CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Memorial Mission Hospital and Asheville Surgery Ce

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $1,817
Cash Discount Price: $3,977
vs. Medicare Baseline: 17.01x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Memorial Mission Hospital and Asheville Surgery Ce is $1,817. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,977. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 17.01x the Medicare baseline. Located in 509 Biltmore Ave, Asheville, NC.

Cash / Self-Pay

$3,977

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,817

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: $3,977 (3723%)

Insurance Median: $1,817 (1701%)

Cash: $3,977 (3723% of Medicare)

Ins. Median: $1,817 (1701% 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 1701% of the Medicare baseline (a markup of 1601%). 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
United	$245 - $2,441	229%
Blue Cross Blue Shield	$702 - $759	657%
Wellcare	$724 - $781	678%
Amerihealth	$730 - $789	683%
Partners Health Management	$738 - $797	691%
Vaya Health	$738 - $797	691%
Apex Health	$765 - $826	716%
Cigna	$1,419 - $2,057	1329%
Caresource	$1,683 - $1,817	1576%
Medcost	$2,154 - $3,510	2017%
Magellan	$2,294 - $2,478	2148%
Magellan Behavioral Health	$2,294 - $2,478	2148%
Aetna	$2,765 - $2,986	2589%
Multiplan	$3,059 - $3,304	2864%
Avalon Administrative Services	$3,250 - $3,510	3043%
Prime Health	$3,365 - $3,717	3150%

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 $3,977.
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 Memorial Mission Hospital and Asheville Surgery Ce 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.