CMS Price Transparency Data
CT scan, lower back (lumbar spine)
Facility: Saint Agnes Medical Center
Billing Code: 72131 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72131
- Insurance Median: $32
- Cash Discount Price: $119
- vs. Medicare Baseline: 0.30x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Saint Agnes Medical Center is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.30x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$119
Average discount available for prompt cash payment at this facility.
Insurance Median
$32
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: $119 (111%)
Insurance Median: $32 (30%)
Cash: $119 (111% of Medicare)
Ins. Median: $32 (30% 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 |
|---|---|---|
| Medicaid / KanCare | $30 - $119 | 28% |
| Aetna | $32 - $918 | 30% |
| Albany County Correctional Facility | $32 | 30% |
| Ambetter / Centene | $32 | 30% |
| Amish Mennonite | $32 | 30% |
| Andrie Inc | $32 | 30% |
| Ascension St. Vincent Public Safety Medical | $32 | 30% |
| Bcccp-Michigan | $32 | 30% |
| Bccp | $32 | 30% |
| Blue Cross Blue Shield | $32 - $1,287 | 30% |
| Bmc Healthnet | $32 | 30% |
| Breast Grant-Connecticut | $32 | 30% |
| Broward County Dept Of Health | $32 | 30% |
| California Health And Wellness | $32 | 30% |
| Can Community Health Inc | $32 | 30% |
| Cardinal Innovations Lme | $32 | 30% |
| Care Connections Of Northern Iowa | $32 | 30% |
| Care Oregon Ohp | $32 | 30% |
| Cencal Health Plan | $32 | 30% |
| Cenpatico | $32 | 30% |
| Chhuny | $32 | 30% |
| Childrens Comm Health Plan | $32 | 30% |
| Childrens Medical Services Title 19 | $32 | 30% |
| Cigna | $32 - $1,695 | 30% |
| City Of Philadelphia | $32 | 30% |
| Cmh Allegan County | $32 | 30% |
| Cmh Ausable Valley | $32 | 30% |
| Cmh Barry County | $32 | 30% |
| Cmh Bay-Arenac County | $32 | 30% |
| Cmh Berrien County | $32 | 30% |
| Cmh Cass County | $32 | 30% |
| Cmh Central Mi County | $32 | 30% |
| Cmh Clinton-Eaton-Ingham County | $32 | 30% |
| Cmh Detroit Wayne Integrated Health Network | $32 | 30% |
| Cmh Genesee County | $32 | 30% |
| Cmh Ionia County | $32 | 30% |
| Cmh Jackson County/Lifeways | $32 | 30% |
| Cmh Kalamazoo | $32 | 30% |
| Cmh Kent County | $32 | 30% |
| Cmh Lenawee County | $32 | 30% |
| Cmh Livingston County | $32 | 30% |
| Cmh Macomb | $32 | 30% |
| Cmh Misc | $32 | 30% |
| Cmh Monroe County | $32 | 30% |
| Cmh Montcalm County | $32 | 30% |
| Cmh Muskegon County | $32 | 30% |
| Cmh Newaygo County | $32 | 30% |
| Cmh North Country | $32 | 30% |
| Cmh Northern Lakes County | $32 | 30% |
| Cmh Oakland County | $32 | 30% |
| Cmh Ottawa County | $32 | 30% |
| Cmh Van Buren County | $32 | 30% |
| Cmh Washtenaw County | $32 | 30% |
| Cmh Wayne County/Carelink | $32 | 30% |
| Cmh Wayne Cty/Com Liv Svcs | $32 | 30% |
| Cmh West Mi County | $32 | 30% |
| Community Benefit Health | $32 | 30% |
| Community Care Behavorial Health | $32 | 30% |
| Community Care Partners | $32 | 30% |
| Community Health Choice | $32 | 30% |
| Connections Csp | $32 | 30% |
| County Coroner | $32 | 30% |
| County Funding Generic | $32 | 30% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $32 | 30% |
| Dean Wi Badgercare | $32 | 30% |
| Delaware County Department Of Health | $32 | 30% |
| Delaware First Health | $32 | 30% |
| Delta Dental Nj | $32 | 30% |
| Dph Tb Program | $32 | 30% |
| Dscc | $32 | 30% |
| East Greenbush Central School District | $32 | 30% |
| Eastpointe Lme | $32 | 30% |
| Family Health Network | $32 | 30% |
| Freedom First Healthcare | $32 | 30% |
| Fresno County Ccs | $32 | 30% |
| Genex Wc | $32 | 30% |
| Ghc Scw Wi Badgercare | $32 | 30% |
| Harbor Health | $32 | 30% |
| Health Safety Net | $32 | 30% |
| Healthsmart Workers Comp | $32 | 30% |
| Healthy Blue Ne | $32 | 30% |
| Hennepin Health | $32 | 30% |
| Humana | $32 - $138 | 30% |
| Id County Ada | $32 | 30% |
| Id County Canyon | $32 | 30% |
| Id County Cat Fund | $32 | 30% |
| Id County Other | $32 | 30% |
| Id County Payette | $32 | 30% |
| Idaho Dept Health And Wellfare | $32 | 30% |
| Idaho Womens Health Check | $32 | 30% |
| Indiana Breast Cervical Cancer | $32 | 30% |
| Inland Empire Health Plan | $32 | 30% |
| Intercommunity Health Ohp | $32 | 30% |
| Iowa Total Care | $32 | 30% |
| Jag Source | $32 | 30% |
| Jai Medical System | $32 | 30% |
| Kern Family Health Plan | $32 | 30% |
| Keystone First | $32 | 30% |
| Keystone First Chip | $32 | 30% |
| La Care Health Plan | $32 | 30% |
| Lakeland Care Inc | $32 | 30% |
| Managed Health Services - Indiana | $32 | 30% |
| Maryland Breast & Cervical Program | $32 | 30% |
| Maryland Healthy Smiles - Scion Dental | $32 | 30% |
| Maryland Physicians Care | $32 | 30% |
| Massachusetts Behavioral Health Partnership | $32 | 30% |
| Mdwise | $32 | 30% |
| Medi-Cal | $32 | 30% |
| Medi-Cal Healthnet | $32 - $154 | 30% |
| Medstar Dc Healthy Family | $32 | 30% |
| Medstar Md Health Choice | $32 | 30% |
| Mo Home State Health Plan | $32 | 30% |
| Molina Centennial Care | $32 | 30% |
| Nascentia Health Options | $32 | 30% |
| Nebraska Total Care | $32 | 30% |
| New York Cancer Services Program | $32 | 30% |
| New York State Insurance Fund | $32 | 30% |
| Nextlevel Health | $32 | 30% |
| Njm Insurance Group | $32 | 30% |
| Oregon Screenwise | $32 | 30% |
| Pace Of Southwest Michigan | $32 - $46 | 30% |
| Paramount Advantage | $32 | 30% |
| Parkland Community Health Plan | $32 | 30% |
| Partners Behavioral Lme | $32 | 30% |
| Peach State Healthplan | $32 | 30% |
| Philadelphia County Funding | $32 | 30% |
| Presbyterian Centennial Care | $32 | 30% |
| Prestige Health Choice | $32 | 30% |
| Priority Partners | $32 | 30% |
| Robert F Sing Program | $32 | 30% |
| Rx 340B Pass Along | $32 | 30% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $32 | 30% |
| Rx Heatlhcomp | $32 | 30% |
| Rx Medi-Cal | $32 | 30% |
| Rx Meridian Rx | $32 | 30% |
| Rx Restat | $32 | 30% |
| Rx Saif Opdp Wc | $32 | 30% |
| Rx Worker'S Comp | $32 | 30% |
| Ryan White Florida Mssrp | $32 | 30% |
| Sandhills Center Lme | $32 | 30% |
| Screening For Life | $32 | 30% |
| St Joseph County Hlth Dpt | $32 | 30% |
| Stephenson Cty Health | $32 | 30% |
| Sunshine State Health Plan | $32 | 30% |
| Superior Health | $32 | 30% |
| Tenncare | $32 | 30% |
| Texas Children'S Health Plan | $32 | 30% |
| Trillium Community Ohp | $32 | 30% |
| Tufts Health Public Plans | $32 | 30% |
| UnitedHealthcare | $32 - $738 | 30% |
| Vaya Health Lme | $32 | 30% |
| Washtenaw Health Plan | $32 | 30% |
| Wc Accident Fund | $32 | 30% |
| Wc Ace | $32 | 30% |
| Wc Acs Federal Employees | $32 | 30% |
| Wc Acuity | $32 | 30% |
| Wc Advantage | $32 | 30% |
| Wc Aegis | $32 | 30% |
| Wc Aig | $32 | 30% |
| Wc Aims | $32 | 30% |
| Wc Alaska National Ins | $32 | 30% |
| Wc Align Network | $32 | 30% |
| Wc Allied | $32 | 30% |
| Wc Am Trust N America | $32 | 30% |
| Wc American Claims Mgmt | $32 | 30% |
| Wc Amerisure | $32 | 30% |
| Wc Amtrust | $32 | 30% |
| Wc Asu Risk Mgt | $32 | 30% |
| Wc Benetech | $32 | 30% |
| Wc Berkley Admin | $32 | 30% |
| Wc Broadspire | $32 | 30% |
| Wc Broward County | $32 | 30% |
| Wc Bunch & Associates | $32 | 30% |
| Wc California State Comp Ins | $32 | 30% |
| Wc California State Ins Fund | $32 | 30% |
| Wc Capitol Area Health Consortium | $32 | 30% |
| Wc Ccmsi | $32 | 30% |
| Wc Chartis | $32 | 30% |
| Wc Chubb | $32 | 30% |
| Wc Cirma | $32 | 30% |
| Wc City Of Albany | $32 | 30% |
| Wc City Of Sioux City | $32 | 30% |
| Wc Claims Mgmt Inc | $32 | 30% |
| Wc Cna | $32 | 30% |
| Wc Comp One Admin C/O Manageability | $32 | 30% |
| Wc Compone Admin | $32 | 30% |
| Wc Ct Healthcare Trust | $32 | 30% |
| Wc Donegal Insurance Group | $32 | 30% |
| Wc Emc Insurance Company | $32 | 30% |
| Wc Employee Mutual | $32 | 30% |
| Wc Enablecomp | $32 | 30% |
| Wc Encore Health Network | $32 | 30% |
| Wc Erie | $32 | 30% |
| Wc Esis | $32 | 30% |
| Wc Evolutions | $32 | 30% |
| Wc Fcci | $32 | 30% |
| Wc Fed Ex | $32 | 30% |
| Wc Federal Black Lung | $32 | 30% |
| Wc Federated | $32 | 30% |
| Wc Finley Occupational Health | $32 | 30% |
| Wc First Agency/Occunet | $32 | 30% |
| Wc Ford Motor | $32 | 30% |
| Wc Fresno Unified Emp | $32 | 30% |
| Wc Gallagher Bassett | $32 | 30% |
| Wc General Motors | $32 | 30% |
| Wc Generic | $32 | 30% |
| Wc Genex Care For Ohio | $32 | 30% |
| Wc Great West Casualty | $32 | 30% |
| Wc Guarantee Insurance | $32 | 30% |
| Wc Guard Insurance Company | $32 | 30% |
| Wc Hab | $32 | 30% |
| Wc Hartford | $32 | 30% |
| Wc Hastings | $32 | 30% |
| Wc Health Management | $32 | 30% |
| Wc Heritage Summit | $32 | 30% |
| Wc Hireright | $32 | 30% |
| Wc Horizon | $32 | 30% |
| Wc Icw Group | $32 | 30% |
| Wc Idaho State Ins Fund | $32 | 30% |
| Wc Intercare Insurance | $32 | 30% |
| Wc Intermountain | $32 | 30% |
| Wc Johns Eastern | $32 | 30% |
| Wc Kemberton | $32 | 30% |
| Wc Key Ins & Benefit Solutions | $32 | 30% |
| Wc Liberty Mutual | $32 | 30% |
| Wc Mac Risk Management | $32 | 30% |
| Wc Massachusetts | $32 | 30% |
| Wc Mdia | $32 | 30% |
| Wc Meadowbrook Claim | $32 | 30% |
| Wc Medical Administrators | $32 | 30% |
| Wc Meijers | $32 | 30% |
| Wc Memic | $32 | 30% |
| Wc Mercy Workcare | $32 | 30% |
| Wc Michigan | $32 | 30% |
| Wc Michigan Millers Mutual | $32 | 30% |
| Wc Mitchell Frankenmuth | $32 | 30% |
| Wc Mra | $32 | 30% |
| Wc Nationwide | $32 | 30% |
| Wc Nca Comp | $32 | 30% |
| Wc New York | $32 | 30% |
| Wc New York Special Funds | $32 | 30% |
| Wc North American Rishces | $32 | 30% |
| Wc Northeast Health | $32 | 30% |
| Wc Notre Dame | $32 | 30% |
| Wc Novanet | $32 | 30% |
| Wc O'Hara Corp | $32 | 30% |
| Wc Occ Health Allen | $32 | 30% |
| Wc Ohio Bureau | $32 | 30% |
| Wc One Call Medical | $32 | 30% |
| Wc Paradigm | $32 | 30% |
| Wc Peerless | $32 | 30% |
| Wc Pma | $32 | 30% |
| Wc Praxis Health Network | $32 | 30% |
| Wc Price Chopper | $32 | 30% |
| Wc Procura Management | $32 | 30% |
| Wc Qualcare | $32 | 30% |
| Wc Quiktrip | $32 | 30% |
| Wc Reny Company | $32 | 30% |
| Wc Rev Claims | $32 | 30% |
| Wc Risico | $32 | 30% |
| Wc Rural Mutual | $32 | 30% |
| Wc Saif Oregon | $32 | 30% |
| Wc Secura | $32 | 30% |
| Wc Sedgwick | $32 | 30% |
| Wc Sentry | $32 | 30% |
| Wc Sheakley Unicomp | $32 | 30% |
| Wc Smile Lodge | $32 | 30% |
| Wc Society | $32 | 30% |
| Wc Srs | $32 | 30% |
| Wc Taconic (Mro) | $32 | 30% |
| Wc Taconic Farms | $32 | 30% |
| Wc Travelers | $32 | 30% |
| Wc Triad Group | $32 | 30% |
| Wc Tristar | $32 | 30% |
| Wc Troy Ny | $32 | 30% |
| Wc Tyson | $32 | 30% |
| Wc Unified Health Services | $32 | 30% |
| Wc United Heartland | $32 | 30% |
| Wc Us Dept Of Labor | $32 | 30% |
| Wc Velocity | $32 | 30% |
| Wc Walmart | $32 | 30% |
| Wc West Bend | $32 | 30% |
| Wc West Bend Mutual/Argent | $32 | 30% |
| Wc Winnebago Industries | $32 | 30% |
| Wc Yankee Trails | $32 | 30% |
| Wc York Risk | $32 | 30% |
| Wc Zenith | $32 | 30% |
| Wc Zurich | $32 | 30% |
| Wellsense Health Plan | $32 | 30% |
| Wi Womens Wellness | $32 | 30% |
| Ally Align Care Adv | $46 | 43% |
| American Health Advantage Of Idaho | $46 | 43% |
| American Health Plan | $46 | 43% |
| Aurora Special Needs | $46 | 43% |
| Blue Care Network Advantage | $46 | 43% |
| Blue Shield - De (Highmark) Medciare Advantage | $46 | 43% |
| Care Dimensions | $46 | 43% |
| Care Improvement Plus | $46 | 43% |
| Care Resources Pace | $46 | 43% |
| Careplus Health Plans | $46 | 43% |
| Cca - Zing Health | $46 | 43% |
| Cca Senior Care Options | $46 | 43% |
| Central Valley Medical Services Corp Pace | $46 | 43% |
| Champion Health Plan Mcr Advantage | $46 | 43% |
| Champva | $46 | 43% |
| Clear Spring Health | $46 | 43% |
| Clover Health | $46 | 43% |
| Commonwealth Care Alliance | $46 | 43% |
| Community Pace At Home | $46 | 43% |
| Eddy Senior Care-Pace | $46 | 43% |
| Eddy Seniorcare Pace | $46 | 43% |
| Elementcare | $46 | 43% |
| Evercare | $46 | 43% |
| Everence | $46 | 43% |
| Gateway Health Plan | $46 | 43% |
| Genesys Pace Of Genesee County | $46 | 43% |
| Georgia Health Advantage | $46 | 43% |
| Gold Advantage | $46 | 43% |
| Gpa Croell Redi Mix | $46 | 43% |
| Health America Advantra | $46 | 43% |
| Highmark Health Options Dual Plan | $46 | 43% |
| Hope Select Pace | $46 | 43% |
| Horizon Nj Total Care | $46 | 43% |
| Hudson Headwaters Pace | $46 | 43% |
| Huron Valley Pace | $46 | 43% |
| Innovative Integrated Health Community Plans | $46 | 43% |
| Iowa Health Advantage | $46 | 43% |
| Johns Hopkins Advantage Md | $46 | 43% |
| Lasso Healthcare Msa | $46 | 43% |
| Life St Marys Pace | $46 | 43% |
| Lifecircles Pace | $46 | 43% |
| Longevity Health Plan | $46 | 43% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $46 | 43% |
| Martins Point Generations Advantage | $46 | 43% |
| Mass General Brigham Mcr Adv | $46 | 43% |
| Medicare (plans) | $46 - $138 | 43% |
| Medipak Advantage | $46 | 43% |
| Mercy Life | $46 | 43% |
| Mercyone Cedar Valley | $46 | 43% |
| Meridian Complete | $46 | 43% |
| Michigan Complete Health | $46 | 43% |
| Nascentia Health Plus | $46 | 43% |
| New Centry Health Careplus | $46 | 43% |
| Osu Prime Care Advantage | $46 | 43% |
| Pace Cny | $46 | 43% |
| Pace Iowa Immanuel Pathways | $46 | 43% |
| Pace Southeast | $46 | 43% |
| Pace-Trinity Health | $46 | 43% |
| Peak Pace Solutions | $46 | 43% |
| Perennial Advantage | $46 | 43% |
| Preferred Care Partners | $46 | 43% |
| Presbyterian Senior Plan | $46 | 43% |
| Provider Partners Health Plan Of Illinois | $46 | 43% |
| Provider Partners Health Plan Of Indiana | $46 | 43% |
| Pruitthealth Premier | $46 | 43% |
| Reliance Community Care Partners Care Resources Pace | $46 | 43% |
| Rx Allwin | $46 | 43% |
| Rx Grane Grnmedd | $46 | 43% |
| Rx Retiree Rx Care | $46 | 43% |
| Scan Health Plan Mcr Ipa Meritage Oon | $46 | 43% |
| Secure Horizons Ma Pffs | $46 | 43% |
| Serenity Pace | $46 | 43% |
| Siouxland Pace | $46 | 43% |
| Solis Health Plans | $46 | 43% |
| Sunnyview-Pace Finance Dept | $46 | 43% |
| Texan Plus | $46 | 43% |
| The Health Plan | $46 | 43% |
| Thome Pace | $46 | 43% |
| Todays Options | $46 | 43% |
| Tribute Health Plans | $46 | 43% |
| Tricare | $46 | 43% |
| Triwest Health Alliance | $46 | 43% |
| Um Health Advantage | $46 | 43% |
| Union Health Service | $46 | 43% |
| Us Family Health Plan | $46 | 43% |
| Veterans Eval Services | $46 | 43% |
| Wellmed | $46 | 43% |
| Veterans Administration | $47 | 44% |
| Multiplan | $48 - $1,847 | 45% |
| Phcs | $48 - $1,847 | 45% |
| Welbe Health | $49 - $138 | 46% |
| Align Senior Care | $54 - $155 | 51% |
| Meritain | $54 - $869 | 51% |
| Healthnet | $55 - $1,790 | 51% |
| Blue Shield - Ca | $57 - $1,287 | 53% |
| Coventry | $57 - $1,513 | 53% |
| First Health | $57 | 53% |
| Cba Network By Design | $61 - $1,649 | 57% |
| Advantek Central Usd | $64 - $279 | 60% |
| Geha | $73 - $738 | 68% |
| Bcn Domestic | $75 | 70% |
| Blue Benefit Administrators Of Massachusetts | $75 - $1,287 | 70% |
| Blue Care Network | $75 - $1,287 | 70% |
| Blue Distinction Transplant | $75 - $1,287 | 70% |
| Blue Shield - Id (Regence) | $75 - $1,287 | 70% |
| Blue Shield - Ny Highmark Northeastern | $75 - $1,287 | 70% |
| Blue Shield - Ny Highmark Western | $75 - $1,287 | 70% |
| Blue Shield - Pa (Highmark) | $75 - $1,287 | 70% |
| Blue Shield - Wa (Regence) | $75 - $1,287 | 70% |
| Health Choices | $75 | 70% |
| Kaiser Domestic | $75 | 70% |
| Pre-Employment | $75 | 70% |
| Wc Domestic | $75 | 70% |
| Kaiser Permanente | $92 - $235 | 86% |
| Wc Corvel | $92 - $107 | 86% |
| Correctcare Integrated Health | $124 | 116% |
| Trustmark Small Business Benefits | $869 | 814% |
| Allied Benefit Systems | $918 | 859% |
| Boon Chapman | $918 | 859% |
| Hap | $918 | 859% |
| Webtpa | $918 | 859% |
| St Agnes Nicu Valley Childrens Hospital | $1,429 | 1338% |
| Network Health | $1,649 | 1544% |
| Allegiance | $1,695 | 1587% |
| American Postal Workers Secondary | $1,695 | 1587% |
| Interplan | $1,979 | 1853% |