CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Garrett Regional Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $187
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.75x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Garrett Regional Medical Center is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.75x the Medicare baseline. Located in 251 North Fourth Street, Oakland, MD.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$187

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%)
Insurance Median: $187 (175%)
Ins. Median: $187 (175% 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.

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
Caresource Wv $178 167%
Aetna $183 - $198 171%
Carefirst D-Snp $183 171%
Carefirst Ppo $183 171%
Humana $183 171%
Medicare (plans) $183 171%
Provider Partners $183 171%
Senior Advantage $183 171%
United Mine Workers Of America $183 - $198 171%
UnitedHealthcare $183 - $198 171%
Amerigroup $187 175%
Carefirst Community Health Plan $187 175%
Coventry $187 175%
Highmark Health Options Wv $187 175%
Maryland Physicians Care $187 175%
The Health Plan Of Wv $187 175%
Wellpoint Wv $187 175%
Multiplan $188 176%
Upmc Commercial $196 184%
Alliance Coal $198 185%
American Correctional Healthcare $198 185%
Carefirst Commercial $198 185%
Cigna $198 185%
First Health $198 185%
John Hopkins Healthcare $198 185%
Peak Commercial $198 185%
Stratose/ 4 Most $198 185%
The Health Plan $198 185%
The Health Plan Commercial $198 185%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 251 North Fourth Street, Oakland, MD 21550
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals