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 JT 3+ VWS
Los Angeles, CA
See all hospitals reporting CPT 72202 →Price type
Dignity Community Care’s median price of $142 is about the same as the median hospital's median price ($143), higher than 49% of the 2,619 hospitals reporting CPT 72202. 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, 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 | $55 | $55 | — | — | — | $55 – $55 |
| 2 | Molina medicaid|< 21 fee schedule · outpatient | $59 | $59 | — | — | — | $59 – $59 |
| 3 | Molina medicaid|> 21 fee schedule · outpatient | $59 | $59 | — | — | — | $59 – $59 |
| 4 | Kaiser medicaid|< 21 fee schedule · outpatient | $64 | $64 | — | — | — | $64 – $64 |
| 5 | Kaiser medicaid|> 21 fee schedule · outpatient | $64 | $64 | — | — | — | $64 – $64 |
| 6 | Aetna medicare|all plans fee schedule · outpatient | $135 | $135 | — | — | — | $135 – $135 |
| 7 | Anthem medicare|all plans fee schedule · outpatient | $135 | $135 | — | — | — | $135 – $135 |
| 8 | Blue Cross Blue Shield medicare|all other plans case rate · outpatient | $135 | $135 | — | — | — | $135 – $135 |
| 9 | Molina medicare|all plans fee schedule · outpatient | $135 | $135 | — | — | — | $135 – $135 |
| 10 | UnitedHealthcare medicare|all plans case rate · outpatient | $135 | $135 | — | — | — | $135 – $135 |
| 11 | Anthem commercial|exchange fee schedule · outpatient | $141 | $141 | — | — | — | $141 – $141 |
| 12 | Aetna commercial|all other plans fee schedule · outpatient | $152 | $152 | — | — | — | $152 – $152 |
| 13 | Aetna commercial|hmo fee schedule · outpatient | $152 | $152 | — | — | — | $152 – $152 |
| 14 | Aetna commercial|ppo fee schedule · outpatient | $152 | $152 | — | — | — | $152 – $152 |
| 15 | Blue Cross Blue Shield medicaid|all plans fee schedule · outpatient | $212 | $212 | — | — | — | $212 – $212 |
| 16 | Anthem commercial|all other plans fee schedule · outpatient | $214 | $214 | — | — | — | $214 – $214 |
| 17 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $245 | $245 | — | — | — | $245 – $245 |
| 18 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $245 | $245 | — | — | — | $245 – $245 |
| 19 | Anthem commercial|mcs fee schedule · outpatient | $263 | $263 | — | — | — | $263 – $263 |
| 20 | Cigna commercial|all other plans fee schedule · outpatient | $394 | $394 | — | — | — | $394 – $394 |
| 21 | Cigna commercial|ppo fee schedule · outpatient | $394 | $394 | — | — | — | $394 – $394 |
| 22 | First Health commercial|all plans fee schedule · inpatient | $545 | $545 | — | — | — | $545 – $545 |
| 23 | First Health commercial|all plans fee schedule · outpatient | $545 | $545 | — | — | — | $545 – $545 |
| 24 | Kaiser commercial|all plans fee schedule · inpatient | $553 | $553 | — | — | — | $553 – $553 |
| 25 | Kaiser commercial|all plans fee schedule · outpatient | $553 | $553 | — | — | — | $553 – $553 |
Last updated: Feb 28, 2026
See X-ray of sacroiliac joints, 3 or more views pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.