CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Geisinger-Community Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $1,098
Cash Discount Price: $3,140
vs. Medicare Baseline: 10.28x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Geisinger-Community Medical Center is $1,098. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,140. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.28x the Medicare baseline. Located in 1822 Mulberry Street, Scranton, PA.

Cash / Self-Pay

$3,140

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,098

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: $3,140 (2940%)

Insurance Median: $1,098 (1028%)

Cash: $3,140 (2940% of Medicare)

Ins. Median: $1,098 (1028% 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 1028% of the Medicare baseline (a markup of 928%). 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
Geisinger Health Plan	$105 - $302	98%
Medicare (plans)	$105	98%
Prison Health Services	$105	98%
Humana	$107	100%
Aetna	$110 - $2,988	103%
Medicaid / KanCare	$139	130%
Geisinger Family Plan	$143	134%
Amerihealth	$159	149%
Upmc For You	$163	153%
Health Partners	$166	155%
Upmc Chip	$173	162%
Ambetter / Centene	$347	325%
Blue Cross Blue Shield	$394 - $1,098	369%
UnitedHealthcare	$1,173	1098%
Cigna	$2,233	2091%
Christian Healthcare Ministries	$2,532	2371%
Healthnet	$2,968	2779%
Universal Managed Care	$3,140 - $3,292	2940%
Intergroup Services	$4,051 - $4,558	3793%
Multiplan	$4,304	4030%

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 $3,140.
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 Geisinger-Community 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.