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
HC SPINE,LUMBOSACRAL MIN 4 VIEWS
Grapevine, TX
See all hospitals reporting CPT 72110 →Price type
Baylor Scott & White Medical Center - Grapevine’s median price of $381 is 137% above the median hospital's median price ($161), higher than 80% 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: 9 payers, 29 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 | Superior Healthplan medicaid facility · fee schedule · outpatient | $52.13 | $52.13 | $52.13 – $52.13 |
| 2 | Aetna medicaid facility · fee schedule · outpatient | $53.17 | $53.17 | $53.17 – $53.17 |
| 3 | UnitedHealthcare medicaid/chip facility · fee schedule · outpatient | $55.78 | $55.78 | $55.78 – $55.78 |
| 4 | Baylor Scott White Health Plan medicare advantage facility · fee schedule · outpatient | $99.94 | $99.94 | $99.94 – $99.94 |
| 5 | Aetna medicare advantage facility · fee schedule · outpatient | $105.20 | $105.20 | $105.20 – $105.20 |
| 6 | Humana medicare facility · fee schedule · outpatient | $105.20 | $105.20 | $105.20 – $105.20 |
| 7 | Blue Cross Blue Shield medicare advantage facility · fee schedule · outpatient | $110.46 | $110.46 | $110.46 – $110.46 |
| 8 | Superior Healthplan medicare facility · fee schedule · outpatient | $110.46 | $110.46 | $110.46 – $110.46 |
| 9 | UnitedHealthcare medicare advantage facility · fee schedule · outpatient | $117.82 | $117.82 | $117.82 – $117.82 |
| 10 | Baylor Scott White Health Plan bsw premier - small group facility · fee schedule · outpatient | $126.24 | $126.24 | $126.24 – $126.24 |
| 11 | Baylor Scott White Health Plan bsw premier - individual facility · fee schedule · outpatient | $132.03 | $132.03 | $132.03 – $132.03 |
| 12 | Baylor Scott White Health Plan bsw plus - small group facility · fee schedule · outpatient | $173.58 | $173.58 | $173.58 – $173.58 |
| 13 | Blue Cross Blue Shield blue advantage facility · fee schedule · outpatient | $224.16 | $224.16 | $224.16 – $224.16 |
| 14 | Ambetter ambetter exchange facility · fee schedule · outpatient | $226.18 | $226.18 | $226.18 – $226.18 |
| 15 | Blue Cross Blue Shield blue premier/high performance network/my bluehealth facility · fee schedule · outpatient | $317.19 | $317.19 | $317.19 – $317.19 |
| 16 | Baylor Scott White Health Plan bsw premier - large group/bsw premier direct to employer (rate 1)/bswh employee facility · percent of total billed charges · outpatientfrom % of charges | $390.32 | $390.32 | $390.32 – $390.32 |
| 17 | Cigna local plus facility · percent of total billed charges · outpatientfrom % of charges | $390.32 | $390.32 | $390.32 – $390.32 |
| 18 | Blue Cross Blue Shield city of dallas facility · fee schedule · outpatient | $425.90 | $425.90 | $425.90 – $425.90 |
| 19 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $435.45 | $435.45 | $435.45 – $435.45 |
| 20 | Blue Cross Blue Shield blue essentials (hmo) facility · fee schedule · outpatient | $449.44 | $449.44 | $449.44 – $449.44 |
| 21 | Baylor Scott White Health Plan bsw plus - large group/bsw premier direct to employer (rate 2) facility · percent of total billed charges · outpatientfrom % of charges | $459.20 | $459.20 | $459.20 – $459.20 |
| 22 | Cigna hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges | $459.20 | $459.20 | $459.20 – $459.20 |
| 23 | Blue Cross Blue Shield bluechoice (ppo) facility · fee schedule · outpatient | $472.98 | $472.98 | $472.98 – $472.98 |
| 24 | UnitedHealthcare charter facility · percent of total billed charges · outpatientfrom % of charges | $492.38 | $492.38 | $492.38 – $492.38 |
| 25 | UnitedHealthcare nexus facility · percent of total billed charges · outpatientfrom % of charges | $492.38 | $492.38 | $492.38 – $492.38 |
Last updated: Jun 29, 2026
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