CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Mercy Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $153
  • Cash Discount Price: $441
  • vs. Medicare Baseline: 1.43x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Mercy Medical Center is $153. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $441. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.43x the Medicare baseline. Located in 1320 Mercy Drive Nw, Canton, OH.
Cash / Self-Pay
$441

Average discount available for prompt cash payment at this facility.

Insurance Median
$153

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: $441 (413%)
Insurance Median: $153 (143%)
Cash: $441 (413% of Medicare)
Ins. Median: $153 (143% 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.

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
Summacare $29 - $302 27%
Aetna $44 - $679 41%
Blue Cross Blue Shield $44 - $461 41%
Cigna $44 - $679 41%
Humana $44 - $98 41%
The Health Plan $44 - $1,281 41%
United $44 - $245 41%
Communicare $46 - $103 43%
Mmo $46 - $302 43%
Perennial Health $48 - $106 45%
Zing Health $49 - $108 46%
Aultcare $51 - $278 48%
Oscar $115 - $261 108%
Buckeye $153 143%
Caresource $153 143%
Molina $156 146%
Amerihealth $163 153%
Ohcp $168 - $330 157%
Omas $216 - $340 202%
Phphi $259 - $407 242%
Cc Ehp $271 - $275 254%
Gms $302 - $475 283%
Amish Community Aid Plan $306 - $340 286%
Immergrun $323 - $340 302%
Ohio Healthy $367 344%
Multiplan $388 - $611 363%
Php $407 381%
Medical Benefit Corp $475 445%
Consociate Health $509 477%
Frontpath $611 572%
Managed Care Services $611 572%
Tertiary Care Network $611 572%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 Mercy Drive Nw, Canton, OH 44708
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals