CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Geisinger-Bloomsburg Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $257
Cash Discount Price: $2,602
vs. Medicare Baseline: 2.41x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Geisinger-Bloomsburg Hospital is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,602. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.41x the Medicare baseline. Located in 549 East Fair Street, Bloomsburg, PA.

Cash / Self-Pay

$2,602

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: $2,602 (2436%)

Insurance Median: $257 (241%)

Cash: $2,602 (2436% 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
Cigna	$83	78%
Advantra	$102	95%
Blue Cross Blue Shield	$102 - $2,340	95%
Geisinger Health Plan	$102 - $257	95%
Humana	$102 - $3,567	95%
Medicare (plans)	$102	95%
UnitedHealthcare	$102 - $133	95%
American Progressive	$104	97%
Care Improvement Plus	$104	97%
Medicaid / KanCare	$139	130%
Geisinger Family Plan	$143	134%
Medical Development International	$153	143%
Naphcare	$153	143%
Amerihealth	$159	149%
Upmc For You	$163	153%
Health Partners	$166	155%
Upmc Chip	$173	162%
Ambetter / Centene	$246	230%
Aetna	$1,590 - $2,690	1489%
Intergroup Services	$1,678 - $2,937	1571%
Christian Healthcare Ministries	$2,098	1964%
Multiplan	$3,567	3340%

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 $2,602.
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-Bloomsburg 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.