CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Brattleboro Memorial Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $123
Cash Discount Price: $1,204
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Brattleboro Memorial Hospital is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,204. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.15x the Medicare baseline. Located in 17 Belmont Ave, Brattleboro, VT.

Cash / Self-Pay

$1,204

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $1,204 (1127%)

Insurance Median: $123 (115%)

Cash: $1,204 (1127% of Medicare)

Ins. Median: $123 (115% 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.

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
Amerihealth-Caritas	$39 - $112	37%
New Hampshire Healthy Families	$39 - $112	37%
Wellsense	$39 - $135	37%
Blue Cross Blue Shield	$45 - $1,548	42%
Cigna	$45 - $1,634	42%
Harvard Pilgrim Health Care	$45 - $1,497	42%
Martin'S Point	$45 - $126	42%
Mvp Healthcare	$45 - $1,548	42%
New Hampshire Healthy Families (Wellcare)	$47 - $132	44%
UnitedHealthcare	$71 - $1,634	66%
Humana	$102	95%
Multiplan	$112 - $1,669	105%
Tufts Health Plan	$118 - $1,573	110%
Vermont Health Plan	$122 - $1,540	114%
Aetna	$1,669	1563%
Coventry	$1,669	1563%
Health New England	$1,669	1563%

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 $1,204.
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 Brattleboro Memorial Hospital 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.