CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Alta Vista Regional Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $2,540
Cash Discount Price: $2,032
vs. Medicare Baseline: 23.78x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Alta Vista Regional Hospital is $2,540. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,032. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 23.78x the Medicare baseline. Located in 104 Legion Drive, Las Vegas, NM.

Cash / Self-Pay

$2,032

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,540

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: $2,032 (1902%)

Insurance Median: $2,540 (2378%)

Cash: $2,032 (1902% of Medicare)

Ins. Median: $2,540 (2378% 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 2378% of the Medicare baseline (a markup of 2278%). 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
Commercial Hmo Ppo	$191 - $4,063	179%
Medicaid / KanCare	$205 - $4,063	192%
Php Centennial	$205	192%
Workers Comp	$266 - $4,063	249%
Medicare (plans)	$569 - $4,063	533%
UnitedHealthcare	$569 - $650	533%
Champus	$650 - $4,063	609%
Mcare Mcaid Hmo Dual	$650	609%
Self Pay	$2,032	1902%
Other Covernment	$2,540 - $4,063	2378%
Blue Cross Blue Shield	$3,048 - $4,063	2854%
Mva	$4,063	3804%
Other Government	$4,063	3804%

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 $2,032.
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 Alta Vista Regional 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.