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
X-Ray Lumbosacral 4 Views
Estherville, IA
See all hospitals reporting CPT 72110 →Price type
Avera Holy Family Hospital’s median price of $464 is 188% above the median hospital's median price ($161), higher than 85% 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: 4 payers, 12 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 | Medica com fee schedule · outpatient | $67.44 | $67.44 | $67.44 – $67.44 |
| 2 | Medica ind fee schedule · outpatient | $67.44 | $67.44 | $67.44 – $67.44 |
| 3 | Wellmark hmo case rate · outpatient | $141.08 | $141.08 | $141.08 – $141.08 |
| 4 | Wellmark ppo case rate · outpatient | $141.08 | $141.08 | $141.08 – $141.08 |
| 5 | Wellmark hmo percent of total billed charges · inpatientfrom % of charges | $388.08 | $388.08 | $388.08 – $388.08 |
| 6 | Wellmark ppo percent of total billed charges · inpatientfrom % of charges | $388.08 | $388.08 | $388.08 – $388.08 |
| 7 | Medica ind percent of total billed charges · inpatientfrom % of charges | $450.45 | $450.45 | $450.45 – $450.45 |
| 8 | Medica com percent of total billed charges · inpatientfrom % of charges | $535.00 | $535.00 | $535.00 – $535.00 |
| 9 | UnitedHealthcare com percent of total billed charges · inpatientfrom % of charges | $591.13 | $591.13 | $591.13 – $591.13 |
| 10 | UnitedHealthcare com percent of total billed charges · outpatientfrom % of charges | $591.13 | $591.13 | $591.13 – $591.13 |
| 11 | Healthpartners com percent of total billed charges · inpatientfrom % of charges | $637.56 | $637.56 | $637.56 – $637.56 |
| 12 | Healthpartners com percent of total billed charges · outpatientfrom % of charges | $637.56 | $637.56 | $637.56 – $637.56 |
Last updated: Apr 1, 2026
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