CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Saint Joseph East

Billing Code: 72131 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$377

about 3.5× the $107 Medicare rate · typically $130–$854

modeled estimate · not a bill or quote

What this hospital charges insurers

$849

Well above the fair price

about $472 over the fair price · 7.9× Medicare

Medicare pays $107 Fair price $377 This hospital $849 Cash price $1,324 Hospital's list price $3,297

How we calculate the fair BaseRate →

How this hospital compares to other KY hospitals

Highest price of the 9 KY hospitals we have prices for — worth calling around.

Cheapest $56 Priciest $849

Black dot = this hospital, among the 9 KY hospitals with a price for this procedure. Full list below.

A fair price for a CT scan, lower back (lumbar spine) is about $377 (about 3.5× the $107 Medicare rate). Saint Joseph East charges insurers about $849, or about $1,324 in cash — well above the fair price. Located in Lexington, KY.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $377. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$109 - $2,737	102%
Blue Cross Blue Shieldmajor	$104 - $900	97%
Aetnamajor	$108 - $2,077	101%
Cignamajor	$2,110	1975%
Humanamajor	$104 - $849	97%
CareSource	$209	196%
Molina	$110 - $806	103%
WellCare	$104 - $840	97%

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,324), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72131.

Insurance Before you use insurance

Call your insurance company to confirm Saint Joseph East is in-network.
Ask your insurer whether prior approval is required for CPT code 72131.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Saint Joseph East

Compare: CT scan, lower back (lumbar spine) at other KY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.