CT scan, lower back (lumbar spine)
Facility: Goodland Regional Medical Center
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $938
- Cash Discount Price: $938
- vs. Medicare Baseline: 8.78x 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 878% of the Medicare baseline (a markup of 778%). 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 | $458 | 429% |
| Wppa | $886 - $938 | 830% |
| UnitedHealthcare | $938 | 878% |
Consumer Guidance & Cost Commentary
For a CT scan of the lower back at Goodland Regional Medical Center in Goodland, KS, the facility's cash price of $938 is notably higher than the state average, which sits at $938. While the facility is a Critical Access Hospital with government ownership, the negotiated rates for in-network payers like Blue Cross Blue Shield, Wppa, and UnitedHealthcare range from $458 to $938. It is important to note that these negotiated rates often exceed the cash price due to administrative costs and contract structures; however, for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly can sometimes result in lower total costs compared to the insurance negotiated amount.
The facility's pricing is also evaluated against Medicare benchmarks, where the commercial gross charge of $1,042 represents a significant markup over the Medicare amount of $106.81. This disparity highlights how commercial rates can vary widely from federal standards, with the facility's cash rate being 8.8% higher than the Medicare benchmark. To ensure you are receiving the best possible price, we recommend contacting the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce bills by 20% to 50% if paid in full upfront. Additionally, always request an itemized bill before payment to verify that all charges are accurate and that no unnecessary services have been billed.