CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Presence Mercy Medical Center

Billing Code: 72131 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$126

about 1.2× the $107 Medicare rate · typically $116–$260

modeled estimate · not a bill or quote

What this hospital charges insurers

$118

About the fair price

about $8 under the fair price · 1.1× Medicare

Medicare pays $107 Fair price $126 This hospital $118 Cash price $111 Hospital's list price $3,074

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

Highest price of the 9 IL hospitals we have prices for — worth calling around.

Cheapest $75 Priciest $118

Black dot = this hospital, among the 9 IL hospitals with a price for this procedure. Full list below.

A fair price for a CT scan, lower back (lumbar spine) is about $126 (about 1.2× the $107 Medicare rate). Presence Mercy Medical Center charges insurers about $118, or about $111 in cash — about the fair price. Located in Aurora, IL.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$111 - $246	104%
Blue Cross Blue Shieldmajor	$106 - $156	99%
Aetnamajor	$111 - $1,576	104%
Cignamajor	$111 - $800	104%
Humanamajor	$111 - $134	104%
Ambetter (Centene)	$181	169%
Devoted Health	$111	104%
Health Net	$134	125%
HealthPartners	$111 - $128	104%
Meridian	$117 - $141	110%
Molina	$115 - $167	108%
WellCare	$111	104%
+ 12 smaller / regional plans	$86 - $1,460

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 4 rental-network / third-party entries (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 111), 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 Presence Mercy Medical Center 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 Presence Mercy Medical Center

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

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