CT scan, lower back (lumbar spine)
Facility: Neosho Memorial Regional Medical Center
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $917
- Cash Discount Price: $2,149
- vs. Medicare Baseline: 8.59x 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 859% of the Medicare baseline (a markup of 759%). 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 |
|---|---|---|
| Medicaid / KanCare | $60 | 56% |
| Blue Cross Blue Shield | $531 - $917 | 497% |
| Tricare | $883 | 827% |
| Va_Ccn | $917 | 859% |
| Medadv_Uhc | $917 | 859% |
| Aetna | $917 | 859% |
| Humana | $917 | 859% |
| Medadv_Allwell | $917 | 859% |
| Medicare (plans) | $917 | 859% |
| Ambetter / Centene | $1,444 | 1352% |
| Wppa_Providrscare | $2,378 | 2226% |
| United | $2,384 | 2232% |
| Coventry | $2,722 | 2548% |
| Cigna | $2,722 | 2548% |
| Hpk | $2,722 | 2548% |
Consumer Guidance & Cost Commentary
For this CT scan of the lower back at Neosho Memorial Regional Medical Center in Chanute, Kansas, the facility's cash price of $2,149 is significantly lower than the negotiated rates charged by major insurers like Blue Cross Blue Shield ($531–$917) and United ($2,384). While the facility is a Critical Access Hospital with government local ownership, patients should be aware that commercial insurance contracts often include administrative overhead that inflates the baseline price by 20% to 40%. If you have a high-deductible plan, paying the cash price upfront might be more cost-effective than your insurance allowing a negotiated rate that exceeds the cash amount, provided you have not yet met your deductible.
To ensure you are not overcharged, it is crucial to request an itemized billing audit before paying any invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, if you are self-pay, ask the billing department about "prompt-pay" discounts, which can reduce the total by 20% to 50% if settled within 30 days. Since the facility is in-network for many payers, be cautious of balance billing for out-of-network ancillary services like emergency physicians or labs; under the No Surprises Act, you are generally protected from being billed the difference between the provider's chargemaster and your insurance allowed amount for these services at in-network facilities.