CT scan, lower back (lumbar spine)
Facility: Logan County Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $1,031
- Cash Discount Price: $375
- vs. Medicare Baseline: 9.65x 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 965% of the Medicare baseline (a markup of 865%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $480 | 449% |
| Humana | $636 | 595% |
| Health Partners - All Plans | $1,425 | 1334% |
| Medicaid / KanCare | $1,500 | 1404% |
Consumer Guidance & Cost Commentary
For a CT scan of the lower back at Logan County Hospital in Oakley, Kansas, the facility's negotiated rates range from $480 to $1,500 depending on your insurance plan, with the lowest allowed amount being $480 for Blue Cross Blue Shield. While the facility is a Critical Access Hospital owned by the local government, its cash price of $375 is significantly lower than the median negotiated rate of $1,031 paid by most insurers. This price difference highlights a common billing dynamic where commercial insurance contracts often include administrative overhead that inflates the final cost compared to direct cash payment. If you have a high-deductible plan, paying the cash price upfront might result in lower out-of-pocket expenses than your insurance allowing a higher negotiated rate, provided you have not yet met your deductible.
To ensure you are receiving the best possible rate, it is important to verify your specific plan's allowed amount before scheduling the procedure, as in-network rates can vary widely even within the same facility. The No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, but you should still request a self-pay or prompt-pay discount if you choose to pay directly, which could reduce the cost further. Since over 80% of hospital bills contain errors, do not accept a summary invoice as final; instead, request a detailed itemized bill to review every code and charge. For context, while specific county or state average comparisons were not provided in this dataset, comparing your specific plan's allowed amount to the facility's Medicare benchmark of $106.81 can reveal the true markup of the commercial rates you are being charged.