CT scan, lower back (lumbar spine)
Facility: Watsonville Community Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $3,800
- Cash Discount Price: $5,868
- vs. Medicare Baseline: 35.58x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 3558% of the Medicare baseline (a markup of 3458%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Well Path | $178 - $9,780 | 167% |
| Medicaid / KanCare | $178 | 167% |
| California Childrens Srvs | $178 | 167% |
| Ccs/Monterey County | $178 | 167% |
| Medi-Cal/Eds | $178 | 167% |
| Medi-Cal E.R. | $178 | 167% |
| Healthy Families | $178 | 167% |
| Alliance/Sccho | $179 | 168% |
| Secure Horizons Dign HMO | $515 - $1,956 | 482% |
| Cigna | $515 - $6,846 | 482% |
| Aetna | $515 - $5,402 | 482% |
| Health Net Pmg HMO | $515 - $6,132 | 482% |
| Pacificare HMO | $515 - $3,100 | 482% |
| Great-West/Phcs | $515 - $6,846 | 482% |
| Blue Cross Blue Shield | $515 - $6,507 | 482% |
| UnitedHealthcare | $515 - $3,100 | 482% |
| Blue Shield HMO | $515 - $1,956 | 482% |
| Carpenters H&W Trust | $1,119 - $6,507 | 1048% |
| Monterey Bay Pub Emp Trst | $1,119 - $6,507 | 1048% |
| Laborers Health & Welfare | $1,119 - $6,507 | 1048% |
| Delta Health Systems | $1,119 - $6,507 | 1048% |
| Robert Kennedy/Ccn | $1,119 - $6,507 | 1048% |
| Western Growers Trust/Bc | $1,119 - $6,507 | 1048% |
| State Compensation Fund | $1,119 - $6,507 | 1048% |
| Calif Ironworkers Field | $1,119 - $6,507 | 1048% |
| Pinnacle Claims Tpa/Bc | $1,119 - $6,507 | 1048% |
| Sheet Metal Workers | $1,119 - $6,507 | 1048% |
| City of Wats/Pinnacle Clm | $1,119 - $6,507 | 1048% |
| Claims Management Wc | $1,119 - $6,507 | 1048% |
| Operating Engineers | $1,119 - $6,507 | 1048% |
| Teamsters Benefit Trust | $1,119 - $6,507 | 1048% |
| Pacificare PPO | $1,525 - $3,100 | 1428% |
| Health Net Smartcare Netw | $1,525 - $3,100 | 1428% |
| Medicruz | $1,760 | 1648% |
| Victim Compensation Plan | $1,760 - $9,780 | 1648% |
| First Health | $3,200 - $7,824 | 2996% |
| Adventist Risk Management | $3,200 - $7,824 | 2996% |
| Geha (Ccn) | $3,200 - $7,824 | 2996% |
| Transwestern | $3,200 - $7,824 | 2996% |
| Western Health Advantage | $4,890 | 4578% |
| Self Pay | $5,868 | 5494% |
| Health Net of California | $6,132 | 5741% |
| Health Net Blue and Gold | $6,132 | 5741% |
| Health Net Canopycare HMO | $6,132 | 5741% |
| Private Healthcare System | $7,628 | 7142% |
| Multiplan Inc PPO | $7,628 | 7142% |
| Salinas Valley Mem Hops | $8,313 | 7783% |
| Coastal Healthcare Admin | $8,313 - $8,802 | 7783% |
| Prucare Pmg HMO | $9,780 | 9156% |
| Aaa | $9,780 | 9156% |
| State Farm Ins | $9,780 | 9156% |
| Farmers Insurance | $9,780 | 9156% |
| Wholesale Beer Distributo | $9,780 | 9156% |
| United Administrative | $9,780 | 9156% |
| Zenith National Ins | $9,780 | 9156% |
| Apwu Health Plan | $9,780 | 9156% |
| Miscellaneous Insurance | $9,780 | 9156% |
| Miscellaneous Auto | $9,780 | 9156% |
| Sutter Health Plus | $9,780 | 9156% |
| Physicians Mutual | $9,780 | 9156% |
| North Calif Bakery Driver | $9,780 | 9156% |
| Aarp | $9,780 | 9156% |
| Bankers Life & Casualty | $9,780 | 9156% |
| Prucare Pmg POS | $9,780 | 9156% |
| Humana | $9,780 | 9156% |
| Allstate | $9,780 | 9156% |
| Travelers Insurance | $9,780 | 9156% |