Imaging prices at Baystate Franklin Medical Center
Greenfield, MA · every code in this section with a posted price and a Medicare benchmark.
261 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) | $357.75 | $357.75 | 3.4× |
| Abdomen 2 views (74019) | $524.86 | $524.86 | 4.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,347.87 | $1,347.87 | 2.8× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$425.57–$542 | $425.57–$542 | varies |
| Arthrogram hip (73525) | $1,346.80 | $1,346.80 | 3.2× |
| Basic radiation dosimetry calculation (77300) | $766.88 | $766.88 | 4.8× |
| Bone age studies (77072) | $611 | $611 | 4.9× |
| Bone Imaging 3 Phase (78315) | $1,630.66 | $1,630.66 | 3.4× |
| Bone Imaging Limited Area (78300) | $1,264.08 | $1,264.08 | 2.6× |
| Bone Imaging Whole Body (78306) | $1,646.40 | $1,646.40 | 3.4× |
| Bone marrow imaging limited area (78102) | $1,347.87 | $1,347.87 | 2.8× |
| Bone survey infant (77076) | $611 | $611 | 4.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,958 | $2,958 | 7.1× |
| Cat Scan Follow-Up Study (76380) | $731 | $731 | 7.0× |
| Chest 1 view (71045) | $267 | $267 | 2.6× |
| Chest 2 views (71046) | $339 | $339 | 3.3× |
| Chest 3 views (71047) | $343 | $343 | 3.3× |
| Chest 4 or more views (71048) | $512 | $512 | 4.1× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$442.80–$451.12 | $442.80–$451.12 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,163 | $1,163 | 9.3× |
| Contrast X-Ray Bladder (74430) | $1,186 | $1,186 | 2.8× |
| Contrast X-Ray Of Knee Joint (73580) | $2,134 | $2,134 | 5.1× |
| Contrast Xray Throat/Cerv Esopha (74210) | $623 | $623 | 3.0× |
| CT abdomen and pelvis without and with contrast (74178) | $3,509 | $3,509 | 8.4× |
| CT abdomen and pelvis without contrast (74176) | $2,083 | $2,083 | 7.3× |
| CT abdomen w contrast (74160) | $1,545 | $1,545 | 7.3× |
| CT abdomen w wo contrast (74170) | $1,838 | $1,838 | 8.7× |
| CT abdomen w/o contrast (74150) | $1,255 | $1,255 | 10.0× |
| CT Angio Abdomen and Pelvis (74174) | $5,483 | $5,483 | 13.1× |
| CT Angio Chest (71275) | $1,752 | $1,752 | 8.3× |
| CT Angio Head (70496) | $1,508 | $1,508 | 7.2× |
| CT angio hrt w/3d image (75574) | $2,095 | $2,095 | 5.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,408 | $2,408 | 11.5× |
| CT Angio Neck (70498) | $1,400 | $1,400 | 6.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,996 | $1,996 | 9.5× |
| CT cervical spine w/ contrast (72126) | $1,843 | $1,843 | 4.4× |
| CT cervical spine w/o contrast (72125) | $1,165 | $1,165 | 9.3× |
| CT chest w contrast (71260) | $1,475 | $1,475 | 7.0× |
| CT colonography screening (74263) | $3,894 | $3,894 | 13.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $2,436 | $2,436 | 19.4× |
| CT head/brain with contrast (70460) | $1,256 | $1,256 | 6.0× |
| CT head/brain without and with contrast (70470) | $1,382 | $1,382 | 6.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,465 | $1,465 | 3.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $1,064 | $1,064 | 10.2× |
| CT iac w contrast (70481) | $1,282 | $1,282 | 6.1× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,168–$1,653.05 | $1,168–$1,653.05 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,688–$2,226.89 | $1,688–$2,226.89 | varies |
| CT lumbar spine w contrast (72132) | $2,150 | $2,150 | 5.1× |
| CT lumbar spine w/o contrast (72131) | $1,382 | $1,382 | 11.0× |
| CT maxillofacial w contrast (70487) | $1,256 | $1,256 | 6.0× |
| CT maxillofacial wo contrast (70486) | $1,014 | $1,014 | 8.1× |
| CT neck tissue combo (70492) | $1,678 | $1,678 | 8.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,903 | $1,903 | 9.1× |
| CT orbits w/o contrast (70480) | $1,014 | $1,014 | 8.1× |
| CT pelvis w&w/o contrast (72194) | $2,040 | $2,040 | 9.7× |
| CT pelvis w/o contrast (72192) | $1,346 | $1,346 | 10.7× |
| CT scan of leg combo (73702) | $1,800 | $1,800 | 8.6× |
| CT scans face/jaw combo (70488) | $1,391 | $1,391 | 6.6× |
| CT soft tissue neck w contrast (70491) | $1,282 | $1,282 | 6.1× |
| CT soft tissue neck w/o contrast (70490) | $1,014 | $1,014 | 8.1× |
| CT thoracic spine w contrast (72129) | $1,546 | $1,546 | 7.4× |
| CT thoracic spine w/o contrast (72128) | $1,407 | $1,407 | 11.2× |
| CT thoracic spine w/wo cont (72130) | $2,665 | $2,665 | 12.7× |
| CT thorax w/o contrast (71250) | $1,163 | $1,163 | 9.3× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,178–$1,237 | $1,178–$1,237 | varies |
| CT upper extremity with contrast (73201) | $2,150 | $2,150 | 5.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,895 | $1,895 | 9.0× |
| Cta Abdomen (74175) | $1,701 | $1,701 | 8.1× |
| CTA pelvis (72191) | $2,254 | $2,254 | 10.7× |
| Doppler Fetal Mid Cerebral Artery (76821) | $543 | $543 | 4.3× |
| Dxa Bone Density Axial (77080) | $636 | $636 | 5.1× |
| Dxa bone density study (77085) | $615 | $615 | 4.9× |
| Echo exam uterus (76831) | $932 | $932 | 3.3× |
| Esophagram (74220) | $808.22 | $808.22 | 3.8× |
| Fetal Biophys Profile W/Nst (76818) | $978 | $978 | 7.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $932 | $932 | 7.4× |
| Fluoroscopy up to 1 hr (76000) | $930 | $930 | 3.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$397.40–$424.35 | $397.40–$424.35 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$442.80–$463.50 | $442.80–$463.50 | varies |
| Gated Heart, Multiple (78473) | $1,372 | $1,372 | 2.9× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$611–$733.20 | $611–$733.20 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,981.18 | $1,981.18 | 3.0× |
| Ht Muscle Image Spect Sing (78451) | $4,570 | $4,570 | 2.9× |
| Hysterosalpingogram (74740) | $2,176 | $2,176 | 7.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $717 | $717 | 6.9× |
| K Flow/Funct Image Multiple (78709) | $1,821 | $1,821 | 2.8× |
| K Flow/Funct Image W/Drug (78708) | $2,458.35 | $2,458.35 | 3.8× |
| K Flow/Funct Image W/O Drug (78707) | $1,821 | $1,821 | 2.8× |
| Kidney Imaging Morphol (78700) | $1,347.87 | $1,347.87 | 2.8× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$406–$504.58 | $406–$504.58 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,372 | $1,372 | 2.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,372 | $1,372 | 2.9× |
| Lung Perf&Ventilat Diferentl (78598) | $1,821 | $1,821 | 2.8× |
| Lung Ventilat&Perfus Imaging (78582) | $1,821 | $1,821 | 2.8× |
| Lung Ventilation Imaging (78579) | $1,372 | $1,372 | 2.9× |
| Lymph System Imaging (78195) | $1,576.94 | $1,576.94 | 2.4× |
| Magnetic Image Jaw Joint (70336) | $2,369.60 | $2,369.60 | 8.3× |
| Meckels Divert Exam (78290) | $1,372 | $1,372 | 2.9× |
| Mlc imrt design & construction per imrt plan (77338) | $2,835 | $2,835 | 6.3× |
| Mra Head W/O & W/Contrast Material (70546) | $3,049 | $3,049 | 7.3× |
| MRA head w/o contrast (70544) | $1,995 | $1,995 | 7.0× |
| MRA head with contrast (70545) | $2,838 | $2,838 | 6.8× |
| MRA neck w contrast (70548) | $2,838 | $2,838 | 6.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,662 | $3,662 | 8.8× |
| MRA neck w/o contrast (70547) | $2,002 | $2,002 | 7.0× |
| MRI abdomen w/o contrast (74181) | $1,985 | $1,985 | 6.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,980 | $2,980 | 7.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,901.18 | $2,901.18 | 3.1× |
| MRI cardiac w/o contrast (75557) | $2,402 | $2,402 | 8.4× |
| MRI cervical spine w contrast (72142) | $2,838 | $2,838 | 6.8× |
| MRI cervical spine w/o cont (72141) | $1,961 | $1,961 | 6.9× |
| MRI chest w/o contrast (71550) | $2,321 | $2,321 | 8.1× |
| MRI chest wo w contrast (71552) | $4,141 | $4,141 | 9.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,611.63 | $2,611.63 | 6.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,072.51 | $3,072.51 | 7.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,851 | $1,851 | 6.5× |
| MRI lumbar spine w contrast (72149) | $2,838 | $2,838 | 6.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,325 | $3,325 | 8.0× |
| MRI orbit face &/neck w/o contrast (70540) | $2,951 | $2,951 | 10.3× |
| MRI orbit face neck w contrast (70542) | $4,136 | $4,136 | 9.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,359 | $4,359 | 10.4× |
| MRI pelvis w/o & w contrast (72197) | $3,321.11 | $3,321.11 | 7.9× |
| MRI pelvis w/o contrast (72195) | $2,336.97 | $2,336.97 | 8.2× |
| MRI thoracic spine w/o contrast (72146) | $1,961 | $1,961 | 6.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,442.84 | $2,442.84 | 8.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,231.31 | $3,231.31 | 7.7× |
| MRI, abdomen, combo (74183) | $3,281 | $3,281 | 7.8× |
| MRI, dorsal spine combo (72157) | $3,325 | $3,325 | 8.0× |
| MRI, dorsal spine contrast (72147) | $2,838 | $2,838 | 6.8× |
| MRI, joint upper extrem (73221) | $2,104.80 | $2,104.80 | 7.4× |
| MRI, joint upper extrem combo (73223) | $2,931 | $2,931 | 7.0× |
| MRI, lumbar spine combo (72158) | $3,452 | $3,452 | 8.3× |
| Myelogram cervical (72240) | $3,492.24 | $3,492.24 | 3.7× |
| Myelogram Lumbar (72265) | $3,492.24 | $3,492.24 | 3.7× |
| Myelograpy 2/more regions rs&i (72270) | $3,492.24 | $3,492.24 | 3.7× |
| Myocardial Spect Multiple Studies (78452) | $5,050.53 | $5,050.53 | 3.3× |
| Neck soft tissue (70360) | $457.18 | $457.18 | 4.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $9,710 | $9,710 | 5.9× |
| Nuclear Rx Oral Admin (79005) | $1,030 | $1,030 | 3.7× |
| Ob us nuchal meas 1 gest (76813) | $692.40 | $692.40 | 5.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$328–$742 | $328–$742 | varies |
| Pelvis 1 or 2 views (72170) | $611 | $611 | 4.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,372 | $1,372 | 2.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $734.75 | $734.75 | 5.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,176 | $2,176 | 3.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$487.20–$494.57 | $487.20–$494.57 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$369–$486.14 | $369–$486.14 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$465.60–$515 | $465.60–$515 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $611 | $611 | 4.9× |
| Radex fingr minimum 2 views (73140) | $424.78 | $424.78 | 4.1× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$441.90–$545 | $441.90–$545 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$672.10–$733.20 | $672.10–$733.20 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $369 | $369 | 3.5× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $623.17 | $623.17 | 6.0× |
| Radex Ribs Unilateral 2 Views (71100) | $478.77 | $478.77 | 4.6× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$442.80–$531.44 | $442.80–$531.44 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $369 | $369 | 3.5× |
| Radex Spine 1 View Specify Level (72020) | $369 | $369 | 3.5× |
| Radex Sternum Minimum 2 Views (71120) | $414 | $414 | 4.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $379 | $379 | 3.6× |
| Radex Toe Minimum 2 Views (73660) | $369 | $369 | 3.5× |
| Radex upper extremity infant minimum 2 views (73092) | $381 | $381 | 3.0× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$468–$536 | $468–$536 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $611 | $611 | 4.9× |
| Radiologic exam colon double contrast study (74280) | $1,186 | $1,186 | 5.6× |
| Radiologic exam colon single contrast study (74270) | $1,166.40 | $1,166.40 | 5.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $643 | $643 | 3.1× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$611–$877 | $611–$877 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $642 | $642 | 5.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $623 | $623 | 3.0× |
| Radiologic exam swallow function contrast study (74230) | $870.75 | $870.75 | 4.1× |
| Radiologic exam teeth complete full mouth (70320) | $1,164 | $1,164 | 4.1× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $1,164 | $1,164 | 4.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $677 | $677 | 3.2× |
| Radiologic examination femur 1 view (73551) | $369 | $369 | 3.5× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$393–$460 | $393–$460 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$369–$433 | $369–$433 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $611 | $611 | 4.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$369–$485 | $369–$485 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) | $416 | $416 | 4.0× |
| Ribs bilateral 3 views (71110) | $611 | $611 | 4.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,570 | $4,570 | 7.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,119.06 | $2,119.06 | 3.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $4,570 | $4,570 | 7.0× |
| Rp Therapy Intravenous Administration (79101) | $1,030 | $1,030 | 3.7× |
| Scapula (73010) range across 2 matching MRF lines |
$498.15–$515 | $498.15–$515 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$155–$209.25 | $155–$209.25 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$369–$515 | $369–$515 | varies |
| Shoulder Arthrography (73040) | $2,072 | $2,072 | 5.0× |
| Skull less than 4 views (70250) | $549.90 | $549.90 | 4.4× |
| Sternoclavicular joints (71130) | $455.40 | $455.40 | 4.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,003.11 | $1,003.11 | 4.8× |
| Thoracic spine 2 views (72070) | $659 | $659 | 5.3× |
| Thoracic spine 3 views (72072) | $673 | $673 | 5.4× |
| Thoracolumbar 2 views (72080) | $448 | $448 | 4.3× |
| Thyroid Imaging With Vascular Flow (78013) | $1,347.87 | $1,347.87 | 2.8× |
| Thyroid Met Imaging Body (78018) | $1,372 | $1,372 | 2.1× |
| Thyroid Uptake Measurement (78012) | $1,372 | $1,372 | 2.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,372 | $1,372 | 2.9× |
| Ultrasound Breast Limited (76642) range across 5 matching MRF lines |
$559–$1,116 | $559–$1,116 | varies |
| Ultrasound Elastography Parenchyma (76981) | $964 | $964 | 7.7× |
| Ultrasound Exam Aaa Screen (76706) | $457 | $457 | 3.6× |
| Ultrasound, abdomen limited (76705) range across 6 matching MRF lines |
$220–$932 | $220–$932 | varies |
| Umbilical-artery Doppler (OB) (76820) | $718.76 | $718.76 | 5.7× |
| Upper gi w/o kub (74240) | $913.95 | $913.95 | 4.3× |
| Ureteral Reflux Study (78740) | $1,372 | $1,372 | 2.9× |
| Urethrocystogram voiding (74455) | $2,176 | $2,176 | 7.6× |
| Urethrocystography retrograde (74450) | $1,186 | $1,186 | 4.1× |
| Us chest (76604) range across 3 matching MRF lines |
$220–$752.39 | $220–$752.39 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$292–$590.69 | $292–$590.69 | varies |
| Us head (76506) | $591 | $591 | 4.7× |
| Us kidney transplant (76776) | $932 | $932 | 7.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$126–$614.90 | $126–$614.90 | varies |
| Us ob detailed single fetus (76811) | $1,026 | $1,026 | 3.6× |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$262–$932 | $262–$932 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$297–$1,118.40 | $297–$1,118.40 | varies |
| Us pelvic non ob complete (76856) | $953.85 | $953.85 | 7.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $932 | $932 | 7.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $834.30 | $834.30 | 6.7× |
| Us retroperitoneal complete (76770) | $978 | $978 | 7.8× |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$220–$932 | $220–$932 | varies |
| Us scrotum and contents (76870) | $932 | $932 | 7.4× |
| Us spinal canal and contents (76800) | $678 | $678 | 5.4× |
| Us thyroid (76536) | $932 | $932 | 7.4× |
| Us transrectal (76872) | $932 | $932 | 7.4× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$235.20–$489 | $235.20–$489 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $327.56 | $327.56 | 3.1× |
| X-ray antegrade pyelogram tube (74425) | $1,931.65 | $1,931.65 | 4.6× |
| X-Ray Bend Only L-S Spine (72120) | $642 | $642 | 5.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$442.80–$483 | $442.80–$483 | varies |
| X-Ray Exam Breast Specimen (76098) | $2,196 | $2,196 | 3.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $369 | $369 | 3.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $843.77 | $843.77 | 6.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $369 | $369 | 3.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $388 | $388 | 3.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $611 | $611 | 4.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $642 | $642 | 5.1× |
| X-Ray Exam L-S Spine Bending (72114) | $673.65 | $673.65 | 5.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $640.99 | $640.99 | 6.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $744.49 | $744.49 | 5.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $665.22 | $665.22 | 5.3× |
| X-ray eye for foreign body (70030) | $424 | $424 | 4.1× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$369–$399 | $369–$399 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $369 | $369 | 3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $369 | $369 | 3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $611 | $611 | 4.9× |
| X-ray nose-rectum child f.b. (76010) | $1,186 | $1,186 | 11.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $841.05 | $841.05 | 6.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $810.07 | $810.07 | 6.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $611 | $611 | 4.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $472.19 | $472.19 | 4.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $460.34 | $460.34 | 4.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $611 | $611 | 4.9× |
| X-ray thoracic spine 4 vw (72074) | $727 | $727 | 5.8× |
| X-Ray Tmj Unilat (70328) | $369 | $369 | 3.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,176 | $2,176 | 5.2× |
| X-Rays Bone Length Studies (77073) | $477.90 | $477.90 | 3.8× |
| X-Rays Bone Survey Complete (77075) | $673 | $673 | 5.4× |
| Xr c-spine 4 or 5 views (72050) | $643.10 | $643.10 | 5.1× |
| Xr facial bones less than 3 views (70140) | $369 | $369 | 3.5× |
| Xr orbits complete 4 views (70200) | $727.90 | $727.90 | 5.8× |
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.