Imaging prices at Cumberland Memorial Hospital
Cumberland, WI · every code in this section with a posted price and a Medicare benchmark.
256 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) | $332.95 | $332.95 | 3.9× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$437.20–$503.20 | $437.20–$503.20 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,557.30 | $1,557.30 | 4.0× |
| Ankle 2 views (73600) | $317.25 | $317.25 | 3.8× |
| Bone age studies (77072) | $326.95 | $326.95 | 3.2× |
| Bone Imaging 3 Phase (78315) | $1,916.95 | $1,916.95 | 4.9× |
| Bone Imaging Limited Area (78300) | $1,502.50 | $1,502.50 | 3.9× |
| Bone Imaging Multiple Areas (78305) | $1,729.50 | $1,729.50 | 4.5× |
| Bone Imaging Whole Body (78306) | $1,916.95 | $1,916.95 | 4.9× |
| Brain imaging < 4 static views (78600) | $1,839.05 | $1,839.05 | 4.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,486.25 | $1,486.25 | 2.8× |
| Cerebrospinal Fluid Scan (78630) | $4,475.65 | $4,475.65 | 8.5× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$216.65–$355.05 | $216.65–$355.05 | varies |
| Chest 2 views (71046) | $351.60 | $351.60 | 4.2× |
| Chest 3 views (71047) range across 3 matching MRF lines |
$316.95–$452.30 | $316.95–$452.30 | varies |
| Chest 4 or more views (71048) | $383.65 | $383.65 | 3.8× |
| Cholecystography Oral Contrast (74290) | $470.10 | $470.10 | 2.8× |
| Clavicle complete (73000) | $290.20 | $290.20 | 3.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $557.60 | $557.60 | 5.5× |
| CT abdomen and pelvis without and with contrast (74178) | $4,377.70 | $4,377.70 | 12.9× |
| CT abdomen and pelvis without contrast (74176) | $3,259.20 | $3,259.20 | 14.1× |
| CT abdomen w contrast (74160) | $2,129.75 | $2,129.75 | 12.5× |
| CT abdomen w wo contrast (74170) | $2,366.40 | $2,366.40 | 13.9× |
| CT abdomen w/o contrast (74150) | $1,823.40 | $1,823.40 | 18.0× |
| CT Angio Abdomen and Pelvis (74174) | $4,848.20 | $4,848.20 | 14.3× |
| CT Angio Chest (71275) | $3,232.25 | $3,232.25 | 19.0× |
| CT Angio Head (70496) | $3,232.25 | $3,232.25 | 19.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $3,232.25 | $3,232.25 | 19.0× |
| CT Angio Neck (70498) | $3,232.25 | $3,232.25 | 19.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $3,232.25 | $3,232.25 | 19.0× |
| CT cervical spine w/ contrast (72126) | $2,237.85 | $2,237.85 | 6.6× |
| CT cervical spine w/o contrast (72125) | $2,072 | $2,072 | 20.4× |
| CT cervical spine w/wo cont (72127) | $2,296 | $2,296 | 13.5× |
| CT chest w contrast (71260) | $2,506.05 | $2,506.05 | 14.7× |
| CT chest w/wo contrast (71270) | $2,642.15 | $2,642.15 | 15.5× |
| CT head/brain with contrast (70460) | $1,743.85 | $1,743.85 | 10.2× |
| CT head/brain without and with contrast (70470) | $2,129.75 | $2,129.75 | 12.5× |
| CT iac w contrast (70481) | $1,740.65 | $1,740.65 | 10.2× |
| CT l-spine w&w/o contrast (72133) | $2,237.85 | $2,237.85 | 13.1× |
| CT lower ext w/o (73700) | $1,656.65 | $1,656.65 | 16.3× |
| CT lower extremity w/contrast material (73701) range across 8 matching MRF lines |
$1,694.75–$1,780.60 | $1,694.75–$1,780.60 | varies |
| CT lumbar spine w contrast (72132) | $2,072 | $2,072 | 6.1× |
| CT lumbar spine w/o contrast (72131) | $2,011.45 | $2,011.45 | 19.8× |
| CT maxillofacial w contrast (70487) | $1,740.65 | $1,740.65 | 10.2× |
| CT maxillofacial wo contrast (70486) | $1,656.65 | $1,656.65 | 16.3× |
| CT neck tissue combo (70492) | $2,237.85 | $2,237.85 | 13.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,906.15 | $1,906.15 | 11.2× |
| CT orbits w/o contrast (70480) | $1,657.60 | $1,657.60 | 16.3× |
| CT pelvis w&w/o contrast (72194) | $1,906.15 | $1,906.15 | 11.2× |
| CT pelvis w/o contrast (72192) | $1,656.65 | $1,656.65 | 16.3× |
| CT scan of leg combo (73702) range across 8 matching MRF lines |
$1,740.65–$1,893.25 | $1,740.65–$1,893.25 | varies |
| CT scans face/jaw combo (70488) | $1,906.15 | $1,906.15 | 11.2× |
| CT soft tissue neck w contrast (70491) | $2,072 | $2,072 | 12.2× |
| CT soft tissue neck w/o contrast (70490) | $1,823.40 | $1,823.40 | 18.0× |
| CT thoracic spine w contrast (72129) | $2,072 | $2,072 | 12.2× |
| CT thoracic spine w/o contrast (72128) | $2,011.45 | $2,011.45 | 19.8× |
| CT thoracic spine w/wo cont (72130) | $2,237.85 | $2,237.85 | 13.1× |
| CT thorax w/o contrast (71250) | $2,044.60 | $2,044.60 | 20.1× |
| CT upper ext wo (73200) range across 8 matching MRF lines |
$1,325.90–$1,656.65 | $1,325.90–$1,656.65 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,893.25 | $1,893.25 | 11.1× |
| CT upper extremity with contrast (73201) range across 8 matching MRF lines |
$1,656.65–$1,780.60 | $1,656.65–$1,780.60 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,631.50 | $2,631.50 | 15.4× |
| Cta Abdomen (74175) | $3,232.25 | $3,232.25 | 19.0× |
| CTA pelvis (72191) | $3,232.25 | $3,232.25 | 19.0× |
| Dxa Bone Density Axial (77080) | $599.10 | $599.10 | 5.9× |
| Esophagram (74220) | $820.30 | $820.30 | 4.8× |
| Fetal Biophys Profile W/Nst (76818) | $518.80 | $518.80 | 5.1× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$420.35–$539.18 | $420.35–$539.18 | varies |
| Foot 2 views (73620) | $314.35 | $314.35 | 3.7× |
| Forearm 2 views (73090) | $378.25 | $378.25 | 4.5× |
| Gastric emptying imaging study (78264) | $1,760.80 | $1,760.80 | 4.5× |
| Gated Heart Planar Single (78472) | $1,925.75 | $1,925.75 | 5.0× |
| Hand 2 views (73120) | $378.25 | $378.25 | 3.7× |
| Hepatobil Syst Image W/Drug (78227) | $2,128.20 | $2,128.20 | 4.0× |
| Hepatobiliary System Imaging (78226) | $1,064.30 | $1,064.30 | 2.7× |
| Ht Muscle Image Spect Sing (78451) range across 5 matching MRF lines |
$469.35–$5,055.05 | $469.35–$5,055.05 | varies |
| Hysterosalpingogram (74740) | $400 | $400 | 1.7× |
| K Flow/Funct Image W/Drug (78708) | $3,129.80 | $3,129.80 | 5.9× |
| K Flow/Funct Image W/O Drug (78707) | $2,934.15 | $2,934.15 | 5.6× |
| Kidney Imaging Morphol (78700) | $1,103.40 | $1,103.40 | 2.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,651.15 | $1,651.15 | 4.3× |
| Knee 3 Views (73562) | $433.80 | $433.80 | 5.1× |
| Leveen/Shunt Patency Exam (78291) | $1,870.05 | $1,870.05 | 4.8× |
| Liver & Spleen Imaging Static Only (78215) | $2,073.70 | $2,073.70 | 5.3× |
| Liver imaging static only (78201) | $1,557.30 | $1,557.30 | 3.0× |
| Lung Ventilat&Perfus Imaging (78582) | $3,192.50 | $3,192.50 | 6.1× |
| Lung Ventilation Imaging (78579) | $1,425.85 | $1,425.85 | 3.7× |
| Magnetic Image Jaw Joint (70336) | $3,030.10 | $3,030.10 | 13.1× |
| Mammary ductogram or galactogram single (77053) | $623.95 | $623.95 | 2.7× |
| Meckels Divert Exam (78290) | $1,393.05 | $1,393.05 | 3.6× |
| Mra Head W/O & W/Contrast Material (70546) | $4,089.75 | $4,089.75 | 12.1× |
| MRA head w/o contrast (70544) | $3,354.10 | $3,354.10 | 14.5× |
| MRA head with contrast (70545) | $3,431.40 | $3,431.40 | 10.1× |
| MRA neck w contrast (70548) | $3,549.55 | $3,549.55 | 10.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,394.60 | $4,394.60 | 13.0× |
| MRA neck w/o contrast (70547) | $3,775.05 | $3,775.05 | 16.3× |
| MRI abdomen w contrast (74182) | $3,670.50 | $3,670.50 | 10.8× |
| MRI abdomen w/o contrast (74181) | $3,113.60 | $3,113.60 | 13.4× |
| MRI any jt lower extrem w/contrast material (73722) | $3,455 | $3,455 | 4.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,455 | $3,455 | 10.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,837.65 | $3,837.65 | 5.0× |
| MRI cervical spine w contrast (72142) | $4,030.85 | $4,030.85 | 11.9× |
| MRI cervical spine w/o cont (72141) | $3,273.75 | $3,273.75 | 14.1× |
| MRI chest w/o contrast (71550) | $3,790.65 | $3,790.65 | 16.4× |
| MRI chest with contrast (71551) | $4,156 | $4,156 | 5.5× |
| MRI chest wo w contrast (71552) | $4,488.65 | $4,488.65 | 13.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,463.65 | $3,463.65 | 10.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,821.95 | $3,821.95 | 11.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,256.85 | $3,256.85 | 14.1× |
| MRI lumbar spine w contrast (72149) | $3,870.65 | $3,870.65 | 11.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,462.30 | $4,462.30 | 13.2× |
| MRI orbit face &/neck w/o contrast (70540) | $3,674 | $3,674 | 15.9× |
| MRI orbit face neck w contrast (70542) | $4,034.25 | $4,034.25 | 11.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,417.10 | $4,417.10 | 13.0× |
| MRI pelvis w contrast (72196) | $3,804.55 | $3,804.55 | 11.2× |
| MRI pelvis w/o & w contrast (72197) | $3,804.55 | $3,804.55 | 11.2× |
| MRI pelvis w/o contrast (72195) | $3,446.15 | $3,446.15 | 14.9× |
| MRI thoracic spine w/o contrast (72146) | $3,505.25 | $3,505.25 | 15.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,635.90 | $3,635.90 | 10.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,391.20 | $3,391.20 | 14.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,587.75 | $3,587.75 | 10.6× |
| MRI, abdomen, combo (74183) | $3,670.50 | $3,670.50 | 10.8× |
| MRI, dorsal spine combo (72157) | $4,505.90 | $4,505.90 | 13.3× |
| MRI, dorsal spine contrast (72147) | $4,307.50 | $4,307.50 | 12.7× |
| MRI, joint upper extrem (73221) | $3,391.20 | $3,391.20 | 14.6× |
| MRI, joint upper extrem combo (73223) | $3,952.85 | $3,952.85 | 11.7× |
| MRI, lumbar spine combo (72158) | $4,614.55 | $4,614.55 | 13.6× |
| Myelogram Lumbar (72265) | $771.80 | $771.80 | 1.0× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,361.70 | $1,361.70 | 3.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) range across 2 matching MRF lines |
$469.35–$3,048.95 | $469.35–$3,048.95 | varies |
| Myocardial Spect Multiple Studies (78452) | $4,961.98 | $4,961.98 | 3.9× |
| Neck soft tissue (70360) | $382.05 | $382.05 | 4.5× |
| Nm unlisted gi procedure (78299) | $962.60 | $962.60 | 2.5× |
| Parathyroid Planar Imaging (78070) | $2,464.95 | $2,464.95 | 6.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,464.95 | $2,464.95 | 6.3× |
| Pelvis 1 or 2 views (72170) | $346.90 | $346.90 | 3.4× |
| PET image w/CT, full body (78816) | $9,280.40 | $9,280.40 | 6.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,791.40 | $8,791.40 | 6.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,735.45 | $1,735.45 | 4.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $503.20 | $503.20 | 5.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $603.65 | $603.65 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $416.20 | $416.20 | 4.9× |
| Radex Calcaneus Minimum 2 Views (73650) | $255.40 | $255.40 | 3.0× |
| Radex elbow complete minimum 3 views (73080) | $378.25 | $378.25 | 4.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $419.15 | $419.15 | 4.1× |
| Radex fingr minimum 2 views (73140) | $299.25 | $299.25 | 3.5× |
| Radex foot complete minimum 3 views (73630) | $379.85 | $379.85 | 4.5× |
| Radex Hand Minimum 3 Views (73130) | $399.75 | $399.75 | 4.7× |
| Radex lower extremity infant minimum 2 views (73592) | $323.80 | $323.80 | 3.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $364.50 | $364.50 | 4.3× |
| Radex Ribs Unilateral 2 Views (71100) | $443.85 | $443.85 | 5.3× |
| Radex shoulder complete minimum 2 views (73030) | $416.20 | $416.20 | 4.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $353.95 | $353.95 | 4.2× |
| Radex Spine 1 View Specify Level (72020) | $352.45 | $352.45 | 4.2× |
| Radex Sternum Minimum 2 Views (71120) | $417.25 | $417.25 | 4.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $566.75 | $566.75 | 6.7× |
| Radex Toe Minimum 2 Views (73660) | $296.75 | $296.75 | 3.5× |
| Radex upper extremity infant minimum 2 views (73092) | $323.80 | $323.80 | 3.2× |
| Radex Wrist Complete Minimum 3 Views (73110) | $397.25 | $397.25 | 4.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $410.25 | $410.25 | 4.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $432.95 | $432.95 | 4.3× |
| Radiologic exam colon double contrast study (74280) | $787.20 | $787.20 | 4.6× |
| Radiologic exam colon single contrast study (74270) | $757 | $757 | 4.4× |
| Radiologic exam knee complete 4/more views (73564) | $497.60 | $497.60 | 4.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $670.55 | $670.55 | 6.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $728 | $728 | 4.3× |
| Radiologic exam swallow function contrast study (74230) | $727.40 | $727.40 | 4.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $779.60 | $779.60 | 4.6× |
| Radiologic examination femur 1 view (73551) | $287.20 | $287.20 | 3.4× |
| Radiologic examination femur minimum 2 views (73552) | $396.95 | $396.95 | 4.7× |
| Radiologic examination knee 1/2 views (73560) | $343.35 | $343.35 | 4.1× |
| Radiologic Examination Salivary Gland Calculus (70380) | $348.90 | $348.90 | 4.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $399.75 | $399.75 | 4.7× |
| Ribs bilateral 3 views (71110) | $512.60 | $512.60 | 5.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$1,775.10–$2,120.60 | $1,775.10–$2,120.60 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,129.95 | $2,129.95 | 5.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$4,225.20–$4,350.70 | $4,225.20–$4,350.70 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 5 matching MRF lines |
$2,675.95–$4,475.65 | $2,675.95–$4,475.65 | varies |
| Salivary Gland Imaging Serial Images (78231) | $1,236.65 | $1,236.65 | 3.2× |
| Scapula (73010) range across 4 matching MRF lines |
$354.50–$400.70 | $354.50–$400.70 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $55.30 | $55.30 | 2.4× |
| Sella turcica (70240) | $294.90 | $294.90 | 3.5× |
| Shoulder 1 view (73020) | $320.60 | $320.60 | 3.8× |
| Sialogram (70390) range across 2 matching MRF lines |
$664.25–$1,132.85 | $664.25–$1,132.85 | varies |
| Skull less than 4 views (70250) | $401.05 | $401.05 | 3.9× |
| Spleen Imaging (78185) | $1,260.10 | $1,260.10 | 3.2× |
| Sternoclavicular joints (71130) | $441.50 | $441.50 | 5.2× |
| Testicular Imaging W/Flow (78761) | $1,440.15 | $1,440.15 | 3.7× |
| Thoracic spine 2 views (72070) | $435.55 | $435.55 | 4.3× |
| Thoracic spine 3 views (72072) | $566.55 | $566.55 | 5.6× |
| Thoracolumbar 2 views (72080) | $439.60 | $439.60 | 5.2× |
| Thyroid Imaging With Vascular Flow (78013) | $811.35 | $811.35 | 2.1× |
| Thyroid Met Imaging Body (78018) | $4,303.15 | $4,303.15 | 8.2× |
| Thyroid Uptake Measurement (78012) | $497.80 | $497.80 | 1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$1,760.80–$2,464.95 | $1,760.80–$2,464.95 | varies |
| Ultrasound Exam Aaa Screen (76706) | $636.75 | $636.75 | 6.3× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$201.25–$830.30 | $201.25–$830.30 | varies |
| Umbilical-artery Doppler (OB) (76820) | $177.75 | $177.75 | 1.8× |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$100.65–$196.05 | $100.65–$196.05 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $860.75 | $860.75 | 2.2× |
| Upper gi w/o kub (74240) | $524.20 | $524.20 | 3.1× |
| Ureteral Reflux Study (78740) | $1,088.20 | $1,088.20 | 2.8× |
| Urethrocystogram voiding (74455) | $661.95 | $661.95 | 2.9× |
| Us breast unilateral complete (76641) | $642.55 | $642.55 | 6.3× |
| Us chest (76604) range across 3 matching MRF lines |
$134.68–$688.50 | $134.68–$688.50 | varies |
| Us complete joint (76881) | $660.25 | $660.25 | 6.5× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$186.25–$588 | $186.25–$588 | varies |
| Us head (76506) | $845.05 | $845.05 | 8.3× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$139.95–$313.30 | $139.95–$313.30 | varies |
| Us ob transvaginal (76817) | $391.35 | $391.35 | 3.9× |
| Us pelvic non ob complete (76856) | $820.30 | $820.30 | 8.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $766.20 | $766.20 | 7.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $325.35 | $325.35 | 3.2× |
| Us retroperitoneal complete (76770) | $831 | $831 | 8.2× |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$140.85–$799.70 | $140.85–$799.70 | varies |
| Us scrotum and contents (76870) | $621.75 | $621.75 | 6.1× |
| Us thyroid (76536) | $868.75 | $868.75 | 8.6× |
| Us transrectal (76872) | $860.75 | $860.75 | 8.5× |
| Venous thrombosis imaging (78457) | $1,197.25 | $1,197.25 | 2.3× |
| Wrist 2 views (73100) | $378.25 | $378.25 | 4.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $457.20 | $457.20 | 5.4× |
| X-Ray Bend Only L-S Spine (72120) | $648.85 | $648.85 | 6.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $320.60 | $320.60 | 3.8× |
| X-Ray Exam Breast Specimen (76098) | $557.60 | $557.60 | 1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $668.15 | $668.15 | 7.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $386.05 | $386.05 | 4.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 6 matching MRF lines |
$198.15–$432.75 | $198.15–$432.75 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,098 | $1,098 | 10.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $586 | $586 | 5.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $679.75 | $679.75 | 6.7× |
| X-Ray Exam L-S Spine Bending (72114) | $648.85 | $648.85 | 6.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $466.35 | $466.35 | 5.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $565.10 | $565.10 | 5.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $477.90 | $477.90 | 4.7× |
| X-ray eye for foreign body (70030) | $239.40 | $239.40 | 2.8× |
| X-ray humerus (73060) | $396.95 | $396.95 | 4.7× |
| X-ray IV pyelogram (ivp) (74400) | $529.10 | $529.10 | 3.1× |
| X-ray IV pyelogram+tomography (74415) | $924.45 | $924.45 | 5.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $332.25 | $332.25 | 3.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $365.15 | $365.15 | 4.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $466.35 | $466.35 | 4.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $593.80 | $593.80 | 5.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $387.35 | $387.35 | 3.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $348.90 | $348.90 | 3.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $420.35 | $420.35 | 5.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $508.30 | $508.30 | 6.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $484.35 | $484.35 | 4.8× |
| X-ray thoracic spine 4 vw (72074) | $578.80 | $578.80 | 5.7× |
| X-Ray Tmj Unilat (70328) | $502.55 | $502.55 | 5.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,406.15 | $1,406.15 | 4.1× |
| X-Rays Bone Length Studies (77073) | $603.65 | $603.65 | 5.9× |
| X-Rays Bone Survey Complete (77075) | $685.25 | $685.25 | 6.7× |
| Xr c-spine 4 or 5 views (72050) | $566.75 | $566.75 | 5.6× |
| Xr facial bones less than 3 views (70140) | $320.60 | $320.60 | 3.8× |
| Xr orbits complete 4 views (70200) | $483.90 | $483.90 | 4.8× |
| Xr Tomogram Single Plane (76100) | $503.20 | $503.20 | 5.0× |
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.