CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Howard County Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $443
Cash Discount Price: $2,669
vs. Medicare Baseline: 4.15x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Howard County Medical Center is $443. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,669. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.15x the Medicare baseline. Located in P O Box 406, 1113 Sherman St, St Paul, NE.

Cash / Self-Pay

$2,669

Average discount available for prompt cash payment at this facility.

Insurance Median

$443

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: $2,669 (2499%)

Insurance Median: $443 (415%)

Cash: $2,669 (2499% of Medicare)

Ins. Median: $443 (415% 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 415% of the Medicare baseline (a markup of 315%). 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
Medica Standard Premier	$44 - $121	41%
Aetna	$45 - $2,536	42%
Medica Elevate	$86 - $237	81%
Midland'S Choice	$90 - $249	84%
Humana	$101	95%
Blue Cross Blue Shield	$119 - $2,536	111%
Great Plains	$119 - $1,521	111%
Medica Chi	$119 - $1,521	111%
Tricare	$119 - $2,002	111%
UnitedHealthcare	$119 - $2,562	111%
Nebraska Total Care - Wellcare	$122	114%
Molina Healthcare	$124 - $1,334	116%
Oscar Health	$207	194%
Ambetter / Centene	$237	222%
Beshp	$237	222%
Nebraska Total Care	$1,334	1249%
Medica Chi Aco	$2,429	2274%
Medica Choice National	$2,429	2274%
Medica Ifb Aco	$2,562	2399%
Medica Ifb Open Access	$2,562	2399%

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 $2,669.
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 Howard County 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.