SelfPayRates — hospital cash prices, from the source
Cash prices at 4 facilities across 2 cities for code 72110, as an outpatient — the setting a self-pay patient normally buys. Collected Sep 23, 2026; the hospital files themselves were last updated between — and —.
| Hospital | Cash price | List price | Off | File date | |
|---|---|---|---|---|---|
| Ascension NE Wisconsin, Inc.
APPLETON, WI HC X-RAY EXAM L-2 SPINE 4/>VWS |
$156.18 | $274.00 | 43% | — file |
|
| Thedacare Regional Medical Center-Appleton Inc.
APPLETON, WI X-RAY LUMBAR SPINE 4 VW |
$227.47 | $406.20 | 44% | — file |
|
| Thedacare Regional Medical Center-Appleton Inc
APPLETON, WI X-RAY LUMBAR SPINE 4 VW |
$227.47 | $406.20 | 44% | — file |
|
| Thedacare Regional Medical Center-Appleton Inc
APPLETON, WI HC X-Ray Lumbar Spine 4 Vw |
$236.49 | $422.30 | 44% | — file |
|
| Thedacare Regional Medical Center-Appleton Inc.
APPLETON, WI HC X-Ray Lumbar Spine 4 Vw |
$236.49 | $422.30 | 44% | — file |
|
| Ascension Calumet Hospital, Inc.
CHILTON, WI HC X-RAY EXAM L-2 SPINE 4/>VWS |
$239.40 | $420.00 | 43% | — file |
|
| Thedacare Regional Medical Center-Appleton Inc
APPLETON, WI HC X-RAY LUMBAR SPINE 4 VW |
$307.44 | $549.00 | 44% | — file |
|
| Thedacare Regional Medical Center-Appleton Inc.
APPLETON, WI HC X-RAY LUMBAR SPINE 4 VW |
$307.44 | $549.00 | 44% | — file |
Outpatient: lowest $156.18, median $236.49, highest $307.44 — a 2.0× difference within the same market.