CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Maimonides Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $50
  • Cash Discount Price: $375
  • vs. Medicare Baseline: 0.47x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Maimonides Medical Center is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $375. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.47x the Medicare baseline. Located in 4802 Tenth Avenue, Brooklyn, NY.
Cash / Self-Pay
$375

Average discount available for prompt cash payment at this facility.

Insurance Median
$50

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: $375 (351%)
Insurance Median: $50 (47%)
Cash: $375 (351% of Medicare)
Ins. Median: $50 (47% 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 Community Plan $23 - $144 22%
UnitedHealthcare $23 - $172 22%
Aetna $24 - $130 22%
Blue Cross Blue Shield $27 - $551 25%
Emblem Health - Hip $28 - $130 26%
Healthfirst $29 - $128 27%
Fidelis $30 - $63 28%
Molina $31 - $94 29%
Metroplus $39 - $157 37%
Villagecare Maxx Fida $39 - $102 37%
Wellcare $40 - $52 37%
Visiting Nurse Svc Of Ny $41 - $48 38%
Emblem Health - Hip Vip $47 - $50 44%
Elderplan $48 - $53 45%
Centers Plan For Healthy Living $51 48%
Emblem Health - Ghi $51 - $397 48%
Hamaspik $53 50%
Magnacare $66 62%
Oxford Health Plan $66 - $172 62%
Cigna $70 - $218 66%
Oxford Liberty $71 - $172 66%
Local 1199 $73 - $302 68%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4802 Tenth Avenue, Brooklyn, NY 11219
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals