CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Metro Nashville General Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $44
  • Cash Discount Price: $1,353
  • vs. Medicare Baseline: 0.41x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Metro Nashville General Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,353. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.41x the Medicare baseline. Located in 1818 Albion Street, Nashville, TN.
Cash / Self-Pay
$1,353

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

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: $1,353 (1267%)
Insurance Median: $44 (41%)
Cash: $1,353 (1267% of Medicare)
Ins. Median: $44 (41% 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 $24 - $44 22%
Corizon $29 27%
Amerigroup $38 36%
Amerivantage $38 36%
Cigna $39 - $44 37%
Aetna $44 - $1,240 41%
Blue $44 41%
Humana $44 41%
Medicare (plans) $44 41%
Upmc $44 41%
Wellcare $44 41%
Farm Bureau $45 42%
Corecivic $48 45%
Ambetter / Centene $61 57%
Naphcare $66 62%
Provider Network Of America $75 70%
Blue Cross Blue Shield $130 - $171 122%
Bluecare $139 130%
Tenncare $139 130%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1818 Albion Street, Nashville, TN 37208
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals