CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Mercy St Francis Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $2,299
Cash Discount Price: $1,660
vs. Medicare Baseline: 21.52x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Mercy St Francis Hospital is $2,299. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,660. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 21.52x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.

Cash / Self-Pay

$1,660

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,299

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: $1,660 (1554%)

Insurance Median: $2,299 (2152%)

Cash: $1,660 (1554% of Medicare)

Ins. Median: $2,299 (2152% 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 2152% of the Medicare baseline (a markup of 2052%). 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
Medicaid / KanCare	$60 - $1,326	56%
Medicare (plans)	$99 - $912	93%
Blue Cross Blue Shield	$100 - $2,477	94%
UnitedHealthcare	$140 - $2,426	131%
Tricare	$869	814%
Aetna	$876 - $2,273	820%
Cherokee Nation Health Serv Contracted [320066]	$876	820%
Cigna	$876 - $2,426	820%
Cross Timbers Hospice [20098]	$876	820%
Dept Of Veteran Affairs Contracted [320106]	$876	820%
Elara Caring Aspire Hospice [20433]	$876	820%
Globalhealth Contracted [320145]	$876	820%
Halo Hcr Inc Hospice Contracted [320432]	$876	820%
Halo Hcr Inc Hospice [20432]	$876	820%
Humana	$876 - $2,299	820%
Indian Health Service Contracted [320198]	$876	820%
Kindful Hospice Contracted [320434]	$876	820%
Kindful Hospice [20434]	$876	820%
Medical Associates Health Contracted [320444]	$876	820%
Mercy Hospice Okc [20252]	$876	820%
Mercy Mgd Behavioral Health Contracted [320259]	$876	820%
Pace Of The Ozarks Contracted [320518]	$876	820%
Provider Partners Health Plans Contracted [320450]	$876	820%
Qual Choice Contracted [320325]	$876	820%
Administrative Payor Contracted [320005]	$1,149	1076%
Healthscope Contracted [320182]	$1,165	1091%
Ambetter / Centene	$1,326	1241%
Home State Health Plan Contracted [320187]	$1,326	1241%
Novasys Contracted [320285]	$1,326	1241%
Centivo Contracted [320505]	$1,481	1387%
Healthlink Contracted [320179]	$1,660 - $2,426	1554%
Preferred Health Plan Contracted [320522]	$1,660	1554%
Workers Comp [20426]	$2,043 - $2,171	1913%
Auxiant Contracted [320462]	$2,299 - $2,426	2152%
Mercy Benefit Admin Contracted [320251]	$2,299 - $2,426	2152%
Point C Contracted [320238]	$2,299 - $2,426	2152%
United Medical Resources Contracted [320454]	$2,299 - $2,375	2152%
Medica Contracted [320239]	$2,414	2260%
90 Degree Benefits Contracted [320436]	$2,426	2271%
Aither Health Contracted [320449]	$2,426	2271%
Benefit Management Contracted [320052]	$2,426	2271%
Ebms Contracted [320493]	$2,426	2271%
Edison Health Solutions Contracted [320502]	$2,426	2271%
Evolutions Health Care Contracted [320124]	$2,426	2271%
First Health Contracted [320128]	$2,426	2271%
Health Systems Inc Contracted [320174]	$2,426	2271%
Imagine 360 Contracted [320494]	$2,426	2271%
Insurance System Inc Contracted [320465]	$2,426	2271%
Multiplan Contracted [320270]	$2,426	2271%
Point C [20238]	$2,426	2271%
Private Health Care Systems Contracted [320320]	$2,426	2271%
Reflect Health Contracted [320492]	$2,426	2271%
Show-Me Health Administrators Contracted [320483]	$2,426	2271%
Usa Managed Care Org Contracted [320429]	$2,426	2271%
Yuzu Health Contracted [320521]	$2,426	2271%

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 $1,660.
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 Mercy St Francis 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.