CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: HCA Houston Healthcare Conroe

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $1,301
  • Cash Discount Price: $11,003
  • vs. Medicare Baseline: 12.18x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at HCA Houston Healthcare Conroe is $1,301. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,003. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.18x the Medicare baseline. Located in 504 Medical Center Blvd, Conroe, TX.
Cash / Self-Pay
$11,003

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,301

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: $11,003 (10301%)
Insurance Median: $1,301 (1218%)
Cash: $11,003 (10301% of Medicare)
Ins. Median: $1,301 (1218% 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 1218% of the Medicare baseline (a markup of 1118%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Texas Health Network $103 96%
Amerigroup $105 98%
Liberty County Indigent $105 98%
Texas Childrens Health Plans $105 - $3,359 98%
Community Health Choice Mcd $107 100%
United $109 - $7,409 102%
Aetna $115 - $1,301 108%
Molina Healthcare $115 108%
Humana $131 - $2,273 123%
Blue Cross Blue Shield $241 - $5,762 226%
Superior Health Plan $333 - $988 312%
Tx Workforce Commission $1,330 - $3,951 1245%
Cigna $1,635 - $2,106 1531%
Christus (Usfhp) $2,217 - $6,586 2076%
Healthsmart Preferred Care $2,383 - $13,994 2231%
Fidelis Securecare Of Tx $2,494 - $7,409 2335%
Coventry National First Health $2,954 - $8,775 2766%
Physicians Cooperative Of Texas $3,049 - $9,055 2855%
Rockport Workers Comp $3,049 - $9,055 2855%
Independent Medical System $3,326 - $9,878 3114%
National Healthcare Solutions $3,326 - $9,878 3114%
Southwest Medical $3,326 - $9,878 3114%
Coastal Comp $3,603 - $10,702 3373%
Multiplan $4,157 - $13,994 3892%
Physicians, Inc $4,711 - $13,994 4411%
Affiliated Ppo $4,989 - $14,818 4671%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 504 Medical Center Blvd, Conroe, TX 77304
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals