CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: University Health System, Inc

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $1,096
Cash Discount Price: $685
vs. Medicare Baseline: 10.26x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at University Health System, Inc is $1,096. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $685. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.26x the Medicare baseline. Located in 1924 Alcoa Highway, Knoxville, TN.

Cash / Self-Pay

$685

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,096

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: $685 (641%)

Insurance Median: $1,096 (1026%)

Cash: $685 (641% of Medicare)

Ins. Median: $1,096 (1026% 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 1026% of the Medicare baseline (a markup of 926%). 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
UnitedHealthcare	$31 - $1,917	29%
Cigna	$97 - $2,079	91%
Humana	$97	91%
Wellpoint	$99 - $103	93%
Blue Cross Blue Shield	$100 - $1,753	94%
Aetna	$101 - $1,917	95%
Devoted Health	$101	95%
Wellcare-Windsor Medadv	$102	95%
American Health	$103	96%
Medicare (plans)	$103 - $104	96%
Nhc	$103	96%
Fentress County Sheriffs Dept	$1,096	1026%
Multiplan	$1,643	1538%
Nx Health	$1,643	1538%
Phcs	$1,643	1538%
Naphcare	$1,780	1667%
Coventry	$1,917	1795%
Beechstreet	$2,054	1923%
Prime Health	$2,054 - $2,739	1923%
Seven Corners	$2,054	1923%
Usa	$2,191	2051%
Evolutions	$2,465	2308%
Galaxy	$2,465	2308%
Healthsmart	$2,465	2308%

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 $685.
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 University Health System, Inc 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.