CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Ascension St Vincent Jennings

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $131
Cash Discount Price: $1,245
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Ascension St Vincent Jennings is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,245. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.23x the Medicare baseline. Located in 301 Henry St, North Vernon, IN.

Cash / Self-Pay

$1,245

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $1,245 (1166%)

Insurance Median: $131 (123%)

Cash: $1,245 (1166% of Medicare)

Ins. Median: $131 (123% 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.

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
Blue Cross Blue Shield	$36 - $1,386	34%
Medicaid / KanCare	$36 - $131	34%
Mhs Care Connect	$36 - $131	34%
UnitedHealthcare	$36 - $259	34%
Aetna	$67 - $650	63%
Ambetter / Centene	$67	63%
Ascension Complete Mcr	$67	63%
Caresource Marketplace	$67	63%
Corizon	$67	63%
Humana	$67	63%
Immergrun	$67	63%
Medicare (plans)	$67	63%
Personalized Care	$67	63%
Secure Horizons-Pacificare	$67	63%
Smarthealth Ppo	$150	140%
Smarthealth Ppo/Hdhp 20161001	$150	140%
Encore Exclusive	$168	157%
Patoka Valley Tier 1	$168	157%
Patoka Valley Tier 2	$168	157%

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 $1,245.
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 Ascension St Vincent Jennings 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.