CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Mahaska Health Partnership

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $346
Cash Discount Price: $842
vs. Medicare Baseline: 3.24x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Mahaska Health Partnership is $346. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $842. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.24x the Medicare baseline. Located in 1229 C Avenue East, Oskaloosa, IA.

Cash / Self-Pay

$842

Average discount available for prompt cash payment at this facility.

Insurance Median

$346

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: $842 (788%)

Insurance Median: $346 (324%)

Cash: $842 (788% of Medicare)

Ins. Median: $346 (324% 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 324% of the Medicare baseline (a markup of 224%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$44 - $1,794	41%
Amerigroup Mcr Adv	$44 - $1,018	41%
Humana	$44 - $1,018	41%
UnitedHealthcare	$44 - $1,193	41%
Iowa Total Care Mcr	$46 - $1,018	43%
Iowa Total Care Comm - All Other Plans	$51 - $1,018	48%
Midlands Choice - All Plans	$101 - $1,794	95%
Medicaid / KanCare	$132 - $758	124%
Molina Mcaid - All Plans	$132 - $758	124%
Wellmark Hmo	$329	308%
Wellmark Ppo - All Other Plans	$362	339%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $842.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72131.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mahaska Health Partnership is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72131.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.