CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Medstar Montgomery Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $122
  • Cash Discount Price: $120
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Medstar Montgomery Medical Center is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.14x the Medicare baseline. Located in 18101 Prince Philip Drive, Olney, MD.
Cash / Self-Pay
$120

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $120 (112%)
Insurance Median: $122 (114%)
Cash: $120 (112% of Medicare)
Ins. Median: $122 (114% 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
Aetna $122 114%
Amerigroup $122 114%
Amerihealth Caritas District Of Columbia $122 114%
Carefirst Advantage Inc $122 114%
Carefirst Blue Choice Inc $122 114%
Cigna $122 114%
First Health $122 114%
Hscsn $122 114%
Humana $122 114%
Kaiser Permanente $122 114%
Magellan Behavioral Health Inc $122 114%
Mamsi $122 114%
Medstar Family Choice $122 114%
Medstar Family Choice Inc $122 114%
Ncppo Healthlink Ppo $122 114%
Pfc $122 114%
Private Healthcare Systems (Phcs) $122 114%
Tricare $122 114%
United Behavioral Health Inc $122 114%
UnitedHealthcare $122 114%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 18101 Prince Philip Drive, Olney, MD 20832
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals