CMS Price Transparency Data
CT scan, lower back (lumbar spine)
Facility: Mercy Hospital - Cassville
Billing Code: 72131 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72131
- Insurance Median: $2,039
- Cash Discount Price: $1,657
- vs. Medicare Baseline: 19.09x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Mercy Hospital - Cassville is $2,039. 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 19.09x the Medicare baseline. Located in 94 Main Street, Cassville, MO.
Cash / Self-Pay
$1,657
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,039
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: $2,039 (1909%)
Cash: $1,657 (1551% of Medicare)
Ins. Median: $2,039 (1909% 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 1909% of the Medicare baseline (a markup of 1809%). 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.
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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 - $1,325 | 56% |
| Aetna | $95 - $2,269 | 89% |
| Humana | $95 - $2,167 | 89% |
| Medicare (plans) | $99 - $1,092 | 93% |
| Blue Cross Blue Shield | $100 - $2,473 | 94% |
| UnitedHealthcare | $140 - $2,422 | 131% |
| Dept Of Veteran Affairs Contracted [320106] | $869 | 814% |
| Tricare | $1,033 | 967% |
| Cherokee Nation Health Serv Contracted [320066] | $1,050 | 983% |
| Cigna | $1,050 - $2,422 | 983% |
| Cross Timbers Hospice [20098] | $1,050 | 983% |
| Elara Caring Aspire Hospice [20433] | $1,050 | 983% |
| Globalhealth Contracted [320145] | $1,050 | 983% |
| Halo Hcr Inc Hospice Contracted [320432] | $1,050 | 983% |
| Halo Hcr Inc Hospice [20432] | $1,050 | 983% |
| Indian Health Service Contracted [320198] | $1,050 | 983% |
| Kindful Hospice Contracted [320434] | $1,050 | 983% |
| Kindful Hospice [20434] | $1,050 | 983% |
| Medical Associates Health Contracted [320444] | $1,050 | 983% |
| Mercy Hospice Okc [20252] | $1,050 | 983% |
| Mercy Mgd Behavioral Health Contracted [320259] | $1,050 | 983% |
| Pace Of The Ozarks Contracted [320518] | $1,050 | 983% |
| Provider Partners Health Plans Contracted [320450] | $1,050 | 983% |
| Qual Choice Contracted [320325] | $1,050 | 983% |
| Healthscope Contracted [320182] | $1,065 | 997% |
| Administrative Payor Contracted [320005] | $1,147 | 1074% |
| Centivo Contracted [320505] | $1,300 | 1217% |
| Ambetter / Centene | $1,325 | 1241% |
| Home State Health Plan Contracted [320187] | $1,325 | 1241% |
| Novasys Contracted [320285] | $1,325 | 1241% |
| 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 - $2,294 | 1909% |
| Point C [20238] | $2,039 | 1909% |
| United Medical Resources Contracted [320454] | $2,039 - $2,167 | 1909% |
| Workers Comp [20426] | $2,039 - $2,294 | 1909% |
| Municipal Health Plan Contracted [320271] | $2,065 | 1933% |
| Medica Contracted [320239] | $2,284 | 2138% |
| 90 Degree Benefits Contracted [320436] | $2,294 | 2148% |
| Aither Health Contracted [320449] | $2,294 | 2148% |
| American Healthcare Alliance Contracted [320020] | $2,294 | 2148% |
| Auxiant Contracted [320462] | $2,294 | 2148% |
| Benefit Management Contracted [320052] | $2,294 | 2148% |
| Ebms Contracted [320493] | $2,294 | 2148% |
| Edison Health Solutions Contracted [320502] | $2,294 | 2148% |
| Evolutions Health Care Contracted [320124] | $2,294 | 2148% |
| Imagine 360 Contracted [320494] | $2,294 | 2148% |
| Mercy Benefit Admin Contracted [320251] | $2,294 | 2148% |
| Reflect Health Contracted [320492] | $2,294 | 2148% |
| Show-Me Health Administrators Contracted [320483] | $2,294 | 2148% |
| Usa Managed Care Org Contracted [320429] | $2,294 | 2148% |
| Yuzu Health Contracted [320521] | $2,294 | 2148% |
| First Health Contracted [320128] | $2,422 | 2268% |
| Multiplan Contracted [320270] | $2,422 | 2268% |
| Private Health Care Systems Contracted [320320] | $2,422 | 2268% |