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
Xr Pelvis Complete Min 3 Views Pf
Perryville, MO
See all hospitals reporting CPT 72190 →Price type
Mercy Perry’s median price of $150 is 2% above the median hospital's median price ($147), higher than 51% of the 2,549 hospitals reporting CPT 72190. 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, 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 | Medicaid hb wash jefn linc samc pcmh stod il medicaid facility · percent of total billed charges · outpatientfrom % of charges | $49 | $49 | $23 | 46% | — | $26 – $71 |
| 2 | Blue Cross Blue Shield hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $99 | $99 | $46 | 46% | 2–20 | $54 – $145 |
| 3 | Humana hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $99 | $99 | $46 | 46% | 2–20 | $54 – $145 |
| 4 | Medica hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $99 | $99 | $46 | 46% | — | $54 – $145 |
| 5 | Medicare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $99 | $99 | $46 | 46% | 2–20 | $54 – $145 |
| 6 | UnitedHealthcare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $99 | $99 | $46 | 46% | — | $54 – $145 |
| 7 | WellCare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $99 | $99 | $46 | 46% | — | $54 – $145 |
| 8 | UnitedHealthcare hb pcmh uhc medicare w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $101 | $101 | $47 | 46% | 2–20 | $55 – $148 |
| 9 | Aetna hb pcmh aetna/coventry medicare 102% w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $103 | $103 | $47 | 46% | 2–20 | $56 – $151 |
| 10 | Devoted hb pcmh devoted health medicare advantage 104% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $103 | $103 | $47 | 46% | — | $56 – $151 |
| 11 | Tricare hb pcmh tricare facility · percent of total billed charges · outpatientfrom % of charges | $118 | $118 | $54 | 46% | — | $64 – $173 |
| 12 | Blue Cross Blue Shield hb pcmh missouri care health plan/healthy blue facility · fee schedule · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 13 | Medicaid hb pcmh mo medicaid facility · fee schedule · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 14 | Medica hb linc pcmh medica exchange new 010122 facility · percent of total billed charges · outpatientfrom % of charges | $137 | $137 | $63 | 46% | — | $74 – $200 |
| 15 | UnitedHealthcare hb pcmh uhc managed medicaid facility · fee schedule · outpatient | $140 | $140 | — | — | — | $140 – $140 |
| 16 | Ambetter hb pcmh ambetter exchange facility · percent of total billed charges · outpatientfrom % of charges | $155 | $155 | $71 | 46% | — | $83 – $226 |
| 17 | Blue Cross Blue Shield hb stlo wash jefn linc samc cape stod pcmh bcbs ascension facility · percent of total billed charges · outpatientfrom % of charges | $155 | $155 | $71 | 46% | — | $84 – $226 |
| 18 | UnitedHealthcare hb pcmh uhc core facility · percent of total billed charges · outpatientfrom % of charges | $186 | $186 | $86 | 46% | — | $100 – $271 |
| 19 | Blue Cross Blue Shield hb pcmh anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges | $202 | $202 | $93 | 46% | — | $109 – $295 |
| 20 | Blue Cross Blue Shield hb pcmh anthem pathway/exchange facility · percent of total billed charges · outpatientfrom % of charges | $202 | $202 | $93 | 46% | — | $109 – $295 |
| 21 | Aetna hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $214 | $214 | $98 | 46% | — | $115 – $312 |
| 22 | First Health hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $214 | $214 | $98 | 46% | — | $115 – $312 |
| 23 | Optum hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges | $215 | $215 | $99 | 46% | — | $116 – $314 |
| 24 | UnitedHealthcare hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges | $215 | $215 | $99 | 46% | — | $116 – $314 |
| 25 | Anthem hb pcmh anthem blue access facility · percent of total billed charges · outpatientfrom % of charges | $228 | $228 | $105 | 46% | — | $123 – $333 |
Last updated: Mar 12, 2026
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