CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: The University of Vermont Health Network - Champl

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $107
  • Cash Discount Price: $2,193
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at The University of Vermont Health Network - Champl is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,193. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.00x the Medicare baseline. Located in 75 Beekman Street, Plattsburgh, NY.
Cash / Self-Pay
$2,193

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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: $2,193 (2053%)
Insurance Median: $107 (100%)
Cash: $2,193 (2053% of Medicare)
Ins. Median: $107 (100% 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.

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
UnitedHealthcare $31 - $3,244 29%
Blue Cross Blue Shield $34 - $2,721 32%
Mvp $38 - $3,384 36%
Aetna $44 - $3,032 41%
Capital District Physicians' Health Plan $44 - $3,352 41%
Fidelis Care $44 - $130 41%
Humana $44 - $123 41%
Martins Point $44 - $139 41%
Veterans Affairs Community Care Network $44 - $130 41%
Highmark Blueshield $56 - $3,359 52%
Wellpath $62 - $195 58%
Harvard Pilgrim $107 - $3,402 100%
Magnacare $107 - $3,402 100%
St. Regis $107 - $130 100%
Coventry $121 - $3,827 113%
Multiplan $127 - $4,039 119%
Emblem Health $3,402 3185%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 75 Beekman Street, Plattsburgh, NY 12901
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals