CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Capital Health Medical Center - Hopewell

Billing Code: 72131 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$195

about 1.8× the $107 Medicare rate · typically $144–$221

modeled estimate · not a bill or quote

What this hospital charges insurers

$219

About the fair price

about $24 over the fair price · 2.0× Medicare

Medicare pays $107 Fair price $195 This hospital $219 Hospital's list price $34,463

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

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

Cheapest $118 Priciest $219

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

A fair price for a CT scan, lower back (lumbar spine) is about $195 (about 1.8× the $107 Medicare rate). Capital Health Medical Center - Hopewell charges insurers about $219 — about the fair price. Located in Pennington, NJ.

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	$287 - $1,444	269%
Blue Cross Blue Shieldmajor	$118 - $4,318	110%
Aetnamajor	$1,772 - $12,817	1659%
Cignamajor	$325 - $27,078	304%
Humanamajor	$120	112%
Clover Health	$118	110%
Fidelis Care	$186	174%
+ 1 smaller / regional plan	$252

Government programs also on file: Medicare, Medicaid.

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, 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 Capital Health Medical Center - Hopewell 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 Capital Health Medical Center - Hopewell

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

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