Imaging prices at Baylor Scott and White Surgical Hospital at Sherma
Sherman, TX · every code in this section with a posted price and a Medicare benchmark.
254 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) | $216 | $360 | 2.5× |
| Abdomen 2 views (74019) | $250.20 | $417 | 2.4× |
| Angio internal mammary (75756) | $4,140 | $6,900 | 1.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,672 | $6,120 | 1.2× |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$2,257.20–$4,099.80 | $3,762–$6,833 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$3,942–$4,099.80 | $6,570–$6,833 | varies |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$266.40–$534 | $444–$890 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$6,951.60–$7,229.40 | $11,586–$12,049 | varies |
| Aortography thoracic w/o serialography rs&i (75600) | $4,140 | $6,900 | 1.3× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$6,951.60–$7,229.40 | $11,586–$12,049 | varies |
| Artery X-Rays Adrenal Gland (75731) | $3,672 | $6,120 | 1.2× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$6,951.60–$7,229.40 | $11,586–$12,049 | varies |
| Arthrogram ankle (73615) range across 8 matching MRF lines |
$793.20–$1,983.60 | $1,322–$3,306 | varies |
| Arthrogram hip (73525) range across 11 matching MRF lines |
$799.80–$2,000.40 | $1,333–$3,334 | varies |
| Arthrogram Wrist (73115) range across 10 matching MRF lines |
$653.40–$1,633.80 | $1,089–$2,723 | varies |
| Bone age studies (77072) | $233.40 | $389 | 2.2× |
| Bone Imaging Limited Area (78300) | $332.40 | $554 | 0.8× |
| Bone Imaging Whole Body (78306) | $966.60 | $1,611 | 2.4× |
| Chest 1 view (71045) | $216 | $360 | 2.5× |
| Chest 2 views (71046) | $292.20 | $487 | 3.3× |
| Chest 3 views (71047) | $358.20 | $597 | 4.1× |
| Chest 4 or more views (71048) | $347.40 | $579 | 3.3× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$275.40–$550.20 | $459–$917 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $409.20 | $682 | 3.9× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$3,942–$4,099.80 | $6,570–$6,833 | varies |
| Contrast X-Ray Bladder (74430) | $641.40 | $1,069 | 1.8× |
| Contrast X-Ray Of Elbow (73085) range across 9 matching MRF lines |
$753–$1,885.20 | $1,255–$3,142 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 9 matching MRF lines |
$973.20–$2,433.60 | $1,622–$4,056 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $375.60 | $626 | 2.1× |
| CT abdomen and pelvis without and with contrast (74178) | $900 | $1,500 | 2.6× |
| CT abdomen and pelvis without contrast (74176) | $566.40 | $944 | 2.4× |
| CT abdomen w contrast (74160) | $2,601 | $4,335 | 14.7× |
| CT abdomen w wo contrast (74170) | $3,201.60 | $5,336 | 18.1× |
| CT abdomen w/o contrast (74150) | $2,184.60 | $3,641 | 20.7× |
| CT Angio Abdomen and Pelvis (74174) | $900 | $1,500 | 2.6× |
| CT Angio Chest (71275) | $3,642 | $6,070 | 20.6× |
| CT Angio Head (70496) | $2,884.20 | $4,807 | 16.3× |
| CT angio hrt w/3d image (75574) | $1,408.80 | $2,348 | 4.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 55 matching MRF lines |
$2,050.20–$4,102.20 | $3,417–$6,837 | varies |
| CT Angio Neck (70498) | $2,884.20 | $4,807 | 16.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 16 matching MRF lines |
$2,150.40–$4,301.40 | $3,584–$7,169 | varies |
| CT bone density (77078) | $499.80 | $833 | 5.7× |
| CT cervical spine w/ contrast (72126) | $2,268 | $3,780 | 6.4× |
| CT cervical spine w/o contrast (72125) | $1,876.80 | $3,128 | 17.8× |
| CT cervical spine w/wo cont (72127) | $2,794.20 | $4,657 | 15.8× |
| CT chest w contrast (71260) | $2,335.20 | $3,892 | 13.2× |
| CT chest w/wo contrast (71270) | $2,960.40 | $4,934 | 16.7× |
| CT colonography screening (74263) | $241.20 | $402 | 1.0× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $609.60 | $1,016 | 3.4× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $307.80 | $513 | 2.9× |
| CT head/brain with contrast (70460) | $1,709.40 | $2,849 | 9.7× |
| CT head/brain without and with contrast (70470) | $2,184.60 | $3,641 | 12.4× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,418.40 | $2,364 | 4.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $126 | $210 | 1.4× |
| CT hrt w/3d image congen (75573) | $1,408.80 | $2,348 | 4.0× |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$1,741.20–$3,484.80 | $2,902–$5,808 | varies |
| CT l-spine w&w/o contrast (72133) | $2,668.20 | $4,447 | 15.1× |
| CT lower ext w/o (73700) range across 19 matching MRF lines |
$1,117.80–$2,233.80 | $1,863–$3,723 | varies |
| CT lower extremity w/contrast material (73701) range across 19 matching MRF lines |
$1,267.20–$2,534.40 | $2,112–$4,224 | varies |
| CT lumbar spine w contrast (72132) | $2,209.80 | $3,683 | 6.3× |
| CT lumbar spine w/o contrast (72131) | $1,867.20 | $3,112 | 17.7× |
| CT maxillofacial w contrast (70487) | $1,726.20 | $2,877 | 9.8× |
| CT maxillofacial wo contrast (70486) | $1,500.60 | $2,501 | 14.2× |
| CT neck tissue combo (70492) | $2,158.80 | $3,598 | 12.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 5 matching MRF lines |
$2,168.40–$4,335 | $3,614–$7,225 | varies |
| CT orbits w/o contrast (70480) | $1,542.60 | $2,571 | 14.6× |
| CT pelvis w&w/o contrast (72194) | $2,368.20 | $3,947 | 13.4× |
| CT pelvis w/o contrast (72192) | $1,658.40 | $2,764 | 15.7× |
| CT scan of leg combo (73702) range across 18 matching MRF lines |
$1,641.60–$3,285.60 | $2,736–$5,476 | varies |
| CT scans face/jaw combo (70488) | $2,134.20 | $3,557 | 12.1× |
| CT soft tissue neck w contrast (70491) | $1,726.20 | $2,877 | 9.8× |
| CT soft tissue neck w/o contrast (70490) | $1,518 | $2,530 | 14.4× |
| CT thoracic spine w contrast (72129) | $2,251.20 | $3,752 | 12.7× |
| CT thoracic spine w/o contrast (72128) | $1,876.80 | $3,128 | 17.8× |
| CT thoracic spine w/wo cont (72130) | $2,751 | $4,585 | 15.6× |
| CT thorax w/o contrast (71250) | $2,085 | $3,475 | 19.8× |
| CT upper ext wo (73200) range across 24 matching MRF lines |
$1,149.60–$2,300.40 | $1,916–$3,834 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 22 matching MRF lines |
$1,592.40–$3,184.80 | $2,654–$5,308 | varies |
| CT upper extremity with contrast (73201) range across 21 matching MRF lines |
$1,325.40–$2,650.20 | $2,209–$4,417 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,017.80 | $3,363 | 11.4× |
| Cta Abdomen (74175) | $3,918 | $6,530 | 22.2× |
| CTA pelvis (72191) | $3,010.20 | $5,017 | 17.0× |
| Discography Cerv/Thor Spine (72285) | $7,969.80 | $13,283 | 4.0× |
| Diskography lumbar (72295) | $7,969.80 | $13,283 | 4.0× |
| Dxa Bone Density Axial (77080) | $233.40 | $389 | 2.2× |
| Echograp Trans R Pros Study (76873) | $459 | $765 | 4.4× |
| Esophagram (74220) | $466.20 | $777 | 2.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $325.80 | $543 | 3.1× |
| Fluoroscopy up to 1 hr (76000) | $382.80 | $638 | 1.6× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$258–$517.20 | $430–$862 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$258–$517.20 | $430–$862 | varies |
| Hand 2 views (73120) range across 6 matching MRF lines |
$275.40–$550.20 | $459–$917 | varies |
| Hysterosalpingogram (74740) | $809.40 | $1,349 | 3.4× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$332.40–$666.60 | $554–$1,111 | varies |
| Magnetic Image Jaw Joint (70336) | $1,175.40 | $1,959 | 4.9× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $4,035.60 | $6,726 | 7.3× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) | $5,310.60 | $8,851 | 30.0× |
| Mra Head W/O & W/Contrast Material (70546) | $2,101.20 | $3,502 | 6.0× |
| MRA head w/o contrast (70544) | $1,459.20 | $2,432 | 6.1× |
| MRA head with contrast (70545) | $1,617 | $2,695 | 4.6× |
| MRA neck w contrast (70548) | $1,633.80 | $2,723 | 4.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,101.20 | $3,502 | 6.0× |
| MRA neck w/o contrast (70547) | $1,434 | $2,390 | 6.0× |
| MRI abdomen w contrast (74182) range across 3 matching MRF lines |
$1,550.40–$1,703.40 | $2,584–$2,839 | varies |
| MRI abdomen w/o contrast (74181) | $4,560 | $7,600 | 19.0× |
| MRI any jt lower extrem w/contrast material (73722) range across 10 matching MRF lines |
$1,703.40–$3,406.80 | $2,839–$5,678 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 10 matching MRF lines |
$1,767–$3,535.80 | $2,945–$5,893 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 10 matching MRF lines |
$1,703.40–$3,406.80 | $2,839–$5,678 | varies |
| MRI cervical spine w contrast (72142) | $1,709.40 | $2,849 | 4.9× |
| MRI cervical spine w/o cont (72141) | $1,703.40 | $2,839 | 7.1× |
| MRI chest w/o contrast (71550) range across 5 matching MRF lines |
$1,676.40–$1,703.40 | $2,794–$2,839 | varies |
| MRI chest with contrast (71551) | $1,858.80 | $3,098 | 2.4× |
| MRI chest wo w contrast (71552) | $2,584.20 | $4,307 | 7.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 25 matching MRF lines |
$1,417.20–$3,406.80 | $2,362–$5,678 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 10 matching MRF lines |
$1,792.80–$3,585.60 | $2,988–$5,976 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 10 matching MRF lines |
$1,703.40–$3,406.80 | $2,839–$5,678 | varies |
| MRI lumbar spine w contrast (72149) | $1,783.80 | $2,973 | 5.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,217.60 | $3,696 | 6.3× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,703.40–$1,704.60 | $2,839–$2,841 | varies |
| MRI orbit face neck w contrast (70542) | $1,876.80 | $3,128 | 5.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,350.80 | $3,918 | 6.7× |
| MRI pelvis w contrast (72196) | $1,776 | $2,960 | 5.1× |
| MRI pelvis w/o & w contrast (72197) | $2,259.60 | $3,766 | 6.4× |
| MRI pelvis w/o contrast (72195) | $1,703.40 | $2,839 | 7.1× |
| MRI thoracic spine w/o contrast (72146) | $1,703.40 | $2,839 | 7.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 16 matching MRF lines |
$1,703.40–$3,406.80 | $2,839–$5,678 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 19 matching MRF lines |
$1,092.60–$3,406.80 | $1,821–$5,678 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 19 matching MRF lines |
$1,651.20–$3,406.80 | $2,752–$5,678 | varies |
| MRI, abdomen, combo (74183) | $1,960.20 | $3,267 | 5.6× |
| MRI, dorsal spine combo (72157) | $2,335.20 | $3,892 | 6.6× |
| MRI, dorsal spine contrast (72147) | $1,809 | $3,015 | 5.1× |
| MRI, joint upper extrem (73221) range across 12 matching MRF lines |
$1,703.40–$3,406.80 | $2,839–$5,678 | varies |
| MRI, joint upper extrem combo (73223) range across 10 matching MRF lines |
$1,851.60–$3,702 | $3,086–$6,170 | varies |
| MRI, lumbar spine combo (72158) | $2,317.80 | $3,863 | 6.6× |
| Myelogram cervical (72240) | $1,476 | $2,460 | 1.9× |
| Myelogram Lumbar (72265) | $1,476 | $2,460 | 1.9× |
| Myelograpy 2/more regions rs&i (72270) | $1,676.40 | $2,794 | 2.1× |
| N-invas est c ffr sw aly CTA (75580) | $2,336.40 | $3,894 | 2.7× |
| Neck soft tissue (70360) | $216 | $360 | 2.5× |
| Pelvis 1 or 2 views (72170) | $233.40 | $389 | 2.2× |
| Peritoneogram Rs&I (74190) | $839.40 | $1,399 | 1.5× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,315.20 | $2,192 | 1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $275.40 | $459 | 2.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$299.40–$601.20 | $499–$1,002 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 5 matching MRF lines |
$250.20–$499.80 | $417–$833 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$325.80–$650.40 | $543–$1,084 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $325.80 | $543 | 3.1× |
| Radex fingr minimum 2 views (73140) | $208.20 | $347 | 2.4× |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$292.20–$583.20 | $487–$972 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$275.40–$550.20 | $459–$917 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$233.40–$466.20 | $389–$777 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $208.20 | $347 | 2.4× |
| Radex Ribs Unilateral 2 Views (71100) | $275.40 | $459 | 3.1× |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$332.40–$666.60 | $554–$1,111 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $150.60 | $251 | 1.7× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $260.40 | $434 | 1.5× |
| Radex Spine 1 View Specify Level (72020) | $233.40 | $389 | 2.7× |
| Radex Sternum Minimum 2 Views (71120) | $299.40 | $499 | 3.4× |
| Radex Toe Minimum 2 Views (73660) | $241.20 | $402 | 2.7× |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$233.40–$466.20 | $389–$777 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$275.40–$550.20 | $459–$917 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $382.80 | $638 | 3.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $283.20 | $472 | 2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $250.20 | $417 | 2.4× |
| Radiologic exam colon single contrast study (74270) | $799.20 | $1,332 | 4.5× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$375.60–$749.40 | $626–$1,249 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $266.40 | $444 | 2.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $591.60 | $986 | 3.3× |
| Radiologic exam swallow function contrast study (74230) | $375.60 | $626 | 2.1× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $266.40 | $444 | 1.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $700.20 | $1,167 | 4.0× |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$325.80–$650.40 | $543–$1,084 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 7 matching MRF lines |
$325.80–$650.40 | $543–$1,084 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$283.20–$566.40 | $472–$944 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $352.80 | $588 | 3.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 7 matching MRF lines |
$283.20–$566.40 | $472–$944 | varies |
| Ribs bilateral 3 views (71110) | $367.20 | $612 | 3.5× |
| Scapula (73010) range across 4 matching MRF lines |
$325.80–$650.40 | $543–$1,084 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$233.40–$466.20 | $389–$777 | varies |
| Shoulder Arthrography (73040) range across 9 matching MRF lines |
$746.40–$1,867.20 | $1,244–$3,112 | varies |
| Skull less than 4 views (70250) | $266.40 | $444 | 2.5× |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$150.60–$299.40 | $251–$499 | varies |
| Thoracic spine 2 views (72070) | $350.40 | $584 | 3.3× |
| Thoracic spine 3 views (72072) | $416.40 | $694 | 4.0× |
| Thoracolumbar 2 views (72080) | $382.80 | $638 | 4.4× |
| Ultrasound Breast Limited (76642) | $224.40 | $374 | 2.6× |
| Ultrasound Exam Aaa Screen (76706) | $298.20 | $497 | 2.8× |
| Ultrasound, abdomen limited (76705) | $325.80 | $543 | 3.1× |
| Unlisted fluoroscopic procedure (76496) | $332.40 | $554 | 3.8× |
| Unlisted magnetic resonance procedure (76498) | $3,120.60 | $5,201 | 35.6× |
| Unlisted us procedure (76999) | $224.40 | $374 | 2.6× |
| Upper gi w/o kub (74240) | $634.20 | $1,057 | 3.6× |
| Urethrocystography retrograde (74450) | $411.60 | $686 | 1.7× |
| Us breast unilateral complete (76641) | $224.40 | $374 | 2.1× |
| Us chest (76604) | $325.80 | $543 | 3.1× |
| Us complete joint (76881) range across 7 matching MRF lines |
$325.80–$650.40 | $543–$1,084 | varies |
| Us exam, pelvic, limited (76857) | $283.20 | $472 | 2.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 9 matching MRF lines |
$224.40–$450.60 | $374–$751 | varies |
| Us ob detailed single fetus (76811) | $459 | $765 | 1.9× |
| Us ob limited 1 or more fetuses (76815) | $224.40 | $374 | 2.1× |
| Us ob transvaginal (76817) | $325.80 | $543 | 3.1× |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$260.40–$325.80 | $434–$543 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $325.80 | $543 | 3.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $224.40 | $374 | 2.1× |
| Us retroperitoneal complete (76770) | $325.80 | $543 | 3.1× |
| Us retroperitoneal limited (76775) | $325.80 | $543 | 3.1× |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$260.40–$325.80 | $434–$543 | varies |
| Us spinal canal and contents (76800) | $250.20 | $417 | 2.4× |
| Us thyroid (76536) | $325.80 | $543 | 3.1× |
| Us transrectal (76872) | $325.80 | $543 | 3.1× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$2,049.60–$2,131.80 | $3,416–$3,553 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$4,173–$4,339.80 | $6,955–$7,233 | varies |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$2,365.80–$2,460.60 | $3,943–$4,101 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$2,365.80–$2,460.60 | $3,943–$4,101 | varies |
| Venography Renal Bilateral (75833) | $2,286.60 | $3,811 | 0.7× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$241.20–$484.20 | $402–$807 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $375.60 | $626 | 4.3× |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$4,173–$4,339.80 | $6,955–$7,233 | varies |
| X-Ray Bend Only L-S Spine (72120) | $499.80 | $833 | 4.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$258–$517.20 | $430–$862 | varies |
| X-Ray Exam Breast Specimen (76098) | $809.40 | $1,349 | 1.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $382.80 | $638 | 4.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $382.80 | $638 | 3.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $382.80 | $638 | 3.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $258 | $430 | 2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $325.80 | $543 | 3.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $325.80 | $543 | 3.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $292.20 | $487 | 2.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $292.20 | $487 | 2.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $292.20 | $487 | 2.8× |
| X-Ray Exam L-S Spine Bending (72114) | $641.40 | $1,069 | 6.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $341.40 | $569 | 3.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $575.40 | $959 | 5.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $316.80 | $528 | 3.0× |
| X-ray eye for foreign body (70030) | $266.40 | $444 | 3.0× |
| X-ray humerus (73060) range across 6 matching MRF lines |
$307.80–$617.40 | $513–$1,029 | varies |
| X-ray IV pyelogram (ivp) (74400) | $709.20 | $1,182 | 4.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $150.60 | $251 | 1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $266.40 | $444 | 3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $358.20 | $597 | 3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $434.40 | $724 | 4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 4 matching MRF lines |
$233.40–$466.20 | $389–$777 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 4 matching MRF lines |
$175.20–$350.40 | $292–$584 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $208.20 | $347 | 2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $400.80 | $668 | 4.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $382.80 | $638 | 3.6× |
| X-ray thoracic spine 4 vw (72074) | $508.80 | $848 | 4.8× |
| X-Ray Tmj Unilat (70328) | $382.80 | $638 | 4.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $641.40 | $1,069 | 1.8× |
| X-Rays Bone Survey Complete (77075) | $382.80 | $638 | 3.6× |
| Xr c-spine 4 or 5 views (72050) | $484.20 | $807 | 4.6× |
| Xr facial bones less than 3 views (70140) | $266.40 | $444 | 3.0× |
| XR Mastoids < 3 Views Bilateral (70120) | $260.40 | $434 | 2.5× |
| Xr orbits complete 4 views (70200) | $341.40 | $569 | 3.2× |
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.