CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Roane Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $102
  • Cash Discount Price: $562
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Roane Medical Center is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $562. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.95x the Medicare baseline. Located in 8045 Roane Medical Center Drive, Harriman, TN.
Cash / Self-Pay
$562

Average discount available for prompt cash payment at this facility.

Insurance Median
$102

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: $562 (526%)
Insurance Median: $102 (95%)
Cash: $562 (526% of Medicare)
Ins. Median: $102 (95% 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
UnitedHealthcare $53 - $230 50%
Farm Bureau $96 90%
Tricare $97 91%
Humana $100 94%
Aetna $102 - $396 95%
Blue Cross Blue Shield $102 - $522 95%
Cigna $102 - $276 95%
Devoted Health $102 95%
Wellcare $102 95%
Wellpoint $102 95%
Ambetter / Centene $617 578%
Ehn $816 764%
Correctional Medical Services $1,088 1019%
Community Services Network $1,179 1104%
Usa Managed Care Organization $1,270 1189%
Novanet $1,360 1273%
Direct Care America $1,451 1358%
Medsave Usa $1,451 1358%
National Provider Network $1,451 1358%
Beech Street $1,542 1444%
Ccn Managed Care $1,542 1444%
Initial Group $1,596 1494%
Galaxy Health Network $1,633 1529%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8045 Roane Medical Center Drive, Harriman, TN 37748
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals