Lumbar spine X-ray myelogram

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

MYELOGRAPHY L-S SPINE

Payers reporting CPT 72265

Payer pricing summary

Low

$102

Average

$925

Median

$868

High

$2.7k

Payer rate distribution

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#
1	Molina fee schedule · outpatient · +28 other terms	223	$648	$504	$495	98%	2–20	$1 – $3.2k
2	UnitedHealthcare fee schedule · outpatient · +35 other terms	671	$1.0k	$964	$910	94%	1–10	$1 – $23.2k
3	Anthem fee schedule · outpatient · +28 other terms	179	$414	$459	$703	153%	1–10	$19 – $5.7k
4	Aetna fee schedule · outpatient · +34 other terms	605	$729	$742	$611	82%	—	$1 – $8.4k
5	Cigna fee schedule · outpatient · +29 other terms	469	$875	$1.0k	$1.1k	102%	—	$41 – $12.4k
6	Blue Cross Blue Shield fee schedule · outpatient · +29 other terms	445	$949	$1.1k	$975	88%	—	$1 – $5.9k
7	Humana fee schedule · outpatient · +28 other terms	366	$766	$564	$412	73%	—	$1 – $2.3k
8	WellCare fee schedule · outpatient · +20 other terms	145	$791	$776	$371	48%	—	$42 – $1.9k
9	MultiPlan fee schedule · outpatient · +22 other terms	116	$1.5k	$1.5k	$1.0k	68%	—	$53 – $6.7k
10	Kaiser fee schedule · outpatient · +22 other terms	99	$1.1k	$1.2k	$1.0k	87%	—	$41 – $5.8k
11	Ambetter fee schedule · outpatient · +20 other terms	82	$1.2k	$844	$661	78%	—	$5 – $2.3k
12	Aetna Better Health fee schedule · outpatient · +15 other terms	73	$119	$175	$169	97%	—	$67 – $878
13	Devoted facility · fee schedule · outpatient · +16 other terms	67	$796	$872	$501	57%	—	$718 – $5.0k
14	Oscar facility · fee schedule · outpatient · +17 other terms	65	$1.1k	$1.0k	$437	44%	—	$118 – $1.5k
15	First Health fee schedule · outpatient · +18 other terms	64	$819	$943	$1.1k	116%	—	$49 – $5.8k
16	Tricare fee schedule · outpatient · +20 other terms	56	$767	$758	$170	22%	—	$40 – $1.0k
17	Optum fee schedule · outpatient · +20 other terms	55	$728	$944	$666	70%	—	$67 – $2.9k
18	Caresource fee schedule · outpatient · +16 other terms	53	$749	$602	$339	56%	—	$1 – $1.3k
19	Highmark facility · fee schedule · outpatient · +15 other terms	48	$937	$946	$808	85%	—	$30 – $3.6k
20	Amerihealth Caritas facility · fee schedule · outpatient · +11 other terms	39	$70	$334	$396	119%	—	$37 – $1.8k
21	Medicaid facility · fee schedule · outpatient · +13 other terms	38	$366	$404	$328	81%	—	$33 – $943
22	Medicare facility · fee schedule · outpatient · +16 other terms	37	$808	$954	$607	64%	—	$313 – $4.9k
23	Cigna Healthspring fee schedule · outpatient · +9 other terms	36	$634	$563	$340	60%	—	$109 – $980
24	Clover fee schedule · outpatient · +10 other terms	29	$874	$845	$63	7%	—	$708 – $945
25	Medica fee schedule · outpatient · +19 other terms	27	$367	$392	$356	91%	—	$38 – $1.9k

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