Imaging prices at Blessing Hospital
Quincy, IL · every code in this section with a posted price and a Medicare benchmark.
256 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) | $1,152.96 | $1,921.60 | 0.8× |
| Abdomen 1 View (74018) | $49.12 | $81.86 | 0.5× |
| Abdomen 2 views (74019) | $59.32 | $98.86 | 0.5× |
| Angio pulmonary bilat (75743) | $146.57 | $244.28 | 0.0× |
| Angiography extremity bilateral rs&i (75716) | $158.10 | $263.49 | 0.0× |
| Angiography extremity unilateral rs&i (75710) | $142.33 | $237.21 | 0.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $101.01 | $168.35 | 0.0× |
| Ankle 2 views (73600) | $78.24 | $130.39 | 0.8× |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$101.58 | $169.29 | 0.0× |
| Aortography thoracic w/o serialography rs&i (75600) | $44.27 | $73.78 | 0.0× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$158.99 | $264.97 | 0.0× |
| Arthrogram ankle (73615) | $198.32 | $330.52 | 0.5× |
| Arthrogram hip (73525) | $191.82 | $319.69 | 0.5× |
| Arthrogram Wrist (73115) | $200.05 | $333.41 | 0.5× |
| Basic radiation dosimetry calculation (77300) | $167.06 | $278.42 | 1.2× |
| Bone age studies (77072) | $42.36 | $70.59 | 0.4× |
| Bone survey infant (77076) | $187.29 | $312.14 | 1.7× |
| Brachytx isodose complex (77318) | $685.37 | $1,142.27 | 1.7× |
| Brachytx isodose intermed (77317) | $434.01 | $723.35 | 1.1× |
| Brachytx Isodose Plan Simple (77316) | $457.65 | $762.75 | 1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,611.39 | $12,685.65 | 5.0× |
| Chest 1 view (71045) | $42.83 | $71.38 | 0.5× |
| Chest 2 views (71046) | $55.92 | $93.20 | 0.6× |
| Chest 3 views (71047) | $70.14 | $116.89 | 0.8× |
| Chest 4 or more views (71048) | $75.72 | $126.19 | 0.7× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $188.43 | $314.05 | 1.7× |
| Clavicle complete (73000) | $52.68 | $87.80 | 0.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $264.68 | $441.13 | 2.4× |
| Contrast Exam Abdominl Aorta (75625) | $117.18 | $195.30 | 0.0× |
| Contrast X-Ray Of Elbow (73085) | $171.11 | $285.17 | 0.5× |
| Contrast X-Ray Of Knee Joint (73580) | $228.97 | $381.61 | 0.6× |
| CT abdomen and pelvis without and with contrast (74178) | $769.41 | $1,282.34 | 2.1× |
| CT abdomen and pelvis without contrast (74176) | $388.64 | $647.73 | 1.5× |
| CT abdomen w contrast (74160) | $534.98 | $891.62 | 2.8× |
| CT abdomen w wo contrast (74170) | $706.68 | $1,177.79 | 3.8× |
| CT abdomen w/o contrast (74150) | $394.91 | $658.17 | 3.5× |
| CT Angio Abdomen and Pelvis (74174) | $950.19 | $1,583.65 | 2.5× |
| CT Angio Chest (71275) | $774.53 | $1,290.87 | 4.1× |
| CT Angio Head (70496) | $946.01 | $1,576.68 | 5.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $762.30 | $1,270.50 | 4.1× |
| CT Angio Neck (70498) | $970.89 | $1,618.15 | 5.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $705.28 | $1,175.46 | 3.8× |
| CT cervical spine w/ contrast (72126) | $508.09 | $846.81 | 1.4× |
| CT cervical spine w/o contrast (72125) | $415.73 | $692.87 | 3.7× |
| CT cervical spine w/wo cont (72127) | $608.03 | $1,013.37 | 3.2× |
| CT chest w contrast (71260) | $507.62 | $846.02 | 2.7× |
| CT chest w/wo contrast (71270) | $619.67 | $1,032.78 | 3.3× |
| CT head/brain with contrast (70460) | $418.37 | $697.28 | 2.2× |
| CT head/brain without and with contrast (70470) | $448.11 | $746.85 | 2.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $45 | $75 | 0.5× |
| CT iac w contrast (70481) | $608.36 | $1,013.93 | 3.2× |
| CT l-spine w&w/o contrast (72133) | $611.49 | $1,019.14 | 3.3× |
| CT lower ext w/o (73700) | $393.83 | $656.38 | 3.5× |
| CT lower extremity w/contrast material (73701) | $486.30 | $810.50 | 2.6× |
| CT lumbar spine w contrast (72132) | $506.93 | $844.87 | 1.4× |
| CT lumbar spine w/o contrast (72131) | $407.78 | $679.62 | 3.6× |
| CT maxillofacial w contrast (70487) | $523.62 | $872.69 | 2.8× |
| CT maxillofacial wo contrast (70486) | $435.23 | $725.37 | 3.9× |
| CT neck tissue combo (70492) | $614.55 | $1,024.25 | 3.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $680.01 | $1,133.35 | 3.6× |
| CT orbits w/o contrast (70480) | $525.24 | $875.39 | 4.7× |
| CT pelvis w&w/o contrast (72194) | $614.11 | $1,023.51 | 3.3× |
| CT pelvis w/o contrast (72192) | $395.55 | $659.24 | 3.5× |
| CT scan of leg combo (73702) | $615.51 | $1,025.85 | 3.3× |
| CT scans face/jaw combo (70488) | $632.33 | $1,053.87 | 3.4× |
| CT soft tissue neck w contrast (70491) | $512.49 | $854.14 | 2.7× |
| CT soft tissue neck w/o contrast (70490) | $426.17 | $710.27 | 3.8× |
| CT thoracic spine w contrast (72129) | $508.09 | $846.81 | 2.7× |
| CT thoracic spine w/o contrast (72128) | $408.92 | $681.53 | 3.7× |
| CT thoracic spine w/wo cont (72130) | $583.12 | $971.86 | 3.1× |
| CT thorax w/o contrast (71250) | $409.05 | $681.74 | 3.7× |
| CT upper ext wo (73200) | $393.27 | $655.44 | 3.5× |
| CT upper extremity w/o & w/contrast material (73202) | $615.51 | $1,025.85 | 3.3× |
| CT upper extremity with contrast (73201) | $481.23 | $802.04 | 1.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $852.40 | $1,420.66 | 4.5× |
| Cta Abdomen (74175) | $825.87 | $1,376.45 | 4.4× |
| CTA pelvis (72191) | $796.76 | $1,327.92 | 4.2× |
| Discography Cerv/Thor Spine (72285) | $238.37 | $397.28 | 0.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $174.32 | $290.52 | 1.6× |
| Dxa Bone Density Axial (77080) | $163.17 | $271.95 | 1.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $51.32 | $85.52 | 0.6× |
| Echo Guide For Artery Repair (76936) | $821.85 | $1,369.75 | 3.6× |
| Echograp Trans R Pros Study (76873) | $489.18 | $815.29 | 4.4× |
| Esophagram (74220) | $157.40 | $262.33 | 0.8× |
| Fetal Biophys Profile W/Nst (76818) | $339.51 | $565.85 | 3.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $251.57 | $419.27 | 2.2× |
| Fluoroscopy up to 1 hr (76000) | $113.36 | $188.92 | 0.4× |
| Foot 2 views (73620) | $71.68 | $119.46 | 0.8× |
| Forearm 2 views (73090) | $48.36 | $80.60 | 0.5× |
| Gated Heart Planar Single (78472) | $85.74 | $142.89 | 0.2× |
| Hand 2 views (73120) | $73.39 | $122.31 | 0.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $405.72 | $676.20 | 4.4× |
| Infant hip ultrasound, limited static exam (76886) | $284.10 | $473.49 | 3.0× |
| Interstitial radiation source applic complex (77778) | $2,087.75 | $3,479.57 | 2.8× |
| Intracavitary Radiation Source Applic Intermed (77762) | $925.02 | $1,541.70 | 1.6× |
| Intracavitary radiation source applic simple (77761) | $634.22 | $1,057.02 | 1.1× |
| Joint Survey Single View (77077) | $76.34 | $127.23 | 0.7× |
| Knee 3 Views (73562) | $65.88 | $109.80 | 0.7× |
| Lymph System Imaging (78195) | $104.73 | $174.55 | 0.2× |
| Magnetic Image Jaw Joint (70336) | $717.27 | $1,195.45 | 2.8× |
| Mlc imrt design & construction per imrt plan (77338) | $1,166.19 | $1,943.65 | 2.9× |
| Mra Head W/O & W/Contrast Material (70546) | $1,365.92 | $2,276.53 | 3.7× |
| MRA head w/o contrast (70544) | $868.06 | $1,446.76 | 3.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,369.13 | $2,281.87 | 3.7× |
| MRA neck w/o contrast (70547) | $888.02 | $1,480.02 | 3.5× |
| MRI abdomen w/o contrast (74181) | $723.41 | $1,205.67 | 2.8× |
| MRI any jt lower extrem w/contrast material (73722) | $1,319.62 | $2,199.36 | 1.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,068.63 | $1,781.04 | 2.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $832.23 | $1,387.05 | 1.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $446.69 | $744.48 | 1.7× |
| MRI cervical spine w/o cont (72141) | $751.53 | $1,252.54 | 2.9× |
| MRI chest w/o contrast (71550) | $919.93 | $1,533.21 | 3.6× |
| MRI chest wo w contrast (71552) | $1,323.09 | $2,205.14 | 3.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $889.88 | $1,483.13 | 2.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,134.75 | $1,891.25 | 3.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $793.43 | $1,322.38 | 3.1× |
| MRI lumbar spine w contrast (72149) | $927.81 | $1,546.34 | 2.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,138.85 | $1,898.08 | 3.0× |
| MRI orbit face &/neck w/o contrast (70540) | $782.12 | $1,303.53 | 3.1× |
| MRI orbit face neck w contrast (70542) | $879.14 | $1,465.23 | 2.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,112.16 | $1,853.59 | 3.0× |
| MRI pelvis w contrast (72196) | $924.37 | $1,540.61 | 2.5× |
| MRI pelvis w/o & w contrast (72197) | $1,164.92 | $1,941.52 | 3.1× |
| MRI pelvis w/o contrast (72195) | $831.82 | $1,386.36 | 3.3× |
| MRI thoracic spine w/o contrast (72146) | $757.33 | $1,262.21 | 3.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $887.62 | $1,479.36 | 2.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $803.33 | $1,338.88 | 3.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,129.68 | $1,882.79 | 3.0× |
| MRI, abdomen, combo (74183) | $1,139.34 | $1,898.90 | 3.0× |
| MRI, dorsal spine combo (72157) | $1,068.17 | $1,780.27 | 2.9× |
| MRI, dorsal spine contrast (72147) | $850.42 | $1,417.36 | 2.3× |
| MRI, joint upper extrem (73221) | $766.83 | $1,278.05 | 3.0× |
| MRI, joint upper extrem combo (73223) | $1,067.51 | $1,779.17 | 2.9× |
| MRI, lumbar spine combo (72158) | $1,119.66 | $1,866.09 | 3.0× |
| Myocardial Spect Multiple Studies (78452) | $137.68 | $229.46 | 0.1× |
| Neck soft tissue (70360) | $35.90 | $59.82 | 0.4× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $819.81 | $1,366.34 | 2.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,498.59 | $5,830.98 | 2.4× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $143.27 | $238.77 | 1.3× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $310.07 | $516.78 | 2.2× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $132.30 | $220.49 | 1.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $164.97 | $274.94 | 1.5× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $25.80 | $42.99 | 0.8× |
| Pelvis 1 or 2 views (72170) | $48.43 | $80.71 | 0.4× |
| PET image w/CT, full body (78816) | $8,659.77 | $14,432.95 | 5.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,369.23 | $13,948.71 | 5.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $83.75 | $139.57 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) | $58.03 | $96.71 | 0.6× |
| Radex Calcaneus Minimum 2 Views (73650) | $74.24 | $123.73 | 0.8× |
| Radex elbow complete minimum 3 views (73080) | $59.16 | $98.59 | 0.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $78.15 | $130.24 | 0.7× |
| Radex fingr minimum 2 views (73140) | $58.34 | $97.22 | 0.6× |
| Radex foot complete minimum 3 views (73630) | $55.19 | $91.98 | 0.6× |
| Radex Hand Minimum 3 Views (73130) | $85.55 | $142.58 | 0.9× |
| Radex lower extremity infant minimum 2 views (73592) | $84.41 | $140.67 | 0.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $62.10 | $103.50 | 0.7× |
| Radex Ribs Unilateral 2 Views (71100) | $59.27 | $98.78 | 0.6× |
| Radex shoulder complete minimum 2 views (73030) | $54.65 | $91.07 | 0.6× |
| Radex Sinuses Paransl < 3 Views (70210) | $56 | $93.32 | 0.6× |
| Radex Spine 1 View Specify Level (72020) | $42.54 | $70.90 | 0.5× |
| Radex Sternum Minimum 2 Views (71120) | $56.75 | $94.57 | 0.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $87.17 | $145.28 | 0.9× |
| Radex Toe Minimum 2 Views (73660) | $52.14 | $86.90 | 0.6× |
| Radex upper extremity infant minimum 2 views (73092) | $48.93 | $81.54 | 0.4× |
| Radex Wrist Complete Minimum 3 Views (73110) | $64.80 | $107.99 | 0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $72.18 | $120.29 | 0.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $47.94 | $79.90 | 0.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $184.79 | $307.97 | 1.0× |
| Radiologic exam knee complete 4/more views (73564) | $76.35 | $127.24 | 0.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $77.04 | $128.39 | 0.7× |
| Radiologic exam swallow function contrast study (74230) | $207.83 | $346.37 | 1.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $217.41 | $362.34 | 1.2× |
| Radiologic examination femur minimum 2 views (73552) | $86.25 | $143.75 | 0.9× |
| Radiologic examination knee 1/2 views (73560) | $55.30 | $92.16 | 0.6× |
| Radiologic Examination Osseous Survey Limited (77074) | $121.18 | $201.96 | 1.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $76.67 | $127.77 | 0.8× |
| Ribs bilateral 3 views (71110) | $72.93 | $121.54 | 0.7× |
| Rp Therapy Intravenous Administration (79101) | $375.56 | $625.93 | 1.5× |
| Scapula (73010) | $55.73 | $92.87 | 0.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $95.30 | $158.83 | 4.1× |
| Sella turcica (70240) | $54.69 | $91.15 | 0.6× |
| Shoulder 1 view (73020) | $42.08 | $70.13 | 0.5× |
| Shoulder Arthrography (73040) | $195.20 | $325.32 | 0.5× |
| Skull less than 4 views (70250) | $66.26 | $110.42 | 0.6× |
| Special dosimetry (77331) | $284.31 | $473.84 | 2.0× |
| Special teletherapy port plan (77321) | $327.34 | $545.56 | 0.8× |
| Special treatment procedure (77470) | $1,205.22 | $2,008.69 | 2.0× |
| Sternoclavicular joints (71130) | $68.28 | $113.79 | 0.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $941.78 | $1,569.63 | 2.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $346.34 | $577.23 | 0.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $510.61 | $851.01 | 1.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $194.16 | $323.59 | 0.5× |
| Ther rad simulaj-aided field setting simple (77280) | $176.51 | $294.18 | 1.2× |
| Thoracic spine 2 views (72070) | $60.33 | $100.54 | 0.5× |
| Thoracic spine 3 views (72072) | $66.72 | $111.20 | 0.6× |
| Thoracolumbar 2 views (72080) | $66.11 | $110.17 | 0.7× |
| Tx Devices Design & Construction Complex (77334) | $336.62 | $561.03 | 0.8× |
| Tx devices design & construction intermediate (77333) | $119.83 | $199.71 | 0.8× |
| Tx devices design & construction simple (77332) | $176.51 | $294.18 | 1.2× |
| Ultrasound Breast Limited (76642) | $773.44 | $1,289.06 | 8.3× |
| Ultrasound Elastography Parenchyma (76981) | $54.72 | $91.19 | 0.5× |
| Ultrasound Exam Aaa Screen (76706) | $294.49 | $490.81 | 2.6× |
| Umbilical-artery Doppler (OB) (76820) | $121.02 | $201.70 | 1.1× |
| Unlisted us procedure (76999) | $145.86 | $243.09 | 1.6× |
| Upper gi w/o kub (74240) | $194.25 | $323.75 | 1.0× |
| Us kidney transplant (76776) | $417.50 | $695.82 | 3.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $142.47 | $237.45 | 1.3× |
| Us ob detailed single fetus (76811) | $333.40 | $555.66 | 1.3× |
| Us pelvic non ob complete (76856) | $341.64 | $569.40 | 3.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $355.02 | $591.70 | 3.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $327.95 | $546.58 | 2.9× |
| Us retroperitoneal complete (76770) | $364.79 | $607.97 | 3.3× |
| Us scrotum and contents (76870) | $339.87 | $566.44 | 3.0× |
| Us spinal canal and contents (76800) | $374.89 | $624.81 | 3.3× |
| Us thyroid (76536) | $328.94 | $548.22 | 2.9× |
| Us transrectal (76872) | $324.29 | $540.47 | 2.9× |
| Venography caval inferior serialography rs&i (75825) | $100.71 | $167.85 | 0.0× |
| Venography extremity unilateral rs&i (75820) | $83.74 | $139.56 | 0.0× |
| Wrist 2 views (73100) | $56.24 | $93.73 | 0.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $72.35 | $120.58 | 0.8× |
| X-Ray Aorta Leg Arteries (75630) | $160.35 | $267.24 | 0.0× |
| X-Ray Bend Only L-S Spine (72120) | $78.83 | $131.38 | 0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $74.98 | $124.96 | 0.8× |
| X-Ray Exam Breast Specimen (76098) | $631.79 | $1,052.98 | 1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $70.63 | $117.71 | 0.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $115.73 | $192.87 | 1.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $53.31 | $88.84 | 0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $76.56 | $127.60 | 0.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $74.13 | $123.55 | 0.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $70.11 | $116.85 | 0.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $89.04 | $148.39 | 0.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $99.81 | $166.35 | 0.9× |
| X-Ray Exam L-S Spine Bending (72114) | $117.93 | $196.55 | 1.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $71.31 | $118.84 | 0.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $121.94 | $203.23 | 1.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $68.77 | $114.61 | 0.6× |
| X-ray eye for foreign body (70030) | $54.11 | $90.17 | 0.6× |
| X-ray humerus (73060) | $76.84 | $128.06 | 0.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $47.94 | $79.90 | 0.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $64.53 | $107.54 | 0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $66.69 | $111.14 | 0.6× |
| X-ray nose-rectum child f.b. (76010) | $47.87 | $79.77 | 0.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $94.53 | $157.54 | 0.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $65.10 | $108.50 | 0.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $40.08 | $66.80 | 0.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $54.05 | $90.08 | 0.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $70.35 | $117.25 | 0.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $84.80 | $141.32 | 0.8× |
| X-Ray Stress View (77071) | $90.40 | $150.66 | 1.0× |
| X-Ray Tmj Unilat (70328) | $55.93 | $93.21 | 0.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $40.88 | $68.13 | 0.1× |
| X-Rays Bone Length Studies (77073) | $73.37 | $122.27 | 0.7× |
| X-Rays Bone Survey Complete (77075) | $179.91 | $299.85 | 1.6× |
| Xr c-spine 4 or 5 views (72050) | $95.60 | $159.33 | 0.9× |
| Xr facial bones less than 3 views (70140) | $54.37 | $90.61 | 0.6× |
| Xr orbits complete 4 views (70200) | $79.32 | $132.20 | 0.7× |