CT scan, lower back (lumbar spine)
Facility: Lindsborg Community Hospital
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $2,473
- Cash Discount Price: $1,892
- vs. Medicare Baseline: 23.15x 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 2315% of the Medicare baseline (a markup of 2215%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $453 | 424% |
| Tricare | $1,270 | 1189% |
| Coventry Mcr Adv | $1,283 | 1201% |
| Cigna | $2,297 | 2151% |
| Coventry Comm-All Other Plans | $2,432 | 2277% |
| UnitedHealthcare | $2,432 | 2277% |
| Multiplan-All Plans | $2,513 | 2353% |
| Phcs Preferred-All Plans | $2,513 | 2353% |
| Coventry Wc | $2,567 | 2403% |
| Wppa-All Plans | $2,567 | 2403% |
| Century Health-All Plans | $2,567 | 2403% |
| Health Partners -All Plans | $2,567 | 2403% |
Consumer Guidance & Cost Commentary
For a CT scan of the lower back (lumbar spine) at Lindsborg Community Hospital, the facility's cash price of $1,892 is lower than the median negotiated rate of $2,513 paid by insurance plans. This cash rate is also significantly lower than the gross chargemaster of $2,703. While the facility is a Critical Access Hospital in Lindsborg, KS, the data provided does not include specific county or state average comparisons for this procedure, so no direct regional benchmarking is available. However, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates from payers like Multiplan and Phcs Preferred exceed the cash amount.
To minimize out-of-pocket costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the bill. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request an itemized bill to ensure no unbundled codes or services not rendered are included. Since over 80% of hospital bills contain errors, reviewing the line-by-line charges against the Medicare benchmark of $106.81 can help identify any discrepancies, though commercial rates often run higher than this federal baseline due to administrative and contract structures.