CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Larkin Community Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $107
  • Cash Discount Price: $375
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Larkin Community Hospital is $107. 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 1.00x the Medicare baseline. Located in 7031 Sw 62Nd Ave, South Miami, FL.
Cash / Self-Pay
$375

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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: $107 (100%)
Cash: $375 (351% of Medicare)
Ins. Median: $107 (100% 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) $33 - $4,391 31%
Jipa Network-All Plans $46 - $348 43%
Medicaid / KanCare $47 - $536 44%
Aetna $48 - $4,182 45%
Fci-All Plans $48 - $123 45%
Global Excel-All Plans $48 - $2,509 45%
Clear Springs Hlth-All Plans $50 - $112 47%
Fdc-All Plans $55 51%
UnitedHealthcare $59 - $144 55%
Corvel Mcaid Workers Comp $61 57%
Sunshine Behavioral $61 57%
Ambetter / Centene $67 63%
Community Care Phks Mcaid-All Other Plans $67 63%
Florida Comm Care Mcaid $67 63%
Humana $67 - $4,182 63%
Magellan Complete Care $67 63%
Molina Exch Marketplace-All Other Plans $67 63%
Avmed-All Plans $71 - $4,182 66%
Bright Health-All Other Plans $71 - $5,018 66%
Coventry Comml-All Plans $71 - $4,182 66%
Blue Cross Blue Shield $101 - $1,722 95%
Florida Comm Care Mcare-All Other Plans $107 100%
Ops Maritime-All Plans $107 100%
Opus Hospice Ip Only-All Plans $107 100%
Preferred Care Partners Mcare-All Plans $107 100%
Unicare Simply Mcare Ppo-All Plans $112 105%
Wellpath-All Plans $117 110%
Allianz (Azga)-All Plans $139 130%
Healthsun-All Plans $350 328%
Jmh Health Plan Hmo/Ppo-All Other Plans $450 421%
Cigna $500 468%
Florida Health Solution/Hmo-All Plans $500 468%
Star Network-All Plans $1,673 1566%
Haa Preferred Partners-All Plans $2,509 2349%
Corvel Mcare Workers Comp-All Plans $3,764 3524%
Careplus Health-All Other Plans $4,182 3915%
Centurion-All Plans $4,182 3915%
Doctors Healthcare-All Plans $4,182 3915%
First Med Hp Of Fl-All Plans $4,182 3915%
Oscar Health-All Plans $8,364 7831%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7031 Sw 62Nd Ave, South Miami, FL 33143
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals