CT scan, lower back (lumbar spine)
Facility: Bob Wilson Memorial Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $2,233
- Cash Discount Price: $1,093
- vs. Medicare Baseline: 20.91x 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 2091% of the Medicare baseline (a markup of 1991%). 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 |
|---|---|---|
| Centura Employee Plan | $337 | 316% |
| Blue Cross Blue Shield | $641 | 600% |
| Medicare (plans) | $875 | 819% |
| Aetna | $875 - $2,187 | 819% |
| Humana | $875 | 819% |
| UnitedHealthcare | $875 - $2,280 | 819% |
| Kansas Health | $875 | 819% |
| Multiplan | $2,460 - $2,542 | 2303% |
| Health Partners Of Kansas | $2,569 | 2405% |
| Wppa | $2,597 | 2431% |
Consumer Guidance & Cost Commentary
For a CT scan of the lower back at Bob Wilson Memorial Hospital in Ulysses, Kansas, the cash price is $1,093, which is significantly lower than the facility's negotiated rates with major insurers like Aetna, UnitedHealthcare, and Multiplan. While the hospital's negotiated rates range from $641 to $2,597 depending on the plan, the cash price offers a clear alternative for patients with high-deductible plans or those without insurance, as paying out-of-pocket can sometimes result in a lower total cost than what insurance negotiates. It is important to note that Medicare covers this service at a rate of only $106.81, highlighting that commercial rates are substantially higher than the federal benchmark.
Patients should be aware that while the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the final amount owed depends heavily on whether you use insurance or pay directly. If you choose to use insurance, you may face balance billing if you are out-of-network, though the No Surprises Act protects you from surprise bills for emergency care at in-network facilities. To minimize costs, we recommend requesting a prompt-pay discount before scheduling your visit, as paying in full upfront can often reduce the bill by 20% to 50%. Additionally, if you receive an itemized bill, ensure it breaks down every specific code and service to avoid paying for unbundled charges or items not rendered, and always dispute any errors in writing rather than accepting summary invoices.