Imaging prices at Casa Colina Hospital
Pomona, CA · every code in this section with a posted price and a Medicare benchmark.
248 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 2 matching MRF lines |
$145.51 | $260.64–$264.15 | 1.3× |
| Abdomen 2 views (74019) | $174.80 | $320.64 | 1.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $668.42 | $1,166.04 | 1.3× |
| Ankle 2 views (73600) | $145.51 | $51.42 | 1.3× |
| Arthrogram ankle (73615) | $583.32 | $1,105.29 | 1.3× |
| Arthrogram hip (73525) | $583.32 | $1,105.29 | 1.3× |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$583.32 | $168.36–$1,105.29 | 1.3× |
| Bone age studies (77072) | $174.80 | $320.64 | 1.3× |
| Bone Imaging 3 Phase (78315) | $668.42 | $1,166.04 | 1.3× |
| Bone Imaging Whole Body (78306) | $668.42 | $1,166.04 | 1.3× |
| Bone survey infant (77076) | $174.80 | $320.64 | 1.3× |
| Brain Image W/Flow < 4 Views (78601) | $668.42 | $1,166.04 | 1.3× |
| Cat Scan Follow-Up Study (76380) | $145.51 | $260.64 | 1.3× |
| Chest 1 view (71045) | $145.51 | $260.64 | 1.3× |
| Chest 2 views (71046) | $145.51 | $260.64 | 1.3× |
| Chest 4 or more views (71048) | $174.80 | $320.64 | 1.3× |
| Cholecystography Oral Contrast (74290) | $293.27 | $541.02 | 1.3× |
| Clavicle complete (73000) | $145.51 | $54.45 | 1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $174.80 | $321.57 | 1.3× |
| Contrast X-Ray Bladder (74430) | $583.32 | $112.44 | 1.3× |
| Contrast X-Ray Of Elbow (73085) | $583.32 | $1,105.29 | 1.3× |
| Contrast X-Ray Of Knee Joint (73580) | $583.32 | $277.29 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) | $583.32 | $1,002.72 | 1.3× |
| CT abdomen and pelvis without contrast (74176) | $398.95 | $581.55 | 1.3× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$293.27 | $640.80–$771.93 | 1.3× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$293.27 | $640.80–$956.95 | 1.3× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$174.80 | $320.64–$638.90 | 1.3× |
| CT Angio Abdomen and Pelvis (74174) | $583.32 | $451.61 | 1.3× |
| CT Angio Chest (71275) | $293.27 | $1,378.70 | 1.3× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$293.27 | $541.02–$1,197.83 | 1.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$293.27 | $541.02–$558.98 | 1.3× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$293.27 | $541.02–$1,197.83 | 1.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $293.27 | $541.02 | 1.3× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$583.32 | $797.73–$1,105.29 | 1.3× |
| CT cervical spine w/o contrast (72125) | $174.80 | $666.90 | 1.3× |
| CT cervical spine w/wo cont (72127) | $293.27 | $998.35 | 1.3× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$293.27 | $541.02–$797.73 | 1.3× |
| CT chest w/wo contrast (71270) | $293.27 | $998.35 | 1.3× |
| CT head/brain with contrast (70460) | $293.27 | $638.90 | 1.3× |
| CT head/brain without and with contrast (70470) | $293.27 | $797.73 | 1.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $145.51 | $260.64 | 1.3× |
| CT iac w contrast (70481) | $293.27 | $541.02 | 1.3× |
| CT l-spine w&w/o contrast (72133) | $293.27 | $998.35 | 1.3× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$174.80 | $320.64–$558.98 | 1.3× |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$293.27 | $541.02–$666.90 | 1.3× |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$583.32 | $797.73–$1,105.29 | 1.3× |
| CT lumbar spine w/o contrast (72131) | $174.80 | $666.90 | 1.3× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$293.27 | $541.02–$866 | 1.3× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$174.80 | $276.17–$320.64 | 1.3× |
| CT neck tissue combo (70492) | $293.27 | $797.73 | 1.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $293.27 | $541.02 | 1.3× |
| CT orbits w/o contrast (70480) range across 4 matching MRF lines |
$174.80 | $320.64–$1,220.64 | 1.3× |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$293.27 | $640.80–$959.45 | 1.3× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$174.80 | $320.64–$666.90 | 1.3× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$293.27 | $541.02–$837.35 | 1.3× |
| CT scans face/jaw combo (70488) | $293.27 | $541.02 | 1.3× |
| CT soft tissue neck w contrast (70491) | $293.27 | $638.90 | 1.3× |
| CT soft tissue neck w/o contrast (70490) | $174.80 | $532.78 | 1.3× |
| CT thoracic spine w contrast (72129) | $293.27 | $797.73 | 1.3× |
| CT thoracic spine w/o contrast (72128) | $174.80 | $797.73 | 1.3× |
| CT thoracic spine w/wo cont (72130) | $293.27 | $998.35 | 1.3× |
| CT thorax w/o contrast (71250) | $174.80 | $666.90 | 1.3× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$174.80 | $320.64–$1,105.29 | 1.3× |
| CT upper extremity w/o & w/contrast material (73202) | $293.27 | $541.02 | 1.3× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$583.32 | $666.90–$1,105.29 | 1.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $293.27 | $1,763.98 | 1.3× |
| Cta Abdomen (74175) | $293.27 | $541.02 | 1.3× |
| CTA pelvis (72191) | $293.27 | $1,340.50 | 1.3× |
| Diskography lumbar (72295) | $3,264.99 | $832.44 | 1.3× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$174.80 | $282.69–$320.64 | 1.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $145.51 | $260.64 | 1.3× |
| Echo exam uterus (76831) | $398.95 | $700.56 | 1.3× |
| Esophagram (74220) range across 2 matching MRF lines |
$293.27 | $125.67–$541.02 | 1.3× |
| Fetal Biophys Profile W/Nst (76818) | $174.80 | $320.64 | 1.3× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$398.95 | $138.63–$700.53 | 1.3× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$145.51 | $51.42–$260.64 | 1.3× |
| Forearm 2 views (73090) | $145.51 | $54.45 | 1.3× |
| Gastric emptying imaging study (78264) | $668.42 | $1,166.04 | 1.3× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$174.80 | $51.42–$320.64 | 1.3× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$907.86 | $1,220–$1,513.50 | 1.3× |
| Hepatobiliary System Imaging (78226) | $668.42 | $1,166.04 | 1.3× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$398.95 | $138.63–$700.56 | 1.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $145.51 | $260.64 | 1.3× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$907.86 | $1,056–$1,513.50 | 1.3× |
| K Flow/Funct Image W/O Drug (78707) | $907.86 | $1,513.50 | 1.3× |
| Knee 3 Views (73562) | $145.51 | $61.02 | 1.3× |
| Liver & Spleen Imaging Static Only (78215) | $668.42 | $1,166.04 | 1.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $668.42 | $1,166.04 | 1.3× |
| Liver imaging static only (78201) | $907.86 | $1,513.50 | 1.3× |
| Liver imaging w/vascular flow (78202) | $907.86 | $1,513.50 | 1.3× |
| Lung Ventilat&Perfus Imaging (78582) | $907.86 | $1,513.50 | 1.3× |
| Mammary ductogram or galactogram multiple (77054) | $398.95 | $700.56 | 1.3× |
| Mammary ductogram or galactogram single (77053) | $398.95 | $700.56 | 1.3× |
| Mra Head W/O & W/Contrast Material (70546) | $583.32 | $1,105.29 | 1.3× |
| MRA head w/o contrast (70544) | $398.95 | $1,328 | 1.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $583.32 | $1,105.29 | 1.3× |
| MRA neck w/o contrast (70547) | $398.95 | $1,264 | 1.3× |
| MRI abdomen w/o contrast (74181) | $398.95 | $1,254.15 | 1.3× |
| MRI any jt lower extrem w/contrast material (73722) | $1,310.73 | $2,222.25 | 1.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$583.32 | $1,105.29–$2,299.05 | 1.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,310.73 | $2,222.25 | 1.3× |
| MRI brain functional w/o physician admnistration (70554) | $398.95 | $1,298.82 | 1.3× |
| MRI cervical spine w contrast (72142) | $583.32 | $1,516.25 | 1.3× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$398.95 | $700.56–$1,264 | 1.3× |
| MRI chest w/o contrast (71550) | $398.95 | $700.56 | 1.3× |
| MRI chest wo w contrast (71552) | $583.32 | $1,105.29 | 1.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $583.32 | $1,105.29 | 1.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $583.32 | $1,105.29 | 1.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$398.95 | $700.56–$1,054 | 1.3× |
| MRI lumbar spine w contrast (72149) | $583.32 | $1,516.25 | 1.3× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$583.32 | $1,105.29–$2,807.88 | 1.3× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$398.95 | $700.56–$1,838 | 1.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $583.32 | $1,105.29 | 1.3× |
| MRI pelvis w/o & w contrast (72197) | $583.32 | $1,105.29 | 1.3× |
| MRI pelvis w/o contrast (72195) | $398.95 | $700.56 | 1.3× |
| MRI thoracic spine w/o contrast (72146) | $398.95 | $1,402.88 | 1.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $583.32 | $1,105.29 | 1.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $398.95 | $700.56 | 1.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$583.32 | $1,105.26–$1,105.29 | 1.3× |
| MRI, abdomen, combo (74183) | $583.32 | $2,781.88 | 1.3× |
| MRI, dorsal spine combo (72157) | $583.32 | $1,105.29 | 1.3× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$398.95 | $700.56–$1,249.93 | 1.3× |
| MRI, joint upper extrem combo (73223) | $583.32 | $1,105.29 | 1.3× |
| MRI, lumbar spine combo (72158) | $583.32 | $571.55 | 1.3× |
| Myelogram cervical (72240) | $1,310.73 | $504.48 | 1.3× |
| Myelogram Lumbar (72265) | $1,310.73 | $432.96 | 1.3× |
| Myelography thoracic (72255) | $1,310.73 | $458.46 | 1.3× |
| Myelograpy 2/more regions rs&i (72270) | $1,310.73 | $647.91 | 1.3× |
| Myocardial Spect Multiple Studies (78452) | $2,164.67 | $3,600 | 1.3× |
| Neck soft tissue (70360) | $145.51 | $43.26 | 1.3× |
| Nm csf leak detection (78650) | $2,164.67 | $3,981.81 | 1.3× |
| Optic foramina (70190) | $145.51 | $266.04 | 1.3× |
| Parathyroid Planar Imaging (78070) | $668.42 | $1,166.04 | 1.3× |
| Pelvis 1 or 2 views (72170) | $174.80 | $296.19 | 1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$174.80 | $79.08–$320.64 | 1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 3 matching MRF lines |
$913.62 | $112.44–$1,509.39 | 1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) | $145.51 | $55.47 | 1.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $145.51 | $49.38 | 1.3× |
| Radex elbow complete minimum 3 views (73080) | $145.51 | $61.02 | 1.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $174.80 | $320.64 | 1.3× |
| Radex fingr minimum 2 views (73140) | $145.51 | $43.26 | 1.3× |
| Radex foot complete minimum 3 views (73630) | $145.51 | $55.47 | 1.3× |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$145.51 | $55.47–$260.64 | 1.3× |
| Radex lower extremity infant minimum 2 views (73592) | $145.51 | $260.64 | 1.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $174.80 | $320.64 | 1.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $145.51 | $54.45 | 1.3× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) range across 3 matching MRF lines |
$145.51 | $138.63–$260.64 | 1.3× |
| Radex Ribs Unilateral 2 Views (71100) | $145.51 | $61.02 | 1.3× |
| Radex shoulder complete minimum 2 views (73030) | $145.51 | $61.02 | 1.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $145.51 | $260.64 | 1.3× |
| Radex Spine 1 View Specify Level (72020) | $145.51 | $260.64 | 1.3× |
| Radex Sternum Minimum 2 Views (71120) | $145.51 | $69.18 | 1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $145.51 | $90.30 | 1.3× |
| Radex Toe Minimum 2 Views (73660) | $145.51 | $43.26 | 1.3× |
| Radex upper extremity infant minimum 2 views (73092) | $174.80 | $320.64 | 1.3× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$145.51 | $55.47–$260.64 | 1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $174.80 | $66.12 | 1.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$174.80 | $66.12–$320.64 | 1.3× |
| Radiologic exam colon double contrast study (74280) | $293.27 | $237.81 | 1.3× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$293.27 | $182.34–$541.02 | 1.3× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$174.80 | $66.12–$320.64 | 1.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $174.80 | $320.64 | 1.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$293.27 | $138.63–$541.02 | 1.3× |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$293.27 | $159.82–$541.02 | 1.3× |
| Radiologic exam upr gi trc double contrast study (74246) range across 4 matching MRF lines |
$293.27 | $175.50–$541.02 | 1.3× |
| Radiologic examination femur minimum 2 views (73552) | $145.51 | $260.64 | 1.3× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$145.51 | $54.45–$260.64 | 1.3× |
| Radiologic Examination Osseous Survey Limited (77074) | $174.80 | $320.64 | 1.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $145.51 | $54.45 | 1.3× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $913.62 | $1,509.39 | 1.3× |
| Ribs bilateral 3 views (71110) | $174.80 | $84.18 | 1.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $907.86 | $3,981.81 | 1.3× |
| Scapula (73010) | $174.80 | $54.45 | 1.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $74.28 | $86.73 | 3.2× |
| Shoulder 1 view (73020) | $145.51 | $49.38 | 1.3× |
| Shoulder Arthrography (73040) | $583.32 | $222.81 | 1.3× |
| Sialogram (70390) | $398.95 | $700.56 | 1.3× |
| Skull less than 4 views (70250) | $174.80 | $66.12 | 1.3× |
| Sternoclavicular joints (71130) | $145.51 | $260.64 | 1.3× |
| Thoracic spine 2 views (72070) | $174.80 | $69.18 | 1.3× |
| Thoracic spine 3 views (72072) | $174.80 | $79.08 | 1.3× |
| Thoracolumbar 2 views (72080) | $145.51 | $71.22 | 1.3× |
| Ultrasound Breast Limited (76642) | $145.51 | $260.64 | 1.3× |
| Ultrasound Elastography Parenchyma (76981) | $174.80 | $314.67 | 1.3× |
| Ultrasound Exam Aaa Screen (76706) | $174.80 | $320.64 | 1.3× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$174.80 | $160.63–$320.64 | 1.3× |
| Unlisted Dx Radiographic Procedure (76499) | $145.51 | $140 | 1.3× |
| Unlisted us procedure (76999) | $145.51 | $260.64 | 1.3× |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$293.27 | $157.71–$814.74 | 1.3× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$398.95 | $168.36–$700.56 | 1.3× |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$398.95 | $154.65–$700.56 | 1.3× |
| Us breast unilateral complete (76641) | $174.80 | $320.64 | 1.3× |
| Us chest (76604) | $174.80 | $320.64 | 1.3× |
| Us complete joint (76881) | $174.80 | $463.36 | 1.3× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$174.80 | $190.88–$320.64 | 1.3× |
| Us head (76506) | $174.80 | $320.64 | 1.3× |
| Us kidney transplant (76776) | $174.80 | $320.64 | 1.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$174.80 | $160.63–$320.64 | 1.3× |
| Us ob limited 1 or more fetuses (76815) | $174.80 | $320.64 | 1.3× |
| Us pelvic non ob complete (76856) | $174.80 | $108.40 | 1.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $174.80 | $320.64 | 1.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $174.80 | $320.64 | 1.3× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$174.80 | $130.80–$320.64 | 1.3× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$174.80 | $160.63–$320.64 | 1.3× |
| Us scrotum and contents (76870) | $174.80 | $113.96 | 1.3× |
| Us spinal canal and contents (76800) | $174.80 | $82.29 | 1.3× |
| Us thyroid (76536) range across 2 matching MRF lines |
$174.80 | $160.63–$320.64 | 1.3× |
| Us transrectal (76872) | $174.80 | $320.64 | 1.3× |
| Venography caval inferior serialography rs&i (75825) | $5,279.37 | $523.60 | 1.3× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$2,632.02 | $156.69–$4,463.55 | 1.3× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$2,632.02 | $101.22–$4,463.55 | 1.3× |
| Wrist 2 views (73100) | $145.51 | $51.42 | 1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $145.51 | $260.64 | 1.3× |
| X-Ray Bend Only L-S Spine (72120) | $174.80 | $95.10 | 1.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $145.51 | $54.45 | 1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $145.51 | $60.55 | 1.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $174.80 | $320 | 1.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $145.51 | $49.38 | 1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$145.51 | $61.02–$260.64 | 1.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$174.80 | $71.22–$320.64 | 1.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $174.80 | $320.64 | 1.3× |
| X-Ray Exam L-S Spine Bending (72114) | $174.80 | $125.67 | 1.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $145.51 | $260.64 | 1.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $174.80 | $119.55 | 1.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $174.80 | $71.22 | 1.3× |
| X-ray eye for foreign body (70030) | $145.51 | $43.26 | 1.3× |
| X-ray humerus (73060) | $145.51 | $61.02 | 1.3× |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$293.27 | $154.65–$541.02 | 1.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $145.51 | $66.12 | 1.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$145.51 | $51.42–$260.64 | 1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$174.80 | $71.22–$320.64 | 1.3× |
| X-ray nose-rectum child f.b. (76010) | $145.51 | $260.64 | 1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$174.80 | $95.10–$320.64 | 1.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$174.80 | $66.12–$320.64 | 1.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $174.80 | $320.64 | 1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$145.51 | $61.02–$260.64 | 1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $145.51 | $84.18 | 1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $174.80 | $95.10 | 1.3× |
| X-Ray Stress View (77071) | $145.51 | $260.64 | 1.3× |
| X-ray thoracic spine 4 vw (72074) | $174.80 | $320.64 | 1.3× |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$145.51 | $61.55–$62.55 | 1.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $583.32 | $277.29 | 1.3× |
| X-Rays Bone Length Studies (77073) | $174.80 | $84.18 | 1.3× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$174.80 | $320.64–$345 | 1.3× |
| Xr c-spine 4 or 5 views (72050) | $174.80 | $320.64 | 1.3× |
| Xr facial bones less than 3 views (70140) | $145.51 | $260.64 | 1.3× |
| XR Mastoids < 3 Views Bilateral (70120) | $174.80 | $164.90 | 1.3× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$174.80 | $84.18–$320.64 | 1.3× |
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.