CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Claiborne Medical Center

Billing Code: 72131 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$131

about 1.2× the $107 Medicare rate · typically $101–$182

modeled estimate · not a bill or quote

What this hospital charges insurers

$109

Below the fair price — a good deal

about $22 under the fair price · 1.0× Medicare

Medicare pays $107 Fair price $131 This hospital $109

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

Highest price of the 9 TN hospitals we have prices for — worth calling around.

Cheapest $44 Priciest $109

Black dot = this hospital, among the 9 TN hospitals with a price for this procedure. Full list below.

A fair price for a CT scan, lower back (lumbar spine) is about $131 (about 1.2× the $107 Medicare rate). Claiborne Medical Center charges insurers about $109 — below the fair price — a good deal. Located in Tazewell, TN.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$53 - $941	50%
Blue Cross Blue Shieldmajor	$106 - $522	99%
Aetnamajor	$109 - $396	102%
Cignamajor	$109 - $276	102%
Humanamajor	$107	100%
Ambetter (Centene)	$617	578%
Devoted Health	$109	102%
WellCare	$109	102%
+ 1 smaller / regional plan	$103

Government programs also on file: Military & VA.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72131.

Insurance Before you use insurance

Call your insurance company to confirm Claiborne Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 72131.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Claiborne Medical Center

Compare: CT scan, lower back (lumbar spine) at other TN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.