CT scan, lower back (lumbar spine)
Facility: Providence Medical Center
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $133
- Cash Discount Price: $98
- vs. Medicare Baseline: 1.25x 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 |
|---|---|---|
| Medicaid / KanCare | $60 | 56% |
| UnitedHealthcare | $91 - $202 | 85% |
| Celtic | $93 - $158 | 87% |
| Healthy Blue | $93 - $103 | 87% |
| Midland Care Connection | $98 | 92% |
| Medicare (plans) | $98 | 92% |
| Aetna | $98 - $321 | 92% |
| Cigna | $98 | 92% |
| Tricare | $98 | 92% |
| Kansas Superior Select | $103 | 96% |
| Corizon | $128 | 120% |
| Well Path Prison | $138 | 129% |
| Employer Direct Healthcare | $138 | 129% |
| Centurion | $148 | 139% |
| Naphcare | $153 | 143% |
| Blue Cross Blue Shield | $158 - $255 | 148% |
| Comp Alliance - Fka Compresults Worker Compensation | $191 | 179% |
| Oha Networks | $205 | 192% |
| Worker Compensation | $212 | 198% |
| First Health | $750 | 702% |
Consumer Guidance & Cost Commentary
For a CT scan of the lower back at Providence Medical Center in Kansas City, KS, the facility's cash price of $98.00 is significantly lower than the state average of $1045.00 and the national Medicare benchmark of $106.81. While many commercial payers negotiate rates ranging from $60 to $750, the cash rate remains the lowest option available, making it an attractive choice for patients with high-deductible plans or those without insurance. Because commercial negotiated rates often include administrative overhead and contract markups, paying out-of-pocket can sometimes result in substantial savings compared to what an insurance plan would allow. Patients should verify their specific plan's deductible status before scheduling, as paying the cash price upfront may bypass the higher negotiated amounts charged to insured members.
To ensure you are not overcharged, it is recommended to request a detailed, itemized bill before finalizing payment, as summary invoices often obscure individual line items or unbundled charges. If you receive a balance bill for the difference between the provider's full list price and your insurance allowed amount, you may have protections under the No Surprises Act, which bans such billing for emergency care and non-emergency services at in-network facilities. Additionally, ask the hospital directly about "prompt-pay" discounts, which can reduce the cash price by 20% to 50% if paid in full within 30 days, effectively lowering the cost further than the standard cash rate. Always dispute any unexpected charges in writing to avoid credit damage and ensure all services rendered are accurately reflected on your statement.