CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: T J Samson Community Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $119
Cash Discount Price: $578
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at T J Samson Community Hospital is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $578. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.11x the Medicare baseline. Located in 1301 North Race Street, Glasgow, KY.

Cash / Self-Pay

$578

Average discount available for prompt cash payment at this facility.

Insurance Median

$119

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: $578 (541%)

Insurance Median: $119 (111%)

Cash: $578 (541% of Medicare)

Ins. Median: $119 (111% 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.

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
Blue Cross Blue Shield	$45 - $1,409	42%
Center Care Select - All Plans	$45 - $1,409	42%
Signature Health - All Plans	$45 - $107	42%
Wellcare Mcr Adv - All Other Plans	$45 - $106	42%
Molina Mcr Adv	$46 - $108	43%
Devoted Mcr Adv - All Plans	$47 - $112	44%
Humana	$47 - $209	44%
Caresource - All Plans	$58 - $159	54%
Molina Marketplace - All Other Plans	$58 - $159	54%
Wellcare Mcaid	$104 - $119	97%
Aetna	$119 - $209	111%
Molina Mcaid	$123 - $216	115%
UnitedHealthcare	$1,288	1206%
Phcs/Multiplan - All Plans	$1,559	1460%
First Health - All Plans	$1,575	1475%

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 $578.
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 T J Samson Community 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.