CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Simpson General Hospital Cah

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $349
Cash Discount Price: $473
vs. Medicare Baseline: 3.27x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Simpson General Hospital Cah is $349. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $473. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.27x the Medicare baseline. Located in 1842 Simpson Highway 149, Mendenhall, MS.

Cash / Self-Pay

$473

Average discount available for prompt cash payment at this facility.

Insurance Median

$349

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: $473 (443%)

Insurance Median: $349 (327%)

Cash: $473 (443% of Medicare)

Ins. Median: $349 (327% 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 327% of the Medicare baseline (a markup of 227%). 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
UnitedHealthcare	$43 - $920	40%
Magnolia Hp Mcaid - All Plans	$46 - $90	43%
Usa Hlth Network - All Plans	$160 - $978	150%
Ambetter / Centene	$200 - $448	187%
Blue Cross Blue Shield	$250	234%
Aetna	$690	646%
Adv Hlth Systems - All Plans	$862	807%
Health Partners - All Plans	$920	861%
Ms Phys Care Network - All Plans	$978	916%

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 $473.
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 Simpson General Hospital Cah 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.