CT scan, lower back (lumbar spine)
Facility: Republic County Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $1,104
- Cash Discount Price: $900
- vs. Medicare Baseline: 10.34x 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 1034% of the Medicare baseline (a markup of 934%). 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% |
| Aetna | $1,080 | 1011% |
| Meritain-All Plans | $1,080 | 1011% |
| UnitedHealthcare | $1,104 | 1034% |
| Cigna | $1,140 | 1067% |
| Midlands Choice-All Plans | $1,140 | 1067% |
| First Health-All Plans | $1,140 | 1067% |
Consumer Guidance & Cost Commentary
For a CT scan of the lower back at Republic County Hospital in Belleville, Kansas, the negotiated rates paid by major insurance carriers range from $1,020 to $1,140, with a median negotiated amount of $1,080. This commercial rate is significantly higher than the facility's cash price of $900, which may represent a better option for patients with high-deductible plans who have not yet met their out-of-pocket maximum. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the data indicates a 10.3% variance compared to the Medicare benchmark of $106.81, highlighting that commercial contracts often include substantial administrative markups. Patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting the deductible can result in substantial out-of-pocket costs.
To minimize unexpected expenses, consumers should proactively request a self-pay or prompt-pay discount before check-in, which can reduce the total cost by 20% to 50% by bypassing insurance claims processing fees. If a balance bill arises from an out-of-network service, such as an emergency physician or lab, patients are protected under the No Surprises Act and should dispute the bill with their insurer rather than paying immediately. Furthermore, patients should demand a full itemized CPT-coded bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors like double-billing or unbundled codes that can be corrected through a formal written audit dispute sent to the billing supervisor.