CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Englewood Hospital and Medical Center

Billing Code: 72131 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$194

about 1.8× the $107 Medicare rate · typically $132–$256

modeled estimate · not a bill or quote

What this hospital charges insurers

$133

Below the fair price — a good deal

about $61 under the fair price · 1.2× Medicare

Medicare pays $107 Fair price $194 This hospital $133 Cash price $208 Hospital's list price $2,080

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

On the higher side — 7 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.

A fair price for a CT scan, lower back (lumbar spine) is about $194 (about 1.8× the $107 Medicare rate). Englewood Hospital and Medical Center charges insurers about $133, or about $208 in cash — below the fair price — a good deal. Located in Englewood, 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	$125 - $648	117%
Blue Cross Blue Shieldmajor	$125 - $1,206	117%
Aetnamajor	$125 - $1,560	117%
Cignamajor	$1,341	1256%
Humanamajor	$125	117%
Amerigroup	$125 - $204	117%
AmeriHealth	$125 - $955	117%
Clover Health	$125	117%
MagnaCare	$412 - $1,664	386%
WellCare	$135 - $163	126%
+ 13 smaller / regional plans	$113 - $7,783

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 208), 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 Englewood Hospital and Medical Center 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 Englewood Hospital and Medical Center

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

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