CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Los Robles Hospital & Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $2,280
Cash Discount Price: $6,993
vs. Medicare Baseline: 21.35x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Los Robles Hospital & Medical Center is $2,280. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,993. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 21.35x the Medicare baseline. Located in 215 W Janss Rd, Thousand Oaks, CA.

Cash / Self-Pay

$6,993

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,280

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: $6,993 (6547%)

Insurance Median: $2,280 (2135%)

Cash: $6,993 (6547% of Medicare)

Ins. Median: $2,280 (2135% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 2135% of the Medicare baseline (a markup of 2035%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Brand New Day	$145	136%
Gold Coast Health Plan	$145	136%
Blue Cross Blue Shield	$232 - $707	217%
United	$245 - $2,122	229%
Medcare Partners	$380 - $1,133	356%
Aetna	$1,263 - $7,553	1182%
First Health	$1,723 - $6,042	1613%
Choicecare Network	$1,774 - $5,287	1661%
Multiplan	$2,027 - $7,175	1898%
Ppo Next	$2,027 - $6,042	1898%
Interplan Corporation	$2,280 - $6,797	2135%
Ventura County Foundation	$2,280 - $6,797	2135%
Blue Shield	$2,918 - $4,169	2732%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $6,993.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72131.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Los Robles Hospital & Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72131.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.