Imaging prices at Baylor Scott and White Medical Center Sunnyvale
Sunnyvale, TX · every code in this section with a posted price and a Medicare benchmark.
287 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) | $160.20 | $267 | 1.8× |
| Abdomen 2 views (74019) | $209.40 | $349 | 2.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $458.40 | $764 | 1.1× |
| Angiography extremity bilateral rs&i (75716) | $3,482.40 | $5,804 | 1.1× |
| Angiography extremity unilateral rs&i (75710) | $2,355 | $3,925 | 0.7× |
| Ankle 2 views (73600) | $181.20 | $302 | 2.1× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,802.40 | $3,004 | 0.3× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,109 | $3,515 | 0.4× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,403 | $4,005 | 0.4× |
| Arthrogram hip (73525) | $181.80 | $303 | 0.5× |
| Arthrogram Wrist (73115) | $128.40 | $214 | 0.4× |
| Bone age studies (77072) | $130.80 | $218 | 1.2× |
| Bone Imaging 3 Phase (78315) | $1,210.20 | $2,017 | 3.0× |
| Bone Imaging Limited Area (78300) | $333.60 | $556 | 0.8× |
| Bone Imaging Whole Body (78306) | $1,134 | $1,890 | 2.8× |
| Bone survey infant (77076) | $186.60 | $311 | 1.8× |
| Brain Flow Imaging Only (78610) | $244.20 | $407 | 0.4× |
| Cat Scan Follow-Up Study (76380) | $641.40 | $1,069 | 7.3× |
| Chest 1 view (71045) | $127.20 | $212 | 1.5× |
| Chest 2 views (71046) | $171 | $285 | 2.0× |
| Chest 3 views (71047) | $210 | $350 | 2.4× |
| Chest 4 or more views (71048) | $291.60 | $486 | 2.8× |
| Clavicle complete (73000) | $196.20 | $327 | 2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $128.40 | $214 | 1.2× |
| Contrast Exam Abdominl Aorta (75625) | $3,076.80 | $5,128 | 1.0× |
| Contrast X-Ray Bladder (74430) | $222 | $370 | 0.6× |
| Contrast X-Ray Of Elbow (73085) | $246.60 | $411 | 0.7× |
| Contrast X-Ray Of Knee Joint (73580) | $220.20 | $367 | 0.6× |
| CT abdomen and pelvis without and with contrast (74178) | $3,568.20 | $5,947 | 10.2× |
| CT abdomen and pelvis without contrast (74176) | $2,735.40 | $4,559 | 11.4× |
| CT abdomen w contrast (74160) | $1,747.80 | $2,913 | 9.9× |
| CT abdomen w wo contrast (74170) | $1,779 | $2,965 | 10.1× |
| CT abdomen w/o contrast (74150) | $1,385.40 | $2,309 | 13.2× |
| CT Angio Abdomen and Pelvis (74174) | $4,165.20 | $6,942 | 11.9× |
| CT Angio Chest (71275) | $1,713.60 | $2,856 | 9.7× |
| CT Angio Head (70496) | $1,976.40 | $3,294 | 11.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,297.80 | $2,163 | 7.4× |
| CT Angio Neck (70498) | $1,977.60 | $3,296 | 11.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,027.40 | $3,379 | 11.5× |
| CT cervical spine w/ contrast (72126) | $1,725 | $2,875 | 4.9× |
| CT cervical spine w/o contrast (72125) | $1,358.40 | $2,264 | 12.9× |
| CT cervical spine w/wo cont (72127) | $1,837.80 | $3,063 | 10.4× |
| CT chest w contrast (71260) | $1,713.60 | $2,856 | 9.7× |
| CT chest w/wo contrast (71270) | $1,939.80 | $3,233 | 11.0× |
| CT head/brain with contrast (70460) | $1,466.40 | $2,444 | 8.3× |
| CT head/brain without and with contrast (70470) | $1,780.80 | $2,968 | 10.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,375.20 | $2,292 | 3.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $82.80 | $138 | 0.9× |
| CT iac w contrast (70481) | $1,576.20 | $2,627 | 8.9× |
| CT l-spine w&w/o contrast (72133) | $1,931.40 | $3,219 | 11.0× |
| CT lower ext w/o (73700) | $1,496.40 | $2,494 | 14.2× |
| CT lower extremity w/contrast material (73701) | $1,795.80 | $2,993 | 10.2× |
| CT lumbar spine w contrast (72132) | $1,666.20 | $2,777 | 4.8× |
| CT lumbar spine w/o contrast (72131) | $1,524.60 | $2,541 | 14.5× |
| CT maxillofacial w contrast (70487) | $1,431.60 | $2,386 | 8.1× |
| CT maxillofacial wo contrast (70486) | $1,130.40 | $1,884 | 10.8× |
| CT neck tissue combo (70492) | $1,371 | $2,285 | 7.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,750.80 | $2,918 | 9.9× |
| CT orbits w/o contrast (70480) | $1,435.80 | $2,393 | 13.7× |
| CT pelvis w&w/o contrast (72194) | $1,789.20 | $2,982 | 10.2× |
| CT pelvis w/o contrast (72192) | $1,350.60 | $2,251 | 12.9× |
| CT scan of leg combo (73702) | $1,955.40 | $3,259 | 11.1× |
| CT scans face/jaw combo (70488) | $1,711.80 | $2,853 | 9.7× |
| CT soft tissue neck w contrast (70491) | $1,484.40 | $2,474 | 8.4× |
| CT soft tissue neck w/o contrast (70490) | $1,257 | $2,095 | 12.0× |
| CT thoracic spine w contrast (72129) | $1,701.60 | $2,836 | 9.7× |
| CT thoracic spine w/o contrast (72128) | $1,574.40 | $2,624 | 15.0× |
| CT thoracic spine w/wo cont (72130) | $1,931.40 | $3,219 | 11.0× |
| CT thorax w/o contrast (71250) | $1,437 | $2,395 | 13.7× |
| CT upper ext wo (73200) | $1,579.80 | $2,633 | 15.0× |
| CT upper extremity w/o & w/contrast material (73202) | $1,923 | $3,205 | 10.9× |
| CT upper extremity with contrast (73201) | $1,830 | $3,050 | 5.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,085.60 | $3,476 | 11.8× |
| Cta Abdomen (74175) | $2,251.80 | $3,753 | 12.8× |
| CTA pelvis (72191) | $1,913.40 | $3,189 | 10.9× |
| Dilation ureters/urethra rs&i (74485) | $282 | $470 | 0.1× |
| Dxa Bone Density Axial (77080) | $332.40 | $554 | 3.2× |
| Esophagram (74220) | $403.80 | $673 | 2.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $126 | $210 | 1.2× |
| Fluoroscopy up to 1 hr (76000) | $370.20 | $617 | 1.5× |
| Foot 2 views (73620) | $250.80 | $418 | 2.9× |
| Forearm 2 views (73090) | $264.60 | $441 | 3.0× |
| Gastric emptying imaging study (78264) | $1,069.20 | $1,782 | 2.7× |
| Gated Heart Planar Single (78472) | $986.40 | $1,644 | 2.5× |
| Gated Heart, Multiple (78473) | $1,996.20 | $3,327 | 5.0× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,463 | $4,105 | 4.5× |
| Hand 2 views (73120) | $277.80 | $463 | 2.6× |
| Hepatobil Syst Image W/Drug (78227) | $1,203.60 | $2,006 | 2.2× |
| Hepatobiliary System Imaging (78226) | $1,174.80 | $1,958 | 2.9× |
| Ht Musc Image Planar Mult (78454) | $1,563 | $2,605 | 1.2× |
| Ht Muscle Image Spect Sing (78451) | $1,549.80 | $2,583 | 1.2× |
| Hysterosalpingogram (74740) | $446.40 | $744 | 1.9× |
| Infusion Ivp (74410) | $514.80 | $858 | 2.9× |
| K Flow/Funct Image W/Drug (78708) | $1,080.60 | $1,801 | 2.0× |
| K Flow/Funct Image W/O Drug (78707) | $1,081.20 | $1,802 | 2.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $310.80 | $518 | 0.8× |
| Knee 3 Views (73562) | $265.80 | $443 | 3.0× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $302.40 | $504 | 0.8× |
| Liver & Spleen Imaging Static Only (78215) | $384.60 | $641 | 1.0× |
| Lung Perf&Ventilat Diferentl (78598) | $684 | $1,140 | 1.3× |
| Lung perfusion differential (78597) | $301.20 | $502 | 0.8× |
| Lung Ventilat&Perfus Imaging (78582) | $1,444.20 | $2,407 | 2.6× |
| Lung Ventilation Imaging (78579) | $650.40 | $1,084 | 1.6× |
| Lymph System Imaging (78195) | $950.40 | $1,584 | 1.7× |
| Mammary ductogram or galactogram multiple (77054) | $315 | $525 | 1.3× |
| Mammary ductogram or galactogram single (77053) | $249.60 | $416 | 1.0× |
| Meckels Divert Exam (78290) | $418.20 | $697 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $2,532.60 | $4,221 | 7.2× |
| MRA head w/o contrast (70544) | $1,272.60 | $2,121 | 5.3× |
| MRA head with contrast (70545) | $1,310.40 | $2,184 | 3.7× |
| MRA neck w contrast (70548) | $1,675.20 | $2,792 | 4.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,193.60 | $3,656 | 6.3× |
| MRA neck w/o contrast (70547) | $1,626.60 | $2,711 | 6.8× |
| MRI abdomen w contrast (74182) | $1,797.60 | $2,996 | 5.1× |
| MRI abdomen w/o contrast (74181) | $1,737.60 | $2,896 | 7.2× |
| MRI any jt lower extrem w/contrast material (73722) | $2,160 | $3,600 | 2.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,904.40 | $3,174 | 5.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,545.60 | $2,576 | 2.0× |
| MRI brain functional w/o physician admnistration (70554) | $1,066.80 | $1,778 | 4.5× |
| MRI cervical spine w contrast (72142) | $1,905 | $3,175 | 5.4× |
| MRI cervical spine w/o cont (72141) | $1,849.80 | $3,083 | 7.7× |
| MRI chest w/o contrast (71550) | $1,315.80 | $2,193 | 5.5× |
| MRI chest with contrast (71551) | $1,356 | $2,260 | 1.7× |
| MRI chest wo w contrast (71552) | $1,951.80 | $3,253 | 5.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,741.80 | $2,903 | 5.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,322 | $3,870 | 6.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,726.80 | $2,878 | 7.2× |
| MRI lumbar spine w contrast (72149) | $1,862.40 | $3,104 | 5.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,533.80 | $4,223 | 7.2× |
| MRI orbit face &/neck w/o contrast (70540) | $1,267.20 | $2,112 | 5.3× |
| MRI orbit face neck w contrast (70542) | $1,286.40 | $2,144 | 3.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,192.40 | $3,654 | 6.3× |
| MRI pelvis w contrast (72196) | $1,647.60 | $2,746 | 4.7× |
| MRI pelvis w/o & w contrast (72197) | $2,047.80 | $3,413 | 5.8× |
| MRI pelvis w/o contrast (72195) | $1,518 | $2,530 | 6.3× |
| MRI thoracic spine w/o contrast (72146) | $1,660.20 | $2,767 | 6.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,782 | $2,970 | 7.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,709.60 | $4,516 | 7.7× |
| MRI, abdomen, combo (74183) | $2,400 | $4,000 | 6.8× |
| MRI, dorsal spine combo (72157) | $2,681.40 | $4,469 | 7.7× |
| MRI, dorsal spine contrast (72147) | $1,933.80 | $3,223 | 5.5× |
| MRI, joint upper extrem (73221) | $1,985.40 | $3,309 | 8.3× |
| MRI, joint upper extrem combo (73223) | $1,872 | $3,120 | 5.3× |
| MRI, lumbar spine combo (72158) | $2,608.80 | $4,348 | 7.4× |
| Myelogram cervical (72240) | $858 | $1,430 | 1.1× |
| Myelogram Lumbar (72265) | $1,339.20 | $2,232 | 1.7× |
| Myelography thoracic (72255) | $1,108.80 | $1,848 | 1.4× |
| Myelograpy 2/more regions rs&i (72270) | $1,424.40 | $2,374 | 1.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,042.20 | $1,737 | 0.8× |
| Myocardial Spect Multiple Studies (78452) | $2,514 | $4,190 | 1.9× |
| Neck soft tissue (70360) | $130.80 | $218 | 1.5× |
| Nm myocard infarct spect (78469) | $477 | $795 | 0.9× |
| Nonvascular Shunt X-Ray (75809) | $766.80 | $1,278 | 7.3× |
| Nuclear Rx Intra-Arterial (79445) | $529.20 | $882 | 2.3× |
| Ob us nuchal meas 1 gest (76813) | $392.40 | $654 | 3.7× |
| Parathyroid Planar Imaging (78070) | $996.60 | $1,661 | 2.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,309.80 | $2,183 | 3.3× |
| Pelvis 1 or 2 views (72170) | $223.80 | $373 | 2.1× |
| Peritoneogram Rs&I (74190) | $342 | $570 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $301.20 | $502 | 0.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $398.40 | $664 | 3.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $271.20 | $452 | 0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) | $246.60 | $411 | 2.8× |
| Radex Calcaneus Minimum 2 Views (73650) | $100.80 | $168 | 1.2× |
| Radex elbow complete minimum 3 views (73080) | $271.20 | $452 | 3.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $220.80 | $368 | 2.1× |
| Radex fingr minimum 2 views (73140) | $180.60 | $301 | 2.1× |
| Radex foot complete minimum 3 views (73630) | $318.60 | $531 | 3.6× |
| Radex Hand Minimum 3 Views (73130) | $277.20 | $462 | 3.2× |
| Radex lower extremity infant minimum 2 views (73592) | $109.20 | $182 | 1.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $184.80 | $308 | 2.1× |
| Radex Ribs Unilateral 2 Views (71100) | $229.20 | $382 | 2.6× |
| Radex shoulder complete minimum 2 views (73030) | $255 | $425 | 2.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $114.60 | $191 | 1.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $285 | $475 | 1.6× |
| Radex Spine 1 View Specify Level (72020) | $235.80 | $393 | 2.7× |
| Radex Sternum Minimum 2 Views (71120) | $171.60 | $286 | 2.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $181.20 | $302 | 2.1× |
| Radex Toe Minimum 2 Views (73660) | $159.60 | $266 | 1.8× |
| Radex upper extremity infant minimum 2 views (73092) | $103.20 | $172 | 1.0× |
| Radex Wrist Complete Minimum 3 Views (73110) | $258 | $430 | 3.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $562.80 | $938 | 5.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $137.40 | $229 | 1.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $193.20 | $322 | 1.8× |
| Radiologic exam colon double contrast study (74280) | $588 | $980 | 3.3× |
| Radiologic exam colon single contrast study (74270) | $516.60 | $861 | 2.9× |
| Radiologic exam knee complete 4/more views (73564) | $311.40 | $519 | 3.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $280.80 | $468 | 2.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $453.60 | $756 | 2.6× |
| Radiologic exam swallow function contrast study (74230) | $440.40 | $734 | 2.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $433.20 | $722 | 2.5× |
| Radiologic examination femur 1 view (73551) | $126 | $210 | 1.4× |
| Radiologic examination femur minimum 2 views (73552) | $194.40 | $324 | 2.2× |
| Radiologic examination knee 1/2 views (73560) | $228 | $380 | 2.6× |
| Radiologic Examination Osseous Survey Limited (77074) | $263.40 | $439 | 2.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $255 | $425 | 2.9× |
| Ribs bilateral 3 views (71110) | $342 | $570 | 3.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $795.60 | $1,326 | 1.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,035 | $1,725 | 1.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $627.60 | $1,046 | 1.2× |
| Scapula (73010) | $195.60 | $326 | 1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $57.60 | $96 | 2.5× |
| Shoulder 1 view (73020) | $223.20 | $372 | 2.6× |
| Shoulder Arthrography (73040) | $172.20 | $287 | 0.5× |
| Skull less than 4 views (70250) | $207 | $345 | 2.0× |
| Spleen Imaging (78185) | $276.60 | $461 | 0.7× |
| Sternoclavicular joints (71130) | $216 | $360 | 2.5× |
| Testicular Imaging W/Flow (78761) | $440.40 | $734 | 1.1× |
| Thoracic spine 2 views (72070) | $234 | $390 | 2.2× |
| Thoracic spine 3 views (72072) | $297.60 | $496 | 2.8× |
| Thoracolumbar 2 views (72080) | $234 | $390 | 2.7× |
| Thyroid Uptake Measurement (78012) | $133.20 | $222 | 0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $525.60 | $876 | 1.3× |
| Ultrasound Breast Limited (76642) | $153 | $255 | 1.8× |
| Ultrasound elastography first target lesion (76982) | $763.20 | $1,272 | 7.3× |
| Ultrasound Elastography Parenchyma (76981) | $763.20 | $1,272 | 7.3× |
| Ultrasound Exam Aaa Screen (76706) | $484.80 | $808 | 4.6× |
| Ultrasound, abdomen limited (76705) | $445.80 | $743 | 4.2× |
| Unlisted Dx Radiographic Procedure (76499) | $379.80 | $633 | 4.3× |
| Unlisted fluoroscopic procedure (76496) | $264 | $440 | 3.0× |
| Unlisted us procedure (76999) | $250.20 | $417 | 2.9× |
| Upper gi w/o kub (74240) | $462.60 | $771 | 2.6× |
| Ureteral Reflux Study (78740) | $318 | $530 | 0.8× |
| Urethrocystogram voiding (74455) | $254.40 | $424 | 1.1× |
| Urethrocystography retrograde (74450) | $321 | $535 | 1.3× |
| Us breast unilateral complete (76641) | $153 | $255 | 1.5× |
| Us chest (76604) | $311.40 | $519 | 3.0× |
| Us complete joint (76881) | $557.40 | $929 | 5.3× |
| Us exam, pelvic, limited (76857) | $412.80 | $688 | 3.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $278.40 | $464 | 2.7× |
| Us ob detailed single fetus (76811) | $398.40 | $664 | 1.7× |
| Us ob limited 1 or more fetuses (76815) | $125.40 | $209 | 1.2× |
| Us ob transvaginal (76817) | $206.40 | $344 | 2.0× |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$487.24–$527.40 | $812.06–$879 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $364.80 | $608 | 3.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $87.60 | $146 | 0.8× |
| Us retroperitoneal complete (76770) | $421.20 | $702 | 4.0× |
| Us retroperitoneal limited (76775) | $421.20 | $702 | 4.0× |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$368.18–$398.40 | $613.63–$664 | varies |
| Us spinal canal and contents (76800) | $252.60 | $421 | 2.4× |
| Us thyroid (76536) | $420.60 | $701 | 4.0× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$1,092–$1,681.20 | $1,820–$2,802 | varies |
| Venogram Sinus/Jugular (75860) | $1,021.20 | $1,702 | 0.3× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$1,176.60–$1,899.60 | $1,961–$3,166 | varies |
| Venography extremity bilateral rs&i (75822) | $489.60 | $816 | 0.3× |
| Venography extremity unilateral rs&i (75820) | $764.40 | $1,274 | 0.5× |
| Venography Renal Unilateral (75831) | $1,047.60 | $1,746 | 0.3× |
| Wrist 2 views (73100) | $254.40 | $424 | 2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $94.20 | $157 | 1.1× |
| X-ray antegrade pyelogram tube (74425) | $480 | $800 | 1.4× |
| X-Ray Aorta Leg Arteries (75630) | $3,177 | $5,295 | 1.0× |
| X-Ray Bend Only L-S Spine (72120) | $399.60 | $666 | 3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $254.40 | $424 | 2.9× |
| X-Ray Exam Breast Specimen (76098) | $94.80 | $158 | 0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $145.80 | $243 | 1.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $285 | $475 | 2.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $423.60 | $706 | 4.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $112.20 | $187 | 1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $189 | $315 | 2.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $265.80 | $443 | 2.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $213 | $355 | 2.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $318.60 | $531 | 3.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $425.40 | $709 | 4.1× |
| X-Ray Exam L-S Spine Bending (72114) | $442.80 | $738 | 4.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $254.40 | $424 | 2.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $357.60 | $596 | 3.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $352.80 | $588 | 3.4× |
| X-ray eye for foreign body (70030) | $223.20 | $372 | 2.6× |
| X-ray head for orthodontia (70350) | $112.80 | $188 | 1.3× |
| X-ray humerus (73060) | $258 | $430 | 3.0× |
| X-ray IV pyelogram (ivp) (74400) | $514.80 | $858 | 2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $261.60 | $436 | 3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $265.20 | $442 | 2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $432.60 | $721 | 4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $130.20 | $217 | 1.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $90.60 | $151 | 0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $227.40 | $379 | 2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $246 | $410 | 2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $294 | $490 | 2.8× |
| X-Ray Stress View (77071) | $90.60 | $151 | 1.0× |
| X-ray thoracic spine 4 vw (72074) | $372 | $620 | 3.5× |
| X-Ray Tmj Unilat (70328) | $90.60 | $151 | 1.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $538.80 | $898 | 1.5× |
| X-Rays Bone Survey Complete (77075) | $706.80 | $1,178 | 6.7× |
| Xr c-spine 4 or 5 views (72050) | $342 | $570 | 3.3× |
| Xr facial bones less than 3 views (70140) | $93 | $155 | 1.1× |
| Xr orbits complete 4 views (70200) | $99 | $165 | 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.