CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Northern Nevada Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $1,660
Cash Discount Price: $3,516
vs. Medicare Baseline: 15.54x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Northern Nevada Medical Center is $1,660. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,516. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.54x the Medicare baseline. Located in 2375 E Prater Way, Sparks, NV.

Cash / Self-Pay

$3,516

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,660

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: $3,516 (3292%)

Insurance Median: $1,660 (1554%)

Cash: $3,516 (3292% of Medicare)

Ins. Median: $1,660 (1554% 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 1554% of the Medicare baseline (a markup of 1454%). 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
Blue Cross Blue Shield	$202	189%
Smart_Choice	$202	189%
Silver_Summit	$206	193%
Molina	$208	195%
United_Healthcare	$252	236%
Humana	$810 - $858	758%
Prominence	$1,264 - $2,323	1183%
Sierra_Health_Options	$1,313 - $2,414	1229%
Cigna	$1,332 - $3,530	1247%
Aetna	$1,404 - $3,086	1314%
Nevada_Preferred_Providers	$1,641 - $3,018	1536%
Business_Coalition	$3,623 - $6,662	3392%
Multiplan	$4,460 - $8,199	4176%

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 $3,516.
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 Northern Nevada Medical Center 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.