Imaging prices at CommonSpirit Saint Joseph Hospital - Mount Sterling
Mount Sterling, KY · every code in this section with a posted price and a Medicare benchmark.
286 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $120.58 | $329 | 1.4× |
| Abdomen 2 views (74019) | $205.97 | $562 | 2.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $507.58 | $1,385 | 1.3× |
| Ankle 2 views (73600) | $133.77 | $365 | 1.6× |
| Arthrogram hip (73525) | $413.39 | $1,128 | 1.2× |
| Arthrogram Wrist (73115) | $413.39 | $1,128 | 1.2× |
| Bone age studies (77072) | $79.90 | $218 | 0.8× |
| Bone Imaging 3 Phase (78315) | $888.72 | $2,425 | 2.3× |
| Bone Imaging Limited Area (78300) | $668.47 | $1,824 | 1.7× |
| Bone Imaging Multiple Areas (78305) | $487.79 | $1,331 | 1.3× |
| Bone Imaging Whole Body (78306) | $786.47 | $2,146 | 2.0× |
| Bone survey infant (77076) | $200.47 | $547 | 2.0× |
| Brain Image W/Flow < 4 Views (78601) | $463.97 | $1,266 | 1.2× |
| Cat Scan Follow-Up Study (76380) | $358.06 | $977 | 4.3× |
| Cerebrospinal Fluid Scan (78630) | $1,152.22 | $3,144 | 2.2× |
| Chest 1 view (71045) | $157.96 | $431 | 1.9× |
| Chest 2 views (71046) | $211.46 | $577 | 2.5× |
| Chest 3 views (71047) | $286.96 | $783 | 3.4× |
| Chest 4 or more views (71048) | $142.20 | $388 | 1.4× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$167.85–$335.70 | $458–$916 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $633.65 | $1,729 | 6.3× |
| Continuing medical physics consltj pr wk (77336) | $188.38 | $514 | 1.4× |
| Contrast X-Ray Bladder (74430) | $171.88 | $469 | 0.5× |
| Contrast X-Ray Of Knee Joint (73580) | $413.39 | $1,128 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) | $1,965.07 | $5,362 | 5.8× |
| CT abdomen and pelvis without contrast (74176) | $1,432.21 | $3,908 | 6.2× |
| CT abdomen w contrast (74160) | $733.70 | $2,002 | 4.3× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$827.15–$909.61 | $2,257–$2,482 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$600.30–$660.40 | $1,638–$1,802 | varies |
| CT Angio Abdomen and Pelvis (74174) | $1,114.11 | $3,040 | 3.3× |
| CT Angio Chest (71275) | $1,343.52 | $3,666 | 7.9× |
| CT Angio Head (70496) | $1,130.60 | $3,085 | 6.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,154.78 | $3,151 | 6.8× |
| CT Angio Neck (70498) | $1,130.60 | $3,085 | 6.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$685.32–$1,231.01 | $1,870–$3,359 | varies |
| CT bone density (77078) | $233.45 | $637 | 2.8× |
| CT cervical spine w/ contrast (72126) | $1,156.62 | $3,156 | 3.4× |
| CT cervical spine w/o contrast (72125) | $918.04 | $2,505 | 9.1× |
| CT cervical spine w/wo cont (72127) | $1,165.78 | $3,181 | 6.9× |
| CT chest w contrast (71260) | $782.44 | $2,135 | 4.6× |
| CT chest w/wo contrast (71270) | $845.11 | $2,306 | 5.0× |
| CT head/brain with contrast (70460) | $770.71 | $2,103 | 4.5× |
| CT head/brain without and with contrast (70470) | $948.82 | $2,589 | 5.6× |
| CT iac w contrast (70481) | $738.83 | $2,016 | 4.4× |
| CT l-spine w&w/o contrast (72133) | $1,147.45 | $3,131 | 6.8× |
| CT lower ext w/o (73700) | $710.61 | $1,939 | 7.0× |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$675.06–$810.29 | $1,842–$2,211 | varies |
| CT lumbar spine w contrast (72132) | $1,156.62 | $3,156 | 3.4× |
| CT lumbar spine w/o contrast (72131) | $918.04 | $2,505 | 9.1× |
| CT maxillofacial w contrast (70487) | $945.16 | $2,579 | 5.6× |
| CT maxillofacial wo contrast (70486) | $859.03 | $2,344 | 8.5× |
| CT neck tissue combo (70492) | $844.38 | $2,304 | 5.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $805.53 | $2,198 | 4.7× |
| CT orbits w/o contrast (70480) | $642.81 | $1,754 | 6.4× |
| CT pelvis w&w/o contrast (72194) | $845.84 | $2,308 | 5.0× |
| CT pelvis w/o contrast (72192) | $640.61 | $1,748 | 6.3× |
| CT scan of leg combo (73702) | $888.35 | $2,424 | 5.2× |
| CT scans face/jaw combo (70488) | $1,022.12 | $2,789 | 6.0× |
| CT soft tissue neck w contrast (70491) | $760.82 | $2,076 | 4.5× |
| CT soft tissue neck w/o contrast (70490) | $639.15 | $1,744 | 6.3× |
| CT thoracic spine w contrast (72129) | $835.95 | $2,281 | 4.9× |
| CT thoracic spine w/o contrast (72128) | $819.46 | $2,236 | 8.1× |
| CT thoracic spine w/wo cont (72130) | $1,024.32 | $2,795 | 6.0× |
| CT thorax w/o contrast (71250) | $633.65 | $1,729 | 6.3× |
| CT upper ext wo (73200) | $745.06 | $2,033 | 7.4× |
| CT upper extremity w/o & w/contrast material (73202) | $931.23 | $2,541 | 5.5× |
| CT upper extremity with contrast (73201) | $856.84 | $2,338 | 2.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,418.65 | $3,871 | 8.4× |
| Cta Abdomen (74175) | $1,114.11 | $3,040 | 6.6× |
| CTA pelvis (72191) | $1,231.01 | $3,359 | 7.3× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$244.45–$254.71 | $667–$695 | varies |
| Dxa bone density study (77085) | $275.23 | $751 | 2.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $122.41 | $334 | 1.5× |
| Esophagram (74220) range across 2 matching MRF lines |
$305.65–$382.24 | $834–$1,043 | varies |
| Fetal Biophys Profile W/Nst (76818) | $301.25 | $822 | 3.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $107.02 | $292 | 1.1× |
| Fluoroscopy up to 1 hr (76000) | $309.68 | $845 | 1.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$122.04–$241.52 | $333–$659 | varies |
| Forearm 2 views (73090) | $179.58 | $490 | 2.1× |
| Gastric emptying imaging study (78264) | $1,098.71 | $2,998 | 2.8× |
| Gated Heart Planar Single (78472) | $969.71 | $2,646 | 2.5× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$92.72–$172.98 | $253–$472 | varies |
| Hepatobil Syst Image W/Drug (78227) | $885.42 | $2,416 | 1.7× |
| Hepatobiliary System Imaging (78226) | $505.01 | $1,378 | 1.3× |
| Ht Musc Image Planar Mult (78454) | $1,022.85 | $2,791 | 0.8× |
| Ht Muscle Image Spect Sing (78451) | $865.27 | $2,361 | 0.7× |
| Hysterosalpingogram (74740) | $199.74 | $545 | 0.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $293.92 | $802 | 3.5× |
| Infusion Ivp (74410) | $244.45 | $667 | 1.4× |
| K Flow/Funct Image Multiple (78709) | $543.50 | $1,483 | 1.0× |
| K Flow/Funct Image W/Drug (78708) | $930.13 | $2,538 | 1.8× |
| K Flow/Funct Image W/O Drug (78707) | $794.17 | $2,167 | 1.5× |
| Knee 3 Views (73562) | $191.67 | $523 | 2.3× |
| Leveen/Shunt Patency Exam (78291) | $677.99 | $1,850 | 1.8× |
| Liver & Spleen Imaging Static Only (78215) | $460.30 | $1,256 | 1.2× |
| Lung perfusion differential (78597) | $333.50 | $910 | 0.9× |
| Lung Ventilat&Perfus Imaging (78582) | $955.79 | $2,608 | 1.8× |
| Lung Ventilation Imaging (78579) | $611.29 | $1,668 | 1.6× |
| Magnetic Image Jaw Joint (70336) | $1,021.75 | $2,788 | 4.4× |
| Mammary ductogram or galactogram single (77053) | $270.10 | $737 | 1.2× |
| Meckels Divert Exam (78290) | $731.13 | $1,995 | 1.9× |
| Mlc imrt design & construction per imrt plan (77338) | $2,047.90 | $5,588 | 5.7× |
| Mr safety determination physician/other qhp (76016) | $82.46 | $225 | 1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $23.09 | $63 | 0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $86.49 | $236 | 0.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $226.49 | $618 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $981.81 | $2,679 | 2.9× |
| MRA head w/o contrast (70544) | $755.32 | $2,061 | 3.3× |
| MRA head with contrast (70545) | $891.29 | $2,432 | 2.6× |
| MRA neck w contrast (70548) | $779.88 | $2,128 | 2.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $860.13 | $2,347 | 2.5× |
| MRA neck w/o contrast (70547) | $768.15 | $2,096 | 3.3× |
| MRI abdomen w contrast (74182) | $1,136.46 | $3,101 | 3.4× |
| MRI abdomen w/o contrast (74181) | $1,081.12 | $2,950 | 4.7× |
| MRI any jt lower extrem w/contrast material (73722) | $1,132.80 | $3,091 | 1.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$895.32–$1,235.78 | $2,443–$3,372 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,020.65 | $2,785 | 1.3× |
| MRI cervical spine w contrast (72142) | $1,086.25 | $2,964 | 3.2× |
| MRI cervical spine w/o cont (72141) | $1,097.25 | $2,994 | 4.8× |
| MRI chest w/o contrast (71550) | $869.66 | $2,373 | 3.8× |
| MRI chest with contrast (71551) | $902.65 | $2,463 | 1.2× |
| MRI chest wo w contrast (71552) | $937.46 | $2,558 | 2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $891.29 | $2,432 | 2.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $882.86 | $2,409 | 2.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $856.84 | $2,338 | 3.7× |
| MRI lumbar spine w contrast (72149) | $1,053.27 | $2,874 | 3.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,558.28 | $4,252 | 4.6× |
| MRI orbit face &/neck w/o contrast (70540) | $1,021.75 | $2,788 | 4.4× |
| MRI orbit face neck w contrast (70542) | $937.46 | $2,558 | 2.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,062.80 | $2,900 | 3.1× |
| MRI pelvis w contrast (72196) | $1,036.04 | $2,827 | 3.1× |
| MRI pelvis w/o & w contrast (72197) | $1,177.14 | $3,212 | 3.5× |
| MRI pelvis w/o contrast (72195) | $953.59 | $2,602 | 4.1× |
| MRI thoracic spine w/o contrast (72146) | $839.98 | $2,292 | 3.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,012.59 | $2,763 | 3.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $973.74 | $2,657 | 4.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,051.80 | $2,870 | 3.1× |
| MRI, abdomen, combo (74183) | $1,386.03 | $3,782 | 4.1× |
| MRI, dorsal spine combo (72157) | $1,554.25 | $4,241 | 4.6× |
| MRI, dorsal spine contrast (72147) | $1,100.55 | $3,003 | 3.3× |
| MRI, joint upper extrem (73221) | $990.23 | $2,702 | 4.3× |
| MRI, joint upper extrem combo (73223) | $1,020.65 | $2,785 | 3.0× |
| MRI, lumbar spine combo (72158) | $1,558.28 | $4,252 | 4.6× |
| Myelogram Lumbar (72265) | $703.28 | $1,919 | 0.9× |
| Myelograpy 2/more regions rs&i (72270) | $616.42 | $1,682 | 0.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $323.61 | $883 | 0.8× |
| Myocardial Spect Multiple Studies (78452) | $2,622.17 | $7,155 | 2.1× |
| N-invas est c ffr sw aly CTA (75580) | $912.54 | $2,490 | 1.1× |
| Neck soft tissue (70360) | $137.44 | $375 | 1.6× |
| Nonvascular Shunt X-Ray (75809) | $484.13 | $1,321 | 4.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,562.31 | $4,263 | 1.2× |
| Ob us nuchal meas 1 gest (76813) | $158.69 | $433 | 1.6× |
| Parathyroid Planar Imaging (78070) | $957.25 | $2,612 | 2.5× |
| Pelvis 1 or 2 views (72170) | $139.63 | $381 | 1.4× |
| Perineogram (74775) | $199.74 | $545 | 0.9× |
| Peritoneogram Rs&I (74190) | $246.28 | $672 | 0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $555.59 | $1,516 | 1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $351.46 | $959 | 3.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $329.47 | $899 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) | $151.73 | $414 | 1.8× |
| Radex Calcaneus Minimum 2 Views (73650) | $75.87 | $207 | 0.9× |
| Radex elbow complete minimum 3 views (73080) | $192.04 | $524 | 2.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$144.40–$232.72 | $394–$635 | varies |
| Radex fingr minimum 2 views (73140) | $141.83 | $387 | 1.7× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$200.84–$265.34 | $548–$724 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$140.73–$196.80 | $384–$537 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$177.75–$197.17 | $485–$538 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $177.75 | $485 | 1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $149.90 | $409 | 1.8× |
| Radex Ribs Unilateral 2 Views (71100) | $139.63 | $381 | 1.7× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$183.25–$617.52 | $500–$1,685 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $68.90 | $188 | 0.8× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $616.06 | $1,681 | 3.6× |
| Radex Spine 1 View Specify Level (72020) | $98.22 | $268 | 1.2× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$130.11–$240.42 | $355–$656 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $120.21 | $328 | 1.4× |
| Radex Toe Minimum 2 Views (73660) | $123.88 | $338 | 1.5× |
| Radex upper extremity infant minimum 2 views (73092) | $115.81 | $316 | 1.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $183.25 | $500 | 2.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $277.06 | $756 | 2.7× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$170.78–$280.36 | $466–$765 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $170.78 | $466 | 1.7× |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$413.39–$433.92 | $1,128–$1,184 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$273.77–$287.33 | $747–$784 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $254.34 | $694 | 1.5× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$189.84–$206.70 | $518–$564 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $183.98 | $502 | 1.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $485.22 | $1,324 | 2.9× |
| Radiologic exam swallow function contrast study (74230) | $292.46 | $798 | 1.7× |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$242.25–$368.32 | $661–$1,005 | varies |
| Radiologic examination femur 1 view (73551) | $88.33 | $241 | 1.0× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$129.74–$425.12 | $354–$1,160 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$140.37–$273.03 | $383–$745 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $278.16 | $759 | 2.7× |
| Radiologic examination tibia & fibula 2 views (73590) | $131.94 | $360 | 1.6× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $76.23 | $208 | 0.9× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$172.62–$279.26 | $471–$762 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $684.22 | $1,867 | 1.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,058.40 | $2,888 | 2.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $721.97 | $1,970 | 1.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,093.22 | $2,983 | 2.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$820.19–$1,093.22 | $2,238–$2,983 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $497.32 | $1,357 | 0.4× |
| Scapula (73010) | $105.55 | $288 | 1.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $25.29 | $69 | 1.1× |
| Sella turcica (70240) | $74.40 | $203 | 0.9× |
| Shoulder 1 view (73020) | $142.93 | $390 | 1.7× |
| Shoulder Arthrography (73040) | $432.82 | $1,181 | 1.3× |
| Sialogram (70390) | $193.87 | $529 | 0.8× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$135.97–$183.98 | $371–$502 | varies |
| Sternoclavicular joints (71130) | $80.26 | $219 | 1.0× |
| Thoracic spine 2 views (72070) | $212.93 | $581 | 2.1× |
| Thoracic spine 3 views (72072) | $308.58 | $842 | 3.0× |
| Thoracolumbar 2 views (72080) | $262.77 | $717 | 3.1× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $533.23 | $1,455 | 1.4× |
| Thyroid Imaging With Vascular Flow (78013) | $281.10 | $767 | 0.7× |
| Thyroid Uptake Measurement (78012) | $461.04 | $1,258 | 1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $427.69 | $1,167 | 1.1× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$205.60–$367.58 | $561–$1,003 | varies |
| Ultrasound Exam Aaa Screen (76706) | $130.11 | $355 | 1.3× |
| Ultrasound, abdomen limited (76705) | $573.55 | $1,565 | 5.7× |
| Upper gi w/o kub (74240) | $336.80 | $919 | 2.0× |
| Urethrocystogram voiding (74455) | $171.88 | $469 | 0.7× |
| Urethrocystography retrograde (74450) | $211.83 | $578 | 0.9× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$186.54–$355.49 | $509–$970 | varies |
| Us chest (76604) | $346.33 | $945 | 3.4× |
| Us complete joint (76881) | $340.10 | $928 | 3.4× |
| Us exam, pelvic, limited (76857) | $263.50 | $719 | 2.6× |
| Us head (76506) | $245.55 | $670 | 2.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$234.92–$340.10 | $641–$928 | varies |
| Us ob detailed single fetus (76811) | $405.33 | $1,106 | 1.8× |
| Us ob limited 1 or more fetuses (76815) | $216.59 | $591 | 2.1× |
| Us ob transvaginal (76817) | $424.76 | $1,159 | 4.2× |
| Us pelvic non ob complete (76856) | $548.63 | $1,497 | 5.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $171.52 | $468 | 1.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $131.57 | $359 | 1.3× |
| Us retroperitoneal complete (76770) | $345.96 | $944 | 3.4× |
| Us retroperitoneal limited (76775) | $345.96 | $944 | 3.4× |
| Us scrotum and contents (76870) | $399.47 | $1,090 | 3.9× |
| Us spinal canal and contents (76800) | $141.83 | $387 | 1.4× |
| Us thyroid (76536) | $308.95 | $843 | 3.1× |
| Us transrectal (76872) | $1,553.88 | $4,240 | 15.4× |
| Venography caval inferior serialography rs&i (75825) | $1,341.32 | $3,660 | 0.4× |
| Venography extremity bilateral rs&i (75822) | $484.13 | $1,321 | 0.3× |
| Venography extremity unilateral rs&i (75820) | $329.47 | $899 | 0.2× |
| Vertebral fracture assessment via dxa (77086) | $106.28 | $290 | 1.3× |
| Wrist 2 views (73100) | $128.27 | $350 | 1.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $80.26 | $219 | 1.0× |
| X-ray antegrade pyelogram tube (74425) | $448.21 | $1,223 | 1.3× |
| X-Ray Bend Only L-S Spine (72120) | $296.12 | $808 | 2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $138.17 | $377 | 1.6× |
| X-Ray Exam Breast Specimen (76098) | $71.10 | $194 | 0.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $127.17 | $347 | 1.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $232.72 | $635 | 2.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $119.11 | $325 | 1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$135.60–$234.92 | $370–$641 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $215.50 | $588 | 2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$197.90–$257.64 | $540–$703 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $503.18 | $1,373 | 5.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $183.25 | $500 | 2.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$378.95–$393.60 | $1,034–$1,074 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) | $367.22 | $1,002 | 3.6× |
| X-ray eye for foreign body (70030) | $74.77 | $204 | 0.9× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$148.43–$311.51 | $405–$850 | varies |
| X-ray IV pyelogram (ivp) (74400) | $387.74 | $1,058 | 2.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $221.73 | $605 | 2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$138.53–$204.87 | $378–$559 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$237.12–$269.37 | $647–$735 | varies |
| X-ray nose-rectum child f.b. (76010) | $88.69 | $242 | 1.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$345.23–$411.20 | $942–$1,122 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $218.43 | $596 | 2.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $115.45 | $315 | 1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $124.24 | $339 | 1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$180.31–$286.23 | $492–$781 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$196.80–$303.45 | $537–$828 | varies |
| X-Ray Stress View (77071) | $72.20 | $197 | 0.9× |
| X-ray thoracic spine 4 vw (72074) | $370.15 | $1,010 | 3.7× |
| X-Ray Tmj Unilat (70328) | $120.21 | $328 | 1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $263.50 | $719 | 0.8× |
| X-Rays Bone Length Studies (77073) | $254.34 | $694 | 2.5× |
| X-Rays Bone Survey Complete (77075) | $409 | $1,116 | 4.0× |
| Xr c-spine 4 or 5 views (72050) | $298.32 | $814 | 2.9× |
| Xr facial bones less than 3 views (70140) | $116.18 | $317 | 1.4× |
| XR Mastoids < 3 Views Bilateral (70120) | $171.15 | $467 | 1.7× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$154.66–$163.46 | $422–$446 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$305.65–$581.98 | $834–$1,588 | 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.