CMS Price Transparency Data
CT scan, lower back (lumbar spine)
Facility: AHMC Anaheim Regional Medical Center
Billing Code: 72131 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72131
- Insurance Median: $174
- Cash Discount Price: $4,170
- vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at AHMC Anaheim Regional Medical Center is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,170. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.63x the Medicare baseline. Located in 1111 W La Palma Avenue, Anaheim, CA.
Cash / Self-Pay
$4,170
Average discount available for prompt cash payment at this facility.
Insurance Median
$174
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: $4,170 (3904%)
Insurance Median: $174 (163%)
Cash: $4,170 (3904% of Medicare)
Ins. Median: $174 (163% 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 |
|---|---|---|
| Private Pay Flat Rate | $40 | 37% |
| Msi/Medical Services For Indigents | $52 | 49% |
| Veterans Administration | $94 | 88% |
| Monarch Healthcare Medical Group | $113 | 106% |
| Prospect Medical Group | $121 | 113% |
| Altamed Health Network | $124 - $132 | 116% |
| Applecare Medical Group | $124 | 116% |
| Beverly Hospital | $124 - $148 | 116% |
| Brand New Day | $124 - $168 | 116% |
| Health Net | $124 | 116% |
| Healthcare Partners | $124 - $132 | 116% |
| Healthy Way La | $124 | 116% |
| Heritage Provider Network | $124 - $182 | 116% |
| Non Contracted Medi-Cal | $124 | 116% |
| Talbert Medical Group | $124 - $226 | 116% |
| Alta Los Angeles Hospital | $126 | 118% |
| Prospect Health Plan | $126 - $182 | 118% |
| Tricare | $128 | 120% |
| Aetna | $132 - $919 | 124% |
| Aids Health Foundation | $132 - $334 | 124% |
| Alignment Health Plan | $132 | 124% |
| Apa Aco Inc | $132 | 124% |
| Avanti | $132 - $334 | 124% |
| Blue Cross Blue Shield | $132 - $623 | 124% |
| Blue Shield Of California | $132 - $2,761 | 124% |
| California Health Plan | $132 | 124% |
| Caloptima | $132 - $417 | 124% |
| Central Health Of California | $132 | 124% |
| Davita Heatlhcare Partners Plan Inc | $132 - $957 | 124% |
| Healthnet | $132 | 124% |
| Humana | $132 | 124% |
| Kaiser Foundation Hospitals | $132 - $334 | 124% |
| Medicare (plans) | $132 - $400 | 124% |
| Monarch Health Plan | $132 - $2,831 | 124% |
| Pacificare | $132 | 124% |
| Scan Health Plan | $132 | 124% |
| Seoul Medical Group | $132 - $134 | 124% |
| Wellcare | $132 | 124% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $134 | 125% |
| Emanate Health | $134 - $334 | 125% |
| Innovative Integrated Health (Iih)/Orange County Pace | $134 | 125% |
| Memorial Healthcare Ipa/Cap/Valuation Rates | $134 | 125% |
| Self-Pay | $134 | 125% |
| Nchp | $139 | 130% |
| Align Senior Care | $140 | 131% |
| Affiliated Doctors Of Orange County | $150 | 140% |
| Angels Baseball Workers Comp | $152 | 142% |
| Interplan | $161 - $2,919 | 151% |
| Ahmc Health Self-Insurance Epo | $168 | 157% |
| Knox-Keene Act | $168 | 157% |
| First Health | $173 - $3,336 | 162% |
| Orange County Preferred Provider Organization | $173 - $3,128 | 162% |
| UnitedHealthcare | $178 | 167% |
| Athens Administrators | $179 | 168% |
| Capp Care | $179 - $3,128 | 168% |
| Cigna | $179 - $1,520 | 168% |
| Corvel | $179 - $3,128 | 168% |
| Marriot Intl | $179 | 168% |
| Non Contracted Workers Comp | $179 | 168% |
| Memorial Healthcare Ipa | $200 | 187% |
| Health Net Inc | $334 - $3,203 | 313% |
| Healthnet Cal Optima Medi-Cal/Healthy Families | $334 | 313% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $334 | 313% |
| Hollywood Presbyterian Medpoint Mcal | $334 | 313% |
| Medi-Cal | $334 | 313% |
| Medical Safety Net Program | $334 | 313% |
| Ahmc Reciprocity Agreement | $345 | 323% |
| Genesis Healthcare Ipa Ancillary | $413 | 387% |
| Medical Acquisition Company | $425 | 398% |
| Care First | $600 - $630 | 562% |
| Multiplan Inc | $600 | 562% |
| Private Healthcare Systems | $810 | 758% |
| Healthcare Partners Commercial | $957 | 896% |
| Huntington Memorial Hospital | $957 | 896% |
| Netcare Life And Health Insurance | $1,042 | 976% |
| Advance Clinical Research Institute | $1,251 | 1171% |
| Affiliated Health Fund | $2,919 | 2733% |
| Allnet Preferred Provider | $2,919 | 2733% |
| Choicecare | $3,000 | 2809% |
| National Provider Network | $3,336 | 3123% |
| Three Rivers Providers Network | $3,336 | 3123% |
| Health Payors Organization | $3,753 | 3514% |
| Non Contracted Commercial | $4,170 | 3904% |