CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Henrico Doctors' Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $1,372
  • Cash Discount Price: $6,415
  • vs. Medicare Baseline: 12.85x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Henrico Doctors' Hospital is $1,372. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,415. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.85x the Medicare baseline. Located in 1602 Skipwith Road, Richmond, VA.
Cash / Self-Pay
$6,415

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,372

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: $6,415 (6006%)
Insurance Median: $1,372 (1285%)
Cash: $6,415 (6006% of Medicare)
Ins. Median: $1,372 (1285% 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 1285% of the Medicare baseline (a markup of 1185%). 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
Blue Cross Blue Shield $148 - $587 139%
United $245 - $2,984 229%
Cigna $886 - $1,393 830%
Lifeworks $1,178 - $1,260 1103%
Universal Healthcare Group $1,364 - $1,459 1277%
Aetna $1,408 - $1,705 1318%
Virginia Health Network $2,169 - $4,311 2031%
Greenvbrier Sporting Club $3,719 - $3,979 3482%
Corvel $4,463 - $4,775 4178%
Occunet Workers Comp $4,958 - $5,306 4642%
4Most Health Nework $5,578 - $5,969 5222%
Multiplan $5,578 - $5,969 5222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1602 Skipwith Road, Richmond, VA 23229
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals