CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Paradise Valley Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $134
  • Cash Discount Price: $133
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Paradise Valley Hospital is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $133. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.25x the Medicare baseline. Located in 2400 East 4Th St, National City, CA.
Cash / Self-Pay
$133

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: $133 (125%)
Insurance Median: $134 (125%)
Cash: $133 (125% 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

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $132 - $171 124%
Blue Sheid Of Promise $132 124%
County Of San Diego $132 124%
Golden Physicians Medical Group $132 - $167 124%
Health Excel Ins $132 - $134 124%
Heritage Provider Netwrok $132 - $174 124%
Molina $132 - $134 124%
Traditional Medi-Cal $132 124%
UnitedHealthcare $132 - $307 124%
Blue Shield Of Ca, Va $134 125%
Ca Foundation For Medical Care $134 125%
Central Health $134 125%
Choice Physicians Network $134 125%
Clever Care Of Golden State, Inc $134 125%
Community Health Group $134 - $158 125%
Health Net Of Ca $134 - $195 125%
Managed Health Network $134 125%
Medicare (plans) $134 125%
Renal Payer Solutions $134 125%
Tricare $134 125%
Usa Senior Care Network $134 125%
Verda Health Plan $134 125%
Brand New Day $135 - $201 126%
Imperial Health Plan Of Ca $142 133%
Health Net Federal Service (Cdcr) $167 156%
Veterans Evaluation Services $167 156%
Worker Comp $176 165%
Integrated Medical Solutions $177 166%
Ca Dept Of Correction & Rehab $187 175%
Employer Direct Healthcare $187 175%
Naphcare $207 - $268 194%
Scripps Health $227 213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 East 4Th St, National City, CA 91950
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals