CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Baylor Scott & White Medical Center Hillcrest

Billing Code: 72131 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$164

about 1.5× the $107 Medicare rate · typically $112–$339

modeled estimate · not a bill or quote

What this hospital charges insurers

$166

About the fair price

about $2 over the fair price · 1.6× Medicare

Medicare pays $107 Fair price $164 This hospital $166 Cash price $1,603 Hospital's list price $2,672

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

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

Cheapest $46 Priciest $166

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, lower back (lumbar spine) is about $164 (about 1.5× the $107 Medicare rate). Baylor Scott & White Medical Center Hillcrest charges insurers about $166, or about $1,603 in cash — about the fair price. Located in Waco, TX.

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	$116 - $1,747	109%
Blue Cross Blue Shieldmajor	$106 - $536	99%
Aetnamajor	$1,470	1376%
Cignamajor	$1,466 - $1,725	1373%
Humanamajor	$101 - $1,870	95%
Baylor Scott & White	$96 - $1,586	90%
+ 10 smaller / regional plans	$106 - $2,004

Government programs also on file: Medicaid, Military & VA.

Excludes 6 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 (about 1,603), 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 Baylor Scott & White Medical Center Hillcrest 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 Baylor Scott & White Medical Center Hillcrest

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

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