CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Medstar Harbor Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $207
  • Cash Discount Price: $203
  • vs. Medicare Baseline: 1.94x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Medstar Harbor Hospital is $207. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $203. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.94x the Medicare baseline. Located in 3001 South Hanover Street, Baltimore, MD.
Cash / Self-Pay
$203

Average discount available for prompt cash payment at this facility.

Insurance Median
$207

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: $203 (190%)
Insurance Median: $207 (194%)
Cash: $203 (190% of Medicare)
Ins. Median: $207 (194% 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 $207 194%
Amerigroup $207 194%
Amerihealth Caritas District Of Columbia $207 194%
Carefirst Advantage Inc $207 194%
Carefirst Blue Choice Inc $207 194%
Cigna $207 194%
First Health $207 194%
Hscsn $207 194%
Humana $207 194%
Kaiser Permanente $207 194%
Magellan Behavioral Health Inc $207 194%
Mamsi $207 194%
Medstar Family Choice $207 194%
Medstar Family Choice Inc $207 194%
Ncppo Healthlink Ppo $207 194%
Pfc $207 194%
Private Healthcare Systems (Phcs) $207 194%
Tricare $207 194%
United Behavioral Health Inc $207 194%
UnitedHealthcare $207 194%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3001 South Hanover Street, Baltimore, MD 21225
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals