CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Ogallala Community Hospital

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72131
Insurance Median: $2,970
Cash Discount Price: $1,994
vs. Medicare Baseline: 27.81x Medicare

The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Ogallala Community Hospital is $2,970. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,994. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 27.81x the Medicare baseline. Located in 2601 North Spruce St, Ogallala, NE.

Cash / Self-Pay

$1,994

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,970

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: $1,994 (1867%)

Insurance Median: $2,970 (2781%)

Cash: $1,994 (1867% of Medicare)

Ins. Median: $2,970 (2781% 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 2781% of the Medicare baseline (a markup of 2681%). 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
Banner Health	$1,375	1287%
Blue Cross Blue Shield	$1,375 - $3,001	1287%
Medica	$1,375 - $2,979	1287%
Triwest Healthcare Alliance Corp - Va Ccn	$1,375	1287%
UnitedHealthcare	$1,438 - $2,970	1346%
Molina Healthcare	$1,532	1434%
Nebraska Total Care	$1,532	1434%
Keith County Sheriff’S Office	$2,344	2195%
Apostrophe, Inc.	$2,813	2634%
Coventry	$3,001	2810%
First Health	$3,001	2810%
Midlands Choice	$3,001	2810%
Multiplan	$3,032	2839%

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 $1,994.
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 Ogallala Community Hospital 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.