20 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| Chest 1 view (71045) |
$621.10 |
$621.10 |
7.1× |
| CT abdomen and pelvis without contrast (74176) |
$10,701 |
$10,701 |
44.6× |
| CT c-spine w/o contrast (72125) |
$6,817 |
$6,817 |
64.9× |
| CT lumbar spine w & w/o contrast (72133) |
$4,211 |
$4,211 |
23.9× |
| CT lumbar spine w/o contrast (72131) |
$5,758 |
$5,758 |
54.8× |
| CT maxillofacial w/o contrast (70486) |
$4,845 |
$4,845 |
46.1× |
| CT thoracic spine w/o contrast (72128) |
$6,920 |
$6,920 |
65.9× |
| CT thorax w/o contrast (71250) |
$5,260 |
$5,260 |
50.1× |
| Cta Abdomen (74175) |
$5,643 |
$5,643 |
32.0× |
| Hand 3 views (73130) |
$653 |
$653 |
7.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$9,930 |
$9,930 |
28.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$621.10 |
$621.10 |
7.1× |
| Ultrasound, abdomen limited (76705) |
$1,406 |
$1,406 |
13.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,120 |
$1,120 |
10.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,212 |
$1,212 |
11.5× |
| Us soft tissue head/neck (76536) |
$1,384 |
$1,384 |
13.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$765 |
$765 |
8.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$758 |
$758 |
8.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$801 |
$801 |
9.2× |
| Xray knee 1 or 2 views rt (73560) |
$564 |
$564 |
6.5× |