Lumbosacral spine X-ray, 2 to 3 views at Forsyth Memorial Hospital, Inc.

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

LUMBAR SPINE 2 OR 3 VIEWS

Winston-Salem, NC

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How this price compares nationally

Forsyth Memorial Hospital, Inc.’s median price of $106 is 26% below the median hospital's median price ($144), higher than 25% of the 2,629 hospitals reporting CPT 72100. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 72100 at Forsyth Memorial Hospital, Inc.

Negotiated rates from the hospital’s own file: 11 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	Blue Cross Blue Shield healthy blue medicaid fee schedule · outpatient	$76.32	$76.32	$76.32 – $76.32
2	UnitedHealthcare medicaid fee schedule · outpatient	$76.32	$76.32	$76.32 – $76.32
3	WellCare medicaid fee schedule · outpatient	$76.32	$76.32	$76.32 – $76.32
4	Blue Cross Blue Shield blue medicare fee schedule · outpatient	$101.39	$101.39	$101.39 – $101.39
5	Humana medicare fee schedule · outpatient	$101.39	$101.39	$101.39 – $101.39
6	UnitedHealthcare medicare fee schedule · outpatient	$101.39	$101.39	$101.39 – $101.39
7	Aetna medicare fee schedule · outpatient	$103.92	$103.92	$103.92 – $103.92
8	Cigna healthspring fee schedule · outpatient	$104.43	$104.43	$104.43 – $104.43
9	Cigna aca fee schedule · outpatient	$155.96	$155.96	$155.96 – $155.96
10	Caresource qualified health plan fee schedule · outpatient	$161.20	$161.20	$161.20 – $161.20
11	Blue Cross Blue Shield blue home fee schedule · outpatient	$210.36	$210.36	$210.36 – $210.36
12	Blue Cross Blue Shield blue value fee schedule · outpatient	$217.62	$217.62	$217.62 – $217.62
13	Cigna commercial fee schedule · outpatient	$239.38	$239.38	$239.38 – $239.38
14	Aetna commercial fee schedule · outpatient	$248.24	$248.24	$248.24 – $248.24
15	UnitedHealthcare all payer fee schedule · outpatient	$271.21	$271.21	$271.21 – $271.21
16	Blue Cross Blue Shield hmo fee schedule · outpatient	$276.86	$276.86	$276.86 – $276.86
17	Blue Cross Blue Shield ppo fee schedule · outpatient	$276.86	$276.86	$276.86 – $276.86
18	Cigna commercial percent of total billed charges · outpatientfrom % of charges	$299.97	$299.97	$299.97 – $299.97
19	Humana commercial fee schedule · outpatient	$313.93	$313.93	$313.93 – $313.93
20	Aetna aca fee schedule · outpatient	$322.40	$322.40	$322.40 – $322.40
21	Aetna first health fee schedule · outpatient	$322.40	$322.40	$322.40 – $322.40
22	Aetna non-par products of apcn fee schedule · outpatient	$322.40	$322.40	$322.40 – $322.40
23	Aetna rental network products fee schedule · outpatient	$322.40	$322.40	$322.40 – $322.40
24	Aetna whole health non-multitier fee schedule · outpatient	$322.40	$322.40	$322.40 – $322.40
25	Medcost mbs fee schedule · outpatient	$342.55	$342.55	$342.55 – $342.55

Page 1 of 2 · 29 rates

Last updated: Mar 30, 2026

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