CT scan, lower back (lumbar spine)
Facility: Kansas Surgery & Recovery Center
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $207
- Cash Discount Price: $782
- vs. Medicare Baseline: 1.94x 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 |
|---|---|---|
| Aetna | $96 - $469 | 90% |
| Blue Cross Blue Shield | $96 - $458 | 90% |
| UnitedHealthcare | $98 - $534 | 92% |
| Cigna | $251 | 235% |
Consumer Guidance & Cost Commentary
For a CT scan of the lower back at Kansas Surgery & Recovery Center in Wichita, KS, the cash median price is $782.00, which is significantly lower than the facility's gross charge of $786.00. While commercial insurance negotiated rates for this procedure range from $96 to $534 depending on the payer, patients with high-deductible plans may find the cash price more affordable if their insurance negotiated rate exceeds $782.00. It is important to note that commercial rates often include administrative overhead and can be higher than cash prices; therefore, patients should explicitly ask the facility about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are receiving the lowest possible rate.
This procedure's cash price is also notably higher than the state of Kansas average, as indicated by the 1.9x Medicare benchmark ratio, which suggests the facility's pricing is well above the federal baseline. Medicare allows $106.81 for this service, while the facility's median negotiated rate is $207.00. Because over 80% of hospital bills contain errors, patients should request a full itemized CPT-coded bill rather than accepting a summary invoice to identify any unbundled codes or services not rendered. If a balance bill arises from an out-of-network component, patients should verify the legality of the charge under the No Surprises Act before paying immediately or signing away their rights via consent waivers.