Sacroiliac joint X-ray

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC DI SACRO-ILIAC JOINTS<3 VIEWS

Payers reporting CPT 72200

Payer pricing summary

Low

$26

Average

$173

Median

$148

High

$479

Payer rate distribution

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#
1	Blue Cross Blue Shield fee schedule · outpatient · +33 other terms	471	$129	$169	$146	86%	21–30	$1 – $931
2	Bcbs Mt fee schedule · outpatient · +2 other terms	1	$244	$244	—	—	20	$244 – $244
3	Anthem fee schedule · outpatient · +30 other terms	176	$91	$77	$93	122%	7–70	$2 – $765
4	UnitedHealthcare fee schedule · outpatient · +38 other terms	699	$161	$165	$194	118%	6–60	$1 – $4.8k
5	Medicare other · both · +21 other terms	40	$111	$120	$64	53%	6–60	$40 – $442
6	Humana fee schedule · outpatient · +31 other terms	379	$104	$112	$147	131%	1–10	$1 – $3.4k
7	Aetna fee schedule · outpatient · +37 other terms	623	$109	$174	$296	171%	—	$1 – $8.4k
8	Cigna fee schedule · outpatient · +31 other terms	473	$149	$189	$144	76%	—	$9 – $1.2k
9	Molina fee schedule · outpatient · +31 other terms	236	$89	$79	$63	80%	—	$1 – $487
10	WellCare fee schedule · outpatient · +25 other terms	158	$111	$112	$43	39%	—	$9 – $249
11	MultiPlan fee schedule · outpatient · +23 other terms	107	$394	$332	$298	90%	—	$5 – $1.3k
12	Ambetter fee schedule · outpatient · +23 other terms	100	$176	$145	$79	54%	—	$20 – $341
13	Kaiser fee schedule · outpatient · +26 other terms	100	$135	$165	$151	92%	—	$9 – $841
14	Aetna Better Health fee schedule · outpatient · +16 other terms	82	$36	$48	$43	88%	—	$23 – $385
15	Devoted facility · fee schedule · outpatient · +19 other terms	76	$105	$163	$513	315%	—	$85 – $4.9k
16	Caresource fee schedule · outpatient · +19 other terms	74	$105	$90	$54	60%	—	$1 – $245
17	Oscar facility · fee schedule · outpatient · +22 other terms	65	$153	$141	$53	37%	—	$38 – $294
18	Optum fee schedule · outpatient · +22 other terms	55	$98	$215	$242	112%	—	$9 – $992
19	First Health fee schedule · outpatient · +20 other terms	53	$109	$215	$279	130%	—	$10 – $1.1k
20	Highmark facility · fee schedule · outpatient · +21 other terms	52	$120	$123	$98	80%	—	$6 – $482
21	Tricare facility · fee schedule · outpatient · +21 other terms	51	$105	$165	$508	308%	—	$22 – $4.6k
22	Medica fee schedule · outpatient · +25 other terms	47	$112	$149	$137	91%	—	$8 – $531
23	Amerihealth Caritas facility · fee schedule · outpatient · +15 other terms	44	$35	$64	$46	72%	—	$17 – $235
24	Medicaid facility · fee schedule · outpatient · +18 other terms	43	$42	$58	$42	73%	—	$14 – $132
25	Cigna Healthspring fee schedule · outpatient · +11 other terms	37	$97	$80	$34	42%	—	$33 – $112

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