Imaging prices at Children's Hospital of The King's Daughters
Norfolk, VA · every code in this section with a posted price and a Medicare benchmark.
279 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) | $355.23 | $394.70 | 4.2× |
| Abdomen 2 views (74019) | $564.10 | $626.78 | 5.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $3,724.51 | $4,138.34 | 9.5× |
| Angiography extremity unilateral rs&i (75710) | $8,478.16 | $9,420.18 | 2.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,989.27 | $4,432.52 | 1.3× |
| Ankle 2 views (73600) | $554.81 | $616.46 | 6.5× |
| Aortography thoracic serialography rs&i (75605) | $7,274.81 | $8,083.12 | 1.3× |
| Aortography thoracic w/o serialography rs&i (75600) | $3,618.84 | $4,020.93 | 1.2× |
| Arthrogram ankle (73615) | $1,058.91 | $1,176.57 | 3.1× |
| Arthrogram hip (73525) | $1,313.98 | $1,459.98 | 3.9× |
| Arthrogram Wrist (73115) | $1,277.03 | $1,418.92 | 3.8× |
| Bone age studies (77072) | $341.33 | $379.26 | 3.3× |
| Bone Imaging 3 Phase (78315) | $4,275.60 | $4,750.67 | 11.0× |
| Bone Imaging Limited Area (78300) | $1,983.73 | $2,204.14 | 5.1× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$2,892.65–$3,691.92 | $3,214.05–$4,102.13 | varies |
| Bone survey infant (77076) | $688.87 | $765.41 | 6.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,577.96 | $1,753.29 | 3.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $10,337.51 | $11,486.12 | 7.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $4,045.40 | $4,494.89 | 11.9× |
| Cat Scan Follow-Up Study (76380) | $920.45 | $1,022.72 | 10.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $954.93 | $1,061.03 | 1.8× |
| Chest 1 view (71045) | $351.50 | $390.56 | 4.1× |
| Chest 2 views (71046) | $494.88 | $549.87 | 5.8× |
| Chest 3 views (71047) | $519.19 | $576.88 | 6.1× |
| Chest 4 or more views (71048) | $525.90 | $584.33 | 5.2× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $1,707.47 | $1,897.19 | 16.7× |
| Clavicle complete (73000) | $573.03 | $636.70 | 6.7× |
| Contrast Exam Abdominl Aorta (75625) | $3,317.31 | $3,685.90 | 1.1× |
| Contrast X-Ray Bladder (74430) | $659.10 | $732.33 | 1.9× |
| Contrast X-Ray Of Elbow (73085) | $1,310.01 | $1,455.57 | 3.8× |
| Contrast X-Ray Of Knee Joint (73580) | $789.70 | $877.44 | 2.3× |
| CT abdomen and pelvis without and with contrast (74178) | $7,005.53 | $7,783.92 | 20.6× |
| CT abdomen and pelvis without contrast (74176) | $5,095.70 | $5,661.89 | 21.9× |
| CT abdomen w contrast (74160) | $2,850.25 | $3,166.94 | 16.7× |
| CT abdomen w wo contrast (74170) | $3,193.31 | $3,548.12 | 18.7× |
| CT abdomen w/o contrast (74150) | $2,245.05 | $2,494.50 | 22.0× |
| CT Angio Abdomen and Pelvis (74174) | $6,873.56 | $7,637.29 | 20.2× |
| CT Angio Chest (71275) | $4,194.99 | $4,661.10 | 24.5× |
| CT Angio Head (70496) | $4,121.56 | $4,579.51 | 24.1× |
| CT angio hrt w/3d image (75574) | $2,580.35 | $2,867.06 | 7.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $3,074.99 | $3,416.65 | 18.0× |
| CT Angio Neck (70498) | $3,960.82 | $4,400.91 | 23.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $4,485.72 | $4,984.13 | 26.2× |
| CT cervical spine w/ contrast (72126) | $3,788.66 | $4,209.62 | 11.1× |
| CT cervical spine w/o contrast (72125) | $2,156.16 | $2,395.73 | 21.1× |
| CT cervical spine w/wo cont (72127) | $3,811.23 | $4,234.70 | 22.3× |
| CT chest w contrast (71260) | $3,103.52 | $3,448.35 | 18.1× |
| CT chest w/wo contrast (71270) | $3,406.15 | $3,784.61 | 19.9× |
| CT head/brain with contrast (70460) | $2,963.60 | $3,292.89 | 17.3× |
| CT head/brain without and with contrast (70470) | $3,586 | $3,984.44 | 21.0× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,498.13 | $1,664.59 | 4.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $840.24 | $933.60 | 9.9× |
| CT hrt w/3d image congen (75573) | $2,474.92 | $2,749.91 | 7.3× |
| CT iac w contrast (70481) | $2,442.43 | $2,713.81 | 14.3× |
| CT l-spine w&w/o contrast (72133) | $3,520.06 | $3,911.18 | 20.6× |
| CT lower ext w/o (73700) | $2,831.14 | $3,145.71 | 27.8× |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$3,146.43–$3,255.81 | $3,496.03–$3,617.57 | varies |
| CT lumbar spine w contrast (72132) | $2,752.45 | $3,058.28 | 8.1× |
| CT lumbar spine w/o contrast (72131) | $2,873.31 | $3,192.57 | 28.2× |
| CT maxillofacial w contrast (70487) | $3,335.45 | $3,706.06 | 19.5× |
| CT maxillofacial wo contrast (70486) | $2,648.31 | $2,942.57 | 26.0× |
| CT neck tissue combo (70492) | $2,932.60 | $3,258.44 | 17.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,605.16 | $2,894.62 | 15.2× |
| CT orbits w/o contrast (70480) | $2,147.98 | $2,386.64 | 21.1× |
| CT pelvis w&w/o contrast (72194) | $3,657.59 | $4,063.99 | 21.4× |
| CT pelvis w/o contrast (72192) | $2,759.20 | $3,065.78 | 27.1× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$3,128.93–$3,744.17 | $3,476.59–$4,160.19 | varies |
| CT scans face/jaw combo (70488) | $3,951.14 | $4,390.16 | 23.1× |
| CT soft tissue neck w contrast (70491) | $2,693.71 | $2,993.01 | 15.7× |
| CT soft tissue neck w/o contrast (70490) | $2,125.59 | $2,361.77 | 20.8× |
| CT thoracic spine w contrast (72129) | $2,798.70 | $3,109.67 | 16.4× |
| CT thoracic spine w/o contrast (72128) | $2,920.19 | $3,244.66 | 28.6× |
| CT thoracic spine w/wo cont (72130) | $3,973.72 | $4,415.24 | 23.2× |
| CT thorax w/o contrast (71250) | $2,872.81 | $3,192.01 | 28.2× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$2,831.14–$2,849.74 | $3,145.71–$3,166.38 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $3,744.17 | $4,160.19 | 21.9× |
| CT upper extremity with contrast (73201) | $3,255.81 | $3,617.57 | 9.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $6,873.56 | $7,637.29 | 40.2× |
| Cta Abdomen (74175) | $3,436.66 | $3,818.51 | 20.1× |
| CTA pelvis (72191) | $3,167.42 | $3,519.36 | 18.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $555.17 | $616.85 | 5.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $812.90 | $903.22 | 8.0× |
| Dxa Bone Density Axial (77080) | $1,109.34 | $1,232.60 | 10.9× |
| Echo exam of fetal heart (76825) | $1,140.09 | $1,266.77 | 2.1× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $758.08 | $842.31 | 3.3× |
| Esophagram (74220) | $928.25 | $1,031.39 | 5.4× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $6,741.59 | $7,490.66 | 29.0× |
| Fluoroscopy up to 1 hr (76000) | $321.73 | $357.48 | 1.4× |
| Follow-Up Angiography (75898) | $1,983.73 | $2,204.14 | 0.6× |
| Foot 2 views (73620) | $512.99 | $569.99 | 6.0× |
| Forearm 2 views (73090) | $565.34 | $628.15 | 6.7× |
| Gastric emptying imaging study (78264) | $3,346.37 | $3,718.19 | 8.6× |
| Gastroesophageal Reflux Exam (78262) | $1,304.01 | $1,448.90 | 3.3× |
| Gated Heart Planar Single (78472) | $1,509.17 | $1,676.85 | 3.9× |
| Hand 2 views (73120) | $398.89 | $443.21 | 3.9× |
| Hepatobil Syst Image W/Drug (78227) | $4,112.13 | $4,569.03 | 7.8× |
| Hepatobiliary System Imaging (78226) | $3,103.52 | $3,448.35 | 8.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,192.69 | $1,325.21 | 14.0× |
| Infant hip ultrasound, limited static exam (76886) | $1,192.69 | $1,325.21 | 14.0× |
| Joint Survey Single View (77077) | $707.47 | $786.08 | 6.9× |
| K Flow/Funct Image W/Drug (78708) | $3,523.48 | $3,914.98 | 6.7× |
| K Flow/Funct Image W/O Drug (78707) | $2,652.79 | $2,947.54 | 5.0× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $3,201 | $3,556.67 | 8.2× |
| Kidney Imaging Morphol (78700) | $2,380.41 | $2,644.90 | 6.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $4,172.78 | $4,636.42 | 10.7× |
| Knee 3 Views (73562) | $587.66 | $652.95 | 6.9× |
| Liver & Spleen Imaging Static Only (78215) | $1,746.23 | $1,940.25 | 4.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $3,652.15 | $4,057.94 | 9.4× |
| Lung Perf&Ventilat Diferentl (78598) | $4,887.53 | $5,430.59 | 9.2× |
| Lung perfusion differential (78597) | $3,364.47 | $3,738.30 | 8.6× |
| Lung Ventilation Imaging (78579) | $1,988.04 | $2,208.93 | 5.1× |
| Lymph System Imaging (78195) | $1,745.96 | $1,939.95 | 3.3× |
| Magnetic Image Jaw Joint (70336) | $3,049.18 | $3,387.98 | 13.1× |
| Meckels Divert Exam (78290) | $1,885.52 | $2,095.02 | 4.8× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$5,214.28–$6,190.89 | $5,793.64–$6,878.77 | varies |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$4,524.66–$4,699.54 | $5,027.40–$5,221.71 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$4,874.92–$5,051.21 | $5,416.58–$5,612.45 | varies |
| MRA neck w contrast (70548) | $4,546 | $5,051.11 | 13.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,793.53 | $6,437.26 | 17.0× |
| MRA neck w/o contrast (70547) | $4,451.48 | $4,946.09 | 19.1× |
| MRI abdomen w contrast (74182) | $5,363.35 | $5,959.28 | 15.8× |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$3,418.97–$3,770.10 | $3,798.86–$4,189 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$3,107.73–$3,237.71 | $3,453.03–$3,597.46 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,983.14–$4,149.84 | $4,425.71–$4,610.93 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$3,428.97–$3,572.60 | $3,809.97–$3,969.56 | varies |
| MRI cardiac w/o contrast (75557) | $1,864.44 | $2,071.60 | 8.0× |
| MRI cervical spine w contrast (72142) | $5,001.18 | $5,556.87 | 14.7× |
| MRI cervical spine w/o cont (72141) | $4,706.74 | $5,229.71 | 20.2× |
| MRI chest w/o contrast (71550) | $4,981.34 | $5,534.82 | 21.4× |
| MRI chest with contrast (71551) | $7,204.73 | $8,005.25 | 9.4× |
| MRI chest wo w contrast (71552) | $6,617.31 | $7,352.57 | 19.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$4,816.39–$6,380.41 | $5,351.54–$7,089.34 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$3,319.33–$4,567.82 | $3,688.14–$5,075.36 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$3,043.48–$3,170.99 | $3,381.64–$3,523.32 | varies |
| MRI lumbar spine w contrast (72149) | $5,310.52 | $5,900.58 | 15.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $6,234.06 | $6,926.73 | 18.3× |
| MRI orbit face &/neck w/o contrast (70540) | $5,412.74 | $6,014.15 | 23.3× |
| MRI orbit face neck w contrast (70542) | $5,473.62 | $6,081.80 | 16.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $6,750.52 | $7,500.58 | 19.8× |
| MRI pelvis w contrast (72196) | $4,738.99 | $5,265.54 | 13.9× |
| MRI pelvis w/o & w contrast (72197) | $5,235.62 | $5,817.35 | 15.4× |
| MRI pelvis w/o contrast (72195) | $4,028.78 | $4,476.42 | 17.3× |
| MRI spectroscopy (76390) | $2,110.66 | $2,345.18 | 24.9× |
| MRI thoracic spine w/o contrast (72146) | $4,838.96 | $5,376.62 | 20.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$3,310.34–$4,023.74 | $3,678.15–$4,470.82 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,498.92 | $3,887.69 | 15.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$3,642.55–$3,795.11 | $4,047.28–$4,216.79 | varies |
| MRI, abdomen, combo (74183) | $4,935.70 | $5,484.11 | 14.5× |
| MRI, dorsal spine combo (72157) | $6,605.91 | $7,339.90 | 19.4× |
| MRI, dorsal spine contrast (72147) | $5,299.36 | $5,888.18 | 15.6× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$3,358.28–$3,498.92 | $3,731.42–$3,887.69 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$4,395.18–$4,579.24 | $4,883.53–$5,088.04 | varies |
| MRI, lumbar spine combo (72158) | $6,619.55 | $7,355.05 | 19.4× |
| Myelogram cervical (72240) | $2,680.39 | $2,978.21 | 3.5× |
| Myelogram Lumbar (72265) | $1,824.93 | $2,027.70 | 2.4× |
| Myelography thoracic (72255) | $2,095.74 | $2,328.60 | 2.7× |
| Myelograpy 2/more regions rs&i (72270) | $2,680.39 | $2,978.21 | 3.5× |
| Myocardial Spect Multiple Studies (78452) | $6,481.88 | $7,202.09 | 5.1× |
| Neck soft tissue (70360) | $523.91 | $582.12 | 6.2× |
| Panoramic X-ray of jaws (70355) | $492.90 | $547.67 | 5.8× |
| Parathyroid Planar Imaging (78070) | $1,634.54 | $1,816.15 | 4.2× |
| Pelvis 1 or 2 views (72170) | $479.50 | $532.78 | 4.7× |
| Perineogram (74775) | $799.41 | $888.23 | 3.4× |
| Pet Image Skull-Thigh (78812) | $9,110.10 | $10,122.33 | 6.5× |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$7,793.14–$8,338.63 | $8,659.04–$9,265.14 | varies |
| PET image w/CT, full body (78816) | $10,759.96 | $11,955.51 | 7.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $10,311.97 | $11,457.74 | 7.4× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $8,855.83 | $9,839.81 | 7.0× |
| PET whole body (78813) | $10,147.99 | $11,275.54 | 7.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,086.52 | $1,207.24 | 10.7× |
| Radex Ankle Complete Minimum 3 Views (73610) | $615.20 | $683.55 | 7.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $516.03 | $573.37 | 6.1× |
| Radex elbow complete minimum 3 views (73080) | $597.34 | $663.71 | 7.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $687.38 | $763.76 | 6.7× |
| Radex fingr minimum 2 views (73140) | $428.65 | $476.28 | 5.0× |
| Radex foot complete minimum 3 views (73630) | $579.47 | $643.86 | 6.8× |
| Radex Hand Minimum 3 Views (73130) | $560.62 | $622.91 | 6.6× |
| Radex lower extremity infant minimum 2 views (73592) | $419.23 | $465.81 | 4.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $504.84 | $560.93 | 4.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $384.99 | $427.77 | 4.5× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $398.29 | $442.54 | 4.7× |
| Radex Ribs Unilateral 2 Views (71100) | $621.41 | $690.46 | 7.3× |
| Radex shoulder complete minimum 2 views (73030) | $590.63 | $656.26 | 7.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $318.27 | $353.63 | 3.7× |
| Radex Spine 1 View Specify Level (72020) | $589.64 | $655.16 | 6.9× |
| Radex Sternum Minimum 2 Views (71120) | $631.31 | $701.46 | 7.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $596.10 | $662.33 | 7.0× |
| Radex Toe Minimum 2 Views (73660) | $472.55 | $525.06 | 5.6× |
| Radex upper extremity infant minimum 2 views (73092) | $419.23 | $465.81 | 4.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $584.19 | $649.10 | 6.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,291.67 | $1,435.19 | 12.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $602.54 | $669.49 | 5.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $555.90 | $617.67 | 5.5× |
| Radiologic exam colon double contrast study (74280) | $1,317.51 | $1,463.90 | 7.7× |
| Radiologic exam colon single contrast study (74270) | $1,362.11 | $1,513.46 | 8.0× |
| Radiologic exam knee complete 4/more views (73564) | $705.99 | $784.43 | 6.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $904.69 | $1,005.21 | 8.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $781.40 | $868.22 | 4.6× |
| Radiologic exam swallow function contrast study (74230) | $771.89 | $857.66 | 4.5× |
| Radiologic examination femur 1 view (73551) | $347.04 | $385.60 | 4.1× |
| Radiologic examination femur minimum 2 views (73552) | $593.12 | $659.02 | 7.0× |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$645.96–$652.91 | $717.73–$725.45 | varies |
| Radiologic examination tibia & fibula 2 views (73590) | $505.56 | $561.73 | 6.0× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $182.70 | $203 | 2.2× |
| Ribs bilateral 3 views (71110) | $779.08 | $865.64 | 7.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,863.16 | $5,403.51 | 9.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $5,026.49 | $5,584.99 | 9.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 8 matching MRF lines |
$3,340.73–$4,469.26 | $3,711.92–$4,965.84 | varies |
| Scapula (73010) | $590.63 | $656.26 | 5.8× |
| Sella turcica (70240) | $379.35 | $421.50 | 4.5× |
| Shoulder 1 view (73020) | $586.17 | $651.30 | 6.9× |
| Shoulder Arthrography (73040) | $1,454.89 | $1,616.54 | 4.3× |
| Skull less than 4 views (70250) | $693.83 | $770.92 | 6.8× |
| Sternoclavicular joints (71130) | $339.10 | $376.78 | 4.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,046.33 | $1,162.59 | 6.1× |
| Thoracic spine 2 views (72070) | $642.98 | $714.42 | 6.3× |
| Thoracolumbar 2 views (72080) | $1,329.42 | $1,477.13 | 15.7× |
| Thyroid Imaging With Vascular Flow (78013) | $1,138.90 | $1,265.44 | 2.9× |
| Thyroid Met Imaging Body (78018) | $2,962.66 | $3,291.84 | 5.6× |
| Ultrasound Breast Limited (76642) | $744.19 | $826.88 | 8.8× |
| Ultrasound Elastography Parenchyma (76981) | $699.79 | $777.54 | 6.9× |
| Ultrasound, abdomen limited (76705) | $1,250.24 | $1,389.15 | 12.3× |
| Unlisted magnetic resonance procedure (76498) | $2,012.53 | $2,236.14 | 23.7× |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$1,278.77–$1,640.93 | $1,420.85–$1,823.26 | varies |
| Ureteral Reflux Study (78740) | $1,440.41 | $1,600.46 | 3.7× |
| Urethrocystogram voiding (74455) | $1,141.34 | $1,268.15 | 4.9× |
| Urethrocystography retrograde (74450) | $1,011.96 | $1,124.40 | 4.3× |
| Us breast unilateral complete (76641) | $1,038.11 | $1,153.45 | 10.2× |
| Us chest (76604) | $818.60 | $909.56 | 8.0× |
| Us complete joint (76881) | $1,404.78 | $1,560.87 | 13.8× |
| Us head (76506) | $1,112.56 | $1,236.18 | 10.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $702.51 | $780.57 | 6.9× |
| Us ob transvaginal (76817) | $586.67 | $651.85 | 5.8× |
| Us pelvic non ob complete (76856) | $928.25 | $1,031.39 | 9.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $624.63 | $694.03 | 6.1× |
| Us retroperitoneal complete (76770) | $1,160.19 | $1,289.10 | 11.4× |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$959.51–$1,026.73 | $1,066.12–$1,140.81 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$945.62–$1,011.85 | $1,050.69–$1,124.28 | varies |
| Us spinal canal and contents (76800) | $912.87 | $1,014.30 | 8.9× |
| Us thyroid (76536) | $1,075.36 | $1,194.84 | 10.5× |
| Vein X-Ray Chest (75827) | $2,731.91 | $3,035.46 | 1.8× |
| Venography caval inferior serialography rs&i (75825) | $2,859.67 | $3,177.41 | 0.9× |
| Venography extremity bilateral rs&i (75822) | $2,202.26 | $2,446.95 | 1.4× |
| Venography extremity unilateral rs&i (75820) | $2,054.46 | $2,282.73 | 1.3× |
| Wrist 2 views (73100) | $488.46 | $542.73 | 5.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $577.24 | $641.38 | 6.8× |
| X-ray antegrade pyelogram tube (74425) | $840.44 | $933.82 | 2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $526.64 | $585.15 | 6.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $502.33 | $558.14 | 5.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $740.47 | $822.74 | 7.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $926.27 | $1,029.19 | 9.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $492.66 | $547.40 | 5.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $644.72 | $716.35 | 7.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $554.18 | $615.75 | 5.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $803.84 | $893.16 | 7.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $953.01 | $1,058.90 | 9.3× |
| X-Ray Exam L-S Spine Bending (72114) | $1,397.33 | $1,552.59 | 13.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $430.39 | $478.21 | 5.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,057.25 | $1,174.72 | 10.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $676.72 | $751.91 | 6.6× |
| X-ray head for orthodontia (70350) | $623.56 | $692.84 | 7.3× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$465.87–$495.66 | $517.63–$550.73 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $393.68 | $437.42 | 4.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $412.53 | $458.37 | 4.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$649.93–$1,054.02 | $722.14–$1,171.13 | varies |
| X-ray nose-rectum child f.b. (76010) | $222.27 | $246.97 | 2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $929.49 | $1,032.77 | 9.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $417.49 | $463.88 | 4.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $637.27 | $708.08 | 7.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $720.38 | $800.42 | 8.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,155.73 | $1,284.14 | 11.3× |
| X-Ray Stress View (77071) | $308.59 | $342.88 | 3.6× |
| X-Ray Tmj Unilat (70328) | $364.99 | $405.54 | 4.3× |
| X-Rays Bone Length Studies (77073) | $714.92 | $794.36 | 7.0× |
| X-Rays Bone Survey Complete (77075) | $1,199.20 | $1,332.44 | 11.8× |
| Xr c-spine 4 or 5 views (72050) | $949.83 | $1,055.37 | 9.3× |
| Xr facial bones less than 3 views (70140) | $522.35 | $580.39 | 6.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $393.92 | $437.69 | 3.9× |
| Xr orbits complete 4 views (70200) | $839.94 | $933.27 | 8.2× |
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.