CMS Price Transparency Data
CT scan, lower back (lumbar spine)
Facility: John Muir Medical Center - Concord Campus
Billing Code: 72131 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72131
- Insurance Median: $148
- Cash Discount Price: $2,252
- vs. Medicare Baseline: 1.39x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at John Muir Medical Center - Concord Campus is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,252. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.39x the Medicare baseline. Located in 2540 East St, Concord, CA.
Cash / Self-Pay
$2,252
Average discount available for prompt cash payment at this facility.
Insurance Median
$148
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: $2,252 (2108%)
Insurance Median: $148 (139%)
Cash: $2,252 (2108% of Medicare)
Ins. Median: $148 (139% 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 |
|---|---|---|
| Jmpn Canopy Hn [1640000011] | $91 | 85% |
| UnitedHealthcare | $91 - $1,176 | 85% |
| Aetna | $121 - $175 | 113% |
| Contra Costa County Jail [1012104] | $124 | 116% |
| United Behavioral Health [1048103] | $128 | 120% |
| Health Net-Network Mcare [1028127] | $145 | 136% |
| Alignment Health [1177113] | $148 | 139% |
| Blue Cross Blue Shield | $148 - $3,253 | 139% |
| Blue Shield-Network Mcare [1006127] | $148 | 139% |
| Care 1St Health Plan [1094113] | $148 | 139% |
| Caremore [1171113] | $148 | 139% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] | $148 | 139% |
| Easy Choice Health Plan [1083113] | $148 | 139% |
| Essence Healthcare [1049028] | $148 | 139% |
| Essence Healthcare [1049128] | $148 | 139% |
| Golden State-Network Mcare [1023127] | $148 | 139% |
| Hospice Of East Bay [1085104] | $148 | 139% |
| Humana | $148 - $4,154 | 139% |
| Medicare (plans) | $148 - $4,003 | 139% |
| Scan-Network Mcare [1043127] | $148 | 139% |
| Veterans Administration [1051113] | $148 | 139% |
| Tricare | $158 | 148% |
| Workers' Comp [1024005] | $167 | 156% |
| Generic Commercial/Indemnity [1017001] | $185 - $2,002 | 173% |
| Generic Hmo [1018103] | $185 | 173% |
| Generic Ppo [1021104] | $185 | 173% |
| Canopy Hn Hmo [1166103] | $270 | 253% |
| Blue Shield Hmo [1006103] | $1,176 - $1,201 | 1101% |
| Blue Shield Ppo [1006104] | $1,201 - $1,261 | 1124% |
| Blue Shield-Network [1006026] | $1,201 | 1124% |
| Health Net Hmo [1028103] | $1,221 | 1143% |
| Health Net Ppo [1028104] | $1,221 | 1143% |
| Health Net-Network [1028026] | $1,221 | 1143% |
| Cigna | $1,295 | 1212% |
| Carecentrix [1011001] | $2,002 | 1874% |
| Aps Healthcare [1003103] | $2,252 | 2108% |
| Carelon Behavioral Health [1050104] | $2,752 | 2577% |
| Fortified Provider Network [1063104] | $2,752 | 2577% |
| Medigap [1036001] | $2,752 | 2577% |
| Three Rivers Provider Network [1073104] | $2,752 | 2577% |
| Contra Costa Health Plan Hmo [1013103] | $3,003 | 2812% |
| Western Health Advantage Hmo [1053103] | $3,503 - $4,003 | 3280% |
| Kaiser Hmo [1033103] | $3,703 | 3467% |
| Donor Network West [1008103] | $4,000 | 3745% |
| Federal Correction Institute [1062104] | $4,003 | 3748% |
| First Health [1016104] | $4,003 - $4,254 | 3748% |
| Healthsmart - Pka Interplan [1031104] | $4,003 | 3748% |
| Networks By Design [1084104] | $4,003 | 3748% |
| Pponext [1072104] | $4,003 | 3748% |
| Sutter Preferred Health Plan [1044104] | $4,003 | 3748% |
| Health Management Network [1066104] | $4,254 | 3983% |
| Healthcomp [1089104] | $4,254 | 3983% |
| Galaxy Health Network [1064104] | $4,504 | 4217% |
| Integrated Health Plan [1075104] | $4,504 | 4217% |