CT scan, lower back (lumbar spine)
Facility: Adventist Health Tehachapi Valley
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $293
- Cash Discount Price: $188
- vs. Medicare Baseline: 2.74x 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 274% of the Medicare baseline (a markup of 174%). 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 |
|---|---|---|
| Cigna | $26 - $3,084 | 24% |
| Healthnet Mcare | $47 - $750 | 44% |
| Tricare | $47 - $750 | 44% |
| UnitedHealthcare | $47 - $1,935 | 44% |
| Universal Ipa Mcr Adv Op/Profee Only-All Other Pla | $47 - $750 | 44% |
| Ah Employee Health Plan - All Plans | $52 - $2,093 | 49% |
| Network Providers- All Plans | $52 - $960 | 49% |
| Oscar Health Plan- All Plans | $54 - $171 | 51% |
| Aetna | $57 - $992 | 53% |
| Coventry- All Plans | $57 - $3,554 | 53% |
| Healthnet- All Other Plans | $69 - $3,041 | 65% |
| Centivo - All Plans | $71 - $1,688 | 66% |
| Western Grwrs/Pinnacle - All Plans | $71 - $1,659 | 66% |
| Blue Shield Epn- All Other Plans | $86 - $1,670 | 81% |
| Blue Shield Non-Epn | $91 - $1,974 | 85% |
| Medi-Cal | $124 - $232 | 116% |
| Universal Ipa Mcal Op/Profee Only | $124 - $232 | 116% |
| Medicare (plans) | $132 - $750 | 124% |
| Kaiser Ip/Op Only- All Other Plans | $227 - $1,291 | 213% |
| Kaiser Medi-Cal Ip/Op Only | $232 | 217% |
| Bc Mcal | $239 | 224% |
| Healthnet Medi-Cal | $285 | 267% |
| Khs-Kern Hlth Systm Mcal | $299 | 280% |
| Klhp-Kern Legacy Epo -All Other Plans | $348 - $1,974 | 326% |
| Blue Cross Blue Shield | $361 - $1,420 | 338% |