CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: St Joseph's University Medical Center Inc

Billing Code: 72131 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$162

about 1.5× the $107 Medicare rate · typically $109–$187

modeled estimate · not a bill or quote

What this hospital charges insurers

$130

Below the fair price — a good deal

about $32 under the fair price · 1.2× Medicare

Medicare pays $107 Fair price $162 This hospital $130 Cash price $2,335 Hospital's list price $2,335

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

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

Cheapest $118 Priciest $147

Black dot = this hospital, among the 9 NJ 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 $162 (about 1.5× the $107 Medicare rate). St Joseph's University Medical Center Inc charges insurers about $130, or about $2,335 in cash — below the fair price — a good deal. Located in Paterson, NJ.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$38 - $415	36%
Blue Cross Blue Shieldmajor	$50 - $466	47%
Aetnamajor	$50 - $480	47%
Cignamajor	$2,335	2186%
Ambetter (Centene)	$50 - $186	47%
AmeriHealth	$50 - $1,487	47%
Clover Health	$50 - $147	47%
Fidelis Care	$38 - $467	36%
Health Net	$386 - $2,102	361%
MagnaCare	$1,634	1530%
Oscar Health	$2,200	2060%
+ 4 smaller / regional plans	$50 - $238

Excludes 2 rental-network / third-party entries (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 2,335), 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 St Joseph's University Medical Center Inc 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 St Joseph's University Medical Center Inc

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

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