CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Oklahoma Heart Hospital, LLC

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $291
Cash Discount Price: $222
vs. Medicare Baseline: 2.72x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Oklahoma Heart Hospital, LLC is $291. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $222. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.72x the Medicare baseline. Located in 4050 West Memorial Road, Oklahoma City, OK.

Cash / Self-Pay

$222

Average discount available for prompt cash payment at this facility.

Insurance Median

$291

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: $222 (208%)

Insurance Median: $291 (272%)

Cash: $222 (208% of Medicare)

Ins. Median: $291 (272% 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 272% of the Medicare baseline (a markup of 172%). 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
Aetna	$94 - $120	88%
Humana	$94 - $437	88%
Blue Cross Blue Shield	$101 - $633	95%
Cigna	$101 - $338	95%
Medicare (plans)	$101 - $104	95%
UnitedHealthcare	$101 - $107	95%
Va Ccn	$101	95%
Veterans Eval Services	$101	95%
Geha	$107	100%
Coventry	$127	119%
Ambetter / Centene	$141	132%
Healthcare Highways	$158 - $380	148%
Community Care	$201 - $444	188%
The Kempton Group	$251	235%
Healthscope	$291	272%
Oscar Insurance Company	$291	272%
Webtpa Chickasaw Nation Hch	$298	279%
Webtpa Hobby Lobby Hch	$336	315%
Global Health	$399	374%
Sana Benefits	$412	386%
Ufcw	$412	386%
First Health Network	$437	409%
Manhattan Life	$437	409%
Phcs	$444	416%
Preferred Community Choice	$482	451%
Multiplan	$570	534%

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 $222.
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 Oklahoma Heart Hospital, LLC 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.