CT scan, lower back (lumbar spine)
Facility: Jewell County Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $1,140
- Cash Discount Price: $900
- vs. Medicare Baseline: 10.67x 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 1067% of the Medicare baseline (a markup of 967%). 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 |
|---|---|---|
| Rural Carriers - All Plans | $1,020 | 955% |
| Meritain - All Plans | $1,080 | 1011% |
| Aetna | $1,080 | 1011% |
| UnitedHealthcare | $1,140 | 1067% |
| Midlands Choice - All Plans | $1,140 | 1067% |
| First Health - All Plans | $1,140 | 1067% |
| Cigna | $1,140 | 1067% |
Consumer Guidance & Cost Commentary
For the CT scan of the lower back (lumbar spine) at Jewell County Hospital in Mankato, KS, the facility's cash median price is $900, which is lower than the state average of $1,140. While the hospital's negotiated rate with most insurance carriers is $1,140, this amount exceeds the cash price, meaning patients with high-deductible plans might save money by paying cash directly. It is important to note that commercial negotiated rates often include administrative overhead and can be significantly higher than the Medicare benchmark of $106.81 for this procedure, which serves as the objective baseline for evaluating hospital pricing markups.
Patients should verify their specific plan details before scheduling, as assuming that being in-network guarantees the lowest possible price is a common pitfall. If you choose to pay out-of-pocket, ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% by bypassing costly insurance claims processing. Additionally, if you have insurance, ensure you understand your deductible status before using the service, as you may be responsible for the full negotiated rate if you haven't met your out-of-pocket threshold.