CT scan, lower back (lumbar spine)
Facility: Overland Park Reg Med Ctr
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $2,074
- Cash Discount Price: $9,817
- vs. Medicare Baseline: 19.42x 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 1942% of the Medicare baseline (a markup of 1842%). 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 |
|---|---|---|
| Amerigroup | $60 | 56% |
| United | $60 - $4,668 | 56% |
| Healthyblue | $61 | 57% |
| Aetna | $62 - $5,290 | 58% |
| Unicare | $62 | 58% |
| Medicaid / KanCare | $62 | 58% |
| Home State Health Plan | $95 | 89% |
| Cigna | $122 - $181 | 114% |
| Multiplan | $169 - $7,676 | 158% |
| Corvel Corporation | $201 - $6,742 | 188% |
| Oha Network | $210 - $5,186 | 197% |
| Blue Cross Blue Shield | $323 - $4,460 | 302% |
| Humana | $363 - $468 | 340% |
| Ambetter / Centene | $1,723 - $1,929 | 1613% |
| Nhc Advantage | $1,760 - $1,971 | 1648% |
| Wppa Providrs Care Network | $1,852 - $2,074 | 1734% |
| Universal Healthcare | $3,241 - $3,630 | 3034% |
| Coventry | $3,723 - $4,170 | 3486% |
| Coventry Kc Mo | $3,797 - $4,253 | 3555% |
| College Park Family Care Center | $3,982 - $4,460 | 3728% |
| Triwest Health Alliance | $6,946 - $7,779 | 6503% |
| Focus Healthcare Mgmt, Inc | $6,946 - $7,779 | 6503% |
| Cco, Inc. | $6,946 - $7,779 | 6503% |
Consumer Guidance & Cost Commentary
For the CT scan of the lower back (lumbar spine) at Overland Park Reg Med Ctr, the cash price is $9,817.00, which matches the facility's cash median. This rate is significantly higher than the state average, reflecting the facility's proprietary ownership and location in Overland Park, KS. While commercial insurance plans like Amerigroup and Healthyblue have negotiated rates starting at $60, many other payers, including Blue Cross Blue Shield and Triwest Health Alliance, have negotiated rates ranging from $3,230 to $7,779. Patients with high-deductible plans should consider that paying cash upfront might be more cost-effective than relying on insurance, as the negotiated rates for many insurers exceed the cash price. It is advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full before services are rendered.
To avoid unexpected costs, patients should request an itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If a patient receives a balance bill for out-of-network services, they may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. When reviewing the bill, compare the total charges against the Medicare amount of $106.81 to understand the true cost basis, noting that commercial rates often include administrative markups. Finally, always verify your deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in significantly higher