CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: HCA Florida Palms West Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $2,464
Cash Discount Price: $12,906
vs. Medicare Baseline: 23.07x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at HCA Florida Palms West Hospital is $2,464. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,906. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 23.07x the Medicare baseline. Located in 13001 Southern Blvd, Loxahatchee, FL.

Cash / Self-Pay

$12,906

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,464

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: $12,906 (12083%)

Insurance Median: $2,464 (2307%)

Cash: $12,906 (12083% of Medicare)

Ins. Median: $2,464 (2307% 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 2307% of the Medicare baseline (a markup of 2207%). 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 - $5,808	229%
Healthy Palm Beaches	$550	515%
Aetna	$868 - $3,872	813%
Avmed	$890 - $6,453	833%
Freedom Health	$1,110 - $2,065	1039%
Optimum	$1,110	1039%
Simply Healthcare Plans	$1,678	1571%
Corvel Corporation	$2,426	2271%
Molina	$2,452 - $3,485	2296%
Careworks (Rockport)	$2,477	2319%
Prime Health	$2,477	2319%
Health Sun Health Plan	$2,749	2574%
Aids Healthcare	$2,839 - $15,487	2658%
Mmm Of Fl (Health Advantage Plan)	$2,968	2779%
United Ppo	$3,059	2864%
Sunshine State Health Plan	$3,356	3142%
Health Care District	$6,453	6042%
Palm Beach Juvenile Correction	$6,453	6042%
Plotkin Health	$6,453	6042%
Prime Health Sherriff	$6,453	6042%
Medica Healthcare	$7,485	7008%
Multiplan	$9,680 - $10,970	9063%

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 $12,906.
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 Palms West 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.