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
Ct chest spine w/o dye
Lebanon, NH
See all hospitals reporting CPT 72128 →Price type
Mary Hitchcock Memorial Hospital’s median price of $226 is 32% below the median hospital's median price ($334), higher than 40% 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: 10 payers, 102 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 anthem - medicare advantage - dhp professional · fee schedule · outpatient | $50.62 | $50.62 | $45.55 – $55.68 |
| 2 | Bcbs Vt bcbs of vermont - medicare advantage - dhp professional · fee schedule · outpatient | $50.62 | $50.62 | $45.55 – $55.68 |
| 3 | UnitedHealthcare uhc - medicare advantage - dhp professional · fee schedule · outpatient | $50.62 | $50.62 | $45.55 – $55.68 |
| 4 | UnitedHealthcare uhc - va community care network - dhpn professional · fee schedule · outpatient | $50.62 | $50.62 | $45.55 – $55.68 |
| 5 | Aetna aetna medicare advantage - dhp professional · fee schedule · outpatient | $52.13 | $52.13 | $46.91 – $57.35 |
| 6 | Cigna cigna medicare advantage - dhp professional · fee schedule · outpatient | $52.13 | $52.13 | $46.91 – $57.35 |
| 7 | WellCare wellcare - medicare advantage - dhp professional · fee schedule · outpatient | $52.64 | $52.64 | $47.37 – $57.90 |
| 8 | Ambetter ambetter commercial - exchange behavioral health - dhp professional · fee schedule · outpatient | $53.14 | $53.14 | $47.82 – $58.46 |
| 9 | Amerihealth Caritas amerihealth caritas - nh managed medicaid - dhp professional · fee schedule · outpatient | $73.36 | $73.36 | $66.18 – $80.54 |
| 10 | UnitedHealthcare uhc - tiered freedom plan professional · fee schedule · outpatient | $88.06 | $88.06 | $55.93 – $120.19 |
| 11 | UnitedHealthcare uhc - freedom plan - dhp professional · fee schedule · outpatient | $97.84 | $97.84 | $62.14 – $133.54 |
| 12 | Ambetter ambetter commercial - exchange - dhpn professional · fee schedule · outpatient | $102.71 | $102.71 | $55.68 – $149.74 |
| 13 | Amerihealth Caritas amerihealth caritas - nh managed medicaid professional · percent of total billed charges · outpatientfrom % of charges | $109.11 | $109.11 | $109.11 – $109.11 |
| 14 | Anthem anthem - medicare advantage facility · case rate · outpatient | $119.00 | $119.00 | $119.00 – $119.00 |
| 15 | Bcbs Vt bcbs of vermont - medicare advantage facility · case rate · outpatient | $119.00 | $119.00 | $119.00 – $119.00 |
| 16 | UnitedHealthcare uhc - medicare advantage facility · case rate · outpatient | $119.00 | $119.00 | $119.00 – $119.00 |
| 17 | UnitedHealthcare uhc - va community care network facility · case rate · outpatient | $119.00 | $119.00 | $119.00 – $119.00 |
| 18 | Aetna aetna medicare advantage facility · case rate · outpatient | $122.57 | $122.57 | $122.57 – $122.57 |
| 19 | Cigna cigna medicare advantage facility · case rate · outpatient | $122.57 | $122.57 | $122.57 – $122.57 |
| 20 | WellCare wellcare - medicare advantage facility · case rate · outpatient | $123.76 | $123.76 | $123.76 – $123.76 |
| 21 | UnitedHealthcare uhc - va community care network - dhps professional · fee schedule · outpatient | $130.79 | $130.79 | $130.79 – $130.79 |
| 22 | Amerihealth Caritas amerihealth caritas - nh managed medicaid professional · fee schedule · outpatient | $148.81 | $148.81 | $148.81 – $148.81 |
| 23 | Ambetter ambetter commercial - exchange - dhps professional · fee schedule · outpatient | $155.11 | $155.11 | $108.04 – $202.18 |
| 24 | Ambetter ambetter commercial - exchange behavioral health facility · case rate · outpatient | $164.11 | $164.11 | $164.11 – $164.11 |
| 25 | Anthem anthem indiv qhp - exchange facility · case rate · outpatient | $182.80 | $182.80 | $182.80 – $182.80 |
Last updated: Jan 1, 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.