CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Ste Genevieve County Memorial Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $600
Cash Discount Price: $627
vs. Medicare Baseline: 5.62x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Ste Genevieve County Memorial Hospital is $600. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $627. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.62x the Medicare baseline. Located in Hwys 61 & 32, Sainte Genevieve, MO.

Cash / Self-Pay

$627

Average discount available for prompt cash payment at this facility.

Insurance Median

$600

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: $627 (587%)

Insurance Median: $600 (562%)

Cash: $627 (587% of Medicare)

Ins. Median: $600 (562% 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 562% of the Medicare baseline (a markup of 462%). 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
Blue Cross Blue Shield	$27 - $2,644	25%
Medicare (plans)	$27 - $600	25%
Va	$27 - $600	25%
Aetna	$28 - $1,846	26%
Allwell	$28 - $611	26%
Pphp	$31 - $689	29%
Ambetter / Centene	$34 - $749	32%
Meritain	$83 - $1,846	78%
Multiplan/Phcs	$92 - $2,038	86%
Medicaid / KanCare	$151	141%
Homestate	$157	147%
Healthy_Blue	$181	169%
Uhc_Community	$181	169%
Healthlink_Hmo	$405 - $913	379%
Healthlink_Compmanagement	$432 - $974	404%
Healthlink_Ppo	$432 - $974	404%
UnitedHealthcare	$452 - $1,199	423%
Cigna	$1,966	1841%

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 $627.
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 Ste Genevieve County Memorial 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.