Imaging prices at Ascension Saint Thomas Highlands
Sparta, TN · every code in this section with a posted price and a Medicare benchmark.
244 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) | $146.03 | $486.75 | 1.8× |
| Abdomen 2 views (74019) | $160.07 | $533.55 | 1.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $649.56 | $2,165.20 | 1.7× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$81.39–$110.46 | $271.30–$368.20 | varies |
| Bone age studies (77072) | $80.31 | $267.70 | 0.8× |
| Bone Imaging 3 Phase (78315) | $995.72 | $3,319.05 | 2.6× |
| Bone Imaging Limited Area (78300) | $468.23 | $1,560.75 | 1.2× |
| Bone Imaging Whole Body (78306) | $845.66 | $2,818.85 | 2.2× |
| Bone marrow imaging limited area (78102) | $759.27 | $2,530.90 | 2.0× |
| Bone marrow imaging; multiple areas (78103) | $759.27 | $2,530.90 | 2.0× |
| Bone marrow imaging; whole body (78104) | $759.27 | $2,530.90 | 2.0× |
| Bone survey infant (77076) | $160.85 | $536.15 | 1.6× |
| Cat Scan Follow-Up Study (76380) | $247.43 | $824.75 | 3.0× |
| Chest 1 view (71045) range across 7 matching MRF lines |
$96.41–$101.22 | $321.35–$337.40 | varies |
| Chest 2 views (71046) | $113.87 | $379.55 | 1.4× |
| Chest 3 views (71047) | $94.35 | $314.50 | 1.1× |
| Clavicle complete (73000) | $128.76 | $429.20 | 1.6× |
| Contrast X-Ray Bladder (74430) | $497.66 | $1,658.85 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) | $2,001.08 | $6,670.25 | 6.0× |
| CT abdomen and pelvis without contrast (74176) | $1,721.63 | $5,738.75 | 7.6× |
| CT abdomen w contrast (74160) | $848.61 | $2,828.70 | 5.1× |
| CT abdomen w wo contrast (74170) | $963.39 | $3,211.30 | 5.8× |
| CT abdomen w/o contrast (74150) | $776.76 | $2,589.20 | 7.8× |
| CT Angio Abdomen and Pelvis (74174) | $1,707.77 | $5,692.55 | 5.2× |
| CT Angio Chest (71275) | $1,211.85 | $4,039.50 | 7.3× |
| CT Angio Head (70496) | $1,097.79 | $3,659.30 | 6.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$731.48–$768.05 | $2,438.25–$2,560.15 | varies |
| CT Angio Neck (70498) | $1,097.79 | $3,659.30 | 6.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $988.25 | $3,294.15 | 5.9× |
| CT cervical spine w/ contrast (72126) | $852.78 | $2,842.60 | 2.6× |
| CT cervical spine w/o contrast (72125) | $888.18 | $2,960.60 | 8.9× |
| CT cervical spine w/wo cont (72127) | $904.56 | $3,015.20 | 5.4× |
| CT chest w contrast (71260) | $832.46 | $2,774.85 | 5.0× |
| CT chest w/wo contrast (71270) | $956.16 | $3,187.20 | 5.7× |
| CT head/brain with contrast (70460) | $881.88 | $2,939.60 | 5.3× |
| CT head/brain without and with contrast (70470) | $885.95 | $2,953.15 | 5.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $101.15 | $337.15 | 1.2× |
| CT iac w contrast (70481) | $699.03 | $2,330.10 | 4.2× |
| CT l-spine w&w/o contrast (72133) | $904.56 | $3,015.20 | 5.4× |
| CT lower ext w/o (73700) range across 7 matching MRF lines |
$640.52–$701.21 | $2,135.05–$2,337.35 | varies |
| CT lower extremity w/contrast material (73701) range across 6 matching MRF lines |
$687.89–$732.74 | $2,292.95–$2,442.45 | varies |
| CT lumbar spine w contrast (72132) | $1,009.76 | $3,365.85 | 3.0× |
| CT lumbar spine w/o contrast (72131) | $934.41 | $3,114.70 | 9.4× |
| CT maxillofacial w contrast (70487) | $622.91 | $2,076.35 | 3.7× |
| CT maxillofacial wo contrast (70486) | $554.03 | $1,846.75 | 5.6× |
| CT neck tissue combo (70492) | $1,185.41 | $3,951.35 | 7.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $740.12 | $2,467.05 | 4.4× |
| CT orbits w/o contrast (70480) | $643.59 | $2,145.30 | 6.5× |
| CT pelvis w&w/o contrast (72194) | $926.10 | $3,087 | 5.6× |
| CT pelvis w/o contrast (72192) | $817.49 | $2,724.95 | 8.2× |
| CT scan of leg combo (73702) range across 8 matching MRF lines |
$718.02–$753.93 | $2,393.40–$2,513.10 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$658.53–$691.10 | $2,195.10–$2,303.65 | varies |
| CT soft tissue neck w contrast (70491) | $1,120.97 | $3,736.55 | 6.7× |
| CT soft tissue neck w/o contrast (70490) | $764.10 | $2,547 | 7.7× |
| CT thoracic spine w contrast (72129) | $783.14 | $2,610.45 | 4.7× |
| CT thoracic spine w/o contrast (72128) | $859.25 | $2,864.15 | 8.7× |
| CT thorax w/o contrast (71250) | $770.84 | $2,569.45 | 7.8× |
| CT upper ext wo (73200) range across 7 matching MRF lines |
$573.59–$725.55 | $1,911.95–$2,418.50 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $811.20 | $2,704 | 4.9× |
| CT upper extremity with contrast (73201) | $668.72 | $2,229.05 | 2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,211.16 | $4,037.20 | 7.3× |
| Cta Abdomen (74175) | $1,479.80 | $4,932.65 | 8.9× |
| CTA pelvis (72191) | $893.39 | $2,977.95 | 5.4× |
| Dxa Bone Density Axial (77080) | $161.37 | $537.90 | 1.6× |
| Echo exam uterus (76831) | $361.50 | $1,205 | 1.6× |
| Echograp Trans R Pros Study (76873) | $253.65 | $845.50 | 2.6× |
| Esophagram (74220) | $165 | $550 | 1.0× |
| Fetal Biophys Profile W/Nst (76818) | $323.75 | $1,079.15 | 3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $131.31 | $437.70 | 1.3× |
| Fluoroscopy up to 1 hr (76000) | $179.36 | $597.85 | 0.8× |
| Foot 2 views (73620) | $70.29 | $234.30 | 0.9× |
| Forearm 2 views (73090) | $115.02 | $383.40 | 1.4× |
| Gastric emptying imaging study (78264) | $681.51 | $2,271.70 | 1.8× |
| Gated Heart Planar Single (78472) | $801.99 | $2,673.30 | 2.1× |
| Hand 2 views (73120) | $87.17 | $290.55 | 0.9× |
| Hepatobil Syst Image W/Drug (78227) | $906.38 | $3,021.25 | 1.8× |
| Hepatobiliary System Imaging (78226) | $906.38 | $3,021.25 | 2.4× |
| Ht Muscle Image Spect Sing (78451) | $1,895.25 | $6,317.50 | 1.5× |
| Hysterosalpingogram (74740) | $287.55 | $958.50 | 1.3× |
| Infant hip ultrasound, limited static exam (76886) | $126.59 | $421.95 | 1.5× |
| K Flow/Funct Image Multiple (78709) | $607.47 | $2,024.90 | 1.2× |
| K Flow/Funct Image W/Drug (78708) | $750.63 | $2,502.10 | 1.5× |
| K Flow/Funct Image W/O Drug (78707) | $567.90 | $1,893 | 1.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $567.18 | $1,890.60 | 1.5× |
| Knee 3 Views (73562) | $160.85 | $536.15 | 1.9× |
| Liver & Spleen Imaging Static Only (78215) | $540.84 | $1,802.80 | 1.4× |
| Lung perfusion differential (78597) | $657.60 | $2,192 | 1.7× |
| Lung Ventilat&Perfus Imaging (78582) | $783.81 | $2,612.70 | 1.5× |
| Lymph System Imaging (78195) | $718.80 | $2,396 | 1.4× |
| Meckels Divert Exam (78290) | $674.18 | $2,247.25 | 1.8× |
| Mr safety determination physician/other qhp (76016) | $75.90 | $253 | 0.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $21.11 | $70.35 | 0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $78.39 | $261.30 | 0.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $208.35 | $694.50 | 0.9× |
| Mra Head W/O & W/Contrast Material (70546) | $1,187.03 | $3,956.75 | 3.6× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$780.39–$780.50 | $2,601.30–$2,601.65 | varies |
| MRA neck w contrast (70548) | $901.76 | $3,005.85 | 2.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,037.03 | $3,456.75 | 3.1× |
| MRA neck w/o contrast (70547) | $976.59 | $3,255.30 | 4.3× |
| MRI abdomen w/o contrast (74181) | $924.95 | $3,083.15 | 4.1× |
| MRI any jt lower extrem w/contrast material (73722) | $1,207.62 | $4,025.40 | 1.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,021.52 | $3,405.05 | 3.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $972.71 | $3,242.35 | 1.3× |
| MRI cervical spine w contrast (72142) | $1,209.72 | $4,032.40 | 3.7× |
| MRI cervical spine w/o cont (72141) | $976.83 | $3,256.10 | 4.3× |
| MRI chest w/o contrast (71550) | $755.40 | $2,518 | 3.3× |
| MRI chest wo w contrast (71552) | $1,245.62 | $4,152.05 | 3.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,065.93 | $3,553.10 | 3.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,356.87 | $4,522.90 | 4.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $882.66 | $2,942.20 | 3.9× |
| MRI lumbar spine w contrast (72149) | $1,013.60 | $3,378.65 | 3.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,324.91 | $4,416.35 | 4.0× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$870.69–$1,158.41 | $2,902.30–$3,861.35 | varies |
| MRI orbit face neck w contrast (70542) | $1,001.88 | $3,339.60 | 3.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,152.21 | $3,840.70 | 3.5× |
| MRI pelvis w contrast (72196) | $976.83 | $3,256.10 | 2.9× |
| MRI pelvis w/o & w contrast (72197) | $1,333.79 | $4,445.95 | 4.0× |
| MRI pelvis w/o contrast (72195) | $882.27 | $2,940.90 | 3.9× |
| MRI thoracic spine w/o contrast (72146) | $976.83 | $3,256.10 | 4.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $950.48 | $3,168.25 | 2.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $958.56 | $3,195.20 | 4.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,041.24 | $3,470.80 | 3.1× |
| MRI, abdomen, combo (74183) | $1,248.29 | $4,160.95 | 3.8× |
| MRI, dorsal spine combo (72157) | $1,383.93 | $4,613.10 | 4.2× |
| MRI, dorsal spine contrast (72147) | $1,152.21 | $3,840.70 | 3.5× |
| MRI, joint upper extrem (73221) | $936.15 | $3,120.50 | 4.1× |
| MRI, joint upper extrem combo (73223) | $1,138.83 | $3,796.10 | 3.4× |
| MRI, lumbar spine combo (72158) | $1,424.84 | $4,749.45 | 4.3× |
| Myocardial Spect Multiple Studies (78452) | $1,179.32 | $3,931.05 | 1.0× |
| Neck soft tissue (70360) | $123.83 | $412.75 | 1.5× |
| Nonvascular Shunt X-Ray (75809) | $142.49 | $474.95 | 1.4× |
| Nuclear Rx Oral Admin (79005) | $584.61 | $1,948.70 | 2.6× |
| Parathyroid Planar Imaging (78070) | $579.72 | $1,932.40 | 1.5× |
| Pelvis 1 or 2 views (72170) | $148.86 | $496.20 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $657.60 | $2,192 | 1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $200.93 | $669.75 | 2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $183.54 | $611.80 | 0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) | $139.32 | $464.40 | 1.7× |
| Radex Calcaneus Minimum 2 Views (73650) | $119.61 | $398.70 | 1.4× |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$144.59–$144.62 | $481.95–$482.05 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $166.83 | $556.10 | 1.7× |
| Radex fingr minimum 2 views (73140) | $115.19 | $383.95 | 1.4× |
| Radex foot complete minimum 3 views (73630) | $127.34 | $424.45 | 1.5× |
| Radex Hand Minimum 3 Views (73130) | $117.84 | $392.80 | 1.4× |
| Radex lower extremity infant minimum 2 views (73592) | $67.71 | $225.70 | 0.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $147.12 | $490.40 | 1.8× |
| Radex Ribs Unilateral 2 Views (71100) | $158.01 | $526.70 | 1.9× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$93.75–$150.29 | $312.50–$500.95 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $81.03 | $270.10 | 1.0× |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$96.56–$96.96 | $321.85–$323.20 | varies |
| Radex Sternum Minimum 2 Views (71120) | $132.98 | $443.25 | 1.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $124.34 | $414.45 | 1.5× |
| Radex Toe Minimum 2 Views (73660) | $91.08 | $303.60 | 1.1× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$84.90–$125.58 | $283–$418.60 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $261.71 | $872.35 | 2.6× |
| Radiologic exam colon double contrast study (74280) | $377.21 | $1,257.35 | 2.3× |
| Radiologic exam colon single contrast study (74270) | $293.31 | $977.70 | 1.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $173 | $576.65 | 1.0× |
| Radiologic exam knee complete 4/more views (73564) | $153.44 | $511.45 | 1.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $72.54 | $241.80 | 0.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $257.81 | $859.35 | 1.5× |
| Radiologic exam swallow function contrast study (74230) | $200.67 | $668.90 | 1.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $202.23 | $674.10 | 1.2× |
| Radiologic examination femur 1 view (73551) | $96.20 | $320.65 | 1.2× |
| Radiologic examination femur minimum 2 views (73552) | $125.25 | $417.50 | 1.5× |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$94.44–$115.35 | $314.80–$384.50 | varies |
| Radiologic examination tibia & fibula 2 views (73590) | $124.85 | $416.15 | 1.5× |
| Ribs bilateral 3 views (71110) | $151.20 | $504 | 1.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $168.95 | $563.15 | 0.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $721.88 | $2,406.25 | 1.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $772.52 | $2,575.05 | 1.5× |
| Scapula (73010) | $126.99 | $423.30 | 1.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $32.45 | $108.15 | 1.4× |
| Shoulder 1 view (73020) | $116.42 | $388.05 | 1.4× |
| Skull less than 4 views (70250) | $127.67 | $425.55 | 1.3× |
| Sternoclavicular joints (71130) | $86.57 | $288.55 | 1.0× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) | $129.47 | $431.55 | 1.6× |
| Tbs technical calculation only (77091) | $129.47 | $431.55 | 1.6× |
| Testicular Imaging W/Flow (78761) | $329.15 | $1,097.15 | 0.9× |
| Thoracic spine 2 views (72070) | $142.88 | $476.25 | 1.4× |
| Thoracic spine 3 views (72072) | $190.44 | $634.80 | 1.9× |
| Thoracolumbar 2 views (72080) | $142.88 | $476.25 | 1.7× |
| Thyroid Imaging With Vascular Flow (78013) | $370.16 | $1,233.85 | 1.0× |
| Thyroid Uptake Measurement (78012) | $325.98 | $1,086.60 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $801.02 | $2,670.05 | 2.1× |
| Ultrasound Breast Limited (76642) range across 9 matching MRF lines |
$165.20–$330.39 | $550.65–$1,101.30 | varies |
| Ultrasound Exam Aaa Screen (76706) | $178.85 | $596.15 | 1.8× |
| Ultrasound, abdomen limited (76705) | $227.54 | $758.45 | 2.3× |
| Upper gi w/o kub (74240) | $228.68 | $762.25 | 1.4× |
| Urethrocystogram voiding (74455) | $254.57 | $848.55 | 1.1× |
| Us breast unilateral complete (76641) range across 9 matching MRF lines |
$173.48–$346.94 | $578.25–$1,156.45 | varies |
| Us chest (76604) | $218.07 | $726.90 | 2.2× |
| Us complete joint (76881) | $301.68 | $1,005.60 | 3.0× |
| Us exam, pelvic, limited (76857) | $151.50 | $505 | 1.5× |
| Us head (76506) | $199.89 | $666.30 | 2.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $275.09 | $916.95 | 2.8× |
| Us ob detailed single fetus (76811) | $338.91 | $1,129.70 | 1.5× |
| Us ob limited 1 or more fetuses (76815) | $86.70 | $289 | 0.9× |
| Us ob transvaginal (76817) | $372.18 | $1,240.60 | 3.7× |
| Us pelvic non ob complete (76856) | $371.07 | $1,236.90 | 3.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $253.16 | $843.85 | 2.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $211.22 | $704.05 | 2.1× |
| Us retroperitoneal complete (76770) | $239.15 | $797.15 | 2.4× |
| Us retroperitoneal limited (76775) | $252.51 | $841.70 | 2.5× |
| Us scrotum and contents (76870) | $333.84 | $1,112.80 | 3.4× |
| Us spinal canal and contents (76800) | $376.25 | $1,254.15 | 3.8× |
| Us thyroid (76536) range across 2 matching MRF lines |
$200.45–$289.56 | $668.15–$965.20 | varies |
| Us transrectal (76872) | $190.08 | $633.60 | 1.9× |
| Venography extremity bilateral rs&i (75822) | $1,338.96 | $4,463.20 | 0.9× |
| Venography extremity unilateral rs&i (75820) | $1,338.96 | $4,463.20 | 0.9× |
| Wrist 2 views (73100) | $103.49 | $344.95 | 1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $151.28 | $504.25 | 1.8× |
| X-Ray Bend Only L-S Spine (72120) | $77.61 | $258.70 | 0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $102.63 | $342.10 | 1.2× |
| X-Ray Exam Breast Specimen (76098) | $149.76 | $499.20 | 0.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $127.17 | $423.90 | 1.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $133.65 | $445.50 | 1.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $102.80 | $342.65 | 1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $131.57 | $438.55 | 1.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $200.78 | $669.25 | 2.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $164.49 | $548.30 | 1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $164.49 | $548.30 | 1.7× |
| X-Ray Exam L-S Spine Bending (72114) | $187.68 | $625.60 | 1.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $127.55 | $425.15 | 1.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $220.38 | $734.60 | 2.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $216.24 | $720.80 | 2.2× |
| X-ray eye for foreign body (70030) | $107.96 | $359.85 | 1.3× |
| X-ray humerus (73060) | $114.62 | $382.05 | 1.4× |
| X-ray IV pyelogram (ivp) (74400) | $328.65 | $1,095.50 | 2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $229.59 | $765.30 | 2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $76.20 | $254 | 0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $180.96 | $603.20 | 1.8× |
| X-ray nose-rectum child f.b. (76010) | $71.43 | $238.10 | 0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $229.20 | $764 | 2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $179.15 | $597.15 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $194.33 | $647.75 | 2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $221.45 | $738.15 | 2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $142.10 | $473.65 | 1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $424.40 | $1,414.65 | 1.3× |
| X-Rays Bone Length Studies (77073) | $69.21 | $230.70 | 0.7× |
| X-Rays Bone Survey Complete (77075) | $397.41 | $1,324.70 | 4.0× |
| Xr c-spine 4 or 5 views (72050) | $220.38 | $734.60 | 2.2× |
| Xr facial bones less than 3 views (70140) | $110.36 | $367.85 | 1.3× |
| Xr orbits complete 4 views (70200) | $173.90 | $579.65 | 1.8× |
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.