CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Mercy Hospital Aurora

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $2,156
  • Cash Discount Price: $1,657
  • vs. Medicare Baseline: 20.19x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Mercy Hospital Aurora is $2,156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,657. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.19x the Medicare baseline. Located in 500 Porter Avenue, Aurora, MO.
Cash / Self-Pay
$1,657

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,156

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: $1,657 (1551%)
Insurance Median: $2,156 (2019%)
Cash: $1,657 (1551% of Medicare)
Ins. Median: $2,156 (2019% 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 2019% of the Medicare baseline (a markup of 1919%). 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 $60 - $1,292 56%
Medicare (plans) $99 - $754 93%
Blue Cross Blue Shield $140 - $2,549 131%
UnitedHealthcare $140 - $2,422 131%
Aetna $725 - $2,269 679%
Cherokee Nation Health Serv Contracted [320066] $725 679%
Cigna $725 - $2,167 679%
Cross Timbers Hospice [20098] $725 679%
Elara Caring Aspire Hospice [20433] $725 679%
Globalhealth Contracted [320145] $725 679%
Halo Hcr Inc Hospice Contracted [320432] $725 679%
Halo Hcr Inc Hospice [20432] $725 679%
Humana $725 - $2,167 679%
Indian Health Service Contracted [320198] $725 679%
Kindful Hospice Contracted [320434] $725 679%
Kindful Hospice [20434] $725 679%
Medical Associates Health Contracted [320444] $725 679%
Mercy Hospice Okc [20252] $725 679%
Mercy Mgd Behavioral Health Contracted [320259] $725 679%
Pace Of The Ozarks Contracted [320518] $725 679%
Provider Partners Health Plans Contracted [320450] $725 679%
Qual Choice Contracted [320325] $725 679%
Dept Of Veteran Affairs Contracted [320106] $742 695%
Tricare $742 695%
Healthscope Contracted [320182] $939 879%
Centivo Contracted [320505] $1,020 955%
Administrative Payor Contracted [320005] $1,147 1074%
Ambetter / Centene $1,292 1210%
Home State Health Plan Contracted [320187] $1,292 1210%
Novasys Contracted [320285] $1,292 1210%
Healthlink Contracted [320179] $1,657 - $2,294 1551%
Preferred Health Plan Contracted [320522] $1,657 1551%
Health Systems Inc Contracted [320174] $2,039 1909%
Insurance System Inc Contracted [320465] $2,039 1909%
Point C Contracted [320238] $2,039 - $2,167 1909%
Point C [20238] $2,039 1909%
Workers Comp [20426] $2,039 - $2,167 1909%
Medica Contracted [320239] $2,156 2019%
90 Degree Benefits Contracted [320436] $2,167 2029%
Aither Health Contracted [320449] $2,167 2029%
American Healthcare Alliance Contracted [320020] $2,167 2029%
Auxiant Contracted [320462] $2,167 2029%
Benefit Management Contracted [320052] $2,167 2029%
Ebms Contracted [320493] $2,167 2029%
Edison Health Solutions Contracted [320502] $2,167 2029%
Evolutions Health Care Contracted [320124] $2,167 2029%
First Health Contracted [320128] $2,167 2029%
Imagine 360 Contracted [320494] $2,167 2029%
Mercy Benefit Admin Contracted [320251] $2,167 2029%
Reflect Health Contracted [320492] $2,167 2029%
Show-Me Health Administrators Contracted [320483] $2,167 2029%
United Medical Resources Contracted [320454] $2,167 - $2,243 2029%
Yuzu Health Contracted [320521] $2,167 2029%
Usa Managed Care Org Contracted [320429] $2,243 2100%
Multiplan Contracted [320270] $2,422 2268%
Private Health Care Systems Contracted [320320] $2,422 2268%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 Porter Avenue, Aurora, MO 65605
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals