72131

Ct scan of lower spine without contrast

Medicare pricing data for 30,108 providers across 52 states

🤖AI Overview

This procedure has a 6.5x markup — hospitals charge $362.68 but Medicare allows only $55.62. Uninsured patients may face bills 6.5 times higher than what insurance negotiates. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Ct scan of lower spine without contrast (HCPCS code 72131) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $55.62, but hospitals typically charge $362.68 — a 6.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$11.12

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $55.62, your out-of-pocket cost would be approximately $11.12. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$55.62
Average Hospital Charge
$362.68
Markup Ratio
6.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$362.68
Medicare Allowed$55.62
Medicare Payment$42.46

Hospitals charge 6.5x more than what Medicare allows for this procedure. Medicare actually pays $42.46 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$88$7671021,172+58.3%
Puerto Rico$72$202103504+28.7%
Maryland$69$34460211,265+24.3%
New Jersey$68$42877413,208+21.5%
California$66$4202,76747,873+18.3%
New York$65$3951,58930,728+17.7%
District of Columbia$64$3141032,108+15.6%
Florida$62$4412,16549,030+10.6%
Connecticut$61$3734466,270+9.5%
Nevada$59$4582674,428+5.8%
Arizona$59$44947911,918+5.6%
Montana$56$3211001,243+1.4%
Colorado$56$3705139,496+0.6%
Louisiana$55$3964326,864-0.7%
Texas$55$4602,08447,972-1.0%
Delaware$54$274881,863-2.1%
South Carolina$54$3705066,842-2.1%
Wyoming$54$44255919-2.6%
Rhode Island$54$2651222,640-3.1%
Washington$54$27668410,173-3.4%
Minnesota$54$3571,09521,981-3.7%
Georgia$53$40187013,904-4.0%
Hawaii$53$2441181,349-4.7%
Virginia$53$33881114,886-5.3%
Tennessee$52$36081411,853-5.8%
Massachusetts$52$26078410,803-6.0%
New Mexico$51$3091671,979-7.5%
Pennsylvania$51$2841,35920,355-7.5%
Alabama$51$2744718,994-8.6%
North Carolina$51$3531,06416,193-8.7%
Illinois$51$3501,25122,655-8.8%
Oregon$50$2553604,285-9.9%
Missouri$50$26768015,395-10.3%
Iowa$50$2982833,279-10.8%
Oklahoma$49$3133297,383-11.1%
Kansas$49$2343005,968-11.4%
New Hampshire$49$5321662,433-12.2%
Maine$49$2341061,011-12.2%
Wisconsin$49$4867067,137-12.5%
North Dakota$49$219971,221-12.6%
Utah$48$1952714,364-12.8%
Kentucky$48$2663527,582-13.0%
Michigan$48$24382216,711-13.1%
Indiana$48$3055149,190-13.5%
Idaho$48$3401451,986-13.6%
Nebraska$48$2392094,432-13.7%
Mississippi$48$3382435,010-14.6%
Ohio$47$3111,07021,423-15.5%
South Dakota$47$2101141,272-15.6%
Arkansas$46$2183225,969-16.7%
West Virginia$46$2551623,365-17.6%
Vermont$46$27537750-18.1%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber