CT scan, lower back (lumbar spine)
Facility: Lancaster General Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $1,289
- Cash Discount Price: $1,748
- vs. Medicare Baseline: 12.07x 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 1207% of the Medicare baseline (a markup of 1107%). 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 |
|---|---|---|
| Medicaid / KanCare | $88 - $207 | 82% |
| Tricare | $96 | 90% |
| UnitedHealthcare | $97 - $1,629 | 91% |
| Gateway | $103 | 96% |
| Highmark | $105 - $1,917 | 98% |
| Albright Life | $106 | 99% |
| Coatesville Va | $106 | 99% |
| Hospice Generic | $106 | 99% |
| Lebanon Veterans Hospital | $106 | 99% |
| Medicare (plans) | $106 - $117 | 99% |
| Aetna | $107 - $1,189 | 100% |
| Amerihealth Caritas | $108 | 101% |
| Blue Cross Blue Shield | $108 - $1,629 | 101% |
| Cigna | $109 - $1,447 | 102% |
| Health Partners Mcr Advantage | $109 | 102% |
| Devoted Health | $112 | 105% |
| Pa Health And Wellness Mcr | $112 | 105% |
| Elap Employees | $151 | 141% |
| Oscar Health Plan | $207 | 194% |
| Upmc For You | $207 | 194% |
| Hospice And Community Care | $300 - $364 | 281% |
| Claim Watcher Plus | $319 | 299% |
| Claim Watcher | $350 | 328% |
| Elap Other Groups | $387 | 362% |
| Old Order Group | $426 - $613 | 399% |
| Lg Coresource/Lg Eliance | $450 - $546 | 421% |
| Lancashire Hall | $474 - $1,917 | 444% |
| Nursing Home Op Services | $474 - $575 | 444% |
| Affilia Home Health | $632 - $1,917 | 592% |
| Masonic Homes | $663 - $1,917 | 621% |
| Eliance Health Solutions | $1,011 - $1,227 | 947% |
| Highmark Commercial Preferred | $1,056 - $1,917 | 989% |
| Ehp | $1,295 - $1,572 | 1212% |
| Upmc Commercial | $1,295 - $1,629 | 1212% |
| Devon | $1,342 - $1,629 | 1256% |
| Geisinger Commercial | $1,342 - $1,629 | 1256% |
| Intergroup Services | $1,342 - $1,629 | 1256% |
| Preferred Healthcare | $1,342 - $1,629 | 1256% |
| Medi-Share Christian Care | $1,500 - $1,821 | 1404% |
| Commercial Generic | $1,579 - $1,917 | 1478% |
| Highmark Commercial Non-Preferred | $1,579 - $1,933 | 1478% |
| Magellan | $1,579 - $1,917 | 1478% |
| United Behavioral Health | $1,579 - $1,917 | 1478% |
| Value Options | $1,579 - $1,917 | 1478% |
| Workers Compensation | $1,579 - $1,917 | 1478% |
| Gift Of Life Donor Program | $13,500 | 12639% |