CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Lewisgale Hospital Montgomery

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $2,799
Cash Discount Price: $3,942
vs. Medicare Baseline: 26.21x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Lewisgale Hospital Montgomery is $2,799. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,942. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 26.21x the Medicare baseline. Located in 3700 South Main Street, Blacksburg, VA.

Cash / Self-Pay

$3,942

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,799

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: $3,942 (3691%)

Insurance Median: $2,799 (2621%)

Cash: $3,942 (3691% of Medicare)

Ins. Median: $2,799 (2621% 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 2621% of the Medicare baseline (a markup of 2521%). 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
Blue Cross Blue Shield	$196 - $627	184%
United	$245 - $1,774	229%
Cigna	$686	642%
Lifeworks	$749	701%
Universal Healthcare Group	$867	812%
Virginia Health Network	$1,380 - $2,799	1292%
Greenvbrier Sporting Club	$2,365	2214%
Aetna	$2,807 - $4,356	2628%
Corvel	$2,838	2657%
Richfield Nursing Center	$2,956	2768%
Richfield Retirement Community	$2,956	2768%
Multiplan	$3,035	2841%
Community Care Network	$3,154	2953%
Graham-White Manufacturing	$3,154	2953%
Occunet Workers Comp	$3,154	2953%
One Health Plan	$3,154	2953%
Phcs	$3,351	3137%
Patients Choice	$3,469	3248%
4Most	$3,548	3322%
American Postal Workers Union	$3,548	3322%
Star Transportation	$3,548	3322%

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 $3,942.
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 Lewisgale Hospital Montgomery 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.