CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Hospital Pavia Hato Rey, Inc

Billing Code: 72131 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$126

about 1.2× the $107 Medicare rate · typically $68–$181

modeled estimate · not a bill or quote

What this hospital charges insurers

$122

About the fair price

about $4 under the fair price · 1.1× Medicare

Medicare pays $107 Fair price $126 This hospital $122 Cash price $712 Hospital's list price $712

How we calculate the fair BaseRate →

How this hospital compares to other PR hospitals

One of the lower prices — 6 of 8 other PR hospitals charge more for the same procedure.

Cheapest $109 Priciest $138

Black dot = this hospital, among the 9 PR 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 $126 (about 1.2× the $107 Medicare rate). Hospital Pavia Hato Rey, Inc charges insurers about $122, or about $712 in cash — about the fair price. Located in Hato Rey, PR.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ Cigna✓ Humana UnitedHealthcareBlue Cross Blue ShieldAetnaKaiser 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
Cignamajor	$139	130%
Humanamajor	$132 - $138	124%
+ 13 smaller / regional plans	$56 - $275

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 (about 712), 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 Hospital Pavia Hato Rey, Inc 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 Hospital Pavia Hato Rey, Inc

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

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