CT scan, lower back (lumbar spine)
Facility: Physicians Care Surgical Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $394
- Cash Discount Price: $292
- vs. Medicare Baseline: 3.69x 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 369% of the Medicare baseline (a markup of 269%). 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 |
|---|---|---|
| Connecticare | $124 | 116% |
| Highmark | $194 | 182% |
| Blue Cross Blue Shield | $194 - $394 | 182% |
| UnitedHealthcare | $365 - $774 | 342% |
| Aetna | $365 - $1,051 | 342% |
| Pcsh Aarp | $365 | 342% |
| Cigna | $365 | 342% |
| Shenandoah Life | $365 | 342% |
| Vibra Health Plan | $365 | 342% |
| Humana | $365 | 342% |
| Tricare | $365 | 342% |
| Ibc Security 65 | $365 | 342% |
| Medicare (plans) | $365 | 342% |
| Gpm Health and Life Insurance Mc Supplement | $365 | 342% |
| Devon Health Services | $365 | 342% |
| Aarp | $365 | 342% |
| Keystone 65 HMO | $365 | 342% |
| Personal Choice 65 | $365 | 342% |
| Unified Health Services | $365 | 342% |
| Ibc - Local | $394 | 369% |
| Amerihealth Administrators | $394 | 369% |
| Ibc 2021 | $394 | 369% |
| Regence Blue Shield | $394 | 369% |
| Keystone Direct POS | $394 | 369% |
| Ibc Local | $394 | 369% |
| Keystone HMO | $394 | 369% |
| Carefirst Administrators | $394 | 369% |
| Independence Bc | $394 | 369% |
| Personal Choice | $394 | 369% |
| Independence Administrators | $394 | 369% |
| Keystone Healthplan East | $394 | 369% |
| Pcsh Ibc | $394 | 369% |
| Ibc | $394 | 369% |
| Horizon of New Jersey | $394 | 369% |
| Amerihealth New Jersey HMO | $394 | 369% |
| Empire Plan | $394 | 369% |
| Independence Federal | $394 | 369% |
| Allsavers | $774 | 725% |
| Oxford Health Plan | $774 | 725% |
| Oxford Life Insurance Company | $774 | 725% |
| Surest | $774 | 725% |
| Golden Rule Op | $774 | 725% |
| Allied Benefits Systems | $1,051 | 984% |
| Coventry | $1,051 | 984% |
| Lucent Health | $1,051 | 984% |
| Marpai Health | $1,051 | 984% |
| Ag Administrators | $1,051 | 984% |
| Trustmark | $1,051 | 984% |
| Ag Administrators Inc | $1,051 | 984% |
| Healthez | $1,051 | 984% |
| Geha | $1,051 | 984% |
| Meritain Health | $1,051 | 984% |
| Allied Benefit Systems | $1,051 | 984% |
| Continental Benefits | $1,051 | 984% |
| Premier Care Network | $1,051 | 984% |