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
CHG CT THORACIC SPINE W/O CONTRAST MATERIAL
Jasper, IN
See all hospitals reporting CPT 72128 →Price type
Little Company of Mary Hospital of Indiana Inc’s median price of $122 is 63% below the median hospital's median price ($334), higher than 13% of the 2,605 hospitals reporting CPT 72128. 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, 21 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 hmo/ppo/traditional facility · fee schedule · outpatient | $94.16 | $94.16 | $94.16 – $94.16 |
| 2 | Aetna medicare advantage professional · fee schedule · both | $119.62 | $94.32 | $43.71 – $119.62 |
| 3 | Anthem medicare advantage professional · fee schedule · both | $119.62 | $94.32 | $43.71 – $119.62 |
| 4 | Caresource medicare advantage professional · fee schedule · both | $119.62 | $94.32 | $43.71 – $119.62 |
| 5 | Humana medicare advantage professional · fee schedule · both | $119.62 | $94.32 | $43.71 – $119.62 |
| 6 | Tricare government professional · fee schedule · both | $119.62 | $94.32 | $43.71 – $119.62 |
| 7 | Tricare government facility · case rate · outpatient | $94.69 | $94.69 | $94.69 – $94.69 |
| 8 | Anthem managed medicaid facility · fee schedule · outpatient | $98.51 | $98.51 | $98.51 – $98.51 |
| 9 | Anthem managed medicaid professional · fee schedule · both | $116.94 | $101.53 | $36.86 – $135.37 |
| 10 | Aetna medicare advantage facility · case rate · outpatient | $111.40 | $111.40 | $111.40 – $111.40 |
| 11 | Anthem medicare advantage facility · case rate · outpatient | $111.40 | $111.40 | $111.40 – $111.40 |
| 12 | Caresource medicare advantage facility · case rate · outpatient | $111.40 | $111.40 | $111.40 – $111.40 |
| 13 | Humana medicare advantage facility · case rate · outpatient | $111.40 | $111.40 | $111.40 – $111.40 |
| 14 | UnitedHealthcare commercial professional · fee schedule · both | $146.04 | $113.69 | $49.00 – $146.04 |
| 15 | Caresource commercial professional · fee schedule · both | $149.53 | $117.90 | $54.64 – $149.53 |
| 16 | Ambetter commercial professional · fee schedule · both | $155.51 | $122.61 | $56.82 – $155.51 |
| 17 | Caresource commercial facility · case rate · outpatient | $139.25 | $139.25 | $139.25 – $139.25 |
| 18 | Ambetter commercial facility · case rate · outpatient | $144.82 | $144.82 | $144.82 – $144.82 |
| 19 | Anthem hmo/ppo/traditional professional · fee schedule · both | $243.06 | $187.11 | $75.20 – $243.06 |
| 20 | Aetna commercial professional · fee schedule · both | $427.53 | $336.47 | $154.35 – $427.53 |
| 21 | Cigna commercial professional · fee schedule · both | $427.53 | $336.47 | $154.35 – $427.53 |
Last updated: Feb 13, 2026
See CT scan of chest and spine without contrast dye pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.