Imaging prices at Baptist Memorial Hospital-Tipton
Covington, TN · every code in this section with a posted price and a Medicare benchmark.
268 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) | $1,679.52 | $6,998 | 1.3× |
| Abdomen 1 View (74018) | $96 | $400 | 1.2× |
| Abdomen 2 views (74019) | $111.84 | $466 | 1.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $380.64 | $1,586 | 1.0× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$60.48–$72 | $252–$300 | varies |
| Basic radiation dosimetry calculation (77300) | $158.64 | $661 | 1.3× |
| Bone age studies (77072) | $250.80 | $1,045 | 2.6× |
| Bone Imaging 3 Phase (78315) | $460.56 | $1,919 | 1.2× |
| Bone Imaging Limited Area (78300) | $237.84 | $991 | 0.6× |
| Bone Imaging Whole Body (78306) | $345.36 | $1,439 | 0.9× |
| Bone survey infant (77076) | $160.80 | $670 | 1.7× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$357.84–$408.96 | $1,491–$1,704 | varies |
| Chest 1 view (71045) | $96 | $400 | 1.2× |
| Chest 2 views (71046) | $109.92 | $458 | 1.4× |
| Chest 3 views (71047) | $113.76 | $474 | 1.4× |
| Chest 4 or more views (71048) | $123.36 | $514 | 1.3× |
| Clavicle complete (73000) | $79.20 | $330 | 1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $53.28 | $222 | 0.6× |
| Continuing medical physics consltj pr wk (77336) | $300.72 | $1,253 | 2.4× |
| Contrast X-Ray Bladder (74430) | $135.36 | $564 | 0.4× |
| CT abdomen and pelvis without and with contrast (74178) | $2,416.80 | $10,070 | 7.5× |
| CT abdomen and pelvis without contrast (74176) | $1,544.64 | $6,436 | 7.0× |
| CT abdomen w contrast (74160) | $1,067.28 | $4,447 | 6.6× |
| CT abdomen w wo contrast (74170) | $1,209.12 | $5,038 | 7.4× |
| CT abdomen w/o contrast (74150) | $786.72 | $3,278 | 8.1× |
| CT Angio Abdomen and Pelvis (74174) | $2,057.76 | $8,574 | 6.4× |
| CT Angio Chest (71275) | $1,027.92 | $4,283 | 6.3× |
| CT Angio Head (70496) | $994.32 | $4,143 | 6.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $891.12 | $3,713 | 5.5× |
| CT Angio Neck (70498) | $828 | $3,450 | 5.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $891.12 | $3,713 | 5.5× |
| CT cervical spine w/ contrast (72126) | $906 | $3,775 | 2.8× |
| CT cervical spine w/o contrast (72125) | $842.64 | $3,511 | 8.7× |
| CT cervical spine w/wo cont (72127) | $944.40 | $3,935 | 5.8× |
| CT chest w contrast (71260) | $1,067.28 | $4,447 | 6.6× |
| CT chest w/wo contrast (71270) | $1,209.12 | $5,038 | 7.4× |
| CT head/brain with contrast (70460) | $1,067.28 | $4,447 | 6.6× |
| CT head/brain without and with contrast (70470) | $1,209.12 | $5,038 | 7.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $64.56 | $269 | 0.8× |
| CT iac w contrast (70481) | $940.56 | $3,919 | 5.8× |
| CT l-spine w&w/o contrast (72133) | $944.40 | $3,935 | 5.8× |
| CT lower ext w/o (73700) | $779.04 | $3,246 | 8.0× |
| CT lower extremity w/contrast material (73701) | $1,067.28 | $4,447 | 6.6× |
| CT lumbar spine w contrast (72132) | $906 | $3,775 | 2.8× |
| CT lumbar spine w/o contrast (72131) | $842.64 | $3,511 | 8.7× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$731.28–$1,010.16 | $3,047–$4,209 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$447.60–$954.72 | $1,865–$3,978 | varies |
| CT neck tissue combo (70492) | $1,209.12 | $5,038 | 7.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,154.40 | $4,810 | 7.1× |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$552.72–$873.60 | $2,303–$3,640 | varies |
| CT pelvis w&w/o contrast (72194) | $1,209.12 | $5,038 | 7.4× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$701.04–$758.88 | $2,921–$3,162 | varies |
| CT scan of leg combo (73702) | $849.12 | $3,538 | 5.2× |
| CT scans face/jaw combo (70488) | $1,209.12 | $5,038 | 7.4× |
| CT soft tissue neck w contrast (70491) | $1,067.28 | $4,447 | 6.6× |
| CT soft tissue neck w/o contrast (70490) | $758.88 | $3,162 | 7.8× |
| CT thoracic spine w contrast (72129) | $906 | $3,775 | 5.6× |
| CT thoracic spine w/o contrast (72128) | $803.04 | $3,346 | 8.3× |
| CT thoracic spine w/wo cont (72130) | $944.40 | $3,935 | 5.8× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$78.96–$758.88 | $329–$3,162 | varies |
| CT upper ext wo (73200) | $779.04 | $3,246 | 8.0× |
| CT upper extremity w/o & w/contrast material (73202) | $847.68 | $3,532 | 5.2× |
| CT upper extremity with contrast (73201) | $878.40 | $3,660 | 2.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,027.92 | $4,283 | 6.3× |
| Cta Abdomen (74175) | $1,027.92 | $4,283 | 6.3× |
| CTA pelvis (72191) | $1,027.92 | $4,283 | 6.3× |
| Dxa Bone Density Axial (77080) | $119.76 | $499 | 1.2× |
| Dxa bone density study (77085) | $57.84 | $241 | 0.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $47.04 | $196 | 0.6× |
| Echo Guide For Artery Repair (76936) | $194.64 | $811 | 1.0× |
| Esophagram (74220) | $142.56 | $594 | 0.9× |
| Fetal Biophys Profile W/Nst (76818) | $361.92 | $1,508 | 3.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $296.64 | $1,236 | 3.1× |
| Fluoroscopy up to 1 hr (76000) | $289.68 | $1,207 | 1.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$44.88–$81.60 | $187–$340 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$45.84–$89.28 | $191–$372 | varies |
| Gastric emptying imaging study (78264) | $660.24 | $2,751 | 1.8× |
| Gastroesophageal Reflux Exam (78262) | $239.76 | $999 | 0.6× |
| Gated Heart Planar Single (78472) | $457.20 | $1,905 | 1.2× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$48–$66.24 | $200–$276 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $2,253.60 | $9,390 | 3.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,782.72 | $7,428 | 2.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,648.08 | $6,867 | 2.6× |
| Hepatobil Syst Image W/Drug (78227) | $458.40 | $1,910 | 0.9× |
| Hepatobiliary System Imaging (78226) | $409.44 | $1,706 | 1.1× |
| Ht Muscle Image Spect Sing (78451) | $1,502.64 | $6,261 | 1.3× |
| Hysterosalpingogram (74740) | $197.52 | $823 | 0.9× |
| K Flow/Funct Image W/Drug (78708) | $519.36 | $2,164 | 1.0× |
| Knee 3 Views (73562) | $119.28 | $497 | 1.5× |
| Liver & Spleen Imaging Static Only (78215) | $279.12 | $1,163 | 0.8× |
| Lung Perf&Ventilat Diferentl (78598) | $767.76 | $3,199 | 1.5× |
| Lung perfusion differential (78597) | $502.08 | $2,092 | 1.4× |
| Lung Ventilat&Perfus Imaging (78582) | $767.76 | $3,199 | 1.5× |
| Lymph System Imaging (78195) | $447.84 | $1,866 | 0.9× |
| Meckels Divert Exam (78290) | $380.16 | $1,584 | 1.0× |
| Mlc imrt design & construction per imrt plan (77338) | $852 | $3,550 | 2.5× |
| MRA head w/o contrast (70544) | $979.92 | $4,083 | 4.4× |
| MRA head with contrast (70545) | $1,153.20 | $4,805 | 3.6× |
| MRA neck w/o contrast (70547) | $979.92 | $4,083 | 4.4× |
| MRI abdomen w/o contrast (74181) | $975.36 | $4,064 | 4.4× |
| MRI any jt lower extrem w/contrast material (73722) | $1,030.08 | $4,292 | 1.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,256.16 | $5,234 | 3.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,030.08 | $4,292 | 1.4× |
| MRI cervical spine w contrast (72142) | $1,014.96 | $4,229 | 3.1× |
| MRI cervical spine w/o cont (72141) | $975.36 | $4,064 | 4.4× |
| MRI chest w/o contrast (71550) | $898.56 | $3,744 | 4.1× |
| MRI chest wo w contrast (71552) | $1,449.12 | $6,038 | 4.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,256.16 | $5,234 | 3.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $979.92 | $4,083 | 4.4× |
| MRI lumbar spine w contrast (72149) | $1,153.20 | $4,805 | 3.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,533.84 | $6,391 | 4.7× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$397.68–$943.68 | $1,657–$3,932 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$1,030.08–$1,520.88 | $4,292–$6,337 | varies |
| MRI pelvis w contrast (72196) | $1,183.20 | $4,930 | 3.7× |
| MRI pelvis w/o & w contrast (72197) | $1,520.88 | $6,337 | 4.7× |
| MRI pelvis w/o contrast (72195) | $975.36 | $4,064 | 4.4× |
| MRI thoracic spine w/o contrast (72146) | $975.36 | $4,064 | 4.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $979.92 | $4,083 | 4.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,183.20 | $4,930 | 3.7× |
| MRI, abdomen, combo (74183) | $1,544.16 | $6,434 | 4.8× |
| MRI, dorsal spine combo (72157) | $1,533.84 | $6,391 | 4.7× |
| MRI, dorsal spine contrast (72147) | $1,030.08 | $4,292 | 3.2× |
| MRI, joint upper extrem (73221) | $975.36 | $4,064 | 4.4× |
| MRI, joint upper extrem combo (73223) | $1,075.44 | $4,481 | 3.3× |
| MRI, lumbar spine combo (72158) | $1,533.84 | $6,391 | 4.7× |
| Myocardial Spect Multiple Studies (78452) | $1,733.52 | $7,223 | 1.4× |
| Neck soft tissue (70360) | $93.12 | $388 | 1.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $166.32 | $693 | 0.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,321.20 | $5,505 | 1.0× |
| Parathyroid Planar Imaging (78070) | $283.68 | $1,182 | 0.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $358.08 | $1,492 | 1.0× |
| Pelvis 1 or 2 views (72170) | $85.68 | $357 | 0.9× |
| PET image w/CT, full body (78816) | $3,114.48 | $12,977 | 2.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,114.48 | $12,977 | 2.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $279.12 | $1,163 | 0.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $181.44 | $756 | 1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $165.84 | $691 | 0.3× |
| Radex Ankle Complete Minimum 3 Views (73610) | $101.52 | $423 | 1.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $60.72 | $253 | 0.8× |
| Radex elbow complete minimum 3 views (73080) | $88.80 | $370 | 1.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $104.16 | $434 | 1.1× |
| Radex fingr minimum 2 views (73140) | $79.20 | $330 | 1.0× |
| Radex foot complete minimum 3 views (73630) | $101.52 | $423 | 1.3× |
| Radex Hand Minimum 3 Views (73130) | $79.20 | $330 | 1.0× |
| Radex lower extremity infant minimum 2 views (73592) | $77.04 | $321 | 1.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $93.84 | $391 | 1.2× |
| Radex Ribs Unilateral 2 Views (71100) | $111.12 | $463 | 1.4× |
| Radex shoulder complete minimum 2 views (73030) | $111.12 | $463 | 1.4× |
| Radex Sinuses Paransl < 3 Views (70210) | $71.04 | $296 | 0.9× |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$66.24–$85.68 | $276–$357 | varies |
| Radex Sternum Minimum 2 Views (71120) | $79.92 | $333 | 1.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $112.08 | $467 | 1.4× |
| Radex Toe Minimum 2 Views (73660) | $69.60 | $290 | 0.9× |
| Radex upper extremity infant minimum 2 views (73092) | $71.04 | $296 | 0.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $99.36 | $414 | 1.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $174.72 | $728 | 1.8× |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$102.72–$161.04 | $428–$671 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$152.16–$238.08 | $634–$992 | varies |
| Radiation treatment delivery level 3 (77412) | $300.72 | $1,253 | 0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $131.28 | $547 | 1.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $108.48 | $452 | 1.1× |
| Radiologic exam colon double contrast study (74280) | $302.40 | $1,260 | 1.9× |
| Radiologic exam colon single contrast study (74270) | $194.64 | $811 | 1.2× |
| Radiologic exam knee complete 4/more views (73564) | $128.88 | $537 | 1.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $99.36 | $414 | 1.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $226.80 | $945 | 1.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $344.40 | $1,435 | 2.1× |
| Radiologic examination femur 1 view (73551) | $56.64 | $236 | 0.7× |
| Radiologic examination femur minimum 2 views (73552) | $102.24 | $426 | 1.3× |
| Radiologic examination knee 1/2 views (73560) | $103.92 | $433 | 1.3× |
| Radiologic Examination Osseous Survey Limited (77074) | $220.08 | $917 | 2.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $92.64 | $386 | 1.1× |
| Ribs bilateral 3 views (71110) | $125.04 | $521 | 1.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $379.44 | $1,581 | 1.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $437.76 | $1,824 | 0.9× |
| Scapula (73010) | $111.12 | $463 | 1.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $48 | $200 | 2.1× |
| Shoulder 1 view (73020) | $66.24 | $276 | 0.8× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$47.76–$83.52 | $199–$348 | varies |
| Special dosimetry (77331) | $89.04 | $371 | 0.7× |
| Special Physics Consult (77370) | $334.56 | $1,394 | 2.7× |
| Special teletherapy port plan (77321) | $401.28 | $1,672 | 1.2× |
| Special treatment procedure (77470) | $1,039.44 | $4,331 | 2.0× |
| Stereotactic Body Radiation Delivery (77373) | $3,068.88 | $12,787 | 1.9× |
| Sternoclavicular joints (71130) | $89.28 | $372 | 1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$406.56–$636.72 | $1,694–$2,653 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$256.08–$401.04 | $1,067–$1,671 | varies |
| Testicular Imaging W/Flow (78761) | $336.72 | $1,403 | 0.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $532.56 | $2,219 | 1.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $297.12 | $1,238 | 0.9× |
| Ther rad simulaj-aided field setting simple (77280) | $196.08 | $817 | 1.6× |
| Thoracic spine 2 views (72070) | $131.28 | $547 | 1.4× |
| Thoracic spine 3 views (72072) | $130.56 | $544 | 1.3× |
| Thoracolumbar 2 views (72080) | $124.08 | $517 | 1.5× |
| Thyroid Imaging With Vascular Flow (78013) | $179.52 | $748 | 0.5× |
| Thyroid Uptake Measurement (78012) | $256.56 | $1,069 | 0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $238.08 | $992 | 0.6× |
| Tx Devices Design & Construction Complex (77334) | $395.52 | $1,648 | 1.1× |
| Tx devices design & construction intermediate (77333) | $194.64 | $811 | 1.6× |
| Tx devices design & construction simple (77332) | $116.64 | $486 | 0.9× |
| Ultrasound Breast Limited (76642) | $102 | $425 | 1.3× |
| Ultrasound Exam Aaa Screen (76706) | $100.80 | $420 | 1.0× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$164.40–$210.48 | $685–$877 | varies |
| Umbilical-artery Doppler (OB) (76820) | $135.36 | $564 | 1.4× |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$382.32–$538.56 | $1,593–$2,244 | varies |
| Unlisted Procedure Clinical Brachytherapy (77799) | $251.52 | $1,048 | 2.7× |
| Upper gi w/o kub (74240) | $282 | $1,175 | 1.7× |
| Urethrocystogram voiding (74455) | $230.64 | $961 | 1.0× |
| Urethrocystography retrograde (74450) | $121.20 | $505 | 0.5× |
| Us breast unilateral complete (76641) | $151.44 | $631 | 1.6× |
| Us chest (76604) | $124.08 | $517 | 1.3× |
| Us complete joint (76881) | $184.56 | $769 | 1.9× |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$153.12–$153.36 | $638–$639 | varies |
| Us head (76506) | $184.56 | $769 | 1.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$116.88–$134.88 | $487–$562 | varies |
| Us ob detailed single fetus (76811) | $488.64 | $2,036 | 2.2× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$153.12–$238.56 | $638–$994 | varies |
| Us ob transvaginal (76817) | $88.08 | $367 | 0.9× |
| Us pelvic non ob complete (76856) | $230.64 | $961 | 2.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $137.28 | $572 | 1.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $173.04 | $721 | 1.8× |
| Us retroperitoneal complete (76770) | $231.12 | $963 | 2.4× |
| Us retroperitoneal limited (76775) | $245.52 | $1,023 | 2.5× |
| Us scrotum and contents (76870) | $242.64 | $1,011 | 2.5× |
| Us spinal canal and contents (76800) | $124.08 | $517 | 1.3× |
| Us thyroid (76536) | $180.48 | $752 | 1.9× |
| Us transrectal (76872) | $251.04 | $1,046 | 2.6× |
| Vascular Flow Imaging (78445) | $345.36 | $1,439 | 0.9× |
| Vertebral fracture assessment via dxa (77086) | $39.12 | $163 | 0.5× |
| Wrist 2 views (73100) | $66.24 | $276 | 0.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $92.88 | $387 | 1.2× |
| X-Ray Bend Only L-S Spine (72120) | $96.48 | $402 | 1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$45.84–$89.28 | $191–$372 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$342.48–$363.60 | $1,427–$1,515 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $95.28 | $397 | 1.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $105.60 | $440 | 1.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $151.44 | $631 | 1.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $63.12 | $263 | 0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $123.36 | $514 | 1.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $136.56 | $569 | 1.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $119.52 | $498 | 1.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $136.56 | $569 | 1.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $158.16 | $659 | 1.6× |
| X-Ray Exam L-S Spine Bending (72114) | $130.56 | $544 | 1.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $116.64 | $486 | 1.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $181.20 | $755 | 1.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $117.36 | $489 | 1.2× |
| X-ray eye for foreign body (70030) | $131.28 | $547 | 1.6× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$60.24–$89.28 | $251–$372 | varies |
| X-ray IV pyelogram (ivp) (74400) | $435.84 | $1,816 | 2.7× |
| X-ray IV pyelogram+tomography (74415) | $527.04 | $2,196 | 3.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $89.04 | $371 | 1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $71.04 | $296 | 0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $121.20 | $505 | 1.3× |
| X-ray nose-rectum child f.b. (76010) | $105.60 | $440 | 1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $128.88 | $537 | 1.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $85.68 | $357 | 0.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $92.88 | $387 | 1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $97.20 | $405 | 1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $126 | $525 | 1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $133.92 | $558 | 1.4× |
| X-ray thoracic spine 4 vw (72074) | $161.04 | $671 | 1.7× |
| X-Ray Tmj Unilat (70328) | $41.52 | $173 | 0.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $220.08 | $917 | 0.7× |
| X-Rays Bone Survey Complete (77075) | $228.72 | $953 | 2.4× |
| Xr c-spine 4 or 5 views (72050) | $150 | $625 | 1.5× |
| Xr facial bones less than 3 views (70140) | $50.88 | $212 | 0.6× |
| Xr orbits complete 4 views (70200) | $88.80 | $370 | 0.9× |
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.