CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Community Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $3,001
Cash Discount Price: $1,876
vs. Medicare Baseline: 28.10x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Community Hospital is $3,001. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,876. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 28.10x the Medicare baseline. Located in 2000 Campbell Drive, Torrington, WY.

Cash / Self-Pay

$1,876

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,001

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: $1,876 (1756%)

Insurance Median: $3,001 (2810%)

Cash: $1,876 (1756% of Medicare)

Ins. Median: $3,001 (2810% 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 2810% of the Medicare baseline (a markup of 2710%). 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
Banner Health	$1,375	1287%
Cigna	$1,375 - $3,032	1287%
Humana	$1,375	1287%
Naphcare	$1,375	1287%
Triwest Healthcare Alliance Corp - Va Ccn	$1,375	1287%
UnitedHealthcare	$1,375 - $2,970	1287%
Interwest Health	$1,403 - $3,063	1314%
Prime Health Services	$1,403 - $3,063	1314%
Medica	$1,407 - $2,967	1317%
Blue Cross Blue Shield	$2,970	2781%
First Choice Health Network	$2,970	2781%
Hue Health, Inc	$2,970	2781%
Imagine Health, Llc (Wka Wise Provider Network)	$2,970	2781%
Mountain Health Cooperative (Co-Op)	$2,970	2781%
Coventry	$3,001	2810%
First Health	$3,001	2810%
Midlands Choice	$3,001	2810%
Multiplan	$3,032	2839%

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 $1,876.
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 Community 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.