CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Ochsner Watkins Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $838
Cash Discount Price: $958
vs. Medicare Baseline: 7.85x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Ochsner Watkins Hospital is $838. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $958. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.85x the Medicare baseline. Located in 605 South Archusa Avenue, Quitman, MS.

Cash / Self-Pay

$958

Average discount available for prompt cash payment at this facility.

Insurance Median

$838

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: $958 (897%)

Insurance Median: $838 (785%)

Cash: $958 (897% of Medicare)

Ins. Median: $838 (785% 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 785% of the Medicare baseline (a markup of 685%). 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	$81 - $86	76%
UnitedHealthcare	$174 - $829	163%
Prime Health Services Ppo -Workers Comp	$305	286%
Cor Vel	$312	292%
Blue Cross Blue Shield	$351 - $1,144	329%
Cigna	$500 - $829	468%
Humana	$669 - $829	626%
Medicare (plans)	$829 - $954	776%
Ambetter / Centene	$838	785%
Magnolia Health Plan – Wellcare By All Well Of Mississippi	$838	785%
Shared Health Mississippi	$871	815%
Aetna	$930	871%
Select Administrative Services Network	$1,001	937%
Claritev D/B/A Multiplan/Phcs/American Life Care	$1,072	1004%
Zelis	$1,072	1004%
Prime Health Services Ppo	$1,144	1071%
Primewell Health Services Commercial Exchange Plan	$1,173	1098%
Primewell Health Services – Commercial	$1,173	1098%

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 $958.
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 Ochsner Watkins 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.