Imaging prices at Carilion Rockbridge Community Hospital
Lexington, VA · every code in this section with a posted price and a Medicare benchmark.
255 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) range across 3 matching MRF lines |
$106.40–$145.25 | $304–$415 | varies |
| Abdomen 2 views (74019) | $184.80 | $528 | 1.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $757.40 | $2,164 | 1.9× |
| Ankle 2 views (73600) | $236.25 | $675 | 2.8× |
| Arthrogram hip (73525) | $587.30 | $1,678 | 1.7× |
| Arthrogram Wrist (73115) | $462 | $1,320 | 1.4× |
| Bone age studies (77072) | $170.10 | $486 | 1.7× |
| Bone Imaging 3 Phase (78315) | $1,237.95 | $3,537 | 3.2× |
| Bone Imaging Limited Area (78300) | $859.25 | $2,455 | 2.2× |
| Bone Imaging Whole Body (78306) | $974.75 | $2,785 | 2.5× |
| Bone survey infant (77076) | $153.65 | $439 | 1.5× |
| Brain Image W/Flow < 4 Views (78601) | $931.70 | $2,662 | 2.4× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,236.20 | $3,532 | 2.3× |
| Cat Scan Follow-Up Study (76380) | $513.10 | $1,466 | 6.0× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$44.45–$127.40 | $127–$364 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$66.85–$145.25 | $191–$415 | varies |
| Chest 3 views (71047) | $145.25 | $415 | 1.7× |
| Chest 4 or more views (71048) | $166.95 | $477 | 1.6× |
| Clavicle complete (73000) | $287.35 | $821 | 3.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $539.70 | $1,542 | 5.3× |
| Contrast X-Ray Bladder (74430) | $443.10 | $1,266 | 1.3× |
| Contrast X-Ray Of Knee Joint (73580) | $534.45 | $1,527 | 1.6× |
| CT abdomen and pelvis without and with contrast (74178) | $2,153.90 | $6,154 | 6.3× |
| CT abdomen and pelvis without contrast (74176) | $1,132.25 | $3,235 | 4.9× |
| CT abdomen w contrast (74160) | $1,149.75 | $3,285 | 6.7× |
| CT abdomen w wo contrast (74170) | $1,233.05 | $3,523 | 7.2× |
| CT abdomen w/o contrast (74150) | $795.55 | $2,273 | 7.8× |
| CT Angio Abdomen and Pelvis (74174) | $1,985.55 | $5,673 | 5.8× |
| CT Angio Chest (71275) | $1,095.15 | $3,129 | 6.4× |
| CT Angio Head (70496) | $1,354.85 | $3,871 | 7.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,385.65 | $3,959 | 8.1× |
| CT Angio Neck (70498) | $1,204.35 | $3,441 | 7.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,160.60 | $3,316 | 6.8× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,017.10 | $2,906 | 5.9× |
| CT cervical spine w/ contrast (72126) | $2,105.95 | $6,017 | 6.2× |
| CT cervical spine w/o contrast (72125) | $1,004.15 | $2,869 | 9.8× |
| CT cervical spine w/wo cont (72127) | $1,405.25 | $4,015 | 8.2× |
| CT chest w contrast (71260) | $1,028.65 | $2,939 | 6.0× |
| CT chest w/wo contrast (71270) | $1,373.40 | $3,924 | 8.0× |
| CT head/brain with contrast (70460) | $1,029 | $2,940 | 6.0× |
| CT head/brain without and with contrast (70470) | $1,261.40 | $3,604 | 7.4× |
| CT iac w contrast (70481) | $1,097.25 | $3,135 | 6.4× |
| CT l-spine w&w/o contrast (72133) | $1,271.55 | $3,633 | 7.4× |
| CT lower ext w/o (73700) | $841.40 | $2,404 | 8.2× |
| CT lower extremity w/contrast material (73701) | $1,090.60 | $3,116 | 6.4× |
| CT lumbar spine w contrast (72132) | $1,205.05 | $3,443 | 3.5× |
| CT lumbar spine w/o contrast (72131) | $1,026.55 | $2,933 | 10.1× |
| CT maxillofacial w contrast (70487) | $1,011.15 | $2,889 | 5.9× |
| CT maxillofacial wo contrast (70486) | $775.60 | $2,216 | 7.6× |
| CT neck tissue combo (70492) | $1,405.95 | $4,017 | 8.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,316 | $3,760 | 7.7× |
| CT orbits w/o contrast (70480) | $952 | $2,720 | 9.3× |
| CT pelvis w&w/o contrast (72194) | $1,221.85 | $3,491 | 7.1× |
| CT pelvis w/o contrast (72192) | $700.35 | $2,001 | 6.9× |
| CT scan of leg combo (73702) | $1,332.45 | $3,807 | 7.8× |
| CT scans face/jaw combo (70488) | $1,286.60 | $3,676 | 7.5× |
| CT soft tissue neck w contrast (70491) | $1,016.40 | $2,904 | 5.9× |
| CT soft tissue neck w/o contrast (70490) | $527.80 | $1,508 | 5.2× |
| CT thoracic spine w contrast (72129) | $1,291.15 | $3,689 | 7.5× |
| CT thoracic spine w/o contrast (72128) | $724.85 | $2,071 | 7.1× |
| CT thoracic spine w/wo cont (72130) | $1,090.95 | $3,117 | 6.4× |
| CT thorax w/o contrast (71250) | $868.70 | $2,482 | 8.5× |
| CT upper ext wo (73200) | $873.60 | $2,496 | 8.6× |
| CT upper extremity w/o & w/contrast material (73202) | $1,088.85 | $3,111 | 6.4× |
| CT upper extremity with contrast (73201) | $1,301.30 | $3,718 | 3.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,125.25 | $3,215 | 6.6× |
| Cta Abdomen (74175) | $1,004.50 | $2,870 | 5.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,543.10 | $7,266 | 7.5× |
| CTA pelvis (72191) | $990.50 | $2,830 | 5.8× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$351.40–$370.30 | $1,004–$1,058 | varies |
| Dxa bone density study (77085) | $269.85 | $771 | 2.6× |
| Echo exam of fetal heart (76825) | $680.40 | $1,944 | 1.3× |
| Esophagram (74220) | $301.35 | $861 | 1.8× |
| Fetal Biophys Profile W/Nst (76818) | $621.95 | $1,777 | 6.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $281.05 | $803 | 2.8× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,038.45 | $2,967 | 4.5× |
| Fluoroscopy up to 1 hr (76000) | $421.75 | $1,205 | 1.8× |
| Foot 2 views (73620) | $176.05 | $503 | 2.1× |
| Forearm 2 views (73090) | $204.75 | $585 | 2.4× |
| Gastric emptying imaging study (78264) | $1,370.95 | $3,917 | 3.5× |
| Gated Heart Planar Single (78472) | $693.70 | $1,982 | 1.8× |
| Hand 2 views (73120) | $324.45 | $927 | 3.2× |
| Hepatobil Syst Image W/Drug (78227) | $1,735.65 | $4,959 | 3.3× |
| Hepatobiliary System Imaging (78226) | $748.65 | $2,139 | 1.9× |
| Ht Muscle Image Spect Sing (78451) | $2,242.80 | $6,408 | 1.8× |
| Hysterosalpingogram (74740) | $591.85 | $1,691 | 2.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $382.90 | $1,094 | 4.5× |
| K Flow/Funct Image Multiple (78709) | $1,353.10 | $3,866 | 2.6× |
| K Flow/Funct Image W/Drug (78708) | $667.80 | $1,908 | 1.3× |
| K Flow/Funct Image W/O Drug (78707) | $992.95 | $2,837 | 1.9× |
| Knee 3 Views (73562) | $311.50 | $890 | 3.7× |
| Liver & Spleen Imaging Static Only (78215) | $720.30 | $2,058 | 1.8× |
| Lung Ventilat&Perfus Imaging (78582) | $990.50 | $2,830 | 1.9× |
| Lung Ventilation Imaging (78579) | $498.40 | $1,424 | 1.3× |
| Lymph System Imaging (78195) | $987.70 | $2,822 | 1.9× |
| Magnetic Image Jaw Joint (70336) | $1,004.15 | $2,869 | 4.3× |
| Meckels Divert Exam (78290) | $521.15 | $1,489 | 1.3× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$1,284.15–$1,369.55 | $3,669–$3,913 | varies |
| MRA head w/o contrast (70544) | $1,156.05 | $3,303 | 5.0× |
| MRA head with contrast (70545) | $938.70 | $2,682 | 2.8× |
| MRA neck w contrast (70548) | $983.15 | $2,809 | 2.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,827.70 | $5,222 | 5.4× |
| MRA neck w/o contrast (70547) | $815.15 | $2,329 | 3.5× |
| MRI abdomen w contrast (74182) | $1,265.95 | $3,617 | 3.7× |
| MRI abdomen w/o contrast (74181) | $1,137.85 | $3,251 | 4.9× |
| MRI any jt lower extrem w/contrast material (73722) | $1,591.80 | $4,548 | 2.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,424.10 | $6,926 | 7.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,031.75 | $5,805 | 2.7× |
| MRI cervical spine w contrast (72142) | $1,981.70 | $5,662 | 5.8× |
| MRI cervical spine w/o cont (72141) | $1,349.95 | $3,857 | 5.8× |
| MRI chest w/o contrast (71550) | $1,455.65 | $4,159 | 6.3× |
| MRI chest wo w contrast (71552) | $1,987.65 | $5,679 | 5.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,894.20 | $5,412 | 5.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,417.10 | $6,906 | 7.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,623.65 | $4,639 | 7.0× |
| MRI lumbar spine w contrast (72149) | $1,169.35 | $3,341 | 3.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,256.80 | $6,448 | 6.6× |
| MRI orbit face &/neck w/o contrast (70540) | $1,394.40 | $3,984 | 6.0× |
| MRI orbit face neck w contrast (70542) | $1,638.35 | $4,681 | 4.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,073.75 | $5,925 | 6.1× |
| MRI pelvis w contrast (72196) | $1,923.25 | $5,495 | 5.7× |
| MRI pelvis w/o & w contrast (72197) | $2,877 | $8,220 | 8.5× |
| MRI pelvis w/o contrast (72195) | $1,744.40 | $4,984 | 7.5× |
| MRI thoracic spine w/o contrast (72146) | $1,228.50 | $3,510 | 5.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,885.10 | $5,386 | 5.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,744.05 | $4,983 | 7.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,271.15 | $6,489 | 6.7× |
| MRI, abdomen, combo (74183) | $1,989.40 | $5,684 | 5.8× |
| MRI, dorsal spine combo (72157) | $2,256.45 | $6,447 | 6.6× |
| MRI, joint upper extrem (73221) | $1,689.10 | $4,826 | 7.3× |
| MRI, joint upper extrem combo (73223) | $2,315.25 | $6,615 | 6.8× |
| MRI, lumbar spine combo (72158) | $2,249.80 | $6,428 | 6.6× |
| Myocardial Spect Multiple Studies (78452) | $2,742.60 | $7,836 | 2.2× |
| Neck soft tissue (70360) | $151.55 | $433 | 1.8× |
| Nm unlisted gi procedure (78299) | $647.15 | $1,849 | 1.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $219.45 | $627 | 2.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $856.10 | $2,446 | 1.6× |
| Parathyroid Planar Imaging (78070) | $498.40 | $1,424 | 1.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $537.60 | $1,536 | 1.4× |
| Pelvis 1 or 2 views (72170) | $187.25 | $535 | 1.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $508.20 | $1,452 | 1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $286.30 | $818 | 2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $680.40 | $1,944 | 1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) | $310.45 | $887 | 3.7× |
| Radex Calcaneus Minimum 2 Views (73650) | $128.10 | $366 | 1.5× |
| Radex elbow complete minimum 3 views (73080) | $262.85 | $751 | 3.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $210.70 | $602 | 2.1× |
| Radex fingr minimum 2 views (73140) | $237.30 | $678 | 2.8× |
| Radex foot complete minimum 3 views (73630) | $179.55 | $513 | 2.1× |
| Radex Hand Minimum 3 Views (73130) | $392.35 | $1,121 | 4.6× |
| Radex lower extremity infant minimum 2 views (73592) | $170.80 | $488 | 2.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $153.65 | $439 | 1.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $285.25 | $815 | 3.4× |
| Radex Ribs Unilateral 2 Views (71100) | $161.35 | $461 | 1.9× |
| Radex shoulder complete minimum 2 views (73030) | $323.40 | $924 | 3.8× |
| Radex Sinuses Paransl < 3 Views (70210) | $109.55 | $313 | 1.3× |
| Radex Spine 1 View Specify Level (72020) | $176.40 | $504 | 2.1× |
| Radex Sternum Minimum 2 Views (71120) | $234.15 | $669 | 2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $135.45 | $387 | 1.6× |
| Radex Toe Minimum 2 Views (73660) | $138.60 | $396 | 1.6× |
| Radex upper extremity infant minimum 2 views (73092) | $185.85 | $531 | 1.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $334.25 | $955 | 3.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $536.90 | $1,534 | 5.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $229.25 | $655 | 2.2× |
| Radiologic exam colon double contrast study (74280) | $519.40 | $1,484 | 3.0× |
| Radiologic exam colon single contrast study (74270) | $595.70 | $1,702 | 3.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $283.50 | $810 | 1.7× |
| Radiologic exam knee complete 4/more views (73564) | $341.60 | $976 | 3.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $230.65 | $659 | 2.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $305.55 | $873 | 1.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $493.85 | $1,411 | 2.9× |
| Radiologic examination femur 1 view (73551) | $109.55 | $313 | 1.3× |
| Radiologic examination femur minimum 2 views (73552) | $170.45 | $487 | 2.0× |
| Radiologic examination knee 1/2 views (73560) | $148.40 | $424 | 1.7× |
| Radiologic Examination Osseous Survey Limited (77074) | $153.65 | $439 | 1.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $306.60 | $876 | 3.6× |
| Ribs bilateral 3 views (71110) | $349.30 | $998 | 3.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $570.50 | $1,630 | 1.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$684.25–$1,025.85 | $1,955–$2,931 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,619.45 | $4,627 | 3.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,654.45 | $4,727 | 3.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,654.45 | $4,727 | 1.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,025.80 | $5,788 | 1.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,654.45 | $4,727 | 1.3× |
| Scapula (73010) | $159.60 | $456 | 1.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $29.75 | $85 | 1.3× |
| Shoulder 1 view (73020) | $138.60 | $396 | 1.6× |
| Shoulder Arthrography (73040) | $563.15 | $1,609 | 1.7× |
| Skull less than 4 views (70250) | $223.30 | $638 | 2.2× |
| Sternoclavicular joints (71130) | $275.45 | $787 | 3.2× |
| Thoracic spine 2 views (72070) | $324.45 | $927 | 3.2× |
| Thoracic spine 3 views (72072) | $403.20 | $1,152 | 4.0× |
| Thoracolumbar 2 views (72080) | $313.95 | $897 | 3.7× |
| Thyroid Imaging With Vascular Flow (78013) | $498.40 | $1,424 | 1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$637–$728 | $1,820–$2,080 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$264.25–$542.50 | $755–$1,550 | varies |
| Ultrasound Exam Aaa Screen (76706) | $203.35 | $581 | 2.0× |
| Ultrasound, abdomen limited (76705) | $653.80 | $1,868 | 6.4× |
| Umbilical-artery Doppler (OB) (76820) | $330.75 | $945 | 3.2× |
| Upper gi w/o kub (74240) | $486.85 | $1,391 | 2.8× |
| Urethrocystogram voiding (74455) | $653.80 | $1,868 | 2.8× |
| Urethrocystography retrograde (74450) | $357 | $1,020 | 1.5× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$386.40–$772.80 | $1,104–$2,208 | varies |
| Us chest (76604) | $406.35 | $1,161 | 4.0× |
| Us complete joint (76881) | $602.35 | $1,721 | 5.9× |
| Us exam, pelvic, limited (76857) | $298.20 | $852 | 2.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $290.50 | $830 | 2.8× |
| Us ob limited 1 or more fetuses (76815) | $283.15 | $809 | 2.8× |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$345.45–$355.95 | $987–$1,017 | varies |
| Us pelvic non ob complete (76856) | $715.40 | $2,044 | 7.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $311.15 | $889 | 3.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $249.20 | $712 | 2.4× |
| Us retroperitoneal complete (76770) | $394.80 | $1,128 | 3.9× |
| Us retroperitoneal limited (76775) | $262.50 | $750 | 2.6× |
| Us scrotum and contents (76870) | $603.75 | $1,725 | 5.9× |
| Us thyroid (76536) | $556.15 | $1,589 | 5.5× |
| Us transrectal (76872) | $432.95 | $1,237 | 4.2× |
| Wrist 2 views (73100) | $269.50 | $770 | 3.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $306.60 | $876 | 3.6× |
| X-Ray Bend Only L-S Spine (72120) | $355.60 | $1,016 | 3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $232.40 | $664 | 2.7× |
| X-Ray Exam Breast Specimen (76098) | $680.40 | $1,944 | 1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $122.85 | $351 | 1.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $388.15 | $1,109 | 3.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $511.35 | $1,461 | 5.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $109.55 | $313 | 1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $142.10 | $406 | 1.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $299.25 | $855 | 2.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $165.90 | $474 | 1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $362.95 | $1,037 | 3.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $406 | $1,160 | 4.0× |
| X-Ray Exam L-S Spine Bending (72114) | $558.25 | $1,595 | 5.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $374.85 | $1,071 | 4.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $627.20 | $1,792 | 6.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $202.65 | $579 | 2.0× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$141.05–$211.40 | $403–$604 | varies |
| X-ray humerus (73060) | $188.30 | $538 | 2.2× |
| X-ray IV pyelogram (ivp) (74400) | $429.10 | $1,226 | 2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $150.15 | $429 | 1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $156.10 | $446 | 1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $337.75 | $965 | 3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $442.75 | $1,265 | 4.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $220.85 | $631 | 2.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $153.65 | $439 | 1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $304.85 | $871 | 3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $263.90 | $754 | 3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $430.15 | $1,229 | 4.2× |
| X-ray thoracic spine 4 vw (72074) | $466.90 | $1,334 | 4.6× |
| X-Ray Tmj Unilat (70328) | $109.55 | $313 | 1.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $493.85 | $1,411 | 1.5× |
| X-Rays Bone Length Studies (77073) | $150.85 | $431 | 1.5× |
| X-Rays Bone Survey Complete (77075) | $482.30 | $1,378 | 4.7× |
| Xr c-spine 4 or 5 views (72050) | $519.05 | $1,483 | 5.1× |
| Xr facial bones less than 3 views (70140) | $141.05 | $403 | 1.7× |
| Xr orbits complete 4 views (70200) | $255.85 | $731 | 2.5× |
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.