CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: HCA Florida Memorial Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $3,226
  • Cash Discount Price: $14,662
  • vs. Medicare Baseline: 30.20x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at HCA Florida Memorial Hospital is $3,226. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,662. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 30.20x the Medicare baseline. Located in 3625 University Blvd S, Jacksonville, FL.
Cash / Self-Pay
$14,662

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,226

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: $14,662 (13727%)
Insurance Median: $3,226 (3020%)
Cash: $14,662 (13727% of Medicare)
Ins. Median: $3,226 (3020% 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 3020% of the Medicare baseline (a markup of 2920%). 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
United $245 - $6,598 229%
Aetna $716 - $4,399 670%
Avmed $825 - $1,863 772%
Optimum Healthcare $1,232 1153%
Simply Healthcare $2,258 2114%
City Of Jacksonville $2,310 2163%
Corvel Corporation $2,310 2163%
Prime Health $2,359 2209%
Positive Healthcare $3,226 3020%
Sunshine State Health Plan $3,739 3501%
Molina Healthcare $3,959 3707%
Plotkin Health $7,331 6864%
Multiplan $11,436 - $12,463 10707%
Evernorth $11,730 10982%
Evolutions Healthcare $11,730 - $12,463 10982%
Ppo Next $12,463 11668%
Novanet $13,196 12355%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3625 University Blvd S, Jacksonville, FL 32216
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals