CT scan, lower back (lumbar spine)
Facility: St. Catherine Hospital - Garden City
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $383
- Cash Discount Price: $1,698
- vs. Medicare Baseline: 3.59x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 359% of the Medicare baseline (a markup of 259%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Cigna | $73 - $310 | 68% |
| Medicare (plans) | $73 - $85 | 68% |
| Kansas Health | $73 | 68% |
| Blue Cross Blue Shield | $73 - $569 | 68% |
| Humana | $73 - $85 | 68% |
| UnitedHealthcare | $73 - $1,692 | 68% |
| Kaiser | $73 - $1,586 | 68% |
| Aetna | $73 - $2,300 | 68% |
| Innovage | $85 | 80% |
| Devoted Health | $85 | 80% |
| United Colorado Doctor'S Plan | $245 | 229% |
| Direct To Employer | $322 - $2,302 | 301% |
| Centura Employee Plan | $337 | 316% |
| Peak Health | $433 - $2,245 | 405% |
| Multiplan | $592 - $4,892 | 554% |
| Denver Health | $1,358 | 1271% |
| Wpaa | $1,913 | 1791% |
| Christian Health Aid | $2,187 | 2048% |
| Health Partners Of Kansas | $2,651 | 2482% |
Consumer Guidance & Cost Commentary
For a CT scan of the lower back at St. Catherine Hospital in Garden City, Kansas, the facility's cash price is $1,698, which is significantly higher than the state average for this procedure. While commercial insurance plans negotiate rates that often cap payments between $73 and $4,892 depending on the carrier, many of these negotiated amounts exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that while the hospital is an in-network facility for most major payers, specific services like emergency care or certain lab tests could potentially trigger balance billing if they are provided by out-of-network providers, though the No Surprises Act protects patients from such surprise bills for non-emergency services at in-network hospitals.
To ensure you are not overcharged, you should request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Additionally, since the facility offers a prompt-pay discount for upfront payment, you should contact the billing department before scheduling your visit to confirm the self-pay rate and request a waiver of insurance submission to avoid automatic claims processing. Comparing the facility's performance to regional standards, the hospital holds a 2-star rating and is a voluntary non-profit church-owned facility, so verifying the exact allowed amount with your specific insurance plan is the most effective way to determine your final out-of-pocket cost.