CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Robert Wood Johnson University Hospital - Somerset

Billing Code: 72131 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$192

about 1.8× the $107 Medicare rate · typically $132–$243

modeled estimate · not a bill or quote

What this hospital charges insurers

$221

Above the fair price

about $29 over the fair price · 2.1× Medicare

Medicare pays $107 Fair price $192 This hospital $221 Cash price $622 Hospital's list price $3,681

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 $221

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 $192 (about 1.8× the $107 Medicare rate). Robert Wood Johnson University Hospital - Somerset charges insurers about $221, or about $622 in cash — above the fair price. Located in Somerville, NJ.

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 $192. 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	$119 - $532	111%
Blue Cross Blue Shieldmajor	$73 - $3,367	68%
Aetnamajor	$116 - $582	109%
Cignamajor	$221 - $296	207%
Humanamajor	$116	109%
AmeriHealth	$387	362%
Clover Health	$116	109%
Fidelis Care	$116 - $547	109%
WellCare	$231	216%
+ 2 smaller / regional plans	$203 - $1,409

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 622), 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 Robert Wood Johnson University Hospital - Somerset 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 Robert Wood Johnson University Hospital - Somerset

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

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