CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Good Samaritan Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $219
Cash Discount Price: $206
vs. Medicare Baseline: 2.05x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Good Samaritan Medical Center is $219. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $206. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.05x the Medicare baseline. Located in 235 North Pearl Street, Brockton, MA.

Cash / Self-Pay

$206

Average discount available for prompt cash payment at this facility.

Insurance Median

$219

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: $206 (193%)

Insurance Median: $219 (205%)

Cash: $206 (193% of Medicare)

Ins. Median: $219 (205% 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 205% of the Medicare baseline (a markup of 105%). 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	$125 - $292	117%
Blue Cross Blue Shield	$125 - $280	117%
Humana	$125	117%
Medicare (plans)	$125 - $132	117%
Neighborhood Pace [1206]	$125	117%
Ubh Hphc [8016]	$125	117%
United Community Plan [1202]	$125	117%
UnitedHealthcare	$125	117%
Veterans Admin [9003]	$125	117%
Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010]	$125	117%
Cca [1215]	$132	124%
Zzzcca Onecare [1216]	$132	124%
Eternalhealth [1227]	$133	125%
Fallon [8008]	$163	153%
Senior Whole Health [1210]	$188	176%
Harvard Pilgrim Health Care [8001]	$219	205%
Mass General Brigham Health Plan Commercial [8009]	$265	248%
Mass General Brigham Health Plan Prime [7003]	$265	248%
Cigna	$275 - $373	257%
Unicare [8004]	$277	259%
Wellpoint [2034]	$277	259%
Meritain Health [1023]	$292	273%
Tufts [8002]	$318 - $373	298%
Hsn Bad Debt [4003]	$395	370%
Hsn Confidential [4007]	$395	370%
Hsn Dental [4006]	$395	370%
Hsn Partial [4002]	$395	370%
Hsn [4001]	$395	370%

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 $206.
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 Good Samaritan 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.