CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Morris Hospital & Healthcare Centers

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $2,176
  • Cash Discount Price: $957
  • vs. Medicare Baseline: 20.37x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Morris Hospital & Healthcare Centers is $2,176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $957. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.37x the Medicare baseline. Located in 150 W High St, Morris, IL.
Cash / Self-Pay
$957

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,176

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: $957 (896%)
Insurance Median: $2,176 (2037%)
Cash: $957 (896% of Medicare)
Ins. Median: $2,176 (2037% 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 2037% of the Medicare baseline (a markup of 1937%). 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
Choicecare Hum Mcr Ppo $112 105%
UnitedHealthcare $112 - $3,063 105%
Aetna $114 - $2,442 107%
Health Alliance Mcr Adv $115 108%
Caterpillar - All Plans $730 683%
Blue Cross Blue Shield $1,718 - $1,909 1608%
Cigna $1,754 - $2,984 1642%
Capp Care Ppo-Oth $1,909 1787%
Ambetter / Centene $2,785 2607%
Choicecare Hum Othr - All Other Plans $3,182 2979%
Multiplan - All Other Plans $3,182 2979%
Multiplan Prime Ntwrk $3,182 2979%
Health Alliance - All Other Plans $3,381 3165%
Hfn All Plans - All Plans $3,381 3165%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 150 W High St, Morris, IL 60450
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals