CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Veterans Memorial Hospital

Billing Code: 72131 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$121

about 1.1× the $107 Medicare rate · typically $66–$1,160

modeled estimate · not a bill or quote

What this hospital charges insurers

$55

Below the fair price — a good deal

about $66 under the fair price · 0.5× Medicare

Medicare pays $107 Fair price $121 This hospital $55 Cash price $786 Hospital's list price $1,380

How we calculate the fair BaseRate →

How this hospital compares to other IA hospitals

One of the lower prices — 7 of 8 other IA hospitals charge more for the same procedure.

Cheapest $44 Priciest $102

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 $121 (about 1.1× the $107 Medicare rate). Veterans Memorial Hospital charges insurers about $55, or about $786 in cash — below the fair price — a good deal. Located in Waukon, IA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

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	$913 - $1,805	855%
Blue Cross Blue Shieldmajor	$126	118%
Aetnamajor	$44 - $1,418	41%
Humanamajor	$38 - $1,592	36%
Amerigroup	$44 - $913	41%
Medica	$913 - $918	855%
Molina	$44 - $1,083	41%
Quartz	$44 - $1,592	41%
+ 4 smaller / regional plans	$44 - $1,083

Excludes 1 rental-network / third-party entry (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 786), 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 Veterans Memorial Hospital 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 Veterans Memorial Hospital

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

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