CT scan, lower back (lumbar spine)
Facility: Via Christi Hospital Wichita St Teresa, Inc
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $99
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.93x 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 |
|---|---|---|
| Saint Lukes Health Systems | $98 | 92% |
| Medicare (plans) | $98 - $100 | 92% |
| Humana | $98 | 92% |
| Via Christi Research | $98 | 92% |
| Vc Hope | $98 | 92% |
| Va | $98 | 92% |
| UnitedHealthcare | $100 - $275 | 94% |
| Blue Cross Blue Shield | $100 | 94% |
| Corizon | $123 | 115% |
| Smarthealth | $138 | 129% |
| Medicaid / KanCare | $167 | 156% |
| Aetna | $321 - $405 | 301% |
Consumer Guidance & Cost Commentary
For the CPT code 72131, representing a CT scan of the lower back, the negotiated rates at Via Christi Hospital Wichita St Teresa, Inc. range from $98 to $405 depending on the payer. The lowest negotiated amount is $98, which aligns with the rates for Saint Lukes Health Systems, Humana, and several other payers, while the highest negotiated amount is $405 for Aetna. The facility's median negotiated rate is $99.00, which is slightly higher than the state average of $98.00. For patients with high-deductible plans, it is important to note that cash-pay rates can sometimes be lower than the insurance negotiated rate, particularly when the insurance allowed amount exceeds the cash price. Patients should verify self-pay or prompt-pay discounts directly with the hospital before scheduling to ensure they are not paying the full negotiated amount.
The Medicare benchmark for this procedure is $106.81, which serves as a baseline for evaluating the facility's pricing. The facility's median negotiated rate of $99.00 is slightly below the Medicare amount, indicating a competitive pricing structure relative to the federal standard. While the facility is a voluntary non-profit church-owned acute care hospital in Wichita, KS, with a facility rating of 4, patients should be aware of billing principles such as balance billing and itemized audits. If a patient receives care from an out-of-network provider at this in-network facility, the No Surprises Act may protect them from balance billing for emergency services. Additionally, patients should request a detailed, itemized bill to identify any errors or unbundled codes, as summary bills often obscure the