CT scan, lower back (lumbar spine)
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $2,570
- Cash Discount Price: $3,427
- vs. Medicare Baseline: 24.06x 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 2406% of the Medicare baseline (a markup of 2306%). 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 | $2,056 | 1925% |
| Americas Choice Provider Network | $2,399 | 2246% |
| Velocity | $2,570 | 2406% |
| Quiktrip Corporation | $2,570 | 2406% |
| Usa Managed Care Organization | $2,570 | 2406% |
| Provider Network Of America | $2,570 | 2406% |
| Multiplan-Phcs | $2,741 | 2566% |
| Prime Health Services | $2,913 | 2727% |
| Medincrease | $3,084 | 2887% |
Consumer Guidance & Cost Commentary
For the CPT code 72131 (CT scan, lower back), the Rehabilitation Hospital Of Overland Park lists a cash median price of $3,427.00, which matches the facility's gross charge. This cash rate is significantly higher than the state of Kansas average, which is 24.1% lower than the facility's listed price. While commercial payers negotiate rates ranging from $2,056 to $2,913 depending on the specific insurance plan, these negotiated amounts remain below the cash price. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $3,427.00 upfront may result in lower total costs compared to having insurance pay a negotiated rate that exceeds the cash amount.
It is important to note that the facility's cash rate serves as the baseline for potential discounts; commercial insurance contracts often include administrative overhead that inflates the baseline price by 20% to 40% relative to the cash price. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these incentives can reduce the final amount owed. Additionally, consumers should avoid accepting summary bills that obscure individual charges, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. To ensure accuracy, always request a full itemized CPT-coded statement before making any payment or negotiating a settlement.