CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: SSM Health St Anthony Hospital - Midwest

Billing Code: 72131 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$179

about 1.7× the $107 Medicare rate · typically $109–$462

modeled estimate · not a bill or quote

What this hospital charges insurers

$134

Below the fair price — a good deal

about $45 under the fair price · 1.3× Medicare

Medicare pays $107 Fair price $179 This hospital $134 Cash price $4,181 Hospital's list price $7,601

How we calculate the fair BaseRate →

How this hospital compares to other OK hospitals

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

Cheapest $46 Priciest $134

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, lower back (lumbar spine) is about $179 (about 1.7× the $107 Medicare rate). SSM Health St Anthony Hospital - Midwest charges insurers about $134, or about $4,181 in cash — below the fair price — a good deal. Located in Midwest City, OK.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Humana UnitedHealthcareAetnaCignaKaiser 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
Blue Cross Blue Shieldmajor	$101 - $104	95%
Humanamajor	$102	95%
Ambetter (Centene)	$136	127%
Health Net	$215 - $220	201%
Medica	$123	115%
Oscar Health	$132	124%
+ 2 smaller / regional plans	$196 - $213

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 (about 4,181), 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 SSM Health St Anthony Hospital - Midwest 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 SSM Health St Anthony Hospital - Midwest

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

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