Imaging prices at Adventist Health Twin Cities
Templeton, CA · every code in this section with a posted price and a Medicare benchmark.
261 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $354.97 | $5,071 | 0.2× |
| Abdomen 1 View (74018) | $87.36 | $1,248 | 0.8× |
| Abdomen 2 views (74019) | $133.98 | $1,914 | 1.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $328.09 | $4,687 | 0.6× |
| Angiography extremity unilateral rs&i (75710) | $742.42 | $10,606 | 0.2× |
| Ankle 2 views (73600) | $79.17 | $1,131 | 0.7× |
| Arthrogram ankle (73615) | $85.33 | $1,219 | 0.2× |
| Arthrogram Wrist (73115) | $321.72 | $4,596 | 0.7× |
| Basic radiation dosimetry calculation (77300) | $62.79 | $897 | 0.4× |
| Bone age studies (77072) | $68.53 | $979 | 0.5× |
| Bone Imaging 3 Phase (78315) | $586.74 | $8,382 | 1.1× |
| Bone Imaging Limited Area (78300) | $329 | $4,700 | 0.6× |
| Bone Imaging Multiple Areas (78305) | $466.55 | $6,665 | 0.9× |
| Bone Imaging Whole Body (78306) | $470.33 | $6,719 | 0.9× |
| Bone marrow imaging limited area (78102) | $501.13 | $7,159 | 1.0× |
| Bone marrow imaging; whole body (78104) | $665.77 | $9,511 | 1.3× |
| Bone survey infant (77076) | $112.07 | $1,601 | 0.8× |
| Brain Flow Imaging Only (78610) | $199.43 | $2,849 | 0.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $360.01 | $5,143 | 0.5× |
| Cardiac Shunt Detection (78428) | $176.89 | $2,527 | 0.3× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$405.51–$425.81 | $5,793–$6,083 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $144.62 | $2,066 | 0.2× |
| Cerebrospinal Fluid Scan (78630) | $317.66 | $4,538 | 0.5× |
| Chest 1 view (71045) | $82.32 | $1,176 | 0.7× |
| Chest 2 views (71046) | $114.10 | $1,630 | 1.0× |
| Chest 3 views (71047) | $134.89 | $1,927 | 1.2× |
| Chest 4 or more views (71048) | $161.70 | $2,310 | 1.2× |
| Clavicle complete (73000) | $105.98 | $1,514 | 0.9× |
| Continuing medical physics consltj pr wk (77336) | $83.37 | $1,191 | 0.5× |
| Contrast X-Ray Bladder (74430) | $125.86 | $1,798 | 0.3× |
| Contrast X-Ray Of Knee Joint (73580) | $229.81 | $3,283 | 0.5× |
| CT abdomen and pelvis without and with contrast (74178) | $1,276.03 | $18,229 | 2.8× |
| CT abdomen and pelvis without contrast (74176) | $1,088.08 | $15,544 | 3.5× |
| CT abdomen w contrast (74160) | $654.92 | $9,356 | 2.9× |
| CT abdomen w wo contrast (74170) | $600.04 | $8,572 | 2.7× |
| CT abdomen w/o contrast (74150) | $441.98 | $6,314 | 3.3× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$392.42–$1,302.63 | $5,606–$18,609 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$719.46–$858.76 | $10,278–$12,268 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$494.62–$686 | $7,066–$9,800 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$403.34–$653.38 | $5,762–$9,334 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$485.03–$597.03 | $6,929–$8,529 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $848.05 | $12,115 | 3.8× |
| CT cervical spine w/ contrast (72126) | $645.89 | $9,227 | 1.4× |
| CT cervical spine w/o contrast (72125) | $729.47 | $10,421 | 5.4× |
| CT chest w contrast (71260) | $719.46 | $10,278 | 3.2× |
| CT chest w/wo contrast (71270) | $821.03 | $11,729 | 3.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $176.12 | $2,516 | 1.3× |
| CT head/brain with contrast (70460) | $596.96 | $8,528 | 2.6× |
| CT head/brain without and with contrast (70470) | $612.36 | $8,748 | 2.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $237.16 | $3,388 | 2.1× |
| CT iac w contrast (70481) | $567.98 | $8,114 | 2.5× |
| CT l-spine w&w/o contrast (72133) | $1,188.74 | $16,982 | 5.3× |
| CT lower ext w/o (73700) | $409.50 | $5,850 | 3.0× |
| CT lower extremity w/contrast material (73701) | $391.65 | $5,595 | 1.7× |
| CT lumbar spine w contrast (72132) | $695.24 | $9,932 | 1.5× |
| CT lumbar spine w/o contrast (72131) | $714.84 | $10,212 | 5.3× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$564.27–$592.41 | $8,061–$8,463 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$554.89–$584.08 | $7,927–$8,344 | varies |
| CT neck tissue combo (70492) | $745.85 | $10,655 | 3.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $804.79 | $11,497 | 3.6× |
| CT orbits w/o contrast (70480) | $554.89 | $7,927 | 4.1× |
| CT pelvis w&w/o contrast (72194) | $753.48 | $10,764 | 3.3× |
| CT pelvis w/o contrast (72192) | $577.78 | $8,254 | 4.3× |
| CT scan of leg combo (73702) | $524.86 | $7,498 | 2.3× |
| CT scans face/jaw combo (70488) | $675.15 | $9,645 | 3.0× |
| CT soft tissue neck w contrast (70491) | $757.33 | $10,819 | 3.4× |
| CT soft tissue neck w/o contrast (70490) | $494.20 | $7,060 | 3.7× |
| CT thoracic spine w contrast (72129) | $605.78 | $8,654 | 2.7× |
| CT thoracic spine w/o contrast (72128) | $703.43 | $10,049 | 5.2× |
| CT thorax w/o contrast (71250) | $609.84 | $8,712 | 4.5× |
| CT upper ext wo (73200) | $431.83 | $6,169 | 3.2× |
| CT upper extremity w/o & w/contrast material (73202) | $679.98 | $9,714 | 3.0× |
| CT upper extremity with contrast (73201) | $412.93 | $5,899 | 0.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $755.86 | $10,798 | 3.4× |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$654.92–$791.56 | $9,356–$11,308 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$778.12–$1,010.10 | $11,116–$14,430 | varies |
| Dilation ureters/urethra rs&i (74485) | $349.02 | $4,986 | 0.1× |
| Esophagram (74220) | $163.94 | $2,342 | 0.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $264.53 | $3,779 | 2.0× |
| Fluoroscopy up to 1 hr (76000) | $108.15 | $1,545 | 0.4× |
| Foot 2 views (73620) | $79.17 | $1,131 | 0.7× |
| Forearm 2 views (73090) | $104.86 | $1,498 | 0.9× |
| Gastric emptying imaging study (78264) | $420.91 | $6,013 | 0.8× |
| Gated Heart, Multiple (78473) | $580.86 | $8,298 | 1.1× |
| Hand 2 views (73120) | $79.17 | $1,131 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $499.59 | $7,137 | 0.7× |
| Hepatobiliary System Imaging (78226) | $208.32 | $2,976 | 0.4× |
| Ht Muscle Image Spect Sing (78451) | $535.01 | $7,643 | 0.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $74.55 | $1,065 | 0.7× |
| K Flow/Funct Image W/Drug (78708) | $376.74 | $5,382 | 0.5× |
| K Flow/Funct Image W/O Drug (78707) | $381.43 | $5,449 | 0.5× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $332.64 | $4,752 | 0.6× |
| Knee 3 Views (73562) | $122.22 | $1,746 | 1.1× |
| Liver & Spleen Imaging Static Only (78215) | $384.93 | $5,499 | 0.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $532.21 | $7,603 | 1.0× |
| Lung Perf&Ventilat Diferentl (78598) | $244.02 | $3,486 | 0.3× |
| Lung Ventilat&Perfus Imaging (78582) | $284.55 | $4,065 | 0.4× |
| Lung Ventilation Imaging (78579) | $242.55 | $3,465 | 0.5× |
| Lymph System Imaging (78195) | $284.55 | $4,065 | 0.4× |
| Magnetic Image Jaw Joint (70336) | $618.87 | $8,841 | 2.0× |
| Meckels Divert Exam (78290) | $58.52 | $836 | 0.1× |
| Mra Head W/O & W/Contrast Material (70546) | $785.54 | $11,222 | 1.8× |
| MRA head w/o contrast (70544) | $731.08 | $10,444 | 2.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $694.33 | $9,919 | 1.5× |
| MRA neck w/o contrast (70547) | $719.67 | $10,281 | 2.3× |
| MRI abdomen w/o contrast (74181) | $839.23 | $11,989 | 2.7× |
| MRI any jt lower extrem w/contrast material (73722) | $968.24 | $13,832 | 1.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $893.90 | $12,770 | 2.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $707.91 | $10,113 | 0.7× |
| MRI Breast W/O Contrast Bilateral (77047) | $593.67 | $8,481 | 1.9× |
| MRI cervical spine w/o cont (72141) | $741.72 | $10,596 | 2.4× |
| MRI chest w/o contrast (71550) | $740.60 | $10,580 | 2.4× |
| MRI chest wo w contrast (71552) | $814.66 | $11,638 | 1.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $512.89 | $7,327 | 1.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $451.64 | $6,452 | 1.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $741.72 | $10,596 | 1.7× |
| MRI orbit face &/neck w/o contrast (70540) | $986.58 | $14,094 | 3.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $977.27 | $13,961 | 2.2× |
| MRI pelvis w/o & w contrast (72197) | $999.95 | $14,285 | 2.2× |
| MRI pelvis w/o contrast (72195) | $811.58 | $11,594 | 2.6× |
| MRI thoracic spine w/o contrast (72146) | $775.11 | $11,073 | 2.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $641.90 | $9,170 | 2.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $641.90 | $9,170 | 1.4× |
| MRI, abdomen, combo (74183) | $922.95 | $13,185 | 2.1× |
| MRI, dorsal spine combo (72157) | $775.11 | $11,073 | 1.7× |
| MRI, joint upper extrem (73221) | $641.90 | $9,170 | 2.1× |
| MRI, joint upper extrem combo (73223) | $786.03 | $11,229 | 1.8× |
| MRI, lumbar spine combo (72158) | $863.31 | $12,333 | 1.9× |
| Myelogram cervical (72240) | $320.11 | $4,573 | 0.3× |
| Myelogram Lumbar (72265) | $294.77 | $4,211 | 0.3× |
| Myelography thoracic (72255) | $320.11 | $4,573 | 0.3× |
| Myelograpy 2/more regions rs&i (72270) | $404.81 | $5,783 | 0.4× |
| Myocardial Spect Multiple Studies (78452) | $647.57 | $9,251 | 0.4× |
| Neck soft tissue (70360) | $110.46 | $1,578 | 1.0× |
| Nm csf leak detection (78650) | $333.41 | $4,763 | 0.2× |
| Nm myocard infarct spect (78469) | $604.80 | $8,640 | 0.9× |
| Nuclear Rx Oral Admin (79005) | $407.89 | $5,827 | 1.4× |
| Parathyroid Planar Imaging (78070) | $413.49 | $5,907 | 0.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $353.01 | $5,043 | 0.7× |
| Pelvis 1 or 2 views (72170) | $84 | $1,200 | 0.6× |
| PET image w/CT, full body (78816) | $448.42 | $6,406 | 0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $242.55 | $3,465 | 0.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $134.89 | $1,927 | 1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) | $133.77 | $1,911 | 1.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $79.17 | $1,131 | 0.7× |
| Radex elbow complete minimum 3 views (73080) | $133.77 | $1,911 | 1.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $151.69 | $2,167 | 1.1× |
| Radex fingr minimum 2 views (73140) | $76.79 | $1,097 | 0.7× |
| Radex foot complete minimum 3 views (73630) | $124.88 | $1,784 | 1.1× |
| Radex Hand Minimum 3 Views (73130) | $129.64 | $1,852 | 1.2× |
| Radex lower extremity infant minimum 2 views (73592) | $84.07 | $1,201 | 0.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $110.46 | $1,578 | 1.0× |
| Radex Ribs Unilateral 2 Views (71100) | $117.53 | $1,679 | 1.1× |
| Radex shoulder complete minimum 2 views (73030) | $119.49 | $1,707 | 1.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $110.46 | $1,578 | 1.0× |
| Radex Spine 1 View Specify Level (72020) | $83.72 | $1,196 | 0.7× |
| Radex Sternum Minimum 2 Views (71120) | $90.02 | $1,286 | 0.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $87.22 | $1,246 | 0.8× |
| Radex Toe Minimum 2 Views (73660) | $75.11 | $1,073 | 0.7× |
| Radex upper extremity infant minimum 2 views (73092) | $79.17 | $1,131 | 0.6× |
| Radex Wrist Complete Minimum 3 Views (73110) | $116.41 | $1,663 | 1.0× |
| Radiation treatment delivery level 1 (77402) | $75.25 | $1,075 | 0.6× |
| Radiation treatment delivery level 2 (77407) | $82.74 | $1,182 | 0.2× |
| Radiation treatment delivery level 3 (77412) | $99.89 | $1,427 | 0.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $141.26 | $2,018 | 1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $92.75 | $1,325 | 0.7× |
| Radiologic exam colon double contrast study (74280) | $314.16 | $4,488 | 1.4× |
| Radiologic exam colon single contrast study (74270) | $276.92 | $3,956 | 1.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $163.94 | $2,342 | 0.7× |
| Radiologic exam knee complete 4/more views (73564) | $136.29 | $1,947 | 1.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $113.75 | $1,625 | 0.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $169.26 | $2,418 | 0.8× |
| Radiologic exam swallow function contrast study (74230) | $144.90 | $2,070 | 0.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $219.03 | $3,129 | 1.0× |
| Radiologic examination femur 1 view (73551) | $83.23 | $1,189 | 0.7× |
| Radiologic examination femur minimum 2 views (73552) | $120.54 | $1,722 | 1.1× |
| Radiologic examination knee 1/2 views (73560) | $94.15 | $1,345 | 0.8× |
| Radiologic Examination Osseous Survey Limited (77074) | $145.81 | $2,083 | 1.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $110.39 | $1,577 | 1.0× |
| Ribs bilateral 3 views (71110) | $124.46 | $1,778 | 0.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $337.05 | $4,815 | 0.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $265.72 | $3,796 | 0.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $471.66 | $6,738 | 0.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $235.69 | $3,367 | 0.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $734.79 | $10,497 | 0.4× |
| Scapula (73010) | $90.79 | $1,297 | 0.7× |
| Shoulder 1 view (73020) | $83.23 | $1,189 | 0.7× |
| Shoulder Arthrography (73040) | $183.40 | $2,620 | 0.4× |
| Skull less than 4 views (70250) | $132.65 | $1,895 | 1.0× |
| Sternoclavicular joints (71130) | $107.73 | $1,539 | 1.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $147.49 | $2,107 | 0.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $111.37 | $1,591 | 0.2× |
| Ther rad simulaj-aided field setting simple (77280) | $82.18 | $1,174 | 0.5× |
| Thoracic spine 2 views (72070) | $119.28 | $1,704 | 0.9× |
| Thoracic spine 3 views (72072) | $102.20 | $1,460 | 0.8× |
| Thoracolumbar 2 views (72080) | $101.15 | $1,445 | 0.9× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $337.68 | $4,824 | 0.7× |
| Thyroid Met Imaging Body (78018) | $342.93 | $4,899 | 0.5× |
| Thyroid Uptake Measurement (78012) | $167.93 | $2,399 | 0.3× |
| Tx Devices Design & Construction Complex (77334) | $86.45 | $1,235 | 0.2× |
| Tx devices design & construction simple (77332) | $86.31 | $1,233 | 0.5× |
| Ultrasound Breast Limited (76642) | $57.68 | $824 | 0.5× |
| Ultrasound Exam Aaa Screen (76706) | $70.07 | $1,001 | 0.5× |
| Ultrasound, abdomen limited (76705) | $231.35 | $3,305 | 1.7× |
| Upper gi w/o kub (74240) | $201.67 | $2,881 | 0.9× |
| Ureteral Reflux Study (78740) | $157.85 | $2,255 | 0.3× |
| Urethrocystogram voiding (74455) | $299.53 | $4,279 | 1.0× |
| Urethrocystography retrograde (74450) | $249.06 | $3,558 | 0.8× |
| Us breast unilateral complete (76641) | $70.91 | $1,013 | 0.5× |
| Us chest (76604) | $107.73 | $1,539 | 0.8× |
| Us complete joint (76881) | $180.74 | $2,582 | 1.3× |
| Us exam, pelvic, limited (76857) | $155.89 | $2,227 | 1.2× |
| Us head (76506) | $109.97 | $1,571 | 0.8× |
| Us kidney transplant (76776) | $112.49 | $1,607 | 0.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $147.56 | $2,108 | 1.1× |
| Us ob detailed single fetus (76811) | $319.48 | $4,564 | 1.0× |
| Us ob transvaginal (76817) | $165.69 | $2,367 | 1.2× |
| Us pelvic non ob complete (76856) | $266 | $3,800 | 2.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $290.78 | $4,154 | 2.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $134.61 | $1,923 | 1.0× |
| Us retroperitoneal complete (76770) | $191.24 | $2,732 | 1.4× |
| Us retroperitoneal limited (76775) | $182.49 | $2,607 | 1.4× |
| Us scrotum and contents (76870) | $231.98 | $3,314 | 1.7× |
| Us spinal canal and contents (76800) | $126.21 | $1,803 | 0.9× |
| Us thyroid (76536) | $149.87 | $2,141 | 1.1× |
| Us transrectal (76872) | $168.63 | $2,409 | 1.3× |
| Vascular Flow Imaging (78445) | $257.11 | $3,673 | 0.5× |
| Vein X-Ray Chest (75827) | $743.47 | $10,621 | 0.4× |
| Wrist 2 views (73100) | $87.29 | $1,247 | 0.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $99.26 | $1,418 | 0.9× |
| X-ray antegrade pyelogram tube (74425) | $86.87 | $1,241 | 0.2× |
| X-Ray Bend Only L-S Spine (72120) | $35.70 | $510 | 0.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $79.17 | $1,131 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $100.24 | $1,432 | 0.9× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$83.23–$105.21 | $1,189–$1,503 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$103.95–$107.73 | $1,485–$1,539 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $114.94 | $1,642 | 0.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $145.53 | $2,079 | 1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $165.90 | $2,370 | 1.2× |
| X-Ray Exam L-S Spine Bending (72114) | $219.59 | $3,137 | 1.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$111.02–$145.95 | $1,586–$2,085 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $165.06 | $2,358 | 1.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $137.55 | $1,965 | 1.0× |
| X-ray eye for foreign body (70030) | $147.63 | $2,109 | 1.3× |
| X-ray humerus (73060) | $79.17 | $1,131 | 0.7× |
| X-ray IV pyelogram (ivp) (74400) | $248.85 | $3,555 | 1.1× |
| X-ray IV pyelogram+tomography (74415) | $299.18 | $4,274 | 1.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $90.02 | $1,286 | 0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $137.34 | $1,962 | 1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $140.42 | $2,006 | 1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $111.30 | $1,590 | 0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $105.14 | $1,502 | 0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $153.37 | $2,191 | 1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $159.46 | $2,278 | 1.2× |
| X-ray thoracic spine 4 vw (72074) | $139.37 | $1,991 | 1.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $170.73 | $2,439 | 0.4× |
| X-Rays Bone Length Studies (77073) | $144.27 | $2,061 | 1.1× |
| X-Rays Bone Survey Complete (77075) | $189.63 | $2,709 | 1.4× |
| Xr c-spine 4 or 5 views (72050) | $153.44 | $2,192 | 1.1× |
| Xr facial bones less than 3 views (70140) | $101.43 | $1,449 | 0.9× |
| Xr orbits complete 4 views (70200) | $77.07 | $1,101 | 0.6× |
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.