CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Sunrise Hospital and Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $123
  • Cash Discount Price: $416
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Sunrise Hospital and Medical Center is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $416. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.15x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.
Cash / Self-Pay
$416

Average discount available for prompt cash payment at this facility.

Insurance Median
$123

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: $416 (389%)
Insurance Median: $123 (115%)
Cash: $416 (389% of Medicare)
Ins. Median: $123 (115% 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
United $32 - $2,142 30%
Humana $33 - $328 31%
Amerigroup $39 - $202 37%
Health Plan Nevada $39 - $212 37%
Molina $41 - $222 38%
Silver Summit $41 - $222 38%
Healthcare Partners Of Nv $44 - $171 41%
Aetna $45 - $929 42%
Alignment Health Plan $45 - $127 42%
Blue Cross Blue Shield $45 - $212 42%
Caremore $47 - $134 44%
Multiplan $49 - $7,482 46%
Community Care Health $51 - $201 48%
Molina Healthcare $51 - $209 48%
Sierra Hpn $51 - $201 48%
Hometown Health Providers $52 - $231 49%
Ambetter / Centene $54 - $2,152 51%
Cigna $57 - $556 53%
Sierra $59 - $245 55%
Culinary Health Fund $61 - $454 57%
Select Health $90 - $2,362 84%
Legacy Provider Network $864 809%
Corvel $912 - $964 854%
Comp-Med Workers Comp $931 872%
Olympus Medsave Usa $960 - $7,687 899%
Prominence Healthfirst $3,075 2879%
Cmn Global $4,305 4031%
Nv Health & Welfare Trust $6,149 5757%
First Health $6,764 - $8,199 6333%
Medcare International $7,687 7197%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3186 S Maryland Pkwy, Las Vegas, NV 89109
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals