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Mid-Back Myelogram X-Ray of the Spinal Canal

Wisconsin rates for HCPCS 62303

Contrast dye is injected through a needle in the lower back into the fluid-filled space around the spinal cord, and x-ray images are then taken of the mid-back portion of the spine. The dye outlines the spinal cord and the nerve roots so pressure on them from a disc, bone spur, or narrowing shows up clearly. The images are interpreted and reported as part of the service.

Rates data updated July 2026.

Facilitymedian $2,818 · 10th–90th $245$5,3700%10%10th90th$2,818Professionalmedian $380 · 10th–90th $200$8510%5%10%10th90th$380$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$933.25
Typical High
$3,019.95
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,187.76
Median
$3,090.30
Typical High
$5,754.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$794.33
Typical High
$1,258.93
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$269.15
Typical High
$3,311.31
Medica
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$288.40
Typical High
$3,630.78
Network Health
Setting
Facility
Modifier
Global
Typical Low
$1,819.70
Median
$3,019.95
Typical High
$3,235.94
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$234.42
Typical High
$446.68
Quartz
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$380.19
Typical High
$851.14
Quartz
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$794.33
Typical High
$794.33
Security Health
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$954.99
United
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$2,818.38
Typical High
$4,365.16