CT scan, lower back (lumbar spine)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $98
- Cash Discount Price: $706
- vs. Medicare Baseline: 0.92x 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 | $39 - $275 | 37% |
| Medicaid / KanCare | $40 - $140 | 37% |
| Aetna | $40 - $94 | 37% |
| Providrs Care | $64 - $178 | 60% |
| Va | $98 | 92% |
| Humana | $98 - $99 | 92% |
| Medicare (plans) | $98 - $100 | 92% |
| Smarthealth | $138 | 129% |
| Ambetter / Centene | $167 | 156% |
| Tricare | $174 | 163% |
| Blue Cross Blue Shield | $520 - $548 | 487% |
Consumer Guidance & Cost Commentary
For the CPT code 72131 (CT scan, lower back), Ascension Via Christi Hospital Manhattan, Inc. lists a gross charge of $1,765.00, with a cash median price of $706.00. While the facility's negotiated rates for in-network payers range from $39 to $548, the cash price is notably lower than the highest negotiated amounts seen for Blue Cross Blue Shield ($520–$548). Patients with high-deductible plans or those without insurance may find the cash price more affordable than their specific insurance allowed amount, which could exceed the cash rate. It is important to note that while the facility offers a cash median of $706.00, the actual self-pay or prompt-pay discount should be confirmed directly with the hospital before scheduling, as these rates can vary based on payment timing and plan specifics.
This service is benchmarked against Medicare, which pays $106.81 for this procedure, indicating that the facility's cash rate is significantly higher than the federal baseline. The facility is located in Manhattan, KS (zip 66502), and operates as a voluntary non-profit acute care hospital. Although the data does not provide explicit state or county average comparisons for this specific code, the wide variance in negotiated rates across different payers—from Medicaid/KanCare at $40–$140 to Tricare at $174—highlights the importance of verifying your specific plan's allowed amount. To avoid unexpected balance billing, patients should request an itemized bill to ensure no unbundled charges or services not rendered are included, and they should be aware