CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Incline Village Community Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $283
Cash Discount Price: $1,338
vs. Medicare Baseline: 2.65x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Incline Village Community Hospital is $283. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,338. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.65x the Medicare baseline. Located in 880 Alder Street, Incline Village, NV.

Cash / Self-Pay

$1,338

Average discount available for prompt cash payment at this facility.

Insurance Median

$283

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: $1,338 (1253%)

Insurance Median: $283 (265%)

Cash: $1,338 (1253% of Medicare)

Ins. Median: $283 (265% 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 265% of the Medicare baseline (a markup of 165%). 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
UnitedHealthcare	$42 - $2,142	39%
Medicare (plans)	$46 - $928	43%
Healthnet - All Plans	$62 - $2,261	58%
Blue Cross Blue Shield	$164 - $2,142	154%
Ca Hlth And Wellness - All Plans	$206 - $2,428	193%
Aetna	$260 - $2,094	243%
Prominence Healthfirst - All Plans	$260 - $2,094	243%
Admar Multiplan - All Plans	$266 - $2,142	249%
First Health - All Plans	$266 - $2,142	249%
Great West/One Health - All Plans	$266 - $2,142	249%
Hometown Hp - All Plans	$266 - $2,142	249%
Humana	$266 - $2,142	249%
Interplan - All Plans	$266 - $2,142	249%
Multiplan - All Plans	$266 - $2,142	249%
Phcs - All Plans	$266 - $2,142	249%
Cigna	$271 - $2,190	254%
Beech Street/Capp Care - All Plans	$280 - $2,261	262%
Uhn - All Plans	$280 - $2,261	262%
Sierra Health - All Plans	$286 - $2,309	268%

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 $1,338.
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 Incline Village Community 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.