CT scan, lower back (lumbar spine)
Facility: Pratt Regional Medical Center
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $160
- Cash Discount Price: $831
- vs. Medicare Baseline: 1.50x 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.
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 |
|---|---|---|
| Celtic Insurance Company | $102 | 95% |
| Healthy Blue | $105 | 98% |
| UnitedHealthcare | $112 - $2,257 | 105% |
| Christian Health Aid | $120 - $1,660 | 112% |
| Health Partners Of Kansas | $136 - $1,881 | 127% |
| Aetna | $144 - $1,992 | 135% |
| Choicecare | $160 - $2,213 | 150% |
Consumer Guidance & Cost Commentary
Pratt Regional Medical Center, located at 200 Commodore St in Pratt, Kansas, offers a CT scan of the lower back (lumbar spine) with a cash median price of $831. This facility is a proprietary acute care hospital rated 4 stars. While the facility's cash price is significantly lower than its gross charge of $1,187, it is important to note that commercial insurance negotiated rates can sometimes exceed the cash price due to administrative costs and contract dynamics. For example, UnitedHealthcare has a negotiated rate range of $112 to $2,257, and Aetna ranges from $144 to $1,992, meaning patients with high-deductible plans might save money by paying the cash rate directly if they have not yet met their deductible.
To understand the value of this service, it is helpful to compare the pricing against federal benchmarks. The Medicare amount for this procedure is $106.81, and the commercial negotiated rates shown here average approximately 1.5 times the Medicare rate. Patients should be aware that while the facility is in-network for several payers, the final amount owed depends heavily on individual plan deductibles and copays. If you choose to pay out-of-pocket, you may be eligible for a prompt-pay discount, which is a fee reduction typically offered when bills are paid upfront, potentially lowering the $831 cash median further. Always verify specific self-pay or prompt-pay discounts directly with the hospital before scheduling to ensure you are receiving the best possible rate.