CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Ochsner St Anne General Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $281
  • Cash Discount Price: $399
  • vs. Medicare Baseline: 2.63x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Ochsner St Anne General Hospital is $281. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $399. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.63x the Medicare baseline. Located in 4608 Highway 1, Raceland, LA.
Cash / Self-Pay
$399

Average discount available for prompt cash payment at this facility.

Insurance Median
$281

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: $399 (374%)
Insurance Median: $281 (263%)
Cash: $399 (374% of Medicare)
Ins. Median: $281 (263% 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 263% of the Medicare baseline (a markup of 163%). 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
Medicaid / KanCare $81 76%
UnitedHealthcare $245 - $281 229%
Tricare $252 - $280 236%
Humana $270 - $281 253%
Healthy Blue (Healthy Louisiana) $275 257%
Louisiana Healthcare Connections (Healthy Louisiana) $275 257%
Aetna $278 - $1,297 260%
Amerihealth Caritas Louisiana (Healthy Louisiana) $278 260%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan) $281 263%
Blue Cross Blue Shield $281 - $700 263%
Healthy Blue Dual Advantage (Hmo-D-Snp) $281 263%
Medicare (plans) $281 263%
Ochsner Health Plan $281 263%
Healthcomp & Personify Health (Formerly Gilsbar) $680 637%
Louisiana Workers' Compensation Corporation (Lwcc) $680 637%
Mississippi Physicians Care Network $680 637%
Employers Health Network (Ehn) $770 721%
First Health Network $770 721%
Prime Health Services Ppo $770 721%
Claritev D/B/A Multiplan/Phcs/American Life Care $815 763%
Usa Managed Care Network $815 763%
Zelis $815 763%
Cigna $867 812%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4608 Highway 1, Raceland, LA 70394
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals