CT scan, lower back (lumbar spine)
Facility: Osborne County Memorial Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $933
- Cash Discount Price: $876
- vs. Medicare Baseline: 8.74x 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 874% of the Medicare baseline (a markup of 774%). 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 |
|---|---|---|
| UnitedHealthcare | $784 | 734% |
| Health Partners Of Kansas | $887 | 830% |
| Wppa | $979 | 917% |
| Blue Cross Blue Shield | $1,010 | 946% |
Consumer Guidance & Cost Commentary
For the CT scan of the lower back at Osborne County Memorial Hospital, the cash price of $876.00 is notably lower than the facility's gross charge of $1,031.00. While the hospital is a Critical Access Hospital in Osborne, Kansas, and is owned by the local government, the data indicates that the cash rate is higher than the Medicare benchmark of $106.81. It is important to note that while cash payments can sometimes be cheaper for patients with high-deductible plans, the negotiated rates for this procedure range from $784 to $1,010 depending on the specific insurance carrier. Patients should verify their specific plan's allowed amount before scheduling, as the negotiated rate serves as a ceiling that protects in-network members but may still exceed the cash price.
To minimize potential costs, patients should proactively ask about "prompt-pay" discounts, which are fee reductions typically offered for upfront payment within 30 days. These discounts bypass the administrative overhead of insurance claims processing and can significantly lower the final bill. Additionally, if a patient receives a surprise balance bill for out-of-network services, they may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. Consumers are advised to request a full itemized bill before paying and to dispute any errors in writing, as over 80% of hospital bills contain mistakes that can be corrected to reduce medical debt.