CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Harrison County Community Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $928
Cash Discount Price: $1,040
vs. Medicare Baseline: 8.69x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Harrison County Community Hospital is $928. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,040. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.69x the Medicare baseline. Located in 2600 Miller Street, Bethany, MO.

Cash / Self-Pay

$1,040

Average discount available for prompt cash payment at this facility.

Insurance Median

$928

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: $1,040 (974%)

Insurance Median: $928 (869%)

Cash: $1,040 (974% of Medicare)

Ins. Median: $928 (869% 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 869% of the Medicare baseline (a markup of 769%). 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
Cigna	$114 - $1,280	107%
Multiplan	$114 - $1,280	107%
Provider Partners Health Plans	$114 - $1,002	107%
Care Improvement Plus	$118 - $928	110%
Blue Cross Blue Shield	$122 - $1,408	114%
Healthy Blue	$129 - $135	121%
Home State	$129 - $135	121%
UnitedHealthcare	$129 - $1,360	121%
Allwell	$131 - $928	123%
Ambetter / Centene	$131 - $928	123%
Blue Advantage Plus	$131 - $928	123%
Humana	$131 - $1,440	123%
Aetna	$160 - $1,408	150%
6 Degrees Health	$166 - $1,280	155%
Wellmark	$1,280	1198%

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 $1,040.
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 Harrison County Community Hospital 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.