CT scan, lower back (lumbar spine)
Facility: Oakleaf Surgical Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $104
- Cash Discount Price: $1,983
- vs. Medicare Baseline: 0.97x 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.
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 |
|---|---|---|
| Blue Cross Blue Shield | $104 - $1,748 | 97% |
| Dean Health Plan | $104 | 97% |
| Group Health Cooperative Of Eau Claire | $104 | 97% |
| Healthpartners | $104 | 97% |
| Humana | $104 | 97% |
| Medica | $104 | 97% |
| Quartz Health Solutions | $104 | 97% |
| Security Health Plan Of Wi | $104 - $876 | 97% |
| Ucare Wi | $104 | 97% |
| UnitedHealthcare | $104 | 97% |
| Alliance | $518 | 485% |
Consumer Guidance & Cost Commentary
For patients paying cash directly for a CT scan of the lower back (lumbar spine) at Oakleaf Surgical Hospital, the most important step is to confirm whether the facility offers a "self-pay" or "prompt-pay" discount before scheduling, as these upfront incentives can significantly reduce the final cost. The cash median rate for this procedure is $1,983; however, patients with high-deductible plans should verify if the insurance negotiated rate exceeds this amount, as paying the lower cash price upfront might be more financially advantageous than facing a higher allowed amount after meeting a deductible.
In the broader context of pricing, the facility's cash rate is notably higher than the state of Wisconsin's average, which is $104. While Oakleaf Surgical Hospital is a physician-owned acute care facility with a gross charge of $2,204, the median negotiated rate across 11 payers is $104, aligning with the state average. It is crucial to note that the Medicare amount for this code is $106.81, which serves as the objective benchmark for evaluating the markup on commercial rates. Since the facility is in Altoona, WI, and the data reflects the 2026-06 vintage, patients should request an itemized bill to ensure no errors exist before finalizing payment, as over 80% of hospital bills contain discrepancies.