CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Sarah Bush Lincoln Health Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $218
  • Cash Discount Price: $1,972
  • vs. Medicare Baseline: 2.04x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Sarah Bush Lincoln Health Center is $218. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,972. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.04x the Medicare baseline. Located in 1000 Health Center Drive P O Box 372, Mattoon, IL.
Cash / Self-Pay
$1,972

Average discount available for prompt cash payment at this facility.

Insurance Median
$218

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: $1,972 (1846%)
Insurance Median: $218 (204%)
Cash: $1,972 (1846% of Medicare)
Ins. Median: $218 (204% 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 204% of the Medicare baseline (a markup of 104%). 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.

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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 $47 - $3,308 44%
Bc Comm Mmai $47 - $120 44%
Beacon Health Options Behav-All Plans $47 - $120 44%
Hlth Alliance Mcr Adv $47 - $120 44%
Humana $47 - $122 44%
Meridian Mcaid $47 - $134 44%
Meridian Mmai-All Other Plans $47 - $120 44%
Molina Mmai-All Other Plans $47 - $120 44%
Tricare $47 - $120 44%
UnitedHealthcare $47 - $3,050 44%
Va Ccn-All Plans $47 - $120 44%
Wellcare Med Adv-All Plans $47 - $120 44%
Bc Med Adv Ppo/Hmo $48 - $124 45%
Blue Cross Blue Shield $60 - $2,940 56%
First Health-All Plans $69 - $3,124 65%
Multiplan-All Plans $86 - $3,160 81%
Plain Church Mg-All Plans $108 - $1,470 101%
Mennonite-All Plans $121 - $1,654 113%
Bc Comm Care Mcaid $134 - $319 125%
Hlth Alliance Mcaid $134 - $319 125%
Molina Mcaid $134 - $319 125%
Eiu Athlete-All Other Plans $188 - $2,572 176%
Healthscope-All Plans $199 - $2,720 186%
Rural King-All Plans $199 - $2,720 186%
Hope Trust-All Plans $215 - $2,940 201%
Eiu Student $221 - $3,014 207%
Allied National-All Plans $226 - $3,087 212%
Companion Life-All Plans $226 - $3,087 212%
Innovative Hlthware-All Plans $229 - $3,124 214%
Healthlink Hmo $231 - $3,160 216%
Healthlink Ppo - All Other Plans $231 - $3,160 216%
Cigna $242 - $3,308 227%
Consociate-All Plans $242 - $2,940 227%
Cphp-All Plans $242 - $3,308 227%
Beech Street-All Plans $247 - $3,381 231%
Hfn-All Plans $247 - $3,381 231%
Hlth Alliance-All Other Plans $3,087 2890%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Health Center Drive P O Box 372, Mattoon, IL 61938
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals