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
Ct chest spine w/o dye
Fond Du Lac, WI
See all hospitals reporting CPT 72128 →Price type
Agnesian Healthcare Inc.’s median price of $200 is 40% below the median hospital's median price ($334), higher than 35% of the 2,605 hospitals reporting CPT 72128. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 3 payers, 6 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Molina medicare managed care plan fee schedule · outpatient | $77.56 | $77.56 | $77.56 – $77.56 |
| 2 | Blue Cross Blue Shield anthem medicare managed care plan fee schedule · outpatient | $103.41 | $103.41 | $103.41 – $103.41 |
| 3 | WellCare medicare managed care plan fee schedule · outpatient | $105.48 | $105.48 | $105.48 – $105.48 |
| 4 | Blue Cross Blue Shield blue preferred / blue preferred plus hmo/pos fee schedule · outpatient | $430.83 | $430.83 | $430.83 – $430.83 |
| 5 | Blue Cross Blue Shield blue access ppo fee schedule · outpatient | $446.24 | $446.24 | $446.24 – $446.24 |
| 6 | Blue Cross Blue Shield blue traditional traditional fee schedule · outpatient | $446.24 | $446.24 | $446.24 – $446.24 |
Last updated: Apr 1, 2026
See CT scan of chest and spine without contrast dye pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.