CMS Price Transparency Data
CT scan, lower back (lumbar spine)
Facility: Clovis Community Medical Center
Billing Code: 72131 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72131
- Insurance Median: $134
- Cash Discount Price: $3,000
- vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Clovis Community Medical Center is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,000. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.25x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
$3,000
Average discount available for prompt cash payment at this facility.
Insurance Median
$134
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: $3,000 (2809%)
Insurance Median: $134 (125%)
Cash: $3,000 (2809% of Medicare)
Ins. Median: $134 (125% 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.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Shield 65 Plus HMO Ehs | $47 - $139 | 44% |
| Blue Shield 65 Plus HMO First Choice | $47 - $139 | 44% |
| Healthnet HMO - La Salle | $47 - $139 | 44% |
| Railroad Part A | $47 - $139 | 44% |
| Cares Act Provider Relief Fund | $47 - $139 | 44% |
| Bscphp - Dhmso | $47 - $139 | 44% |
| Hartford Life Supplement | $47 - $139 | 44% |
| Medi-Cal Innovative Integrated Health | $47 - $139 | 44% |
| Healthnet HMO - Dhmso | $47 - $139 | 44% |
| Bscphp HMO - First Choice | $47 - $139 | 44% |
| Meritage Healthnet HMO | $47 - $139 | 44% |
| Healthnet HMO - Sante | $47 - $139 | 44% |
| Sante-Sub Cap Ma Brand New Day | $47 - $139 | 44% |
| Blue Shield Hmo-Cvmp/Medpro | $47 - $139 | 44% |
| Sante-Blue Shield/Sante | $47 - $139 | 44% |
| Blue Shield Sante | $47 - $139 | 44% |
| Victims of Crime | $47 - $139 | 44% |
| Scan Health Plan | $47 - $139 | 44% |
| Meritage Blue Shield 65 Plus | $47 - $139 | 44% |
| Generic Bscphp | $47 - $139 | 44% |
| UnitedHealthcare | $47 - $1,966 | 44% |
| Medicare (plans) | $47 - $139 | 44% |
| Sante-Healthnet Seniority | $47 - $139 | 44% |
| Gemcare HMO | $47 - $139 | 44% |
| Railroad Part B | $47 - $139 | 44% |
| Generic Victims of Crime | $47 - $139 | 44% |
| Healthnet Sante Dual Risk | $47 - $139 | 44% |
| Humana | $47 - $3,188 | 44% |
| Railroad Part A & B | $47 - $139 | 44% |
| Blue Shield | $47 - $2,134 | 44% |
| Sante | $47 - $193 | 44% |
| Care1St HMO - Ehs | $47 - $139 | 44% |
| Todays Pyramid | $47 - $139 | 44% |
| Healthnet Sante - Sub Cap Dual Risk | $47 - $139 | 44% |
| Aetna | $47 - $1,875 | 44% |
| Healthnet HMO - Cvmp/Medpro | $47 - $139 | 44% |
| Cigna | $47 - $2,326 | 44% |
| Meritage Brand New Day | $47 - $139 | 44% |
| Healthnet Sante | $47 - $139 | 44% |
| Generic | $47 - $139 | 44% |
| Us Marshal | $47 - $139 | 44% |
| Bscphp - First Choice | $47 - $139 | 44% |
| Advantek Table Mountain Rancheria Tribal Member | $47 - $139 | 44% |
| Blue Shield Promise - Imperial | $47 - $139 | 44% |
| Sante Sub Cap Healthnet Seniority | $47 - $139 | 44% |
| Blue Shield Saint Agnes | $47 - $139 | 44% |
| Wellcare | $47 - $139 | 44% |
| Sequoia Pace - Peak Tpa | $47 - $139 | 44% |
| Blue Cross Blue Shield | $47 - $2,385 | 44% |
| Sante Sub Cap-Blue Shield/Sante | $47 - $139 | 44% |
| Brand New Day | $47 - $139 | 44% |
| Well Path (Cfmg) | $47 - $4,125 | 44% |
| Alignment Health Plan | $52 - $152 | 49% |
| Champion Health Plan of California Ma | $52 - $152 | 49% |
| Innovative Integrated Health Community Plans HMO | $52 - $152 | 49% |
| Imperial Health Plan HMO | $54 - $159 | 51% |
| Correctcare Integrated Health | $61 - $180 | 57% |
| Coalinga State Hospital | $94 - $277 | 88% |
| Naphcare Inc-Mendota | $101 - $298 | 95% |
| Kaiser | $107 | 100% |
| Medi-Cal Community Health Group | $124 | 116% |
| Ccs Madera/Sacramento | $124 | 116% |
| Medi-Cal Molina | $124 | 116% |
| Ccs Merced | $124 | 116% |
| Ccs Kings | $124 | 116% |
| Chdp | $124 | 116% |
| Ccs Mariposa | $124 | 116% |
| Fresno County Funded Specialty Care | $124 | 116% |
| Medi-Cal La Care Health | $124 | 116% |
| Medi-Cal Partnership Health Plan of Ca | $124 | 116% |
| Santa Clara Family Health Plan - Valley Health | $124 | 116% |
| Santa Clara Family Health Plan - Premier Health | $124 | 116% |
| Medi-Cal Contra Costa Health Plan | $124 | 116% |
| Ccs Tulare | $124 | 116% |
| Medi-Cal Health Plan of San Mateo | $124 | 116% |
| Gold Coast Medi-Cal | $124 | 116% |
| Ccs Kern | $124 | 116% |
| Generic Care Out of County | $124 | 116% |
| Genetically Handicapped Person | $124 | 116% |
| Ccs Fresno | $124 | 116% |
| Medi-Cal Kern Family Health | $124 | 116% |
| Ccs Stanislaus | $124 | 116% |
| Generic Ccs Other Counties | $124 | 116% |
| San Francisco Health Plan Medi-Cal | $124 | 116% |
| Medi-Cal Blue Shield Promise Health | $124 | 116% |
| Medi-Cal California Health & Wellness Plan | $124 | 116% |
| Medi-Cal Inland Empire Health | $124 | 116% |
| Medi-Cal Alameda Alliance for Health | $124 | 116% |
| Medi-Cal Cencal Health | $124 | 116% |
| Cal Caloptima | $124 | 116% |
| Health Plan of San Joaquin | $187 | 175% |
| Sequoia Pace | $187 | 175% |
| Adventist -McL Calviva Sub Cap | $205 | 192% |
| Healthnet | $239 - $2,201 | 224% |
| Central Valley Medical Providers | $938 - $2,625 | 878% |
| Community Care | $956 | 895% |
| Employer 90/40 | $1,500 | 1404% |
| Nx Health Network PPO | $2,062 | 1931% |
| Central Ca Indian Health | $2,062 | 1931% |
| Healthsmart | $2,550 - $3,000 | 2387% |
| Network By Design | $2,812 | 2633% |
| Coventry Health Care (First Health Network) | $2,812 | 2633% |
| Generic Multiplan | $3,188 | 2985% |
| PHCS | $3,188 | 2985% |