Imaging prices at Coosa Valley Medical Center

Sylacauga, AL · every code in this section with a posted price and a Medicare benchmark.

304 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $53 $221 0.7×
Abdomen 2 views (74019) $68 $282 0.7×
Acute Gastrointestinal Blood Loss Imaging (78278) $261 $1,086 0.7×
Angio internal mammary (75756) $655 $2,730 0.2×
Angio pulmonary bilat (75743) $655 $2,730 0.2×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $719 $2,996 0.3×
Angiography extremity bilateral rs&i (75716) $1,228 $5,117 0.4×
Angiography extremity unilateral rs&i (75710)
range across 7 matching MRF lines		 $655–$1,228 $2,730–$5,117 varies
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $655 $2,730 0.2×
Ankle 2 views (73600) $64 $265 0.8×
Aortography thoracic serialography rs&i (75605)
range across 2 matching MRF lines		 $1,018–$1,130 $4,242–$4,710 varies
Aortography thoracic w/o serialography rs&i (75600) $655 $2,730 0.2×
Artery X-Rays Abdomen (75726) $1,130 $4,710 0.2×
Artery X-Rays Adrenal Gland (75731) $560 $2,333 0.2×
Arthrogram ankle (73615) $196 $816 0.6×
Arthrogram hip (73525) $164 $682 0.5×
Arthrogram Wrist (73115) $196 $816 0.6×
Bone age studies (77072) $64 $268 0.7×
Bone Imaging 3 Phase (78315) $377 $1,570 1.1×
Bone Imaging Limited Area (78300) $204 $849 0.6×
Bone Imaging Multiple Areas (78305) $360 $1,500 1.0×
Bone Imaging Whole Body (78306) $360 $1,500 1.0×
Bone survey infant (77076) $102 $425 1.1×
Brain Imaging Pet Metabolic Evaluation (78608) $1,208 $5,034 0.9×
Cat Scan Follow-Up Study (76380) $56 $235 0.7×
Chest 1 view (71045) $52 $217 0.7×
Chest 2 views (71046)
range across 3 matching MRF lines		 $73–$148 $304–$617 varies
Chest 3 views (71047)
range across 2 matching MRF lines		 $170–$186 $710–$775 varies
Chest 4 or more views (71048)
range across 2 matching MRF lines		 $186–$232 $775–$966 varies
Cholecystography Oral Contrast (74290) $108 $448 0.7×
Clavicle complete (73000) $48 $201 0.6×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $56 $235 0.6×
Contrast Exam Abdominl Aorta (75625)
range across 4 matching MRF lines		 $655–$2,354 $2,730–$9,810 varies
Contrast X-Ray Bladder (74430) $150 $626 0.5×
Contrast X-Ray Of Elbow (73085) $180 $751 0.6×
Contrast X-Ray Of Knee Joint (73580) $196 $816 0.6×
Contrast Xray Throat/Cerv Esopha (74210) $59 $246 0.4×
CT abdomen and pelvis without and with contrast (74178) $1,569 $6,538 5.0×
CT abdomen and pelvis without contrast (74176)
range across 2 matching MRF lines		 $891 $19–$3,713 4.2×
CT abdomen w contrast (74160) $792 $3,301 5.0×
CT abdomen w wo contrast (74170) $828 $3,452 5.3×
CT abdomen w/o contrast (74150)
range across 2 matching MRF lines		 $26–$483 $107–$2,014 varies
CT Angio Abdomen and Pelvis (74174) $2,254 $9,393 7.2×
CT Angio Chest (71275) $1,068 $4,451 6.8×
CT Angio Head (70496) $973 $4,055 6.2×
CT angio hrt w/3d image (75574) $556 $2,317 1.8×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,044 $4,352 6.6×
CT Angio Neck (70498) $973 $4,055 6.2×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,044 $4,352 6.6×
CT cervical spine w/ contrast (72126) $786 $3,275 2.5×
CT cervical spine w/o contrast (72125) $524 $2,183 5.6×
CT cervical spine w/wo cont (72127) $818 $3,410 5.2×
CT chest w contrast (71260) $688 $2,866 4.4×
CT chest w/wo contrast (71270) $726 $3,024 4.6×
CT head/brain with contrast (70460) $630 $2,625 4.0×
CT head/brain without and with contrast (70470) $655 $2,729 4.2×
CT heart no contrast quant eval coronry calcium (75571) $30 $126 0.4×
CT iac w contrast (70481) $556 $2,315 3.5×
CT l-spine w&w/o contrast (72133) $799 $3,329 5.1×
CT lower ext w/o (73700) $390 $1,627 4.2×
CT lower extremity w/contrast material (73701) $621 $2,589 3.9×
CT lumbar spine w contrast (72132) $723 $3,012 2.3×
CT lumbar spine w/o contrast (72131) $489 $2,039 5.2×
CT maxillofacial w contrast (70487) $642 $2,675 4.1×
CT maxillofacial wo contrast (70486)
range across 3 matching MRF lines		 $366–$408 $1,527–$1,699 varies
CT neck tissue combo (70492) $708 $2,950 4.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $713 $2,969 4.5×
CT orbits w/o contrast (70480) $388 $1,616 4.1×
CT pelvis w&w/o contrast (72194) $741 $3,087 4.7×
CT pelvis w/o contrast (72192) $408 $1,699 4.4×
CT scan of leg combo (73702) $697 $2,903 4.4×
CT scans face/jaw combo (70488) $710 $2,958 4.5×
CT soft tissue neck w contrast (70491) $688 $2,866 4.4×
CT soft tissue neck w/o contrast (70490) $474 $1,975 5.1×
CT thoracic spine w contrast (72129) $705 $2,936 4.5×
CT thoracic spine w/o contrast (72128) $489 $2,039 5.2×
CT thoracic spine w/wo cont (72130) $781 $3,254 5.0×
CT thorax w/o contrast (71250) $484 $2,016 5.2×
CT upper ext wo (73200) $395 $1,647 4.2×
CT upper extremity w/o & w/contrast material (73202) $702 $2,924 4.5×
CT upper extremity with contrast (73201) $395 $1,647 1.3×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635)
range across 2 matching MRF lines		 $1,351–$2,396 $5,631–$9,982 varies
Cta Abdomen (74175) $1,171 $4,879 7.4×
CTA pelvis (72191) $1,084 $4,515 6.9×
Dilation ureters/urethra rs&i (74485) $408 $1,700 0.2×
Dxa Bone Density Axial (77080) $121 $504 1.3×
Echo Guide For Artery Repair (76936) $65 $271 0.3×
Echograp Trans R Pros Study (76873) $171 $712 1.8×
Esophagram (74220) $59 $246 0.4×
Fetal Biophys Profile W/Nst (76818) $243 $1,012 2.6×
Fluoroscopy up to 1 hr (76000)
range across 3 matching MRF lines		 $107–$117 $444–$487 varies
Follow-Up Angiography (75898) $655 $2,730 0.2×
Foot 2 views (73620) $48 $201 0.6×
Forearm 2 views (73090) $69 $287 0.9×
Gastric emptying imaging study (78264) $207 $864 0.6×
Gastroesophageal Reflux Exam (78262) $193 $806 0.5×
Gated Heart Planar Single (78472) $263 $1,097 0.7×
Hand 2 views (73120) $39 $162 0.4×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $655 $2,730 0.2×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $655 $2,730 0.2×
Hepatobil Syst Image W/Drug (78227) $395 $1,647 0.8×
Hepatobiliary System Imaging (78226) $306 $1,276 0.9×
Ht Muscle Image Spect Sing (78451) $435 $1,812 0.4×
Hysterosalpingogram (74740) $221 $920 1.0×
Infant hip ultrasound with hip movement (dynamic) (76885) $69 $289 0.9×
Infant hip ultrasound, limited static exam (76886) $69 $289 0.9×
Joint Survey Single View (77077) $28 $117 0.3×
K Flow/Funct Image W/Drug (78708) $740 $3,084 1.5×
K Flow/Funct Image W/O Drug (78707) $306 $1,274 0.6×
Knee 3 Views (73562) $78 $325 1.0×
Liver & Spleen Imaging Static Only (78215) $226 $941 0.6×
Liver & Spleen Imaging W/Vascular Flow (78216) $226 $941 0.6×
Lung perfusion differential (78597) $117 $487 0.3×
Lung Ventilat&Perfus Imaging (78582) $303 $1,263 0.6×
Lung Ventilation Imaging (78579) $198 $825 0.6×
Lymph System Imaging (78195) $175 $730 0.4×
Lymphangiography Extremity Only Bilateral Rs&I (75803) $327 $1,364 0.2×
Lymphangiography extremity only unilateral rs&i (75801) $127 $531 0.2×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $655 $2,730 0.2×
Lymphangiography, pelvic/abdominal, unilateral (75805) $655 $2,730 0.2×
Magnetic Image Jaw Joint (70336)
range across 2 matching MRF lines		 $787 $50–$3,280 3.7×
Mammary ductogram or galactogram multiple (77054) $200 $834 0.9×
Mammary ductogram or galactogram single (77053) $168 $701 0.8×
Meckels Divert Exam (78290) $261 $1,086 0.7×
Mr safety determination physician/other qhp (76016) $49 $203 0.6×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $13 $56 0.5×
Mr safety implt electronics prepj supvj phys/qhp (76018) $51 $212 0.6×
Mr safety implt pos&/immoblj (76019) $33 $137 0.6×
Mr safety med physics xm customization plng&mntr (76017) $133 $556 0.6×
MRA head w/o contrast (70544) $822 $3,427 3.8×
MRA head with contrast (70545) $1,076 $4,483 3.4×
MRA neck w contrast (70548) $1,076 $4,483 3.4×
Mra Neck W/O &W/Contrast Material (70549) $1,344 $5,598 4.3×
MRA neck w/o contrast (70547) $822 $3,427 3.8×
MRI abdomen w/o contrast (74181) $1,003 $4,181 4.7×
MRI any jt lower extrem w/contrast material (73722)
range across 12 matching MRF lines		 $1,216–$1,476 $5,068–$6,151 varies
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,476 $6,151 4.7×
MRI any jt upper extremity w/contrast matrl (73222)
range across 13 matching MRF lines		 $956–$1,476 $3,984–$6,151 varies
MRI cervical spine w contrast (72142) $1,313 $5,472 4.2×
MRI cervical spine w/o cont (72141) $1,025 $4,272 4.8×
MRI chest w/o contrast (71550) $1,003 $4,181 4.7×
MRI chest with contrast (71551) $1,013 $4,222 1.4×
MRI chest wo w contrast (71552) $1,621 $6,755 5.2×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,216 $5,068 3.9×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 9 matching MRF lines		 $820–$1,476 $3,418–$6,151 varies
MRI lower extrem oth/thn jt w/o contr matrl (73718) $956 $3,984 4.5×
MRI lumbar spine w contrast (72149) $1,216 $5,068 3.9×
Mri Neck Spine W/O & W/Dye (72156) $1,622 $6,758 5.2×
MRI orbit face &/neck w/o contrast (70540) $1,029 $4,289 4.8×
MRI orbit face neck w contrast (70542) $892 $3,715 2.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $1,329 $5,536 4.2×
MRI pelvis w contrast (72196) $1,003 $4,181 3.2×
MRI pelvis w/o & w contrast (72197) $1,597 $6,656 5.1×
MRI pelvis w/o contrast (72195) $1,003 $4,181 4.7×
MRI thoracic spine w/o contrast (72146) $944 $3,932 4.4×
MRI upper extremity oth than jt w/contr matrl (73219) $1,216 $5,068 3.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $956 $3,984 4.5×
Mri Uppr Extremity W/O&W/Dye (73220) $1,476 $6,151 4.7×
MRI, abdomen, combo (74183) $1,494 $6,224 4.8×
MRI, dorsal spine combo (72157) $1,621 $6,755 5.2×
MRI, dorsal spine contrast (72147) $1,230 $5,124 3.9×
MRI, joint upper extrem (73221) $956 $3,984 4.5×
MRI, joint upper extrem combo (73223) $1,476 $6,151 4.7×
MRI, lumbar spine combo (72158) $1,709 $7,119 5.5×
Myocardial Spect Multiple Studies (78452) $677 $2,820 0.6×
Neck soft tissue (70360) $37 $153 0.5×
Nonvascular Shunt X-Ray (75809) $29 $121 0.3×
Ophthalmic Ultrasonic Foreign Body Localization (76529) $73 $304 0.9×
Parathyroid Planar Imaging (78070) $227 $945 0.6×
Pelvis 1 or 2 views (72170) $64 $265 0.7×
Pet Image W/Ct Lmtd (78814) $1,474 $6,141 1.1×
PET image w/CT, full body (78816) $1,354 $5,640 1.1×
PET imaging CT attenuation skull base mid-thigh (78815) $1,233 $5,138 1.0×
Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) $2 $9 0.0×
Pulmonary Perfusion Imaging Particulate (78580) $394 $1,643 1.1×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $104 $434 1.1×
Radex abscess/fistula/sinus tract rs&i (76080) $111 $461 0.2×
Radex Ankle Complete Minimum 3 Views (73610) $76 $315 1.0×
Radex Calcaneus Minimum 2 Views (73650) $37 $155 0.5×
Radex elbow complete minimum 3 views (73080) $85 $355 1.1×
Radex Facial Bones Complete Minimum 3 Views (70150) $83 $344 0.9×
Radex fingr minimum 2 views (73140) $42 $177 0.5×
Radex foot complete minimum 3 views (73630) $64 $265 0.8×
Radex Hand Minimum 3 Views (73130) $56 $235 0.7×
Radex lower extremity infant minimum 2 views (73592)
range across 3 matching MRF lines		 $28–$56 $117–$233 varies
Radex Nasal Bones Complete Minimum 3 Views (70160) $55 $229 0.7×
Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) $32 $134 0.4×
Radex Ribs Unilateral 2 Views (71100) $55 $230 0.7×
Radex shoulder complete minimum 2 views (73030) $64 $268 0.8×
Radex Sinuses Paransl < 3 Views (70210) $83 $344 1.1×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $139 $580 0.9×
Radex Spine 1 View Specify Level (72020) $48 $201 0.6×
Radex Sternum Minimum 2 Views (71120) $139 $578 1.8×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $60 $252 0.8×
Radex Toe Minimum 2 Views (73660) $29 $122 0.4×
Radex upper extremity infant minimum 2 views (73092)
range across 3 matching MRF lines		 $28–$56 $117–$233 varies
Radex Wrist Complete Minimum 3 Views (73110) $85 $355 1.1×
Radiolog exam mandible compl minimum 4 views (70110) $60 $252 0.6×
Radiologic exam colon double contrast study (74280) $133 $555 0.8×
Radiologic exam colon single contrast study (74270) $116 $484 0.7×
Radiologic Exam Esophagus Double Contrast Study (74221) $64 $266 0.4×
Radiologic exam knee complete 4/more views (73564) $108 $451 1.2×
Radiologic exam pelvis compl minimum 3 views (72190) $95 $394 1.0×
Radiologic Exam Small Int Single Contrast Study (74250) $64 $268 0.4×
Radiologic exam swallow function contrast study (74230) $59 $246 0.4×
Radiologic exam upr gi trc double contrast study (74246) $121 $503 0.8×
Radiologic examination femur minimum 2 views (73552) $69 $287 0.9×
Radiologic examination knee 1/2 views (73560)
range across 3 matching MRF lines		 $64–$78 $265–$325 varies
Radiologic Examination Osseous Survey Limited (77074) $89 $371 0.9×
Radiologic Examination Salivary Gland Calculus (70380) $47 $194 0.6×
Radiologic examination tibia & fibula 2 views (73590) $42 $177 0.5×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $111 $461 0.2×
Red Cell Volume Determination Spx Mult Samplings (78121) $2 $9 0.0×
Ribs bilateral 3 views (71110) $138 $576 1.5×
Rp loclzj tum plnr 1 area single day imaging (78800) $86 $357 0.2×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $349 $1,456 1.0×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 4 matching MRF lines		 $292–$589 $1,217–$2,455 varies
Scapula (73010) $55 $230 0.6×
Screening Digital Breast Tomosynthesis Bi (77063) $71 $297 3.0×
Sella turcica (70240) $24 $101 0.3×
Shoulder 1 view (73020) $48 $201 0.6×
Shoulder Arthrography (73040)
range across 5 matching MRF lines		 $157–$1,216 $653–$5,068 varies
Sialogram (70390) $89 $369 0.4×
Skull less than 4 views (70250) $64 $265 0.7×
Sternoclavicular joints (71130) $139 $578 1.8×
Temporomandble Jt Arthrography Rs&I (70332) $255 $1,061 1.2×
Testicular Imaging W/Flow (78761) $220 $917 0.6×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $116 $484 0.7×
Thoracic spine 2 views (72070) $64 $265 0.7×
Thoracic spine 3 views (72072) $83 $344 0.9×
Thoracolumbar 2 views (72080) $64 $265 0.8×
Thyroid Imaging With Vascular Flow (78013) $222 $924 0.6×
Thyroid Uptake Measurement (78012)
range across 2 matching MRF lines		 $264–$342 $1,100–$1,423 varies
Ultrasound Breast Limited (76642) $132 $551 1.7×
Ultrasound elastography first target lesion (76982) $35 $146 0.4×
Ultrasound Elastography Parenchyma (76981) $70 $292 0.7×
Ultrasound, abdomen limited (76705) $91 $378 1.0×
Unlisted us procedure (76999)
range across 2 matching MRF lines		 $49–$85 $206–$353 varies
Upper gi w/o kub (74240)
range across 5 matching MRF lines		 $86–$150 $360–$626 varies
Urethrocystogram voiding (74455) $150 $626 0.7×
Urethrocystography retrograde (74450)
range across 2 matching MRF lines		 $150 $27–$626 0.7×
Us breast unilateral complete (76641) $132 $551 1.4×
Us chest (76604) $143 $595 1.5×
Us complete joint (76881) $54 $225 0.6×
Us exam, pelvic, limited (76857) $120 $499 1.3×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 3 matching MRF lines		 $35–$132 $146–$551 varies
Us ob limited 1 or more fetuses (76815) $125 $519 1.3×
Us ob transvaginal (76817) $125 $519 1.3×
Us pelvic non ob complete (76856) $120 $499 1.3×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $113 $470 1.2×
Us preg uterus real time f/u trnsabdl per fetus (76816) $113 $470 1.2×
Us retroperitoneal complete (76770) $121 $506 1.3×
Us retroperitoneal limited (76775) $103 $430 1.1×
Us scrotum and contents (76870) $168 $702 1.8×
Us thyroid (76536) $99 $414 1.1×
Vein X-Ray Chest (75827) $327 $1,364 0.2×
Venogram Sinus/Jugular (75860) $655 $2,730 0.2×
Venography Adrenal Unilateral (75840) $655 $2,730 0.2×
Venography caval inferior serialography rs&i (75825)
range across 2 matching MRF lines		 $655–$1,228 $2,730–$5,117 varies
Venography extremity bilateral rs&i (75822)
range across 2 matching MRF lines		 $291–$301 $1,213–$1,253 varies
Venography extremity unilateral rs&i (75820)
range across 4 matching MRF lines		 $291–$327 $1,213–$1,364 varies
Venography Renal Bilateral (75833) $655 $2,730 0.2×
Venography Renal Unilateral (75831)
range across 2 matching MRF lines		 $655–$1,228 $2,730–$5,117 varies
Venous sampling by catheter (75893) $1,130 $4,710 0.2×
Wrist 2 views (73100) $69 $287 0.9×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $68 $282 0.9×
X-ray antegrade pyelogram tube (74425) $81 $338 0.3×
X-Ray Aorta Leg Arteries (75630)
range across 3 matching MRF lines		 $570–$1,018 $2,373–$4,242 varies
X-Ray Bend Only L-S Spine (72120) $93 $387 1.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $64 $265 0.8×
X-Ray Exam Breast Specimen (76098)
range across 3 matching MRF lines		 $49–$234 $206–$975 varies
X-Ray Exam Entire Spi 1 Vw (72081)
range across 2 matching MRF lines		 $64–$115 $265–$479 varies
X-Ray Exam Entire Spi 2/3 Vw (72082) $59 $245 0.6×
X-Ray Exam Hip Uni 1 View (73501)
range across 4 matching MRF lines		 $78–$128 $325–$533 varies
X-Ray Exam Hip Uni 2-3 Views (73502) $105 $438 1.3×
X-Ray Exam Hips Bi 3-4 Views (73522) $126 $525 1.3×
X-Ray Exam L-S Spine Bending (72114) $148 $617 1.6×
X-Ray Exam Neck Spine 2-3 Vw (72040) $129 $539 1.7×
X-Ray Exam Neck Spine 6/>Vws (72052) $167 $694 1.8×
X-Ray Exam Unilat Ribs/Chest (71101)
range across 3 matching MRF lines		 $138 $9–$576 1.5×
X-ray eye for foreign body (70030) $62 $257 0.8×
X-ray humerus (73060) $76 $318 1.0×
X-ray IV pyelogram (ivp) (74400) $228 $949 1.4×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $34 $143 0.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $78 $325 1.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $93 $387 1.0×
X-ray nose-rectum child f.b. (76010) $107 $444 1.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $190 $791 2.0×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $80 $334 0.9×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $48 $201 0.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $80 $334 1.0×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $95 $395 1.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $95 $395 1.0×
X-Ray Stress View (77071) $85 $355 1.1×
X-ray thoracic spine 4 vw (72074) $111 $462 1.2×
X-Ray Tmj Unilat (70328) $34 $143 0.4×
X-Ray Urinary Tract Exam With Contrast Material (74420) $162 $677 0.5×
X-Rays Bone Length Studies (77073)
range across 2 matching MRF lines		 $64–$138 $268–$577 varies
X-Rays Bone Survey Complete (77075) $158 $658 1.7×
Xr c-spine 4 or 5 views (72050) $148 $617 1.6×
Xr facial bones less than 3 views (70140) $48 $199 0.6×
XR Mastoids < 3 Views Bilateral (70120) $34 $143 0.4×
Xr orbits complete 4 views (70200) $83 $344 0.9×
Xr Tomogram Single Plane (76100) $226 $943 2.4×

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.