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
PR XR SPINE LUMBOSACRAL 2-3V
Sparta, WI
See all hospitals reporting CPT 72100 →Price type
Mayo Clinic Health System’s median price of $216 is 49% above the median hospital's median price ($144), higher than 68% of the 2,629 hospitals reporting CPT 72100. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 16 payers, 37 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 | Ucare ucare msho medicare advantage plan [1106] professional · fee schedule · outpatient | $27.27 | $23.61 | $8.42 – $31.48 |
| 2 | Tricare swwi tricare [689] professional · fee schedule · outpatient | $31.74 | $27.56 | $10.01 – $36.74 |
| 3 | Blue Cross Blue Shield blue cross blue shield federal retiree [950] professional · fee schedule · outpatient | $33.42 | $28.94 | $10.32 – $38.58 |
| 4 | Optum veteran affairs optum [1057] professional · fee schedule · outpatient | $33.42 | $28.94 | $10.32 – $38.58 |
| 5 | Medica medica advantage solution [791] professional · fee schedule · outpatient | $34.43 | $29.81 | $10.63 – $39.74 |
| 6 | Blue Cross Blue Shield & swwi bcbs medicare advantage plan aco [1278] professional · fee schedule · outpatient | $36.69 | $31.59 | $10.87 – $42.12 |
| 7 | Blue Cross Blue Shield & swwi bcbs medicare advantage plan msho [257] professional · fee schedule · outpatient | $37.40 | $32.20 | $11.08 – $42.93 |
| 8 | Medica swwi medica dual solution msho [1006] professional · fee schedule · outpatient | $37.40 | $32.20 | $11.08 – $42.93 |
| 9 | Ucare swwi ucare essentia care medicare advantage plan [774] professional · fee schedule · outpatient | $38.44 | $33.28 | $11.87 – $44.37 |
| 10 | Medica swwi medica engage ifb [1299] professional · percent of total billed charges · outpatientfrom % of charges | $147.55 | $151.67 | $79.95 – $227.50 |
| 11 | Medica deanhp by medica west mc hmo [1261] professional · percent of total billed charges · outpatientfrom % of charges | $163.44 | $168.00 | $88.56 – $252.00 |
| 12 | Medica swwi medica non mayo employee group [761] professional · percent of total billed charges · outpatientfrom % of charges | $181.60 | $186.67 | $98.40 – $280.00 |
| 13 | Blue Cross Blue Shield & swwi blueplus with mayo clinic [239] professional · percent of total billed charges · outpatientfrom % of charges | $192.95 | $198.33 | $104.55 – $297.50 |
| 14 | Medica medica complete health full [1313] professional · percent of total billed charges · outpatientfrom % of charges | $192.95 | $198.33 | $104.55 – $297.50 |
| 15 | Blue Cross Blue Shield swwi anthem hmo and pos [59] professional · fee schedule · outpatient | $227.00 | $201.14 | $94.23 – $334.46 |
| 16 | Ucare swwi ucare ifp [1112] professional · percent of total billed charges · outpatientfrom % of charges | $199.76 | $205.33 | $108.24 – $308.00 |
| 17 | Blue Cross Blue Shield swwi bcbs [647] professional · percent of total billed charges · outpatientfrom % of charges | $204.30 | $210.00 | $110.70 – $315.00 |
| 18 | Medica medica complete health self [207] professional · percent of total billed charges · outpatientfrom % of charges | $204.30 | $210.00 | $110.70 – $315.00 |
| 19 | UnitedHealthcare swwi uhc [243] professional · percent of total billed charges · outpatientfrom % of charges | $208.84 | $214.67 | $113.16 – $322.00 |
| 20 | Anthem swwi anthem ppo [19] professional · percent of total billed charges · outpatientfrom % of charges | $211.11 | $217.00 | $114.39 – $325.50 |
| 21 | Blue Cross Blue Shield swwi anthem ppo [19] professional · percent of total billed charges · outpatientfrom % of charges | $211.11 | $217.00 | $114.39 – $325.50 |
| 22 | Healthpartners noncontracted [930] professional · percent of total billed charges · outpatientfrom % of charges | $213.38 | $219.33 | $115.62 – $329.00 |
| 23 | Medica multi medica choice [205] professional · percent of total billed charges · outpatientfrom % of charges | $213.38 | $219.33 | $115.62 – $329.00 |
| 24 | Medica multi medica ifb [1076] professional · percent of total billed charges · outpatientfrom % of charges | $213.38 | $219.33 | $115.62 – $329.00 |
| 25 | Cigna cigna [284] professional · percent of total billed charges · outpatientfrom % of charges | $215.65 | $221.67 | $116.85 – $332.50 |
Last updated: Aug 14, 2026
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