CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: The Children's Mercy Hospital

Billing Code: 72131 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$106

about 1.0× the $107 Medicare rate · typically $76–$300

modeled estimate · not a bill or quote

What this hospital charges insurers

$93

Below the fair price — a good deal

about $13 under the fair price · 0.9× Medicare

Medicare pays $107 Fair price $106 This hospital $93 Cash price $980 Hospital's list price $2,042

How we calculate the fair BaseRate →

How this hospital compares to other MO hospitals

A typical price — 5 charge more and 3 charge less, among the 9 MO hospitals compared.

Cheapest $66 Priciest $103

Black dot = this hospital, among the 9 MO hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, lower back (lumbar spine) is about $106 (about 1.0× the $107 Medicare rate). The Children's Mercy Hospital charges insurers about $93, or about $980 in cash — below the fair price — a good deal. Located in Kansas City, MO.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$41 - $2,638	38%
Blue Cross Blue Shieldmajor	$102 - $2,905	95%
Aetnamajor	$104 - $2,905	97%
Cignamajor	$53 - $2,729	50%
Humanamajor	$92 - $2,611	86%
Health Net	$117 - $2,905	110%
HealthLink	$61 - $3,455	57%
Medica	$92 - $2,289	86%
+ 11 smaller / regional plans	$43 - $3,337

Government programs also on file: Medicaid.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 980), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72131.

Insurance Before you use insurance

Call your insurance company to confirm The Children's Mercy Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 72131.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at The Children's Mercy Hospital

Compare: CT scan, lower back (lumbar spine) at other MO hospitals

Insurance negotiated median for the same procedure, sorted lowest first.