CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Mercy Medical Center

Billing Code: 72131 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$146

about 1.4× the $107 Medicare rate · typically $126–$300

modeled estimate · not a bill or quote

What this hospital charges insurers

$141

About the fair price

about $5 under the fair price · 1.3× Medicare

Medicare pays $107 Fair price $146 This hospital $141 Hospital's list price $2,400

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $48 Priciest $141

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

A fair price for a CT scan, lower back (lumbar spine) is about $146 (about 1.4× the $107 Medicare rate). Mercy Medical Center charges insurers about $141 — about the fair price. Located in Rockville Centre, NY.

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	$126 - $1,560	118%
Blue Cross Blue Shieldmajor	$123 - $413	115%
Aetnamajor	$126 - $2,331	118%
Cignamajor	$1,365 - $1,560	1278%
Humanamajor	$128	120%
AmeriHealth	$283	265%
Cigna HealthSpring	$126	118%
Fidelis Care	$126 - $318	118%
Independent Health	$126 - $141	118%
MVP Health Care	$126 - $1,365	118%
Oscar Health	$984	921%
UniCare	$1,560	1461%
WellCare	$138	129%
+ 44 smaller / regional plans	$126 - $2,400

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 7 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, 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 Mercy Medical Center 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 Mercy Medical Center

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

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