CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Mercyone Dyersville Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $1,930
  • Cash Discount Price: $1,517
  • vs. Medicare Baseline: 18.07x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Mercyone Dyersville Medical Center is $1,930. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,517. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 18.07x the Medicare baseline. Located in 1111 3Rd Street Sw, Dyersville, IA.
Cash / Self-Pay
$1,517

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,930

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: $1,517 (1420%)
Insurance Median: $1,930 (1807%)
Cash: $1,517 (1420% of Medicare)
Ins. Median: $1,930 (1807% 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 1807% of the Medicare baseline (a markup of 1707%). 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
Health Choices $882 826%
Blue Cross Blue Shield $1,294 1211%
Medicare (plans) $1,320 - $1,441 1236%
UnitedHealthcare $1,385 - $1,634 1297%
The Alliance $1,420 1329%
Iowa Total Care $1,619 1516%
Geha $1,634 1530%
Medicaid / KanCare $1,643 - $1,651 1538%
Amish Hospital Aid $1,738 1627%
1199 National Benefit Fund $1,930 1807%
Aetna $1,930 1807%
Allied Benefit Systems $1,930 1807%
Asr Health Benefits $1,930 1807%
Christian Brother Services $1,930 1807%
Coventry $1,930 1807%
First Health $1,930 1807%
Luminare Health $1,930 1807%
Medical Mutual $1,930 1807%
Meritain $1,930 1807%
Trustmark Small Business Benefits $1,930 1807%
Webtpa $1,930 1807%
Auxiant $2,101 1967%
Cigna $2,101 1967%
Medica $2,101 1967%
Midlands $2,101 1967%
Midlands Choice $2,101 1967%
Multiplan $2,101 1967%
Ambetter / Centene $2,196 2056%
Crime Victim Assistance $2,334 2185%
Iowa Dept Of Public Health $2,334 2185%
Claimdoc $2,627 2460%
Nova $2,627 2460%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 3Rd Street Sw, Dyersville, IA 52040
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals