CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $1,706
  • Cash Discount Price: $1,759
  • vs. Medicare Baseline: 15.97x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at University of Wi Hospitals & Clinics Authority is $1,706. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,759. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.97x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.
Cash / Self-Pay
$1,759

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,706

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: $1,759 (1647%)
Insurance Median: $1,706 (1597%)
Cash: $1,759 (1647% of Medicare)
Ins. Median: $1,706 (1597% 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 1597% of the Medicare baseline (a markup of 1497%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $107 - $2,351 100%
Blue Cross Blue Shield $107 - $2,784 100%
Humana $107 100%
Medicare (plans) $107 - $109 100%
UnitedHealthcare $107 - $1,835 100%
Alliance_Premier_Network $1,400 1311%
Mercycare $1,454 1361%
Triology $1,495 - $1,788 1400%
Security_Health_Plan $1,583 - $1,861 1482%
Employer'S_Coalition_On_Health $1,612 - $2,257 1509%
Alliance $1,648 1543%
Hfn $1,671 - $2,257 1564%
United_Healthcare $1,679 - $2,488 1572%
Beloit_Health_System $1,700 1592%
Aspirus_Health_Plan $1,712 1603%
Cigna $1,759 1647%
Health_Partners_Insurance $1,788 1674%
Health_Payment_Systems $1,796 1681%
Dean_Health_Plan $1,876 1756%
Medical_Associates $1,934 1811%
Wps $2,031 - $2,236 1902%
Employers_Healthcare_Coalition_Of_Wi $2,052 1921%
Aspirus_Network_Inc $2,257 2113%
Chorus_Community $2,345 2195%
Ghc_Eau_Claire_Health_Plan $2,345 2195%
Multiplan $2,345 - $2,697 2195%
Sheybogan_Employers_Health_Network $2,345 2195%
Coventry $2,491 2332%
Dean_Care $2,491 2332%
Healthsmart $2,579 2415%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Highland Avenue, Madison, WI 53792
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals