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
XR SP COMP LUMB MIN 4 VWS
Smithville, TX
See all hospitals reporting CPT 72110 →Price type
Ascension Seton’s median price of $51 is 68% below the median hospital's median price ($161), higher than 5% of the 2,619 hospitals reporting CPT 72110. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 54 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 3879_superior ambetter (chi,dcn) inpatient 20240901 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 2 | Blue Cross Blue Shield 3594_blue cross chip/star kids (chi,dcn) inpatient 20240901 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 3 | Blue Cross Blue Shield 3600_blue cross chip/star kids (smv) inpatient 20240901 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 4 | Blue Cross Blue Shield 3693_chirp blue cross star (chi,dcn) inpatient 20240901 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 5 | Blue Cross Blue Shield 3699_chirp blue cross star (smv) inpatient 20240901 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 6 | Blue Cross Blue Shield 4174_blue cross chip/star kids (smv) outpatient 20241201 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 7 | Blue Cross Blue Shield 4219_chirp blue cross star (chi,dcn) outpatient 20241201 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 8 | Blue Cross Blue Shield 4225_chirp blue cross star (smv) outpatient 20241201 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 9 | UnitedHealthcare 3737_chirp uhc star (chi,dcn) inpatient 20240901 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 10 | UnitedHealthcare 3743_chirp uhc star (smv) inpatient 20240901 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 11 | UnitedHealthcare 3748_chirp uhc star plus (chi,dcn) inpatient 20240901 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 12 | UnitedHealthcare 3754_chirp uhc star plus (smv) inpatient 20240901 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 13 | UnitedHealthcare 4253_chirp uhc star (chi,dcn) outpatient 20241201 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 14 | UnitedHealthcare 4264_chirp uhc star plus (chi,dcn) outpatient 20241201 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 15 | UnitedHealthcare 4311_uhc star kids (chi,dcn) outpatient 20241201 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 16 | UnitedHealthcare 4322_uhc star kids (chi,dcn) inpatient 20240901 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 17 | UnitedHealthcare 4328_uhc star kids (smv) inpatient 20240901 fee schedule · both | $46.11 | $46.11 | $46.11 – $46.11 |
| 18 | Ambetter 3880_superior ambetter (chi,dcn) outpatient 20240901 fee schedule · outpatient | $51.45 | $51.45 | $51.45 – $51.45 |
| 19 | Blue Cross Blue Shield 4168_blue cross chip (chi,dcn) outpatient 20241201 fee schedule · outpatient | $51.45 | $51.45 | $51.45 – $51.45 |
| 20 | Blue Cross Blue Shield 4168_blue cross chip/star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $51.45 | $51.45 | $51.45 – $51.45 |
| 21 | Blue Cross Blue Shield 4174_blue cross chip (smv) outpatient 20241201 fee schedule · outpatient | $51.45 | $51.45 | $51.45 – $51.45 |
| 22 | Blue Cross Blue Shield 5003_blue cross star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $51.45 | $51.45 | $51.45 – $51.45 |
| 23 | Blue Cross Blue Shield 5015_blue cross star kids (smv) outpatient 20241201 fee schedule · outpatient | $51.45 | $51.45 | $51.45 – $51.45 |
| 24 | UnitedHealthcare 4259_chirp uhc star (smv) outpatient 20241201 fee schedule · outpatient | $51.45 | $51.45 | $51.45 – $51.45 |
| 25 | UnitedHealthcare 4270_chirp uhc star plus (smv) outpatient 20241201 fee schedule · outpatient | $51.45 | $51.45 | $51.45 – $51.45 |
Last updated: Jan 1, 2026
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