CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Poplar Bluff Regional Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $215
  • Cash Discount Price: $305
  • vs. Medicare Baseline: 2.01x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Poplar Bluff Regional Medical Center is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $305. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.01x the Medicare baseline. Located in 3100 Oak Grove Road, Poplar Bluff, MO.
Cash / Self-Pay
$305

Average discount available for prompt cash payment at this facility.

Insurance Median
$215

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: $305 (286%)
Insurance Median: $215 (201%)
Cash: $305 (286% of Medicare)
Ins. Median: $215 (201% 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 201% of the Medicare baseline (a markup of 101%). 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
Medicaid / KanCare $15 - $1,257 14%
Self Pay $18 - $1,509 17%
Blue Cross Blue Shield $20 - $1,628 19%
Cigna $41 - $5,030 38%
Evolutions Healthcare $41 - $3,427 38%
Tyson Foods $41 - $3,458 38%
UnitedHealthcare $41 - $3,383 38%
Access Health Services, Llc $43 - $3,584 40%
Parker Hannifin $45 - $4,401 42%
Healthlink $47 - $3,930 44%
First Health $49 - $4,087 46%
Blue Traditional $56 - $4,851 52%
Coventry Wc $60 - $5,030 56%
Municipal Health $60 - $5,030 56%
Multiplan $66 - $5,470 62%
Phcs $66 - $5,470 62%
Compresults Wc $68 - $5,658 64%
Veterans Eval Services $75 - $91 70%
Node Champva $106 99%
Tricare $106 99%
Medicare (plans) $110 103%
Node United Behavioral Health Mcr Adv $110 103%
Humana $111 104%
Node Hospice Non Par Agree $112 105%
Node Va $112 105%
Node Ahs Mcr Adv $115 108%
Node Devoted Health Mcr Adv $116 109%
Node Pphp Mcr Adv $127 119%
Centurion Correctional $140 131%
Us Department Of Labor $140 131%
Naphcare $213 199%
Home State Exchange $280 262%
W W Wood $280 262%
Blue Access $384 360%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Oak Grove Road, Poplar Bluff, MO 63901
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals