CT scan, lower back (lumbar spine)
Facility: Mitchell County Hospital Health Systems
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $1,791
- Cash Discount Price: $1,697
- vs. Medicare Baseline: 16.77x 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 1677% of the Medicare baseline (a markup of 1577%). 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 | $107 - $1,885 | 100% |
| Blue Cross Blue Shield | $458 | 429% |
| Triwest Well Mark All Plans | $1,602 | 1500% |
| Pref Hlth Care Sytms Comm - All Plans | $1,696 | 1588% |
| First Health-All Plans | $1,696 | 1588% |
| Aetna | $1,696 | 1588% |
| Auxiant-All Plans | $1,791 | 1677% |
| Multiplan Ppo - All Plans | $1,791 | 1677% |
| Phc Leased Ntwrk Access - All Plans | $1,791 | 1677% |
| Health Partners Ks-All Plans | $1,866 | 1747% |
| Cigna | $1,866 | 1747% |
Consumer Guidance & Cost Commentary
For the CPT code 72131 (CT scan, lower back), Mitchell County Hospital Health Systems lists a cash median price of $1,697, which is significantly lower than the facility's gross charge of $1,885. While the facility is a Critical Access Hospital in Beloit, KS, with a government-local ownership structure, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead. For instance, UnitedHealthcare's negotiated rate ranges from $107 to $1,885 across three plans, and Blue Cross Blue Shield's single plan rate is $458, both of which are lower than the cash median. However, many other payers, including Aetna, Cigna, and Triwest Well Mark All Plans, have fixed negotiated rates ranging from $1,696 to $1,866, which are higher than the cash price. This demonstrates that for patients with high-deductible plans, paying the cash median of $1,697 upfront may result in lower out-of-pocket costs compared to the insurance allowed amounts if their deductible has not yet been met.
To ensure you receive the most accurate pricing, it is essential to request a prompt-pay discount before scheduling your visit, as hospitals often offer fee reductions of 20% to 50% for upfront payment to bypass costly claims processing. Additionally, if you are concerned about balance billing or unexpected charges, you should demand a full itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. When comparing costs, remember that the Medicare