CT scan, lower back (lumbar spine)
Facility: Ascension Via Christi Hospitals Wichita, Inc.
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $99
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.93x 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 |
|---|---|---|
| Humana | $98 | 92% |
| Saint Lukes Health Systems | $98 | 92% |
| Medicare (plans) | $98 - $100 | 92% |
| Via Christi Research | $98 | 92% |
| Va | $98 | 92% |
| Vc Hope | $98 | 92% |
| Blue Cross Blue Shield | $100 | 94% |
| UnitedHealthcare | $100 - $275 | 94% |
| Corizon | $123 | 115% |
| Smarthealth | $138 | 129% |
| Medicaid / KanCare | $167 | 156% |
| Aetna | $321 - $405 | 301% |
Consumer Guidance & Cost Commentary
For the CPT code 72131, representing a CT scan of the lower back at Ascension Via Christi Hospitals Wichita, Inc., the facility's negotiated rates range from $98 to $405 depending on the insurance carrier. While the facility's median negotiated rate of $99.00 is slightly higher than the state average of $98.00, it remains significantly lower than the facility's Medicare benchmark of $106.81. This comparison highlights that the facility is charging a rate very close to the federal government's cost-based baseline, which serves as the objective standard for fair pricing. For patients with high-deductible plans, paying the cash price could be more economical if the insurance negotiated rate exceeds the cash price, though cash rates are not listed for this specific service.
Patients should be aware that commercial insurance contracts often include administrative overhead that inflates the baseline price by 20% to 40%, and in-network rates do not always represent the lowest possible cost. To potentially reduce out-of-pocket expenses, individuals should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can offer fee reductions of 20% to 50% for upfront payment. Additionally, before scheduling, it is crucial to verify your specific plan's deductible status and allowed amount, as paying a high negotiated rate without meeting your deductible can result in significant financial strain. Always request a full itemized bill before finalizing payment to ensure accuracy and avoid unexpected charges.