CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Great Plains Health

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $165
Cash Discount Price: $740
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Great Plains Health is $165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $740. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.54x the Medicare baseline. Located in 601 West Leota St, North Platte, NE.

Cash / Self-Pay

$740

Average discount available for prompt cash payment at this facility.

Insurance Median

$165

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: $740 (693%)

Insurance Median: $165 (154%)

Cash: $740 (693% of Medicare)

Ins. Median: $165 (154% 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.

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
Nebraska Total Care	$48 - $115	45%
Molina	$52 - $126	49%
Midwest Network Alliance	$90 - $1,997	84%
Blue Cross Blue Shield	$94 - $2,028	88%
Ambetter / Centene	$101 - $524	95%
Medica	$118 - $2,108	110%
Midlands Choice	$159 - $2,131	149%
Oscar Health	$162 - $2,131	152%
Coventry	$164 - $2,176	154%
Geha	$164 - $2,154	154%
Mutual Of Omaha	$165 - $2,176	154%
UnitedHealthcare	$362 - $2,176	339%

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 $740.
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 Great Plains Health 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.