CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Deaconess Henderson Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $125
  • Cash Discount Price: $534
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Deaconess Henderson Hospital is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $534. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.17x the Medicare baseline. Located in 1305 N Elm St, Henderson, KY.
Cash / Self-Pay
$534

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $534 (500%)
Insurance Median: $125 (117%)
Cash: $534 (500% of Medicare)
Ins. Median: $125 (117% 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.

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 $42 - $1,726 39%
Blue Cross Blue Shield $42 - $125 39%
Humana $42 - $1,423 39%
Medicare (plans) $42 - $97 39%
Mhs Mco $42 - $97 39%
Molina Healthcare Of Ky $42 - $97 39%
Molina Healthcare Of Ky - Exchange $42 - $97 39%
Mytru Advantage $42 - $97 39%
Umwa $42 - $97 39%
UnitedHealthcare $42 - $356 39%
Wellcare Il $42 - $97 39%
Wellcare Ky $42 - $160 39%
Caresource In $44 - $77 41%
Medicaid / KanCare $44 - $356 41%
Center Care Narrow $45 - $896 42%
Center Care Open Access $45 - $596 42%
Caresource In Marketplace $55 - $145 51%
Wellcare Ky Commercial Exchange $55 - $198 51%
Alliance Coal $59 - $145 55%
Noncontracted $68 - $154 64%
Encircle/Encore Combined $70 - $1,030 66%
Encircle/Encore Prime $70 - $960 66%
Ky Racing Health & Welfare Fund $100 - $516 94%
Self-Pay $100 - $534 94%
Amish And Mennonite Of Western Ky $145 - $504 136%
First Health Network (Coventry) $154 - $1,512 144%
Healthlink $154 - $1,334 144%
Iu Health Plans $154 - $755 144%
Phcs/Multiplan $154 - $1,601 144%
Sagamore $154 - $1,566 144%
Cigna $172 - $1,139 161%
Claimdoc $172 - $1,067 161%
Hopetrust $172 - $466 161%
Hstechnology $172 - $466 161%
One Care $212 198%
Coventry National Network $230 - $1,423 215%
Webster County Detention Center $230 - $1,423 215%
Henderson County Detention Center $258 - $1,601 242%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1305 N Elm St, Henderson, KY 42420
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals