CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Snoqualmie Valley Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $254
Cash Discount Price: $851
vs. Medicare Baseline: 2.38x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Snoqualmie Valley Hospital is $254. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $851. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.38x the Medicare baseline. Located in 9801 Frontier Ave Se, Snoqualmie, WA.

Cash / Self-Pay

$851

Average discount available for prompt cash payment at this facility.

Insurance Median

$254

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: $851 (797%)

Insurance Median: $254 (238%)

Cash: $851 (797% of Medicare)

Ins. Median: $254 (238% 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 238% of the Medicare baseline (a markup of 138%). 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
Community Health Plan Of Wa Mcd Rep	$79 - $1,245	74%
Medicaid / KanCare	$79 - $1,245	74%
UnitedHealthcare	$79 - $2,454	74%
Amerigroup Wellpoint	$83 - $1,320	78%
Washington Coordinated Care	$85 - $1,345	80%
Molina Healthcare Of Washington Mcd Rep	$87 - $1,345	81%
Aetna	$113 - $1,550	106%
Humana	$114 - $1,135	107%
Blue Shield Of Wa Regence Mcr Adv	$150 - $1,135	140%
Community Health Plan Of Wa	$150 - $1,147	140%
Medicare (plans)	$150 - $1,124	140%
Molina Healthcare Of Washington Mcr Adv	$150 - $1,124	140%
Molina Healthcare Of Washington	$153 - $1,147	143%
Kaiser Foundation Health Plan Of The Northwest	$169 - $1,679	158%
Blue Cross Blue Shield	$181 - $1,600	169%
Blue Shield Of Wa Regence	$185 - $225	173%
Cigna	$214 - $2,134	200%
First Choice Health Network	$240 - $1,867	225%

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 $851.
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 Snoqualmie Valley 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.