CMS Price Transparency Data
CT scan, lower back (lumbar spine)
Facility: Ohio Valley Surgical Hospital
Billing Code: 72131 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72131
- Insurance Median: $178
- Cash Discount Price: $770
- vs. Medicare Baseline: 1.67x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Ohio Valley Surgical Hospital is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $770. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.67x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$770
Average discount available for prompt cash payment at this facility.
Insurance Median
$178
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: $770 (721%)
Insurance Median: $178 (167%)
Cash: $770 (721% of Medicare)
Ins. Median: $178 (167% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aarp | $101 - $1,284 | 95% |
| Aarp Supplemental | $101 - $1,284 | 95% |
| Aetna | $101 - $41,161 | 95% |
| American Continental Insurance | $101 | 95% |
| American Continental Life | $101 | 95% |
| American Republic | $101 - $1,284 | 95% |
| American Retirement | $101 - $1,284 | 95% |
| Aultcare Primetime Health Plan | $101 - $1,284 | 95% |
| Bankers Fidelity | $101 - $1,284 | 95% |
| Bankers Life And Casualty | $101 - $1,284 | 95% |
| Blue Cross Blue Shield | $101 - $1,265 | 95% |
| Central States | $101 - $1,284 | 95% |
| Champus | $101 - $1,284 | 95% |
| Cigna | $101 - $36,579 | 95% |
| Communicare Advantage | $101 - $1,284 | 95% |
| Everest | $101 - $1,284 | 95% |
| Gateway Health Plan | $101 - $1,284 | 95% |
| Humana | $101 - $23,478 | 95% |
| Medicare (plans) | $101 - $1,284 | 95% |
| Medigold | $101 | 95% |
| Mmoh | $101 - $809 | 95% |
| Molina | $101 - $642 | 95% |
| Molina Dual Mcr | $101 | 95% |
| Molina Marketplace | $101 - $642 | 95% |
| Molina Dual Mcr | $101 | 95% |
| Molina Mcr | $101 - $642 | 95% |
| Molina Mcr Mcd | $101 | 95% |
| Molina Mcr+Mcd | $101 | 95% |
| Patient No Pay | $101 - $1,284 | 95% |
| Prosperity Supplement | $101 - $1,284 | 95% |
| UnitedHealthcare | $101 - $34,088 | 95% |
| Wellcare By Allwell | $101 - $1,284 | 95% |
| Wraparound Pl Supp | $101 - $1,284 | 95% |
| The Health Plan | $106 | 99% |
| Employer Direct | $117 - $29,995 | 110% |
| Devoted Health | $120 - $27,000 | 112% |
| Caresource | $152 | 142% |
| Caresourse | $152 | 142% |
| Medicaid / KanCare | $152 | 142% |
| Geha | $157 - $41,161 | 147% |
| Genworth | $157 - $41,161 | 147% |
| Mail Handlers | $157 - $41,161 | 147% |
| Meritain | $157 - $41,161 | 147% |
| Meritain Heatlh | $157 - $41,161 | 147% |
| Mhbp | $157 - $41,161 | 147% |
| Ngs Coresource | $157 - $41,161 | 147% |
| Nippon Life | $157 - $41,161 | 147% |
| Pacific Source | $157 - $41,161 | 147% |
| Personify Health | $157 - $41,161 | 147% |
| Healthgram | $164 - $36,579 | 154% |
| Nalc | $164 - $36,579 | 154% |
| Samba | $164 - $36,579 | 154% |
| Sbma | $164 - $36,579 | 154% |
| Unified Group | $164 - $36,579 | 154% |
| Golden Rule | $178 | 167% |
| Medica | $178 | 167% |
| Oxford | $178 | 167% |
| Shl | $178 | 167% |
| Surest | $178 | 167% |
| Ushealth | $178 | 167% |
| Self Pay Imaging | $230 - $642 | 215% |
| Mmo Cin. Hmo | $591 - $809 | 553% |
| Mmoh (Supermed) | $591 - $597 | 553% |
| Luminare Health | $1,156 | 1082% |
| Medben | $1,156 | 1082% |
| Ohio Health | $1,156 | 1082% |
| Preferred Health | $1,156 | 1082% |