CT scan, lower back (lumbar spine)
Facility: University Of Ks Hlth System Great Bend Campus
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $566
- Cash Discount Price: $392
- vs. Medicare Baseline: 5.30x 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 530% of the Medicare baseline (a markup of 430%). 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 |
|---|---|---|
| Ku Athletics [503200094] | $98 | 92% |
| Workers Comp [503999901] | $98 | 92% |
| UnitedHealthcare | $98 | 92% |
| Medicare (plans) | $100 | 94% |
| Blue Cross Blue Shield | $101 | 95% |
| Allwell [503200078] | $101 | 95% |
| Triwest [503201703] | $103 | 96% |
| Tricare | $103 | 96% |
| Humana | $103 | 96% |
| Centurion [5032000966] | $127 | 119% |
| Ambetter / Centene | $142 | 133% |
| Fort Hays State Student Athletes [5032000960] | $205 | 192% |
| Occunet [503999930] | $205 | 192% |
| 6 Degrees Health [503999050] | $244 | 228% |
| Advanced Medical Pricing Solutions [503301513] | $309 | 289% |
| Alt Wppa [5032000964] | $823 | 771% |
| Wppa [503200056] | $823 | 771% |
| Meritain Health [503200039] | $823 - $1,176 | 771% |
| Alt Carelon Behavioral Health [503200905] | $980 | 918% |
| Alt Meritain Health [503999911] | $1,176 | 1101% |
| Cigna | $1,176 - $1,568 | 1101% |
| Php [503200005] | $1,176 | 1101% |
| Aha-Healthcare Preferred [503200050] | $1,176 | 1101% |
| Aetna | $1,176 | 1101% |
| Allied National [503999937] | $1,176 | 1101% |
| National Assn Letter Carriers [503200019] | $1,176 | 1101% |
| First Health [5032000110] | $1,176 | 1101% |
| Correct Care Solutions [50311253] | $1,372 | 1285% |
| Usa Managed Care [503999030] | $1,764 | 1652% |
Consumer Guidance & Cost Commentary
For CPT code 72131, a CT scan of the lower back, the University of Kansas Health System Great Bend Campus charged a gross price of $1,960.00, which is significantly higher than the state average for this service. While the facility's cash median price is $392.00, commercial insurance negotiated rates vary widely, ranging from $98.00 for Ku Athletics to $1,764.00 for USA Managed Care. It is important to note that while in-network insurance often caps costs, these negotiated rates can sometimes exceed the cash price; for instance, the cash median of $392.00 is lower than the lowest commercial negotiated rate of $98.00 shown for specific plans, though many other payers have negotiated rates well above this amount. Patients with high-deductible plans should verify if paying cash upfront or utilizing a prompt-pay discount might result in lower out-of-pocket costs compared to their specific insurance allowed amount.
The facility's negotiated rates are benchmarked against Medicare, which sets a baseline of $106.81 for this procedure. The data indicates a "vs_medicare" ratio of 5.3, meaning the commercial negotiated rates are approximately 5.3 times the Medicare rate, reflecting the typical markup found in commercial contracts. Additionally, the median paid amount across all payers was $105.00, which is slightly lower than the Medicare amount. Given that over 80% of hospital bills often contain errors, patients are encouraged to request a detailed, itemized billing audit before finalizing payment to ensure no unbundled codes or services not rendered are