Imaging prices at Ascension Sacred Heart Gulf

Port Saint Joe, FL · every code in this section with a posted price and a Medicare benchmark.

320 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Acute gi blood loss imaging (78278) $2,104 $5,260 5.0×
Angiogram extremity bilateral (75716) $3,094.80 $7,737 0.9×
Ankle 2 views (73600) $122 $305 1.3×
Arthrography knee lt (73580) $650.80 $1,627 1.8×
Arthrography wrist lt (73115) $447.20 $1,118 1.2×
Barium enema (74270) $428.80 $1,072 2.3×
Bone age studies (77072) $426 $1,065 3.9×
Bone imaging limited area (78300) $1,426 $3,565 3.4×
Bone marrow imaging whole body (78104) $1,369.60 $3,424 3.3×
Bone survey complete (77075) $180 $450 1.6×
Bowel imaging (78290) $1,138.80 $2,847 2.7×
Brain image w/flow 4 + views (78606) $990 $2,475 1.7×
Card MRI w/stress img & dye (75563) $1,012 $2,530 1.2×
Cardiac MRI w/stress img (75559) $660.80 $1,652 1.2×
Cardiac MRI w/wo contrast & further seq (75561) $1,652.40 $4,131 4.5×
Cerebrospinal fluid leakage (78650) $678 $1,695 0.5×
Cholecystography, oral contrast Other Diagnostic Radiology FS (74290) $466.80 $1,167 2.5×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $564.40 $1,411 3.1×
Cisternogram (78630) $1,192.80 $2,982 2.1×
Clavicle complete (73000) $266.80 $667 2.9×
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) $1,384 $3,460 7.6×
Csf shunt evaluation (78645) $775.20 $1,938 1.4×
CT - st neck w&wo contr (70492) $1,110 $2,775 6.1×
CT abdomen and pelvis without and with contrast (74178) $1,460.80 $3,652 4.0×
CT abdomen and pelvis without contrast (74176) $1,460.80 $3,652 5.9×
CT abdomen w wo contrast (74170) $1,313.20 $3,283 7.2×
CT abdomen w/contrast (74160) $1,310.40 $3,276 7.2×
CT abdomen w/o contrast (74150) $924 $2,310 8.5×
CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) $3,413.60 $8,534 9.4×
CT angio abdom w/o & w/dye (74175) $2,561.60 $6,404 14.0×
CT angio abdominal arteries (75635) $2,561.60 $6,404 14.0×
CT angio hrt w/3d image (75574) $507.20 $1,268 1.4×
CT angiograph pelv w/o&w/dye (72191) $2,567.60 $6,419 14.0×
CT cervical spine w/contrast (72126) $1,418 $3,545 3.9×
CT cervical spine w/o contrast (72125) $1,382.40 $3,456 12.7×
CT chest w/contrast (71260) $1,213.60 $3,034 6.6×
CT extremity upper w & w/o contrast (73202) $1,692.40 $4,231 9.2×
CT head/brain with contrast (70460) $1,460.80 $3,652 8.0×
CT head/brain without and with contrast (70470) $1,460.80 $3,652 8.0×
CT heart contrast eval cardiac structure&morph (75572) $507.20 $1,268 1.4×
CT limited/localized follow up study (76380) $528.40 $1,321 5.8×
CT lower ext w/wo contrast (73702) $1,152.40 $2,881 6.3×
CT lower extremity w contrast (73701) $1,152.40 $2,881 6.3×
CT lower extremity w/o contrast unilateral (73700) $1,152.40 $2,881 10.6×
CT lumbar spine w/contrast (72132) $1,373.60 $3,434 3.8×
CT lumbar spine w/o contrast (72131) $1,246 $3,115 11.4×
CT lumbar spine w/o then w/ con (72133) $1,635.20 $4,088 8.9×
CT maxillofacial area w/o contrast (70486) $1,196.80 $2,992 11.0×
CT maxillofacial w/contrast (70487) $1,337.60 $3,344 7.3×
CT maxillofacial w/o then w/ con (70488) $1,592.80 $3,982 8.7×
CT orbit sella ear w/o con (70480) $1,384.40 $3,461 12.7×
CT orbit/ear/fossa w/o then w/ con (70482) $1,647.20 $4,118 9.0×
CT pelvis w & w/o contrast (72194) $1,293.20 $3,233 7.1×
CT pelvis w/o contrast (72192) $1,009.20 $2,523 9.2×
CT soft tissue neck w/contrast (70491) $1,042.80 $2,607 5.7×
CT soft tissue neck w/o contrast (70490) $1,110 $2,775 10.2×
CT spine cervical w/wo contrast (72127) $1,687.20 $4,218 9.2×
CT thoracic spine w/contrast (72129) $1,578.40 $3,946 8.6×
CT thoracic spine w/o contrast (72128) $1,413.60 $3,534 12.9×
CT thoracic spine w/o then w/ con (72130) $1,878.80 $4,697 10.3×
CT thorax lung cancer scr c- (71271) $1,313.20 $3,283 12.0×
CT thorax w/o contrast (71250) $1,287.20 $3,218 11.8×
CT thorax w/o then w/ contrast (71270) $1,460.80 $3,652 8.0×
CT upper extremity w/dye (73201) $1,421.20 $3,553 3.9×
CT upper extremity w/o contrast rt (73200) $1,421.20 $3,553 13.0×
CTA chest w/wo contrast (71275) $1,460.80 $3,652 8.0×
CTA head w contrast (70496) $2,039.20 $5,098 11.1×
CTA lower extremity w/wo contrast unilateral (73706) $1,460.80 $3,652 8.0×
Cta Neck (70498) $2,140.40 $5,351 11.7×
CTA upper extremity w/wo contrast unilateral (73206) $2,563.60 $6,409 14.0×
Doppler echo fetal spectral display complete (76827) $115.40 $288.50 1.1×
Dxa bone density study axial skeleton (77085) $329.60 $824 3.0×
Echo exam of eye thickness (76514) $8.74 $21.86 0.3×
Esophogram (74220) $348.40 $871 1.9×
Fetal biophysical profile w/o nst (76819) $268 $670 2.5×
Fluoroscopy up to 1 hour physician/qhp time (76000) $445.20 $1,113 1.8×
Gastric emptying study (78264) $2,093.60 $5,234 5.0×
Gastroesophageal reflux study (78262) $2,104 $5,260 5.0×
Gated heart planar single (78472) $876.40 $2,191 2.1×
Hepatobil syst image w/drug (78227) $2,187.60 $5,469 3.9×
Hepatobiliary system imaging (78226) $2,187.60 $5,469 5.2×
Humerus min 2 views (73060) $283.20 $708 3.1×
Hysterosalpingography (74740) $552 $1,380 2.2×
Ivp (74400) $1,007.60 $2,519 5.5×
Ivp w tomography (74415) $968.40 $2,421 5.3×
Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) $2,327.60 $5,819 4.1×
Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) $2,626.40 $6,566 4.6×
Kidney w vascular flow (78701) $1,218.40 $3,046 2.9×
Liver & spleen; static only (78215) $1,740.80 $4,352 4.2×
Liver & spleen; w vasc flow (78216) $1,301.60 $3,254 3.1×
Lung perfusion differential (78597) $573.60 $1,434 1.4×
Lung ventilat&perfus imaging (78582) $1,426.80 $3,567 2.5×
Lung ventilation imaging (78579) $514 $1,285 1.2×
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) $1,414.80 $3,537 3.9×
Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) $1,140.80 $2,852 3.1×
Mammary ductogram multiple ducts (77054) $242 $605 1.0×
Mammary ductogram single (77053) $242 $605 1.0×
MRA head w & w/o contrast (70546) $2,009.20 $5,023 5.5×
MRA head w/contrast (70545) $1,155.20 $2,888 3.2×
MRA head w/o contrast (70544) $895.20 $2,238 3.6×
MRA neck w/contrast (70548) $1,155.20 $2,888 3.2×
MRA neck w/o contrast (70547) $895.20 $2,238 3.6×
MRA neck w/wo contrast (70549) $2,009.20 $5,023 5.5×
MRI abdomen w/contrast (74182) $1,333.60 $3,334 3.7×
MRI abdomen w/o & w/contrast material (74183) $1,066.80 $2,667 2.9×
MRI abdomen w/o contrast (74181) $1,009.60 $2,524 4.1×
MRI any jnt lwr ext with con lt (73722) $1,009.60 $2,524 1.2×
MRI breast without contrast bilateral (77047) $2,239.60 $5,599 9.0×
MRI breast without contrast material unilateral (77046) $1,606.80 $4,017 6.4×
MRI cardiac w/o contrast (75557) $1,172.40 $2,931 4.7×
MRI cervical spine w/o contrast (72141) $1,009.60 $2,524 4.1×
MRI cervical spine with contrast (72142) $1,252 $3,130 3.4×
MRI chest w & w/o contrast (71552) $1,333.60 $3,334 3.7×
MRI chest w/contrast (71551) $1,333.60 $3,334 1.6×
MRI chest w/o contrast (71550) $1,333.60 $3,334 5.4×
MRI joint upper ext w/contrast (73222) $1,342.80 $3,357 1.6×
MRI joint upr extr w/o&w/dye (73223) $1,566.40 $3,916 4.3×
MRI joint upr extrem w/o dye (73221) $1,009.60 $2,524 4.1×
Mri Lower Extremity W/O Dye (73718) $1,009.60 $2,524 4.1×
MRI lumbar spine with contrast (72149) $1,278 $3,195 3.5×
MRI lumbar w/wo contrast (72158) $1,009.60 $2,524 2.8×
MRI lwr ext w/o jnts with con rt (73719) $1,209.60 $3,024 3.3×
MRI orbit/face/neck w/contrast (70542) $895.20 $2,238 2.5×
MRI orbit/face/neck w/o & w/contrast (70543) $1,184 $2,960 3.2×
MRI orbit/face/neck w/o contrast (70540) $895.20 $2,238 3.6×
MRI pelvis w/ contrast (72196) $1,066.80 $2,667 2.9×
MRI pelvis w/o contrast (72195) $1,009.60 $2,524 4.1×
MRI pelvis w/wo contrast (72197) $1,066.80 $2,667 2.9×
MRI spectroscopy (76390) $1,106 $2,765 12.2×
MRI spine cervical wo/w contrast (72156) $1,539.20 $3,848 4.2×
MRI spine thoracic w/contrast (72147) $1,262.80 $3,157 3.5×
MRI thoracic spine w wo contrast (72157) $1,009.60 $2,524 2.8×
MRI thoracic spine w/o contrast (72146) $1,009.60 $2,524 4.1×
MRI tmj (70336) $1,172.40 $2,931 4.7×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,009.60 $2,524 4.1×
Mri Upper Extremity W/Dye (73219) $1,342.80 $3,357 3.7×
MRI upr ext w/o jnts w/o-w/con rt (73220) $1,266.40 $3,166 3.5×
Myelogram Cpa (70010) $844.40 $2,111 2.3×
Myelogram thoracic (72255) $868.40 $2,171 1.1×
Myelography 2 or more regions (72270) $1,330.40 $3,326 1.6×
Myelography lumbosacral (72265) $934.40 $2,336 1.1×
Myocardial spect single study at rest or stress (78451) $2,430.80 $6,077 1.8×
Nm bone 3 phase (78315) $2,536.40 $6,341 6.1×
Nm bone imaging whole body (78306) $2,358 $5,895 5.6×
Nm bone marrow scan limited (78102) $1,158.80 $2,897 2.8×
Nm heart perfusion spect stress rest (78452) $4,977.60 $12,444 3.7×
Nm kidney function (78725) $654 $1,635 1.6×
Nm kidney imaging morphology (78700) $1,235.60 $3,089 3.0×
Nm lymph system (78195) $2,392 $5,980 4.2×
Nm thyroid imaging only (78013) $1,165.20 $2,913 2.8×
Nose to rectum for fb child (76010) $313.60 $784 3.5×
Nuclear rx IV admin (79101) $1,595.60 $3,989 6.5×
Ob us < 14 wks single fetus (76801) $232 $580 2.1×
Ob us nuchal meas 1 gest (76813) $288 $720 2.6×
Oral radiopharm rx (79005) $1,384.40 $3,461 5.7×
Orthopantogram (70355) $160.40 $401 1.8×
Parathyroid imaging (78070) $2,517.20 $6,293 6.0×
Pulmonary perfusion imaging particulate (78580) $693.60 $1,734 1.7×
Radex abscess/fistula/sinus tract rs&i (76080) $550.80 $1,377 1.0×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $160.80 $402 1.8×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $266.80 $667 2.4×
Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) $508 $1,270 4.7×
Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) $508 $1,270 4.7×
Radex hip unilateral with pelvis 1 view (73501) $160.80 $402 1.8×
Radex hip unilateral with pelvis 2-3 views (73502) $160.80 $402 1.8×
Radex hip unilateral with pelvis minimum 4 views (73503) $266.80 $667 2.4×
Radex hips bilateral with pelvis 2 views (73521) $266.80 $667 2.4×
Radex hips bilateral with pelvis minimum 5 views (73523) $508 $1,270 4.7×
Radex spine cervical 2 or 3 views (72040) $91.20 $228 1.0×
Radex spine cervical 4 or 5 views (72050) $417.20 $1,043 3.8×
Radex spine cervical 6 or more views (72052) $438.80 $1,097 4.0×
Radex X-Ray Exam Thoracolmb 2+ Vw - Xr Thoracolumbar Spine 2 Views (72080) $292.40 $731 3.2×
Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) $308.60 $771.50 2.8×
Radiologic exam esophagus double contrast study (74221) $653.20 $1,633 3.6×
Radiologic exam upr gi trc double contrast study (74246) $222 $555 1.2×
Radiologic exam upr gi trc single contrast study (74240) $222 $555 1.2×
Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) $160.80 $402 1.8×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $160.80 $402 1.8×
Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) $311.60 $779 2.9×
Radiologic examination, salivary gland for calculus Other Diagnostic Radiology FS (70380) $445.20 $1,113 4.9×
Radiologic examination, single plane body section (eg, tomography), other than with urography Other Diagnostic… (76100) $224 $560 2.1×
Radiologic examination, spine; thoracic, minimum of 4 views Other Diagnostic Radiology FS (72074) $348.80 $872 3.2×
Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion UNSCHEDULED (79403) $3,235.20 $8,088 13.3×
Rp loclzj tum plnr 1 area single day imaging (78800) $2,876 $7,190 6.9×
Rp loclzj tum plnr whole body 2+ days imaging (78804) $4,551.20 $11,378 8.0×
Rp loclzj tum plnr whole body single day imaging (78802) $2,876 $7,190 5.1×
Rp loclzj tum spect 1 area single day imaging (78803) $717.20 $1,793 1.3×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $4,551.20 $11,378 3.4×
Saline infused sonohysterogram (76831) $332.40 $831 1.3×
Salivary gland funct study (78232) $753.60 $1,884 1.8×
Salivary gland imaging (78230) $757.60 $1,894 1.8×
Screening digital breast tomosynthesis; bilateral (77063) $46 $115 2.0×
Shoulder arthrogram (73040) $834 $2,085 2.3×
Small bowel series (74250) $486.80 $1,217 2.7×
Speech evaluation complex (70371) $234.80 $587 0.9×
Tbs technical calculation only (77091) $147.60 $369 1.6×
Temporomandibular joint arthrography, radiological supervision and interpretation Other Diagnostic Radiology FS (70332) $550.80 $1,377 2.2×
Therapeutic enema barium or air (74283) $781.60 $1,954 4.3×
Thyroid met imaging body (78018) $2,670.80 $6,677 4.7×
Thyroid uptake single/multiple quant measurement (78012) $956.40 $2,391 2.3×
Thyroid uptake w/blood flow sngle/mult quan meas (78014) $1,342 $3,355 3.2×
Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) $147.60 $369 1.6×
Ultrasound breast limited (76642) $247.60 $619 2.7×
Ultrasound, abdomen limited (76705) $377.20 $943 3.5×
Ultrasound, elastography; first target lesion (76982) $410 $1,025 3.8×
Unlisted diagnostic radiographic procedure (76499) $355.60 $889 3.9×
Unlisted fluoroscopic procedure (76496) $95.80 $239.49 1.1×
Ureteral reflux study (78740) $845.20 $2,113 2.0×
Urethrocystography retrograde rs&i (74450) $429.20 $1,073 1.7×
Urethrocystography voiding (74455) $285.20 $713 1.1×
Urography antegrade (74425) $371.20 $928 1.0×
Urography retrograde w/wo kub (74420) $499.60 $1,249 1.4×
Us abdominal aorta real time screen study aaa (76706) $292 $730 2.7×
Us breast uni real time with image complete (76641) $247.60 $619 2.3×
Us chest (76604) $178.40 $446 1.6×
Us compl joint r-t w/image documentation (76881) $233.60 $584 2.1×
Us elastography parenchyma (76981) $438.40 $1,096 4.0×
Us encephalogram (76506) $451.20 $1,128 4.1×
Us guided compression repair (76936) $506.80 $1,267 2.2×
Us inft hips r-t img dynamic req phys/qhp manj (76885) $432.80 $1,082 4.8×
Us inft hips r-t img lmtd static phys/qhp manj (76886) $304 $760 3.3×
Us kidney transplanted (76776) $359.20 $898 3.3×
Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) $146.40 $366 1.3×
Us ob detailed single fetus (76811) $277.60 $694 1.1×
Us ob followup per fetus (76816) $102.40 $256 0.9×
Us ob limited 1 or more fetuses (76815) $158.80 $397 1.5×
Us obstetric transvaginal (76817) $144.40 $361 1.3×
Us pelvic limited or f/u non-ob (76857) $255.20 $638 2.3×
Us pelvis complete (76856) $698 $1,745 6.4×
Us retroperitoneal complete (76770) $265.60 $664 2.4×
Us retroperitoneal limited (76775) $428 $1,070 3.9×
Us scrotum (76870) $570 $1,425 5.2×
Us soft tissue head/neck (76536) $485.20 $1,213 4.4×
Us spinal canal (76800) $451.20 $1,128 4.1×
Us transrectal (76872) $346 $865 3.2×
Us trgt dyn mbubb 1st les (76978) $345.60 $864 0.9×
Us unlstd proc (76999) $195.60 $489 2.2×
Venogram extremity bilateral (75822) $1,800 $4,500 1.1×
Venography ext unilateral (75820) $1,439.60 $3,599 0.9×
Vertebral fracture assessment via dxa (77086) $206 $515 2.3×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $151.60 $379 1.7×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $303.20 $758 3.3×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $689.60 $1,724 3.8×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $321.20 $803 3.5×
X-ray exam hips bi 3-4 views (73522) $266.80 $667 2.4×
X-ray exam of finger(s) (73140) $264.80 $662 2.9×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $1,008.40 $2,521 5.5×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $388 $970 4.3×
X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) $242 $605 2.7×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $275.20 $688 3.0×
X-Ray Hand 2 Vw - Xr Hand 1-2 Views Right (73120) $260.40 $651 2.4×
X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) $300.40 $751 3.3×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $295.20 $738 3.2×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $138.80 $347 1.5×
X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) $273.60 $684 3.0×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $360.40 $901 3.3×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $224 $560 2.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $226.80 $567 2.1×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $413.20 $1,033 3.8×
X-Ray Mastoids 3+ Vw - Xr Mastoids 3+ Views (70130) $430.40 $1,076 3.9×
X-ray perineogram (74775) $391.20 $978 1.6×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $129.20 $323 1.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $534 $1,335 4.9×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $243.60 $609 2.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $292.40 $731 3.2×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $315.20 $788 3.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $465.20 $1,163 5.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $462 $1,155 4.2×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $248.80 $622 2.3×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $166.80 $417 1.8×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $190.80 $477 2.1×
X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) $276.40 $691 3.0×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $318.80 $797 3.5×
Xr abdomen 1 view (74018) $189.20 $473 2.1×
Xr abdomen 2 views (74019) $191.60 $479 1.8×
Xr abdomen 3 views (74021) $217.80 $544.50 2.0×
Xr arthrogram ankle (73615) $550.80 $1,377 1.5×
Xr arthrogram elbow (73085) $550.80 $1,377 1.5×
Xr arthrogram hip (73525) $416.80 $1,042 1.1×
Xr bone density appendicular (77081) $71.20 $178 0.8×
Xr bone density axial (77080) $127.80 $319.50 1.2×
Xr bone length study (77073) $460.60 $1,151.50 4.2×
Xr bone survey infant (77076) $328.40 $821 3.0×
Xr bone survey limited (77074) $199.20 $498 1.8×
Xr chest 1 view (71045) $145 $362.50 1.6×
Xr chest 2 views (71046) $166.80 $417 1.8×
Xr chest 3 views (71047) $286.20 $715.50 3.1×
Xr cystogram 3+ views (74430) $392.80 $982 1.1×
Xr eye foreign body (70030) $395.20 $988 4.3×
Xr facial bones 3 views (70150) $409.20 $1,023 3.7×
Xr joint survey 1 view (77077) $495.20 $1,238 4.5×
Xr lower extremity 2 views infant (73592) $126.80 $317 1.4×
Xr lumbar spine 4 views w/ flex ext (72120) $173.20 $433 1.6×
Xr mandible 4 views (70110) $311.60 $779 2.9×
Xr myelogram c-spine (72240) $1,066 $2,665 1.3×
Xr nasal bones (70160) $256.40 $641 2.8×
Xr pelvis 3 views (72190) $358.80 $897 3.3×
Xr sella turcica (70240) $324.40 $811 3.6×
Xr sialogram (70390) $488.40 $1,221 2.0×
Xr spine 1 view (72020) $316 $790 3.5×
Xr sternum 2 views (71120) $280.80 $702 3.1×
Xr stress view joint (77071) $138.80 $347 1.5×
Xr upper extremity 2 views infant (73092) $126.80 $317 1.2×
Xray elbow 2 views (73070) $285.60 $714 3.1×
Xray forearm 2 views (73090) $273.60 $684 3.0×
Xray internal auditory meati compl (70134) $424 $1,060 0.7×
Xray knee 1 or 2 views rt (73560) $261.20 $653 2.9×
Xray neck soft tissue (70360) $277.60 $694 3.1×
Xray optic foramina (70190) $356.40 $891 3.9×
Xray orbits complete min 4 views (70200) $311.60 $779 2.9×
Xray pelvis 1 or 2 views (72170) $154.20 $385.50 1.4×
Xray ribs bilateral 3 views (71110) $131.20 $328 1.2×
Xray ribs unilat w/ pa chest 3v rt (71101) $362.80 $907 3.3×
Xray scapula complete (73010) $271.20 $678 2.5×
Xray shoulder 1 view (73020) $106 $265 1.2×
Xray sinuses paranasal <3 views (70210) $194.40 $486 2.1×
Xray spine thoracic 2 views (72070) $128.40 $321 1.2×
Xray tibia-fibula 2 views bil (73590) $294.40 $736 3.2×
Xray tmj open - closed unilat (70328) $114 $285 1.3×
Xray tmj's bilateral open-clsc (70330) $278.40 $696 3.1×