CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Perham Health

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $1,062
  • Cash Discount Price: $1,918
  • vs. Medicare Baseline: 9.94x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Perham Health is $1,062. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,918. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.94x the Medicare baseline. Located in 1000 Coney Street West, Perham, MN.
Cash / Self-Pay
$1,918

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,062

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: $1,918 (1796%)
Insurance Median: $1,062 (994%)
Cash: $1,918 (1796% of Medicare)
Ins. Median: $1,062 (994% 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 994% of the Medicare baseline (a markup of 894%). 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.

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
Medica Mn (Msho) $546 511%
Medica Mn Senior Hp/Outside Mn $546 511%
Blue Cross Blue Shield $705 - $1,003 660%
Health Partners Mcr Adv $1,003 939%
Humana $1,003 939%
Medica Mcr Adv $1,003 939%
Medicare (plans) $1,003 - $1,115 939%
Ucare Mn Senior Health Options $1,003 939%
UnitedHealthcare $1,032 - $2,301 966%
Ucare Mn Special Needs Basic Care Dual $1,053 986%
Ucare Mn Medical Assistance $1,062 994%
Ucare Mn Minnesota Care $1,062 994%
Ucare Mn Senior Care Plus $1,062 994%
Ucare Mn Special Needs Basic Care $1,062 994%
Medicaid / KanCare $1,063 995%
Medica Mcaid Mn Care $1,080 1011%
Ucare Individual And Family Plan-All Other Plans $1,221 1143%
Health Partners Minnesota Care $1,475 1381%
Medica Commercial-All Other Plans $1,900 1779%
Preferred One (Pchp, Pic, Pas)-All Other Plans $2,212 2071%
Health Partners-All Plans $2,419 2265%
Preferred One (Ppo) $2,508 2348%
Sanford Health Plan-All Plans $2,508 2348%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Coney Street West, Perham, MN 56573
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals