CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Erlanger Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $158
  • Cash Discount Price: $195
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Erlanger Medical Center is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $195. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.48x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.
Cash / Self-Pay
$195

Average discount available for prompt cash payment at this facility.

Insurance Median
$158

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: $195 (183%)
Insurance Median: $158 (148%)
Cash: $195 (183% of Medicare)
Ins. Median: $158 (148% 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 $38 - $260 36%
Amerigroup $44 - $410 41%
Cigna $49 - $792 46%
Caresource $52 - $368 49%
Peach State Hlth Plan $52 - $253 49%
Devoted Health $54 - $186 51%
Bluecare $57 - $475 53%
Humana $60 - $500 56%
Atrio Health $65 - $197 61%
Point Comfort Underwriters $65 - $322 61%
Alexian $71 - $179 66%
Aetna $72 - $862 67%
Pruitthealth Premier $76 - $183 71%
Occunet $93 - $313 87%
Clover $98 - $179 92%
Upmc $98 - $179 92%
American Health $100 - $184 94%
Wellpoint $100 94%
Nhc $102 - $188 95%
Blue Cross Blue Shield $121 - $1,407 113%
Ambetter / Centene $122 - $224 114%
Medicare (plans) $179 168%
Simpra Advantage $197 184%
Pnoa $244 - $370 228%
Caresource Ga $252 - $452 236%
Caresource Tn $252 - $452 236%
Olympus $269 - $1,319 252%
Alliant $286 - $1,319 268%
Caresource Nc $304 - $452 285%
First Health $1,407 - $1,495 1317%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 E 3Rd St, Chattanooga, TN 37403
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals