CT scan, lower back (lumbar spine)
Facility: Wheatland Memorial Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $305
- Cash Discount Price: $1,127
- vs. Medicare Baseline: 2.86x 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 286% of the Medicare baseline (a markup of 186%). 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 | $46 - $75 | 43% |
| Healthnet Federal-All Plans | $46 - $1,168 | 43% |
| Humana | $46 - $1,168 | 43% |
| Pacific Source Mcr Adv | $46 - $1,168 | 43% |
| Triwest-All Plans | $46 - $1,168 | 43% |
| UnitedHealthcare | $46 - $1,877 | 43% |
| Medica Prime Solutions-All Plans | $47 - $1,168 | 44% |
| Naphcare-All Plans | $74 | 69% |
| Allegiance Provider-All Plans | $76 - $1,628 | 71% |
| First Choice Big Sky-All Plans | $77 - $1,819 | 72% |
| Community Health Ntwk-All Plans | $83 - $1,819 | 78% |
| Interwest Ppo-All Plans | $83 - $1,819 | 78% |
| 6 Degrees Health-All Plans | $84 - $1,819 | 79% |
| Ccn-All Plans | $84 - $1,858 | 79% |
| First Health-All Plans | $84 - $1,838 | 79% |
| Mountain Health Co-Op-All Plans | $84 - $1,819 | 79% |
| Rocky Mountain Health Network-All Plans | $84 - $1,819 | 79% |
| Pacific Steel & Recycling-All Plans | $92 - $1,819 | 86% |
| City Of Billings-All Plans | $99 - $2,872 | 93% |
| Pacific Source-All Other Plans | $104 - $1,819 | 97% |
| Amish Old Orders-All Plans | $254 - $1,436 | 238% |
| Fedmed Network-All Plans | $288 - $1,819 | 270% |
| Americas Choice-All Plans | $322 - $1,819 | 301% |
| Three Rivers-All Plans | $322 - $1,819 | 301% |