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Sacroiliac Joint X-ray

Wisconsin rates for HCPCS 72200

This is an X-ray of the sacroiliac joints, the joints where the base of the spine connects to the pelvis, using a limited number of views. It is used to look for signs of arthritis, injury, or inflammation in these joints, which can be a source of low back pain.

Rates data updated July 2026.

Facilitymedian $25 · 10th–90th $12$1000%10%20%10th90th$25Professionalmedian $49 · 10th–90th $11$1580%5%10%10th90th$49$10.0$20.0$50.0$100.0$200.0

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

Insurance Carrier
Aetna
Setting
Facility
Modifier
26 · Professional part
Typical Low
$12.02
Median
$13.80
Typical High
$17.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$48.98
Typical High
$186.21
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$7.41
Median
$10.96
Typical High
$87.10
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$21.38
Median
$29.51
Typical High
$52.48
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$48.98
Typical High
$169.82
Anthem BCBS
Setting
Professional
Modifier
26 · Professional part
Typical Low
$7.76
Median
$12.88
Typical High
$43.65
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$21.38
Median
$37.15
Typical High
$125.89
Cigna
Setting
Facility
Modifier
26 · Professional part
Typical Low
$21.88
Median
$25.12
Typical High
$40.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$97.72
Typical High
$134.90
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$9.33
Median
$24.55
Typical High
$33.11
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$22.91
Median
$72.44
Typical High
$102.33
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$74.13
Typical High
$97.72
DeanCare
Setting
Professional
Modifier
26 · Professional part
Typical Low
$15.49
Median
$18.62
Typical High
$23.99
DeanCare
Setting
Professional
Modifier
TC · Technical part
Typical Low
$46.77
Median
$54.95
Typical High
$74.13
Medica
Setting
Facility
Modifier
26 · Professional part
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Medica
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$57.54
Typical High
$208.93
Medica
Setting
Professional
Modifier
26 · Professional part
Typical Low
$9.12
Median
$17.78
Typical High
$83.18
Medica
Setting
Professional
Modifier
TC · Technical part
Typical Low
$22.39
Median
$42.66
Typical High
$158.49
Molina
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$33.11
Typical High
$70.79
Network Health
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$61.66
Typical High
$131.83
Network Health
Setting
Professional
Modifier
26 · Professional part
Typical Low
$10.47
Median
$19.50
Typical High
$31.62
Network Health
Setting
Professional
Modifier
TC · Technical part
Typical Low
$31.62
Median
$42.66
Typical High
$97.72
Quartz
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$85.11
Typical High
$125.89
Quartz
Setting
Facility
Modifier
26 · Professional part
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Quartz
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$154.88
Typical High
$208.93
Quartz
Setting
Professional
Modifier
26 · Professional part
Typical Low
$11.48
Median
$43.65
Typical High
$85.11
Quartz
Setting
Professional
Modifier
TC · Technical part
Typical Low
$25.12
Median
$109.65
Typical High
$158.49
Security Health
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Security Health
Setting
Professional
Modifier
26 · Professional part
Typical Low
$20.89
Median
$20.89
Typical High
$20.89
Security Health
Setting
Professional
Modifier
TC · Technical part
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
Security Health
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$169.82
Typical High
$208.93
Security Health
Setting
Professional
Modifier
26 · Professional part
Typical Low
$19.05
Median
$24.55
Typical High
$47.86
Security Health
Setting
Professional
Modifier
TC · Technical part
Typical Low
$41.69
Median
$51.29
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$95.50
Typical High
$208.93
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$18.20
Median
$52.48
Typical High
$95.50
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$45.71
Median
$95.50
Typical High
$173.78