CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: North Oaks Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $267
Cash Discount Price: $249
vs. Medicare Baseline: 2.50x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at North Oaks Medical Center is $267. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $249. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.50x the Medicare baseline. Located in 15790 Paul Vega Md Drive, Hammond, LA.

Cash / Self-Pay

$249

Average discount available for prompt cash payment at this facility.

Insurance Median

$267

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: $249 (233%)

Insurance Median: $267 (250%)

Cash: $249 (233% of Medicare)

Ins. Median: $267 (250% 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 250% of the Medicare baseline (a markup of 150%). 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
Tricare	$91 - $97	85%
Aetna	$97 - $3,219	91%
Allwell	$97	91%
Blue Advantage	$97	91%
Champva	$97	91%
Healthy Blue Dual Advantage	$97	91%
Humana	$97 - $2,840	91%
Peoples Health	$97	91%
UnitedHealthcare	$97 - $1,818	91%
Vantage 65	$97	91%
Veterans Administration	$97	91%
Wellcare	$97	91%
Blue Cross Blue Shield	$246 - $249	230%
Mco Lhc	$267	250%
Mco Hb	$272	255%
Mco Lacare Am	$272	255%
Medicaid / KanCare	$272	255%
Coventry	$2,462	2305%
Verity Healthnet	$2,462	2305%
Ppoplus Llc	$2,651	2482%
Multiplan	$2,840	2659%
Cigna	$2,992	2801%

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 $249.
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 North Oaks Medical Center 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.