CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Mercyone Centerville Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $2,187
  • Cash Discount Price: $2,334
  • vs. Medicare Baseline: 20.48x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Mercyone Centerville Medical Center is $2,187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,334. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.48x the Medicare baseline. Located in One St Joseph's Drive, Centerville, IA.
Cash / Self-Pay
$2,334

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,187

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: $2,334 (2185%)
Insurance Median: $2,187 (2048%)
Cash: $2,334 (2185% of Medicare)
Ins. Median: $2,187 (2048% 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 2048% of the Medicare baseline (a markup of 1948%). 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
Medicare (plans) $640 - $703 599%
Iowa Total Care $643 602%
Medicaid / KanCare $652 - $655 610%
Blue Cross Blue Shield $670 627%
Aetna $677 - $2,187 634%
UnitedHealthcare $717 - $2,334 671%
Amish Hospital Aid $900 843%
Ambetter / Centene $1,137 1065%
Claimdoc $1,360 1273%
Nova $1,360 1273%
Geha $1,680 1573%
Health Choices $1,783 1669%
Medical Associates $1,783 1669%
1199 National Benefit Fund $2,187 2048%
Allied Benefit Systems $2,187 2048%
Asr Health Benefits $2,187 2048%
Christian Brother Services $2,187 2048%
Coventry $2,187 2048%
First Health $2,187 2048%
Lucent Health $2,187 2048%
Luminare Health $2,187 2048%
Medical Mutual $2,187 2048%
Meritain $2,187 2048%
Trustmark Small Business Benefits $2,187 2048%
Webtpa $2,187 2048%
Health Partners $2,245 2102%
Auxiant $2,287 2141%
Cigna $2,287 2141%
Medica $2,287 2141%
Midlands $2,287 2141%
Midlands Choice $2,287 2141%
Crime Victim Assistance $2,334 2185%
Iowa Dept Of Public Health $2,334 2185%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Joseph's Drive, Centerville, IA 52544
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals