CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Santa Rosa Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $136
  • Cash Discount Price: $2,295
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Santa Rosa Medical Center is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,295. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.27x the Medicare baseline. Located in 6002 Berryhill Rd, Milton, FL.
Cash / Self-Pay
$2,295

Average discount available for prompt cash payment at this facility.

Insurance Median
$136

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: $2,295 (2149%)
Insurance Median: $136 (127%)
Cash: $2,295 (2149% of Medicare)
Ins. Median: $136 (127% 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
Medicaid / KanCare $67 - $78 63%
Humana $69 - $107 65%
Wellcare $71 66%
Molina $76 71%
Fl Community Care $78 73%
Veterans Eval Services $100 94%
Tricare $104 97%
Aetna $107 - $5,150 100%
Blue Cross Blue Shield $107 - $2,227 100%
Cigna $107 - $2,075 100%
Medicare (plans) $107 100%
UnitedHealthcare $107 - $1,781 100%
Hospice Of Nw Fl $109 102%
Node Champva $109 102%
Node Va $109 102%
Node Wellcare Mcr Adv $113 106%
Geo Group $136 127%
Node Us Dept Of Labor $136 127%
Oscar $202 189%
Prime Health Work Comp Fl $213 199%
Florida State Auto Insurance $218 204%
Florida Workers Compensation $220 206%
Ambetter / Centene $261 244%
Self Pay $2,111 1976%
Prime Health Services $7,344 6876%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6002 Berryhill Rd, Milton, FL 32570
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals