CT scan, lower back (lumbar spine)
Facility: Mercy Hospital Columbus
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $1,858
- Cash Discount Price: $1,663
- vs. Medicare Baseline: 17.40x 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 1740% of the Medicare baseline (a markup of 1640%). 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 |
|---|---|---|
| Centivo Contracted [320505] | $26 | 24% |
| Blue Cross Blue Shield | $91 - $1,858 | 85% |
| UnitedHealthcare | $91 - $2,124 | 85% |
| Medicaid / KanCare | $91 - $1,858 | 85% |
| Humana | $95 - $2,431 | 89% |
| Medicare (plans) | $100 - $1,932 | 94% |
| Insurance System Inc Contracted [320465] | $1,100 | 1030% |
| Health Systems Inc Contracted [320174] | $1,100 | 1030% |
| Administrative Payor Contracted [320005] | $1,152 | 1079% |
| Cross Timbers Hospice [20098] | $1,858 | 1740% |
| Provider Partners Health Plans Contracted [320450] | $1,858 | 1740% |
| Kindful Hospice Contracted [320434] | $1,858 | 1740% |
| Mercy Hospice Okc [20252] | $1,858 | 1740% |
| Medical Associates Health Contracted [320444] | $1,858 | 1740% |
| Indian Health Service Contracted [320198] | $1,858 | 1740% |
| Aetna | $1,858 - $2,303 | 1740% |
| Halo Hcr Inc Hospice [20432] | $1,858 | 1740% |
| Elara Caring Aspire Hospice [20433] | $1,858 | 1740% |
| Home State Health Plan Contracted [320187] | $1,858 | 1740% |
| Ambetter / Centene | $1,858 | 1740% |
| Mercy Mgd Behavioral Health Contracted [320259] | $1,858 | 1740% |
| Cigna | $1,858 | 1740% |
| Halo Hcr Inc Hospice Contracted [320432] | $1,858 | 1740% |
| Pace Of The Ozarks Contracted [320518] | $1,858 | 1740% |
| Globalhealth Contracted [320145] | $1,858 | 1740% |
| Centurion Of Missouri [20459] | $1,858 | 1740% |
| Novasys Contracted [320285] | $1,858 | 1740% |
| Cherokee Nation Health Serv Contracted [320066] | $1,858 | 1740% |
| Dept Of Veteran Affairs Contracted [320106] | $1,858 | 1740% |
| Qual Choice Contracted [320325] | $1,858 | 1740% |
| Kindful Hospice [20434] | $1,858 | 1740% |
| Tricare | $1,864 | 1745% |
| Healthscope Contracted [320182] | $1,973 | 1847% |
| Workers Comp [20426] | $2,047 - $2,175 | 1916% |
| United Medical Resources Contracted [320454] | $2,124 - $2,431 | 1989% |
| Medica Contracted [320239] | $2,293 | 2147% |
| First Health Contracted [320128] | $2,303 | 2156% |
| Usa Managed Care Org Contracted [320429] | $2,303 | 2156% |
| Preferred Health Plan Contracted [320522] | $2,303 | 2156% |
| Healthlink Contracted [320179] | $2,303 - $2,431 | 2156% |
| Mercy Benefit Admin Contracted [320251] | $2,303 - $2,431 | 2156% |
| Federal Medical Center Contracted [320127] | $2,303 | 2156% |
| American Healthcare Alliance Contracted [320020] | $2,303 | 2156% |
| Private Health Care Systems Contracted [320320] | $2,431 | 2276% |
| Benefit Management Contracted [320052] | $2,431 | 2276% |
| Point C Contracted [320238] | $2,431 | 2276% |
| Aither Health Contracted [320449] | $2,431 | 2276% |
| Edison Health Solutions Contracted [320502] | $2,431 | 2276% |
| Auxiant Contracted [320462] | $2,431 | 2276% |
| Ppo Plus Contracted [320310] | $2,431 | 2276% |
| Imagine 360 Contracted [320494] | $2,431 | 2276% |
| Show-Me Health Administrators Contracted [320483] | $2,431 | 2276% |
| Yuzu Health Contracted [320521] | $2,431 | 2276% |
| Ebms Contracted [320493] | $2,431 | 2276% |
| 90 Degree Benefits Contracted [320436] | $2,431 | 2276% |
| Reflect Health Contracted [320492] | $2,431 | 2276% |
Consumer Guidance & Cost Commentary
For the CT scan of the lower back (lumbar spine) at Mercy Hospital Columbus, the cash price is $1,663, which is significantly lower than the facility's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare, which range from $91 to over $2,100. While the facility's cash rate is also lower than the state average for this procedure, patients should be aware that commercial insurance often pays negotiated rates that exceed the cash price. This dynamic can be advantageous for individuals with high-deductible plans, as paying the cash price directly may result in lower out-of-pocket costs compared to the insurance allowed amount, provided the patient's deductible has been met.
To minimize potential costs, patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% for upfront payment. Additionally, if a patient receives an itemized bill that includes unexpected charges or broad category summaries, they should request a full line-by-line audit to identify errors, unbundled codes, or services not rendered. Since over 80% of hospital bills contain inaccuracies, verifying the exact CPT codes and unit costs before paying is a critical step in avoiding unnecessary debt.