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Lower Back Disc Contrast Imaging

Hawaii rates for HCPCS 72295

This is a diagnostic imaging study of a disc in the lower back, performed after contrast dye is injected directly into the disc under X-ray guidance. The images and the pattern of any pain reproduced during the injection help determine whether that disc is a source of back pain.

Rates data updated July 2026.

Facilitymedian $45 · 10th–90th $40$520%20%40%10th90th$45Professionalmedian $93 · 10th–90th $36$4900%5%10%10th90th$93$50.0$100.0$200.0$500.0

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
26 · Professional part
Typical Low
$39.81
Median
$44.67
Typical High
$52.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$93.33
Typical High
$134.90
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$28.18
Median
$35.48
Typical High
$38.02
Cigna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$162.18
Typical High
$446.68
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$34.67
Median
$50.12
Typical High
$61.66
HMSA
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$512.86
Typical High
$575.44
HMSA
Setting
Professional
Modifier
26 · Professional part
Typical Low
$51.29
Median
$52.48
Typical High
$54.95
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$162.18
Typical High
$199.53
Kaiser Permanente
Setting
Professional
Modifier
26 · Professional part
Typical Low
$42.66
Median
$50.12
Typical High
$61.66
United
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$177.83
Typical High
$295.12
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$45.71
Median
$51.29
Typical High
$87.10
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$199.53
Typical High
$512.86
University Health Alliance
Setting
Professional
Modifier
26 · Professional part
Typical Low
$45.71
Median
$60.26
Typical High
$91.20