CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Larkin Community Hospital Palm Springs Campus

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $150
  • Cash Discount Price: $375
  • vs. Medicare Baseline: 1.40x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Larkin Community Hospital Palm Springs Campus is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $375. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.40x the Medicare baseline. Located in 1475 W 49Th St, Hialeah, FL.
Cash / Self-Pay
$375

Average discount available for prompt cash payment at this facility.

Insurance Median
$150

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: $375 (351%)
Insurance Median: $150 (140%)
Cash: $375 (351% of Medicare)
Ins. Median: $150 (140% 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
Medicare (plans) $50 - $4,081 47%
Bright Health Commercial - All Other Plans $52 - $131 49%
Clear Springs Health - All Plans $52 - $115 49%
Aetna $67 - $109 63%
Florida Community Care Mcaid-All Plans $67 63%
Miami Childrens Hp Mcaid-All Plans $67 63%
Sunshine Mcaid $67 63%
Wellcare Mcaid $67 63%
Simply Healthcare Mcaid $75 70%
United Mcaid $75 70%
Ambetter / Centene $109 102%
Blue Cross Blue Shield $109 - $1,722 102%
Opus Hospice Ip Only - All Plans $109 102%
Unicare Simply Mcare Ppo - All Plans $115 108%
Ccs - All Plans $147 138%
Fdc - All Plans $153 143%
Florida Health Solution/Hmo - All Plans $200 187%
Cigna $500 468%
Wellcare Comm (Choice) - All Other Plans $600 562%
Humana $604 - $4,081 565%
Leon Med Center Mcr Adv - All Plans $3,673 3439%
Careplus Health - All Other Plans $4,081 3821%
Centurion Doc - All Plans $4,081 3821%
Doctors Healthcare - All Plans $4,081 3821%
Preferred Care Partners Mcr - All Plans $4,081 3821%
Simply Healthcare Mcr - All Other Plans $4,081 3821%
UnitedHealthcare $4,081 3821%
Naphcare - All Plans $4,693 4394%
Oscar Health-All Plans $8,162 7642%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1475 W 49Th St, Hialeah, FL 33012
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals