CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Geisinger-Lewistown Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $1,714
Cash Discount Price: $2,602
vs. Medicare Baseline: 16.05x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Geisinger-Lewistown Hospital is $1,714. 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 16.05x the Medicare baseline. Located in 400 Highland Avenue, Lewistown, PA.

Cash / Self-Pay

$2,602

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,714

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: $1,714 (1605%)

Cash: $2,602 (2436% of Medicare)

Ins. Median: $1,714 (1605% 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 1605% of the Medicare baseline (a markup of 1505%). 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
Blue Cross Blue Shield	$103 - $2,270	96%
Geisinger Health Plan	$103 - $483	96%
Medicare (plans)	$103	96%
Upmc Health Plan	$103 - $11,890	96%
Advantra	$104	97%
Humana	$104	97%
Medicaid / KanCare	$139	130%
Geisinger Family Plan	$148	139%
Amerihealth	$152	142%
Health Partners	$166	155%
Upmc Chip	$173	162%
Ambetter / Centene	$248	232%
Aetna	$1,714 - $2,039	1605%
Cigna	$1,815 - $2,207	1699%
UnitedHealthcare	$1,859	1740%
Christian Healthcare Ministries	$2,098	1964%
Christian Health Aid	$3,357	3143%
Three Rivers Provider Network Inc.	$3,357	3143%
Multiplan	$3,567	3340%
Healthsmart Payors Organization	$3,776	3535%

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-Lewistown 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.