CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Lee's Summit Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $3,018
Cash Discount Price: $14,105
vs. Medicare Baseline: 28.26x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Lee's Summit Medical Center is $3,018. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,105. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 28.26x the Medicare baseline. Located in 2100 Se Blue Parkway, Lees Summit, MO.

Cash / Self-Pay

$14,105

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,018

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $14,105 (13206%)

Insurance Median: $3,018 (2826%)

Cash: $14,105 (13206% of Medicare)

Ins. Median: $3,018 (2826% of 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 2826% of the Medicare baseline (a markup of 2726%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
United	$60 - $6,790	56%
Healthyblue	$61	57%
Aetna	$62 - $7,695	58%
Amerigroup	$62	58%
Medicaid / KanCare	$62	58%
Unicare	$62	58%
Home State Health Plan	$63	59%
Cigna	$122 - $12,071	114%
Multiplan	$169 - $11,166	158%
Corvel Corporation	$201 - $9,808	188%
Oha Network	$210 - $7,544	197%
Blue Cross Blue Shield	$323 - $6,488	302%
Humana	$363 - $468	340%
Ambetter / Centene	$2,441 - $2,806	2285%
Nhc Advantage	$2,493 - $2,867	2334%
Wppa Providrs Care Network	$2,624 - $3,018	2457%
Universal Healthcare	$4,592 - $5,281	4299%
Coventry	$5,275 - $6,066	4939%
Coventry Kc Mo	$5,380 - $6,186	5037%
College Park Family Care Center	$5,642 - $6,488	5282%
Focus Healthcare Mgmt, Inc	$9,841 - $11,317	9214%
Cco, Inc.	$11,153 - $12,825	10442%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $14,105.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72131.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lee's Summit Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72131.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.