CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Haywood County Community Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $53
Cash Discount Price: $101
vs. Medicare Baseline: 0.50x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Haywood County Community Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.50x the Medicare baseline. Located in 2545 North Washington Avenue, Brownsville, TN.

Cash / Self-Pay

$101

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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: $101 (95%)

Insurance Median: $53 (50%)

Cash: $101 (95% of Medicare)

Ins. Median: $53 (50% 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.

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	$25 - $205	23%
Blue Cross Blue Shield	$35 - $318	33%
Healthspringlife&Healthinsco,Inc.(Il)	$37	35%
Humana	$37 - $97	35%
Bluecareplustennessee(D-Snp)	$41 - $195	38%
Wellpointtennessee,Inc.	$43	40%
Vshpbluecareriskeast/West	$45 - $248	42%
Personifyhealthnorth	$52	49%
Ambetter / Centene	$77 - $174	72%
Oscar	$91	85%
Aetna	$97	91%
Harmonyhealthplanofillinois,Inc.	$97	91%

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 $101.
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 Haywood County Community Hospital 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.