CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Hillcrest Hospital Cushing

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $991
Cash Discount Price: $994
vs. Medicare Baseline: 9.28x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Hillcrest Hospital Cushing is $991. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $994. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.28x the Medicare baseline. Located in 1027 East Cherry Street, Cushing, OK.

Cash / Self-Pay

$994

Average discount available for prompt cash payment at this facility.

Insurance Median

$991

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: $994 (931%)

Insurance Median: $991 (928%)

Cash: $994 (931% of Medicare)

Ins. Median: $991 (928% 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 928% of the Medicare baseline (a markup of 828%). 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
Black Lung [6055]	$828	775%
Healthcare Highways [2210]	$828 - $991	775%
Hooray Health [8000]	$828	775%
Lucent Health [6000]	$828	775%
Oncology Patient Assistance Programs [2295]	$828	775%
Oscar Insurance Company [7005]	$828	775%
Healthscope Benefits [2290]	$901	844%
UnitedHealthcare	$901 - $1,640	844%
Web Tpa [2115]	$991	928%
Cigna	$1,621	1518%
Healthpartners [1500]	$1,621	1518%
National Association Of Letter Carriers [1695]	$1,621	1518%
Pba [1775]	$1,621	1518%
Global Health [1430]	$2,055	1924%
First Health [1375]	$2,297	2151%
Multiplan [1680]	$2,297	2151%
Healthcare Solutions [1485]	$2,353	2203%
Healthsmart [1505]	$2,817	2637%
Pending Ssi [1616]	$3,314	3103%

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 $994.
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 Hillcrest Hospital Cushing 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.