CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Knapp Medical Center

Billing Code: 72131 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72131
  • Insurance Median: $110
  • Cash Discount Price: $104
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a CT scan, lower back (lumbar spine) at Knapp Medical Center is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.03x the Medicare baseline. Located in 1401 East Eight Street, Weslaco, TX.
Cash / Self-Pay
$104

Average discount available for prompt cash payment at this facility.

Insurance Median
$110

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: $104 (97%)
Insurance Median: $110 (103%)
Cash: $104 (97% of Medicare)
Ins. Median: $110 (103% 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.

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
Corvel $73 68%
Zelis Healthcare Fka Stratose $78 73%
Provider Network Of America $84 79%
Provider Select $91 85%
Three Rivers $94 88%
Americas Choice Provider Network (Acpn) $101 95%
Division Of Immigration Health $102 95%
Blue Cross Blue Shield $105 - $405 98%
Cigna $105 - $208 98%
Coventry (First Health) $105 98%
Medicare (plans) $105 98%
Prime Health Services $105 98%
Superior Health Plan $105 - $213 98%
Texas Bluebonnet Health Plan $105 - $172 98%
Tricare $105 98%
UnitedHealthcare $105 - $213 98%
Veterans Evaluation Services $105 98%
Wellmed Aarp Ma Fka Physicians Health Choice $105 98%
Worker Comp $105 98%
Molina $110 - $225 103%
Multiplan $110 103%
Provider Partners Health Plan $110 103%
Imperial Insurance Companies $111 104%
Texas Oncology Pa Op $131 123%
Frontier Health (Fka Asserta Health) $136 127%
Magic Valley Electric Cooperative $136 127%
Employer Direct Healthcare $146 137%
Corporate Remedies (Wc) $157 147%
Naphcare $162 152%
Occunet $183 171%
Medicaid / KanCare $202 - $208 189%
Baker Benefits Administrators $209 196%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 East Eight Street, Weslaco, TX 78596
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals