Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
PR Xr Lumbosacral Spine >= 4 Views|PROFESSIONAL COMPONENT
72 payers file a negotiated rate for this code. Each is shown once, under the terms the most hospitals file it under; rates under different terms (billing class, payment method, setting) are never blended, so open a payer to see them all. Figures are hospital-level averages; the median is across hospitals.
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Filter by billing class
| # | |||||
|---|---|---|---|---|---|
| 1 | UnitedHealthcare fee schedule · outpatient · +41 other terms | 798 | $176.15 | $177.00 | $1.00 – $4,772 |
| 2 | Aetna fee schedule · outpatient · +38 other terms | 725 | $128.50 | $211.70 | $1.00 – $6,900 |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +36 other terms | 545 | $163.32 | $195.43 | $1.00 – $3,605 |
| 4 | Cigna fee schedule · outpatient · +34 other terms | 544 | $182.56 | $228.17 | $8.37 – $2,196 |
| 5 | Humana fee schedule · outpatient · +34 other terms | 435 | $108.44 | $145.85 | $1.10 – $3,409 |
| 6 | Molina fee schedule · outpatient · +36 other terms | 268 | $103.67 | $91.48 | $1.00 – $380.12 |
| 7 | Anthem fee schedule · outpatient · +35 other terms | 204 | $143.28 | $106.81 | $2.07 – $1,070 |
| 8 | WellCare fee schedule · outpatient · +28 other terms | 195 | $111.67 | $113.25 | $10.21 – $712.00 |
| 9 | MultiPlan fee schedule · outpatient · +26 other terms | 136 | $446.25 | $524.85 | $16.74 – $2,403 |
| 10 | Kaiser fee schedule · outpatient · +29 other terms | 110 | $151.54 | $209.11 | $12.88 – $1,482 |
| 11 | Ambetter fee schedule · outpatient · +26 other terms | 106 | $178.42 | $147.78 | $10.00 – $511.10 |
| 12 | Devoted facility · fee schedule · outpatient · +20 other terms | 105 | $104.86 | $133.25 | $8.44 – $4,863 |
| 13 | Aetna Better Health fee schedule · outpatient · +20 other terms | 91 | $56.30 | $71.12 | $37.42 – $385.49 |
| 14 | Medica fee schedule · outpatient · +27 other terms | 87 | $67.44 | $174.14 | $10.41 – $1,044 |
| 15 | Tricare facility · fee schedule · outpatient · +23 other terms | 87 | $105.00 | $138.57 | $7.78 – $4,573 |
| 16 | Caresource fee schedule · outpatient · +24 other terms | 79 | $107.62 | $109.13 | $1.08 – $370.80 |
| 17 | Highmark facility · fee schedule · outpatient · +25 other terms | 72 | $138.26 | $139.49 | $9.26 – $481.50 |
| 18 | Oscar facility · fee schedule · outpatient · +23 other terms | 71 | $152.82 | $143.84 | $41.68 – $351.00 |
| 19 | First Health fee schedule · outpatient · +22 other terms | 66 | $197.28 | $343.79 | $15.46 – $1,788 |
| 20 | Medicaid facility · fee schedule · outpatient · +20 other terms | 63 | $61.84 | $72.77 | $22.50 – $165.86 |
| 21 | Optum fee schedule · outpatient · +28 other terms | 62 | $97.64 | $299.94 | $13.88 – $2,188 |
| 22 | Amerihealth Caritas facility · fee schedule · outpatient · +19 other terms | 54 | $56.17 | $73.74 | $22.50 – $354.00 |
| 23 | Medicare other · both · +23 other terms | 52 | $110.61 | $137.49 | $40.12 – $723.00 |
| 24 | Cigna Healthspring fee schedule · outpatient · +11 other terms | 47 | $104.62 | $86.87 | $44.18 – $134.63 |
| 25 | Clover facility · fee schedule · outpatient · +16 other terms | 36 | $107.04 | $105.27 | $85.23 – $125.23 |
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