CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Southwest Healthcare Rancho Springs Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $2,161
Cash Discount Price: $2,495
vs. Medicare Baseline: 20.23x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Southwest Healthcare Rancho Springs Hospital is $2,161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,495. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.23x the Medicare baseline. Located in 25500 Medical Center Drive, Murrieta, CA.

Cash / Self-Pay

$2,495

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,161

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: $2,495 (2336%)

Insurance Median: $2,161 (2023%)

Cash: $2,495 (2336% of Medicare)

Ins. Median: $2,161 (2023% 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 2023% of the Medicare baseline (a markup of 1923%). 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
Health_Net	$96 - $2,489	90%
Kaiser	$132 - $2,161	124%
United_Healthcare	$132 - $178	124%
Heritage	$144 - $2,786	135%
Iehp	$170	159%
Blue Cross Blue Shield	$367 - $3,094	344%
Aetna	$1,049	982%
Cigna	$1,867 - $2,612	1748%
Primecare	$2,073 - $2,901	1941%
Palomar	$2,444 - $3,420	2288%
Rady_Children'S_Hospital	$3,640 - $5,094	3408%
Multiplan	$4,680 - $6,549	4382%
Sharp_Health_Plan	$4,680 - $6,549	4382%

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 $2,495.
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 Southwest Healthcare Rancho Springs Hospital 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.