CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Stanly Regional Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $911
  • Cash Discount Price: $1,504
  • vs. Medicare Baseline: 8.53x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Stanly Regional Medical Center is $911. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,504. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.53x the Medicare baseline. Located in 301 Yadkin St, Albemarle, NC.
Cash / Self-Pay
$1,504

Average discount available for prompt cash payment at this facility.

Insurance Median
$911

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: $1,504 (1408%)
Insurance Median: $911 (853%)
Cash: $1,504 (1408% of Medicare)
Ins. Median: $911 (853% 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 853% of the Medicare baseline (a markup of 753%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Cigna $44 - $2,406 41%
Humana $45 - $122 42%
Aetna $46 - $2,707 43%
UnitedHealthcare $46 - $2,036 43%
Trillium $48 - $375 45%
Alliance $49 - $372 46%
Amerihealth Caritas $49 - $368 46%
Carolina Complete Health $49 - $364 46%
Healthy Blue $49 - $364 46%
Partners $49 - $361 46%
Vaya $49 - $368 46%
Wellcare $49 - $364 46%
Blue Cross Blue Shield $468 - $808 438%
Ambetter / Centene $920 - $1,119 861%
Employers Health Network $1,330 - $1,739 1245%
Physician Reach Out $1,504 1408%
Magellan $1,805 1690%
Medcost $1,916 - $2,888 1794%
Gmmi $1,955 1830%
Quik Trip $1,955 1830%
Carolina Behavioral Health $2,166 - $2,406 2028%
First Health $2,707 2534%
Healthgram $2,707 2534%
Choicecare $2,828 2648%
Lifesynch Community Choice Care $2,828 2648%
Multiplan $2,828 2648%
Private Health Care Systems $2,828 2648%
Beechstreet $2,888 2704%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 301 Yadkin St, Albemarle, NC 28001
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals