CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Arbor Health Morton Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $1,240
Cash Discount Price: $1,654
vs. Medicare Baseline: 11.61x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Arbor Health Morton Hospital is $1,240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,654. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.61x the Medicare baseline. Located in 521 Adams Street, Morton, WA.

Cash / Self-Pay

$1,654

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,240

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: $1,654 (1549%)

Insurance Median: $1,240 (1161%)

Cash: $1,654 (1549% of Medicare)

Ins. Median: $1,240 (1161% 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 1161% of the Medicare baseline (a markup of 1061%). 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
Comm Health Healthy Options	$1,148	1075%
Kaiser Mcaid	$1,148	1075%
UnitedHealthcare	$1,148 - $2,134	1075%
Amerigroup-All Other Plans	$1,216	1138%
Aetna	$1,227 - $2,348	1149%
Amerigroup Mcr Adv	$1,227	1149%
Comm Health Mcr Adv	$1,227	1149%
Healthnet Mcr Adv - All Plans	$1,227	1149%
Humana	$1,227	1149%
Mcr Railroad Mcr Adv - All Plans	$1,227	1149%
Medicare (plans)	$1,227	1149%
Premera Hmo Mcr Adv	$1,227	1149%
Rural Health Mcare - All Plans	$1,227	1149%
Regence Blue Shield Mcr Adv	$1,240	1161%
Molina Mcr Adv	$1,289	1207%
Wellcare Mcr Adv - All Plans	$1,289	1207%
Molina Marketplace-All Other Plans	$1,571	1471%
Regence Blue Shield Ump-All Other Plans	$1,868	1749%
Kaiser Comm-All Other Plans	$2,094	1960%
Molina Mcaid	$2,215	2074%
Comm Health Basic Sub - All Other Plans	$2,268	2123%
Comm Health Pebb	$2,268	2123%
Premera First-All Other Plans	$2,401	2248%
Cigna	$2,481	2323%
First Choice-All Plans	$2,481	2323%

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 $1,654.
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 Arbor Health Morton 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.