CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Vidant Roanoke Chowan Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $2,688
Cash Discount Price: $2,432
vs. Medicare Baseline: 25.17x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Vidant Roanoke Chowan Hospital is $2,688. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,432. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 25.17x the Medicare baseline. Located in 500 S Academy St, Ahoskie, NC.

Cash / Self-Pay

$2,432

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,688

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: $2,432 (2277%)

Insurance Median: $2,688 (2517%)

Cash: $2,432 (2277% of Medicare)

Ins. Median: $2,688 (2517% 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 2517% of the Medicare baseline (a markup of 2417%). 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	$107	100%
Blue Cross Blue Shield	$107 - $2,375	100%
UnitedHealthcare	$109 - $2,397	102%
Aetna	$112 - $3,553	105%
Liberty Advantage [1313]	$112	105%
Longevity Health [1411]	$139	130%
Carolina Complete Health [1317]	$1,078	1009%
Wellcare [1320]	$1,083	1014%
Amerihealth McAid Adv [1316]	$1,088	1019%
Nc Dept of Public Safety [1095]	$1,581	1480%
Medcost [1067]	$2,688 - $2,832	2517%
Cigna	$3,692 - $4,169	3457%
Multiplan [1031]	$4,126	3863%

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 $2,432.
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 Vidant Roanoke Chowan 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.