CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: St Luke's Hospital - Easton Campus

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $200
Cash Discount Price: $3,527
vs. Medicare Baseline: 1.87x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at St Luke's Hospital - Easton Campus is $200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,527. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.87x the Medicare baseline. Located in 250 South 21St Street, Easton, PA.

Cash / Self-Pay

$3,527

Average discount available for prompt cash payment at this facility.

Insurance Median

$200

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: $3,527 (3302%)

Insurance Median: $200 (187%)

Cash: $3,527 (3302% of Medicare)

Ins. Median: $200 (187% 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
Blue Cross Blue Shield	$106 - $1,357	99%
Highmark	$106 - $482	99%
UnitedHealthcare	$106 - $1,228	99%
Aetna	$108 - $1,483	101%
Geisinger	$108 - $1,195	101%
Humana	$110	103%
Upmc Health Plan	$111 - $1,165	104%
Amerihealth Caritas	$159	149%
Highmark Wholecare	$159	149%
Jefferson Health Plan	$200	187%
Oscar	$1,103	1033%
Cigna	$1,163	1089%

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 $3,527.
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 St Luke's Hospital - Easton Campus 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.