CT scan, lower back (lumbar spine)
Facility: Mcpherson Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $107
- Cash Discount Price: $1,003
- vs. Medicare Baseline: 1.00x 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 |
|---|---|---|
| UnitedHealthcare | $38 - $2,321 | 36% |
| Tricare | $39 - $85 | 37% |
| Blue Cross Blue Shield | $44 - $96 | 41% |
| Healthy Blue Mcr Adv | $44 - $96 | 41% |
| Wellcare Mcr Adv - All Plans | $44 - $96 | 41% |
| Aetna | $44 - $2,321 | 41% |
| Humana | $44 - $96 | 41% |
| Va Ccn - All Plans | $44 - $96 | 41% |
| Ambetter / Centene | $44 - $111 | 41% |
| Multiplan - All Plans | $55 - $2,089 | 51% |
| Medicaid / KanCare | $107 - $2,321 | 100% |
| Health Blue Mcaid - All Other Plans | $109 - $2,367 | 102% |
| Central Plains - All Plans | $293 - $1,741 | 274% |
| Medical Associates - All Plans | $293 - $1,741 | 274% |
| Health Partners - All Plans | $371 - $2,205 | 347% |
| Cigna | $371 - $2,205 | 347% |
| Wppa - All Plans | $1,625 | 1521% |
| Christian Health Aid - All Plans | $1,857 | 1739% |
| First Health - All Plans | $2,205 | 2064% |
Consumer Guidance & Cost Commentary
For the CT scan of the lower back (lumbar spine) at McPherson Hospital in McPherson, Kansas, the facility's cash median price is $1,003, which is lower than the state average of $1,741. While commercial insurance plans like UnitedHealthcare and Aetna negotiate rates ranging from $38 to $2,321, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still verify their specific plan's network status and ask the hospital about self-pay or prompt-pay discounts before scheduling to ensure they are not subject to unexpected charges.
The facility's negotiated rates vary significantly across payers, with some plans like Medicaid/KanCare and Health Blue Medicaid allowing amounts up to $2,367, while others such as WPPA and Christian Health Aid have fixed negotiated rates of $1,625 and $1,857 respectively. These commercial rates are substantially higher than the Medicare benchmark of $106.81, illustrating the typical markup found in commercial contracts. To avoid potential billing errors, patients should request a full itemized bill before paying, as summary invoices can obscure unbundled codes or services not rendered. If a balance bill is received, consumers should dispute it in writing rather than paying immediately, as federal protections may apply depending on the specific circumstances of the care provided.