CT scan, lower back (lumbar spine)
Facility: Liberty Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $212
- Cash Discount Price: $726
- vs. Medicare Baseline: 1.98x 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.
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 | $49 - $2,038 | 46% |
| Aetna | $98 - $1,503 | 92% |
| Cigna | $98 | 92% |
| UnitedHealthcare | $98 - $169 | 92% |
| Medicare (plans) | $99 - $107 | 93% |
| Humana | $100 | 94% |
| Healthy Blue | $105 | 98% |
| Ambetter / Centene | $124 | 116% |
| Home State Health | $143 | 134% |
| Fox Everett | $1,540 - $1,546 | 1442% |
| Phcs | $1,925 - $1,933 | 1802% |
| Multiplan | $2,131 - $2,139 | 1995% |
Consumer Guidance & Cost Commentary
For patients paying out of pocket, the most important thing to know is that cash prices can sometimes be lower than what insurance companies pay, making self-pay a potentially smarter financial choice. For this CT scan of the lumbar spine at Liberty Hospital in Liberty, MO, the cash rate is $726, which is significantly lower than the facility's gross charge of $2,572. However, many commercial payers have negotiated rates that exceed this cash amount; for instance, Blue Cross Blue Shield's lowest allowed amount is $49, while their highest is $2,038, and Aetna's range is $98 to $1,503. Because these negotiated rates vary widely by plan, patients with high-deductible plans should verify if their specific insurer's allowed amount is higher than $726, as paying cash upfront could save them money. It is also crucial to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill.
The broader pricing context shows that while the cash rate of $726 is competitive, the facility's commercial interactions reveal significant markup relative to federal benchmarks. The Medicare allowed amount for this procedure is $106.81, which serves as a baseline for evaluating fair pricing, with commercial negotiated rates typically ranging from 200% to 300% of this figure. Liberty Hospital's negotiated rates align closely with this spectrum, with the highest payer, Multiplan, allowing $2,139 and the lowest, Healthy Blue, allowing $105. Although specific county or state average data was not provided in the source information, understanding that commercial rates often