CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Barnes Jewish Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $982
  • Cash Discount Price: $793
  • vs. Medicare Baseline: 9.19x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Barnes Jewish Hospital is $982. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $793. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.19x the Medicare baseline. Located in One Barnes-Jewish Hospital Plaza, Saint Louis, MO.
Cash / Self-Pay
$793

Average discount available for prompt cash payment at this facility.

Insurance Median
$982

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: $793 (742%)
Insurance Median: $982 (919%)
Cash: $793 (742% of Medicare)
Ins. Median: $982 (919% 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 919% of the Medicare baseline (a markup of 819%). 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
Aetna $105 - $992 98%
Blue Cross Blue Shield $105 - $1,150 98%
Essence Healthcare [221] $105 98%
Humana $105 - $1,817 98%
UnitedHealthcare $105 - $1,210 98%
Cox Health [757] $110 103%
Devoted Health Plan [847] $110 103%
Medica [662] $110 103%
Healthlink [225] $641 - $998 600%
Cox Health Systems Insurance Company [220] $727 - $859 681%
Allied Benefits [498] $766 - $982 717%
Coresource [497] $766 717%
Fmh Benefit Service Inc [222] $766 717%
Mail Handlers [495] $766 717%
Hope Trust [806] $767 718%
Healthscope Benefits [258] $806 - $1,210 755%
Med-Pay [480] $859 - $992 804%
Unicare [568] $859 - $998 804%
Cigna $872 - $1,405 816%
Consociate [478] $970 908%
Sarah Bush Lincoln [636] $970 908%
First Health Commercial [734] $982 919%
Beechstreet [551] $992 929%
Detego Health [868] $992 929%
Health Systems Inc [620] $992 929%
Healthcare Sol Mercy [609] $992 929%
Multiplan Commercial [737] $992 929%
Multiplan [240] $992 929%
Phcs [244] $992 - $1,058 929%
Preferred Health Professionals [561] $998 934%
Medica [661] $1,058 991%
Hfn [563] $1,124 1052%
Apwu Health Plan [216] $1,378 1290%
Nalc Health Benefit Plan [242] $1,378 1290%
Priority Health [648] $1,378 1290%
Health Alliance [224] $1,500 1404%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Barnes-Jewish Hospital Plaza, Saint Louis, MO 63110
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals