CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: St Lukes Regional Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $121
  • Cash Discount Price: $371
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at St Lukes Regional Medical Center is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $371. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.13x the Medicare baseline. Located in 2720 Stone Park Boulevard, Sioux City, IA.
Cash / Self-Pay
$371

Average discount available for prompt cash payment at this facility.

Insurance Median
$121

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: $371 (347%)
Insurance Median: $121 (113%)
Cash: $371 (347% of Medicare)
Ins. Median: $121 (113% 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
Nebraska Total Care $42 - $223 39%
Aetna $44 - $495 41%
Blue Cross Blue Shield $44 - $298 41%
Molina $44 - $121 41%
Amerivantage $46 - $124 43%
Humana $46 - $124 43%
UnitedHealthcare $46 - $284 43%
Avera Health Plan $65 - $557 61%
Wellmark Uph Self-Funded $90 - $253 84%
Cigna $92 - $539 86%
Amerigroup $94 88%
Iowa Total Care $94 88%
Health Partners Open Network $100 - $351 94%
Medica Exchange Inspire $442 414%
Medica Exchange Insure $495 463%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2720 Stone Park Boulevard, Sioux City, IA 51104
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals