CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Shannon Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $1,746
Cash Discount Price: $2,965
vs. Medicare Baseline: 16.35x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Shannon Medical Center is $1,746. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,965. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.35x the Medicare baseline. Located in 120 E Harris Ave., San Angelo, TX.

Cash / Self-Pay

$2,965

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,746

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: $2,965 (2776%)

Insurance Median: $1,746 (1635%)

Cash: $2,965 (2776% of Medicare)

Ins. Median: $1,746 (1635% 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 1635% of the Medicare baseline (a markup of 1535%). 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
Care Improvement	$100	94%
Humana	$100 - $4,743	94%
Wellmed	$100	94%
Molina Healthcare - Chip	$112	105%
Wellpoint	$116 - $135	109%
Scott & White	$160	150%
Insurance Management Services	$163	153%
Insurance Services Of Lubbock	$163	153%
Kempton Group	$200	187%
Pdh/Texas Trust	$200	187%
Ambetter / Centene	$215	201%
90 Degree Benefits	$250	234%
Caprock	$250	234%
Blue Cross Blue Shield	$440 - $4,447	412%
City Of San Angelo	$824	771%
Web Tpa	$2,668	2498%
Aetna	$3,913	3664%
Assurant Health	$3,913	3664%
Cigna	$4,269	3997%
First Health	$4,447	4163%
UnitedHealthcare	$4,625	4330%
Healthsmart	$5,277	4941%

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 $2,965.
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 Shannon 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.