CT scan, lower back (lumbar spine)
Facility: Lane County Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $1,025
- Cash Discount Price: $1,025
- vs. Medicare Baseline: 9.60x 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 960% of the Medicare baseline (a markup of 860%). 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 |
|---|---|---|
| UnitedHealthcare | $922 - $1,025 | 863% |
| Aetna | $922 - $974 | 863% |
| Healthy Blue Mcaid | $1,025 | 960% |
| Healthy Blue Mcr Adv - All Other Plans | $1,025 | 960% |
| Medicaid / KanCare | $1,025 - $1,128 | 960% |
| Wppa Providers-All Plans | $1,538 | 1440% |
Consumer Guidance & Cost Commentary
For a CT scan of the lower back (lumbar spine) at Lane County Hospital in Dighton, KS, the cash price is $1,025, which matches the facility's negotiated rates with UnitedHealthcare, Aetna, and Healthy Blue plans. This cash price is significantly higher than the Medicare benchmark of $106.81, indicating a markup of 9.6 times the federal rate. While commercial insurance contracts often cap charges, patients with high-deductible plans may find paying the full cash price upfront more affordable than their insurance allowing a higher negotiated rate. It is important to verify your specific plan's deductible status before scheduling, as paying out-of-pocket might result in lower total costs if your insurance coverage exceeds the cash price.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, unexpected charges can still occur if ancillary services like labs are out-of-network. To ensure accuracy, always request a full itemized bill before paying, as summary invoices can hide unbundled codes or services not rendered. Additionally, ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within 30 days. These discounts bypass the administrative costs of insurance claims processing and provide immediate liquidity to the facility, potentially lowering your final out-of-pocket expense.