CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Metropolitan Hospital Center

Billing Code: 72131 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$192

about 1.8× the $107 Medicare rate · typically $135–$354

modeled estimate · not a bill or quote

What this hospital charges insurers

$313

Above the fair price

about $121 over the fair price · 2.9× Medicare

Medicare pays $107 Fair price $192 This hospital $313 Hospital's list price $1,100

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 $313

Black dot = this hospital, among the 9 NY 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). Metropolitan Hospital Center charges insurers about $313 — above the fair price. Located in New York, 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 $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.

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	$140 - $880	131%
Blue Cross Blue Shieldmajor	$126 - $880	118%
Aetnamajor	$51 - $1,131	48%
Cignamajor	$1,056	989%
Fidelis Care	$73 - $826	68%
MagnaCare	$825	772%
Oscar Health	$76 - $1,228	71%
WellCare	$55 - $162	51%
+ 14 smaller / regional plans	$41 - $935

Government programs also on file: Military & VA.

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 Metropolitan Hospital 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 Metropolitan Hospital Center

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

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