X-ray of sacroiliac joints, 3 or more views at MVHS, Inc.

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

HC Si Joint, 3 or More Views

Utica, NY

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Pricing by billing methodology

Price type

How this price compares nationally

MVHS, Inc.’s median price of $51 is 64% below the median hospital's median price ($143), higher than 7% of the 2,619 hospitals reporting CPT 72202. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 72202 at MVHS, Inc.

Negotiated rates from the hospital’s own file: 13 payers, 28 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	Excellus excellus bcbs medicaid fee schedule · outpatient	$20	$20	—	—	—	$20 – $20
2	Excellus excellus bcbs medicaid hmo fee schedule · outpatient	$20	$20	—	—	—	$20 – $20
3	Molina misc medicaid mco fee schedule · outpatient	$20	$20	—	—	—	$20 – $20
4	UnitedHealthcare uhc essential plan fee schedule · outpatient	$20	$20	—	—	—	$20 – $20
5	UnitedHealthcare uhc medicaid fee schedule · outpatient	$20	$20	—	—	—	$20 – $20
6	WellCare hb mvhs wellcare medicaid fee schedule · outpatient	$20	$20	—	—	—	$20 – $20
7	UnitedHealthcare uhc empire plan fee schedule · outpatient	$41	$41	—	—	—	$41 – $41
8	Medical Mutual worker's compensation and no fault fee schedule · outpatient	$51	$51	—	—	—	$51 – $51
9	Humana humana military other · outpatient	$120	$120	—	—	—	$120 – $120
10	Tricare humana military other · outpatient	$120	$120	—	—	—	$120 – $120
11	Excellus excellus bcbs medicare advantage other · outpatient	$124	$124	$7	5%	—	$117 – $131
12	Humana humana medicare advantage other · outpatient	$124	$124	$7	5%	1–10	$117 – $131
13	Medicare medicare other · outpatient	$124	$124	$7	5%	—	$117 – $131
14	Optum vaccn optum other · outpatient	$124	$124	$7	5%	—	$117 – $131
15	UnitedHealthcare uhc medicare advantage other · outpatient	$125	$125	$7	5%	—	$119 – $132
16	Aetna aetna medicare advantage other · outpatient	$126	$126	$7	5%	—	$120 – $133
17	WellCare wellcare medicare advantage other · outpatient	$128	$128	$7	5%	—	$121 – $134
18	UnitedHealthcare uhc empire plan percent of total billed charges · inpatientfrom % of charges	$258	$258	—	—	—	$258 – $258
19	Cigna mvp and cigna commercial other · outpatient	$356	$356	$19	5%	—	$337 – $375
20	Aetna aetna commercial percent of total billed charges · bothfrom % of charges	$384	$384	—	—	—	$384 – $384
21	Humana humana hmo/pos percent of total billed charges · inpatientfrom % of charges	$419	$419	—	—	—	$419 – $419
22	Bcbs Ny excellus bcbs indemnity percent of total billed charges · bothfrom % of charges	$439	$439	—	—	—	$439 – $439
23	Blue Cross Blue Shield excellus bcbs hmo/ppo percent of total billed charges · bothfrom % of charges	$439	$439	—	—	—	$439 – $439
24	Excellus excellus bcbs hmo/ppo percent of total billed charges · bothfrom % of charges	$439	$439	—	—	1–10	$439 – $439
25	Excellus excellus bcbs indemnity percent of total billed charges · bothfrom % of charges	$439	$439	—	—	—	$439 – $439

Page 1 of 2 · 28 rates

Last updated: Aug 7, 2026

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