CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Southwest General Health Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $196
  • Cash Discount Price: $1,895
  • vs. Medicare Baseline: 1.84x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Southwest General Health Center is $196. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,895. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.84x the Medicare baseline. Located in 18697 Bagley Road, Middleburg Heights, OH.
Cash / Self-Pay
$1,895

Average discount available for prompt cash payment at this facility.

Insurance Median
$196

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: $1,895 (1774%)
Insurance Median: $196 (184%)
Cash: $1,895 (1774% of Medicare)
Ins. Median: $196 (184% 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
Medical Mutual $42 - $46 39%
Medical Mutual-Ohio $42 - $171 39%
Buckeye $127 - $196 119%
Caresource $127 - $196 119%
Humana $127 - $986 119%
Molina $127 - $196 119%
UnitedHealthcare $127 - $1,365 119%
Amerihealth Caritas $132 - $196 124%
Blue Cross Blue Shield $171 - $227 160%
Valor Health $171 160%
Healthsmart $809 757%
Health Design Plus $935 875%
Clarity Health $1,011 947%
Healthspan $1,011 947%
Healthsmart Preferred $1,137 1065%
Ohio Health Choice Plus $1,223 1145%
Summacare $1,365 1278%
Aetna $1,367 1280%
Cigna $1,382 1294%
Coventry $1,744 1633%
First Health $1,744 1633%
Ohio Health Choice $1,953 1828%
Private Healthare Systems $2,022 1893%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 18697 Bagley Road, Middleburg Heights, OH 44130
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals