CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Mercy Rehabilitation Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $6,665
  • Cash Discount Price: $6,665
  • vs. Medicare Baseline: 62.40x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Mercy Rehabilitation Hospital is $6,665. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,665. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 62.40x the Medicare baseline. Located in 1401 Campus Dr, Clive, IA.
Cash / Self-Pay
$6,665

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,665

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: $6,665 (6240%)
Insurance Median: $6,665 (6240%)
Cash: $6,665 (6240% of Medicare)
Ins. Median: $6,665 (6240% 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 6240% of the Medicare baseline (a markup of 6140%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $6,665 6240%
Humana $6,665 6240%
Health Partners - Commercial (Unitypoint) $6,665 6240%
Medicaid / KanCare $6,665 6240%
UnitedHealthcare $6,665 6240%
Medica - Midlands Choice $6,665 6240%
Cigna $6,665 6240%
Medicare (plans) $6,665 6240%
Consociate Health $6,665 6240%
Medical Associates Health Plan $6,665 6240%
Aetna $6,665 6240%
Oscar Health - Commercial $6,665 6240%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 Campus Dr, Clive, IA 50325
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL