X-Ray Lumbar Spine price: Medicare anchor and facility lever
Prices only. No diagnosis or treatment advice. Use the CPT code and Medicare anchor below to ask for an all-in cash price, then confirm your price in writing before service.
Before you book: confirm your price in writing before service. Ask for the exact CPT code, the setting, and whether professional, facility, anesthesia, and pathology are included.
CPT code
72100
Radiologic examination, spine, lumbosacral; 2 or 3 views
CPT 72100 is two or three views of the lumbosacral spine. A complete study with bending views uses a different code (72114). Confirm the view count on the order.
Verified Medicare anchor
$38.55
Physician Fee Schedule global (professional + technical)
- Professional (26)
- $10.56
- Technical (TC)
- $27.98
Source: CMS Physician Fee Schedule CY2025 via WPS GHA, Michigan Locality 01 - CY2025. Verified 2026-10-04. Medicare anchor only, not a self-pay price.
Hospital OPPS facility anchor
$106.34
APC 5522 - Level 2 Imaging without Contrast (facility portion only, professional extra)
Source: CMS OPPS CY2025 Final Rule CMS-1809-FC - CY2025. Verified 2026-10-04.
What this procedure is, in price terms
X-Ray Lumbar Spine is billed under CPT 72100: Radiologic examination, spine, lumbosacral; 2 or 3 views The code, not the marketing name, determines the Medicare anchor and the cash quote. If the order changes - for example with contrast instead of without, or a biopsy is added - the code changes and the price changes with it. Ask the ordering clinician's office to confirm the expected code before you price-shop, and ask the facility what code will be billed if the plan changes on the day.
What the price includes
- Image acquisition for two or three views
- Radiologist interpretation and written report (professional component, modifier 26)
- Standard image storage
What the price usually excludes
- Additional views billed under a different code
- The ordering visit and follow-up visit
- Comparison with prior imaging billed as a separate interpretation in limited circumstances
A quote is complete only when it states which of the excluded items apply to you and what each costs. Get that in writing.
Why prices vary for CPT 72100
Spine X-ray is a low-anchor service. The billing pattern still matters: a hospital bills an imaging APC plus the professional fee, while an office or imaging center bills one global amount. Because the anchor is small, ask for the all-in cash price rather than comparing one layer at a time.
Geography also matters. Physician Fee Schedule amounts are locality-adjusted, so the Michigan Locality 01 anchor on this page will differ somewhat from the amount in another locality. OPPS amounts are national unadjusted rates before the hospital wage index is applied. Use the anchor for order of magnitude and for the facility comparison, not as a prediction of your bill.
Unique insight for CPT 72100
For this code the hospital facility-only OPPS anchor ($106.34, APC 5522) sits above the single global PFS anchor ($38.55) before the professional fee is even added. That one comparison, computed from the verified anchors above, is the fastest way to see why setting is the first question to ask for X-Ray Lumbar Spine. It is a Medicare payment-system comparison, not a cash-price prediction for any one facility.
Locality caveat: PFS amounts on this page are Michigan Locality 01 anchors. Your locality will differ. Confirm your price in writing before service.
The facility-type lever
Ask for the global cash price at an office or imaging center and compare it with the hospital outpatient quote for the same 72100 code.
Compare the same CPT code in more than one setting when your clinician allows a choice:
- Hospital Outpatient Department - OPPS (APC-based facility payment) + Physician Fee Schedule professional fee. Facility fee: Yes - separate OPPS facility payment to the hospital.
- Ambulatory Surgery Center - ASC payment system (procedure-based, generally below OPPS) + Physician Fee Schedule professional fee. Facility fee: Yes - ASC facility fee, typically lower than hospital OPPS for the same procedure.
- Independent Imaging Center - Physician Fee Schedule global payment when the center owns the equipment and employs or contracts the radiologist. Facility fee: No separate hospital facility fee - the technical component is inside the global PFS payment.
- Physician Office - Physician Fee Schedule nonfacility payment (higher practice-expense component than facility rate). Facility fee: No separate facility fee - office overhead is inside the nonfacility PFS rate.
Use the Price Anchor Explorer to see how the anchor presentation changes by facility type.
Self-pay ranges on this page
Self-pay ranges are not published yet for X-Ray Lumbar Spine. MyCarePrice adds a self-pay range only where it can be verified from a public source under Procedure Price Method v1.0. Until then, this page ships the verified Medicare anchor plus facility-type education. That is deliberate: an invented range would be worse than no range.
To get a real self-pay number today, ask the facility directly: "What is the all-in cash price for CPT 72100, including professional, facility, anesthesia, and pathology if they apply?" See How to ask for the cash price and Questions to ask billing before your procedure.
Questions to ask before you book
- What CPT code will be billed if nothing changes, and what code will be billed if the plan changes?
- Is the quote global, or will the professional fee bill separately?
- What setting is this price for, and what would the same code cost in the other setting you offer?
- Are anesthesia and pathology included, likely, or billed separately?
- Can I have the all-in price in writing, with the code, setting, and inclusions listed?
Frequently asked questions
What is the Medicare anchor for X-Ray Lumbar Spine?
The verified Physician Fee Schedule global anchor for CPT 72100 is $38.55 (CMS Physician Fee Schedule CY2025 via WPS GHA, Michigan Locality 01, CY2025, verified 2026-10-04). The professional component is $10.56 and the technical component is $27.98. This is a Medicare anchor, not your self-pay price. Confirm your price in writing before service.
Why does the same procedure cost more at a hospital?
Medicare pays the facility portion differently by setting. A hospital outpatient department bills OPPS plus the professional fee. An imaging center or office usually bills one global PFS amount. Same CPT code, different payment system. Ask for the all-in cash price in each setting using the same CPT code.
Does this page tell me whether I should get this procedure?
No. MyCarePrice publishes prices only. We do not provide diagnosis, treatment, or should-you-get-this-test advice. Decisions about care belong with you and your clinician.
Why is no self-pay range published for X-Ray Lumbar Spine?
A self-pay range appears only where it can be verified from a public source under Procedure Price Method v1.0. For CPT 72100 that verification is not published yet, so this page ships the verified Medicare anchor plus facility-type education instead of an invented range. Ask the facility for the all-in cash price and confirm it in writing before service.
Sources and verification
- Physician Fee Schedule anchor: CMS Physician Fee Schedule CY2025 via WPS GHA, Michigan Locality 01, CY2025, verified 2026-10-04. Michigan Locality 01 - your locality amount will differ.
- Hospital OPPS facility anchor: CMS OPPS CY2025 Final Rule CMS-1809-FC, CY2025, verified 2026-10-04. APC 5522 - Level 2 Imaging without Contrast. National unadjusted rate before wage-index adjustment.
- Method: Procedure Price Method v1.0. Medicare rates are shown as a separate anchor, never blended into a self-pay range. Self-pay ranges are published only where verified from a public source.
- Also see How Prices Work for the two payment systems behind these anchors.
This page is price information only. It is not medical advice and does not recommend for or against any procedure. Confirm your price in writing before service.