CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: HCA Florida Gulf Coast Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $6,207
  • Cash Discount Price: $13,793
  • vs. Medicare Baseline: 58.11x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at HCA Florida Gulf Coast Hospital is $6,207. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,793. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 58.11x the Medicare baseline. Located in 449 W 23Rd St, Panama City, FL.
Cash / Self-Pay
$13,793

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,207

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: $13,793 (12914%)
Insurance Median: $6,207 (5811%)
Cash: $13,793 (12914% of Medicare)
Ins. Median: $6,207 (5811% 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 5811% of the Medicare baseline (a markup of 5711%). 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 - $6,240 229%
Aetna $1,258 - $4,160 1178%
Avmed $1,695 - $6,933 1587%
Simply $2,123 - $2,135 1988%
Corvel Corporation $2,152 2015%
Prime Health $2,198 2058%
Careworks (Rockport Community) $2,265 2121%
Molina Healthcare $2,620 - $4,437 2453%
Sunshine State Health Plan $3,516 - $3,536 3292%
Plotkin Health $6,894 - $6,933 6454%
Prime Health Sheriff $6,894 - $6,933 6454%
Multiplan $10,755 - $11,786 10069%
Ppo Next $11,720 - $11,786 10973%
Novanet $12,410 - $12,479 11619%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 449 W 23Rd St, Panama City, FL 32405
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals