CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Baptist Medical Center - Nassau

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $673
  • Cash Discount Price: $1,127
  • vs. Medicare Baseline: 6.30x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Baptist Medical Center - Nassau is $673. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,127. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.30x the Medicare baseline. Located in 1250 S 18Th St, Fernandina Beach, FL.
Cash / Self-Pay
$1,127

Average discount available for prompt cash payment at this facility.

Insurance Median
$673

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: $1,127 (1055%)
Insurance Median: $673 (630%)
Cash: $1,127 (1055% of Medicare)
Ins. Median: $673 (630% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 630% of the Medicare baseline (a markup of 530%). 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.

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
Amerigroup Of Georgia $67 63%
Daniel Memorial $67 63%
Humana $67 63%
Nassaua County Sheriff'S Office $67 63%
Simply Healthcare Plans $71 - $81 66%
Simply Healthcare Plans - Cha $71 66%
Amerihealth Caritas $74 69%
Florida Community Care $74 - $112 69%
Sunshine State Health Plan $74 69%
United Community Plan $74 69%
Vivida Health $74 69%
Molina Healthcare Of Florida $80 75%
Aetna $81 - $1,454 76%
Community Hospice Of Northeast Florida $107 100%
Pace $107 100%
Tomorrow'S Rainbow $107 100%
Va Ccn $107 100%
UnitedHealthcare $108 - $893 101%
Corvel $109 - $1,782 102%
Coventry Workers Comp $109 - $1,782 102%
Devoted $113 106%
Upmc $117 110%
Ambetter / Centene $256 240%
Blue Cross Blue Shield $527 - $1,182 493%
Avmed $549 - $1,364 514%
Centivo $595 - $1,545 557%
Borland Groover $727 681%
Occunet $727 681%
Northeast Florida State Hospital $764 715%
Capital Health Plan $836 783%
Geo Group $909 851%
Watchtower $1,000 936%
Fscj Student Insurance $1,091 1021%
Savannah Grand Of Amelia Island $1,091 1021%
Cigna $1,127 - $1,389 1055%
Suddath Company $1,145 1072%
Medicaid / KanCare $1,182 1107%
Peach State Health Plan $1,182 1107%
Phcs $1,364 1277%
Evolutions Healthcare $1,636 1532%
Multiplan $1,636 1532%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1250 S 18Th St, Fernandina Beach, FL 32034
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals