CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Atlanticare Regional Medical Center - City Campus

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $2,540
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 23.78x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Atlanticare Regional Medical Center - City Campus is $2,540. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 23.78x the Medicare baseline. Located in 1925 Pacific Avenue, Atlantic City, NJ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,540

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%)
Insurance Median: $2,540 (2378%)
Ins. Median: $2,540 (2378% 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 2378% of the Medicare baseline (a markup of 2278%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Tricare $106 99%
Devoted Health Plan $121 113%
Oxford $174 163%
Global Exchange Managed Care $176 165%
Health Partners Plan $235 220%
Americhoice $438 410%
UnitedHealthcare $438 - $2,408 410%
Wellcare $468 438%
Horizon $471 - $2,374 441%
Self Pay $509 477%
Magnacare $1,356 - $3,052 1270%
Cigna $1,423 - $1,709 1332%
Evernorth $1,696 1588%
Qualcare Commercial $1,696 1588%
Great West Life $1,709 1600%
Aetna $1,950 - $2,801 1826%
Amerihealth $2,180 - $2,850 2041%
Active Care Plus $2,204 2063%
First Mco $2,204 2063%
Mutual Of Omaha $2,204 2063%
Qualcare Wc $2,204 2063%
Consumer Health Network (Chn) $2,374 - $3,052 2223%
Donio Trucking $2,374 2223%
Devon/ Ullicare $2,543 2381%
Coventry Health Care $2,713 2540%
Private Healthcare System (Phcs) $2,713 2540%
Blue Cross Blue Shield $2,790 2612%
Health Payors Org $2,882 2698%
Health South $2,882 2698%
Metrahealth Of Nj $2,882 2698%
Prime Health Services $2,882 2698%
Three Rivers Provider Network (Trpn) $2,882 2698%
Active Care Nj Pip $3,052 2857%
Beech Street $3,052 2857%
Choice Care $3,052 2857%
Department Of Corrections $3,052 2857%
Galaxy Health Network $3,052 2857%
Health Network Inc $3,052 2857%
Intergroup Preferred Program $3,052 2857%
Mcs Commercial $3,052 2857%
Metracomp $3,052 2857%
Multiplan $3,052 2857%
Provider Select, Inc $3,052 2857%
Atlantis Health Plan $3,137 2937%
Master Care Inc $3,137 2937%
Advance Healthcare System $3,221 3016%
Community Care Network $3,221 3016%
Health Network America $3,221 3016%
Mcsi/Mrsi No Fault $3,221 3016%
Mcsi/Mrsi Worker'S Comp $3,221 3016%
National Health Plan $3,221 3016%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1925 Pacific Avenue, Atlantic City, NJ 08401
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals