CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Seiling Municipal Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $1,930
Cash Discount Price: $1,013
vs. Medicare Baseline: 18.07x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Seiling Municipal Hospital is $1,930. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,013. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 18.07x the Medicare baseline. Located in 809 Ne Highway 60, Seiling, OK.

Cash / Self-Pay

$1,013

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,930

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: $1,013 (948%)

Insurance Median: $1,930 (1807%)

Cash: $1,013 (948% of Medicare)

Ins. Median: $1,930 (1807% 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 1807% of the Medicare baseline (a markup of 1707%). 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
UnitedHealthcare	$46 - $1,013	43%
Healthchoice Ip/Op Only - All Plans	$252	236%
Aetna	$1,013 - $2,356	948%
Blue Cross Blue Shield	$1,013 - $2,003	948%
Wellcare Mcr Adv - All Plans	$1,013	948%
Humana	$1,023 - $2,356	958%
Coventry Comm - All Plans	$1,531	1433%
Cigna	$1,866	1747%
Multiplan Ip/Op Only - All Plans	$1,885	1765%
Ambetter / Centene	$1,976	1850%
Community Choice Ppo Ip/Op Only - All Plans	$2,003	1875%
Preferred Comm Ip/Op Only - All Plans	$2,003	1875%
Soonerselect Mcaid - All Plans	$2,356	2206%

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 $1,013.
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 Seiling 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.