CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Gifford Medical Center

Billing Code: 72131 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$78
about 0.7× the $107 Medicare rate · typically $67–$327
modeled estimate · not a bill or quote
What this hospital charges insurers
$69
Below the fair price — a good deal
about $9 under the fair price · 0.6× Medicare
Medicare pays $107 Fair price $78 This hospital $69 Cash price $72 Hospital's list price $144

How we calculate the fair BaseRate →

How this hospital compares to other VT hospitals

One of the lower prices — 5 of 7 other VT hospitals charge more for the same procedure.

Cheapest $52 Priciest $665

Black dot = this hospital, among the 8 VT hospitals with a price for this procedure. Full list below.

A fair price for a CT scan, lower back (lumbar spine) is about $78 (about 0.7× the $107 Medicare rate). Gifford Medical Center charges insurers about $69, or about $72 in cash — below the fair price — a good deal. Located in Randolph, VT.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $45 - $1,953 42%
Blue Cross Blue Shieldmajor $46 - $1,747 43%
Aetnamajor $135 - $1,953 126%
Cignamajor $70 - $1,644 66%
Harvard Pilgrim $115 - $1,644 108%
MVP Health Care $45 - $1,747 42%
+ 1 smaller / regional plan $45 - $925
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 44 South Main Street, Randolph, VT 05060
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals