Imaging prices at Ahmc Seton Medical Center
Daly City, CA · every code in this section with a posted price and a Medicare benchmark.
272 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) | $10,874 | $10,874 | 5.4× |
| Abdomen 1 View (74018) | $603 | $603 | 4.8× |
| Abdomen 2 views (74019) | $692.50 | $692.50 | 4.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $4,753 | $4,753 | 8.2× |
| Adrenal Cortex & Medulla Img (78075) | $11,080.80 | $11,080.80 | 5.9× |
| Angio pulmonary bilat (75743) | $5,436 | $5,436 | 1.2× |
| Angiography extremity bilateral rs&i (75716) | $10,019 | $10,019 | 2.2× |
| Angiography extremity unilateral rs&i (75710) | $7,585 | $7,585 | 1.7× |
| Artery X-Rays Abdomen (75726) | $8,683 | $8,683 | 1.1× |
| Artery X-Rays Pelvis (75736) | $16,696 | $16,696 | 2.1× |
| Basic radiation dosimetry calculation (77300) | $1,409 | $1,409 | 7.2× |
| Bone age studies (77072) range across 2 matching MRF lines |
$350–$671 | $350–$671 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$2,527–$5,004 | $2,527–$5,004 | varies |
| Bone Imaging Limited Area (78300) | $2,539 | $2,539 | 4.4× |
| Bone Imaging Whole Body (78306) | $4,562 | $4,562 | 7.9× |
| Bone marrow imaging limited area (78102) | $2,070 | $2,070 | 3.6× |
| Brain Imaging Minimum 4 Static Views (78605) | $3,318.16 | $3,318.16 | 4.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $6,900.01 | $6,900.01 | 3.3× |
| Cardiac Shunt Detection (78428) | $1,401 | $1,401 | 2.4× |
| Cardiovasc nucl exam unlisted (78499) | $1,894 | $1,894 | 3.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,378 | $1,378 | 1.7× |
| Cerebrospinal Fluid Scan (78630) range across 3 matching MRF lines |
$2,812–$3,017 | $2,812–$3,017 | varies |
| Chest 1 view (71045) | $698 | $698 | 5.5× |
| Chest 2 views (71046) | $797 | $797 | 6.3× |
| Chest 3 views (71047) | $700 | $700 | 5.5× |
| Chest 4 or more views (71048) | $901 | $901 | 5.9× |
| Clavicle complete (73000) | $745 | $745 | 5.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $5,028 | $5,028 | 33.1× |
| Continuing medical physics consltj pr wk (77336) | $2,025 | $2,025 | 10.4× |
| Contrast Exam Abdominl Aorta (75625) | $7,812 | $7,812 | 1.7× |
| Contrast X-Ray Bladder (74430) | $1,412 | $1,412 | 2.8× |
| CT abdomen and pelvis without and with contrast (74178) | $10,797 | $10,797 | 21.3× |
| CT abdomen and pelvis without contrast (74176) | $8,936 | $8,936 | 25.8× |
| CT abdomen w contrast (74160) | $5,283 | $5,283 | 20.7× |
| CT abdomen w wo contrast (74170) | $6,544 | $6,544 | 25.7× |
| CT abdomen w/o contrast (74150) | $5,189 | $5,189 | 34.2× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$6,890–$12,025 | $6,890–$12,025 | varies |
| CT Angio Chest (71275) | $6,845 | $6,845 | 26.9× |
| CT Angio Head (70496) | $7,052 | $7,052 | 27.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $8,736 | $8,736 | 34.3× |
| CT Angio Neck (70498) | $8,556 | $8,556 | 33.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $7,855 | $7,855 | 30.8× |
| CT cervical spine w/ contrast (72126) | $8,558 | $8,558 | 16.9× |
| CT cervical spine w/o contrast (72125) | $4,851 | $4,851 | 32.0× |
| CT cervical spine w/wo cont (72127) | $4,700 | $4,700 | 18.5× |
| CT chest w contrast (71260) | $5,568 | $5,568 | 21.9× |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$4,850–$5,846 | $4,850–$5,846 | varies |
| CT colonography screening (74263) | $1,779 | $1,779 | 5.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $2,558 | $2,558 | 16.9× |
| CT head/brain with contrast (70460) | $5,072 | $5,072 | 19.9× |
| CT head/brain without and with contrast (70470) | $5,357 | $5,357 | 21.0× |
| CT iac w contrast (70481) | $5,351 | $5,351 | 21.0× |
| CT l-spine w&w/o contrast (72133) | $5,550 | $5,550 | 21.8× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$3,614–$5,028 | $3,614–$5,028 | varies |
| CT lower extremity w/contrast material (73701) | $5,834 | $5,834 | 22.9× |
| CT lumbar spine w contrast (72132) | $6,130 | $6,130 | 12.1× |
| CT lumbar spine w/o contrast (72131) | $5,644 | $5,644 | 37.2× |
| CT maxillofacial w contrast (70487) | $4,552 | $4,552 | 17.9× |
| CT maxillofacial wo contrast (70486) | $4,131 | $4,131 | 27.2× |
| CT neck tissue combo (70492) | $5,577 | $5,577 | 21.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $5,500 | $5,500 | 21.6× |
| CT orbits w/o contrast (70480) | $4,797 | $4,797 | 31.6× |
| CT pelvis w&w/o contrast (72194) | $5,925 | $5,925 | 23.3× |
| CT pelvis w/o contrast (72192) | $5,082 | $5,082 | 33.5× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$4,700–$6,126 | $4,700–$6,126 | varies |
| CT scans face/jaw combo (70488) | $5,000 | $5,000 | 19.6× |
| CT soft tissue neck w contrast (70491) | $5,383 | $5,383 | 21.1× |
| CT soft tissue neck w/o contrast (70490) | $4,214 | $4,214 | 27.8× |
| CT thoracic spine w contrast (72129) | $9,476 | $9,476 | 37.2× |
| CT thoracic spine w/o contrast (72128) | $4,349 | $4,349 | 28.6× |
| CT thoracic spine w/wo cont (72130) | $8,540 | $8,540 | 33.5× |
| CT thorax w/o contrast (71250) | $5,028 | $5,028 | 33.1× |
| CT upper ext wo (73200) | $3,760 | $3,760 | 24.8× |
| CT upper extremity with contrast (73201) | $6,261 | $6,261 | 12.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $7,750 | $7,750 | 30.4× |
| Cta Abdomen (74175) | $6,845 | $6,845 | 26.9× |
| CTA pelvis (72191) | $6,845 | $6,845 | 26.9× |
| Dxa Bone Density Axial (77080) | $1,060 | $1,060 | 7.0× |
| Echo Guide For Artery Repair (76936) range across 4 matching MRF lines |
$893–$937 | $893–$937 | varies |
| Esophagram (74220) | $1,538 | $1,538 | 6.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,094 | $1,094 | 7.2× |
| Fluoroscopy up to 1 hr (76000) | $1,951 | $1,951 | 5.6× |
| Follow-Up Angiography (75898) | $8,585 | $8,585 | 1.9× |
| Forearm 2 views (73090) | $766 | $766 | 6.1× |
| Gastric emptying imaging study (78264) | $4,308 | $4,308 | 7.4× |
| Gastroesophageal Reflux Exam (78262) | $3,276 | $3,276 | 5.6× |
| Gated Heart Planar Single (78472) | $3,875 | $3,875 | 6.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $7,138 | $7,138 | 1.6× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,715–$3,952 | $1,715–$3,952 | varies |
| Hepatobiliary System Imaging (78226) | $3,952 | $3,952 | 6.8× |
| Ht Muscle Image Spect Sing (78451) range across 4 matching MRF lines |
$680–$5,584 | $680–$5,584 | varies |
| Hysterosalpingogram (74740) | $909 | $909 | 2.6× |
| Interstitial radiation source applic complex (77778) | $5,130 | $5,130 | 5.1× |
| K Flow/Funct Image W/Drug (78708) | $3,668.25 | $3,668.25 | 4.7× |
| K Flow/Funct Image W/O Drug (78707) | $3,375 | $3,375 | 4.3× |
| Knee 3 Views (73562) | $984 | $984 | 7.8× |
| Liver & Spleen Imaging Static Only (78215) | $3,350 | $3,350 | 5.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $7,114 | $7,114 | 12.3× |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$3,500–$7,101 | $3,500–$7,101 | varies |
| Lung Ventilat&Perfus Imaging (78582) | $1,841 | $1,841 | 2.3× |
| Lymph System Imaging (78195) | $4,952 | $4,952 | 6.3× |
| Magnetic Image Jaw Joint (70336) | $7,790 | $7,790 | 22.5× |
| Meckels Divert Exam (78290) | $3,819 | $3,819 | 6.6× |
| Mlc imrt design & construction per imrt plan (77338) | $3,897 | $3,897 | 7.2× |
| Mra Head W/O & W/Contrast Material (70546) | $6,968 | $6,968 | 13.8× |
| MRA head w/o contrast (70544) | $5,652 | $5,652 | 16.3× |
| MRA head with contrast (70545) | $5,935 | $5,935 | 11.7× |
| MRA neck w contrast (70548) | $7,766 | $7,766 | 15.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $8,684 | $8,684 | 17.1× |
| MRA neck w/o contrast (70547) | $4,656 | $4,656 | 13.4× |
| MRI abdomen w contrast (74182) | $6,130 | $6,130 | 12.1× |
| MRI abdomen w/o contrast (74181) | $5,838 | $5,838 | 16.9× |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$4,825–$4,875 | $4,825–$4,875 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $8,073 | $8,073 | 15.9× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 6 matching MRF lines |
$5,768–$6,860 | $5,768–$6,860 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $2,739 | $2,739 | 7.9× |
| MRI cervical spine w contrast (72142) | $7,244 | $7,244 | 14.3× |
| MRI cervical spine w/o cont (72141) | $6,115 | $6,115 | 17.7× |
| MRI chest w/o contrast (71550) | $6,882 | $6,882 | 19.9× |
| MRI chest with contrast (71551) | $4,684 | $4,684 | 4.1× |
| MRI chest wo w contrast (71552) | $8,647 | $8,647 | 17.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $6,250 | $6,250 | 12.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $7,204 | $7,204 | 14.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $5,743 | $5,743 | 16.6× |
| MRI lumbar spine w contrast (72149) | $7,023 | $7,023 | 13.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $8,920 | $8,920 | 17.6× |
| MRI orbit face &/neck w/o contrast (70540) | $6,033 | $6,033 | 17.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $8,045 | $8,045 | 15.9× |
| MRI pelvis w contrast (72196) | $5,600 | $5,600 | 11.1× |
| MRI pelvis w/o & w contrast (72197) | $8,013 | $8,013 | 15.8× |
| MRI pelvis w/o contrast (72195) | $5,290 | $5,290 | 15.3× |
| MRI thoracic spine w/o contrast (72146) | $6,021 | $6,021 | 17.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $6,019 | $6,019 | 11.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $6,413 | $6,413 | 18.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $6,908 | $6,908 | 13.6× |
| MRI, abdomen, combo (74183) | $8,579 | $8,579 | 16.9× |
| MRI, dorsal spine combo (72157) | $9,145 | $9,145 | 18.1× |
| MRI, dorsal spine contrast (72147) | $6,322 | $6,322 | 12.5× |
| MRI, joint upper extrem (73221) range across 10 matching MRF lines |
$5,494–$5,768.70 | $5,494–$5,768.70 | varies |
| MRI, joint upper extrem combo (73223) range across 7 matching MRF lines |
$4,171–$7,733 | $4,171–$7,733 | varies |
| MRI, lumbar spine combo (72158) | $9,133 | $9,133 | 18.0× |
| Myelogram Lumbar (72265) | $2,417 | $2,417 | 2.1× |
| Myelography thoracic (72255) | $1,507 | $1,507 | 1.3× |
| Myelograpy 2/more regions rs&i (72270) | $2,097.10 | $2,097.10 | 1.8× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $11,155 | $11,155 | 5.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,175 | $1,175 | 0.6× |
| Myocardial Spect Multiple Studies (78452) range across 7 matching MRF lines |
$1,032–$7,641 | $1,032–$7,641 | varies |
| Neck soft tissue (70360) | $713 | $713 | 5.6× |
| Ntsty modul radthx pln dose-vol histos (77301) | $15,696 | $15,696 | 7.8× |
| Nuclear Rx Intra-Arterial (79445) | $1,585 | $1,585 | 4.7× |
| Nuclear Rx Oral Admin (79005) | $2,058 | $2,058 | 6.1× |
| Ob us nuchal meas 1 gest (76813) | $554 | $554 | 3.6× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $323.60 | $323.60 | 2.6× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $762.79 | $762.79 | 5.0× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,761 | $1,761 | 3.0× |
| Pelvis 1 or 2 views (72170) | $715 | $715 | 4.7× |
| Pet Image W/Ct Lmtd (78814) | $6,329.33 | $6,329.33 | 3.0× |
| PET image w/CT, full body (78816) | $9,108 | $9,108 | 4.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,943 | $8,943 | 4.3× |
| PET whole body (78813) range across 2 matching MRF lines |
$6,900.01–$8,211.48 | $6,900.01–$8,211.48 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $3,618 | $3,618 | 6.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,405 | $1,405 | 1.8× |
| Radex Ankle Complete Minimum 3 Views (73610) | $833 | $833 | 6.6× |
| Radex Calcaneus Minimum 2 Views (73650) | $609 | $609 | 4.8× |
| Radex elbow complete minimum 3 views (73080) | $784 | $784 | 6.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,316 | $1,316 | 8.7× |
| Radex fingr minimum 2 views (73140) | $538 | $538 | 4.3× |
| Radex foot complete minimum 3 views (73630) | $870 | $870 | 6.9× |
| Radex Hand Minimum 3 Views (73130) | $824 | $824 | 6.5× |
| Radex lower extremity infant minimum 2 views (73592) | $611 | $611 | 4.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $957 | $957 | 7.6× |
| Radex Ribs Unilateral 2 Views (71100) range across 5 matching MRF lines |
$925–$1,085 | $925–$1,085 | varies |
| Radex shoulder complete minimum 2 views (73030) | $853 | $853 | 6.8× |
| Radex Sinuses Paransl < 3 Views (70210) | $611 | $611 | 4.8× |
| Radex Spine 1 View Specify Level (72020) | $677 | $677 | 5.4× |
| Radex Sternum Minimum 2 Views (71120) | $756 | $756 | 6.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $825 | $825 | 6.5× |
| Radex Toe Minimum 2 Views (73660) | $509 | $509 | 4.0× |
| Radex upper extremity infant minimum 2 views (73092) | $564 | $564 | 3.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $801 | $801 | 6.3× |
| Radiation treatment delivery level 3 (77412) | $2,980 | $2,980 | 3.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $971 | $971 | 6.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$782–$1,062 | $782–$1,062 | varies |
| Radiologic exam colon single contrast study (74270) | $2,160 | $2,160 | 8.5× |
| Radiologic exam knee complete 4/more views (73564) | $969 | $969 | 6.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $844 | $844 | 5.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $2,089 | $2,089 | 8.2× |
| Radiologic exam swallow function contrast study (74230) | $1,688 | $1,688 | 6.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,991 | $1,991 | 7.8× |
| Radiologic examination femur minimum 2 views (73552) | $745 | $745 | 5.9× |
| Radiologic examination knee 1/2 views (73560) | $765 | $765 | 6.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$611–$761 | $611–$761 | varies |
| Ribs bilateral 3 views (71110) | $942 | $942 | 6.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 4 matching MRF lines |
$1,412–$5,217 | $1,412–$5,217 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 3 matching MRF lines |
$5,576.69–$7,488 | $5,576.69–$7,488 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$3,921.84–$5,161 | $3,921.84–$5,161 | varies |
| Rp Therapy Intravenous Administration (79101) | $1,498 | $1,498 | 4.4× |
| Scapula (73010) | $702 | $702 | 4.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $165 | $165 | 7.1× |
| Skull less than 4 views (70250) | $642 | $642 | 4.2× |
| Special dosimetry (77331) | $749 | $749 | 3.8× |
| Special Physics Consult (77370) | $1,700 | $1,700 | 8.7× |
| Stereotactic Body Radiation Delivery (77373) | $26,975 | $26,975 | 10.4× |
| Sternoclavicular joints (71130) range across 5 matching MRF lines |
$780–$1,108 | $780–$1,108 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $4,732 | $4,732 | 8.7× |
| Testicular Imaging W/Flow (78761) | $1,600 | $1,600 | 2.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $4,848 | $4,848 | 8.9× |
| Ther rad simulaj-aided field setting simple (77280) | $2,313 | $2,313 | 11.9× |
| Thoracic spine 2 views (72070) | $1,126 | $1,126 | 7.4× |
| Thoracic spine 3 views (72072) | $545 | $545 | 3.6× |
| Thoracolumbar 2 views (72080) | $988 | $988 | 7.8× |
| Thyroid Imaging With Vascular Flow (78013) | $1,464 | $1,464 | 2.5× |
| Thyroid Met Imaging Body (78018) range across 3 matching MRF lines |
$3,972–$4,915 | $3,972–$4,915 | varies |
| Thyroid Uptake Measurement (78012) | $1,138.02 | $1,138.02 | 2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,248 | $2,248 | 3.9× |
| Tx Devices Design & Construction Complex (77334) | $2,399 | $2,399 | 4.4× |
| Tx devices design & construction simple (77332) | $1,082 | $1,082 | 5.5× |
| Ultrasound Breast Limited (76642) range across 7 matching MRF lines |
$1,100–$1,650 | $1,100–$1,650 | varies |
| Ultrasound Exam Aaa Screen (76706) | $573 | $573 | 3.8× |
| Ultrasound, abdomen limited (76705) range across 14 matching MRF lines |
$1,234–$2,103.14 | $1,234–$2,103.14 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $1,894 | $1,894 | 3.3× |
| Upper gi w/o kub (74240) | $1,744 | $1,744 | 6.8× |
| Urethrocystography retrograde (74450) | $1,639 | $1,639 | 4.7× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$809–$1,522.26 | $809–$1,522.26 | varies |
| Us chest (76604) | $1,202 | $1,202 | 7.9× |
| Us complete joint (76881) | $1,196 | $1,196 | 7.9× |
| Us exam, pelvic, limited (76857) | $975 | $975 | 6.4× |
| Us kidney transplant (76776) | $1,745 | $1,745 | 11.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 9 matching MRF lines |
$238.86–$573 | $238.86–$573 | varies |
| Us ob limited 1 or more fetuses (76815) | $751 | $751 | 4.9× |
| Us ob transvaginal (76817) | $1,054 | $1,054 | 6.9× |
| Us pelvic non ob complete (76856) | $1,991 | $1,991 | 13.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,392 | $1,392 | 9.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,094 | $1,094 | 7.2× |
| Us retroperitoneal complete (76770) | $1,857 | $1,857 | 12.2× |
| Us retroperitoneal limited (76775) range across 5 matching MRF lines |
$1,024–$1,745 | $1,024–$1,745 | varies |
| Us scrotum and contents (76870) | $1,600 | $1,600 | 10.5× |
| Us thyroid (76536) | $1,529 | $1,529 | 10.1× |
| Vein X-Ray Chest (75827) | $4,576 | $4,576 | 2.0× |
| Venogram Sinus/Jugular (75860) | $5,296 | $5,296 | 1.2× |
| Venography caval inferior serialography rs&i (75825) | $7,571 | $7,571 | 1.7× |
| Venography extremity bilateral rs&i (75822) | $3,966 | $3,966 | 1.7× |
| Venography extremity unilateral rs&i (75820) | $2,551 | $2,551 | 1.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $660 | $660 | 5.2× |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$6,416–$6,736 | $6,416–$6,736 | varies |
| X-Ray Bend Only L-S Spine (72120) | $749 | $749 | 4.9× |
| X-Ray Exam Breast Specimen (76098) | $943 | $943 | 1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $346 | $346 | 2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $1,089 | $1,089 | 7.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $346 | $346 | 2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 9 matching MRF lines |
$665–$924 | $665–$924 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,130 | $1,130 | 7.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,243 | $1,243 | 8.2× |
| X-Ray Exam L-S Spine Bending (72114) | $1,514 | $1,514 | 10.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $787 | $787 | 6.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,430 | $1,430 | 9.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $925 | $925 | 6.1× |
| X-ray eye for foreign body (70030) | $640 | $640 | 5.1× |
| X-ray humerus (73060) | $740 | $740 | 5.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $618 | $618 | 4.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $944 | $944 | 6.2× |
| X-ray nose-rectum child f.b. (76010) | $516 | $516 | 4.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,180 | $1,180 | 7.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,298 | $1,298 | 8.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,075 | $1,075 | 8.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $955 | $955 | 7.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,093 | $1,093 | 7.2× |
| X-ray thoracic spine 4 vw (72074) | $599 | $599 | 3.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,394 | $2,394 | 4.7× |
| X-Rays Bone Length Studies (77073) | $350 | $350 | 2.3× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$1,891–$2,577 | $1,891–$2,577 | varies |
| Xr c-spine 4 or 5 views (72050) | $1,272 | $1,272 | 8.4× |
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.