Initial intraoral X-ray of one tooth at Westchester Medical Center

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

INTRAORAL PERIAPICAL FIRST XR

Valhalla, NY

See all hospitals reporting HCPCS D0220 →

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How this price compares nationally

Westchester Medical Center’s median price of $108 is 17% above the median hospital's median price ($93), higher than 73% of the 760 hospitals reporting HCPCS D0220. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS D0220 at Westchester Medical Center

Negotiated rates from the hospital’s own file: 10 payers, 21 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	Blue Cross Blue Shield blue cross commercial/healthy ny facility · case rate · outpatient	$12	$12	—	—	—	$12 – $12
2	Blue Cross Blue Shield blue cross connection/exchange facility · case rate · outpatient	$12	$12	—	—	—	$12 – $12
3	Blue Cross Blue Shield blue cross small group facility · case rate · outpatient	$12	$12	—	—	—	$12 – $12
4	Aetna aetna hp network facility · percent of total billed charges · outpatientfrom % of charges	$23	$23	—	—	—	$23 – $23
5	Aetna aetna facility · percent of total billed charges · outpatientfrom % of charges	$25	$25	—	—	—	$25 – $25
6	Aetna aetna employee facility · percent of total billed charges · outpatientfrom % of charges	$25	$25	—	—	—	$25 – $25
7	MultiPlan multiplan facility · percent of total billed charges · inpatientfrom % of charges	$27	$27	—	—	—	$27 – $27
8	UnitedHealthcare uhc commercial facility · percent of total billed charges · outpatientfrom % of charges	$27	$27	—	—	—	$27 – $27
9	UnitedHealthcare uhc compass facility · percent of total billed charges · outpatientfrom % of charges	$27	$27	—	—	—	$27 – $27
10	UnitedHealthcare uhc empire facility · percent of total billed charges · outpatientfrom % of charges	$27	$27	—	—	—	$27 – $27
11	UnitedHealthcare uhc exchange facility · percent of total billed charges · outpatientfrom % of charges	$27	$27	—	—	—	$27 – $27
12	MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges	$29	$29	—	—	—	$29 – $29
13	Phcs phcs facility · percent of total billed charges · inpatientfrom % of charges	$33	$33	—	—	—	$33 – $33
14	Phcs phcs facility · percent of total billed charges · outpatientfrom % of charges	$33	$33	—	—	—	$33 – $33
15	Blue Cross Blue Shield blue cross medicare facility · fee schedule · outpatient	$2.0k	$2.0k	$1.9k	95%	—	$108 – $3.9k
16	Medicare medicare facility · fee schedule · outpatient	$2.0k	$2.0k	$1.9k	95%	—	$108 – $3.9k
17	UnitedHealthcare uhc medicare facility · fee schedule · outpatient	$2.0k	$2.0k	$1.9k	95%	—	$108 – $3.9k
18	Oscar oscar medicare facility · fee schedule · outpatient	$2.1k	$2.1k	$2.0k	95%	—	$111 – $4.1k
19	Molina affinity by molina mcr facility · fee schedule · outpatient	$2.1k	$2.1k	$2.0k	95%	—	$114 – $4.1k
20	Tricare tricare facility · fee schedule · outpatient	$3.1k	$3.1k	$3.0k	96%	—	$109 – $6.1k
21	WellCare wellcare exchange (mcr) facility · fee schedule · outpatient	$3.7k	$3.7k	$3.5k	95%	—	$200 – $7.3k

Last updated: Jul 28, 2026

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