CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Bienville Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $1,132
Cash Discount Price: $1,257
vs. Medicare Baseline: 10.60x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Bienville Medical Center is $1,132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,257. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.60x the Medicare baseline. Located in 1175 Pine Street, Arcadia, LA.

Cash / Self-Pay

$1,257

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,132

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: $1,257 (1177%)

Insurance Median: $1,132 (1060%)

Cash: $1,257 (1177% of Medicare)

Ins. Median: $1,132 (1060% 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 1060% of the Medicare baseline (a markup of 960%). 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
Aetna	$123 - $2,096	115%
Medicaid / KanCare	$123 - $1,230	115%
Mmd Amerihealth Caritas	$123 - $1,230	115%
Mmd Healthy Blue	$123 - $1,230	115%
Mmd La Hlth Conn	$123 - $1,230	115%
Mmd Misc	$123 - $1,230	115%
UnitedHealthcare	$123 - $1,230	115%
Cashiering	$838 - $1,257	785%
Cigna	$1,048	981%
Ambetter / Centene	$1,132	1060%
Humana	$1,132 - $1,353	1060%
Mcr American Hlth Adv	$1,132	1060%
Medicare (plans)	$1,132	1060%
Misc Mgd Care	$1,132 - $2,096	1060%
Mmc Blue Advantage	$1,132	1060%
Mmc Misc	$1,132	1060%
Peoples Health Mcr Adv	$1,132	1060%
Va Health	$1,132	1060%
Blue Cross Blue Shield	$1,261	1181%
Wc City Of Arcadia	$1,886	1766%
Wc House Of Raeford	$1,886	1766%
Wc Misc	$1,886	1766%
Wc Stonetrust	$1,886	1766%
Aarp	$2,096	1962%
Allegiance Health Managme	$2,096	1962%
Amfirst	$2,096	1962%
Apwu	$2,096	1962%
Liberty Mutual	$2,096	1962%
Misc Comm A-L	$2,096	1962%
Misc Comm M-Z	$2,096	1962%
Tricare	$2,096	1962%

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 $1,257.
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 Bienville 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.