CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Alice Peck Day Memorial Hospital

Billing Code: 72131 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$426

about 4.0× the $107 Medicare rate · typically $118–$915

modeled estimate · not a bill or quote

What this hospital charges insurers

$367

Below the fair price — a good deal

about $59 under the fair price · 3.4× Medicare

Medicare pays $107 Fair price $426 This hospital $367 Cash price $1,142 Hospital's list price $2,118

How we calculate the fair BaseRate →

How this hospital compares to other NH hospitals

On the higher side — 6 of 8 other NH hospitals charge less.

Cheapest $85 Priciest $422

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, lower back (lumbar spine) is about $426 (about 4.0× the $107 Medicare rate). Alice Peck Day Memorial Hospital charges insurers about $367, or about $1,142 in cash — below the fair price — a good deal. Located in Lebanon, NH.

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	$1,525	1428%
Blue Cross Blue Shieldmajor	$690 - $1,885	646%
Aetnamajor	$1,906 - $2,012	1784%
Cignamajor	$784 - $1,733	734%
Humanamajor	$2,203	2063%
Ambetter (Centene)	$43	40%
Harvard Pilgrim	$1,317 - $1,836	1233%
MVP Health Care	$1,927	1804%
Tufts Health Plan	$1,553	1454%
+ 4 smaller / regional plans	$44 - $832

Government programs also on file: Medicaid.

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 1,142), 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 Alice Peck Day Memorial Hospital 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 Alice Peck Day Memorial Hospital

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

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