CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Medical Center of McKinney

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $737
  • Cash Discount Price: $10,535
  • vs. Medicare Baseline: 6.90x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Medical Center of McKinney is $737. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,535. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.90x the Medicare baseline. Located in 4500 Medical Center Drive, McKinney, TX.
Cash / Self-Pay
$10,535

Average discount available for prompt cash payment at this facility.

Insurance Median
$737

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: $10,535 (9863%)
Insurance Median: $737 (690%)
Cash: $10,535 (9863% of Medicare)
Ins. Median: $737 (690% 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 690% of the Medicare baseline (a markup of 590%). 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
Amerigroup $105 98%
Parkland Community Health Plan $105 98%
United $105 - $1,970 98%
Cigna $110 - $8,428 103%
Aetna $113 - $7,659 106%
Molina $115 - $117 108%
Humana $131 - $6,848 123%
Blue Cross Blue Shield $141 - $4,678 132%
Imaging Providers Of Texas $350 328%
Superior Health Plan $737 690%
Unicare $2,739 - $10,535 2564%
Healthcare Highways $3,561 3334%
Fidelis Securecare $4,741 4439%
National Choicecare $5,268 4932%
Pc Texas Partners $5,794 5425%
Physicians Coop Of Tx $5,794 5425%
Rockport Health Group $5,794 5425%
Averde Health, Inc $6,111 5721%
Magellan Bh $6,321 5918%
Value Options Behavioral Health $6,321 5918%
Coastal Comp Health Networks $7,375 6905%
Mega Life $7,375 6905%
Lewisville Isd/Dls Consulting $7,902 7398%
Compsych Corporation $8,428 7891%
Healthsmart Preferred Care $8,428 7891%
Usa Managed Care $8,428 7891%
Galaxy Health Network $8,955 8384%
Independent Medical Systems $10,535 9863%
National Healthcare Solutions $10,535 9863%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4500 Medical Center Drive, McKinney, TX 75069
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals