CT scan, lower back (lumbar spine)
Facility: Mercy Hospital of Buffalo
Billing Code: 72131 (CPT)
- CPT Billing Code: 72131
- Insurance Median: $98
- Cash Discount Price: $616
- vs. Medicare Baseline: 0.92x 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 |
|---|---|---|
| UnitedHealthcare | $32 - $173 | 30% |
| Medicaid / KanCare | $37 - $199 | 35% |
| VA Veterans Affairs [700001] | $39 - $127 | 37% |
| Univera Healthcare [100169] | $40 - $156 | 37% |
| Univera Healthcare Essential [100170] | $40 - $170 | 37% |
| Fidelis Essential [100163] | $41 - $318 | 38% |
| Beacon Essential [350122] | $41 - $152 | 38% |
| Crime Victims [100176] | $42 - $199 | 39% |
| Vna Option Mltc [350110] | $42 - $199 | 39% |
| Blue Cross Blue Shield | $42 - $318 | 39% |
| Amerigroup [350102] | $42 - $237 | 39% |
| Excellus Rochester McD [350117] | $42 - $199 | 39% |
| Tuscarora Nation [550120] | $42 - $199 | 39% |
| Independent Health Essential [100166] | $42 - $199 | 39% |
| Ghi [100153] | $43 - $120 | 40% |
| Medicare (plans) | $45 - $183 | 42% |
| Aetna | $46 - $133 | 43% |
| Champ VA [700002] | $46 - $127 | 43% |
| Meritain [100063] | $46 - $127 | 43% |
| Hospice [550001] | $46 - $127 | 43% |
| Fallon Health [450115] | $46 - $127 | 43% |
| Humana | $46 - $133 | 43% |
| Seneca Nation [450119] | $46 - $127 | 43% |
| Catholic Health Life Pace [400005] | $46 - $127 | 43% |
| Magnacare [100142] | $46 - $127 | 43% |
| Tricare | $46 - $127 | 43% |
| Cigna | $46 - $184 | 43% |
| Covid19 Hrsa [45013] | $46 - $127 | 43% |
| Fidelis Dual Advantage [450120] | $47 - $133 | 44% |
| Wellcare Fidelis Dual [450451] | $47 - $133 | 44% |
| Wellcare [450129] | $50 - $139 | 47% |
| Iha First Choice [800001] | $50 - $306 | 47% |
| Independent Health [100165] | $50 - $303 | 47% |
| Beacon Health Options [100023] | $55 - $152 | 51% |
| Fidelis Exchange [100164] | $55 - $152 | 51% |
| UPMC Health Plan [100181] | $62 - $289 | 58% |
| Mvp Healthcare [100168] | $62 - $188 | 58% |
| Molina Essential [100167] | $94 - $448 | 88% |
| Federal Workers Compensation [500100] | $129 - $514 | 121% |
| No Fault [114001] | $129 - $514 | 121% |