
Va Ccn	$100	94%
Devoted	$101	95%
Signature	$103 - $1,018	96%
Communicare	$105	98%
Passport	$105 - $1,018	98%
Velocity	$120 - $1,995	112%
Key Benefit Administrators	$130	122%
Wellcare	$135 - $326	126%
UnitedHealthcare	$326 - $971	305%
Aetna	$343	321%
Prime Group Health	$724 - $1,731	678%
Encore	$1,222	1144%
Multiplan	$1,344 - $1,832	1258%
Omca	$1,934	1811%
Corvel	$2,036	1906%
Cshn	$2,036	1906%
Health Smart	$2,036	1906%
National Comp Care	$2,036	1906%

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 $774.
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 Uofl Health - Shelbyville Hospital 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.