CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Black River Memorial Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $2,065
Cash Discount Price: $2,035
vs. Medicare Baseline: 19.33x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Black River Memorial Hospital is $2,065. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,035. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 19.33x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$2,035

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,065

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: $2,035 (1905%)

Insurance Median: $2,065 (1933%)

Cash: $2,035 (1905% of Medicare)

Ins. Median: $2,065 (1933% 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 1933% of the Medicare baseline (a markup of 1833%). 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
Humana	$44 - $2,268	41%
UnitedHealthcare	$44 - $2,366	41%
Blue Cross Blue Shield	$46 - $1,153	43%
Group Health Cooperative Of Eau Claire	$53 - $2,366	50%
My Choice Wisconsin, Inc.	$53 - $1,153	50%
Quartz Health Solutions, Inc	$53 - $2,219	50%
Security Health Plan	$77 - $2,112	72%
The Alliance	$77 - $2,171	72%
Multiplan	$231 - $2,366	216%
Corvel	$1,379 - $1,488	1291%
Triology Health Solutions	$2,035 - $2,317	1905%
Medica	$2,112 - $2,278	1977%
Association Benefits Solution	$2,148 - $2,317	2011%
Family Health Center Of Marshfield	$2,148 - $2,317	2011%
First Health Group Corporation	$2,148 - $2,317	2011%
Provider Network Of America	$2,148 - $2,317	2011%
Cigna	$2,193 - $2,366	2053%
Cofinity	$2,193 - $2,366	2053%
Coventry Health Care	$2,193 - $2,366	2053%
Custom Benefit Administrators	$2,193 - $2,366	2053%
Healthpartners, Inc.	$2,193 - $2,366	2053%
Wisconsin Physicians Service Insurance Corp	$2,193 - $2,366	2053%
Chorus	$2,216 - $2,390	2075%

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 $2,035.
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 Black River Memorial 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.