CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Lewisgale Hospital Alleghany

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $3,742
Cash Discount Price: $7,559
vs. Medicare Baseline: 35.03x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Lewisgale Hospital Alleghany is $3,742. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,559. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 35.03x the Medicare baseline. Located in One Arh Lane - Po Box 7, Low Moor, VA.

Cash / Self-Pay

$7,559

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,742

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: $7,559 (7077%)

Insurance Median: $3,742 (3503%)

Cash: $7,559 (7077% of Medicare)

Ins. Median: $3,742 (3503% 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 3503% of the Medicare baseline (a markup of 3403%). 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	$239 - $767	224%
United	$245 - $3,402	229%
Lifeworks	$1,436	1344%
Universal Healthcare Group	$1,663	1557%
Virginia Health Network	$2,646 - $5,367	2477%
Aetna	$2,807 - $4,082	2628%
Greenvbrier Sporting Club	$4,535	4246%
Corvel	$5,442	5095%
Occunet Workers Comp	$6,047	5661%
Csx Hotels	$6,047	5661%
Health Payors Organization	$6,425	6015%
American Postal Workers Union	$6,803	6369%
Multiplan	$6,803	6369%
One Health Plan	$6,803	6369%
Community Care Network	$6,803	6369%
Alleghany Highland Community	$6,803	6369%
C&O Employees Hospital Assn	$6,803	6369%
4Most	$6,803	6369%

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 $7,559.
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 Alleghany 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.