Imaging prices at Ascension Saint Thomas River Park
McMinnville, TN · every code in this section with a posted price and a Medicare benchmark.
242 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) | $139.08 | $463.60 | 1.7× |
| Abdomen 2 views (74019) | $152.46 | $508.20 | 1.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $649.53 | $2,165.10 | 1.7× |
| Ankle 2 views (73600) | $81.39 | $271.30 | 1.0× |
| Arthrogram hip (73525) | $254.55 | $848.50 | 0.8× |
| Arthrogram Wrist (73115) | $289.29 | $964.30 | 0.9× |
| Bone age studies (77072) | $76.47 | $254.90 | 0.8× |
| Bone Imaging 3 Phase (78315) | $995.70 | $3,319 | 2.6× |
| Bone Imaging Limited Area (78300) | $468.23 | $1,560.75 | 1.2× |
| Bone Imaging Whole Body (78306) | $845.64 | $2,818.80 | 2.2× |
| Bone survey infant (77076) | $153.18 | $510.60 | 1.5× |
| Cat Scan Follow-Up Study (76380) | $235.65 | $785.50 | 2.9× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$91.82–$101.01 | $306.05–$336.70 | varies |
| Chest 2 views (71046) | $103.26 | $344.20 | 1.2× |
| Clavicle complete (73000) | $122.61 | $408.70 | 1.5× |
| Contrast X-Ray Bladder (74430) | $473.94 | $1,579.80 | 1.4× |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$194.49–$235.85 | $648.30–$786.15 | varies |
| 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) | $1,154.13 | $3,847.10 | 6.9× |
| CT Angio Head (70496) | $1,045.52 | $3,485.05 | 6.3× |
| CT angio hrt w/3d image (75574) | $1,085.27 | $3,617.55 | 3.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$731.48–$731.76 | $2,438.25–$2,439.20 | varies |
| CT Angio Neck (70498) | $1,045.52 | $3,485.05 | 6.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $941.18 | $3,137.25 | 5.7× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$812.18–$812.40 | $2,707.25–$2,708 | varies |
| CT cervical spine w/o contrast (72125) | $845.90 | $2,819.65 | 8.5× |
| CT chest w contrast (71260) | $792.81 | $2,642.70 | 4.8× |
| CT chest w/wo contrast (71270) | $910.64 | $3,035.45 | 5.5× |
| CT head/brain with contrast (70460) | $839.87 | $2,799.55 | 5.0× |
| CT head/brain without and with contrast (70470) | $843.75 | $2,812.50 | 5.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,008.18 | $3,360.60 | 3.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $101.15 | $337.15 | 1.2× |
| CT iac w contrast (70481) | $665.75 | $2,219.15 | 4.0× |
| CT l-spine w&w/o contrast (72133) | $861.47 | $2,871.55 | 5.2× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$640.52–$667.80 | $2,135.05–$2,226 | varies |
| CT lower extremity w/contrast material (73701) | $697.83 | $2,326.10 | 4.2× |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$812.40–$961.67 | $2,708–$3,205.55 | varies |
| CT lumbar spine w/o contrast (72131) | $889.92 | $2,966.40 | 9.0× |
| 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) | $1,128.96 | $3,763.20 | 6.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $704.87 | $2,349.55 | 4.2× |
| CT orbits w/o contrast (70480) | $612.93 | $2,043.10 | 6.2× |
| 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 2 matching MRF lines |
$717.96–$718.02 | $2,393.20–$2,393.40 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$658.19–$658.53 | $2,193.95–$2,195.10 | varies |
| CT soft tissue neck w contrast (70491) | $1,067.58 | $3,558.60 | 6.4× |
| CT soft tissue neck w/o contrast (70490) | $727.71 | $2,425.70 | 7.3× |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$745.56–$745.83 | $2,485.20–$2,486.10 | varies |
| CT thoracic spine w/o contrast (72128) | $818.33 | $2,727.75 | 8.2× |
| CT thoracic spine w/wo cont (72130) | $834.83 | $2,782.75 | 5.0× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$734.12–$1,044.56 | $2,447.05–$3,481.85 | varies |
| CT upper ext wo (73200) | $691.01 | $2,303.35 | 7.0× |
| 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) | $1,153.47 | $3,844.90 | 6.9× |
| Cta Abdomen (74175) | $1,409.33 | $4,697.75 | 8.5× |
| 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) | $241.58 | $805.25 | 2.4× |
| Esophagram (74220) | $157.13 | $523.75 | 0.9× |
| Fetal Biophys Profile W/Nst (76818) | $308.31 | $1,027.70 | 3.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $125.04 | $416.80 | 1.3× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$61.31–$179.36 | $204.35–$597.85 | varies |
| Foot 2 views (73620) | $66.95 | $223.15 | 0.8× |
| Forearm 2 views (73090) | $109.55 | $365.15 | 1.3× |
| Gastric emptying imaging study (78264) | $681.48 | $2,271.60 | 1.8× |
| Gated Heart Planar Single (78472) | $801.98 | $2,673.25 | 2.1× |
| Hand 2 views (73120) | $87.17 | $290.55 | 0.9× |
| Hepatobil Syst Image W/Drug (78227) | $906.36 | $3,021.20 | 1.8× |
| Hepatobiliary System Imaging (78226) | $906.36 | $3,021.20 | 2.4× |
| Ht Muscle Image Spect Sing (78451) | $1,895.22 | $6,317.40 | 1.5× |
| Hysterosalpingogram (74740) | $254.55 | $848.50 | 1.1× |
| Infant hip ultrasound, limited static exam (76886) | $120.57 | $401.90 | 1.5× |
| K Flow/Funct Image Multiple (78709) | $607.40 | $2,024.65 | 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) | $567.17 | $1,890.55 | 1.5× |
| Knee 3 Views (73562) | $153.18 | $510.60 | 1.9× |
| Liver & Spleen Imaging Static Only (78215) | $540.83 | $1,802.75 | 1.4× |
| Lung perfusion differential (78597) | $657.60 | $2,192 | 1.7× |
| Lung Ventilat&Perfus Imaging (78582) | $783.87 | $2,612.90 | 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) | $780.39 | $2,601.30 | 3.4× |
| MRA neck w contrast (70548) | $858.83 | $2,862.75 | 2.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $987.66 | $3,292.20 | 3.0× |
| MRA neck w/o contrast (70547) | $930.08 | $3,100.25 | 4.1× |
| MRI abdomen w/o contrast (74181) | $880.91 | $2,936.35 | 3.9× |
| MRI any jt lower extrem w/contrast material (73722) | $1,150.11 | $3,833.70 | 1.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $972.87 | $3,242.90 | 2.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $926.37 | $3,087.90 | 1.2× |
| MRI cervical spine w/o cont (72141) | $930.30 | $3,101 | 4.1× |
| MRI chest w/o contrast (71550) | $719.43 | $2,398.10 | 3.2× |
| MRI chest wo w contrast (71552) | $1,186.28 | $3,954.25 | 3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,015.17 | $3,383.90 | 3.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,292.25 | $4,307.50 | 3.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $882.66 | $2,942.20 | 3.9× |
| MRI lumbar spine w contrast (72149) | $965.33 | $3,217.75 | 2.9× |
| 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–$1,103.24 | $2,902.30–$3,677.45 | 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) | $930.30 | $3,101 | 2.8× |
| MRI pelvis w/o & w contrast (72197) | $1,270.25 | $4,234.15 | 3.8× |
| MRI pelvis w/o contrast (72195) | $840.23 | $2,800.75 | 3.7× |
| MRI thoracic spine w/o contrast (72146) | $930.30 | $3,101 | 4.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $912.90 | $3,043 | 4.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,041.24 | $3,470.80 | 3.1× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,248.29–$1,383.14 | $4,160.95–$4,610.45 | varies |
| MRI, dorsal spine combo (72157) | $1,318.01 | $4,393.35 | 4.0× |
| MRI, dorsal spine contrast (72147) | $1,152.21 | $3,840.70 | 3.5× |
| MRI, joint upper extrem (73221) | $891.57 | $2,971.90 | 3.9× |
| MRI, joint upper extrem combo (73223) | $1,138.83 | $3,796.10 | 3.4× |
| MRI, lumbar spine combo (72158) | $1,356.98 | $4,523.25 | 4.1× |
| Myocardial Spect Multiple Studies (78452) | $1,179.27 | $3,930.90 | 1.0× |
| N-invas est c ffr sw aly CTA (75580) | $2,413.53 | $8,045.10 | 3.0× |
| Neck soft tissue (70360) | $117.95 | $393.15 | 1.4× |
| Nonvascular Shunt X-Ray (75809) | $135.69 | $452.30 | 1.4× |
| Nuclear Rx Oral Admin (79005) | $584.60 | $1,948.65 | 2.6× |
| Parathyroid Planar Imaging (78070) | $579.72 | $1,932.40 | 1.5× |
| Pelvis 1 or 2 views (72170) | $141.77 | $472.55 | 1.4× |
| 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) | $191.36 | $637.85 | 1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $174.78 | $582.60 | 0.3× |
| Radex Ankle Complete Minimum 3 Views (73610) | $132.66 | $442.20 | 1.6× |
| Radex Calcaneus Minimum 2 Views (73650) | $113.90 | $379.65 | 1.4× |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$137.67–$137.73 | $458.90–$459.10 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $158.90 | $529.65 | 1.6× |
| Radex fingr minimum 2 views (73140) | $109.70 | $365.65 | 1.3× |
| Radex foot complete minimum 3 views (73630) | $121.28 | $404.25 | 1.5× |
| Radex Hand Minimum 3 Views (73130) | $112.23 | $374.10 | 1.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $140.12 | $467.05 | 1.7× |
| Radex Ribs Unilateral 2 Views (71100) | $150.48 | $501.60 | 1.8× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$94.07–$143.13 | $313.55–$477.10 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $77.18 | $257.25 | 0.9× |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$91.95–$96.96 | $306.50–$323.20 | varies |
| Radex Sternum Minimum 2 Views (71120) | $126.65 | $422.15 | 1.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $118.41 | $394.70 | 1.4× |
| Radex Toe Minimum 2 Views (73660) | $86.73 | $289.10 | 1.0× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$84.90–$119.61 | $283–$398.70 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $249.24 | $830.80 | 2.5× |
| Radiologic exam colon double contrast study (74280) | $359.24 | $1,197.45 | 2.2× |
| Radiologic exam colon single contrast study (74270) | $279.33 | $931.10 | 1.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $173 | $576.65 | 1.0× |
| Radiologic exam knee complete 4/more views (73564) | $146.13 | $487.10 | 1.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $257.81 | $859.35 | 1.5× |
| Radiologic exam swallow function contrast study (74230) | $191.10 | $637 | 1.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $202.23 | $674.10 | 1.2× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$91.62–$96.20 | $305.40–$320.65 | varies |
| Radiologic examination femur minimum 2 views (73552) | $119.30 | $397.65 | 1.4× |
| Radiologic examination knee 1/2 views (73560) | $109.86 | $366.20 | 1.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $118.89 | $396.30 | 1.4× |
| Renal Cyst Study (74470) | $283.65 | $945.50 | 0.5× |
| Ribs bilateral 3 views (71110) | $144 | $480 | 1.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $721.88 | $2,406.25 | 1.9× |
| Scapula (73010) | $120.95 | $403.15 | 1.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $32.45 | $108.15 | 1.4× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$110.88–$116.42 | $369.60–$388.05 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$276.71–$293.03 | $922.35–$976.75 | varies |
| Skull less than 4 views (70250) | $121.58 | $405.25 | 1.2× |
| Sternoclavicular joints (71130) | $82.44 | $274.80 | 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) | $136.07 | $453.55 | 1.4× |
| Thoracic spine 3 views (72072) | $181.37 | $604.55 | 1.8× |
| Thoracolumbar 2 views (72080) | $136.07 | $453.55 | 1.6× |
| Thyroid Imaging With Vascular Flow (78013) | $370.16 | $1,233.85 | 1.0× |
| 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 elastography first target lesion (76982) | $369.77 | $1,232.55 | 3.7× |
| Ultrasound Exam Aaa Screen (76706) | $170.31 | $567.70 | 1.7× |
| Ultrasound, abdomen limited (76705) | $227.54 | $758.45 | 2.3× |
| Umbilical-artery Doppler (OB) (76820) | $228.42 | $761.40 | 2.3× |
| Unlisted magnetic resonance procedure (76498) | $736.64 | $2,455.45 | 8.9× |
| Upper gi w/o kub (74240) | $217.79 | $725.95 | 1.3× |
| Urethrocystogram voiding (74455) | $242.43 | $808.10 | 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) | $207.68 | $692.25 | 2.1× |
| Us complete joint (76881) range across 3 matching MRF lines |
$209.33–$287.31 | $697.75–$957.70 | varies |
| Us head (76506) | $190.37 | $634.55 | 1.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$252.29–$261.99 | $840.95–$873.30 | varies |
| Us ob detailed single fetus (76811) | $322.76 | $1,075.85 | 1.4× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$81.02–$82.56 | $270.05–$275.20 | varies |
| Us ob transvaginal (76817) | $354.47 | $1,181.55 | 3.6× |
| Us pelvic non ob complete (76856) | $353.40 | $1,178 | 3.6× |
| 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) | $201.17 | $670.55 | 2.0× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$227.75–$280.17 | $759.15–$933.90 | varies |
| Us retroperitoneal limited (76775) | $252.51 | $841.70 | 2.5× |
| Us scrotum and contents (76870) | $317.94 | $1,059.80 | 3.2× |
| Us spinal canal and contents (76800) | $335.93 | $1,119.75 | 3.4× |
| Us thyroid (76536) range across 2 matching MRF lines |
$200.45–$289.52 | $668.15–$965.05 | varies |
| Us transrectal (76872) | $181.01 | $603.35 | 1.8× |
| 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× |
| Vertebral fracture assessment via dxa (77086) | $48.18 | $160.60 | 0.6× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$98.54–$103.49 | $328.45–$344.95 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $144.06 | $480.20 | 1.7× |
| X-Ray Bend Only L-S Spine (72120) | $73.91 | $246.35 | 0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $97.74 | $325.80 | 1.2× |
| X-Ray Exam Breast Specimen (76098) | $142.64 | $475.45 | 0.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $127.17 | $423.90 | 1.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $97.89 | $326.30 | 1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $125.31 | $417.70 | 1.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 4 matching MRF lines |
$191.21–$200.78 | $637.35–$669.25 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $156.66 | $522.20 | 1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $156.66 | $522.20 | 1.6× |
| X-Ray Exam L-S Spine Bending (72114) | $178.76 | $595.85 | 1.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $127.55 | $425.15 | 1.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $209.88 | $699.60 | 2.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $205.92 | $686.40 | 2.1× |
| X-ray eye for foreign body (70030) | $102.81 | $342.70 | 1.2× |
| X-ray humerus (73060) | $109.14 | $363.80 | 1.3× |
| X-ray IV pyelogram (ivp) (74400) | $313.01 | $1,043.35 | 1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $218.67 | $728.90 | 2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $72.56 | $241.85 | 0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $172.35 | $574.50 | 1.7× |
| X-ray nose-rectum child f.b. (76010) | $68 | $226.65 | 0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $218.28 | $727.60 | 2.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $170.60 | $568.65 | 1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $185.07 | $616.90 | 2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $210.90 | $703 | 2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $135.30 | $451 | 1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $424.40 | $1,414.65 | 1.3× |
| X-Rays Bone Length Studies (77073) | $65.90 | $219.65 | 0.7× |
| X-Rays Bone Survey Complete (77075) | $378.47 | $1,261.55 | 3.8× |
| Xr c-spine 4 or 5 views (72050) | $209.88 | $699.60 | 2.1× |
| Xr facial bones less than 3 views (70140) | $105.11 | $350.35 | 1.3× |
| Xr orbits complete 4 views (70200) | $165.59 | $551.95 | 1.7× |
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.