CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Artesia General Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $1,296
Cash Discount Price: $1,944
vs. Medicare Baseline: 12.13x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Artesia General Hospital is $1,296. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,944. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.13x the Medicare baseline. Located in 702 N 13Th Street, Artesia, NM.

Cash / Self-Pay

$1,944

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,296

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: $1,944 (1820%)

Insurance Median: $1,296 (1213%)

Cash: $1,944 (1820% of Medicare)

Ins. Median: $1,296 (1213% 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 1213% of the Medicare baseline (a markup of 1113%). 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
Zelis	$88 - $1,296	82%
Triwest	$101	95%
Blue Cross Blue Shield	$103 - $1,944	96%
Geha	$103 - $2,592	96%
Humana	$103 - $113	96%
Molina Healthcare Of New Mexico	$103 - $237	96%
Presbyterian Health Plan	$103 - $273	96%
UnitedHealthcare	$103 - $2,754	96%
Vistacare Hospice	$103	96%
New Mexico Health Connections	$175	164%
Providence Risk & Insurance Services	$206 - $3,078	193%
First Health	$291 - $2,916	272%
Omni Networks	$2,268	2123%
Three Rivers Provider Network	$2,430	2275%
Cigna	$2,754 - $2,916	2578%
Galaxy Health	$2,916	2730%
One Health Plan	$2,916	2730%
Multiplan	$2,948	2760%
United Payors & United Providers	$3,013	2821%

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 $1,944.
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 Artesia General 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.