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 SACROILIAC JTS <3 VWS
Glendale, CA
See all hospitals reporting CPT 72200 →Price type
Dignity Community Care’s median price of $155 is 21% above the median hospital's median price ($129), higher than 63% of the 2,216 hospitals reporting CPT 72200. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 28 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 | Anthem medicaid|all plans fee schedule · outpatient | $39 | $39 | — | — | — | $39 – $39 |
| 2 | Molina medicaid|all plans fee schedule · outpatient | $43 | $43 | — | — | — | $43 – $43 |
| 3 | Kaiser medicaid|< 21 fee schedule · outpatient | $47 | $47 | — | — | — | $47 – $47 |
| 4 | Kaiser medicaid|> 21 fee schedule · outpatient | $47 | $47 | — | — | — | $47 – $47 |
| 5 | Aetna commercial|all other plans fee schedule · outpatient | $93 | $93 | — | — | — | $93 – $93 |
| 6 | Aetna commercial|hmo fee schedule · outpatient | $93 | $93 | — | — | — | $93 – $93 |
| 7 | Aetna commercial|ppo fee schedule · outpatient | $93 | $93 | — | — | — | $93 – $93 |
| 8 | Humana commercial|all plans fee schedule · outpatient | $135 | $135 | — | — | — | $135 – $135 |
| 9 | UnitedHealthcare medicare|all plans case rate · outpatient | $135 | $135 | — | — | — | $135 – $135 |
| 10 | Anthem commercial|non-mcs fee schedule · outpatient | $138 | $138 | — | — | 1–10 | $138 – $138 |
| 11 | Anthem medicare|alhambra senior fee schedule · outpatient | $155 | $155 | — | — | — | $155 – $155 |
| 12 | Anthem commercial|alhambra fee schedule · outpatient | $169 | $169 | — | — | — | $169 – $169 |
| 13 | Anthem commercial|hcla fee schedule · outpatient | $169 | $169 | — | — | — | $169 – $169 |
| 14 | Anthem commercial|mcs fee schedule · outpatient | $182 | $182 | — | — | — | $182 – $182 |
| 15 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $245 | $245 | — | — | — | $245 – $245 |
| 16 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $245 | $245 | — | — | — | $245 – $245 |
| 17 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $245 | $245 | — | — | — | $245 – $245 |
| 18 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $245 | $245 | — | — | — | $245 – $245 |
| 19 | Cigna commercial|all other plans fee schedule · outpatient | $443 | $443 | — | — | — | $443 – $443 |
| 20 | Cigna commercial|ppo fee schedule · outpatient | $443 | $443 | — | — | — | $443 – $443 |
| 21 | Kaiser commercial|all plans fee schedule · inpatient | $589 | $589 | — | — | — | $589 – $589 |
| 22 | Kaiser commercial|all plans fee schedule · outpatient | $589 | $589 | — | — | — | $589 – $589 |
| 23 | Blue Cross Blue Shield commercial|magellan fee schedule · inpatient | $631 | $631 | — | — | — | $631 – $631 |
| 24 | Blue Cross Blue Shield commercial|magellan fee schedule · outpatient | $631 | $631 | — | — | — | $631 – $631 |
| 25 | First Health commercial|all plans fee schedule · inpatient | $684 | $684 | — | — | — | $684 – $684 |
Last updated: Feb 28, 2026
See Sacroiliac joint X-ray pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.