CMS Price Transparency Data
CT scan, lower back (lumbar spine)
Facility: Avoyelles Hospital
Billing Code: 72131 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72131
- Insurance Median: $2,840
- Cash Discount Price: $947
- vs. Medicare Baseline: 26.59x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Avoyelles Hospital is $2,840. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $947. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 26.59x the Medicare baseline. Located in 4231 Highway 1192, Marksville, LA.
Cash / Self-Pay
$947
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,840
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: $947 (887%)
Insurance Median: $2,840 (2659%)
Cash: $947 (887% of Medicare)
Ins. Median: $2,840 (2659% 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 2659% of the Medicare baseline (a markup of 2559%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 | $176 | 165% |
| Ofc Of Grp Bene | $176 | 165% |
| Aetna | $336 - $1,774 | 315% |
| Amer Contl Ins | $336 - $1,774 | 315% |
| Coventry | $336 - $1,774 | 315% |
| First Choice Health | $336 - $1,774 | 315% |
| Meritan Health | $336 - $3,156 | 315% |
| Cigna | $656 - $1,780 | 614% |
| Correct Cr Int Hlt | $656 | 614% |
| Mcd Amerihealth Caritas | $656 | 614% |
| Mcd Healthy Blue | $656 | 614% |
| Mcd La Hc Conn | $656 | 614% |
| Medicaid / KanCare | $656 | 614% |
| UnitedHealthcare | $656 | 614% |
| Mcd Ms | $722 | 676% |
| Student Assurances | $947 - $3,156 | 887% |
| Humana | $1,136 - $1,789 | 1064% |
| Ppo Plus Llc | $1,894 | 1773% |
| Zelis Healthcare Bpa | $1,894 | 1773% |
| Gilsbar | $1,988 | 1861% |
| Amerind | $2,840 | 2659% |
| Applied Underwriters | $2,840 | 2659% |
| Sedgwick | $2,840 | 2659% |
| Us Dept Of Labor | $2,840 | 2659% |
| Wc Clms Admin Svcs | $2,840 | 2659% |
| Wc Clms Mgmnt Walmart | $2,840 | 2659% |
| Wc Esis | $2,840 | 2659% |
| Wc Fara | $2,840 | 2659% |
| Wc Gallagher Bassett | $2,840 | 2659% |
| Wc Guide One | $2,840 | 2659% |
| Wc Hartford Med | $2,840 | 2659% |
| Wc Luba | $2,840 | 2659% |
| Wc Lwcc | $2,840 | 2659% |
| Wc Paragon Casino Resort | $2,840 | 2659% |
| Wc Risk Mgmnt | $2,840 | 2659% |
| Wc Stone Trust | $2,840 | 2659% |
| Wc Summit Consulting Hold | $2,840 | 2659% |
| Wc Travelers Ins | $2,840 | 2659% |
| Wc Trs Workers Comp Claim | $2,840 | 2659% |
| Wc Us Dol | $2,840 | 2659% |
| Wc Zurich | $2,840 | 2659% |
| Aarp | $3,156 | 2955% |
| Admin Concepts | $3,156 | 2955% |
| All Saints Hospice | $3,156 | 2955% |
| All State | $3,156 | 2955% |
| Allegiance Health Hospice | $3,156 | 2955% |
| Allied Natl | $3,156 | 2955% |
| Amfirst | $3,156 | 2955% |
| Avoy Parish School Board | $3,156 | 2955% |
| Avoyelles Parish Sheriff | $3,156 | 2955% |
| Bollinger | $3,156 | 2955% |
| Ccmsi | $3,156 | 2955% |
| Central States | $3,156 | 2955% |
| Christus Health Plan | $3,156 | 2955% |
| Compassionate Care Hospic | $3,156 | 2955% |
| Core Source | $3,156 | 2955% |
| Coushatta Hlth Dept | $3,156 | 2955% |
| Ebms | $3,156 | 2955% |
| Federated Ins | $3,156 | 2955% |
| Feedom Life | $3,156 | 2955% |
| Fidelity Standard Life Co | $3,156 | 2955% |
| Fox Everette | $3,156 | 2955% |
| Guarantee Trust | $3,156 | 2955% |
| Heart Of Hospice | $3,156 | 2955% |
| Hos Christus Hospice | $3,156 | 2955% |
| Hos Guardian Hospice Care | $3,156 | 2955% |
| Hos Harbor Hospice Alex | $3,156 | 2955% |
| Hos La Hospice Palliative | $3,156 | 2955% |
| Hos Passages Hospice N. | $3,156 | 2955% |
| Hos St Joseph Hospice | $3,156 | 2955% |
| Hospice Miscellaneous | $3,156 | 2955% |
| Ins Mgmnt Admin | $3,156 | 2955% |
| Ins Tpa | $3,156 | 2955% |
| Liberty Health Share | $3,156 | 2955% |
| Lumico | $3,156 | 2955% |
| Manhattan Life Ins | $3,156 | 2955% |
| Medi Share | $3,156 | 2955% |
| Misc Comm | $3,156 | 2955% |
| Nalc | $3,156 | 2955% |
| New Era Life | $3,156 | 2955% |
| North American | $3,156 | 2955% |
| Phcs | $3,156 | 2955% |
| Physicians Mutual | $3,156 | 2955% |
| Pipeline Ind Bene | $3,156 | 2955% |
| Progressive Auto | $3,156 | 2955% |
| Reliance Standard Life | $3,156 | 2955% |
| Rural Carriers | $3,156 | 2955% |
| Shelter Ins Co | $3,156 | 2955% |
| Sierre Health And Life | $3,156 | 2955% |
| State Farm | $3,156 | 2955% |
| State Mutual | $3,156 | 2955% |
| Sterling Investors | $3,156 | 2955% |
| The Health Plan | $3,156 | 2955% |
| Tribal Hlth Partners | $3,156 | 2955% |
| Tricare | $3,156 | 2955% |
| Trustmark Health Benefits | $3,156 | 2955% |
| Tunica Biloxi | $3,156 | 2955% |
| Uct | $3,156 | 2955% |
| Unified Life | $3,156 | 2955% |
| Usaa Life Ins | $3,156 | 2955% |
| Web-Tpa | $3,156 | 2955% |
| Woodmen Of The World | $3,156 | 2955% |