CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Fort Duncan Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $4,877
Cash Discount Price: $4,267
vs. Medicare Baseline: 45.66x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Fort Duncan Medical Center is $4,877. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,267. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 45.66x the Medicare baseline. Located in 3333 N Foster Maldonado Blvd, Eagle Pass, TX.

Cash / Self-Pay

$4,267

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,877

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: $4,267 (3995%)

Insurance Median: $4,877 (4566%)

Cash: $4,267 (3995% of Medicare)

Ins. Median: $4,877 (4566% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 4566% of the Medicare baseline (a markup of 4466%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Superior	$137	128%
Driscoll	$141	132%
Molina	$144	135%
United_Healthcare	$144 - $4,877	135%
Blue_Cross_Blue_Shield_Of_Tx	$370 - $451	346%
Eagle_Pass_Isd	$4,059 - $5,115	3800%
Cigna	$5,909 - $7,447	5532%
Aetna	$7,457 - $9,398	6982%
Healthsmart	$8,967 - $11,301	8395%
Multiplan	$8,967 - $11,301	8395%

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 $4,267.
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 Fort Duncan Medical Center 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.