CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Providence Regional Medical Center Everett

Billing Code: 72131 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$276

about 2.6× the $107 Medicare rate · typically $187–$312

modeled estimate · not a bill or quote

What this hospital charges insurers

$220

Below the fair price — a good deal

about $56 under the fair price · 2.1× Medicare

Medicare pays $107 Fair price $276 This hospital $220 Cash price $643 Hospital's list price $1,236

How we calculate the fair BaseRate →

How this hospital compares to other WA hospitals

Highest price of the 9 WA hospitals we have prices for — worth calling around.

Cheapest $53 Priciest $220

Black dot = this hospital, among the 9 WA hospitals with a price for this procedure. Full list below.

A fair price for a CT scan, lower back (lumbar spine) is about $276 (about 2.6× the $107 Medicare rate). Providence Regional Medical Center Everett charges insurers about $220, or about $643 in cash — below the fair price — a good deal. Located in Everett, WA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Kaiser Permanente Humana

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	$125 - $369	117%
Blue Cross Blue Shieldmajor	$129 - $278	121%
Aetnamajor	$123 - $526	115%
Cignamajor	$399	374%
Kaiser Permanentemajor	$119 - $179	111%
Amerigroup	$131	123%
Providence Health Plan	$276	258%
+ 3 smaller / regional plans	$190 - $471

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 643), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72131.

Insurance Before you use insurance

Call your insurance company to confirm Providence Regional Medical Center Everett is in-network.
Ask your insurer whether prior approval is required for CPT code 72131.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Providence Regional Medical Center Everett

Compare: CT scan, lower back (lumbar spine) at other WA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.