Thoracic spine myelogram 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 Xr Myelogram T-Spine

Payers reporting CPT 72255

Payer pricing summary

Low

$96

Average

$892

Median

$814

High

$2.4k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +34 other terms	626	$1.0k	$977	$938	96%	—	$1 – $23.2k
2	Aetna fee schedule · outpatient · +31 other terms	573	$730	$823	$887	108%	—	$1 – $8.4k
3	Cigna fee schedule · outpatient · +27 other terms	439	$843	$1.0k	$1.0k	105%	—	$54 – $12.4k
4	Blue Cross Blue Shield fee schedule · outpatient · +27 other terms	413	$1.0k	$1.2k	$1.0k	86%	—	$1 – $5.9k
5	Humana fee schedule · outpatient · +25 other terms	345	$766	$584	$571	98%	—	$1 – $4.2k
6	Molina fee schedule · outpatient · +26 other terms	214	$678	$529	$503	95%	—	$1 – $3.2k
7	Anthem fee schedule · outpatient · +23 other terms	157	$336	$365	$582	160%	—	$19 – $5.7k
8	WellCare fee schedule · outpatient · +19 other terms	137	$842	$841	$370	44%	—	$45 – $2.0k
9	MultiPlan fee schedule · outpatient · +21 other terms	98	$1.4k	$1.5k	$1.3k	82%	—	$68 – $6.4k
10	Kaiser fee schedule · outpatient · +20 other terms	83	$1.1k	$1.2k	$1.0k	87%	—	$54 – $5.8k
11	Ambetter fee schedule · outpatient · +19 other terms	81	$1.2k	$911	$675	74%	—	$53 – $2.7k
12	Aetna Better Health fee schedule · outpatient · +14 other terms	73	$130	$178	$160	90%	—	$67 – $878
13	Devoted facility · fee schedule · outpatient · +15 other terms	65	$796	$873	$500	57%	—	$710 – $5.0k
14	Oscar facility · fee schedule · outpatient · +16 other terms	61	$1.1k	$989	$448	45%	—	$107 – $1.5k
15	First Health fee schedule · outpatient · +17 other terms	53	$819	$654	$799	122%	—	$108 – $5.5k
16	Caresource fee schedule · outpatient · +16 other terms	52	$795	$753	$584	78%	—	$1 – $2.1k
17	Tricare fee schedule · outpatient · +19 other terms	52	$762	$756	$175	23%	—	$42 – $1.0k
18	Optum fee schedule · outpatient · +18 other terms	51	$718	$801	$595	74%	—	$63 – $2.9k
19	Highmark facility · fee schedule · outpatient · +16 other terms	42	$940	$974	$825	85%	—	$32 – $3.6k
20	Cigna Healthspring fee schedule · outpatient · +9 other terms	35	$621	$557	$342	61%	—	$108 – $980
21	Amerihealth Caritas facility · fee schedule · outpatient · +11 other terms	33	$67	$344	$411	119%	—	$41 – $1.8k
22	Medicaid facility · fee schedule · outpatient · +14 other terms	30	$364	$404	$320	79%	—	$37 – $943
23	Clover fee schedule · outpatient · +9 other terms	29	$874	$845	$63	7%	—	$708 – $945
24	Medicare facility · fee schedule · outpatient · +15 other terms	29	$808	$919	$681	74%	—	$313 – $4.9k
25	Superior Healthplan facility · fee schedule · outpatient · +6 other terms	27	$467	$442	$354	80%	—	$108 – $961

Page 1 of 3 · 67 payers