Imaging prices at Community Memorial Hospital
Cloquet, MN · every code in this section with a posted price and a Medicare benchmark.
222 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 2 matching MRF lines |
$33.60–$261.76 | $52.50–$409 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$48.64–$330.88 | $76–$517 | varies |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$30.40–$286.72 | $47.50–$448 | varies |
| Arthrogram hip (73525) | $654.72 | $1,023 | 1.8× |
| Arthrogram Wrist (73115) | $654.72 | $1,023 | 1.8× |
| Bone age studies (77072) | $198.40 | $310 | 1.8× |
| Bone Imaging 3 Phase (78315) | $1,007.36 | $1,574 | 2.4× |
| Bone Imaging Limited Area (78300) | $1,039.36 | $1,624 | 2.5× |
| Bone Imaging Multiple Areas (78305) | $1,100.16 | $1,719 | 2.7× |
| Bone Imaging Whole Body (78306) | $1,360 | $2,125 | 3.3× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$57.60–$247.04 | $90–$386 | varies |
| Cat Scan Follow-Up Study (76380) | $676.48 | $1,057 | 7.5× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$33.60–$289.92 | $52.50–$453 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$40–$311.04 | $62.50–$486 | varies |
| Chest 3 views (71047) | $46.72 | $73 | 0.5× |
| Chest 4 or more views (71048) | $80 | $125 | 0.7× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$29.76–$172.16 | $46.50–$269 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,267.84 | $1,981 | 11.8× |
| Contrast X-Ray Bladder (74430) | $413.44 | $646 | 1.1× |
| Contrast X-Ray Of Elbow (73085) | $654.72 | $1,023 | 1.8× |
| Contrast X-Ray Of Knee Joint (73580) | $654.72 | $1,023 | 1.8× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$450.24–$3,404.16 | $703.50–$5,319 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$399.36–$2,170.24 | $624–$3,391 | varies |
| CT abdomen w contrast (74160) | $1,626.24 | $2,541 | 9.0× |
| CT abdomen w wo contrast (74170) | $1,626.24 | $2,541 | 9.0× |
| CT abdomen w/o contrast (74150) | $972.80 | $1,520 | 9.0× |
| CT Angio Abdomen and Pelvis (74174) | $3,404.16 | $5,319 | 9.5× |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$1,626.24–$2,829.44 | $2,541–$4,421 | varies |
| CT Angio Head (70496) | $2,479.36 | $3,874 | 13.7× |
| CT Angio Neck (70498) | $2,479.36 | $3,874 | 13.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$246.72–$1,813.12 | $385.50–$2,833 | varies |
| CT cervical spine w/ contrast (72126) | $3,404.16 | $5,319 | 9.5× |
| CT cervical spine w/o contrast (72125) | $972.80 | $1,520 | 9.0× |
| CT chest w contrast (71260) | $1,626.24 | $2,541 | 9.0× |
| CT chest w/wo contrast (71270) | $1,626.24 | $2,541 | 9.0× |
| CT head/brain with contrast (70460) | $1,544.32 | $2,413 | 8.5× |
| CT head/brain without and with contrast (70470) | $1,820.16 | $2,844 | 10.1× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$135.04–$307.20 | $211–$480 | varies |
| CT iac w contrast (70481) | $1,593.60 | $2,490 | 8.8× |
| CT lower ext w/o (73700) | $972.80 | $1,520 | 9.0× |
| CT lower extremity w/contrast material (73701) | $1,626.24 | $2,541 | 9.0× |
| CT lumbar spine w contrast (72132) | $3,404.16 | $5,319 | 9.5× |
| CT lumbar spine w/o contrast (72131) | $972.80 | $1,520 | 9.0× |
| CT maxillofacial w contrast (70487) | $1,480.96 | $2,314 | 8.2× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,333.76–$1,593.60 | $2,084–$2,490 | varies |
| CT neck tissue combo (70492) | $2,214.40 | $3,460 | 12.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,761.28 | $2,752 | 9.7× |
| CT orbits w/o contrast (70480) range across 4 matching MRF lines |
$1,480.96–$1,776 | $2,314–$2,775 | varies |
| CT pelvis w&w/o contrast (72194) | $1,761.28 | $2,752 | 9.7× |
| CT pelvis w/o contrast (72192) | $972.80 | $1,520 | 9.0× |
| CT scan of leg combo (73702) | $2,319.36 | $3,624 | 12.8× |
| CT scans face/jaw combo (70488) | $1,599.36 | $2,499 | 8.8× |
| CT soft tissue neck w contrast (70491) | $2,122.88 | $3,317 | 11.7× |
| CT soft tissue neck w/o contrast (70490) | $2,122.88 | $3,317 | 19.7× |
| CT thoracic spine w contrast (72129) | $2,009.60 | $3,140 | 11.1× |
| CT thoracic spine w/o contrast (72128) | $972.80 | $1,520 | 9.0× |
| CT thorax w/o contrast (71250) | $972.80 | $1,520 | 9.0× |
| CT upper ext wo (73200) | $972.80 | $1,520 | 9.0× |
| CT upper extremity with contrast (73201) | $3,404.16 | $5,319 | 9.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,686.40 | $5,760 | 20.4× |
| Cta Abdomen (74175) | $1,626.24 | $2,541 | 9.0× |
| CTA pelvis (72191) | $1,813.12 | $2,833 | 10.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $113.92 | $178 | 1.3× |
| Esophagram (74220) range across 2 matching MRF lines |
$144.64–$413.44 | $226–$646 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $855.68 | $1,337 | 7.9× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$42.56–$570.88 | $66.50–$892 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$30.40–$218.24 | $47.50–$341 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$29.76–$230.40 | $46.50–$360 | varies |
| Gastric emptying imaging study (78264) | $1,176.96 | $1,839 | 2.9× |
| Gated Heart Planar Single (78472) | $906.88 | $1,417 | 2.2× |
| Hand 2 views (73120) | $218.24 | $341 | 2.0× |
| Hepatobil Syst Image W/Drug (78227) | $1,176.96 | $1,839 | 2.1× |
| Hepatobiliary System Imaging (78226) | $1,176.96 | $1,839 | 2.9× |
| Hysterosalpingogram (74740) | $663.68 | $1,037 | 2.7× |
| Joint Survey Single View (77077) | $162.56 | $254 | 1.5× |
| K Flow/Funct Image W/O Drug (78707) | $1,050.24 | $1,641 | 1.9× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$34.56–$417.28 | $54–$652 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,466.24 | $2,291 | 3.6× |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$108.80–$1,313.28 | $170–$2,052 | varies |
| Lymph System Imaging (78195) | $1,057.92 | $1,653 | 1.9× |
| Magnetic Image Jaw Joint (70336) | $2,664.96 | $4,164 | 10.8× |
| Meckels Divert Exam (78290) | $861.44 | $1,346 | 2.1× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$148.48–$3,404.16 | $232–$5,319 | varies |
| MRA head w/o contrast (70544) | $2,170.24 | $3,391 | 8.8× |
| MRA head with contrast (70545) | $2,664.96 | $4,164 | 7.4× |
| MRA neck w contrast (70548) | $2,664.96 | $4,164 | 7.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,404.16 | $5,319 | 9.5× |
| MRA neck w/o contrast (70547) | $2,170.24 | $3,391 | 8.8× |
| MRI abdomen w contrast (74182) | $3,404.16 | $5,319 | 9.5× |
| MRI abdomen w/o contrast (74181) | $2,170.24 | $3,391 | 8.8× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$281.92–$2,664.96 | $440.50–$4,164 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,404.16 | $5,319 | 9.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,520 | $5,500 | 4.4× |
| MRI cervical spine w contrast (72142) | $3,404.16 | $5,319 | 9.5× |
| MRI cervical spine w/o cont (72141) | $2,170.24 | $3,391 | 8.8× |
| MRI chest w/o contrast (71550) | $2,664.96 | $4,164 | 10.8× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$2,664.96–$3,742.72 | $4,164–$5,848 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$281.92–$2,664.96 | $440.50–$4,164 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,404.16 | $5,319 | 9.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,170.24 | $3,391 | 8.8× |
| MRI lumbar spine w contrast (72149) | $3,404.16 | $5,319 | 9.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,404.16 | $5,319 | 9.5× |
| MRI orbit face &/neck w/o contrast (70540) | $2,664.96 | $4,164 | 10.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,742.72 | $5,848 | 10.4× |
| MRI pelvis w contrast (72196) | $3,404.16 | $5,319 | 9.5× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$413.12–$3,404.16 | $645.50–$5,319 | varies |
| MRI pelvis w/o contrast (72195) | $2,170.24 | $3,391 | 8.8× |
| MRI thoracic spine w/o contrast (72146) | $2,170.24 | $3,391 | 8.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$290.56–$2,664.96 | $454–$4,164 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,170.24 | $3,391 | 8.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,404.16 | $5,319 | 9.5× |
| MRI, abdomen, combo (74183) | $3,404.16 | $5,319 | 9.5× |
| MRI, dorsal spine combo (72157) | $3,404.16 | $5,319 | 9.5× |
| MRI, dorsal spine contrast (72147) | $3,404.16 | $5,319 | 9.5× |
| MRI, joint upper extrem (73221) | $2,170.24 | $3,391 | 8.8× |
| MRI, joint upper extrem combo (73223) | $3,404.16 | $5,319 | 9.5× |
| MRI, lumbar spine combo (72158) | $3,404.16 | $5,319 | 9.5× |
| Myelogram Lumbar (72265) | $404.16 | $631.50 | 0.5× |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$32.32–$172.16 | $50.50–$269 | varies |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$92.80–$129.92 | $145–$203 | varies |
| Parathyroid Planar Imaging (78070) | $897.92 | $1,403 | 2.2× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$32.32–$261.12 | $50.50–$408 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$163.20–$4,421.12 | $255–$6,908 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$160–$4,401.28 | $250–$6,877 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,021.44 | $1,596 | 2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $490.88 | $767 | 0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$32.32–$339.20 | $50.50–$530 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$30.40–$239.36 | $47.50–$374 | varies |
| Radex elbow complete minimum 3 views (73080) | $32 | $50 | 0.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $339.20 | $530 | 3.1× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$24.96–$211.84 | $39–$331 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$32.32–$316.16 | $50.50–$494 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$32.32–$249.60 | $50.50–$390 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $267.52 | $418 | 3.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $304 | $475 | 3.4× |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$40–$296.32 | $62.50–$463 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$33.60–$319.36 | $52.50–$499 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $158.72 | $248 | 1.8× |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$28.16–$330.88 | $44–$517 | varies |
| Radex Sternum Minimum 2 Views (71120) | $319.36 | $499 | 3.6× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$24.96–$172.16 | $39–$269 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $239.36 | $374 | 2.2× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$32.32–$249.60 | $50.50–$390 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $487.04 | $761 | 4.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $57.60 | $90 | 0.5× |
| Radiologic exam colon double contrast study (74280) | $1,001.60 | $1,565 | 5.5× |
| Radiologic exam colon single contrast study (74270) | $712.32 | $1,113 | 3.9× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$41.60–$487.04 | $65–$761 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$37.44–$279.04 | $58.50–$436 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $673.92 | $1,053 | 3.7× |
| Radiologic exam swallow function contrast study (74230) | $474.88 | $742 | 2.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $727.04 | $1,136 | 4.0× |
| Radiologic examination femur 1 view (73551) | $162.56 | $254 | 1.8× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$48.64–$506.24 | $76–$791 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$33.60–$313.60 | $52.50–$490 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $330.88 | $517 | 3.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$32.32–$400.64 | $50.50–$626 | varies |
| Ribs bilateral 3 views (71110) | $35.20 | $55 | 0.3× |
| Scapula (73010) range across 3 matching MRF lines |
$32.32–$319.36 | $50.50–$499 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$32–$236.54 | $50–$369.60 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$28.16–$172.16 | $44–$269 | varies |
| Shoulder Arthrography (73040) | $654.72 | $1,023 | 1.8× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$43.52–$304 | $68–$475 | varies |
| Thoracic spine 2 views (72070) | $25.60 | $40 | 0.2× |
| Thoracic spine 3 views (72072) | $488.32 | $763 | 4.5× |
| Thoracolumbar 2 views (72080) | $395.52 | $618 | 4.4× |
| Thyroid Imaging With Vascular Flow (78013) | $812.80 | $1,270 | 2.0× |
| Ultrasound Exam Aaa Screen (76706) | $654.08 | $1,022 | 6.1× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$654.08–$981.12 | $1,022–$1,533 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $217.60 | $340 | 2.4× |
| Unlisted us procedure (76999) | $654.08 | $1,022 | 7.3× |
| Urethrocystogram voiding (74455) | $558.08 | $872 | 2.3× |
| Urethrocystography retrograde (74450) | $347.52 | $543 | 1.4× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$654.08–$852.48 | $1,022–$1,332 | varies |
| Us chest (76604) | $611.20 | $955 | 5.7× |
| Us complete joint (76881) range across 2 matching MRF lines |
$46.08–$91.52 | $72–$143 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$616.32–$855.68 | $963–$1,337 | varies |
| Us head (76506) | $654.08 | $1,022 | 6.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$104–$654.08 | $162.50–$1,022 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$204.80–$855.68 | $320–$1,337 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$233.60–$558.72 | $365–$873 | varies |
| Us pelvic non ob complete (76856) | $855.68 | $1,337 | 7.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$176.32–$855.68 | $275.50–$1,337 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$153.92–$855.68 | $240.50–$1,337 | varies |
| Us retroperitoneal complete (76770) | $654.08 | $1,022 | 6.1× |
| Us scrotum and contents (76870) | $654.08 | $1,022 | 6.1× |
| Us thyroid (76536) | $654.08 | $1,022 | 6.1× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$32.32–$239.36 | $50.50–$374 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$37.12–$387.84 | $58–$606 | varies |
| X-ray antegrade pyelogram tube (74425) | $490.24 | $766 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $371.20 | $580 | 3.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$28.16–$230.40 | $44–$360 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$60.80–$395.52 | $95–$618 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$32.32–$261.12 | $50.50–$408 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$39.04–$496.64 | $61–$776 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$57.60–$540.16 | $90–$844 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$39.04–$496.64 | $61–$776 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $521.60 | $815 | 4.8× |
| X-Ray Exam L-S Spine Bending (72114) | $508.16 | $794 | 4.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$40–$304 | $62.50–$475 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $531.20 | $830 | 4.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $371.84 | $581 | 3.4× |
| X-ray eye for foreign body (70030) | $254.08 | $397 | 2.8× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$32.32–$266.24 | $50.50–$416 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$496.64–$837.76 | $776–$1,309 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $463.36 | $724 | 5.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $39.04 | $61 | 0.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$40–$463.36 | $62.50–$724 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$32–$91.52 | $50–$143 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$41.60–$456.96 | $65–$714 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $380.16 | $594 | 3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $380.16 | $594 | 4.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $362.24 | $566 | 4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $542.72 | $848 | 5.0× |
| X-Ray Stress View (77071) | $172.16 | $269 | 1.9× |
| X-ray thoracic spine 4 vw (72074) | $574.72 | $898 | 5.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $558.08 | $872 | 1.5× |
| X-Rays Bone Length Studies (77073) | $321.28 | $502 | 3.0× |
| X-Rays Bone Survey Complete (77075) | $1,118.72 | $1,748 | 10.4× |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$56.96–$487.04 | $89–$761 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$254.08–$304 | $397–$475 | varies |
| Xr Tomogram Single Plane (76100) | $369.92 | $578 | 3.4× |
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.