CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Garden County Health Services

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $2,512
  • Cash Discount Price: $2,033
  • vs. Medicare Baseline: 23.52x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Garden County Health Services is $2,512. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,033. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 23.52x the Medicare baseline. Located in 1100 West 2Nd St, Oshkosh, NE.
Cash / Self-Pay
$2,033

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,512

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: $2,033 (1903%)
Insurance Median: $2,512 (2352%)
Cash: $2,033 (1903% of Medicare)
Ins. Median: $2,512 (2352% 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 2352% of the Medicare baseline (a markup of 2252%). 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.

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 $1,776 1663%
UnitedHealthcare $2,213 2072%
Medica $2,482 2324%
Blue Cross Blue Shield $2,542 2380%
Midlands Choice $2,841 2660%
Aetna $2,870 2687%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 West 2Nd St, Oshkosh, NE 69154
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals