CMS Price Transparency Data
CT scan, lower back (lumbar spine)
Facility: Whittier Hospital Medical Center
Billing Code: 72131 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72131
- Insurance Median: $182
- Cash Discount Price: $699
- vs. Medicare Baseline: 1.70x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Whittier Hospital Medical Center is $182. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $699. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.70x the Medicare baseline. Located in 9080 Colima Rd, Whittier, CA.
Cash / Self-Pay
$699
Average discount available for prompt cash payment at this facility.
Insurance Median
$182
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: $699 (654%)
Insurance Median: $182 (170%)
Cash: $699 (654% of Medicare)
Ins. Median: $182 (170% 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 |
|---|---|---|
| Blue Cross Blue Shield | $36 - $2,590 | 34% |
| Alliance Imaging | $75 | 70% |
| Veterans Administration | $94 | 88% |
| Aids Healthcare Foundation | $124 - $132 | 116% |
| Alta Med Health Network | $124 - $132 | 116% |
| Altamed Health Services Corporation | $124 | 116% |
| Beverly Hospital | $124 - $148 | 116% |
| Brand New Day | $124 - $165 | 116% |
| Emanate Health | $124 - $165 | 116% |
| Health Net | $124 - $2,765 | 116% |
| Healthy Way La | $124 | 116% |
| Heritage Provider Network | $124 - $182 | 116% |
| Kaiser Foundation | $124 - $3,626 | 116% |
| La Care Healthy Families/Healthy Kids | $124 | 116% |
| Non Contracted Medi-Cal | $124 | 116% |
| Prospect Health Plan | $124 - $215 | 116% |
| Synermed | $124 - $134 | 116% |
| Aetna | $132 - $2,640 | 124% |
| Alta Los Angeles Hospitals Inc | $132 | 124% |
| Apa/Aco Inc | $132 | 124% |
| Avanti | $132 - $334 | 124% |
| Caloptima | $132 - $174 | 124% |
| Central Health Plan | $132 | 124% |
| Easy Choice Health Plan | $132 | 124% |
| Humana | $132 | 124% |
| La Care Health Plan | $132 - $2,849 | 124% |
| Medicare (plans) | $132 - $139 | 124% |
| Pacificare Of California | $132 | 124% |
| Scan Health Plan | $132 | 124% |
| Blue Shield Of California | $134 - $2,590 | 125% |
| Caremore | $134 | 125% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $134 | 125% |
| La Care Covered Direct | $134 | 125% |
| Pacific Alliance Medical Center | $134 | 125% |
| Self-Pay | $134 | 125% |
| Tricare | $134 | 125% |
| Alignment Health Plan | $139 | 130% |
| Molina Healthcare Of California | $139 | 130% |
| San Miguel Health Plan | $148 | 139% |
| Chinatown Service Center Pace | $161 | 151% |
| Ahmc Health | $168 | 157% |
| Knox-Keene Act | $168 | 157% |
| Molina Medical Center | $168 - $450 | 157% |
| Fmc Los Angeles County | $170 - $3,885 | 159% |
| Interplan Health Group | $173 | 162% |
| Monarch Healthplan | $174 | 163% |
| UnitedHealthcare | $178 - $2,900 | 167% |
| Athens Administrators Ahmc Work Comp | $179 | 168% |
| Misc 1 | $179 | 168% |
| Multiplan Wc | $179 | 168% |
| Private Pay | $212 | 198% |
| Health Net Inc | $330 - $2,300 | 309% |
| Care First Health Plan | $334 | 313% |
| County Of Los Angeles Dept Of Health Services | $334 | 313% |
| Hollywood Presbyterian Adv Med Mcal | $334 | 313% |
| Hollywood Presbyterian Medpoint Mcal | $334 | 313% |
| Medi Caid/ Medi Cal | $334 | 313% |
| Ahmc Medi-Cal Reciprocity Agreement | $345 | 323% |
| Ahmc Reciprocity | $345 | 323% |
| Allied Physicians Ipa | $350 | 328% |
| Applecare Medical Group | $375 | 351% |
| Healthnet | $404 - $3,595 | 378% |
| Cost Containment | $450 | 421% |
| Physician Healthways | $518 | 485% |
| Davita Healthcare Partners | $618 | 579% |
| Physicians Healthways Medical Corporation | $750 | 702% |
| Central Health Plan Of California | $1,200 | 1123% |
| Ahmc Reciprocity Agreement Senior/Commercial | $1,500 | 1404% |
| Prospect Medical | $1,500 | 1404% |
| Cigna | $1,520 | 1423% |
| Wear And Wood | $1,554 - $2,072 | 1455% |
| Value Healthplan Of California | $1,600 | 1498% |
| Care 1St Health Plan | $2,100 | 1966% |
| Great-West Healthcare Of California | $2,500 | 2341% |
| Prohealth | $2,500 | 2341% |
| New Horizon Medical Group Inc | $3,108 | 2910% |
| Universal Care | $3,367 - $3,626 | 3152% |
| Coventry Health Care | $3,500 | 3277% |
| Coventry Health Care National Network | $3,500 | 3277% |
| Asi/Flex | $3,626 | 3395% |
| Us Comp Care | $3,626 | 3395% |
| Community Care Network | $3,885 | 3637% |
| Interplan Corporation | $3,885 | 3637% |
| Managed Care Administrators | $3,885 | 3637% |
| Multiplan | $4,403 | 4122% |
| Commercial Non Contract | $5,180 | 4850% |
| Medi-Cal Sub Acute | $5,180 | 4850% |
| One Legacy | $5,180 | 4850% |