CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Mosaic Life Care at St Joseph

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $974
Cash Discount Price: $1,020
vs. Medicare Baseline: 9.12x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Mosaic Life Care at St Joseph is $974. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,020. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.12x the Medicare baseline. Located in 5325 Faraon Street, Saint Joseph, MO.

Cash / Self-Pay

$1,020

Average discount available for prompt cash payment at this facility.

Insurance Median

$974

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: $1,020 (955%)

Insurance Median: $974 (912%)

Cash: $1,020 (955% of Medicare)

Ins. Median: $974 (912% 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 912% of the Medicare baseline (a markup of 812%). 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
Aetna	$39 - $2,068	37%
Medicaid / KanCare	$39 - $107	37%
UnitedHealthcare	$39 - $3,525	37%
Blue Cross Blue Shield	$50 - $2,170	47%
Amerigroup Of Iowa	$56 - $257	52%
Iowa Total Care	$56 - $257	52%
Molina Of Iowa	$56 - $257	52%
Multiplan	$196 - $2,250	184%
Ambetter / Centene	$204 - $217	191%
Centurion	$480 - $1,750	449%
Geha Shared Services	$974 - $2,030	912%
Freedom Select Healthlink	$1,030 - $2,146	964%
Healthlink Open Access	$1,030 - $2,146	964%
Preferred Health Professional	$1,030 - $2,146	964%
Sisco	$1,030 - $2,146	964%
Cigna	$1,056 - $2,200	989%
Home State Of Missouri	$1,740 - $3,625	1629%
Healthy Blue Of Missouri	$2,136 - $4,450	2000%

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 $1,020.
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 Mosaic Life Care at St Joseph 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.