CMS Price Transparency Data
CT scan, lower back (lumbar spine)
Facility: Scripps Memorial Hospital La Jolla
Billing Code: 72131 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72131
- Insurance Median: $207
- Cash Discount Price: $480
- vs. Medicare Baseline: 1.94x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Scripps Memorial Hospital La Jolla is $207. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $480. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.94x the Medicare baseline. Located in 9888 Genesee Avenue, La Jolla, CA.
Cash / Self-Pay
$480
Average discount available for prompt cash payment at this facility.
Insurance Median
$207
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: $480 (449%)
Insurance Median: $207 (194%)
Cash: $480 (449% of Medicare)
Ins. Median: $207 (194% 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 |
|---|---|---|
| Mpmg Mcr Adv [836] | $78 | 73% |
| Mpmg [800] | $78 | 73% |
| Ocn Mcr Adv [890] | $78 | 73% |
| UnitedHealthcare | $78 - $365 | 73% |
| Aetna | $100 - $388 | 94% |
| Blue Cross Blue Shield | $115 - $365 | 108% |
| Cigna | $115 - $207 | 108% |
| Mc Alignment [917] | $115 | 108% |
| Mc Blue Shield Promise Health Plan [914] | $115 | 108% |
| Mc Blue Shield [902] | $115 | 108% |
| Mc Health Net [904] | $115 | 108% |
| Mc Scan [905] | $115 | 108% |
| Mc United [906] | $115 | 108% |
| Astiva Mcr Adv [464] | $134 | 125% |
| Bc Mcr Adv [830] | $134 | 125% |
| Bs Mcr Adv [829] | $134 | 125% |
| Central Health Mcr Adv [441] | $134 | 125% |
| Clever Care Mcr Adv [465] | $134 | 125% |
| D-Snp Mcr Adv [889] | $134 | 125% |
| Dsnp/Csnp - Generic [458] | $134 | 125% |
| Family Health Centers Pace Mcr Adv Hmo [556] | $134 | 125% |
| Family Health Centers Pace Medi-Cal [555] | $134 | 125% |
| Gary And Mary West Pace Medi-Cal Hmo [557] | $134 | 125% |
| Gpmg/Altura - Mcr Adv [888] | $134 | 125% |
| Hn Mcr Adv [832] | $134 | 125% |
| Humana | $134 | 125% |
| Integrated Health Partners - Mcr Adv [895] | $134 | 125% |
| Kaiser Northern Ca Region Mcr Adv [386] | $134 | 125% |
| La Care Mcr Adv Hmo [612] | $134 | 125% |
| Medicare (plans) | $134 | 125% |
| San Diego Pace Medi-Cal [553] | $134 | 125% |
| Scan Mcr Adv [835] | $134 | 125% |
| Scan [500] | $134 | 125% |
| Scan [818] | $134 | 125% |
| Sharp Comm Med Grp Mcr Adv [840] | $134 | 125% |
| Sharp Health Plan Mcr Adv [531] | $134 | 125% |
| Sharp Health Plan Mcr Adv [897] | $134 | 125% |
| Sharp Rees Stealy Med Grp Mcr Adv [841] | $134 | 125% |
| St Paul'S Pace Medi-Cal [551] | $134 | 125% |
| Ucsd Mcr Adv [873] | $134 | 125% |
| Uh Mcr Adv [831] | $134 | 125% |
| Uh Palomar Health Mcr Adv [885] | $134 | 125% |
| Alignment Health Plan [443] | $138 | 129% |
| Radys Cpmg [803] | $154 | 144% |
| Sharp Comm Med Grp [812] | $207 - $388 | 194% |
| Sharp Rees Stealy Med Grp [811] | $207 - $388 | 194% |
| Ucsd [807] | $207 - $388 | 194% |
| Health Net [340] | $214 - $342 | 200% |
| Prime Healthcare [614] | $229 | 214% |
| Prospect Med Group [893] | $235 | 220% |
| Blue Shield [230] | $297 - $322 | 278% |
| Bs [816] | $311 - $322 | 291% |
| Imperial County Phys Med Group [855] | $311 - $332 | 291% |
| Bc [814] | $332 | 311% |
| Integrated Health Partners [894] | $332 | 311% |
| Perlman Med Group [899] | $332 | 311% |
| Hn [815] | $342 | 320% |
| Centivo [581] | $345 | 323% |
| Uh [819] | $365 | 342% |
| Palomar Health [892] | $388 | 363% |
| Veba Med Grp [813] | $388 | 363% |
| Kaiser Northern Ca Region Hmo/Ppo [384] | $731 | 684% |
| Kaiser [380] | $731 | 684% |
| Kaiser [383] | $731 | 684% |
| Rady Children'S Hospital [825] | $787 | 737% |
| Multi Plan Network [470] | $1,363 | 1276% |
| First Health Network [330] | $1,439 | 1347% |
| Pnoa [615] | $1,439 | 1347% |
| Choice Care Network [270] | $1,535 | 1437% |
| Healthsmart [350] | $1,535 | 1437% |