CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Reston Hospital Center

Billing Code: 72131 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$246

about 2.3× the $107 Medicare rate · typically $126–$469

modeled estimate · not a bill or quote

What this hospital charges insurers

$360

Above the fair price

about $114 over the fair price · 3.4× Medicare

Medicare pays $107 Fair price $246 This hospital $360 Cash price $6,185 Hospital's list price $6,185

How we calculate the fair BaseRate →

How this hospital compares to other VA hospitals

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

Cheapest $105 Priciest $360

Black dot = this hospital, among the 9 VA 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 $246 (about 2.3× the $107 Medicare rate). Reston Hospital Center charges insurers about $360, or about $6,185 in cash — above the fair price. Located in Reston, VA.

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 $246. 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	$245 - $2,809	229%
Blue Cross Blue Shieldmajor	$177 - $1,331	166%
Aetnamajor	$1,819	1703%
Cignamajor	$1,213 - $2,103	1136%
Health Net	$4,351 - $5,618	4074%
+ 3 smaller / regional plans	$1,164 - $3,745

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 6,185), 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 Reston 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 Reston Hospital Center

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

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