CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Lancaster Rehabilitation Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $525
Cash Discount Price: $525
vs. Medicare Baseline: 4.92x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Lancaster Rehabilitation Hospital is $525. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $525. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.92x the Medicare baseline. Located in 675 Good Dr, Lancaster, PA.

Cash / Self-Pay

$525

Average discount available for prompt cash payment at this facility.

Insurance Median

$525

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: $525 (492%)

Insurance Median: $525 (492%)

Cash: $525 (492% of Medicare)

Ins. Median: $525 (492% 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 492% of the Medicare baseline (a markup of 392%). 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
Multiplan	$315	295%
Fed Med	$341	319%
Triwest	$525	492%
Medishare	$525	492%
Cigna	$525	492%
UPMC for You	$525	492%
UnitedHealthcare	$525	492%
UPMC for Life	$525	492%
Amerihealth Caritas	$525	492%
PA Medical Assistance	$525	492%
Aetna	$525	492%
Geisinger	$525	492%
Geha	$525	492%
Highmark Wholecare McD (Formerly Gateway)	$525	492%
Preferred Health Care (Eliance)	$525	492%
Blue Cross Blue Shield	$525	492%
Freedom Blue Cpd (Highmark Freedcom Blue)	$525	492%
Tricare	$525	492%
Humana	$525	492%
Geisinger Health Cpd	$525	492%
Highmark	$525	492%
All Well - PA Health & Wellness	$525	492%
Optimum Healthcare	$525	492%
Highmark (Freedom Blue)	$525	492%
UPMC Health Plan	$525	492%
Highmark Wholecare Mgg (Formerly Gateway)	$525	492%
Out of Area Blues	$525	492%
Geisinger Gold	$525	492%
Ambetter / Centene	$525	492%

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 $525.
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 Lancaster Rehabilitation 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.