CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Jefferson Abington Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $108
  • Cash Discount Price: $87
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Jefferson Abington Hospital is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.01x the Medicare baseline. Located in 1200 Old York Road, Abington, PA.
Cash / Self-Pay
$87

Average discount available for prompt cash payment at this facility.

Insurance Median
$108

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: $87 (81%)
Insurance Median: $108 (101%)
Cash: $87 (81% of Medicare)
Ins. Median: $108 (101% 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.

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
Jup Health Partners Chip $38 - $230 36%
Medicaid / KanCare $38 - $276 36%
Medicare (plans) $44 - $235 41%
Abington Pro Ibc $50 - $186 47%
Jup Pa Health_Wellness $66 - $180 62%
Aetna $75 - $402 70%
Jup Geisinger Commercial $79 - $418 74%
Jup Highmark $86 - $157 81%
Jefferson Health Plan Aca Qhp Exchange $88 82%
Innovage $92 86%
Inspira Life $92 86%
Point Of Comfort Refugee Resettlement $92 86%
Provider Partners Health Plan $92 86%
St Agnes $92 86%
Tricare $92 86%
UnitedHealthcare $92 - $100 86%
Humana $94 88%
Cigna $96 - $306 90%
Devoted Health Participation $97 91%
Keystone First Vip Choice $99 93%
Allwell Pa Health_Wellness Ma $102 95%
Jab Health Partners $106 99%
Perennial $107 100%
Highmark Wholecare Gateway $108 101%
Keystone First $108 - $170 101%
Ibc Employee Benefit $115 108%
Ibc Main Line Health $115 108%
Pa Health_Wellness Chc $115 108%
Ibc $129 121%
Ambetter / Centene $134 125%
Naphcare $148 139%
Upmc Commercial $306 286%
Blue Cross Blue Shield $371 347%
Geisinger Health Plan $376 - $379 352%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 Old York Road, Abington, PA 19001
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals