CT scan, lower back (lumbar spine)
Facility: Satanta District Hospital, Clinics, & Ltcu
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $546
- Cash Discount Price: $682
- vs. Medicare Baseline: 5.11x 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 511% of the Medicare baseline (a markup of 411%). 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 |
|---|---|---|
| Direct Benefit-All Plans | $182 | 170% |
| UnitedHealthcare | $220 - $758 | 206% |
| Berkley Net-All Plans | $303 | 284% |
| Aetna | $334 - $515 | 313% |
| Trustmark Health Benefits-All Plans | $334 | 313% |
| Meritain Health-All Plans | $341 | 319% |
| Ambetter / Centene | $364 | 341% |
| Axa Equitable - All Plans | $417 | 390% |
| Pinnacol-All Plans | $424 | 397% |
| Medi-Share-All Plans | $432 | 404% |
| Presbyterian-All Plans | $462 | 433% |
| Kasb Work Comp - All Plans | $485 | 454% |
| The Kempton Group Admin-All Plans | $523 | 490% |
| Auxiant - All Plans | $531 | 497% |
| Gpha(Wppa)-All Other Plans | $531 | 497% |
| Wppa- All Plans | $538 | 504% |
| Sisco-All Plans | $546 | 511% |
| Emc-All Plans | $546 | 511% |
| Providers Care Network- All Plans | $546 | 511% |
| Gpha Employee Benefit Plan | $553 | 518% |
| Employee Benefit-All Plans | $568 | 532% |
| Regional Care(Wppa)-All Plans | $568 | 532% |
| First Health -All Plans | $576 | 539% |
| Triangle-All Plans | $576 | 539% |
| One Call Physician-All Plans | $584 | 547% |
| Blue Cross Blue Shield | $599 | 561% |
| Tricare | $606 | 567% |
| Christian Hospital Aid - All Plans | $606 | 567% |
| Humana | $652 | 610% |
| Cigna | $667 | 624% |
| Luminare Health- All Plans | $667 | 624% |
| Coresource-All Plans | $682 | 639% |
| Deseret Mutual(Uhis)-All Plans | $682 | 639% |
| Vaccn-All Plans | $697 | 653% |
| Hma Llc-All Plans | $720 | 674% |
| Reserve National-All Plans | $720 | 674% |
| Wps Vapc-All Plans | $720 | 674% |
| Medicaid / KanCare | $758 | 710% |
Consumer Guidance & Cost Commentary
For the CT scan of the lower back (lumbar spine) at Satanta District Hospital, the cash price is $682.00, which is significantly lower than the negotiated rates charged by most insurance plans. While the facility's cash rate is $155.19 higher than the state average of $526.81, it remains well below the gross charge of $758.00 and the highest negotiated rates seen among payers like Medicaid/KanCare at $758.00 and Humana at $652.00. Because commercial insurance contracts often include administrative overheads that inflate the final allowed amount, paying cash directly can sometimes result in a lower out-of-pocket cost, especially for patients with high deductibles or those without insurance.
Patients should verify if their specific insurance plan has a negotiated rate that exceeds the cash price before scheduling, as some commercial payers may allow amounts higher than the self-pay rate. Additionally, since this facility is a Critical Access Hospital owned by a government authority, it may offer prompt-pay discounts for upfront payment, which can further reduce the final bill. To ensure you are not overcharged, always request an itemized bill before paying and dispute any summary invoices that do not show specific CPT codes, as over 80% of hospital bills contain errors such as unbundled services or charges for items not rendered.