CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Womans Hospital of Texas,The

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $591
Cash Discount Price: $7,143
vs. Medicare Baseline: 5.53x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Womans Hospital of Texas,The is $591. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,143. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.53x the Medicare baseline. Located in 7600 Fannin, Houston, TX.

Cash / Self-Pay

$7,143

Average discount available for prompt cash payment at this facility.

Insurance Median

$591

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: $7,143 (6688%)

Insurance Median: $591 (553%)

Cash: $7,143 (6688% of Medicare)

Ins. Median: $591 (553% 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 553% of the Medicare baseline (a markup of 453%). 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
Texas Health Network	$103	96%
Amerigroup	$105	98%
Texas Childrens Health Plans	$105 - $1,864	98%
Community Health Choice Mcd	$107	100%
United	$109 - $3,214	102%
Aetna	$115 - $1,184	108%
Molina Healthcare	$115	108%
Humana	$131 - $2,273	123%
Blue Cross Blue Shield	$224 - $2,500	210%
Superior Health Plan	$429	402%
Cigna	$1,635 - $2,106	1531%
Christus (Usfhp)	$2,857	2675%
Healthsmart Preferred Care	$3,071 - $6,071	2875%
Fidelis Securecare Of Tx	$3,214	3009%
Coventry National First Health	$3,807	3564%
Physicians Cooperative Of Texas	$3,929	3678%
Rockport Workers Comp	$3,929	3678%
Independent Medical System	$4,286	4013%
National Healthcare Solutions	$4,286	4013%
Southwest Medical	$4,286	4013%
Coastal Comp	$4,643	4347%
Affiliated Ppo	$5,357	5015%
Fiesta Mart, Inc	$5,357	5015%
Multiplan	$5,357 - $6,071	5015%
Physicians, Inc	$6,071	5684%

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 $7,143.
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 Womans Hospital of Texas,The 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.