CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Uh Cleveland Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $1,222
  • Cash Discount Price: $1,637
  • vs. Medicare Baseline: 11.44x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Uh Cleveland Medical Center is $1,222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,637. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.44x the Medicare baseline. Located in 11100 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$1,637

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,222

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: $1,637 (1533%)
Insurance Median: $1,222 (1144%)
Cash: $1,637 (1533% of Medicare)
Ins. Median: $1,222 (1144% 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 1144% of the Medicare baseline (a markup of 1044%). 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
Aetna $99 - $1,717 93%
Blue Cross Blue Shield $99 - $1,753 93%
Cigna $99 - $1,767 93%
Devoted Health $99 93%
Humana $99 93%
Medical Mutual Of Ohio $99 - $1,461 93%
Molina $99 93%
Primetime Health Plan $99 93%
Summacare $99 - $1,990 93%
The Health Plan $99 - $1,418 93%
UnitedHealthcare $99 - $2,142 93%
Wellcare By Allwell $99 93%
Paramount $102 95%
Perennial Advantage Of Ohio $104 97%
Valor Health Plans $104 97%
Ambetter / Centene $177 166%
Caresource $177 166%
University Health Employee Plan (Contigo) $520 487%
Amish Aid Community Plan $600 - $1,091 562%
Amish Church Fund And Workers Aid Plan $600 - $1,091 562%
Buckeye Plain Ministries $600 - $1,091 562%
Christian Healthcare Ministries $900 - $1,091 843%
Aultcare $975 913%
Immergrun $1,091 1021%
Sunrise Plain Communities $1,091 1021%
Clarity $1,222 1144%
Enterprise Group Planning $1,222 1144%
Health Ohio Network $1,266 1185%
Healthsmart $1,418 1328%
Ohio Health Choice $1,418 - $1,964 1328%
Medical Mutual Traditional/Health Ohio $1,527 1430%
Jp Farley $1,594 1492%
Beech Street $1,746 - $1,964 1635%
Ohio Preferred Network $1,746 - $1,964 1635%
First Health $1,811 1696%
Century Health Network $1,855 1737%
Private Healthcare System $1,877 1757%
Configurenet $1,964 1839%
Fortified Provider Network $1,964 1839%
Multiplan $1,964 1839%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11100 Euclid Avenue, Cleveland, OH 44106
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals