CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Bay Area Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $257
Cash Discount Price: $967
vs. Medicare Baseline: 2.41x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Bay Area Hospital is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $967. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.41x the Medicare baseline. Located in 1775 Thompson Road, Coos Bay, OR.

Cash / Self-Pay

$967

Average discount available for prompt cash payment at this facility.

Insurance Median

$257

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: $967 (905%)

Insurance Median: $257 (241%)

Cash: $967 (905% of Medicare)

Ins. Median: $257 (241% 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 241% of the Medicare baseline (a markup of 141%). 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
Healthnet Mcr Adv	$50 - $134	47%
Moda Hlth Mcr Adv	$50 - $137	47%
Southwest Oregon Ipa - All Plans	$56 - $103	52%
Ods Ppo/Pos - All Plans	$71 - $484	66%
Blue Cross Blue Shield	$108 - $8,551	101%
Nasomah Hlth Grp - All Plans	$115 - $1,433	108%
Healthnet Mcaid	$124 - $191	116%
Moda Beacon - All Other Plans	$124 - $337	116%
Moda Connexus/Synergy	$137 - $2,125	128%
Healthnet Comm- All Other Plans	$181 - $2,269	169%
Prov Behav Hlth	$257	241%
Providence - All Other Plans	$257 - $2,221	241%
Providence Pebb	$257 - $480	241%
Pacificsource - All Plans	$349 - $2,030	327%
First Choice - All Plans	$2,173	2034%
Aetna	$2,197	2057%
Cigna	$2,197	2057%
UnitedHealthcare	$2,269	2124%

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 $967.
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 Bay Area 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.