CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Sisters of Charity Hospital

Billing Code: 72131 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$108

about 1.0× the $107 Medicare rate · typically $92–$127

modeled estimate · not a bill or quote

What this hospital charges insurers

$129

Above the fair price

about $21 over the fair price · 1.2× Medicare

Medicare pays $107 Fair price $108 This hospital $129 Cash price $616 Hospital's list price $616

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

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

Cheapest $48 Priciest $129

Black dot = this hospital, among the 9 NY 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 $108 (about 1.0× the $107 Medicare rate). Sisters of Charity Hospital charges insurers about $129, or about $616 in cash — above the fair price. Located in Buffalo, NY.

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 $108. 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	$32 - $173	30%
Blue Cross Blue Shieldmajor	$42 - $318	39%
Aetnamajor	$48 - $133	45%
Cignamajor	$46 - $184	43%
Humanamajor	$48 - $133	45%
Amerigroup	$72 - $237	67%
Fidelis Care	$48 - $318	45%
Independent Health	$42 - $303	39%
Molina	$94 - $448	88%
MVP Health Care	$62 - $188	58%
UPMC Health Plan	$82 - $228	77%
WellCare	$48 - $139	45%
+ 16 smaller / regional plans	$40 - $514

Government programs also on file: Medicare, Medicaid, Military & VA.

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 616), 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 Sisters of Charity 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 Sisters of Charity Hospital

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

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