CT scan, lower back (lumbar spine)
Facility: Minneola District Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $490
- Cash Discount Price: $338
- vs. Medicare Baseline: 4.59x 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 459% of the Medicare baseline (a markup of 359%). 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 | $44 - $615 | 41% |
| Humana | $44 - $412 | 41% |
| Va Community Care Program-All Plans | $44 - $412 | 41% |
| Medicaid / KanCare | $107 - $615 | 100% |
| Providrs Care Network-All Plans | $107 - $523 | 100% |
| Aetna | $107 - $615 | 100% |
| Blue Cross Blue Shield | $458 | 429% |
| Corporate Plan Management-All Plans | $523 | 490% |
| Preferred Health Care (Coventry)-All Other Plans | $554 | 519% |
| Triwest-All Plans | $554 | 519% |
| Health Partners Of Kansas-All Plans | $584 | 547% |
| Phc (Coventry) Leased Network | $584 | 547% |
Consumer Guidance & Cost Commentary
For a CT scan of the lower back at Minneola District Hospital, the cash price is $338, which is lower than the facility's negotiated rates for most major payers. While the facility's cash rate is below the state average of $490, patients with high-deductible plans may find that paying out-of-pocket is more cost-effective than using insurance, as many commercial payers negotiate rates significantly higher than the cash price. For instance, UnitedHealthcare and Aetna have negotiated rates reaching up to $615, whereas the cash option remains at $338. Because this is a Critical Access Hospital in Kansas, patients should explicitly ask about self-pay or prompt-pay discounts before scheduling, as these upfront incentives can further reduce the final cost.
The facility's Medicare benchmarking rate of $106.81 serves as a baseline for evaluating pricing fairness, with the cash rate representing a reasonable markup compared to the federal government's fixed reimbursement. Although the facility is owned by a government hospital district, the data shows that commercial negotiated rates vary widely, ranging from $44 for some plans to $615 for others, reflecting the complex dynamics of insurance contracts. To avoid unexpected balance billing, patients should verify their network status and ensure that any ancillary services, such as lab work, are covered under their plan. If a patient receives a bill exceeding the negotiated amount, they should request an itemized audit to identify errors or unbundled charges, as over 80% of hospital bills contain discrepancies that can be corrected through formal dispute processes.