CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Okeene Municipal Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $542
Cash Discount Price: $689
vs. Medicare Baseline: 5.07x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Okeene Municipal Hospital is $542. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $689. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.07x the Medicare baseline. Located in 207 East F Street, Okeene, OK.

Cash / Self-Pay

$689

Average discount available for prompt cash payment at this facility.

Insurance Median

$542

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: $689 (645%)

Insurance Median: $542 (507%)

Cash: $689 (645% of Medicare)

Ins. Median: $542 (507% 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 507% of the Medicare baseline (a markup of 407%). 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
Pref Community Choice Ppo-All Plans	$129	121%
Aetna	$300 - $861	281%
Blue Cross Blue Shield	$317 - $521	297%
Coventry Mcr Adv	$491	460%
Global Health Mcr Adv	$491	460%
Humana	$491 - $861	460%
Medicare (plans)	$491	460%
UnitedHealthcare	$491 - $612	460%
Cigna	$527	493%
Ihs-All Plans	$558	522%
Ok Complete Health Comm-All Other Plans	$599	561%
Healthchoice Ip Only-All Plans	$603	565%
Global Health-All Other Plans	$638	597%
Healthcare Highways-All Plans	$646	605%
Phcs Savility/Multiplan - All Plans	$646	605%
Medica Commercial-All Other Plans	$663	621%
Community Care Hmo-All Plans	$775	726%
Ok Complete Health Mcaid	$861	806%

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 $689.
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 Okeene Municipal Hospital 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.