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
Radex Spi Lumbosac 2/3 Views
Lebanon, NH
See all hospitals reporting CPT 72100 →Price type
Alice_peck_day_memorial_hospital’s median price of $398 is 176% above the median hospital's median price ($144), higher than 87% of the 2,629 hospitals reporting CPT 72100. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 16 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 | Ambetter nh healthy families ambetter fee schedule · outpatient | $8.10 | $8.10 | $8.10 – $8.10 |
| 2 | Blue Cross Blue Shield anthem hmo/pos/ppo fee schedule · outpatient | $230.84 | $230.84 | $230.84 – $230.84 |
| 3 | Anthem anthem bcbs medicare advantage percent of total billed charges · outpatientfrom % of charges | $273.40 | $273.40 | $273.40 – $273.40 |
| 4 | Blue Cross Blue Shield anthem bcbs individual qhp exchange pathway percent of total billed charges · outpatientfrom % of charges | $273.40 | $273.40 | $273.40 – $273.40 |
| 5 | Blue Cross Blue Shield anthem bcbs shop qhp exchange pathway percent of total billed charges · outpatientfrom % of charges | $382.79 | $382.79 | $382.79 – $382.79 |
| 6 | Blue Cross Blue Shield bcbs medicare advantage percent of total billed charges · outpatientfrom % of charges | $390.09 | $390.09 | $390.09 – $390.09 |
| 7 | UnitedHealthcare uhc mcr percent of total billed charges · outpatientfrom % of charges | $398.16 | $398.16 | $398.16 – $398.16 |
| 8 | UnitedHealthcare united healthcare percent of total billed charges · outpatientfrom % of charges | $398.16 | $398.16 | $398.16 – $398.16 |
| 9 | Cigna cigna hmo/pos percent of total billed charges · outpatientfrom % of charges | $423.60 | $423.60 | $423.60 – $423.60 |
| 10 | Cigna cigna ppo percent of total billed charges · outpatientfrom % of charges | $427.47 | $427.47 | $427.47 – $427.47 |
| 11 | Blue Cross Blue Shield bcbs vt tvhp & managed care percent of total billed charges · outpatientfrom % of charges | $446.82 | $446.82 | $446.82 – $446.82 |
| 12 | Cigna cigna managed care percent of total billed charges · outpatientfrom % of charges | $452.35 | $452.35 | $452.35 – $452.35 |
| 13 | Blue Cross Blue Shield bcbs vt non managed care percent of total billed charges · outpatientfrom % of charges | $473.92 | $473.92 | $473.92 – $473.92 |
| 14 | Blue Cross Blue Shield 85% of billed percent of total billed charges · outpatientfrom % of charges | $492.17 | $492.17 | $492.17 – $492.17 |
| 15 | Aetna aetna percent of total billed charges · outpatientfrom % of charges | $497.70 | $497.70 | $497.70 – $497.70 |
| 16 | Humana humana medicare advantage percent of total billed charges · outpatientfrom % of charges | $575.12 | $575.12 | $575.12 – $575.12 |
Last updated: Jan 1, 2026
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