CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Hillsboro Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $124
Cash Discount Price: $1,732
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Hillsboro Medical Center is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,732. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.16x the Medicare baseline. Located in 335 Se 8Th Avenue, Hillsboro, OR.

Cash / Self-Pay

$1,732

Average discount available for prompt cash payment at this facility.

Insurance Median

$124

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: $1,732 (1622%)

Insurance Median: $124 (116%)

Cash: $1,732 (1622% of Medicare)

Ins. Median: $124 (116% 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.

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
Care Oregon	$91 - $137	85%
Intercommunity Health Network	$91	85%
Medicare (plans)	$91 - $137	85%
Kaiser Foundation Hospitals	$93 - $340	87%
Pacific Source	$93 - $1,706	87%
Cigna	$95	89%
Community Health Plan Of Washington	$116 - $2,665	109%
Providence Health Plan	$116 - $318	109%
Samaritan Health Plan	$116	109%
Trillium	$116	109%
Humana	$120 - $123	112%
UnitedHealthcare	$123 - $391	115%
Aetna	$126 - $466	118%
Moda	$128 - $418	120%
Health Net Health Plan Of Oregon, Inc.	$134 - $1,759	125%
Tuality Health	$209	196%
Blue Cross Blue Shield	$346	324%
First Choice	$2,132	1996%
Coventry First Health	$2,265	2121%
Molina Exchange	$2,665	2495%

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 $1,732.
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 Hillsboro 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.