Imaging prices at Catholic Medical Center
Manchester, NH · every code in this section with a posted price and a Medicare benchmark.
259 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) | $572 | $572 | 6.0× |
| Abdomen 2 views (74019) | $1,143 | $1,143 | 10.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $3,196 | $3,196 | 7.3× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$19,069–$21,384 | $19,069–$21,384 | varies |
| Angiography extremity bilateral rs&i (75716) | $21,428 | $21,428 | 6.2× |
| Angiography extremity unilateral rs&i (75710) | $7,397 | $7,397 | 2.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$9,536–$20,460 | $9,536–$20,460 | varies |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$651–$1,204 | $651–$1,204 | varies |
| Aortography thoracic w/o serialography rs&i (75600) | $14,959 | $14,959 | 4.3× |
| Artery X-Rays Abdomen (75726) | $15,347 | $15,347 | 2.5× |
| Artery X-Rays Pelvis (75736) | $15,347 | $15,347 | 2.5× |
| Bone age studies (77072) | $434 | $434 | 3.8× |
| Bone Imaging 3 Phase (78315) | $3,496 | $3,496 | 8.0× |
| Bone Imaging Limited Area (78300) | $2,829 | $2,829 | 6.5× |
| Bone Imaging Whole Body (78306) | $3,357 | $3,357 | 7.7× |
| Bone survey infant (77076) | $1,049 | $1,049 | 9.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $5,062 | $5,062 | 8.5× |
| Brain Imaging Minimum 4 Static Views (78605) | $2,948 | $2,948 | 5.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $9,550 | $9,550 | 6.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $6,913 | $6,913 | 18.1× |
| Cat Scan Follow-Up Study (76380) | $1,359 | $1,359 | 14.3× |
| Chest 1 view (71045) | $747 | $747 | 7.9× |
| Chest 2 views (71046) | $999 | $999 | 10.5× |
| Chest 3 views (71047) | $908 | $908 | 9.6× |
| Chest 4 or more views (71048) | $927 | $927 | 8.1× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$572–$1,058 | $572–$1,058 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $2,604 | $2,604 | 22.8× |
| Contrast Exam Abdominl Aorta (75625) | $17,001 | $17,001 | 4.9× |
| Contrast X-Ray Bladder (74430) | $1,481 | $1,481 | 3.9× |
| CT abdomen and pelvis without and with contrast (74178) | $8,166 | $8,166 | 21.4× |
| CT abdomen and pelvis without contrast (74176) | $6,211 | $6,211 | 23.8× |
| CT abdomen w contrast (74160) | $3,990 | $3,990 | 20.8× |
| CT abdomen w wo contrast (74170) | $4,081 | $4,081 | 21.3× |
| CT abdomen w/o contrast (74150) | $2,402 | $2,402 | 21.0× |
| CT Angio Abdomen and Pelvis (74174) | $7,348 | $7,348 | 19.3× |
| CT Angio Chest (71275) | $5,508 | $5,508 | 28.7× |
| CT Angio Head (70496) | $3,656 | $3,656 | 19.1× |
| CT angio hrt w/3d image (75574) | $2,417 | $2,417 | 6.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,794–$5,170 | $2,794–$5,170 | varies |
| CT Angio Neck (70498) | $3,554 | $3,554 | 18.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $4,102 | $4,102 | 21.4× |
| CT cervical spine w/ contrast (72126) | $3,763 | $3,763 | 9.9× |
| CT cervical spine w/o contrast (72125) | $2,694 | $2,694 | 23.6× |
| CT chest w contrast (71260) | $3,169 | $3,169 | 16.5× |
| CT chest w/wo contrast (71270) | $4,058 | $4,058 | 21.2× |
| CT colonography screening (74263) | $5,019 | $5,019 | 19.3× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $4,270 | $4,270 | 22.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,817 | $1,817 | 15.9× |
| CT head/brain with contrast (70460) | $3,370 | $3,370 | 17.6× |
| CT head/brain without and with contrast (70470) | $3,500 | $3,500 | 18.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,417 | $2,417 | 6.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $758 | $758 | 8.0× |
| CT iac w contrast (70481) | $3,689 | $3,689 | 19.3× |
| CT l-spine w&w/o contrast (72133) | $3,907 | $3,907 | 20.4× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$3,129–$5,789 | $3,129–$5,789 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$3,502–$6,479 | $3,502–$6,479 | varies |
| CT lumbar spine w contrast (72132) | $3,907 | $3,907 | 10.3× |
| CT lumbar spine w/o contrast (72131) | $2,984 | $2,984 | 26.1× |
| CT maxillofacial w contrast (70487) | $3,741 | $3,741 | 19.5× |
| CT maxillofacial wo contrast (70486) | $2,356 | $2,356 | 20.6× |
| CT neck tissue combo (70492) | $828 | $828 | 4.3× |
| CT orbits w/o contrast (70480) | $2,669 | $2,669 | 23.4× |
| CT pelvis w&w/o contrast (72194) | $3,011 | $3,011 | 15.7× |
| CT pelvis w/o contrast (72192) | $2,356 | $2,356 | 20.6× |
| CT scans face/jaw combo (70488) | $2,514 | $2,514 | 13.1× |
| CT soft tissue neck w contrast (70491) | $3,140 | $3,140 | 16.4× |
| CT soft tissue neck w/o contrast (70490) | $2,891 | $2,891 | 25.3× |
| CT thoracic spine w/o contrast (72128) | $2,827 | $2,827 | 24.8× |
| CT thorax w/o contrast (71250) | $2,854 | $2,854 | 25.0× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$3,276–$6,059 | $3,276–$6,059 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$3,932–$7,274 | $3,932–$7,274 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,512 | $4,512 | 23.5× |
| Cta Abdomen (74175) | $3,922 | $3,922 | 20.5× |
| CTA pelvis (72191) | $4,660 | $4,660 | 24.3× |
| Dxa Bone Density Axial (77080) | $942 | $942 | 8.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $621 | $621 | 6.5× |
| Echo exam uterus (76831) | $1,742 | $1,742 | 6.7× |
| Echo Guide For Artery Repair (76936) | $3,051 | $3,051 | 12.9× |
| Esophagram (74220) | $1,079 | $1,079 | 5.6× |
| Fetal Biophys Profile W/Nst (76818) | $1,248 | $1,248 | 10.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,248 | $1,248 | 10.9× |
| Fluoroscopy up to 1 hr (76000) | $961 | $961 | 3.7× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$676–$1,269 | $676–$1,269 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$572–$1,143 | $572–$1,143 | varies |
| Gastric emptying imaging study (78264) | $3,268 | $3,268 | 7.5× |
| Gated Heart Planar Single (78472) | $3,587 | $3,587 | 8.2× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$582–$2,104 | $582–$2,104 | varies |
| Hepatobil Syst Image W/Drug (78227) | $4,517 | $4,517 | 7.6× |
| Hepatobiliary System Imaging (78226) | $3,329 | $3,329 | 7.6× |
| Ht Muscle Image Spect Sing (78451) | $4,359 | $4,359 | 3.1× |
| Hysterosalpingogram (74740) | $2,794 | $2,794 | 10.7× |
| K Flow/Funct Image W/Drug (78708) | $2,942 | $2,942 | 5.0× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$1,053–$1,263 | $1,053–$1,263 | varies |
| Lung Ventilation Imaging (78579) | $2,381 | $2,381 | 5.5× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $31,649 | $31,649 | 9.2× |
| Magnetic Image Jaw Joint (70336) | $3,574 | $3,574 | 13.7× |
| Magnetic Resonance Elastography (76391) | $2,788 | $2,788 | 10.7× |
| Mr safety determination physician/other qhp (76016) | $444 | $444 | 4.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $124 | $124 | 3.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $463 | $463 | 4.5× |
| Mr safety implt pos&/immoblj (76019) | $300 | $300 | 4.7× |
| Mr safety med physics xm customization plng&mntr (76017) | $1,219 | $1,219 | 4.7× |
| Mra Head W/O & W/Contrast Material (70546) | $6,884 | $6,884 | 18.1× |
| MRA head w/o contrast (70544) | $4,687 | $4,687 | 18.0× |
| MRA head with contrast (70545) | $5,704 | $5,704 | 15.0× |
| MRA neck w contrast (70548) | $4,937 | $4,937 | 13.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $6,930 | $6,930 | 18.2× |
| MRA neck w/o contrast (70547) | $4,388 | $4,388 | 16.8× |
| MRI abdomen w/o contrast (74181) | $5,137 | $5,137 | 19.7× |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$5,704–$10,552 | $5,704–$10,552 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$6,682–$12,362 | $6,682–$12,362 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$5,704–$10,769 | $5,704–$10,769 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $2,762 | $2,762 | 10.6× |
| MRI cardiac w/o contrast (75557) | $2,786 | $2,786 | 10.7× |
| MRI cervical spine w contrast (72142) | $5,704 | $5,704 | 15.0× |
| MRI cervical spine w/o cont (72141) | $5,399 | $5,399 | 20.7× |
| MRI chest w/o contrast (71550) | $4,400 | $4,400 | 16.9× |
| MRI chest wo w contrast (71552) | $7,149 | $7,149 | 18.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$4,702–$8,699 | $4,702–$8,699 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 4 matching MRF lines |
$6,898–$12,761 | $6,898–$12,761 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$4,467–$8,262 | $4,467–$8,262 | varies |
| MRI lumbar spine w contrast (72149) | $5,704 | $5,704 | 15.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $7,218 | $7,218 | 18.9× |
| MRI orbit face &/neck w/o contrast (70540) | $1,222 | $1,222 | 4.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $6,708 | $6,708 | 17.6× |
| MRI pelvis w/o & w contrast (72197) | $7,149 | $7,149 | 18.8× |
| MRI pelvis w/o contrast (72195) | $4,694 | $4,694 | 18.0× |
| MRI thoracic spine w/o contrast (72146) | $4,994 | $4,994 | 19.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$4,702–$8,699 | $4,702–$8,699 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$4,467–$8,262 | $4,467–$8,262 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$6,690–$12,377 | $6,690–$12,377 | varies |
| MRI, abdomen, combo (74183) | $7,693 | $7,693 | 20.2× |
| MRI, dorsal spine combo (72157) | $7,149 | $7,149 | 18.8× |
| MRI, dorsal spine contrast (72147) | $5,704 | $5,704 | 15.0× |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$5,137–$9,502 | $5,137–$9,502 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$6,349–$11,744 | $6,349–$11,744 | varies |
| MRI, lumbar spine combo (72158) | $8,996 | $8,996 | 23.6× |
| Myocardial Spect Multiple Studies (78452) | $10,372 | $10,372 | 7.3× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $11,584 | $11,584 | 7.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $6,573 | $6,573 | 4.2× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $12,058 | $12,058 | 5.0× |
| Neck soft tissue (70360) | $572 | $572 | 6.0× |
| Nonvascular Shunt X-Ray (75809) | $872 | $872 | 7.6× |
| Nuclear Rx Oral Admin (79005) | $2,372 | $2,372 | 9.3× |
| Panoramic X-ray of jaws (70355) | $573 | $573 | 6.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,749 | $3,749 | 6.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,829 | $2,829 | 6.5× |
| Pelvis 1 or 2 views (72170) | $488 | $488 | 4.3× |
| PET image w/CT, full body (78816) | $14,857 | $14,857 | 9.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $14,857 | $14,857 | 9.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $3,012 | $3,012 | 6.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $853 | $853 | 7.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,694 | $2,694 | 4.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$651–$1,302 | $651–$1,302 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$570–$1,053 | $570–$1,053 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$650–$1,299 | $650–$1,299 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $813 | $813 | 7.1× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$496–$917 | $496–$917 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$570–$1,139 | $570–$1,139 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$874–$1,386 | $874–$1,386 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$498–$921 | $498–$921 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $572 | $572 | 6.0× |
| Radex Ribs Unilateral 2 Views (71100) | $617 | $617 | 6.5× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$572–$1,143 | $572–$1,143 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $747 | $747 | 7.9× |
| Radex Spine 1 View Specify Level (72020) | $570 | $570 | 6.0× |
| Radex Sternum Minimum 2 Views (71120) | $676 | $676 | 7.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $1,448 | $1,448 | 15.2× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$570–$1,053 | $570–$1,053 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$169–$312 | $169–$312 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$572–$1,310 | $572–$1,310 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $730 | $730 | 6.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,716 | $1,716 | 15.0× |
| Radiologic exam colon single contrast study (74270) | $1,266 | $1,266 | 6.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,173 | $1,173 | 6.1× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$1,349–$2,694 | $1,349–$2,694 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,477 | $1,477 | 7.7× |
| Radiologic exam swallow function contrast study (74230) | $1,086 | $1,086 | 5.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,532 | $1,532 | 8.0× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$582–$1,164 | $582–$1,164 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$634–$1,493 | $634–$1,493 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$702–$1,302 | $702–$1,302 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $942 | $942 | 8.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$661–$1,450 | $661–$1,450 | varies |
| Ribs bilateral 3 views (71110) | $816 | $816 | 7.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $4,132 | $4,132 | 7.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $4,114 | $4,114 | 6.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $5,208 | $5,208 | 3.7× |
| Scapula (73010) range across 3 matching MRF lines |
$498–$921 | $498–$921 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $174 | $174 | 7.4× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$517–$954 | $517–$954 | varies |
| Skull less than 4 views (70250) | $636 | $636 | 5.6× |
| Sternoclavicular joints (71130) | $550 | $550 | 5.8× |
| Thoracic spine 2 views (72070) | $704 | $704 | 6.2× |
| Thoracolumbar 2 views (72080) | $498 | $498 | 5.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,784 | $2,784 | 6.4× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$438–$1,001 | $438–$1,001 | varies |
| Ultrasound Elastography Parenchyma (76981) | $984 | $984 | 8.6× |
| Ultrasound Exam Aaa Screen (76706) | $1,259 | $1,259 | 11.0× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$1,263–$1,536 | $1,263–$1,536 | varies |
| Umbilical-artery Doppler (OB) (76820) | $864 | $864 | 7.6× |
| Upper gi w/o kub (74240) | $1,266 | $1,266 | 6.6× |
| Urethrocystogram voiding (74455) | $1,666 | $1,666 | 6.4× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$611–$1,168 | $611–$1,168 | varies |
| Us chest (76604) | $890 | $890 | 7.8× |
| Us complete joint (76881) | $1,014 | $1,014 | 8.9× |
| Us exam, pelvic, limited (76857) | $1,031 | $1,031 | 9.0× |
| Us head (76506) | $939 | $939 | 8.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$958–$962 | $958–$962 | varies |
| Us ob limited 1 or more fetuses (76815) | $1,081 | $1,081 | 9.5× |
| Us ob transvaginal (76817) | $1,172 | $1,172 | 10.3× |
| Us pelvic non ob complete (76856) | $1,657 | $1,657 | 14.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,729 | $1,729 | 15.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $940 | $940 | 8.2× |
| Us retroperitoneal complete (76770) | $1,391 | $1,391 | 12.2× |
| Us retroperitoneal limited (76775) | $1,323 | $1,323 | 11.6× |
| Us scrotum and contents (76870) | $1,439 | $1,439 | 12.6× |
| Us spinal canal and contents (76800) | $942 | $942 | 8.2× |
| Us thyroid (76536) | $1,439 | $1,439 | 12.6× |
| Vein X-Ray Chest (75827) | $5,461 | $5,461 | 3.2× |
| Venogram Sinus/Jugular (75860) | $7,303 | $7,303 | 2.1× |
| Venography caval inferior serialography rs&i (75825) | $6,210 | $6,210 | 1.8× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$5,436–$12,243 | $5,436–$12,243 | varies |
| Venography extremity unilateral rs&i (75820) range across 4 matching MRF lines |
$2,110–$7,496 | $2,110–$7,496 | varies |
| Venography Renal Unilateral (75831) | $4,942 | $4,942 | 1.4× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$582–$1,164 | $582–$1,164 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,270 | $1,270 | 13.4× |
| X-ray antegrade pyelogram tube (74425) | $1,674 | $1,674 | 4.4× |
| X-Ray Aorta Leg Arteries (75630) | $7,538 | $7,538 | 2.2× |
| X-Ray Bend Only L-S Spine (72120) | $650 | $650 | 5.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$656–$1,211 | $656–$1,211 | varies |
| X-Ray Exam Breast Specimen (76098) | $5,961 | $5,961 | 10.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $506 | $506 | 5.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $707 | $707 | 6.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $496 | $496 | 5.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $572 | $572 | 6.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,349 | $1,349 | 11.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $816 | $816 | 7.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,050 | $1,050 | 9.2× |
| X-Ray Exam L-S Spine Bending (72114) | $942 | $942 | 8.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $816 | $816 | 8.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $942 | $942 | 8.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $772 | $772 | 6.8× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$572–$1,058 | $572–$1,058 | varies |
| X-ray humerus (73060) | $572 | $572 | 6.0× |
| X-ray IV pyelogram (ivp) (74400) | $1,276 | $1,276 | 6.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $611 | $611 | 6.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $790 | $790 | 6.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $942 | $942 | 8.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $488 | $488 | 4.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $572 | $572 | 6.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $676 | $676 | 7.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $588 | $588 | 5.1× |
| X-ray thoracic spine 4 vw (72074) | $707 | $707 | 6.2× |
| X-Ray Tmj Unilat (70328) | $726 | $726 | 7.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,850 | $2,850 | 7.5× |
| X-Rays Bone Length Studies (77073) | $766 | $766 | 6.7× |
| Xr c-spine 4 or 5 views (72050) | $942 | $942 | 8.2× |
| Xr orbits complete 4 views (70200) | $784 | $784 | 6.9× |
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.