CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Mercy Rehabilitation Hospital Springfield

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $338
  • Cash Discount Price: $338
  • vs. Medicare Baseline: 3.16x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Mercy Rehabilitation Hospital Springfield is $338. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $338. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.16x the Medicare baseline. Located in 5904 S Southwood Rd, Springfield, MO.
Cash / Self-Pay
$338

Average discount available for prompt cash payment at this facility.

Insurance Median
$338

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: $338 (316%)
Insurance Median: $338 (316%)
Cash: $338 (316% of Medicare)
Ins. Median: $338 (316% 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 316% of the Medicare baseline (a markup of 216%). 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
Aetna $203 - $338 190%
Blue Preferred $245 229%
Firsthealth Network $247 231%
Blue Cross Blue Shield $257 - $338 241%
Healthlink Workcomp $287 269%
Allwell From Home State Health $338 316%
Allyalign Health (Nhc Advantage) $338 316%
Ambetter / Centene $338 316%
Architectural Systems, Inc. (Asi) $338 316%
Ava R1 School District (Smbc) $338 316%
Bakersfield School District (Smbc) $338 316%
Blue Access $338 316%
Bolivar School (Smbc) $338 316%
Buchheit $338 316%
Cardinal Scale (Tri State Healthcare Coalition) $338 316%
Carthage R-9 School District (Tri-State Healthcare Coalition) $338 316%
Cigna $338 316%
City Of Springfield $338 316%
City Of Webb City (Tri State Healthcare Coalition) $338 316%
Devoted Healthcare $338 316%
Diversified Plastics $338 316%
Dora School District (Smbc) $338 316%
Easter Seals Midwest $338 316%
Employers Benefit Alliance $338 316%
Essence $338 316%
Evolutions $338 316%
Fabick Cat $338 316%
Fair Grove School District (Smbc) $338 316%
Health Net Federal Services $338 316%
Health Systems, Inc. $338 316%
Healthlink Hmo $338 316%
Healthlink Ppo $338 316%
Heart Of America (Tri State Healthcare Coalition &Amp;#8211; Med Pay) $338 316%
Hickory County Skyline School District (Smbc) $338 316%
Home State Health Plan, Inc. $338 316%
Humana $338 316%
J And M Farms, Inc. (Tri-State Healthcare Coalition) $338 316%
Jayhawk Fine Chemicals/Evonic(Tri State Healthcare Coalition) $338 316%
Laclede County School District Conway (Smbc) $338 316%
Lebanon School District (Smbc) $338 316%
Liberty Utilities (Empire District Electric) $338 316%
Marshfield School District (Smbc) $338 316%
Medica $338 316%
Medicaid / KanCare $338 316%
Mercy Charity Contract $338 316%
Mers Goodwill $338 316%
Missouri State University $338 316%
Mount Vernon School District (Smbc) $338 316%
Mountain Grove R-111 School District (Smbc) $338 316%
Mountain View School District (Smbc) $338 316%
Multiplan/Phcs/Beech Street $338 316%
Ozarks Community Hospital $338 316%
Pathway/Pathway X $338 316%
Phcs Savility $338 316%
Quality Collisson Group $338 316%
Quiktrip Corporation $338 316%
Richards R-V School District (Smbc) $338 316%
Roper Automotive Group (Tri State Healthcare Coalition) $338 316%
S And H Farm Supply $338 316%
Schreiber Foods $338 316%
Shinesolar $338 316%
Springfield Public Schools $338 316%
Springfield Remanufacturing $338 316%
Trailiner $338 316%
UnitedHealthcare $338 316%
Webb City R-Vii School District (Tri-State Healthcare Coalition) $338 316%
Wellcare Health Plans $338 316%
Woodard Cleaning &Amp;#038; Restoration, Inc. $338 316%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5904 S Southwood Rd, Springfield, MO 65804
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL