CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: HCA Florida Mercy Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $3,015
Cash Discount Price: $12,133
vs. Medicare Baseline: 28.23x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at HCA Florida Mercy Hospital is $3,015. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,133. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 28.23x the Medicare baseline. Located in 401 Nw 42Nd Ave, Plantation, FL.

Cash / Self-Pay

$12,133

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,015

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: $12,133 (11359%)

Insurance Median: $3,015 (2823%)

Cash: $12,133 (11359% of Medicare)

Ins. Median: $3,015 (2823% 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 2823% of the Medicare baseline (a markup of 2723%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
United	$245 - $5,460	229%
Aetna	$809 - $3,640	757%
Avmed	$845 - $6,066	791%
Freedom Health	$1,043 - $1,941	977%
Optimum	$1,043	977%
Simply Healthcare Plans	$1,577	1476%
Molina	$2,305 - $3,276	2158%
Corvel Corporation	$2,519	2358%
Careworks (Rockport)	$2,572	2408%
Prime Health	$2,572	2408%
Health Sun Health Plan	$2,584	2419%
Aids Healthcare	$2,669 - $14,560	2499%
Mmm Of Fl (Health Advantage Plan)	$2,791	2613%
United Ppo	$2,876	2693%
Sunshine State Health Plan	$3,155	2954%
Plotkin Health	$6,066	5679%
Prime Health Sherriff	$6,066	5679%
Medica Healthcare	$7,158	6702%
Multiplan	$9,100 - $10,313	8520%
Evernorth Bh	$9,706	9087%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $12,133.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72131.

Insurance In-Network Protection Plan

Contact your insurance company to confirm HCA Florida Mercy Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72131.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.