Imaging prices at Adventist Health Sierra Vista
San Luis Obispo, CA · every code in this section with a posted price and a Medicare benchmark.
264 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $117.63 | $1,307 | 1.1× |
| Abdomen 2 views (74019) | $134.91 | $1,499 | 1.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $430.92 | $4,788 | 0.8× |
| Angio pulmonary bilat (75743) | $1,034.73 | $11,497 | 0.3× |
| Angiography extremity bilateral rs&i (75716) | $1,370.25 | $15,225 | 0.3× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$953.46–$1,091.34 | $10,594–$12,126 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $802.80 | $8,920 | 0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $790.29 | $8,781 | 0.2× |
| Ankle 2 views (73600) | $130.23 | $1,447 | 1.2× |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$655.65–$3,634.11 | $7,285–$40,379 | varies |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$811.35 | $9,015 | 0.1× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$788.58 | $8,762 | 0.1× |
| Arthrogram ankle (73615) | $291.60 | $3,240 | 0.6× |
| Arthrogram hip (73525) | $223.29 | $2,481 | 0.5× |
| Bone age studies (77072) | $97.38 | $1,082 | 0.7× |
| Bone Imaging 3 Phase (78315) | $648.72 | $7,208 | 1.3× |
| Bone Imaging Limited Area (78300) | $387.27 | $4,303 | 0.8× |
| Bone Imaging Whole Body (78306) | $580.50 | $6,450 | 1.1× |
| Bone survey infant (77076) | $91.17 | $1,013 | 0.7× |
| Brain Flow Imaging Only (78610) | $256.41 | $2,849 | 0.4× |
| Cat Scan Follow-Up Study (76380) range across 4 matching MRF lines |
$418.59–$520.20 | $4,651–$5,780 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $200.43 | $2,227 | 0.3× |
| Cerebrospinal Fluid Scan (78630) | $364.41 | $4,049 | 0.5× |
| Chest 1 view (71045) | $137.97 | $1,533 | 1.2× |
| Chest 2 views (71046) | $148.32 | $1,648 | 1.3× |
| Chest 3 views (71047) | $173.43 | $1,927 | 1.5× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$248.94–$256.41 | $2,766–$2,849 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$138.96–$148.05 | $1,544–$1,645 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$1,119.42–$1,249.74 | $12,438–$13,886 | varies |
| Contrast X-Ray Bladder (74430) | $97.74 | $1,086 | 0.2× |
| Contrast X-Ray Of Knee Joint (73580) | $225.63 | $2,507 | 0.5× |
| CT abdomen and pelvis without and with contrast (74178) | $1,246.95 | $13,855 | 2.8× |
| CT abdomen and pelvis without contrast (74176) | $1,178.28 | $13,092 | 3.8× |
| CT abdomen w contrast (74160) | $761.04 | $8,456 | 3.4× |
| CT abdomen w wo contrast (74170) | $831.42 | $9,238 | 3.7× |
| CT abdomen w/o contrast (74150) | $779.04 | $8,656 | 5.8× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$504.54–$549.90 | $5,606–$6,110 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$831.96–$978.93 | $9,244–$10,877 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$734.13–$789.84 | $8,157–$8,776 | varies |
| CT angio hrt w/3d image (75574) | $931.41 | $10,349 | 2.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$663.30–$704.79 | $7,370–$7,831 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$732.51–$964.26 | $8,139–$10,714 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $610.11 | $6,779 | 2.7× |
| CT cervical spine w/ contrast (72126) | $762.75 | $8,475 | 1.7× |
| CT cervical spine w/o contrast (72125) | $1,046.25 | $11,625 | 7.8× |
| CT chest w contrast (71260) | $1,053.27 | $11,703 | 4.7× |
| CT chest w/wo contrast (71270) | $979.92 | $10,888 | 4.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $206.10 | $2,290 | 1.5× |
| CT head/brain with contrast (70460) | $623.43 | $6,927 | 2.8× |
| CT head/brain without and with contrast (70470) | $931.05 | $10,345 | 4.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $15.84 | $176 | 0.1× |
| CT iac w contrast (70481) | $864.63 | $9,607 | 3.8× |
| CT lower ext w/o (73700) | $699.12 | $7,768 | 5.2× |
| CT lower extremity w/contrast material (73701) | $491.94 | $5,466 | 2.2× |
| CT lumbar spine w contrast (72132) | $721.26 | $8,014 | 1.6× |
| CT lumbar spine w/o contrast (72131) | $941.04 | $10,456 | 7.0× |
| CT maxillofacial w contrast (70487) | $898.38 | $9,982 | 4.0× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$627.48–$811.44 | $6,972–$9,016 | varies |
| CT neck tissue combo (70492) | $899.10 | $9,990 | 4.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,052.37 | $11,693 | 4.7× |
| CT orbits w/o contrast (70480) | $746.46 | $8,294 | 5.6× |
| CT pelvis w&w/o contrast (72194) | $1,181.43 | $13,127 | 5.2× |
| CT pelvis w/o contrast (72192) | $737.28 | $8,192 | 5.5× |
| CT scan of leg combo (73702) | $767.79 | $8,531 | 3.4× |
| CT scans face/jaw combo (70488) | $715.77 | $7,953 | 3.2× |
| CT soft tissue neck w contrast (70491) | $917.82 | $10,198 | 4.1× |
| CT soft tissue neck w/o contrast (70490) | $626.31 | $6,959 | 4.7× |
| CT thoracic spine w contrast (72129) | $703.08 | $7,812 | 3.1× |
| CT thoracic spine w/o contrast (72128) | $904.41 | $10,049 | 6.7× |
| CT thorax w/o contrast (71250) | $684.72 | $7,608 | 5.1× |
| CT upper ext wo (73200) | $292.23 | $3,247 | 2.2× |
| CT upper extremity with contrast (73201) | $270.81 | $3,009 | 0.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $937.89 | $10,421 | 4.2× |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$790.92–$950.85 | $8,788–$10,565 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$585.27–$1,009.80 | $6,503–$11,220 | varies |
| Dilation ureters/urethra rs&i (74485) | $260.64 | $2,896 | 0.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$90.90–$94.23 | $1,010–$1,047 | varies |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$588.51–$673.92 | $6,539–$7,488 | varies |
| Esophagram (74220) | $182.61 | $2,029 | 0.8× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$81.18–$105.66 | $902–$1,174 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $110.61 | $1,229 | 0.8× |
| Fluoroscopy up to 1 hr (76000) | $160.65 | $1,785 | 0.5× |
| Follow-Up Angiography (75898) | $163.80 | $1,820 | 0.0× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$105.66–$123.39 | $1,174–$1,371 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$121.05–$139.05 | $1,345–$1,545 | varies |
| Gastric emptying imaging study (78264) | $412.74 | $4,586 | 0.8× |
| Gated Heart Planar Single (78472) | $330.30 | $3,670 | 0.6× |
| Gated Heart, Multiple (78473) | $767.88 | $8,532 | 1.5× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$114.48–$123.75 | $1,272–$1,375 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $435.87 | $4,843 | 0.1× |
| Hepatobil Syst Image W/Drug (78227) | $347.67 | $3,863 | 0.5× |
| Hepatobiliary System Imaging (78226) | $276.39 | $3,071 | 0.5× |
| Ht Muscle Image Spect Sing (78451) | $516.15 | $5,735 | 0.3× |
| Hysterosalpingogram (74740) | $195.93 | $2,177 | 0.6× |
| Infant hip ultrasound, limited static exam (76886) | $115.02 | $1,278 | 1.0× |
| K Flow/Funct Image W/Drug (78708) | $380.88 | $4,232 | 0.5× |
| K Flow/Funct Image W/O Drug (78707) | $360 | $4,000 | 0.5× |
| Liver imaging static only (78201) | $522.09 | $5,801 | 0.7× |
| Lung Perf&Ventilat Diferentl (78598) | $313.74 | $3,486 | 0.4× |
| Lung perfusion differential (78597) | $210.60 | $2,340 | 0.4× |
| Lung Ventilat&Perfus Imaging (78582) | $252.90 | $2,810 | 0.4× |
| Lung Ventilation Imaging (78579) | $210.60 | $2,340 | 0.4× |
| Lymph System Imaging (78195) | $203.85 | $2,265 | 0.3× |
| Magnetic Image Jaw Joint (70336) | $466.29 | $5,181 | 1.5× |
| Meckels Divert Exam (78290) | $373.05 | $4,145 | 0.7× |
| MRA head w/o contrast (70544) | $619.56 | $6,884 | 2.0× |
| MRA neck w contrast (70548) | $1,240.47 | $13,783 | 2.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $573.30 | $6,370 | 1.3× |
| MRA neck w/o contrast (70547) | $915.75 | $10,175 | 3.0× |
| MRI abdomen w contrast (74182) | $667.08 | $7,412 | 1.5× |
| MRI abdomen w/o contrast (74181) | $845.46 | $9,394 | 2.8× |
| MRI any jt lower extrem w/contrast material (73722) | $815.49 | $9,061 | 0.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,053.27 | $11,703 | 2.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $752.49 | $8,361 | 0.7× |
| MRI cervical spine w contrast (72142) | $299.88 | $3,332 | 0.7× |
| MRI cervical spine w/o cont (72141) | $687.96 | $7,644 | 2.2× |
| MRI chest w/o contrast (71550) | $1,124.28 | $12,492 | 3.7× |
| MRI chest with contrast (71551) | $1,360.62 | $15,118 | 1.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $797.94 | $8,866 | 1.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $398.70 | $4,430 | 0.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $611.46 | $6,794 | 2.0× |
| MRI lumbar spine w contrast (72149) | $760.23 | $8,447 | 1.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $907.92 | $10,088 | 2.0× |
| MRI orbit face &/neck w/o contrast (70540) | $1,162.44 | $12,916 | 3.8× |
| MRI orbit face neck w contrast (70542) | $451.44 | $5,016 | 1.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $991.80 | $11,020 | 2.2× |
| MRI pelvis w contrast (72196) | $695.16 | $7,724 | 1.5× |
| MRI pelvis w/o & w contrast (72197) | $991.80 | $11,020 | 2.2× |
| MRI pelvis w/o contrast (72195) | $442.89 | $4,921 | 1.4× |
| MRI spectroscopy (76390) | $424.62 | $4,718 | 3.8× |
| MRI thoracic spine w/o contrast (72146) | $1,037.52 | $11,528 | 3.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $605.61 | $6,729 | 1.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $869.40 | $9,660 | 2.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $601.92 | $6,688 | 1.3× |
| MRI, abdomen, combo (74183) | $991.80 | $11,020 | 2.2× |
| MRI, dorsal spine combo (72157) | $1,170 | $13,000 | 2.6× |
| MRI, joint upper extrem (73221) | $573.30 | $6,370 | 1.9× |
| MRI, joint upper extrem combo (73223) | $1,010.61 | $11,229 | 2.3× |
| MRI, lumbar spine combo (72158) | $1,158.93 | $12,877 | 2.6× |
| Myelogram Lumbar (72265) | $236.79 | $2,631 | 0.2× |
| Myelography thoracic (72255) | $263.34 | $2,926 | 0.3× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $282.87 | $3,143 | 0.6× |
| Myocardial Spect Multiple Studies (78452) | $547.65 | $6,085 | 0.3× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$159.57–$160.20 | $1,773–$1,780 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $71.28 | $792 | 0.1× |
| Nm csf leak detection (78650) | $474.84 | $5,276 | 0.3× |
| Nonvascular Shunt X-Ray (75809) | $280.26 | $3,114 | 2.1× |
| Nuclear Rx Intra-Arterial (79445) | $210.60 | $2,340 | 0.7× |
| Nuclear Rx Oral Admin (79005) | $268.29 | $2,981 | 0.9× |
| Parathyroid Planar Imaging (78070) | $299.61 | $3,329 | 0.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $453.87 | $5,043 | 0.9× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$109.44–$130.50 | $1,216–$1,450 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $157.14 | $1,746 | 0.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$214.83–$228.78 | $2,387–$2,542 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$213.03–$355.77 | $2,367–$3,953 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$148.23–$168.39 | $1,647–$1,871 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$111.69–$119.88 | $1,241–$1,332 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$148.05–$168.03 | $1,645–$1,867 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$233.10–$236.52 | $2,590–$2,628 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$105.03–$111.69 | $1,167–$1,241 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$147.33–$160.56 | $1,637–$1,784 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$147.33–$166.59 | $1,637–$1,851 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $48.42 | $538 | 0.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$154.80–$157.41 | $1,720–$1,749 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$173.97–$176.13 | $1,933–$1,957 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$164.97–$177.84 | $1,833–$1,976 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$121.86–$153.72 | $1,354–$1,708 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$113.22–$132.21 | $1,258–$1,469 | varies |
| Radex Sternum Minimum 2 Views (71120) | $57.06 | $634 | 0.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$211.95–$236.52 | $2,355–$2,628 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$96.57–$103.77 | $1,073–$1,153 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $87.39 | $971 | 0.6× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$146.25–$149.67 | $1,625–$1,663 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$198.09–$236.52 | $2,201–$2,628 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $162.36 | $1,804 | 1.2× |
| Radiologic exam colon double contrast study (74280) | $318.24 | $3,536 | 1.4× |
| Radiologic exam colon single contrast study (74270) | $279.45 | $3,105 | 1.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $144.27 | $1,603 | 0.6× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$164.97–$177.84 | $1,833–$1,976 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $175.50 | $1,950 | 1.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $173.79 | $1,931 | 0.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $297.72 | $3,308 | 1.3× |
| Radiologic examination femur 1 view (73551) | $105.03 | $1,167 | 0.9× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$125.01–$138.33 | $1,389–$1,537 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$145.17–$152.19 | $1,613–$1,691 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$109.80–$124.92 | $1,220–$1,388 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$146.52–$148.05 | $1,628–$1,645 | varies |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $188.64 | $2,096 | 0.4× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$203.04–$236.97 | $2,256–$2,633 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $205.20 | $2,280 | 0.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $135.54 | $1,506 | 0.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $238.05 | $2,645 | 0.3× |
| Scapula (73010) range across 2 matching MRF lines |
$146.97–$163.53 | $1,633–$1,817 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$116.01–$133.20 | $1,289–$1,480 | varies |
| Shoulder Arthrography (73040) | $281.25 | $3,125 | 0.6× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$137.43–$160.83 | $1,527–$1,787 | varies |
| Sternoclavicular joints (71130) | $82.98 | $922 | 0.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $287.19 | $3,191 | 1.3× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$138.24–$144 | $1,536–$1,600 | varies |
| Thoracic spine 3 views (72072) | $201.69 | $2,241 | 1.5× |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$130.23–$152.10 | $1,447–$1,690 | varies |
| Thyroid Met Imaging Body (78018) | $216.18 | $2,402 | 0.3× |
| Thyroid Uptake Measurement (78012) | $273.15 | $3,035 | 0.5× |
| Ultrasound Exam Aaa Screen (76706) | $157.41 | $1,749 | 1.2× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$307.89–$327.60 | $3,421–$3,640 | varies |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$79.38–$80.19 | $882–$891 | varies |
| Upper gi w/o kub (74240) | $196.02 | $2,178 | 0.9× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $74.61 | $829 | 6.7× |
| Ureteral Reflux Study (78740) | $390.42 | $4,338 | 0.8× |
| Urethrocystogram voiding (74455) | $217.17 | $2,413 | 0.7× |
| Urethrocystography retrograde (74450) | $192.87 | $2,143 | 0.6× |
| Us breast unilateral complete (76641) | $140.58 | $1,562 | 1.0× |
| Us chest (76604) | $95.49 | $1,061 | 0.7× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$93.60–$100.17 | $1,040–$1,113 | varies |
| Us head (76506) | $141.48 | $1,572 | 1.1× |
| Us kidney transplant (76776) | $239.22 | $2,658 | 1.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $136.26 | $1,514 | 1.0× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$214.29–$247.41 | $2,381–$2,749 | varies |
| Us ob transvaginal (76817) | $117.45 | $1,305 | 0.9× |
| Us pelvic non ob complete (76856) | $340.56 | $3,784 | 2.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $281.52 | $3,128 | 2.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $218.88 | $2,432 | 1.6× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$179.73–$199.08 | $1,997–$2,212 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$146.79–$171.54 | $1,631–$1,906 | varies |
| Us scrotum and contents (76870) | $314.19 | $3,491 | 2.3× |
| Us spinal canal and contents (76800) | $100.71 | $1,119 | 0.7× |
| Us thyroid (76536) range across 2 matching MRF lines |
$171.27–$199.80 | $1,903–$2,220 | varies |
| Vein X-Ray Chest (75827) | $1,003.59 | $11,151 | 0.5× |
| Venography caval inferior serialography rs&i (75825) | $876.78 | $9,742 | 0.2× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$869.67–$908.82 | $9,663–$10,098 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$607.41–$746.19 | $6,749–$8,291 | varies |
| Venography Renal Bilateral (75833) | $1,038.24 | $11,536 | 0.3× |
| Venography Renal Unilateral (75831) | $809.19 | $8,991 | 0.2× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$119.61–$122.40 | $1,329–$1,360 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$84.15–$92.52 | $935–$1,028 | varies |
| X-ray antegrade pyelogram tube (74425) | $111.69 | $1,241 | 0.2× |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$1,319.04–$1,495.80 | $14,656–$16,620 | varies |
| X-Ray Bend Only L-S Spine (72120) | $45.90 | $510 | 0.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$121.86–$122.31 | $1,354–$1,359 | varies |
| X-Ray Exam Hip Uni 1 View (73501) | $112.59 | $1,251 | 1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$140.13–$142.20 | $1,557–$1,580 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$205.29–$239.67 | $2,281–$2,663 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $199.08 | $2,212 | 1.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $216.27 | $2,403 | 1.6× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$203.94–$245.79 | $2,266–$2,731 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$142.92–$174.69 | $1,588–$1,941 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $134.01 | $1,489 | 1.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $195.39 | $2,171 | 1.5× |
| X-ray eye for foreign body (70030) | $60.30 | $670 | 0.5× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$121.14–$137.43 | $1,346–$1,527 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $145.62 | $1,618 | 1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$133.65–$154.62 | $1,485–$1,718 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $188.82 | $2,098 | 1.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$102.78–$122.40 | $1,142–$1,360 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$134.91–$149.40 | $1,499–$1,660 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$178.02–$225.09 | $1,978–$2,501 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $227.88 | $2,532 | 1.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $317.88 | $3,532 | 0.7× |
| X-Rays Bone Length Studies (77073) | $55.71 | $619 | 0.4× |
| X-Rays Bone Survey Complete (77075) | $190.71 | $2,119 | 1.4× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$184.41–$233.19 | $2,049–$2,591 | varies |
| Xr facial bones less than 3 views (70140) | $136.35 | $1,515 | 1.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $117.99 | $1,311 | 0.9× |
| Xr orbits complete 4 views (70200) | $161.10 | $1,790 | 1.2× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.