CT scan, lower back (lumbar spine)
Facility: Greater El Monte Community Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $729
- Cash Discount Price: $3,170
- vs. Medicare Baseline: 6.83x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 683% of the Medicare baseline (a markup of 583%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| In Custody-Ca Highway Patrol | $20 | 19% |
| Blue Cross Blue Shield | $39 - $1,699 | 37% |
| Aids Health Foundation | $92 - $132 | 86% |
| Altamed Health Network | $92 - $132 | 86% |
| Avanti | $92 - $161 | 86% |
| Beverly Hospital | $92 - $148 | 86% |
| Brand New Day | $92 - $168 | 86% |
| Emanate Health | $92 - $168 | 86% |
| Health Net Foundation | $92 - $2,209 | 86% |
| Healthy Way La | $92 - $124 | 86% |
| La Care Health Plan | $92 - $1,869 | 86% |
| Other Non Contracted Medi-Cal Hmo | $92 - $124 | 86% |
| State Of California | $92 - $124 | 86% |
| Veterans Administration | $94 | 88% |
| Associated Hispanic Physicians | $121 - $334 | 113% |
| Apa/Aco Inc | $132 | 124% |
| Blue Shield Of California | $132 - $2,505 | 124% |
| Cms | $132 | 124% |
| Easy Choice Health Plan | $132 | 124% |
| Health Net Inc | $132 - $2,406 | 124% |
| Other Non Contracted Senior Hmo | $132 | 124% |
| Pacific Alliance Medical Center Reciprocal Contract | $132 | 124% |
| Scan Health Plan | $132 | 124% |
| UnitedHealthcare | $132 - $2,917 | 124% |
| Champus Foundation | $134 | 125% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $134 | 125% |
| Good Samaritan Medical Practice Assoc | $134 - $2,039 | 125% |
| La Care Covered Direct | $134 | 125% |
| Pacificare Of California | $134 | 125% |
| Self-Pay | $134 | 125% |
| Caloptima | $135 - $183 | 126% |
| Alignment Health Plan | $139 | 130% |
| Molina Healthcare | $139 | 130% |
| Inter Valley Health Plan | $141 | 132% |
| Molina Healthcare Of California | $141 - $450 | 132% |
| San Miguel Health Plan | $148 | 139% |
| Chinatown Service Center Pace | $159 | 149% |
| Intercomp | $161 | 151% |
| Ahmc Health Self-Insurance Epo | $168 | 157% |
| Knox-Keene Act | $168 | 157% |
| Preferred Health Network | $170 | 159% |
| Interplan | $173 - $2,548 | 162% |
| Athens Administrators | $179 | 168% |
| Multiplan | $179 - $2,888 | 168% |
| Other Non Contracted Work Comp | $179 | 168% |
| Care 1St Medi Cal Hmo Cap Exceptional Care | $200 | 187% |
| Hollywood Presbyterian Adv Med Mcal | $247 - $334 | 231% |
| Hollywood Presbyterian Medpoint Mcal | $247 - $334 | 231% |
| Universal Care | $250 - $1,250 | 234% |
| Clinica Medica Familiar | $267 - $374 | 250% |
| Central Health Plan | $300 - $598 | 281% |
| Ahmc Reciprocity Agreement | $345 | 323% |
| Cost Containment Strategies | $450 | 421% |
| Employee Health Systems Medical Group | $450 | 421% |
| Bella Vista Medical Group Ipa | $486 - $1,529 | 455% |
| Global Care Medical Group Ipa | $486 - $1,529 | 455% |
| Alta Med Health Services Med Grp | $608 - $850 | 569% |
| Ahmc Reciprocity Agreement Senior/Commercial | $729 - $1,019 | 683% |
| California Thoroughbred Horesmans Foundation | $1,215 - $1,699 | 1138% |
| Cigna | $1,565 | 1465% |
| In Custody Police Dept | $1,580 - $2,209 | 1479% |
| Community Care Network | $1,944 - $2,718 | 1820% |
| Health Payors Organization | $2,187 - $3,058 | 2048% |
| Commercial Non Contract | $2,430 - $3,398 | 2275% |
| Medi-Cal Sub Acute | $2,430 - $3,398 | 2275% |
| Nuclear Medicine/Whmc | $2,430 - $3,398 | 2275% |
| One Legacy | $2,430 - $3,398 | 2275% |