CMS Price Transparency Data
CT scan, lower back (lumbar spine)
Facility: Mercy Hospital Booneville
Billing Code: 72131 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72131
- Insurance Median: $668
- Cash Discount Price: $1,451
- vs. Medicare Baseline: 6.25x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Mercy Hospital Booneville is $668. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,451. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.25x the Medicare baseline. Located in 880 West Main, Booneville, AR.
Cash / Self-Pay
$1,451
Average discount available for prompt cash payment at this facility.
Insurance Median
$668
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: $1,451 (1358%)
Insurance Median: $668 (625%)
Cash: $1,451 (1358% of Medicare)
Ins. Median: $668 (625% 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 625% of the Medicare baseline (a markup of 525%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Aetna | $95 - $1,451 | 89% |
| Humana | $95 - $657 | 89% |
| Medicaid / KanCare | $95 - $906 | 89% |
| Blue Cross Blue Shield | $108 - $657 | 101% |
| Usable Contracted [320409] | $108 | 101% |
| Summit Community Care Contracted [320368] | $215 | 201% |
| Summit Community Care [20368] | $215 | 201% |
| United Medical Resources Contracted [320454] | $252 | 236% |
| UnitedHealthcare | $252 - $657 | 236% |
| Arkansas Total Care Contracted [320039] | $488 | 457% |
| Arkansas Total Care [20039] | $488 | 457% |
| American Health Advantage Of Mo Mcr [20264] | $657 | 615% |
| Cherokee Nation Health Serv Contracted [320066] | $657 | 615% |
| Cross Timbers Hospice [20098] | $657 | 615% |
| Dept Of Veteran Affairs Contracted [320106] | $657 | 615% |
| Elara Caring Aspire Hospice Contracted [320433] | $657 | 615% |
| Elara Caring Aspire Hospice [20433] | $657 | 615% |
| Globalhealth Contracted [320145] | $657 | 615% |
| Halo Hcr Inc Hospice Contracted [320432] | $657 | 615% |
| Halo Hcr Inc Hospice [20432] | $657 | 615% |
| Independent Health [20197] | $657 | 615% |
| Indian Health Service Contracted [320198] | $657 | 615% |
| Indian Health Service [20198] | $657 | 615% |
| Jordan Valley Senior Care Pace [20515] | $657 | 615% |
| Kindful Hospice Contracted [320434] | $657 | 615% |
| Kindful Hospice [20434] | $657 | 615% |
| Medical Associates Health [20444] | $657 | 615% |
| Medicare (plans) | $657 - $690 | 615% |
| Mercy Hospice Okc [20252] | $657 | 615% |
| Pace Of The Ozarks [20518] | $657 | 615% |
| Provider Partners Health Plans Contracted [320450] | $657 | 615% |
| Qual Choice Contracted [320325] | $657 | 615% |
| Spina Bifida Hlthcare Benefit [20506] | $657 | 615% |
| Valir Pace [20503] | $657 | 615% |
| Wellfirst Health Mcr [20443] | $657 | 615% |
| Tricare | $659 | 617% |
| Cigna | $690 - $1,897 | 646% |
| Ambetter / Centene | $906 | 848% |
| Home State Health Plan Contracted [320187] | $906 | 848% |
| Novasys Contracted [320285] | $906 | 848% |
| Qual Choice Contracted [320324] | $921 | 862% |
| Mercy Interfacility [20513] | $1,089 | 1020% |
| Auxiant Contracted [320462] | $1,339 - $1,897 | 1254% |
| Mercy Benefit Admin Contracted [320251] | $1,339 - $1,897 | 1254% |
| Workers Comp [20426] | $1,451 | 1358% |
| Multiplan Contracted [320270] | $1,786 | 1672% |
| Private Health Care Systems Contracted [320320] | $1,786 | 1672% |
| 90 Degree Benefits Contracted [320436] | $1,897 | 1776% |
| Aither Health Contracted [320449] | $1,897 | 1776% |
| Ebms Contracted [320493] | $1,897 | 1776% |
| Edison Health Solutions Contracted [320502] | $1,897 | 1776% |
| Federal Medical Center Contracted [320127] | $1,897 | 1776% |
| Healthlink Contracted [320179] | $1,897 | 1776% |
| Healthscope Contracted [320182] | $1,897 | 1776% |
| Imagine 360 Contracted [320494] | $1,897 | 1776% |
| Insurance System Inc Contracted [320465] | $1,897 | 1776% |
| Personify Health Contracted [320051] | $1,897 | 1776% |
| Point C Contracted [320238] | $1,897 | 1776% |
| Ppo Plus Contracted [320310] | $1,897 | 1776% |
| Preferred Health Plan Contracted [320522] | $1,897 | 1776% |
| Reflect Health Contracted [320492] | $1,897 | 1776% |
| Show-Me Health Administrators Contracted [320483] | $1,897 | 1776% |
| Tri State Healthcare Coalition Contracted [320379] | $1,897 | 1776% |
| Municipal Health Plan Contracted [320271] | $2,009 | 1881% |