Imaging prices at AdventHealth Lake Wales
Lake Wales, FL · every code in this section with a posted price and a Medicare benchmark.
236 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Abdomen 2 views (74019) | $1,473.52 | $1,473.52 | 13.5× |
| Acute gi blood loss imaging (78278) | $4,670.85 | $4,670.85 | 11.2× |
| Angiography extremity bilateral rs&i (75716) | $12,835.75 | $12,835.75 | 3.9× |
| Angiography extremity unilateral rs&i (75710) | $11,696.90 | $11,696.90 | 3.5× |
| Angiography pelvic slctv/supraslctv rs&i (75736) | $12,681.09 | $12,681.09 | 2.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) | $11,853.80 | $11,853.80 | 3.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $7,221.44 | $7,221.44 | 2.2× |
| Ankle 2 views (73600) | $1,165.12 | $1,165.12 | 12.8× |
| Aortogram thoracic (75605) | $12,681.09 | $12,681.09 | 2.2× |
| Aortography abdominal serialography rs&i (75625) | $12,846.89 | $12,846.89 | 3.9× |
| Bone &/Joint Imaging Limited Area (78300) | $3,443.60 | $3,443.60 | 8.2× |
| Bone &/joint imaging whole body (78306) | $5,045.51 | $5,045.51 | 12.1× |
| Bone age studies (77072) | $818.59 | $818.59 | 7.5× |
| Bone Imaging 3 Phase (78315) | $6,579.94 | $6,579.94 | 15.8× |
| Bone survey complete (77075) | $3,327.24 | $3,327.24 | 30.5× |
| Bone survey infant (77076) | $1,655.46 | $1,655.46 | 15.2× |
| Brachytx isodose complex (77318) | $3,546.50 | $3,546.50 | 9.1× |
| Brachytx isodose intermed (77317) | $3,354.82 | $3,354.82 | 8.6× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) | $1,683.31 | $1,683.31 | 4.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,921.40 | $2,921.40 | 5.2× |
| Cervical spine 2 or 3 views (72040) | $1,698.45 | $1,698.45 | 18.7× |
| Chest 1 view (71045) | $1,097.32 | $1,097.32 | 12.1× |
| Chest xray 3 views (71047) | $2,223 | $2,223 | 24.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) | $1,196.04 | $1,196.04 | 6.5× |
| Clavicle complete (73000) | $1,513.93 | $1,513.93 | 16.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $3,203.84 | $3,203.84 | 29.3× |
| CT abdomen and pelvis without and with contrast (74178) | $25,161.02 | $25,161.02 | 69.1× |
| CT abdomen and pelvis without contrast (74176) | $17,217.10 | $17,217.10 | 69.1× |
| CT abdomen w contrast (74160) | $10,159.63 | $10,159.63 | 55.5× |
| CT abdomen w wo contrast (74170) | $12,580.49 | $12,580.49 | 68.7× |
| CT abdomen w/o contrast (74150) | $8,427.48 | $8,427.48 | 77.2× |
| CT angio lwr extr w/o&w/dye (73706) | $8,757.57 | $8,757.57 | 47.8× |
| CT angiography upper extremity lt (73206) | $5,075.29 | $5,075.29 | 27.7× |
| CT c-spine w/contrast (72126) | $12,842.33 | $12,842.33 | 35.3× |
| CT c-spine w/o contrast (72125) | $8,789.66 | $8,789.66 | 80.5× |
| CT cervical spine w&w/o contrast (72127) | $7,112.05 | $7,112.05 | 38.8× |
| CT chest w contrast (71260) | $10,500.28 | $10,500.28 | 57.3× |
| CT chest w/wo contrast (71270) | $12,594.09 | $12,594.09 | 68.8× |
| CT head/brain with contrast (70460) | $8,427.48 | $8,427.48 | 46.0× |
| CT head/brain without and with contrast (70470) | $8,741.72 | $8,741.72 | 47.7× |
| CT iac w contrast (70481) | $8,427.48 | $8,427.48 | 46.0× |
| CT lower ext w/o (73700) | $7,384.23 | $7,384.23 | 67.6× |
| CT lower extremity w wo contrast (73702) | $9,676.14 | $9,676.14 | 52.8× |
| CT lower extremity w/contrast material (73701) | $8,789.66 | $8,789.66 | 48.0× |
| CT lumbar spine w & w/o contrast (72133) | $10,111.41 | $10,111.41 | 55.2× |
| CT lumbar spine w/contrast (72132) | $9,676.14 | $9,676.14 | 26.6× |
| CT lumbar spine w/o contrast (72131) | $8,789.66 | $8,789.66 | 80.5× |
| CT maxillofacial w contrast (70487) | $8,427.48 | $8,427.48 | 46.0× |
| CT maxillofacial w/wo contrast (70488) | $9,097.55 | $9,097.55 | 49.7× |
| CT maxillofacial wo contrast (70486) | $7,582.29 | $7,582.29 | 69.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) | $10,111.41 | $10,111.41 | 55.2× |
| CT orbits w/o contrast (70480) | $7,582.29 | $7,582.29 | 69.5× |
| CT pelvis w/o contrast (72192) | $8,789.66 | $8,789.66 | 80.5× |
| CT pelvis w/wo contrast (72194) | $7,112.05 | $7,112.05 | 38.8× |
| CT scan of arm combo (73202) | $7,112.05 | $7,112.05 | 38.8× |
| CT soft tissue neck w contrast (70491) | $8,427.48 | $8,427.48 | 46.0× |
| CT soft tissue neck w/o & w/contrast material (70492) | $10,111.41 | $10,111.41 | 55.2× |
| CT soft tissue neck w/o contrast (70490) | $7,582.29 | $7,582.29 | 69.5× |
| CT thoracic spine w/contrast (72129) | $7,112.05 | $7,112.05 | 38.8× |
| CT thoracic spine w/o contrast (72128) | $8,789.66 | $8,789.66 | 80.5× |
| CT thorax w/o contrast (71250) | $9,443.83 | $9,443.83 | 86.5× |
| CT upper ext wo (73200) | $7,909.21 | $7,909.21 | 72.4× |
| CT upper extremity with contrast (73201) | $8,789.66 | $8,789.66 | 24.1× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) | $20,656.41 | $20,656.41 | 112.8× |
| Cta Abdomen (74175) | $16,667 | $16,667 | 91.0× |
| CTA abdomen pelvis (74174) | $19,480.53 | $19,480.53 | 53.5× |
| CTA chest (71275) | $2,308.23 | $2,308.23 | 12.6× |
| Cta Head (70496) | $2,813.12 | $2,813.12 | 15.4× |
| Cta Neck (70498) | $8,757.57 | $8,757.57 | 47.8× |
| Facial bones min 3 views (70150) | $1,827.19 | $1,827.19 | 16.7× |
| Fluoroscopy up to 1 hr (76000) | $1,821.13 | $1,821.13 | 7.3× |
| Foot 2 views (73620) | $1,119.21 | $1,119.21 | 12.3× |
| Forearm 2 views (73090) | $1,227.37 | $1,227.37 | 13.5× |
| Hand 2 views (73120) | $1,165.12 | $1,165.12 | 10.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) | $3,484.26 | $3,484.26 | 6.1× |
| Hepatobiliary syst imaging including gallbladder (78226) | $5,046.36 | $5,046.36 | 12.1× |
| Intracavitary Radiation Source Applic Complex (77763) | $3,354.80 | $3,354.80 | 4.6× |
| Intracavitary Radiation Source Applic Intermed (77762) | $2,565.85 | $2,565.85 | 4.4× |
| Intracavitary Radiation Source Applic Simple (77761) | $2,565.85 | $2,565.85 | 4.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) | $5,445.85 | $5,445.85 | 9.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) | $4,988.88 | $4,988.88 | 8.8× |
| Knee 3 views (73562) | $1,325.34 | $1,325.34 | 14.6× |
| Lung perf&ventilat diferentl (78598) | $17,441.59 | $17,441.59 | 30.8× |
| Lymphoscintigraphy (78195) | $5,713.81 | $5,713.81 | 10.1× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) | $1,306.11 | $1,306.11 | 3.6× |
| Mr safety determination physician/other qhp (76016) | $252.89 | $252.89 | 2.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $70.61 | $70.61 | 2.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $265.09 | $265.09 | 2.7× |
| Mr safety implt pos&/immoblj (76019) | $168.42 | $168.42 | 2.7× |
| Mr safety med physics xm customization plng&mntr (76017) | $696.84 | $696.84 | 2.8× |
| MRA head w & w/o contrast (70546) | $7,861.49 | $7,861.49 | 21.6× |
| MRA head w/o contrast (70544) | $16,214.30 | $16,214.30 | 65.1× |
| MRA head with contrast (70545) | $6,164.11 | $6,164.11 | 16.9× |
| MRA neck w contrast (70548) | $6,016.25 | $6,016.25 | 16.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $8,372.67 | $8,372.67 | 23.0× |
| MRA neck w/o contrast (70547) | $6,164.11 | $6,164.11 | 24.7× |
| MRI abdomen w contrast (74182) | $8,161.52 | $8,161.52 | 22.4× |
| MRI abdomen w/o & w/contrast material (74183) | $22,740 | $22,740 | 62.4× |
| MRI abdomen w/o contrast (74181) | $16,214.30 | $16,214.30 | 65.1× |
| MRI any jt lower extrem w/contrast material (73722) | $2,537.52 | $2,537.52 | 3.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,306.96 | $4,306.96 | 11.8× |
| MRI cervical spine w/o contrast (72141) | $13,405 | $13,405 | 53.8× |
| MRI chest w/o & w/contrast material (71552) | $11,302.34 | $11,302.34 | 31.0× |
| MRI chest w/o contrast (71550) | $8,945.94 | $8,945.94 | 35.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $5,782.67 | $5,782.67 | 15.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $15,975.12 | $15,975.12 | 43.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $17,215.30 | $17,215.30 | 69.1× |
| MRI orbit face &/neck w/o contrast (70540) | $9,065.84 | $9,065.84 | 36.4× |
| MRI orbit face neck w contrast (70542) | $9,744.32 | $9,744.32 | 26.7× |
| MRI orbit/face/neck w&w/o cont (70543) | $3,063.10 | $3,063.10 | 8.4× |
| MRI pelvis w/o & w/contrast material (72197) | $3,634.13 | $3,634.13 | 10.0× |
| MRI pelvis w/o contrast (72195) | $2,930.17 | $2,930.17 | 11.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) | $16,091.43 | $16,091.43 | 44.2× |
| MRI spinal canal lumbar w/contrast material (72149) | $10,786.20 | $10,786.20 | 29.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) | $18,799.04 | $18,799.04 | 51.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) | $8,008.68 | $8,008.68 | 22.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) | $18,799.04 | $18,799.04 | 51.6× |
| MRI temporomandibular joint (70336) | $6,727.86 | $6,727.86 | 27.0× |
| MRI thoracic spine w/o contrast (72146) | $14,823.93 | $14,823.93 | 59.5× |
| MRI up ext w/o contrast (73218) | $3,944.52 | $3,944.52 | 15.8× |
| MRI upper ext joint w/o contrast (73221) | $15,975.12 | $15,975.12 | 64.1× |
| MRI, joint upper extrem combo (73223) | $1,306.11 | $1,306.11 | 3.6× |
| Myocardial Spect Multiple Studies (78452) | $12,998.63 | $12,998.63 | 9.6× |
| Neck soft tissue (70360) | $995.31 | $995.31 | 11.0× |
| Nm gastric emptying study (78264) | $3,539.47 | $3,539.47 | 8.5× |
| Nm kidney scan w/flow (78701) | $2,317.14 | $2,317.14 | 5.6× |
| Ntsty modul radthx pln dose-vol histos (77301) | $28,509.06 | $28,509.06 | 19.7× |
| Osseous survey limited (77074) | $1,655.46 | $1,655.46 | 15.2× |
| Parathyroid Planar Imaging (78070) | $1,677.46 | $1,677.46 | 4.0× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,546.78 | $2,546.78 | 6.1× |
| Pelvis 1 or 2 views (72170) | $1,042.61 | $1,042.61 | 9.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,695.61 | $1,695.61 | 4.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) | $4,072.49 | $4,072.49 | 7.2× |
| Radex Ankle Compl Minimum 3 Views (73610) | $1,233.74 | $1,233.74 | 13.6× |
| Radex Calcaneus Minimum 2 Views (73650) | $1,097.32 | $1,097.32 | 12.1× |
| Radex Elbw Compl Minimum 3 Views (73080) | $1,335.86 | $1,335.86 | 14.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) | $1,061.35 | $1,061.35 | 11.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) | $2,915.81 | $2,915.81 | 26.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) | $2,122.33 | $2,122.33 | 19.4× |
| Radex fingr minimum 2 views (73140) | $995.31 | $995.31 | 11.0× |
| Radex Foot Compl Minimum 3 Views (73630) | $1,233.74 | $1,233.74 | 13.6× |
| Radex Hand Minimum 3 Views (73130) | $1,233.74 | $1,233.74 | 13.6× |
| Radex Hip Unilateral With Pelvis 1 View (73501) | $1,329.71 | $1,329.71 | 14.6× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) | $2,577.46 | $2,577.46 | 23.6× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) | $1,335.85 | $1,335.85 | 12.2× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) | $2,227.27 | $2,227.27 | 20.4× |
| Radex Humerus Minimum 2 Views (73060) | $1,335.86 | $1,335.86 | 14.7× |
| Radex Kne 1/2 Views (73560) | $1,479.89 | $1,479.89 | 16.3× |
| Radex Kne Compl 4/More Views (73564) | $1,916.88 | $1,916.88 | 17.6× |
| Radex Mndbl Compl Minimum 4 Views (70110) | $1,445.67 | $1,445.67 | 13.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $849.49 | $849.49 | 9.3× |
| Radex Pelvis Compl Minimum 3 Views (72190) | $1,043.22 | $1,043.22 | 9.6× |
| Radex Sho Compl Minimum 2 Views (73030) | $1,677.42 | $1,677.42 | 18.5× |
| Radex Sinuses Paransl < 3 Views (70210) | $558.58 | $558.58 | 6.1× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) | $1,434.88 | $1,434.88 | 13.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $1,069.70 | $1,069.70 | 11.8× |
| Radex Toe Minimum 2 Views (73660) | $995.31 | $995.31 | 11.0× |
| Radex upper extremity infant minimum 2 views (73092) | $1,587.24 | $1,587.24 | 14.5× |
| Radex Wrst Compl Minimum 3 Views (73110) | $1,233.74 | $1,233.74 | 13.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,878.19 | $1,878.19 | 17.2× |
| Radiation Delivery Stereotactic Cranial Cobalt (77371) | $27,584.98 | $27,584.98 | 3.6× |
| Radiation treatment delivery level 1 (77402) | $424.87 | $424.87 | 4.0× |
| Radiation treatment delivery level 2 (77407) | $1,000.24 | $1,000.24 | 2.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) | $1,479.89 | $1,479.89 | 16.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,745.01 | $1,745.01 | 16.0× |
| Radiologic exam chest 2 views (71046) | $1,793.20 | $1,793.20 | 19.7× |
| Radiologic examination femur 1 view (73551) | $1,035.47 | $1,035.47 | 11.4× |
| Radiologic examination tibia & fibula 2 views (73590) | $1,881.75 | $1,881.75 | 20.7× |
| Ribs bilateral 3 views (71110) | $2,404.94 | $2,404.94 | 22.0× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) | $3,082.12 | $3,082.12 | 7.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) | $7,384.23 | $7,384.23 | 13.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) | $3,769.51 | $3,769.51 | 6.6× |
| Sacroiliac Joints < 3 Views (72200) | $812.84 | $812.84 | 7.4× |
| Scapula (73010) | $1,308.84 | $1,308.84 | 12.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $316.07 | $316.07 | 13.5× |
| Shoulder 1 view (73020) | $1,097.32 | $1,097.32 | 12.1× |
| Spine thoracic 3 views (72072) | $1,718.29 | $1,718.29 | 15.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,683.31 | $1,683.31 | 4.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,683.31 | $1,683.31 | 4.3× |
| Thoracolumbar 2 views (72080) | $1,562.17 | $1,562.17 | 17.2× |
| Thyroid imaging w/blood flow (78013) | $2,094.50 | $2,094.50 | 5.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $4,937.27 | $4,937.27 | 11.8× |
| Ultrasound breast complete (76641) | $1,638.34 | $1,638.34 | 15.0× |
| Ultrasound Exam Aaa Screen (76706) | $7,169.61 | $7,169.61 | 65.7× |
| Ultrasound, abdomen limited (76705) | $2,536.78 | $2,536.78 | 23.2× |
| Us breast unilateral limited (76642) | $1,638.34 | $1,638.34 | 18.0× |
| Us chest (76604) | $2,318.41 | $2,318.41 | 21.2× |
| Us compl joint r-t w/image documentation (76881) | $2,536.78 | $2,536.78 | 23.2× |
| Us encephalogram (76506) | $2,559.22 | $2,559.22 | 23.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,268.36 | $1,268.36 | 11.6× |
| Us ob limited (76815) | $2,536.78 | $2,536.78 | 23.2× |
| Us ob transvaginal (76817) | $372.19 | $372.19 | 3.4× |
| Us pelvic non ob complete (76856) | $1,587.24 | $1,587.24 | 14.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) | $449.45 | $449.45 | 4.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $700.04 | $700.04 | 6.4× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) | $1,587.24 | $1,587.24 | 14.5× |
| Us retroperitoneal complete (76770) | $2,826.05 | $2,826.05 | 25.9× |
| Us retroperitoneal limited (76775) | $2,536.78 | $2,536.78 | 23.2× |
| Us scrotum and contents (76870) | $2,733.97 | $2,733.97 | 25.0× |
| Us soft tissue head/neck (76536) | $2,536.78 | $2,536.78 | 23.2× |
| Us transrectal (76872) | $3,511.87 | $3,511.87 | 32.2× |
| Us,transplanted kidney, real time/ doppler (76776) | $768.21 | $768.21 | 7.0× |
| Venogram extremity bilateral (75822) | $6,544.92 | $6,544.92 | 4.0× |
| Venogram Extremity Unilateral (75820) | $4,555.95 | $4,555.95 | 2.8× |
| Venography caval inferior serialography rs&i (75825) | $14,029.18 | $14,029.18 | 4.3× |
| Venography caval superior serialography rs&i (75827) | $7,980.57 | $7,980.57 | 4.9× |
| Wrist 2 views (73100) | $1,165.12 | $1,165.12 | 12.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) | $1,718.29 | $1,718.29 | 15.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $1,186.69 | $1,186.69 | 13.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $1,335.85 | $1,335.85 | 14.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $318 | $318 | 2.9× |
| X-ray exam of femur 2/> (73552) | $1,616.28 | $1,616.28 | 17.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) | $1,445.67 | $1,445.67 | 15.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $1,137.98 | $1,137.98 | 12.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $513.53 | $513.53 | 5.7× |
| X-ray leg, infant (73592) | $830.26 | $830.26 | 9.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,881.75 | $1,881.75 | 17.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) | $2,748.49 | $2,748.49 | 25.2× |
| X-ray nose-rectum child f.b. (76010) | $1,227.37 | $1,227.37 | 13.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) | $860.60 | $860.60 | 7.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) | $1,335.86 | $1,335.86 | 14.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) | $1,562.17 | $1,562.17 | 14.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $2,483 | $2,483 | 22.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,115.72 | $1,115.72 | 10.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,616.28 | $1,616.28 | 17.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,827.19 | $1,827.19 | 20.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $2,197.29 | $2,197.29 | 20.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) | $1,745.01 | $1,745.01 | 16.0× |
| X-Ray Spine One View - Xr Spine (72020) | $286.89 | $286.89 | 3.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) | $1,520.44 | $1,520.44 | 16.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) | $1,520.44 | $1,520.44 | 13.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) | $2,518.06 | $2,518.06 | 23.1× |
| Xr c-spine 4 or 5 views (72050) | $1,733.30 | $1,733.30 | 15.9× |
| Xr c-spine 6 or more views (72052) | $2,724.68 | $2,724.68 | 25.0× |
| Xr chest 4+ views (71048) | $1,481.51 | $1,481.51 | 13.6× |
| Xr urogram antegrade (74425) | $1,306.11 | $1,306.11 | 3.6× |