CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Sampson Regional Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $784
Cash Discount Price: $2,762
vs. Medicare Baseline: 7.34x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Sampson Regional Medical Center is $784. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,762. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.34x the Medicare baseline. Located in 607 Beaman St, Clinton, NC.

Cash / Self-Pay

$2,762

Average discount available for prompt cash payment at this facility.

Insurance Median

$784

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: $2,762 (2586%)

Insurance Median: $784 (734%)

Cash: $2,762 (2586% of Medicare)

Ins. Median: $784 (734% 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 734% of the Medicare baseline (a markup of 634%). 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
Blue Cross Blue Shield	$100 - $2,450	94%
Liberty Adv - All Plans	$102	95%
UnitedHealthcare	$102 - $1,418	95%
Aetna	$104 - $3,551	97%
Gateway Mcr Adv - All Plans	$104	97%
Medicare (plans)	$110	103%
Prime/Travelers/Three Rivers - All Plans	$110	103%
Healthy Blue Mcaid - All Plans	$784	734%
Wellcare Mcaid - All Plans	$784	734%
Medcost - All Plans	$3,046	2852%
Cigna	$3,551	3325%
Multiplan - All Plans	$3,630	3399%
Bc Nc Indemnity Ip/Op Only	$3,946	3694%

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 $2,762.
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 Sampson Regional Medical Center 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.