CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Huron Regional Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $2,524
Cash Discount Price: $1,112
vs. Medicare Baseline: 23.63x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Huron Regional Medical Center is $2,524. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,112. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 23.63x the Medicare baseline. Located in 172 Fourth Street Se, Huron, SD.

Cash / Self-Pay

$1,112

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,524

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: $1,112 (1041%)

Insurance Median: $2,524 (2363%)

Cash: $1,112 (1041% of Medicare)

Ins. Median: $2,524 (2363% 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 2363% of the Medicare baseline (a markup of 2263%). 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
Sanford	$104 - $3,218	97%
UnitedHealthcare	$105 - $2,491	98%
Midlands	$116	109%
Avera	$223 - $2,557	209%
Medica	$224 - $3,124	210%
Healthpartners	$238 - $3,322	223%
Tlc Advantage	$241 - $3,356	226%
Wellmark	$450	421%
Multiplan	$3,114	2915%
Americas	$3,356	3142%
First Choice Of The Midwest	$3,356	3142%
First Health Coventry	$3,356	3142%
Integrated Health Plan	$3,356	3142%

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 $1,112.
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 Huron Regional Medical Center 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.