CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: M Health Fairview Ridges Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $187
Cash Discount Price: $499
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at M Health Fairview Ridges Hospital is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $499. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.75x the Medicare baseline. Located in 201 East Nicollet Boulevard, Burnsville, MN.

Cash / Self-Pay

$499

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%)

Cash / Self-Pay: $499 (467%)

Insurance Median: $187 (175%)

Cash: $499 (467% of Medicare)

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.

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
Health Partners	$32 - $319	30%
Itasca Medical Care	$32 - $127	30%
Primewest	$32 - $127	30%
South Country Health Alliance	$32 - $127	30%
Ucare	$33 - $352	31%
Medica	$35 - $841	33%
Hennepin Health	$36 - $108	34%
Blue Cross Blue Shield	$37 - $488	35%
Sanford Health Plan	$44 - $691	41%
Security Health Plan	$44 - $880	41%
UnitedHealthcare	$44 - $556	41%
Wellcare	$44 - $127	41%
America'S Ppo	$446 - $845	418%
First Health	$702 - $963	657%
Multiplan	$728 - $998	682%
Private Healthcare Systems	$728 - $998	682%
Wisconsin Physician Services	$770 - $1,057	721%

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 $499.
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 M Health Fairview Ridges Hospital 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.