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 SPINE LS 4+ VW
Payson, AZ
See all hospitals reporting CPT 72110 →Price type
Banner Payson Medical Center’s median price of $196 is 22% above the median hospital's median price ($161), higher than 58% 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, 23 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 | Bcbs Az bxbsaz neighborhood facility · fee schedule · outpatient | $164.25 | $164.25 | $164.25 – $164.25 |
| 2 | Bcbs Az bcbsaz alliance/blue hpn facility · fee schedule · outpatient | $175.20 | $175.20 | $175.20 – $175.20 |
| 3 | Bcbs Az bxbsaz alliance chs facility · fee schedule · outpatient | $183.95 | $183.95 | $183.95 – $183.95 |
| 4 | Aetna banner employee plans facility · percent of total billed charges · outpatientfrom % of charges | $183.96 | $183.96 | $183.96 – $183.96 |
| 5 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $185.32 | $185.32 | $185.32 – $185.32 |
| 6 | Bcbs Az medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $185.32 | $185.32 | $185.32 – $185.32 |
| 7 | Cigna hmo medicare advantage plan/ppo medicare advantage plan facility · percent of total billed charges · outpatientfrom % of charges | $185.32 | $185.32 | $185.32 – $185.32 |
| 8 | Kaiser medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $185.32 | $185.32 | $185.32 – $185.32 |
| 9 | UnitedHealthcare uhc medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $185.32 | $185.32 | $185.32 – $185.32 |
| 10 | Humana medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $196.44 | $196.44 | $196.44 – $196.44 |
| 11 | Devoted medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $203.85 | $203.85 | $203.85 – $203.85 |
| 12 | Bcbs Az bcbsaz medicare facility · fee schedule · outpatient | $209.17 | $209.17 | $209.17 – $209.17 |
| 13 | Bcbs Az bcbsaz workers comp facility · fee schedule · outpatient | $218.99 | $218.99 | $218.99 – $218.99 |
| 14 | Bcbs Az commercial facility · fee schedule · outpatient | $218.99 | $218.99 | $218.99 – $218.99 |
| 15 | Aetna joint venture facility · percent of total billed charges · outpatientfrom % of charges | $239.56 | $239.56 | $239.56 – $239.56 |
| 16 | Aetna aetna qualified health plan facility · percent of total billed charges · outpatientfrom % of charges | $252.22 | $252.22 | $252.22 – $252.22 |
| 17 | Aetna medical rental facility · percent of total billed charges · inpatientfrom % of charges | $290.64 | $290.64 | $290.64 – $290.64 |
| 18 | Aetna medical rental facility · percent of total billed charges · outpatientfrom % of charges | $290.64 | $290.64 | $290.64 – $290.64 |
| 19 | Aetna broad network facility · percent of total billed charges · outpatientfrom % of charges | $299.22 | $299.22 | $299.22 – $299.22 |
| 20 | UnitedHealthcare uhc individual exchange facility · percent of total billed charges · outpatientfrom % of charges | $302.84 | $302.84 | $302.84 – $302.84 |
| 21 | Oscar commercial facility · percent of total billed charges · outpatientfrom % of charges | $305.78 | $305.78 | $305.78 – $305.78 |
| 22 | Cigna commerical/hmo benefit plan/local flex plan/network benefit plan/open access plan facility · percent of total billed charges · inpatientfrom % of charges | $359.79 | $359.79 | $359.79 – $359.79 |
| 23 | Cigna commerical/hmo benefit plan/local flex plan/network benefit plan/open access plan facility · percent of total billed charges · outpatientfrom % of charges | $359.79 | $359.79 | $359.79 – $359.79 |
Last updated: Mar 2, 2026
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