29 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| Cervical spine 2 or 3 views (72040) |
$190.40 |
$272 |
2.2× |
| Chest 1 view (71045) |
$157.50 |
$225 |
1.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,102.50 |
$1,575 |
4.6× |
| CT c-spine w/o contrast (72125) |
$528.50 |
$755 |
5.0× |
| CT chest with contrast (71260) |
$1,295 |
$1,850 |
7.3× |
| CT lumbar spine w/o contrast (72131) |
$1,120 |
$1,600 |
10.7× |
| CT thorax w/o contrast (71250) |
$822.50 |
$1,175 |
7.8× |
| CTA chest (71275) |
$857.50 |
$1,225 |
4.9× |
| Cta Head (70496) |
$1,067.50 |
$1,525 |
6.1× |
| Cta Neck (70498) |
$1,715 |
$2,450 |
9.7× |
| Forearm 2 views (73090) |
$191.80 |
$274 |
2.2× |
| Hand 3 views (73130) |
$210 |
$300 |
2.4× |
| Knee 3 views (73562) |
$227.50 |
$325 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$210 |
$300 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$168.70 |
$241 |
1.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$210 |
$300 |
2.4× |
| Us xtr non-vasc lmtd (76882) |
$219.10 |
$313 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$227.50 |
$325 |
2.6× |
| X-ray exam hip uni 1 view (73501) |
$147.70 |
$211 |
1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$192.50 |
$275 |
2.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$210 |
$300 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$292.60 |
$418 |
2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$245 |
$350 |
2.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$195.30 |
$279 |
2.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$210 |
$300 |
2.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$187.60 |
$268 |
1.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$163.80 |
$234 |
1.6× |
| Xr finger(s) 2+ views (73140) |
$158.90 |
$227 |
1.8× |
| Xray knee 1 or 2 views rt (73560) |
$154.70 |
$221 |
1.8× |