CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Ascension St John Jane Phillips

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $114
  • Cash Discount Price: $844
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Ascension St John Jane Phillips is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $844. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.07x the Medicare baseline. Located in 3500 East Frank Phillips Boulevard, Bartlesville, OK.
Cash / Self-Pay
$844

Average discount available for prompt cash payment at this facility.

Insurance Median
$114

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: $844 (790%)
Insurance Median: $114 (107%)
Cash: $844 (790% of Medicare)
Ins. Median: $114 (107% 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
First Health $73 - $319 68%
Champva $108 101%
Community Care - St John Network Senior - Govt $108 101%
Communitycare Senior $108 101%
Life Pace $108 101%
Longevity Health Plan Of Oklahoma $108 101%
Medicare (plans) $108 101%
UnitedHealthcare $108 - $112 101%
Va Community Care Network $108 101%
Veterans Administration $108 101%
Humana $109 102%
Aetna $113 - $183 106%
Blue Cross Blue Shield $114 - $428 107%
Communitycare (Standard) $119 111%
Community Care (Select) 7/1/13 $130 122%
Ccl&H $141 132%
Smarthealth $152 142%
Community Care Smarthealth $162 - $260 152%
Communitycare (Select) $162 - $249 152%
Connect Health Benefit $217 203%
Evolutions $217 203%
Kempton Group Administrators $244 228%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3500 East Frank Phillips Boulevard, Bartlesville, OK 74006
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals