CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Monroe Surgical Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $166
Cash Discount Price: $1,718
vs. Medicare Baseline: 1.55x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Monroe Surgical Hospital is $166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,718. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.55x the Medicare baseline. Located in 2408 Broadmoor Blvd, Monroe, LA.

Cash / Self-Pay

$1,718

Average discount available for prompt cash payment at this facility.

Insurance Median

$166

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: $1,718 (1608%)

Insurance Median: $166 (155%)

Cash: $1,718 (1608% of Medicare)

Ins. Median: $166 (155% 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
Aetna	$95 - $1,603	89%
Blue_Cross_Blue_Shield	$95 - $159	89%
Ford_Bacon_And_Davis	$95	89%
Humana	$95 - $166	89%
Medicare (plans)	$95	89%
UnitedHealthcare	$95 - $1,550	89%
Vantage	$95 - $166	89%
Insurance_Systems_Smso_Employee	$118	110%
Insurance_Systems	$133	125%
Verity	$150	140%
Gilsbar	$204	191%
Healthy_Blue	$294	275%
Medicaid / KanCare	$294	275%
First_Health	$1,603	1501%
Cigna	$1,718	1608%
Ima	$1,832	1715%
Beech_St	$1,944	1820%
Workers_Comp	$2,061	1930%

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 $1,718.
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 Monroe Surgical 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.