CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Novant Health Thomasville Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $513
Cash Discount Price: $1,661
vs. Medicare Baseline: 4.80x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Novant Health Thomasville Medical Center is $513. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,661. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.80x the Medicare baseline. Located in 207 Old Lexington Rd Box 789, Thomasville, NC.

Cash / Self-Pay

$1,661

Average discount available for prompt cash payment at this facility.

Insurance Median

$513

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: $1,661 (1555%)

Insurance Median: $513 (480%)

Cash: $1,661 (1555% of Medicare)

Ins. Median: $513 (480% 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 480% of the Medicare baseline (a markup of 380%). 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	$101 - $1,902	95%
Humana	$101 - $2,156	95%
Pace Of The Southern Piedmont	$101	95%
UnitedHealthcare	$101 - $1,863	95%
Aetna	$104 - $2,214	97%
Cigna	$104 - $1,686	97%
Liberty Health	$106	99%
Nc Department Of Public Safety	$203 - $503	190%
Carolina Complete	$503	471%
Amerihealth	$513	480%
Wellcare	$513	480%
Caresource North Carolina	$1,107	1036%
Atlantic Corporation Dba Atlantic Packaging	$1,564	1464%
Plotkin Health	$1,661	1555%
Amps	$1,799	1684%
Medcost	$2,353 - $2,602	2203%
Primary Physician Care	$2,436	2281%
Multiplan	$2,491	2332%
Phcs	$2,491	2332%
Employers Choice Network	$2,685	2514%
Three Rivers Provider Network	$2,685	2514%

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 $1,661.
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 Novant Health Thomasville 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.