CT scan, lower back (lumbar spine)
Facility: University Of Kansas Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $2,897
- Cash Discount Price: $1,195
- vs. Medicare Baseline: 27.12x 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 2712% of the Medicare baseline (a markup of 2612%). 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 |
|---|---|---|
| Medicare (plans) | $98 - $100 | 92% |
| Lasso Healthcare [503999926] | $98 | 92% |
| Devoted [503200068] | $98 | 92% |
| Aetna | $98 - $137 | 92% |
| Workers Comp [503999901] | $98 - $5,674 | 92% |
| UnitedHealthcare | $98 - $156 | 92% |
| Ku Athletics [503200094] | $98 | 92% |
| Tricare | $98 | 92% |
| Triwest [503201703] | $98 | 92% |
| Humana | $98 - $100 | 92% |
| Blue Cross Blue Shield | $101 - $4,584 | 95% |
| Allwell [503200078] | $101 | 95% |
| American Health Plans [503200968] | $102 | 95% |
| Oscar [503201609] | $117 | 110% |
| Centurion [5032000966] | $127 | 119% |
| Centivo [5032000982] | $161 | 151% |
| Wellfit [503301514] | $161 | 151% |
| Ambetter / Centene | $166 | 155% |
| 6 Degrees Health [503999050] | $171 - $244 | 160% |
| Alt Wppa [5032000964] | $195 - $3,618 | 183% |
| Fort Hays State Student Athletes [5032000960] | $205 | 192% |
| Occunet [503999930] | $205 | 192% |
| Multiplan [503200057] | $264 | 247% |
| Claimdoc [503301509] | $264 | 247% |
| Advanced Medical Pricing Solutions [503301513] | $293 | 274% |
| Larned State Hospital [503200090] | $1,762 | 1650% |
| Health Plan Inc [503999941] | $2,807 | 2628% |
| Accarent Health [503999034] | $2,986 | 2796% |
| Alt Carelon Behavioral Health [503200905] | $2,986 | 2796% |
| Php [503200005] | $3,584 - $4,414 | 3355% |
| Allied National [503999937] | $3,584 | 3355% |
| Healthlink [503200007] | $3,618 - $4,414 | 3387% |
| Inter-Americas Insurance [503999032] | $3,618 | 3387% |
| Geha [503200036] | $3,618 | 3387% |
| Cerner [503200038] | $3,618 | 3387% |
| Med-Pay [503200040] | $3,618 | 3387% |
| Aha-Healthcare Preferred [503200050] | $3,936 | 3685% |
| First Health [5032000110] | $3,936 | 3685% |
| Consolidated Billing [50311256] | $4,181 | 3914% |
| Ascension Living Hope [503201517] | $4,181 | 3914% |
| Correct Care Solutions [50311253] | $4,181 | 3914% |
| Coeur Plan Services [503301517] | $4,181 | 3914% |
| Orscheln Industries [503201608] | $4,480 | 4194% |
| Empire Plan/Nyship [503200705] | $4,584 | 4292% |
| Alt Lineco [5032000976] | $4,584 | 4292% |
| Alt Lucent Health Solutions [503202603] | $4,584 | 4292% |
| Century Health Solutions [503200054] | $4,778 | 4473% |
| Cigna | $4,778 | 4473% |
| Point Comfort Underwriters [503200018] | $4,778 | 4473% |
| Quiktrip [5032000412] | $4,778 | 4473% |
| Meritain Health [503200039] | $5,017 | 4697% |
| Wppa [503200056] | $5,017 | 4697% |
| Usa Managed Care [503999030] | $5,376 | 5033% |
| Three Rivers Provider Network [503999029] | $5,376 | 5033% |
| Plan Care America [503999026] | $5,376 | 5033% |
| Sanford Health Plan [503999027] | $5,376 | 5033% |
| Employers Health Network [503999025] | $5,376 | 5033% |
Consumer Guidance & Cost Commentary
For the CPT code 72131 (CT scan, lower back), University Of Kansas Hospital in Kansas City, KS, has a gross charge of $5,973.00, which is significantly higher than the national average for this procedure. The facility's cash median price is $1,195.00, while the median negotiated rate across payers is $2,897.00. This negotiated rate is approximately 27.1% higher than the Medicare benchmark of $106.81, reflecting the typical markup found in commercial contracts. Patients should be aware that while in-network insurance plans offer protection against surprise balance billing, the resulting allowed amounts often exceed the cash-pay price due to administrative overhead and contract structures. If you have a high-deductible plan or have not yet met your deductible, paying the cash price of $1,195.00 upfront may result in lower out-of-pocket costs compared to the insurance negotiated rate, provided you can afford the difference.
To ensure you receive the most favorable pricing, it is essential to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% for upfront payment. Before scheduling your appointment, verify your specific plan's allowed amount and confirm whether the facility will submit a claim to your insurer, as automatic submission can void any cash discount agreements. Additionally, if you receive a bill, always request a full itemized statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. By comparing the facility's rates against the Medicare