CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Lewisgale Hospital Pulaski

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $5,043
Cash Discount Price: $9,606
vs. Medicare Baseline: 47.21x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Lewisgale Hospital Pulaski is $5,043. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,606. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 47.21x the Medicare baseline. Located in 2400 Lee Highway, Pulaski, VA.

Cash / Self-Pay

$9,606

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,043

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: $9,606 (8994%)

Insurance Median: $5,043 (4721%)

Cash: $9,606 (8994% of Medicare)

Ins. Median: $5,043 (4721% 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 4721% of the Medicare baseline (a markup of 4621%). 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	$162 - $518	152%
United	$245 - $4,323	229%
Lifeworks	$1,825	1709%
Universal Healthcare Group	$2,113	1978%
Aetna	$2,807 - $4,323	2628%
Virginia Health Network	$3,362 - $6,820	3148%
Greenvbrier Sporting Club	$5,764	5396%
Corvel	$6,916	6475%
Richfield Nursing Center	$7,204	6745%
Richfield Retirement Community	$7,204	6745%
Multiplan	$7,397	6925%
Community Care Network	$7,685	7195%
Graham-White Manufacturing	$7,685	7195%
Occunet Workers Comp	$7,685	7195%
One Health Plan	$7,685	7195%
Patients Choice	$8,453	7914%
4Most	$8,645	8094%
American Postal Workers Union	$8,645	8094%
Phcs	$8,645	8094%
Star Transportation	$8,645	8094%

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 $9,606.
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 Pulaski 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.