CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Stevens Community Medical Center Inc

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $749
Cash Discount Price: $863
vs. Medicare Baseline: 7.01x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Stevens Community Medical Center Inc is $749. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $863. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.01x the Medicare baseline. Located in 400 East First Street, Morris, MN.

Cash / Self-Pay

$863

Average discount available for prompt cash payment at this facility.

Insurance Median

$749

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: $863 (808%)

Insurance Median: $749 (701%)

Cash: $863 (808% of Medicare)

Ins. Median: $749 (701% 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 701% of the Medicare baseline (a markup of 601%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$45 - $757	42%
Triwest - All Plans	$45 - $749	42%
Medica Mcr Adv Mayo	$52 - $757	49%
UnitedHealthcare	$54 - $1,546	51%
Medica Mcaid Mn Care	$131 - $849	123%
Medica Ifb	$205 - $1,329	192%
Medica Comm - All Other Plans	$243 - $1,570	228%
Blue Cross Blue Shield	$539 - $1,236	505%

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 $863.
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 Stevens Community Medical Center Inc 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.