CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Uva Health Culpeper Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $421
Cash Discount Price: $893
vs. Medicare Baseline: 3.94x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Uva Health Culpeper Medical Center is $421. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $893. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.94x the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$893

Average discount available for prompt cash payment at this facility.

Insurance Median

$421

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: $893 (836%)

Insurance Median: $421 (394%)

Cash: $893 (836% of Medicare)

Ins. Median: $421 (394% 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 394% of the Medicare baseline (a markup of 294%). 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
Champva [50002]	$86 - $88	81%
Tricare	$86 - $88	81%
Medicaid / KanCare	$94	88%
Aetna	$105 - $2,015	98%
Blue Cross Blue Shield	$105 - $313	98%
Cigna	$105 - $1,340	98%
HMO Part B [10099]	$105	98%
Humana	$105 - $110	98%
Medicare (plans)	$105 - $108	98%
UnitedHealthcare	$108 - $2,062	101%
VA Ccn [99926]	$108	101%
VA Ccn [99927]	$108	101%
Veterans Administration [99910]	$108	101%
Carefirst [30007]	$732 - $891	685%
Beacon Health Options [40012]	$948	888%
Commercial Generic [40000]	$995	932%
Umwa [40037]	$1,327	1242%
Multiplan Generic [40035]	$1,357 - $1,612	1270%
Vhn Generic [40040]	$1,357 - $1,612	1270%
Sentara Behavioral Health [40052]	$1,387	1299%
Sentara [40021]	$1,387	1299%
Kaiser Permenente [40014]	$1,606	1504%
Gateway Health Alliance [40034]	$1,612	1509%
Geha [40009]	$1,660	1554%
Onenet Workers Comp Generic [60010]	$1,661	1555%

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 $893.
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 Uva Health Culpeper 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.