CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Adventist Health Lodi Memorial

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $175
  • Cash Discount Price: $165
  • vs. Medicare Baseline: 1.64x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Adventist Health Lodi Memorial is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $165. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.64x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$165

Average discount available for prompt cash payment at this facility.

Insurance Median
$175

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: $165 (154%)
Insurance Median: $175 (164%)
Cash: $165 (154% of Medicare)
Ins. Median: $175 (164% 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
Cigna $26 - $9,157 24%
Alignment Health Plan (Ahp)-All Plans $47 - $138 44%
Blue Shield Mcare Adv $47 - $138 44%
Healthnet Mcare $47 - $138 44%
Hp Of San Joaquin Mcr Adv $47 - $138 44%
Humana $47 - $138 44%
Knnex Health - All Plans $47 - $165 44%
Tricare $47 - $138 44%
UnitedHealthcare $47 - $4,223 44%
Hp Healthy Kids Pro Fee $50 47%
Ah Employee Health Plan - All Plans $52 - $248 49%
First Health- All Plans $57 - $5,500 53%
Beech Street- All Plans $61 - $9,157 57%
Hp Of San Joaquin Ppo - All Other Plans $61 - $9,665 57%
Multiplan- All Plans $61 - $8,139 57%
Kaiser Commercial - All Other Plans $64 - $4,171 60%
Kaiser Mcr Adv $64 - $138 60%
Networks By Design- All Plans $64 - $3,500 60%
Healthnet- All Other Plans $69 - $4,996 65%
Western Growers- All Plans $72 - $9,157 67%
Blue Shield Epn - All Other Plans $86 - $3,296 81%
Blue Shield Non-Epn $91 - $3,418 85%
Blue Cross Blue Shield $102 - $1,844 95%
Bc Mcal $124 - $138 116%
Celtic Ins Company - All Plans $124 - $260 116%
Kaiser Mcal $124 - $232 116%
Medi-Cal $124 - $232 116%
Hp Mcal Pro Fee $137 128%
Cca Health Plan Mcr Adv- All Plans $138 129%
Healthnet Mcal $149 - $332 140%
Hp Of San Joaquin Mcal $149 - $290 140%
Bright Health - All Plans $276 258%
Aetna $281 - $2,315 263%
Medcore(Omni Ipa) Op Only- All Plans $612 - $2,645 573%
Three Rivers Provider Network- All Plans $2,118 - $9,157 1983%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals