CMS Price Transparency Data
CT scan, lower back (lumbar spine)
Facility: Uc San Diego Health Hillcrest - Hillcrest Med Ctr
Billing Code: 72131 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72131
- Insurance Median: $1,423
- Cash Discount Price: $1,673
- vs. Medicare Baseline: 13.32x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Uc San Diego Health Hillcrest - Hillcrest Med Ctr is $1,423. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,673. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.32x the Medicare baseline. Located in 200 West Arbor Drive, San Diego, CA.
Cash / Self-Pay
$1,673
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,423
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: $1,673 (1566%)
Insurance Median: $1,423 (1332%)
Cash: $1,673 (1566% of Medicare)
Ins. Median: $1,423 (1332% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 1332% of the Medicare baseline (a markup of 1232%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Champva [1020] | $106 | 99% |
| Mid County Physicians Med Grp [1054] | $106 | 99% |
| Ucr Prompt Pay Payor [8240] | $113 | 106% |
| Alameda Alliance For Health [2027] | $178 | 167% |
| Alignment Health Plan [2020] | $178 | 167% |
| Alternate Medi-Cal [2001] | $178 | 167% |
| Blue Cross Blue Shield | $178 - $1,783 | 167% |
| Brand New Day [1089] | $178 | 167% |
| California Department Of Public Health [1237] | $178 | 167% |
| California Health & Wellness Medi-Cal [1122] | $178 | 167% |
| Caremore [2028] | $178 | 167% |
| Chargers Football Company [1109] | $178 | 167% |
| Cms - County Medical Services [1025] | $178 - $1,977 | 167% |
| Community Care Ipa [1131] | $178 | 167% |
| Community Eldercare [1027] | $178 | 167% |
| Federal Prison [1031] | $178 | 167% |
| Gold Coast Health Plan [2031] | $178 | 167% |
| Health Plan Of San Joaquin [2032] | $178 | 167% |
| Hemet Community Med Grp - Promisecare [1040] | $178 | 167% |
| Imperial Health Holdings [1132] | $178 | 167% |
| Kern Health Systems [2033] | $178 | 167% |
| La Care Health Plan [2025] | $178 | 167% |
| Medi-Cal [1048] | $178 | 167% |
| Medicaid / KanCare | $178 | 167% |
| Padres Workers Compensation [2013] | $178 | 167% |
| Padres [2014] | $178 | 167% |
| Regal Mg 'Heritage Provider Network' [2019] | $178 | 167% |
| San Diego County [1071] | $178 - $1,520 | 167% |
| Sd Physicians Med Grp [1076] | $178 - $1,977 | 167% |
| State Of California [1082] | $178 | 167% |
| UnitedHealthcare | $178 - $3,649 | 167% |
| Unlisted Mcal Hmo Non-Contract [1049] | $178 | 167% |
| Vantage [1092] | $178 - $1,825 | 167% |
| Ximed [2016] | $178 | 167% |
| Blue Shield Promise [1017] | $205 | 192% |
| Alternate Molina [1240] | $225 | 211% |
| Molina [1055] | $225 | 211% |
| Community Health Group [1022] | $230 | 215% |
| Health Net [1039] | $241 - $8,545 | 226% |
| Inland Empire Health Plan Transplant [1126] | $250 | 234% |
| Inland Empire Health Plan [1121] | $250 | 234% |
| Cal Optima [1016] | $259 | 242% |
| Aetna | $365 - $1,329 | 342% |
| Cigna | $365 - $1,825 | 342% |
| Humana | $365 - $2,585 | 342% |
| Mc Blue Shield Generic Payor [164016] | $365 | 342% |
| Mc Blue Shield Hmo [164015] | $365 | 342% |
| Mc Brand New Day Generic Payor [164031] | $365 | 342% |
| Mc Brand New Day Hmo [164030] | $365 | 342% |
| Mc Healthnet Generic Payor [164010] | $365 | 342% |
| Mc Healthnet Hmo [164004] | $365 | 342% |
| Mc Hnet Blue&Gold Aco [164017] | $365 | 342% |
| Mc Scan Generic Payor [164034] | $365 | 342% |
| Mc Scan Hmo [164035] | $365 | 342% |
| Uc Aff Blue Shield Sr/Sdsm [164037] | $365 | 342% |
| Arch Health Partners [2000] | $669 | 626% |
| Scripps Clinic [1073] | $1,064 - $2,433 | 996% |
| Multicultural Med Grp [1057] | $1,104 | 1034% |
| Alternate Scan Health [2088] | $1,216 | 1138% |
| Elizabeth Hospice [2018] | $1,216 | 1138% |
| Scan Health [1072] | $1,216 | 1138% |
| Blue Shield [1014] | $1,290 - $1,837 | 1208% |
| Olympus Managed Healthcare Inc [1102] | $1,329 | 1244% |
| Alternate Healthnet [1007] | $1,423 - $3,041 | 1332% |
| Usoc - Us Olympic Committee [1123] | $1,502 | 1406% |
| Global Excel [1036] | $1,520 | 1423% |
| Sharp Health Plan [1079] | $1,520 - $1,995 | 1423% |
| Alternate Blue Shield [2002] | $1,837 | 1720% |
| Blue Shield Transplants [1113] | $1,837 | 1720% |
| Alternate Sheriff Custody [1106] | $1,977 | 1851% |
| Axa Assistance [1098] | $1,977 | 1851% |
| Cassidy Med Grp [1019] | $1,977 | 1851% |
| Cmn - Canadian Medical Network [1024] | $1,977 | 1851% |
| Ets - Lifetrac Network [1103] | $1,977 | 1851% |
| Health Net Bh (Mhn) [1038] | $1,977 | 1851% |
| Health Net Bh (Mhn) [2010] | $1,977 | 1851% |
| Interlink Health Services Transplant [1124] | $1,977 | 1851% |
| Interlink Health Transplant [2085] | $1,977 | 1851% |
| Mgm Resorts [1053] | $1,977 | 1851% |
| National Healthcare Solutions Inc [1100] | $1,977 | 1851% |
| Quality Health [1069] | $1,977 | 1851% |
| San Diego County Sheriff Custody [2012] | $1,977 | 1851% |
| Scripps Coastal Med Grp [1074] | $1,977 | 1851% |
| Tri-City [1085] | $1,977 | 1851% |
| Graybill Med Grp [1037] | $1,995 | 1868% |
| Sharp Community Med Grp [1078] | $1,995 | 1868% |
| Sharp Rees Stealy [1080] | $1,995 | 1868% |
| Alternate Health Net Bh [2059] | $2,010 | 1882% |
| Healthnet Transplants [1114] | $2,010 | 1882% |
| Kaiser [1046] | $2,037 | 1907% |
| Embassy Sponsored [1101] | $2,068 - $2,129 | 1936% |
| Interplan [1045] | $2,129 | 1993% |
| Mercy Physicians Med Grp [1052] | $2,129 | 1993% |
| Pacific Foundation [1063] | $2,129 | 1993% |
| Beech Street [1012] | $2,281 | 2136% |
| First Health [1032] | $2,281 | 2136% |
| Admar [1001] | $2,342 | 2193% |
| Bps - Benefit Plan Services [1015] | $2,342 | 2193% |
| Multiplan [1058] | $2,342 | 2193% |
| Private Healthcare Systems [1067] | $2,342 - $3,041 | 2193% |
| Carnival Cruises [1018] | $2,433 | 2278% |
| Scripps Health Plan Services [1075] | $2,433 | 2278% |
| Alternate Kaiser Rad Onc [2089] | $3,041 | 2847% |
| Palomar Health [1128] | $3,649 | 3416% |
| Easy Choice [1029] | $3,801 | 3559% |
| Sharp Healthcare Transplant [1119] | $4,105 | 3843% |