CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Univ. of Vermont - Fletcher Allen Health Care

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $170
  • Cash Discount Price: $3,442
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Univ. of Vermont - Fletcher Allen Health Care is $170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,442. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.59x the Medicare baseline. Located in 111 Colchester Ave, Burlington, VT.
Cash / Self-Pay
$3,442

Average discount available for prompt cash payment at this facility.

Insurance Median
$170

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: $3,442 (3223%)
Insurance Median: $170 (159%)
Cash: $3,442 (3223% of Medicare)
Ins. Median: $170 (159% 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.

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
UnitedHealthcare $31 - $3,388 29%
Blue Cross Blue Shield $34 - $3,332 32%
Mvp $38 - $2,687 36%
Aetna $45 - $126 42%
Capital District Physicians' Health Plan $45 - $2,578 42%
Humana $45 - $964 42%
Martins Point $45 - $126 42%
St. Regis $45 - $126 42%
Veterans Affairs Community Care Network $45 - $126 42%
Fidelis Care $51 - $145 48%
Wellpath $62 - $1,893 58%
Ebpa $164 - $2,960 154%
Harvard Pilgrim $170 - $2,754 159%
Magnacare $170 - $2,754 159%
Coventry $181 - $2,926 169%
Nppn $192 - $3,098 180%
Cigna $198 - $3,098 185%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 111 Colchester Ave, Burlington, VT 05401
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals