CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Round Rock Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $1,793
  • Cash Discount Price: $6,360
  • vs. Medicare Baseline: 16.79x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Round Rock Medical Center is $1,793. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,360. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.79x the Medicare baseline. Located in 2400 Round Rock Ave, Round Rock, TX.
Cash / Self-Pay
$6,360

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,793

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: $6,360 (5954%)
Insurance Median: $1,793 (1679%)
Cash: $6,360 (5954% of Medicare)
Ins. Median: $1,793 (1679% 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 1679% of the Medicare baseline (a markup of 1579%). 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
St David’S Hospice $105 98%
United $109 - $2,862 102%
Blue Cross Blue Shield $110 - $2,029 103%
Molina Healthcare $115 108%
Humana $131 123%
Sendero $131 123%
Aetna $132 - $2,612 124%
Amerigroup $218 204%
Superior Health Plan $318 - $1,081 298%
Imo Med - Select Network $1,908 1786%
Texas Healthcare Foundation Heb $2,353 2203%
Texas Workforce Commission $2,480 2322%
Averde Health $2,862 2680%
Comanche County $3,180 2977%
National Choicecare $3,180 2977%
Healthsmart Preferred Care $3,498 - $5,088 3275%
Independent Medical Systems $3,498 3275%
Physicians Cooperative Of Texas $3,498 3275%
Prime Health $3,816 3573%
First Health $4,007 - $4,573 3752%
Coastal Comp Health Networks $4,134 3870%
National Health Care $4,134 3870%
Texas Municipal League $4,452 4168%
Medcorp Southwest $4,770 4466%
Preferred Health Arrangement $4,770 4466%
Rockport Healthcare Group $5,088 - $5,724 4764%
Bce Emergis Corporation $5,724 5359%
Beech Street $5,724 5359%
Medical Control Network Solutions $5,724 5359%
Multiplan $5,724 5359%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 Round Rock Ave, Round Rock, TX 78681
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals