Imaging prices at Carle Richland Memorial Hospital

Olney, IL · every code in this section with a posted price and a Medicare benchmark.

303 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $672 $672 7.2×
Abdomen 2 views (74019) $1,166 $1,166 10.4×
Acute Gastrointestinal Blood Loss Imaging (78278) $2,982 $2,982 7.0×
Ankle 2 views (73600) $499 $499 5.4×
Arthrogram ankle (73615) $1,134 $1,134 3.0×
Arthrogram hip (73525) $1,134 $1,134 3.0×
Bone age studies (77072) $809 $809 7.2×
Bone Imaging 3 Phase (78315) $2,793 $2,793 6.5×
Bone Imaging Limited Area (78300) $1,838 $1,838 4.3×
Bone Imaging Multiple Areas (78305) $2,762 $2,762 6.4×
Bone Imaging Whole Body (78306) $4,032 $4,032 9.4×
Bone survey infant (77076) $735 $735 6.6×
Brain Imaging Minimum 4 Static Views (78605) $966 $966 1.7×
Cat Scan Follow-Up Study (76380) $672 $672 7.2×
Cerebrospinal Fluid Scan (78630) $4,704 $4,704 8.1×
Chest 1 view (71045) $483 $483 5.2×
Chest 2 views (71046) $567 $567 6.1×
Chest 3 views (71047) $1,019 $1,019 10.9×
Chest 4 or more views (71048) $1,103 $1,103 9.8×
Clavicle complete (73000) $893 $893 9.6×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $651 $651 5.8×
Contrast X-Ray Bladder (74430) $1,544 $1,544 4.1×
Contrast X-Ray Of Elbow (73085) $1,019 $1,019 2.7×
CT abdomen and pelvis without and with contrast (74178) $9,923 $9,923 26.5×
CT abdomen and pelvis without contrast (74176) $5,586 $5,586 21.8×
CT abdomen w contrast (74160) $4,883 $4,883 26.0×
CT abdomen w wo contrast (74170) $5,345 $5,345 28.4×
CT abdomen w/o contrast (74150) $3,791 $3,791 33.8×
CT Angio Abdomen and Pelvis (74174) $5,198 $5,198 13.9×
CT Angio Chest (71275) $3,990 $3,990 21.2×
CT Angio Head (70496) $4,767 $4,767 25.4×
Ct Angio Lwr Extr W/O&W/Dye (73706) $3,728 $3,728 19.8×
CT Angio Neck (70498) $4,158 $4,158 22.1×
Ct Angio Upr Extrm W/O&W/Dye (73206) $3,360 $3,360 17.9×
CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) $940 $940 5.0×
CT cervical spine w/ contrast (72126) $4,988 $4,988 13.3×
CT cervical spine w/o contrast (72125) $4,484 $4,484 40.0×
CT cervical spine w/wo cont (72127) $6,584 $6,584 35.0×
CT chest w contrast (71260) $4,442 $4,442 23.6×
CT chest w/wo contrast (71270) $4,883 $4,883 26.0×
CT head/brain with contrast (70460) $4,106 $4,106 21.8×
CT head/brain without and with contrast (70470) $4,883 $4,883 26.0×
CT heart no contrast quant eval coronry calcium (75571) $147 $147 1.6×
CT iac w contrast (70481) $3,266 $3,266 17.4×
CT l-spine w&w/o contrast (72133) $4,883 $4,883 26.0×
CT lower ext w/o (73700) $3,224 $3,224 28.8×
CT lower extremity w/contrast material (73701) $3,749 $3,749 19.9×
CT lumbar spine w contrast (72132) $4,232 $4,232 11.3×
CT lumbar spine w/o contrast (72131) $2,520 $2,520 22.5×
CT maxillofacial w contrast (70487) $3,476 $3,476 18.5×
CT maxillofacial wo contrast (70486) $2,940 $2,940 26.2×
CT neck tissue combo (70492) $4,883 $4,883 26.0×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $3,539 $3,539 18.8×
CT orbits w/o contrast (70480) $2,384 $2,384 21.3×
CT pelvis w&w/o contrast (72194) $4,295 $4,295 22.9×
CT pelvis w/o contrast (72192) $3,581 $3,581 32.0×
CT scan of leg combo (73702) $4,053 $4,053 21.6×
CT scans face/jaw combo (70488) $3,696 $3,696 19.7×
CT soft tissue neck w contrast (70491) $4,862 $4,862 25.9×
CT soft tissue neck w/o contrast (70490) $4,484 $4,484 40.0×
CT thoracic spine w contrast (72129) $3,749 $3,749 19.9×
CT thoracic spine w/o contrast (72128) $3,749 $3,749 33.5×
CT thoracic spine w/wo cont (72130) $3,255 $3,255 17.3×
CT thorax w/o contrast (71250) $3,528 $3,528 31.5×
CT upper ext wo (73200) $2,426 $2,426 21.7×
CT upper extremity w/o & w/contrast material (73202) $4,053 $4,053 21.6×
CT upper extremity with contrast (73201) $3,749 $3,749 10.0×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $4,389 $4,389 23.4×
Cta Abdomen (74175) $4,767 $4,767 25.4×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,869 $1,869 5.0×
CTA pelvis (72191) $4,620 $4,620 24.6×
Dilation ureters/urethra rs&i (74485) $2,594 $2,594 1.2×
Doppler Fetal Mid Cerebral Artery (76821) $914 $914 8.2×
Dxa Bone Density Axial (77080) $693 $693 6.2×
Dxa bone density study (77085) $341 $341 3.0×
Dxa bone density study 1/>sites appendiclr skel (77081) $352 $352 3.8×
Esophagram (74220) $1,481 $1,481 7.9×
Fetal Biophys Profile W/Nst (76818) $1,523 $1,523 13.6×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $1,596 $1,596 14.2×
Fluoroscopy up to 1 hr (76000) $840 $840 3.3×
Foot 2 views (73620) $546 $546 5.9×
Forearm 2 views (73090) $693 $693 7.4×
Gastric emptying imaging study (78264) $2,457 $2,457 5.7×
Gastroesophageal Reflux Exam (78262) $1,428 $1,428 3.3×
Gated Heart Planar Single (78472) $2,846 $2,846 6.6×
Hand 2 views (73120) $683 $683 6.1×
Hepatobil Syst Image W/Drug (78227) $3,077 $3,077 5.3×
Hepatobiliary System Imaging (78226) $3,077 $3,077 7.2×
Ht Musc Image Planar Mult (78454) $5,450 $5,450 3.9×
Ht Muscle Image Spect Sing (78451) $1,859 $1,859 1.3×
Hysterosalpingogram (74740) $1,155 $1,155 4.5×
Infant hip ultrasound, limited static exam (76886) $1,187 $1,187 12.7×
Joint Survey Single View (77077) $735 $735 6.6×
K Flow/Funct Image Multiple (78709) $3,203 $3,203 5.5×
K Flow/Funct Image W/Drug (78708) $2,468 $2,468 4.2×
K Flow/Funct Image W/O Drug (78707) $2,069 $2,069 3.6×
Kidney Imaging Morphol (78700) $3,528 $3,528 8.2×
Knee 3 Views (73562) $945 $945 10.1×
Liver & Spleen Imaging Static Only (78215) $1,890 $1,890 4.4×
Liver imaging static only (78201) $1,974 $1,974 3.4×
Lung perfusion differential (78597) $1,365 $1,365 3.2×
Lung Ventilat&Perfus Imaging (78582) $2,426 $2,426 4.2×
Lymph System Imaging (78195) $1,302 $1,302 2.2×
Magnetic Image Jaw Joint (70336) $4,715 $4,715 18.4×
Mammary ductogram or galactogram multiple (77054) $1,134 $1,134 4.4×
Mammary ductogram or galactogram single (77053) $956 $956 3.7×
Meckels Divert Exam (78290) $3,360 $3,360 7.8×
Medical physics dose eval radiation expos w/rprt (76145) $987 $987 2.5×
Mr safety determination physician/other qhp (76016) $294 $294 3.2×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $81 $81 2.6×
Mr safety implt electronics prepj supvj phys/qhp (76018) $305 $305 3.0×
Mr safety implt pos&/immoblj (76019) $200 $200 3.2×
Mr safety med physics xm customization plng&mntr (76017) $798 $798 3.1×
Mra Head W/O & W/Contrast Material (70546) $5,219 $5,219 14.0×
MRA head w/o contrast (70544) $5,219 $5,219 20.4×
MRA head with contrast (70545) $5,219 $5,219 14.0×
MRA neck w contrast (70548) $5,219 $5,219 14.0×
Mra Neck W/O &W/Contrast Material (70549) $6,174 $6,174 16.5×
MRA neck w/o contrast (70547) $3,560 $3,560 13.9×
MRI abdomen w contrast (74182) $4,316 $4,316 11.5×
MRI abdomen w/o contrast (74181) $2,972 $2,972 11.6×
MRI any jt lower extrem w/contrast material (73722) $4,032 $4,032 4.8×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $4,400 $4,400 11.8×
MRI any jt upper extremity w/contrast matrl (73222) $3,560 $3,560 4.2×
MRI cervical spine w contrast (72142) $6,090 $6,090 16.3×
MRI cervical spine w/o cont (72141) $5,219 $5,219 20.4×
MRI chest w/o contrast (71550) $3,560 $3,560 13.9×
MRI chest with contrast (71551) $4,715 $4,715 5.6×
MRI chest wo w contrast (71552) $4,851 $4,851 13.0×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $4,862 $4,862 13.0×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,715 $4,715 12.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $3,560 $3,560 13.9×
MRI lumbar spine w contrast (72149) $5,597 $5,597 15.0×
Mri Neck Spine W/O & W/Dye (72156) $6,983 $6,983 18.7×
MRI orbit face &/neck w/o contrast (70540) $2,972 $2,972 11.6×
MRI orbit face neck w contrast (70542) $3,938 $3,938 10.5×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $4,988 $4,988 13.3×
MRI pelvis w contrast (72196) $5,250 $5,250 14.0×
MRI pelvis w/o & w contrast (72197) $6,290 $6,290 16.8×
MRI pelvis w/o contrast (72195) $2,226 $2,226 8.7×
MRI thoracic spine w/o contrast (72146) $4,368 $4,368 17.1×
MRI upper extremity oth than jt w/contr matrl (73219) $2,972 $2,972 7.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $3,497 $3,497 13.7×
Mri Uppr Extremity W/O&W/Dye (73220) $3,045 $3,045 8.1×
MRI, abdomen, combo (74183) $4,547 $4,547 12.2×
MRI, dorsal spine combo (72157) $5,838 $5,838 15.6×
MRI, dorsal spine contrast (72147) $4,683 $4,683 12.5×
MRI, joint upper extrem (73221) $5,345 $5,345 20.9×
MRI, joint upper extrem combo (73223) $4,851 $4,851 13.0×
MRI, lumbar spine combo (72158) $7,067 $7,067 18.9×
Myelogram cervical (72240) $2,793 $2,793 3.3×
Myelogram Lumbar (72265) $2,793 $2,793 3.3×
Myelography thoracic (72255) $2,793 $2,793 3.3×
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $1,890 $1,890 4.4×
Myocardial Spect Multiple Studies (78452) $8,064 $8,064 5.8×
N-invas est c ffr sw aly CTA (75580) $3,276 $3,276 3.6×
Neck soft tissue (70360) $1,260 $1,260 13.5×
Nuclear Rx Oral Admin (79005) $2,174 $2,174 8.7×
Optic foramina (70190) $1,050 $1,050 11.3×
Parathyroid Planar Imaging (78070) $2,447 $2,447 5.7×
Pelvis 1 or 2 views (72170) $672 $672 6.0×
PET image w/CT, full body (78816) $11,498 $11,498 7.5×
PET imaging CT attenuation skull base mid-thigh (78815) $11,498 $11,498 7.5×
Pulmonary Perfusion Imaging Particulate (78580) $3,171 $3,171 7.4×
Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) $4,985 $4,985 5.0×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $1,019 $1,019 9.1×
Radex abscess/fistula/sinus tract rs&i (76080) $977 $977 1.7×
Radex Ankle Complete Minimum 3 Views (73610) $672 $672 7.2×
Radex Calcaneus Minimum 2 Views (73650) $683 $683 7.3×
Radex elbow complete minimum 3 views (73080) $1,092 $1,092 11.7×
Radex Facial Bones Complete Minimum 3 Views (70150) $966 $966 8.6×
Radex fingr minimum 2 views (73140) $546 $546 5.9×
Radex foot complete minimum 3 views (73630) $693 $693 7.4×
Radex Hand Minimum 3 Views (73130) $735 $735 7.9×
Radex lower extremity infant minimum 2 views (73592) $704 $704 7.5×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $924 $924 8.2×
Radex Nasal Bones Complete Minimum 3 Views (70160) $987 $987 10.6×
Radex Ribs Unilateral 2 Views (71100) $1,187 $1,187 12.7×
Radex shoulder complete minimum 2 views (73030) $945 $945 10.1×
Radex Sinuses Paransl < 3 Views (70210) $788 $788 8.4×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $2,709 $2,709 14.4×
Radex Spine 1 View Specify Level (72020) $1,187 $1,187 12.7×
Radex Sternum Minimum 2 Views (71120) $956 $956 10.3×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $1,491 $1,491 16.0×
Radex Toe Minimum 2 Views (73660) $425 $425 4.6×
Radex upper extremity infant minimum 2 views (73092) $347 $347 3.1×
Radex Wrist Complete Minimum 3 Views (73110) $987 $987 10.6×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $1,775 $1,775 15.8×
Radiolog exam mandible compl minimum 4 views (70110) $966 $966 8.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $1,134 $1,134 10.1×
Radiologic exam colon double contrast study (74280) $1,649 $1,649 8.8×
Radiologic exam colon single contrast study (74270) $1,344 $1,344 7.2×
Radiologic exam knee complete 4/more views (73564) $1,187 $1,187 10.6×
Radiologic exam pelvis compl minimum 3 views (72190) $1,197 $1,197 10.7×
Radiologic Exam Small Int Single Contrast Study (74250) $1,901 $1,901 10.1×
Radiologic exam swallow function contrast study (74230) $1,617 $1,617 8.6×
Radiologic exam upr gi trc double contrast study (74246) $1,376 $1,376 7.3×
Radiologic examination femur 1 view (73551) $788 $788 8.4×
Radiologic examination femur minimum 2 views (73552) $788 $788 8.4×
Radiologic examination knee 1/2 views (73560) $735 $735 7.9×
Radiologic Examination Osseous Survey Limited (77074) $1,239 $1,239 11.1×
Radiologic Examination Salivary Gland Calculus (70380) $1,082 $1,082 11.6×
Radiologic examination tibia & fibula 2 views (73590) $735 $735 7.9×
Ribs bilateral 3 views (71110) $1,302 $1,302 11.6×
Rp loclzj tum plnr 1 area single day imaging (78800) $3,224 $3,224 7.5×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $3,444 $3,444 8.0×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $3,234 $3,234 5.6×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $1,754 $1,754 3.0×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $1,754 $1,754 3.0×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $3,098 $3,098 2.0×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $4,032 $4,032 2.9×
Scapula (73010) $998 $998 8.9×
Screening Digital Breast Tomosynthesis Bi (77063) $194 $194 8.3×
Sella turcica (70240) $840 $840 9.0×
Shoulder 1 view (73020) $893 $893 9.6×
Shoulder Arthrography (73040) $1,376 $1,376 3.7×
Skull less than 4 views (70250) $987 $987 8.8×
Sternoclavicular joints (71130) $956 $956 10.3×
Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) $547 $547 5.0×
Surf radj ther supfc dlvr<=150 kv per fraction (77437) $547 $547 5.0×
Surf radj ther supfc/orthvlt treatment planning (77436) $200 $200 5.0×
Tbs techl prep&transmis data alys pfrmd elsewhr (77090) $546 $546 5.9×
Tbs technical calculation only (77091) $336 $336 3.6×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $630 $630 3.4×
Thoracic spine 2 views (72070) $987 $987 8.8×
Thoracic spine 3 views (72072) $893 $893 8.0×
Thoracolumbar 2 views (72080) $1,187 $1,187 12.7×
Thyroid Imaging With Vascular Flow (78013) $1,418 $1,418 3.3×
Thyroid Met Imaging Body (78018) $3,465 $3,465 6.0×
Thyroid Uptake Measurement (78012) $499 $499 1.2×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $3,245 $3,245 7.6×
Ultrasound Breast Limited (76642) $1,071 $1,071 11.5×
Ultrasound Exam Aaa Screen (76706) $1,050 $1,050 9.4×
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines		 $1,470–$1,481 $1,470–$1,481 varies
Umbilical-artery Doppler (OB) (76820) $672 $672 6.0×
Unlisted us procedure (76999) $662 $662 7.1×
Upper gi w/o kub (74240) $1,071 $1,071 5.7×
Ureteral Reflux Study (78740) $1,187 $1,187 2.8×
Urethrocystogram voiding (74455) $1,670 $1,670 6.5×
Urethrocystography retrograde (74450) $693 $693 2.7×
Us breast unilateral complete (76641) $1,071 $1,071 9.6×
Us chest (76604) $1,439 $1,439 12.8×
Us complete joint (76881) $1,271 $1,271 11.3×
Us exam, pelvic, limited (76857) $1,344 $1,344 12.0×
Us head (76506) $1,155 $1,155 10.3×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines		 $956–$1,260 $956–$1,260 varies
Us ob detailed single fetus (76811) $1,680 $1,680 6.6×
Us ob limited 1 or more fetuses (76815) $987 $987 8.8×
Us ob transvaginal (76817) $1,901 $1,901 17.0×
Us pelvic non ob complete (76856) $1,722 $1,722 15.4×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $1,680 $1,680 15.0×
Us preg uterus real time f/u trnsabdl per fetus (76816) $956 $956 8.5×
Us retroperitoneal complete (76770) $1,544 $1,544 13.8×
Us retroperitoneal limited (76775) $1,155 $1,155 10.3×
Us scrotum and contents (76870) $1,607 $1,607 14.3×
Us spinal canal and contents (76800) $851 $851 7.6×
Us thyroid (76536) $1,544 $1,544 13.8×
Us transrectal (76872) $914 $914 8.2×
Venography extremity bilateral rs&i (75822) $3,140 $3,140 1.9×
Venography extremity unilateral rs&i (75820) $2,090 $2,090 1.2×
Vertebral fracture assessment via dxa (77086) $299 $299 3.2×
Wrist 2 views (73100) $809 $809 8.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $1,050 $1,050 11.3×
X-ray antegrade pyelogram tube (74425) $1,250 $1,250 3.3×
X-Ray Bend Only L-S Spine (72120) $735 $735 6.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $924 $924 9.9×
X-Ray Exam Breast Specimen (76098) $578 $578 1.0×
X-Ray Exam Entire Spi 1 Vw (72081) $756 $756 8.1×
X-Ray Exam Entire Spi 2/3 Vw (72082) $1,355 $1,355 12.1×
X-Ray Exam Entire Spi 4/5 Vw (72083) $347 $347 3.1×
X-Ray Exam Hip Uni 1 View (73501) $746 $746 8.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $1,092 $1,092 11.7×
X-Ray Exam Hip Uni 4/> Views (73503) $1,092 $1,092 9.7×
X-Ray Exam Hips Bi 2 Views (73521) $1,628 $1,628 14.5×
X-Ray Exam Hips Bi 3-4 Views (73522) $924 $924 8.2×
X-Ray Exam Hips Bi 5/> Views (73523) $924 $924 8.2×
X-Ray Exam L-S Spine Bending (72114) $935 $935 8.3×
X-Ray Exam Neck Spine 2-3 Vw (72040) $956 $956 10.3×
X-Ray Exam Neck Spine 6/>Vws (72052) $1,502 $1,502 13.4×
X-Ray Exam Unilat Ribs/Chest (71101) $1,134 $1,134 10.1×
X-ray eye for foreign body (70030) $452 $452 4.8×
X-ray humerus (73060) $893 $893 9.6×
X-ray IV pyelogram (ivp) (74400) $1,596 $1,596 8.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $567 $567 6.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $977 $977 10.5×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $1,008 $1,008 9.0×
X-ray nose-rectum child f.b. (76010) $683 $683 7.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $819 $819 7.3×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $1,103 $1,103 9.8×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $651 $651 5.8×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $1,124 $1,124 12.1×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $987 $987 10.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $1,124 $1,124 10.0×
X-Ray Stress View (77071) $420 $420 4.5×
X-ray thoracic spine 4 vw (72074) $851 $851 7.6×
X-Ray Tmj Unilat (70328) $1,008 $1,008 10.8×
X-Ray Urinary Tract Exam With Contrast Material (74420) $1,733 $1,733 4.6×
X-Rays Bone Length Studies (77073) $504 $504 4.5×
X-Rays Bone Survey Complete (77075) $2,468 $2,468 22.0×
Xr c-spine 4 or 5 views (72050) $1,176 $1,176 10.5×
Xr facial bones less than 3 views (70140) $546 $546 5.9×
Xr orbits complete 4 views (70200) $1,008 $1,008 9.0×
Xr Tomogram Single Plane (76100) $2,100 $2,100 18.7×

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.