CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Arh Our Lady of the Way

Billing Code: 72131 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$439

about 4.1× the $107 Medicare rate · typically $146–$541

modeled estimate · not a bill or quote

What this hospital charges insurers

$542

Above the fair price

about $103 over the fair price · 5.1× Medicare

Medicare pays $107 Fair price $439 This hospital $542 Cash price $2,089 Hospital's list price $3,481

How we calculate the fair BaseRate →

How this hospital compares to other KY hospitals

Highest price of the 9 KY hospitals we have prices for — worth calling around.

Cheapest $56 Priciest $542

Black dot = this hospital, among the 9 KY hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, lower back (lumbar spine) is about $439 (about 4.1× the $107 Medicare rate). Arh Our Lady of the Way charges insurers about $542, or about $2,089 in cash — above the fair price. Located in Martin, KY.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $439. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$696	652%
Blue Cross Blue Shieldmajor	$542 - $696	507%
Aetnamajor	$696 - $3,063	652%
Humanamajor	$696	652%
Molina	$710	665%
WellCare	$696 - $703	652%
+ 1 smaller / regional plan	$2,263

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 2,089), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72131.

Insurance Before you use insurance

Call your insurance company to confirm Arh Our Lady of the Way is in-network.
Ask your insurer whether prior approval is required for CPT code 72131.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Arh Our Lady of the Way

Compare: CT scan, lower back (lumbar spine) at other KY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.