Imaging prices at Coffee Regional Medical Center
Douglas, GA · 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) range across 4 matching MRF lines |
$216.24–$247.52 | $318–$364 | varies |
| Angio internal mammary (75756) | $5,420.96 | $7,972 | 2.0× |
| Angio pulmonary bilat (75743) | $5,420.96 | $7,972 | 2.0× |
| Angiography extremity bilateral rs&i (75716) | $5,263.20 | $7,740 | 1.9× |
| Angiography extremity unilateral rs&i (75710) range across 5 matching MRF lines |
$3,015.12–$5,263.20 | $4,434–$7,740 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,420.96 | $7,972 | 2.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,165.40 | $4,655 | 1.1× |
| Ankle 2 views (73600) | $255.68 | $376 | 3.4× |
| Aortography thoracic serialography rs&i (75605) | $5,082.32 | $7,474 | 1.0× |
| Artery X-Rays Abdomen (75726) | $9,374.48 | $13,786 | 1.9× |
| Arthrogram ankle (73615) | $603.16 | $887 | 2.0× |
| Arthrogram hip (73525) | $462.40 | $680 | 1.5× |
| Arthrogram Wrist (73115) | $824.84 | $1,213 | 2.7× |
| Bone age studies (77072) | $290.36 | $427 | 3.2× |
| Bone Imaging 3 Phase (78315) | $1,559.92 | $2,294 | 4.5× |
| Bone Imaging Limited Area (78300) | $761.60 | $1,120 | 2.2× |
| Bone Imaging Multiple Areas (78305) | $1,283.84 | $1,888 | 3.7× |
| Bone Imaging Whole Body (78306) | $1,520.48 | $2,236 | 4.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,468.28 | $6,571 | 3.6× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$241.40–$553.52 | $355–$814 | varies |
| Chest 1 view (71045) range across 2 matching MRF lines |
$215.56–$226.44 | $317–$333 | varies |
| Chest 2 views (71046) range across 6 matching MRF lines |
$40.80–$403.92 | $60–$594 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$152.32–$342.72 | $224–$504 | varies |
| Chest 4 or more views (71048) range across 4 matching MRF lines |
$271.32–$516.80 | $399–$760 | varies |
| Clavicle complete (73000) | $347.48 | $511 | 4.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $673.20 | $990 | 7.3× |
| Contrast Exam Abdominl Aorta (75625) | $5,263.20 | $7,740 | 1.9× |
| Contrast X-Ray Bladder (74430) | $639.20 | $940 | 2.1× |
| Contrast X-Ray Of Elbow (73085) | $603.16 | $887 | 2.0× |
| Contrast X-Ray Of Knee Joint (73580) | $603.16 | $887 | 2.0× |
| CT abdomen and pelvis without and with contrast (74178) | $4,543.08 | $6,681 | 14.9× |
| CT abdomen and pelvis without contrast (74176) | $2,949.84 | $4,338 | 14.1× |
| CT abdomen w contrast (74160) | $2,721.36 | $4,002 | 17.7× |
| CT abdomen w wo contrast (74170) | $2,868.92 | $4,219 | 18.7× |
| CT abdomen w/o contrast (74150) | $1,969.28 | $2,896 | 21.5× |
| CT Angio Abdomen and Pelvis (74174) | $3,477.52 | $5,114 | 11.4× |
| CT Angio Chest (71275) | $3,253.12 | $4,784 | 21.2× |
| CT Angio Head (70496) | $3,663.84 | $5,388 | 23.8× |
| CT angio hrt w/3d image (75574) | $1,504.16 | $2,212 | 4.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,564.28–$3,772.64 | $3,771–$5,548 | varies |
| CT Angio Neck (70498) | $1,842.80 | $2,710 | 12.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,564.28 | $3,771 | 16.7× |
| CT cervical spine w/ contrast (72126) | $2,180.08 | $3,206 | 7.1× |
| CT cervical spine w/o contrast (72125) | $1,934.60 | $2,845 | 21.1× |
| CT cervical spine w/wo cont (72127) | $2,405.16 | $3,537 | 15.6× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,623.84–$1,813.56 | $2,388–$2,667 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$1,916.24–$2,440.52 | $2,818–$3,589 | varies |
| CT head/brain without and with contrast (70470) | $2,006 | $2,950 | 13.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,504.16 | $2,212 | 4.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $187 | $275 | 2.5× |
| CT hrt w/3d image congen (75573) | $1,504.16 | $2,212 | 4.9× |
| CT iac w contrast (70481) range across 4 matching MRF lines |
$1,477.64–$2,371.16 | $2,173–$3,487 | varies |
| CT l-spine w&w/o contrast (72133) | $2,339.88 | $3,441 | 15.2× |
| CT lower ext w/o (73700) range across 12 matching MRF lines |
$995.52–$1,141.72 | $1,464–$1,679 | varies |
| CT lower extremity w/contrast material (73701) range across 12 matching MRF lines |
$1,174.36–$1,218.56 | $1,727–$1,792 | varies |
| CT lumbar spine w contrast (72132) | $2,120.92 | $3,119 | 6.9× |
| CT lumbar spine w/o contrast (72131) | $1,630.64 | $2,398 | 17.8× |
| CT maxillofacial w contrast (70487) | $1,471.52 | $2,164 | 9.6× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,272.96–$1,275.68 | $1,872–$1,876 | varies |
| CT neck tissue combo (70492) | $2,531.64 | $3,723 | 16.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,608.48 | $3,836 | 17.0× |
| CT orbits w/o contrast (70480) range across 4 matching MRF lines |
$922.76–$2,155.60 | $1,357–$3,170 | varies |
| CT pelvis w&w/o contrast (72194) | $2,047.48 | $3,011 | 13.3× |
| CT pelvis w/o contrast (72192) | $1,279.76 | $1,882 | 14.0× |
| CT scan of leg combo (73702) range across 12 matching MRF lines |
$1,208.36–$1,295.40 | $1,777–$1,905 | varies |
| CT scans face/jaw combo (70488) | $2,046.80 | $3,010 | 13.3× |
| CT soft tissue neck w contrast (70491) | $2,026.40 | $2,980 | 13.2× |
| CT soft tissue neck w/o contrast (70490) | $1,485.12 | $2,184 | 16.2× |
| CT thoracic spine w contrast (72129) | $1,893.80 | $2,785 | 12.3× |
| CT thoracic spine w/o contrast (72128) | $1,702.04 | $2,503 | 18.6× |
| CT thoracic spine w/wo cont (72130) | $2,324.24 | $3,418 | 15.1× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$1,329.40–$1,396.04 | $1,955–$2,053 | varies |
| CT upper ext wo (73200) range across 12 matching MRF lines |
$1,045.84–$1,141.72 | $1,538–$1,679 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 12 matching MRF lines |
$1,639.48–$1,802 | $2,411–$2,650 | varies |
| CT upper extremity with contrast (73201) range across 12 matching MRF lines |
$1,474.92–$1,642.88 | $2,169–$2,416 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,192.32 | $3,224 | 14.3× |
| Cta Abdomen (74175) | $2,479.28 | $3,646 | 16.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $4,543.08 | $6,681 | 14.9× |
| CTA pelvis (72191) | $2,600.32 | $3,824 | 16.9× |
| Dxa Bone Density Axial (77080) | $418.88 | $616 | 4.6× |
| Dxa bone density study (77085) | $356.32 | $524 | 3.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $303.96 | $447 | 4.0× |
| Echo exam uterus (76831) | $801.04 | $1,178 | 3.8× |
| Echo Guide For Artery Repair (76936) | $534.48 | $786 | 2.8× |
| Esophagram (74220) | $567.80 | $835 | 3.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$82.28–$549.44 | $121–$808 | varies |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$520.88–$680 | $766–$1,000 | varies |
| Follow-Up Angiography (75898) | $3,165.40 | $4,655 | 1.1× |
| Foot 2 views (73620) | $255.68 | $376 | 3.4× |
| Forearm 2 views (73090) | $214.20 | $315 | 2.8× |
| Gastric emptying imaging study (78264) | $1,528.64 | $2,248 | 4.4× |
| Gastroesophageal Reflux Exam (78262) | $722.16 | $1,062 | 2.1× |
| Gated Heart Planar Single (78472) | $1,103.64 | $1,623 | 3.2× |
| Hand 2 views (73120) | $314.84 | $463 | 3.4× |
| Hepatobil Syst Image W/Drug (78227) | $2,066.52 | $3,039 | 4.3× |
| Hepatobiliary System Imaging (78226) | $1,659.88 | $2,441 | 4.7× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$119–$1,356.60 | $175–$1,995 | varies |
| Hysterosalpingogram (74740) | $930.92 | $1,369 | 4.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $382.84 | $563 | 5.0× |
| Infusion Ivp (74410) range across 2 matching MRF lines |
$537.20–$782.68 | $790–$1,151 | varies |
| K Flow/Funct Image W/Drug (78708) | $1,474.24 | $2,168 | 3.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,302.20 | $1,915 | 2.7× |
| Liver & Spleen Imaging Static Only (78215) | $815.32 | $1,199 | 2.3× |
| Lung Ventilat&Perfus Imaging (78582) | $1,368.84 | $2,013 | 2.9× |
| Lymph System Imaging (78195) | $925.48 | $1,361 | 1.9× |
| Magnetic Image Jaw Joint (70336) | $1,821.72 | $2,679 | 8.7× |
| Mammary ductogram or galactogram multiple (77054) | $255.68 | $376 | 1.2× |
| Mammary ductogram or galactogram single (77053) | $484.84 | $713 | 2.3× |
| Meckels Divert Exam (78290) | $678.64 | $998 | 1.9× |
| Mra Head W/O & W/Contrast Material (70546) | $2,960.72 | $4,354 | 9.7× |
| MRA head w/o contrast (70544) | $2,305.20 | $3,390 | 11.0× |
| MRA neck w contrast (70548) | $3,070.20 | $4,515 | 10.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,233.68 | $6,226 | 13.8× |
| MRA neck w/o contrast (70547) | $2,337.16 | $3,437 | 11.2× |
| MRI abdomen w/o contrast (74181) | $2,791.40 | $4,105 | 13.4× |
| MRI any jt lower extrem w/contrast material (73722) range across 6 matching MRF lines |
$2,889.32–$3,532.60 | $4,249–$5,195 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,111.96 | $6,047 | 13.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,920.60 | $4,295 | 4.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,073.72 | $1,579 | 5.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $665.72 | $979 | 3.2× |
| MRI cardiac w/o contrast (75557) | $1,821.72 | $2,679 | 8.7× |
| MRI cervical spine w/o cont (72141) | $2,909.72 | $4,279 | 13.9× |
| MRI chest w/o contrast (71550) | $2,004.64 | $2,948 | 9.6× |
| MRI chest with contrast (71551) | $2,175.32 | $3,199 | 3.2× |
| MRI chest wo w contrast (71552) | $2,346.68 | $3,451 | 7.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 6 matching MRF lines |
$3,070.20–$3,417 | $4,515–$5,025 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 6 matching MRF lines |
$3,213.68–$3,682.88 | $4,726–$5,416 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 6 matching MRF lines |
$2,669.68–$2,913.80 | $3,926–$4,285 | varies |
| Mri Neck Spine W/O & W/Dye (72156) | $3,201.44 | $4,708 | 10.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,666 | $2,450 | 8.0× |
| MRI orbit face neck w contrast (70542) | $2,176.68 | $3,201 | 7.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,218.44 | $4,733 | 10.5× |
| MRI pelvis w contrast (72196) | $2,681.24 | $3,943 | 8.8× |
| MRI pelvis w/o & w contrast (72197) range across 3 matching MRF lines |
$3,830.44–$4,262.92 | $5,633–$6,269 | varies |
| MRI pelvis w/o contrast (72195) range across 3 matching MRF lines |
$2,207.96–$2,274.60 | $3,247–$3,345 | varies |
| MRI thoracic spine w/o contrast (72146) | $2,658.80 | $3,910 | 12.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,814.24 | $2,668 | 5.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,628.60 | $2,395 | 7.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 6 matching MRF lines |
$2,069.24–$2,302.48 | $3,043–$3,386 | varies |
| MRI, abdomen, combo (74183) | $3,429.92 | $5,044 | 11.2× |
| MRI, dorsal spine combo (72157) | $4,012 | $5,900 | 13.1× |
| MRI, dorsal spine contrast (72147) | $3,062.72 | $4,504 | 10.0× |
| MRI, joint upper extrem (73221) | $2,592.16 | $3,812 | 12.4× |
| MRI, joint upper extrem combo (73223) range across 6 matching MRF lines |
$3,650.24–$4,061.64 | $5,368–$5,973 | varies |
| MRI, lumbar spine combo (72158) | $3,451 | $5,075 | 11.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,847.44 | $5,658 | 3.4× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$136–$3,276.92 | $200–$4,819 | varies |
| Neck soft tissue (70360) | $136 | $200 | 1.8× |
| Ob us nuchal meas 1 gest (76813) | $226.44 | $333 | 2.5× |
| Parathyroid Planar Imaging (78070) | $1,202.92 | $1,769 | 3.4× |
| Pelvis 1 or 2 views (72170) | $265.20 | $390 | 2.9× |
| PET image w/CT, full body (78816) | $4,337.72 | $6,379 | 3.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,337.72 | $6,379 | 3.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $784.04 | $1,153 | 2.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $346.12 | $509 | 3.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $514.76 | $757 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $247.52 | $364 | 3.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $314.84 | $463 | 4.1× |
| Radex elbow complete minimum 3 views (73080) | $344.08 | $506 | 4.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $257.72 | $379 | 2.8× |
| Radex fingr minimum 2 views (73140) | $207.40 | $305 | 2.7× |
| Radex foot complete minimum 3 views (73630) | $257.72 | $379 | 3.4× |
| Radex Hand Minimum 3 Views (73130) | $257.04 | $378 | 3.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $295.80 | $435 | 3.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $244.80 | $360 | 3.2× |
| Radex shoulder complete minimum 2 views (73030) | $283.56 | $417 | 3.7× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $424.32 | $624 | 2.8× |
| Radex Spine 1 View Specify Level (72020) | $316.88 | $466 | 4.2× |
| Radex Sternum Minimum 2 Views (71120) | $329.12 | $484 | 4.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $492.32 | $724 | 6.5× |
| Radex Toe Minimum 2 Views (73660) | $233.92 | $344 | 3.1× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$207.40–$212.16 | $305–$312 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $271.32 | $399 | 3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $273.36 | $402 | 3.0× |
| Radiologic exam colon double contrast study (74280) | $883.32 | $1,299 | 5.7× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$501.84–$745.28 | $738–$1,096 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$342.72–$568.48 | $504–$836 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $290.36 | $427 | 3.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $601.80 | $885 | 3.9× |
| Radiologic exam swallow function contrast study (74230) | $586.16 | $862 | 3.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $707.20 | $1,040 | 4.6× |
| Radiologic examination femur minimum 2 views (73552) | $190.40 | $280 | 2.5× |
| Radiologic examination knee 1/2 views (73560) | $347.48 | $511 | 4.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $359.72 | $529 | 4.7× |
| Ribs bilateral 3 views (71110) | $533.80 | $785 | 5.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,388.84 | $3,513 | 6.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,278.40 | $1,880 | 2.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $745.96 | $1,097 | 1.6× |
| Scapula (73010) | $265.20 | $390 | 2.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$49.64–$72.08 | $73–$106 | varies |
| Shoulder Arthrography (73040) | $930.92 | $1,369 | 3.0× |
| Sialogram (70390) | $210.80 | $310 | 1.0× |
| Skull less than 4 views (70250) | $295.80 | $435 | 3.2× |
| Sternoclavicular joints (71130) | $329.12 | $484 | 4.3× |
| Superior sagittal sinus venogram (75870) | $4,033.76 | $5,932 | 1.5× |
| Testicular Imaging W/Flow (78761) | $845.24 | $1,243 | 2.4× |
| Thoracic spine 3 views (72072) | $505.24 | $743 | 5.5× |
| Thoracolumbar 2 views (72080) | $398.48 | $586 | 5.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,215.84 | $1,788 | 3.5× |
| Ultrasound Breast Limited (76642) | $417.52 | $614 | 5.5× |
| Ultrasound Exam Aaa Screen (76706) | $281.52 | $414 | 3.1× |
| Ultrasound, abdomen limited (76705) range across 10 matching MRF lines |
$688.84–$790.16 | $1,013–$1,162 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 4 matching MRF lines |
$82.28–$549.44 | $121–$808 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$465.80–$520.88 | $685–$766 | varies |
| Unlisted us procedure (76999) | $238 | $350 | 3.1× |
| Urethrocystogram voiding (74455) | $531.08 | $781 | 2.5× |
| Urethrocystography retrograde (74450) | $452.88 | $666 | 2.2× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$482.12–$674.56 | $709–$992 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$386.24–$443.36 | $568–$652 | varies |
| Us complete joint (76881) | $578.68 | $851 | 6.3× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$454.92–$519.52 | $669–$764 | varies |
| Us head (76506) | $490.96 | $722 | 5.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 6 matching MRF lines |
$585.48–$671.84 | $861–$988 | varies |
| Us ob detailed single fetus (76811) | $921.40 | $1,355 | 4.4× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$82.28–$502.52 | $121–$739 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$459–$464.44 | $675–$683 | varies |
| Us pelvic non ob complete (76856) | $964.92 | $1,419 | 10.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $770.44 | $1,133 | 8.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 5 matching MRF lines |
$82.28–$350.88 | $121–$516 | varies |
| Us retroperitoneal complete (76770) | $276.08 | $406 | 3.0× |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$478.04–$538.56 | $703–$792 | varies |
| Us scrotum and contents (76870) | $739.84 | $1,088 | 8.1× |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$252.96–$428.40 | $372–$630 | varies |
| Us thyroid (76536) | $809.88 | $1,191 | 8.8× |
| Vascular Flow Imaging (78445) | $1,083.24 | $1,593 | 3.1× |
| Vein X-Ray Chest (75827) | $1,907.40 | $2,805 | 1.4× |
| Venogram Sinus/Jugular (75860) | $4,233 | $6,225 | 1.5× |
| Venography caval inferior serialography rs&i (75825) | $6,032.28 | $8,871 | 2.2× |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$1,483.08–$1,789.08 | $2,181–$2,631 | varies |
| Venography extremity unilateral rs&i (75820) range across 5 matching MRF lines |
$1,274.32–$1,391.96 | $1,874–$2,047 | varies |
| Wrist 2 views (73100) | $267.92 | $394 | 3.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $322.32 | $474 | 4.2× |
| X-Ray Aorta Leg Arteries (75630) | $5,263.20 | $7,740 | 1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $272.68 | $401 | 3.6× |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$477.36–$597.04 | $702–$878 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $398.48 | $586 | 4.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $344.08 | $506 | 4.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $538.56 | $792 | 5.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $350.88 | $516 | 4.6× |
| X-ray humerus (73060) | $193.80 | $285 | 2.5× |
| X-ray IV pyelogram (ivp) (74400) | $505.24 | $743 | 3.3× |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$418.20–$661.64 | $615–$973 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $291.04 | $428 | 3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $335.24 | $493 | 3.7× |
| X-ray nose-rectum child f.b. (76010) | $199.24 | $293 | 2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $551.48 | $811 | 6.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $290.36 | $427 | 3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $338.64 | $498 | 4.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $459 | $675 | 6.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $257.72 | $379 | 2.8× |
| X-ray thoracic spine 4 vw (72074) | $605.20 | $890 | 6.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $962.88 | $1,416 | 3.1× |
| X-Rays Bone Length Studies (77073) | $290.36 | $427 | 3.2× |
| X-Rays Bone Survey Complete (77075) | $841.16 | $1,237 | 9.2× |
| Xr c-spine 4 or 5 views (72050) | $416.84 | $613 | 4.5× |
| Xr facial bones less than 3 views (70140) | $146.20 | $215 | 1.9× |
| Xr myelogram posterior fossa (70010) | $1,079.84 | $1,588 | 3.5× |
| Xr orbits complete 4 views (70200) | $295.80 | $435 | 3.2× |
| Xr Tomogram Single Plane (76100) range across 3 matching MRF lines |
$421.60–$546.04 | $620–$803 | varies |
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.