Sacroiliac joint X-ray at Medical City Plano

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

XR SI JOINTS < 3 V

Plano, TX

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Pricing by billing methodology

Price type

How this price compares nationally

Medical City Plano’s median price of $137 is 6% above the median hospital's median price ($129), higher than 56% of the 2,216 hospitals reporting CPT 72200. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 72200 at Medical City Plano

Negotiated rates from the hospital’s own file: 11 payers, 51 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	Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges	$33	$33	—	—	—	$33 – $33
2	Superior Healthplan mcdstar percent of total billed charges · outpatientfrom % of charges	$33	$33	—	—	—	$33 – $33
3	Superior Healthplan starhealth percent of total billed charges · outpatientfrom % of charges	$33	$33	—	—	—	$33 – $33
4	Superior Healthplan starkids percent of total billed charges · outpatientfrom % of charges	$33	$33	—	—	—	$33 – $33
5	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$33	$33	—	—	—	$33 – $33
6	UnitedHealthcare chip fee schedule · outpatient	$33	$33	—	—	—	$33 – $33
7	UnitedHealthcare star fee schedule · outpatient	$33	$33	—	—	—	$33 – $33
8	UnitedHealthcare starkids fee schedule · outpatient	$33	$33	—	—	—	$33 – $33
9	UnitedHealthcare starperinate fee schedule · outpatient	$33	$33	—	—	—	$33 – $33
10	UnitedHealthcare starplus fee schedule · outpatient	$33	$33	—	—	—	$33 – $33
11	Cigna Healthspring mgmcd fee schedule · outpatient	$35	$35	—	—	—	$35 – $35
12	Aetna Better Health chip fee schedule · outpatient	$36	$36	—	—	—	$36 – $36
13	Aetna Better Health mcd fee schedule · outpatient	$36	$36	—	—	—	$36 – $36
14	Molina chip fee schedule · outpatient	$37	$37	$0	1%	—	$37 – $37
15	Molina mcdstar fee schedule · outpatient	$37	$37	$0	1%	—	$37 – $37
16	Molina star+plus fee schedule · outpatient	$37	$37	$0	1%	—	$37 – $37
17	Molina starkids fee schedule · outpatient	$37	$37	$0	1%	—	$37 – $37
18	Aetna qhphix fee schedule · outpatient	$41	$41	—	—	—	$41 – $41
19	Humana mgmcd fee schedule · outpatient	$42	$42	—	—	—	$42 – $42
20	Aetna newbusiness fee schedule · outpatient	$57	$57	—	—	—	$57 – $57
21	Aetna comm fee schedule · outpatient	$61	$61	—	—	—	$61 – $61
22	Aetna meritain fee schedule · outpatient	$61	$61	—	—	—	$61 – $61
23	Cigna ifp percent of total billed charges · outpatientfrom % of charges	$63	$63	—	—	—	$63 – $63
24	Cigna qhp percent of total billed charges · outpatientfrom % of charges	$65	$65	—	—	—	$65 – $65
25	Aetna oon fee schedule · outpatient	$71	$71	—	—	—	$71 – $71

Page 1 of 3 · 51 rates

Last updated: Mar 1, 2026

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