Imaging prices at Amery Hospital & Clinic
Amery, WI · every code in this section with a posted price and a Medicare benchmark.
251 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) | $116.79 | $224 | 1.4× |
| Abdomen 2 views (74019) | $172.58 | $331 | 1.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,031.85 | $1,979 | 2.7× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$130.35–$155.90 | $250–$299 | varies |
| Bone age studies (77072) | $95.42 | $183 | 0.9× |
| Bone Imaging 3 Phase (78315) | $824.85 | $1,582 | 2.1× |
| Bone Imaging Limited Area (78300) | $619.94 | $1,189 | 1.6× |
| Bone Imaging Multiple Areas (78305) | $782.10 | $1,500 | 2.0× |
| Bone Imaging Whole Body (78306) | $1,031.85 | $1,979 | 2.7× |
| Bone survey infant (77076) | $143.38 | $275 | 1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,172.11 | $2,248 | 2.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,163.86 | $6,068 | 2.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,848.88 | $3,546 | 5.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,134.04 | $2,175 | 2.2× |
| Cerebrospinal Fluid Scan (78630) | $1,207.04 | $2,315 | 2.3× |
| Chest 1 view (71045) | $104.28 | $200 | 1.2× |
| Chest 2 views (71046) | $142.34 | $273 | 1.7× |
| Chest 3 views (71047) | $160.59 | $308 | 1.9× |
| Clavicle complete (73000) | $131.91 | $253 | 1.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $406.17 | $779 | 4.0× |
| Contrast X-Ray Bladder (74430) | $307.10 | $589 | 0.9× |
| Contrast Xray Throat/Cerv Esopha (74210) | $147.56 | $283 | 0.9× |
| CT abdomen and pelvis without and with contrast (74178) | $2,016.78 | $3,868 | 6.0× |
| CT abdomen and pelvis without contrast (74176) | $1,523.53 | $2,922 | 6.6× |
| CT abdomen w contrast (74160) | $1,343.13 | $2,576 | 7.9× |
| CT abdomen w wo contrast (74170) | $1,559.51 | $2,991 | 9.2× |
| CT abdomen w/o contrast (74150) | $1,104.33 | $2,118 | 10.9× |
| CT Angio Abdomen and Pelvis (74174) | $2,228.98 | $4,275 | 6.6× |
| CT Angio Chest (71275) | $1,523.53 | $2,922 | 8.9× |
| CT Angio Head (70496) | $1,540.74 | $2,955 | 9.0× |
| CT angio hrt w/3d image (75574) | $53.18 | $102 | 0.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,406.74 | $2,698 | 8.3× |
| CT Angio Neck (70498) | $1,540.74 | $2,955 | 9.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,294.11 | $2,482 | 7.6× |
| CT cervical spine w/ contrast (72126) | $1,388.49 | $2,663 | 4.1× |
| CT cervical spine w/o contrast (72125) | $1,104.33 | $2,118 | 10.9× |
| CT cervical spine w/wo cont (72127) | $1,673.69 | $3,210 | 9.8× |
| CT chest w contrast (71260) | $1,313.41 | $2,519 | 7.7× |
| CT chest w/wo contrast (71270) | $1,598.09 | $3,065 | 9.4× |
| CT colonography screening (74263) | $1,690.38 | $3,242 | 7.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,447.93 | $2,777 | 14.3× |
| CT head/brain with contrast (70460) | $1,160.11 | $2,225 | 6.8× |
| CT head/brain without and with contrast (70470) | $1,445.32 | $2,772 | 8.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $53.18 | $102 | 0.6× |
| CT iac w contrast (70481) | $1,274.82 | $2,445 | 7.5× |
| CT l-spine w&w/o contrast (72133) | $1,673.69 | $3,210 | 9.8× |
| CT lower ext w/o (73700) | $951.03 | $1,824 | 9.4× |
| CT lower extremity w/contrast material (73701) | $1,065.22 | $2,043 | 6.3× |
| CT lumbar spine w contrast (72132) | $1,388.49 | $2,663 | 4.1× |
| CT lumbar spine w/o contrast (72131) | $1,104.33 | $2,118 | 10.9× |
| CT maxillofacial w contrast (70487) | $1,217.47 | $2,335 | 7.1× |
| CT maxillofacial wo contrast (70486) | $932.78 | $1,789 | 9.2× |
| CT neck tissue combo (70492) | $1,523.53 | $2,922 | 8.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,559.51 | $2,991 | 9.2× |
| CT orbits w/o contrast (70480) | $989.10 | $1,897 | 9.7× |
| CT pelvis w&w/o contrast (72194) | $1,523.53 | $2,922 | 8.9× |
| CT pelvis w/o contrast (72192) | $951.03 | $1,824 | 9.4× |
| CT scan of leg combo (73702) | $1,141.34 | $2,189 | 6.7× |
| CT scans face/jaw combo (70488) | $1,503.20 | $2,883 | 8.8× |
| CT soft tissue neck w contrast (70491) | $1,235.72 | $2,370 | 7.3× |
| CT soft tissue neck w/o contrast (70490) | $951.03 | $1,824 | 9.4× |
| CT thoracic spine w contrast (72129) | $970.33 | $1,861 | 5.7× |
| CT thoracic spine w/o contrast (72128) | $1,104.33 | $2,118 | 10.9× |
| CT thoracic spine w/wo cont (72130) | $580.84 | $1,114 | 3.4× |
| CT thorax w/o contrast (71250) | $1,027.16 | $1,970 | 10.1× |
| CT unlisted procedure (76497) | $336.82 | $646 | 4.0× |
| CT upper ext wo (73200) | $951.03 | $1,824 | 9.4× |
| CT upper extremity w/o & w/contrast material (73202) | $1,141.34 | $2,189 | 6.7× |
| CT upper extremity with contrast (73201) | $913.49 | $1,752 | 2.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,883.30 | $3,612 | 11.1× |
| Cta Abdomen (74175) | $1,908.85 | $3,661 | 11.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $418.68 | $803 | 1.2× |
| CTA pelvis (72191) | $1,529.27 | $2,933 | 9.0× |
| Dxa Bone Density Axial (77080) | $478.65 | $918 | 4.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $147.03 | $282 | 1.7× |
| Echo Guide For Artery Repair (76936) | $240.37 | $461 | 1.1× |
| Esophagram (74220) | $333.70 | $640 | 2.0× |
| Fetal Biophys Profile W/Nst (76818) | $422.86 | $811 | 4.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $346.73 | $665 | 3.4× |
| Fluoroscopy up to 1 hr (76000) | $375.41 | $720 | 1.6× |
| Foot 2 views (73620) | $128.26 | $246 | 1.5× |
| Forearm 2 views (73090) | $125.66 | $241 | 1.5× |
| Gastric emptying imaging study (78264) | $783.14 | $1,502 | 2.0× |
| Hand 2 views (73120) | $128.26 | $246 | 1.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,331.13 | $2,553 | 2.5× |
| Hepatobiliary System Imaging (78226) | $970.85 | $1,862 | 2.5× |
| Ht Muscle Image Spect Sing (78451) | $917.66 | $1,760 | 0.7× |
| Hysterosalpingogram (74740) | $390.53 | $749 | 1.7× |
| Joint Survey Single View (77077) | $227.33 | $436 | 2.2× |
| K Flow/Funct Image W/Drug (78708) | $834.24 | $1,600 | 1.6× |
| K Flow/Funct Image W/O Drug (78707) | $704.93 | $1,352 | 1.3× |
| Knee 3 Views (73562) | $169.98 | $326 | 2.0× |
| Lung Ventilat&Perfus Imaging (78582) | $1,279.52 | $2,454 | 2.4× |
| Lymph System Imaging (78195) | $990.14 | $1,899 | 1.9× |
| Magnetic Image Jaw Joint (70336) | $1,504.24 | $2,885 | 6.5× |
| Meckels Divert Exam (78290) | $593.35 | $1,138 | 1.5× |
| Mra Head W/O & W/Contrast Material (70546) | $2,514.19 | $4,822 | 7.4× |
| MRA head w/o contrast (70544) | $2,056.92 | $3,945 | 8.9× |
| MRA head with contrast (70545) | $2,285.30 | $4,383 | 6.7× |
| MRA neck w contrast (70548) | $2,295.20 | $4,402 | 6.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,848.93 | $5,464 | 8.4× |
| MRA neck w/o contrast (70547) | $2,056.92 | $3,945 | 8.9× |
| MRI abdomen w contrast (74182) | $2,285.30 | $4,383 | 6.7× |
| MRI abdomen w/o contrast (74181) | $1,978.71 | $3,795 | 8.5× |
| MRI any jt lower extrem w/contrast material (73722) | $1,859.83 | $3,567 | 2.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,413.04 | $4,628 | 7.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,859.83 | $3,567 | 2.4× |
| MRI cardiac w/o contrast (75557) | $1,370.24 | $2,628 | 5.9× |
| MRI cervical spine w contrast (72142) | $2,295.20 | $4,402 | 6.8× |
| MRI cervical spine w/o cont (72141) | $2,056.92 | $3,945 | 8.9× |
| MRI chest w/o contrast (71550) | $2,056.92 | $3,945 | 8.9× |
| MRI chest wo w contrast (71552) | $2,925.05 | $5,610 | 8.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,859.83 | $3,567 | 5.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,413.04 | $4,628 | 7.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,622.60 | $3,112 | 7.0× |
| MRI lumbar spine w contrast (72149) | $2,295.20 | $4,402 | 6.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,056.92 | $3,945 | 6.1× |
| MRI orbit face &/neck w/o contrast (70540) | $2,215.43 | $4,249 | 9.6× |
| MRI orbit face neck w contrast (70542) | $2,569.46 | $4,928 | 7.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,074.17 | $5,896 | 9.1× |
| MRI pelvis w contrast (72196) | $2,295.20 | $4,402 | 6.8× |
| MRI pelvis w/o & w contrast (72197) | $2,848.93 | $5,464 | 8.4× |
| MRI pelvis w/o contrast (72195) | $2,056.92 | $3,945 | 8.9× |
| MRI thoracic spine w/o contrast (72146) | $2,056.92 | $3,945 | 8.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,850.97 | $3,550 | 5.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,622.60 | $3,112 | 7.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,413.04 | $4,628 | 7.1× |
| MRI, abdomen, combo (74183) | $2,848.93 | $5,464 | 8.4× |
| MRI, dorsal spine combo (72157) | $2,848.93 | $5,464 | 8.4× |
| MRI, dorsal spine contrast (72147) | $2,295.20 | $4,402 | 6.8× |
| MRI, joint upper extrem (73221) | $1,622.60 | $3,112 | 7.0× |
| MRI, joint upper extrem combo (73223) | $2,053.79 | $3,939 | 6.1× |
| MRI, lumbar spine combo (72158) | $2,848.93 | $5,464 | 8.4× |
| Myocardial Spect Multiple Studies (78452) | $1,900.50 | $3,645 | 1.5× |
| Neck soft tissue (70360) | $123.57 | $237 | 1.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $314.93 | $604 | 0.8× |
| Nuclear Rx Oral Admin (79005) | $731.52 | $1,403 | 3.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$81.34–$222.64 | $156–$427 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 2 matching MRF lines |
$14.08–$20.86 | $27–$40 | varies |
| Panoramic X-ray of jaws (70355) | $95.42 | $183 | 1.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,065.22 | $2,043 | 2.0× |
| Parathyroid Planar Imaging (78070) | $912.97 | $1,751 | 2.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,031.85 | $1,979 | 2.7× |
| Pelvis 1 or 2 views (72170) | $125.66 | $241 | 1.2× |
| Pet Image W/Ct Lmtd (78814) | $3,163.86 | $6,068 | 2.3× |
| PET image w/CT, full body (78816) | $3,545.52 | $6,800 | 2.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,454.80 | $6,626 | 2.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $784.19 | $1,504 | 2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $347.77 | $667 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) | $155.90 | $299 | 1.8× |
| Radex Calcaneus Minimum 2 Views (73650) | $130.35 | $250 | 1.5× |
| Radex elbow complete minimum 3 views (73080) | $165.28 | $317 | 2.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $192.92 | $370 | 1.9× |
| Radex fingr minimum 2 views (73140) | $146.51 | $281 | 1.7× |
| Radex foot complete minimum 3 views (73630) | $149.12 | $286 | 1.8× |
| Radex Hand Minimum 3 Views (73130) | $150.68 | $289 | 1.8× |
| Radex lower extremity infant minimum 2 views (73592) | $149.12 | $286 | 1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $159.03 | $305 | 1.9× |
| Radex Ribs Unilateral 2 Views (71100) | $141.30 | $271 | 1.7× |
| Radex shoulder complete minimum 2 views (73030) | $134 | $257 | 1.6× |
| Radex Sinuses Paransl < 3 Views (70210) | $143.38 | $275 | 1.7× |
| Radex Spine 1 View Specify Level (72020) | $104.28 | $200 | 1.2× |
| Radex Sternum Minimum 2 Views (71120) | $143.91 | $276 | 1.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $231.50 | $444 | 2.7× |
| Radex Toe Minimum 2 Views (73660) | $147.56 | $283 | 1.7× |
| Radex upper extremity infant minimum 2 views (73092) | $145.99 | $280 | 1.4× |
| Radex Wrist Complete Minimum 3 Views (73110) | $166.85 | $320 | 2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $175.71 | $337 | 1.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $172.58 | $331 | 1.7× |
| Radiologic exam colon double contrast study (74280) | $140.78 | $270 | 0.8× |
| Radiologic exam colon single contrast study (74270) | $520.88 | $999 | 3.1× |
| Radiologic exam knee complete 4/more views (73564) | $197.09 | $378 | 1.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$136.61–$197.09 | $262–$378 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $353.51 | $678 | 2.1× |
| Radiologic exam swallow function contrast study (74230) | $333.70 | $640 | 2.0× |
| Radiologic examination femur 1 view (73551) | $561.55 | $1,077 | 6.6× |
| Radiologic examination femur minimum 2 views (73552) | $128.26 | $246 | 1.5× |
| Radiologic examination knee 1/2 views (73560) | $126.70 | $243 | 1.5× |
| Radiologic Examination Osseous Survey Limited (77074) | $250.79 | $481 | 2.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $123.57 | $237 | 1.5× |
| Ribs bilateral 3 views (71110) | $178.84 | $343 | 1.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,217.99 | $2,336 | 3.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,984.97 | $3,807 | 3.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,650.75 | $3,166 | 3.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,880.17 | $3,606 | 3.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,613.73 | $3,095 | 1.3× |
| Scapula (73010) | $138.69 | $266 | 1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $207.52 | $398 | 8.9× |
| Shoulder 1 view (73020) | $106.89 | $205 | 1.3× |
| Skull less than 4 views (70250) | $262.79 | $504 | 2.6× |
| Sternoclavicular joints (71130) | $169.98 | $326 | 2.0× |
| Thoracic spine 2 views (72070) | $147.56 | $283 | 1.5× |
| Thoracic spine 3 views (72072) | $174.15 | $334 | 1.7× |
| Thoracolumbar 2 views (72080) | $160.59 | $308 | 1.9× |
| Thyroid Met Imaging Body (78018) | $1,111.62 | $2,132 | 2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $638.71 | $1,225 | 1.6× |
| Ultrasound Breast Limited (76642) | $363.94 | $698 | 4.3× |
| Ultrasound Exam Aaa Screen (76706) | $385.84 | $740 | 3.8× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$66.22–$462.48 | $127–$887 | varies |
| Umbilical-artery Doppler (OB) (76820) | $211.17 | $405 | 2.1× |
| Upper gi w/o kub (74240) | $417.12 | $800 | 2.4× |
| Urethrocystogram voiding (74455) | $310.23 | $595 | 1.3× |
| Urethrocystography retrograde (74450) | $279.99 | $537 | 1.2× |
| Us chest (76604) range across 3 matching MRF lines |
$62.05–$305.02 | $119–$585 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$55.79–$396.79 | $107–$761 | varies |
| Us kidney transplant (76776) | $368.11 | $706 | 3.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$55.27–$113.67 | $106–$218 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$59.44–$315.97 | $114–$606 | varies |
| Us ob transvaginal (76817) | $357.16 | $685 | 3.5× |
| Us pelvic non ob complete (76856) | $432.24 | $829 | 4.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $451.53 | $866 | 4.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $476.56 | $914 | 4.7× |
| Us retroperitoneal complete (76770) | $486.47 | $933 | 4.8× |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$64.65–$385.84 | $124–$740 | varies |
| Us scrotum and contents (76870) | $430.15 | $825 | 4.2× |
| Us thyroid (76536) range across 4 matching MRF lines |
$49.53–$410.34 | $95–$787 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$370.19–$395.74 | $710–$759 | varies |
| Wrist 2 views (73100) | $143.91 | $276 | 1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $178.84 | $343 | 2.1× |
| X-Ray Bend Only L-S Spine (72120) | $264.87 | $508 | 2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $131.91 | $253 | 1.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $146.51 | $281 | 1.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $111.06 | $213 | 1.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $112.10 | $215 | 1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $175.71 | $337 | 2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $242.45 | $465 | 2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $205.95 | $395 | 2.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $233.59 | $448 | 2.3× |
| X-Ray Exam L-S Spine Bending (72114) | $360.81 | $692 | 3.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $174.15 | $334 | 2.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $315.97 | $606 | 3.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $169.98 | $326 | 1.7× |
| X-ray eye for foreign body (70030) | $131.91 | $253 | 1.6× |
| X-ray humerus (73060) | $134 | $257 | 1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $153.29 | $294 | 1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $104.28 | $200 | 1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $187.70 | $360 | 1.8× |
| X-ray nose-rectum child f.b. (76010) | $98.02 | $188 | 1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $238.80 | $458 | 2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $147.56 | $283 | 1.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $181.97 | $349 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $132.44 | $254 | 1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $172.58 | $331 | 2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $199.17 | $382 | 2.0× |
| X-ray thoracic spine 4 vw (72074) | $220.55 | $423 | 2.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $294.07 | $564 | 0.9× |
| X-Rays Bone Length Studies (77073) | $155.90 | $299 | 1.5× |
| X-Rays Bone Survey Complete (77075) | $489.59 | $939 | 4.8× |
| Xr c-spine 4 or 5 views (72050) | $262.79 | $504 | 2.6× |
| Xr facial bones less than 3 views (70140) | $131.91 | $253 | 1.6× |
| Xr orbits complete 4 views (70200) | $195 | $374 | 1.9× |
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.