CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Hospital San Francisco

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $123
  • Cash Discount Price: $163
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Hospital San Francisco is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.15x the Medicare baseline. Located in 371 De Diego Ave, San Juan, PR.
Cash / Self-Pay
$163

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: $163 (153%)
Insurance Median: $123 (115%)
Cash: $163 (153% 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
First Medical $44 - $154 41%
Mso $56 - $79 52%
Triple S $60 - $288 56%
Aarp $66 62%
Humana $79 - $123 74%
Medicare (plans) $79 74%
Tricare $79 74%
Mcs $86 - $160 81%
Pr Other Insurances $87 81%
Fondo Del Seguro Estado $92 86%
Ch $107 100%
Mpc - Us $107 100%
UnitedHealthcare $107 100%
Us $107 100%
Plan De Salud Menonita $117 - $150 110%
Mapfre $150 140%
Mc $150 140%
Comerciales $153 143%
Privado $162 152%
Western Medical Hospice $162 152%
Acaa $199 186%
Cigna $275 257%
Medicaid / KanCare $275 257%
Prossam $275 257%
Bl $288 270%
Corvel Network $300 281%
Mpc-Pr Other Insurances $300 281%
Va $325 304%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 371 De Diego Ave, San Juan, PR 00923
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals