Imaging prices at Canton-Potsdam Hospital
Potsdam, NY · every code in this section with a posted price and a Medicare benchmark.
285 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) | $6,059.93 | $9,322.97 | 3.5× |
| Abdomen 1 View (74018) | $300.13 | $461.74 | 2.8× |
| Abdomen 2 views (74019) | $362.23 | $557.27 | 2.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $657.14 | $1,010.98 | 1.3× |
| Ankle 2 views (73600) | $285.35 | $439 | 2.6× |
| Arthrogram hip (73525) | $768.18 | $1,181.81 | 1.8× |
| Arthrogram Wrist (73115) | $740.12 | $1,138.64 | 1.7× |
| Basic radiation dosimetry calculation (77300) | $324.44 | $499.14 | 1.9× |
| Bone age studies (77072) | $220.20 | $338.77 | 1.7× |
| Bone Imaging 3 Phase (78315) | $1,587.39 | $2,442.14 | 3.2× |
| Bone Imaging Limited Area (78300) | $640.19 | $984.91 | 1.3× |
| Bone Imaging Whole Body (78306) | $1,463.20 | $2,251.07 | 2.9× |
| Bone survey infant (77076) | $878.64 | $1,351.75 | 6.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $4,507.28 | $6,934.27 | 6.7× |
| Chest 1 view (71045) | $201.54 | $310.06 | 1.9× |
| Chest 2 views (71046) | $315.75 | $485.77 | 2.9× |
| Chest 3 views (71047) | $405.25 | $623.46 | 3.7× |
| Chest 4 or more views (71048) | $229.09 | $352.45 | 1.8× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $256.80 | $395.08 | 2.0× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$234.98–$468.21 | $361.51–$720.33 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $247.40 | $380.61 | 1.9× |
| Continuing medical physics consltj pr wk (77336) | $756.57 | $1,163.95 | 4.5× |
| Contrast X-Ray Bladder (74430) | $328.37 | $505.18 | 0.8× |
| Contrast X-Ray Of Knee Joint (73580) | $740.12 | $1,138.64 | 1.7× |
| Contrast Xray Throat/Cerv Esopha (74210) | $340.14 | $523.29 | 1.6× |
| CT abdomen and pelvis without and with contrast (74178) | $3,094.16 | $4,760.24 | 7.1× |
| CT abdomen and pelvis without contrast (74176) | $2,254.62 | $3,468.65 | 7.6× |
| CT abdomen w contrast (74160) | $1,500.13 | $2,307.89 | 6.9× |
| CT abdomen w wo contrast (74170) | $2,016.38 | $3,102.12 | 9.2× |
| CT abdomen w/o contrast (74150) | $1,410.27 | $2,169.64 | 10.8× |
| CT Angio Abdomen and Pelvis (74174) | $4,172.65 | $6,419.46 | 9.6× |
| CT Angio Chest (71275) | $2,357.33 | $3,626.66 | 10.8× |
| CT Angio Head (70496) | $2,146.35 | $3,302.08 | 9.8× |
| CT angio hrt w/3d image (75574) | $1,831.52 | $2,817.73 | 4.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,045.84 | $3,147.44 | 9.3× |
| CT Angio Neck (70498) | $2,182.82 | $3,358.18 | 10.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,045.84 | $3,147.44 | 9.3× |
| CT cervical spine w/ contrast (72126) | $1,435.69 | $2,208.76 | 3.3× |
| CT cervical spine w/o contrast (72125) | $1,012.60 | $1,557.84 | 7.8× |
| CT chest w contrast (71260) | $1,500.13 | $2,307.89 | 6.9× |
| CT chest w/wo contrast (71270) | $1,633.05 | $2,512.38 | 7.5× |
| CT colonography screening (74263) | $427.13 | $657.13 | 1.4× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $288.38 | $443.66 | 1.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $553.81 | $852.02 | 4.2× |
| CT head/brain with contrast (70460) | $1,500.13 | $2,307.89 | 6.9× |
| CT head/brain without and with contrast (70470) | $1,937.57 | $2,980.87 | 8.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $286.85 | $441.31 | 2.6× |
| CT iac w contrast (70481) | $1,321.90 | $2,033.69 | 6.0× |
| CT l-spine w&w/o contrast (72133) | $1,537.20 | $2,364.93 | 7.0× |
| CT lower ext w/o (73700) | $1,249.39 | $1,922.14 | 9.6× |
| CT lower extremity w/contrast material (73701) | $1,369.77 | $2,107.34 | 6.3× |
| CT lumbar spine w contrast (72132) | $1,435.69 | $2,208.76 | 3.3× |
| CT lumbar spine w/o contrast (72131) | $1,410.27 | $2,169.64 | 10.8× |
| CT maxillofacial w contrast (70487) | $1,584.82 | $2,438.18 | 7.2× |
| CT maxillofacial wo contrast (70486) | $1,500.13 | $2,307.89 | 11.5× |
| CT neck tissue combo (70492) | $1,511.17 | $2,324.88 | 6.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,009.89 | $1,553.67 | 4.6× |
| CT orbits w/o contrast (70480) | $1,150.68 | $1,770.28 | 8.8× |
| CT pelvis w&w/o contrast (72194) | $1,418.38 | $2,182.12 | 6.5× |
| CT pelvis w/o contrast (72192) | $1,410.27 | $2,169.64 | 10.8× |
| CT scan of leg combo (73702) | $1,009.89 | $1,553.67 | 4.6× |
| CT scans face/jaw combo (70488) | $1,615.02 | $2,484.65 | 7.4× |
| CT soft tissue neck w contrast (70491) | $1,124.19 | $1,729.53 | 5.1× |
| CT soft tissue neck w/o contrast (70490) | $1,012.60 | $1,557.84 | 7.8× |
| CT thoracic spine w contrast (72129) | $1,435.69 | $2,208.76 | 6.6× |
| CT thoracic spine w/o contrast (72128) | $1,410.27 | $2,169.64 | 10.8× |
| CT thoracic spine w/wo cont (72130) | $1,681.65 | $2,587.16 | 7.7× |
| CT thorax w/o contrast (71250) | $1,410.27 | $2,169.64 | 10.8× |
| CT upper ext wo (73200) | $1,080.36 | $1,662.10 | 8.3× |
| CT upper extremity w/o & w/contrast material (73202) | $288.38 | $443.66 | 1.3× |
| CT upper extremity with contrast (73201) | $1,249.39 | $1,922.14 | 2.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,357.33 | $3,626.66 | 10.8× |
| Cta Abdomen (74175) | $2,233.24 | $3,435.75 | 10.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $554 | $852.30 | 1.3× |
| CTA pelvis (72191) | $879.20 | $1,352.61 | 4.0× |
| Dxa Bone Density Axial (77080) | $545.52 | $839.26 | 4.2× |
| Echo exam uterus (76831) | $630.62 | $970.19 | 2.1× |
| Esophagram (74220) | $410.88 | $632.13 | 1.9× |
| Fetal Biophys Profile W/Nst (76818) | $277.85 | $427.46 | 2.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $608.90 | $936.77 | 4.7× |
| Fluoroscopy up to 1 hr (76000) | $292.32 | $449.72 | 1.0× |
| Foot 2 views (73620) | $285.35 | $439 | 2.6× |
| Forearm 2 views (73090) | $509.02 | $783.11 | 4.7× |
| Gastric emptying imaging study (78264) | $793.48 | $1,220.74 | 1.6× |
| Gated Heart Planar Single (78472) | $1,184.82 | $1,822.80 | 2.4× |
| Hand 2 views (73120) | $354.84 | $545.90 | 2.7× |
| Hepatobil Syst Image W/Drug (78227) | $1,108.36 | $1,705.17 | 1.6× |
| Hepatobiliary System Imaging (78226) | $1,031.06 | $1,586.25 | 2.1× |
| Ht Muscle Image Spect Sing (78451) | $2,448.65 | $3,767.16 | 1.5× |
| Hysterosalpingogram (74740) | $541.59 | $833.22 | 1.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $462.54 | $711.60 | 4.3× |
| Infant hip ultrasound, limited static exam (76886) | $362.23 | $557.27 | 3.3× |
| Joint Survey Single View (77077) | $277.85 | $427.46 | 2.1× |
| K Flow/Funct Image W/Drug (78708) | $1,201.31 | $1,848.17 | 1.8× |
| K Flow/Funct Image W/O Drug (78707) | $744.41 | $1,145.25 | 1.1× |
| Knee 3 Views (73562) | $211.52 | $325.41 | 1.9× |
| Liver & Spleen Imaging Static Only (78215) | $1,031.06 | $1,586.25 | 2.1× |
| Lung Ventilat&Perfus Imaging (78582) | $1,101.43 | $1,694.51 | 1.6× |
| Lung Ventilation Imaging (78579) | $622.39 | $957.53 | 1.2× |
| Lymph System Imaging (78195) | $1,219.57 | $1,876.26 | 1.8× |
| Magnetic Image Jaw Joint (70336) | $1,234.49 | $1,899.21 | 4.1× |
| Meckels Divert Exam (78290) | $999.37 | $1,537.49 | 2.0× |
| Mlc imrt design & construction per imrt plan (77338) | $1,356.38 | $2,086.74 | 2.9× |
| Mra Head W/O & W/Contrast Material (70546) | $1,544.71 | $2,376.48 | 3.5× |
| MRA head w/o contrast (70544) | $1,882.72 | $2,896.49 | 6.3× |
| MRA head with contrast (70545) | $2,185.37 | $3,362.11 | 5.0× |
| MRA neck w contrast (70548) | $1,957.46 | $3,011.48 | 4.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,725.26 | $5,731.17 | 8.6× |
| MRA neck w/o contrast (70547) | $1,744.25 | $2,683.46 | 5.9× |
| MRI abdomen w contrast (74182) | $2,551.74 | $3,925.76 | 5.9× |
| MRI abdomen w/o contrast (74181) | $2,387.53 | $3,673.13 | 8.0× |
| MRI any jt lower extrem w/contrast material (73722) | $2,294.38 | $3,529.82 | 2.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $6,046.87 | $9,302.88 | 13.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,216.32 | $3,409.72 | 2.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $3,306.99 | $5,087.67 | 11.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $462.95 | $712.23 | 1.6× |
| MRI cervical spine w contrast (72142) | $2,294.38 | $3,529.82 | 5.3× |
| MRI cervical spine w/o cont (72141) | $2,147.84 | $3,304.37 | 7.2× |
| MRI chest w/o contrast (71550) | $1,067.55 | $1,642.38 | 3.6× |
| MRI chest with contrast (71551) | $2,252.39 | $3,465.21 | 2.3× |
| MRI chest wo w contrast (71552) | $1,963.67 | $3,021.03 | 4.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,387.53 | $3,673.13 | 5.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,574.29 | $5,498.91 | 8.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,216.32 | $3,409.72 | 7.4× |
| MRI lumbar spine w contrast (72149) | $2,387.53 | $3,673.13 | 5.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,681.82 | $5,664.34 | 8.5× |
| MRI orbit face &/neck w/o contrast (70540) | $2,165.51 | $3,331.55 | 7.3× |
| MRI orbit face neck w contrast (70542) | $2,294.38 | $3,529.82 | 5.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,231.20 | $6,509.54 | 9.7× |
| MRI pelvis w contrast (72196) | $2,387.53 | $3,673.13 | 5.5× |
| MRI pelvis w/o & w contrast (72197) | $3,681.82 | $5,664.34 | 8.5× |
| MRI pelvis w/o contrast (72195) | $2,384.60 | $3,668.61 | 8.0× |
| MRI thoracic spine w/o contrast (72146) | $2,147.84 | $3,304.37 | 7.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,544.71 | $2,376.48 | 3.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,831.52 | $2,817.73 | 6.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,978.88 | $4,582.89 | 6.8× |
| MRI, abdomen, combo (74183) | $3,681.82 | $5,664.34 | 8.5× |
| MRI, dorsal spine combo (72157) | $2,825.71 | $4,347.25 | 6.5× |
| MRI, dorsal spine contrast (72147) | $2,294.38 | $3,529.82 | 5.3× |
| MRI, joint upper extrem (73221) | $1,987.67 | $3,057.95 | 6.7× |
| MRI, joint upper extrem combo (73223) | $3,574.29 | $5,498.91 | 8.2× |
| MRI, lumbar spine combo (72158) | $3,681.82 | $5,664.34 | 8.5× |
| Myelogram cervical (72240) | $1,510.03 | $2,323.13 | 1.5× |
| Myelograpy 2/more regions rs&i (72270) | $2,162.45 | $3,326.85 | 2.2× |
| Myocardial Spect Multiple Studies (78452) | $3,712.49 | $5,711.52 | 2.3× |
| Neck soft tissue (70360) | $187.21 | $288.02 | 1.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $7,167.83 | $11,027.43 | 4.1× |
| Ob us nuchal meas 1 gest (76813) | $237.17 | $364.87 | 1.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $291.80 | $448.93 | 2.2× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $36.50 | $56.15 | 1.0× |
| Parathyroid Planar Imaging (78070) | $590.66 | $908.71 | 1.2× |
| Pelvis 1 or 2 views (72170) | $305.77 | $470.41 | 2.3× |
| Pet Image W/Ct Lmtd (78814) | $4,069.77 | $6,261.19 | 2.3× |
| PET image w/CT, full body (78816) | $4,069.77 | $6,261.19 | 2.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,507.28 | $6,934.27 | 2.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $405.25 | $623.46 | 0.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $541.59 | $833.22 | 4.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,500.73 | $2,308.81 | 2.2× |
| Radex Ankle Complete Minimum 3 Views (73610) | $256.69 | $394.91 | 2.4× |
| Radex Calcaneus Minimum 2 Views (73650) | $509.02 | $783.11 | 4.7× |
| Radex elbow complete minimum 3 views (73080) | $509.02 | $783.11 | 4.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $426.96 | $656.86 | 3.3× |
| Radex fingr minimum 2 views (73140) | $224.13 | $344.81 | 2.1× |
| Radex foot complete minimum 3 views (73630) | $256.69 | $394.91 | 2.4× |
| Radex Hand Minimum 3 Views (73130) | $256.69 | $394.91 | 2.4× |
| Radex lower extremity infant minimum 2 views (73592) | $256.69 | $394.91 | 2.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $240.93 | $370.66 | 1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $292.32 | $449.72 | 2.7× |
| Radex Ribs Unilateral 2 Views (71100) | $305.77 | $470.41 | 2.8× |
| Radex shoulder complete minimum 2 views (73030) | $224.13 | $344.81 | 2.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $231.52 | $356.18 | 2.1× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$187.21–$205.92 | $288.02–$316.80 | varies |
| Radex Sternum Minimum 2 Views (71120) | $211.52 | $325.41 | 1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $362.23 | $557.27 | 3.3× |
| Radex Toe Minimum 2 Views (73660) | $187.21 | $288.02 | 1.7× |
| Radex upper extremity infant minimum 2 views (73092) | $203.85 | $313.62 | 1.6× |
| Radex Wrist Complete Minimum 3 Views (73110) | $256.69 | $394.91 | 2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $277.85 | $427.46 | 2.1× |
| Radiation treatment delivery level 1 (77402) | $212.43 | $326.82 | 1.7× |
| Radiation treatment delivery level 2 (77407) | $510.67 | $785.64 | 1.1× |
| Radiation treatment delivery level 3 (77412) | $510.67 | $785.64 | 0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $284.47 | $437.65 | 2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $378.31 | $582.01 | 2.9× |
| Radiologic exam colon double contrast study (74280) | $340.14 | $523.29 | 1.6× |
| Radiologic exam colon single contrast study (74270) | $541.59 | $833.22 | 2.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $410.88 | $632.13 | 1.9× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$256.69–$509.02 | $394.91–$783.11 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $304.47 | $468.42 | 2.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $366.99 | $564.60 | 1.7× |
| Radiologic exam swallow function contrast study (74230) | $165.92 | $255.26 | 0.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $641.06 | $986.25 | 2.9× |
| Radiologic examination femur 1 view (73551) | $241.18 | $371.05 | 2.2× |
| Radiologic examination femur minimum 2 views (73552) | $195.01 | $300.02 | 1.8× |
| Radiologic examination knee 1/2 views (73560) | $273.20 | $420.30 | 2.5× |
| Radiologic Examination Osseous Survey Limited (77074) | $318.38 | $489.81 | 2.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$256.69–$509.02 | $394.91–$783.11 | varies |
| Ribs bilateral 3 views (71110) | $498.62 | $767.10 | 3.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,477.98 | $2,273.82 | 2.2× |
| Rp Therapy Intravenous Administration (79101) | $449.51 | $691.56 | 1.5× |
| Scapula (73010) | $256.69 | $394.91 | 2.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $65.14 | $100.22 | 2.8× |
| Shoulder 1 view (73020) | $302.73 | $465.74 | 2.8× |
| Shoulder Arthrography (73040) | $737.90 | $1,135.23 | 1.7× |
| Skull less than 4 views (70250) | $231.52 | $356.18 | 1.8× |
| Special teletherapy port plan (77321) | $861.89 | $1,325.98 | 1.8× |
| Special treatment procedure (77470) | $1,432.30 | $2,203.54 | 2.1× |
| Stereotactic Body Radiation Delivery (77373) | $5,835.39 | $8,977.52 | 2.6× |
| Sternoclavicular joints (71130) | $211.52 | $325.41 | 1.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $972.85 | $1,496.69 | 2.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,537.45 | $2,365.31 | 3.3× |
| Ther rad simulaj-aided field setting simple (77280) | $868.20 | $1,335.69 | 5.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $321.90 | $495.23 | 1.5× |
| Thoracic spine 2 views (72070) | $234.98 | $361.51 | 1.8× |
| Thoracic spine 3 views (72072) | $311.40 | $479.08 | 2.4× |
| Thoracolumbar 2 views (72080) | $263.63 | $405.59 | 2.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $730.52 | $1,123.88 | 1.5× |
| Tx Devices Design & Construction Complex (77334) | $1,179.60 | $1,814.77 | 2.5× |
| Tx devices design & construction intermediate (77333) | $334.13 | $514.04 | 2.0× |
| Ultrasound Breast Limited (76642) | $535.08 | $823.20 | 4.9× |
| Ultrasound Elastography Parenchyma (76981) | $208.93 | $321.43 | 1.6× |
| Ultrasound Exam Aaa Screen (76706) | $184.58 | $283.97 | 1.4× |
| Ultrasound, abdomen limited (76705) | $649.75 | $999.62 | 5.0× |
| Umbilical-artery Doppler (OB) (76820) | $267.40 | $411.39 | 2.0× |
| Unlisted us procedure (76999) | $203.85 | $313.62 | 1.9× |
| Upper gi w/o kub (74240) | $462.54 | $711.60 | 2.1× |
| Urethrocystogram voiding (74455) | $426.96 | $656.86 | 1.4× |
| Urethrocystography retrograde (74450) | $559.38 | $860.59 | 1.9× |
| Us breast unilateral complete (76641) | $543.76 | $836.55 | 4.2× |
| Us chest (76604) | $563.77 | $867.34 | 4.3× |
| Us complete joint (76881) | $302.30 | $465.08 | 2.3× |
| Us exam, pelvic, limited (76857) | $314.87 | $484.42 | 2.4× |
| Us head (76506) | $469.05 | $721.61 | 3.6× |
| Us kidney transplant (76776) | $522.92 | $804.49 | 4.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $300.13 | $461.74 | 2.3× |
| Us ob detailed single fetus (76811) | $681.62 | $1,048.65 | 2.3× |
| Us ob limited 1 or more fetuses (76815) | $410.01 | $630.78 | 3.1× |
| Us ob transvaginal (76817) | $703.16 | $1,081.79 | 5.4× |
| Us pelvic non ob complete (76856) | $608.90 | $936.77 | 4.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $493.40 | $759.07 | 3.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $532.49 | $819.21 | 4.1× |
| Us retroperitoneal complete (76770) | $1,014.98 | $1,561.51 | 7.8× |
| Us retroperitoneal limited (76775) | $750.94 | $1,155.29 | 5.8× |
| Us scrotum and contents (76870) | $608.90 | $936.77 | 4.7× |
| Us spinal canal and contents (76800) | $463.88 | $713.66 | 3.6× |
| Us thyroid (76536) | $649.75 | $999.62 | 5.0× |
| Us transrectal (76872) | $541.59 | $833.22 | 4.2× |
| Wrist 2 views (73100) | $354.84 | $545.90 | 3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $240.99 | $370.76 | 2.2× |
| X-ray antegrade pyelogram tube (74425) | $740.12 | $1,138.64 | 1.7× |
| X-Ray Bend Only L-S Spine (72120) | $273.20 | $420.30 | 2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $354.84 | $545.90 | 3.3× |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$134.79–$257.59 | $207.37–$396.29 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $224.13 | $344.81 | 2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $397.85 | $612.07 | 3.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $203.85 | $313.62 | 1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $412.18 | $634.12 | 3.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $273.20 | $420.30 | 2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $399.57 | $614.72 | 3.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $522.05 | $803.15 | 4.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $520.34 | $800.52 | 4.0× |
| X-Ray Exam L-S Spine Bending (72114) | $552.91 | $850.63 | 4.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $240.21 | $369.55 | 2.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $452.56 | $696.24 | 3.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $346.15 | $532.54 | 2.7× |
| X-ray eye for foreign body (70030) | $241.18 | $371.05 | 2.2× |
| X-ray humerus (73060) | $388.71 | $598.02 | 3.6× |
| X-ray IV pyelogram (ivp) (74400) | $568.94 | $875.30 | 2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $211.52 | $325.41 | 1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $85.16 | $131.01 | 0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$273.20–$319.68 | $420.30–$491.81 | varies |
| X-ray nose-rectum child f.b. (76010) | $296.67 | $456.41 | 2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $545.52 | $839.26 | 4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $328.37 | $505.18 | 2.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $273.61 | $420.94 | 2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $256.69 | $394.91 | 2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $362.23 | $557.27 | 3.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $446.50 | $686.93 | 3.4× |
| X-ray thoracic spine 4 vw (72074) | $277.85 | $427.46 | 2.1× |
| X-Ray Tmj Unilat (70328) | $203.85 | $313.62 | 1.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $511.64 | $787.14 | 1.2× |
| X-Rays Bone Length Studies (77073) | $242.79 | $373.53 | 1.9× |
| X-Rays Bone Survey Complete (77075) | $878.64 | $1,351.75 | 6.7× |
| Xr c-spine 4 or 5 views (72050) | $304.47 | $468.42 | 2.3× |
| Xr facial bones less than 3 views (70140) | $222.83 | $342.82 | 2.1× |
| Xr orbits complete 4 views (70200) | $250.60 | $385.54 | 1.9× |
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.