CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Stillwater Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $2,052
Cash Discount Price: $3,282
vs. Medicare Baseline: 19.21x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Stillwater Medical Center is $2,052. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,282. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 19.21x the Medicare baseline. Located in 1323 West 6Th Street, Stillwater, OK.

Cash / Self-Pay

$3,282

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,052

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: $3,282 (3073%)

Insurance Median: $2,052 (1921%)

Cash: $3,282 (3073% of Medicare)

Ins. Median: $2,052 (1921% 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 1921% of the Medicare baseline (a markup of 1821%). 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
Tricare	$108	101%
Veterans Administration	$108	101%
Healthcare Highways	$190	178%
Healthchoice	$236	221%
Ebms (Employee Benefit Management Services Inc.)	$260	243%
Blue Cross Blue Shield	$291	272%
Coventry	$800	749%
Aetna	$2,052	1921%
Cigna	$2,093	1960%
Community Care	$2,667	2497%
UnitedHealthcare	$2,749	2574%
First Health	$3,488	3266%
Osma Health	$3,611	3381%
Multiplan	$3,693	3458%
Preferred Community Choice	$3,693	3458%

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 $3,282.
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 Stillwater Medical Center 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.