CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Mercyone North Iowa Medical Center

Billing Code: 72131 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$109

about 1.0× the $107 Medicare rate · typically $107–$174

modeled estimate · not a bill or quote

What this hospital charges insurers

$107

About the fair price

about $2 under the fair price · 1.0× Medicare

Medicare pays $107 Fair price $109 This hospital $107 Cash price $1,571 Hospital's list price $2,417

How we calculate the fair BaseRate →

How this hospital compares to other IA hospitals

Highest price of the 9 IA hospitals we have prices for — worth calling around.

Cheapest $44 Priciest $107

Black dot = this hospital, among the 9 IA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, lower back (lumbar spine) is about $109 (about 1.0× the $107 Medicare rate). Mercyone North Iowa Medical Center charges insurers about $107, or about $1,571 in cash — about the fair price. Located in Mason City, IA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Kaiser Permanente Humana

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$113 - $2,417	106%
Blue Cross Blue Shieldmajor	$107 - $112	100%
Aetnamajor	$110 - $1,269	103%
Cignamajor	$1,692	1584%
Kaiser Permanentemajor	$107	100%
Ambetter (Centene)	$189	177%
GEHA	$240	225%
HealthPartners	$1,617	1514%
Medica	$1,692	1584%
Medical Mutual	$1,269	1188%
Oscar Health	$149	140%
+ 25 smaller / regional plans	$101 - $2,417

Government programs also on file: Medicare, Medicaid.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,571), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72131.

Insurance Before you use insurance

Call your insurance company to confirm Mercyone North Iowa Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 72131.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Mercyone North Iowa Medical Center

Compare: CT scan, lower back (lumbar spine) at other IA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.