CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Fisher-Titus Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $942
Cash Discount Price: $1,211
vs. Medicare Baseline: 8.82x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Fisher-Titus Hospital is $942. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,211. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.82x the Medicare baseline. Located in 272 Benedict Avenue, Norwalk, OH.

Cash / Self-Pay

$1,211

Average discount available for prompt cash payment at this facility.

Insurance Median

$942

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: $1,211 (1134%)

Insurance Median: $942 (882%)

Cash: $1,211 (1134% of Medicare)

Ins. Median: $942 (882% 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 882% of the Medicare baseline (a markup of 782%). 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
Perennial Advantage	$44 - $105	41%
UnitedHealthcare	$44 - $1,224	41%
Sidecar	$46 - $933	43%
Aetna	$100 - $1,170	94%
Blue Cross Blue Shield	$100 - $2,132	94%
Buckeye	$100 - $117	94%
Caresource	$100 - $113	94%
Medical Mutual Of Ohio	$100 - $781	94%
Paramount	$100 - $1,210	94%
Summacare	$100 - $1,184	94%
Wellcare	$100	94%
Zing Health	$100	94%
Valor Health	$103	96%
Amerihealth	$117	110%
Molina	$117	110%
Health Ohio Network	$942	882%
Tricare	$1,009 - $1,076	945%
Cigna	$1,076	1007%
Claimsdoc	$1,076	1007%
First Health	$1,210	1133%
Multiplan	$1,210	1133%
Ohio Health Choice	$1,210	1133%
Healthscope	$1,224	1146%
Emerald Health	$1,305	1222%

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 $1,211.
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 Fisher-Titus 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.