CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Intermountain Health Garfield Memorial Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $2,359
Cash Discount Price: $1,863
vs. Medicare Baseline: 22.09x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Intermountain Health Garfield Memorial Hospital is $2,359. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,863. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 22.09x the Medicare baseline. Located in 200 North 400 East, Panguitch, UT.

Cash / Self-Pay

$1,863

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,359

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: $1,863 (1744%)

Insurance Median: $2,359 (2209%)

Cash: $1,863 (1744% of Medicare)

Ins. Median: $2,359 (2209% 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 2209% of the Medicare baseline (a markup of 2109%). 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
Aetna	$46 - $2,384	43%
Health Choice Utah	$46 - $2,210	43%
Healthy U	$46 - $2,210	43%
Medicare (plans)	$46 - $944	43%
Molina	$46 - $2,359	43%
Molina Healthcare Of Utah	$46 - $2,359	43%
Selecthealth	$46 - $2,359	43%
Triwest	$46 - $1,279	43%
Uofu	$46 - $2,359	43%
Byu Athletic Department	$533 - $2,359	499%
Campbell Scientific	$533 - $2,359	499%
Cigna	$533 - $2,359	499%
Deseret Mutual	$533 - $2,359	499%
Emi Health	$533 - $2,359	499%
Franklin County	$533 - $2,359	499%
Health Utah	$533 - $2,359	499%
Juniper Systems	$533 - $2,359	499%
Lw Miller	$533 - $2,359	499%
Managed Care Administrators, Inc.	$533 - $2,359	499%
Motivhealth	$533 - $2,359	499%
Pehp	$533 - $2,359	499%
Prodegi Corporate Benefit Services, Llc	$533 - $2,359	499%
Tanner Llc	$533 - $2,359	499%
Utah State University	$533 - $2,359	499%
Utah Tech University	$533 - $2,359	499%
Wise	$533 - $2,359	499%
Tricare	$1,076 - $1,279	1007%
UnitedHealthcare	$2,037 - $2,086	1907%
Blue Cross Blue Shield	$2,359	2209%
Hygeia Corporation	$2,359	2209%
Medcare International	$2,359	2209%
Springtide	$2,359	2209%

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 $1,863.
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 Intermountain Health Garfield Memorial Hospital 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.