Imaging prices at Dardanelle Regional Medical Center
Dardanelle, AR · every code in this section with a posted price and a Medicare benchmark.
258 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) | $145.89 | $374.08 | 1.8× |
| Abdomen 2 views (74019) | $206.65 | $529.86 | 2.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $476.31 | $1,221.30 | 1.3× |
| Angio pulmonary bilat (75743) | $2,455.05 | $6,295 | 0.9× |
| Angiography extremity bilateral rs&i (75716) | $2,455.05 | $6,295 | 0.9× |
| Angiography extremity unilateral rs&i (75710) | $3,689.21 | $9,459.51 | 1.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,455.05 | $6,295 | 0.9× |
| Ankle 2 views (73600) | $165.24 | $423.70 | 2.1× |
| Aortography thoracic serialography rs&i (75605) | $3,836.04 | $9,836 | 0.8× |
| Artery X-Rays Abdomen (75726) | $3,986.58 | $10,222 | 0.8× |
| Artery X-Rays Pelvis (75736) | $4,066.53 | $10,427 | 0.8× |
| Arthrogram hip (73525) | $437.31 | $1,121.31 | 1.4× |
| Arthrogram Wrist (73115) | $437.31 | $1,121.31 | 1.4× |
| Bone age studies (77072) | $124.37 | $318.90 | 1.3× |
| Bone Imaging 3 Phase (78315) | $1,028.43 | $2,637 | 2.8× |
| Bone Imaging Limited Area (78300) | $343.28 | $880.20 | 0.9× |
| Bone Imaging Whole Body (78306) | $886.28 | $2,272.50 | 2.4× |
| Bone survey infant (77076) | $185.75 | $476.28 | 2.0× |
| Brain Flow Imaging Only (78610) | $355.31 | $911.04 | 0.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,664.79 | $4,268.70 | 1.3× |
| Cat Scan Follow-Up Study (76380) | $342.93 | $879.30 | 4.3× |
| Cerebrospinal Fluid Scan (78630) | $2,093.01 | $5,366.70 | 4.2× |
| Chest 1 view (71045) | $176.72 | $453.13 | 2.2× |
| Chest 2 views (71046) | $181.45 | $465.26 | 2.3× |
| Chest 3 views (71047) | $182.64 | $468.30 | 2.3× |
| Chest 4 or more views (71048) | $191.65 | $491.40 | 2.0× |
| Clavicle complete (73000) | $102.45 | $262.68 | 1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $124.37 | $318.90 | 1.3× |
| Contrast Exam Abdominl Aorta (75625) | $3,689.21 | $9,459.51 | 1.3× |
| Contrast X-Ray Bladder (74430) | $437.31 | $1,121.31 | 1.4× |
| Contrast X-Ray Of Elbow (73085) | $437.31 | $1,121.31 | 1.4× |
| Contrast X-Ray Of Knee Joint (73580) | $437.31 | $1,121.31 | 1.4× |
| CT abdomen and pelvis without and with contrast (74178) | $1,857.49 | $4,762.80 | 5.8× |
| CT abdomen and pelvis without contrast (74176) | $1,403.18 | $3,597.90 | 6.5× |
| CT abdomen w contrast (74160) | $1,101.34 | $2,823.94 | 6.9× |
| CT abdomen w wo contrast (74170) | $1,319.59 | $3,383.57 | 8.3× |
| CT abdomen w/o contrast (74150) | $909.01 | $2,330.80 | 9.5× |
| CT Angio Abdomen and Pelvis (74174) | $1,411.72 | $3,619.80 | 4.4× |
| CT Angio Chest (71275) | $1,025.49 | $2,629.46 | 6.4× |
| CT Angio Head (70496) | $948.09 | $2,431.01 | 5.9× |
| CT angio hrt w/3d image (75574) | $461.92 | $1,184.40 | 1.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $977.77 | $2,507.09 | 6.1× |
| CT Angio Neck (70498) | $948.09 | $2,431.01 | 5.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $837.14 | $2,146.50 | 5.2× |
| CT bone density (77078) | $138.45 | $355.01 | 1.7× |
| CT cervical spine w/ contrast (72126) | $821.34 | $2,106 | 2.6× |
| CT cervical spine w/o contrast (72125) | $847.48 | $2,173.03 | 8.9× |
| CT cervical spine w/wo cont (72127) | $1,037.91 | $2,661.30 | 6.5× |
| CT chest w contrast (71260) | $1,025.49 | $2,629.46 | 6.4× |
| CT chest w/wo contrast (71270) | $1,191.89 | $3,056.13 | 7.5× |
| CT head/brain with contrast (70460) | $1,103.90 | $2,830.50 | 6.9× |
| CT head/brain without and with contrast (70470) | $1,501.86 | $3,850.93 | 9.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $117 | $300.01 | 1.5× |
| CT iac w contrast (70481) | $1,415.23 | $3,628.80 | 8.9× |
| CT l-spine w&w/o contrast (72133) | $873.99 | $2,241 | 5.5× |
| CT lower ext w/o (73700) | $517.39 | $1,326.64 | 5.4× |
| CT lower extremity w/contrast material (73701) | $634.64 | $1,627.29 | 4.0× |
| CT lumbar spine w contrast (72132) | $1,006.14 | $2,579.85 | 3.2× |
| CT lumbar spine w/o contrast (72131) | $847.48 | $2,173.03 | 8.9× |
| CT maxillofacial w contrast (70487) | $1,447.30 | $3,711.02 | 9.1× |
| CT maxillofacial wo contrast (70486) | $1,218.20 | $3,123.60 | 12.8× |
| CT neck tissue combo (70492) | $913.27 | $2,341.71 | 5.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,455.95 | $3,733.20 | 9.1× |
| CT orbits w/o contrast (70480) | $1,353.56 | $3,470.67 | 14.2× |
| CT pelvis w&w/o contrast (72194) | $845.21 | $2,167.20 | 5.3× |
| CT pelvis w/o contrast (72192) | $819.62 | $2,101.59 | 8.6× |
| CT scan of leg combo (73702) | $623.02 | $1,597.50 | 3.9× |
| CT scans face/jaw combo (70488) | $1,286.77 | $3,299.40 | 8.1× |
| CT soft tissue neck w contrast (70491) | $851.35 | $2,182.95 | 5.3× |
| CT soft tissue neck w/o contrast (70490) | $732.68 | $1,878.66 | 7.7× |
| CT thoracic spine w contrast (72129) | $909.44 | $2,331.90 | 5.7× |
| CT thoracic spine w/o contrast (72128) | $847.48 | $2,173.03 | 8.9× |
| CT thoracic spine w/wo cont (72130) | $1,050.19 | $2,692.80 | 6.6× |
| CT thorax w/o contrast (71250) | $894.69 | $2,294.08 | 9.4× |
| CT upper ext wo (73200) | $704.30 | $1,805.90 | 7.4× |
| CT upper extremity w/o & w/contrast material (73202) | $686.91 | $1,761.30 | 4.3× |
| CT upper extremity with contrast (73201) | $725.58 | $1,860.47 | 2.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,034.78 | $2,653.28 | 6.5× |
| Cta Abdomen (74175) | $919.85 | $2,358.58 | 5.8× |
| Dxa Bone Density Axial (77080) | $161.11 | $413.10 | 1.7× |
| Echo Guide For Artery Repair (76936) | $210.99 | $541 | 1.1× |
| Echograp Trans R Pros Study (76873) | $762.02 | $1,953.90 | 8.0× |
| Esophagram (74220) | $244.57 | $627.10 | 1.5× |
| Fluoroscopy up to 1 hr (76000) | $786.65 | $2,017.05 | 3.6× |
| Follow-Up Angiography (75898) | $2,459.47 | $6,306.34 | 0.9× |
| Foot 2 views (73620) | $137.47 | $352.49 | 1.7× |
| Forearm 2 views (73090) | $156.73 | $401.87 | 2.0× |
| Gastric emptying imaging study (78264) | $755.35 | $1,936.80 | 2.1× |
| Gated Heart Planar Single (78472) | $498.77 | $1,278.90 | 1.4× |
| Hand 2 views (73120) | $135.44 | $347.29 | 1.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,455.05 | $6,295 | 0.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,323.23 | $5,957 | 0.8× |
| Hepatobil Syst Image W/Drug (78227) | $726.57 | $1,863 | 1.5× |
| Hepatobiliary System Imaging (78226) | $373.11 | $956.70 | 1.0× |
| Ht Muscle Image Spect Sing (78451) | $1,028.43 | $2,637 | 0.9× |
| Hysterosalpingogram (74740) | $281.16 | $720.93 | 1.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $133.73 | $342.90 | 1.7× |
| Infant hip ultrasound, limited static exam (76886) | $57.92 | $148.50 | 0.7× |
| K Flow/Funct Image W/Drug (78708) | $651.10 | $1,669.50 | 1.3× |
| K Flow/Funct Image W/O Drug (78707) | $433.48 | $1,111.50 | 0.9× |
| Knee 3 Views (73562) | $147.05 | $377.06 | 1.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $479.85 | $1,230.39 | 1.3× |
| Lung Ventilat&Perfus Imaging (78582) | $737.45 | $1,890.90 | 1.5× |
| Lymph System Imaging (78195) | $555.98 | $1,425.60 | 1.1× |
| Meckels Divert Exam (78290) | $270.27 | $693 | 0.7× |
| Mra Head W/O & W/Contrast Material (70546) | $1,185.33 | $3,039.30 | 3.7× |
| MRA head w/o contrast (70544) | $937.26 | $2,403.23 | 4.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,185.33 | $3,039.30 | 3.7× |
| MRA neck w/o contrast (70547) | $850.12 | $2,179.80 | 3.9× |
| MRI abdomen w contrast (74182) | $1,486.42 | $3,811.34 | 4.7× |
| MRI abdomen w/o contrast (74181) | $1,189.19 | $3,049.20 | 5.5× |
| MRI any jt lower extrem w/contrast material (73722) | $1,106.68 | $2,837.64 | 1.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,332.74 | $3,417.28 | 4.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,293.95 | $3,317.81 | 1.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $621.27 | $1,593.01 | 2.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $418.05 | $1,071.93 | 1.9× |
| MRI cervical spine w/o cont (72141) | $1,097.08 | $2,813.03 | 5.0× |
| MRI chest w/o contrast (71550) | $1,092.36 | $2,800.92 | 5.0× |
| MRI chest wo w contrast (71552) | $1,098.55 | $2,816.80 | 3.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,038.08 | $2,661.75 | 3.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,098.92 | $2,817.74 | 5.1× |
| MRI lumbar spine w contrast (72149) | $1,425.47 | $3,655.05 | 4.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,782.81 | $4,571.30 | 5.6× |
| MRI orbit face &/neck w/o contrast (70540) | $948.09 | $2,431.01 | 4.4× |
| MRI orbit face neck w contrast (70542) | $1,452.02 | $3,723.14 | 4.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,185.33 | $3,039.30 | 3.7× |
| MRI pelvis w contrast (72196) | $1,479.54 | $3,793.70 | 4.7× |
| MRI pelvis w/o & w contrast (72197) | $1,468.49 | $3,765.37 | 4.6× |
| MRI pelvis w/o contrast (72195) | $1,113.85 | $2,856.03 | 5.1× |
| MRI thoracic spine w/o contrast (72146) | $1,219.26 | $3,126.31 | 5.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,307.60 | $3,352.83 | 6.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,323.89 | $3,394.60 | 4.2× |
| MRI, abdomen, combo (74183) | $1,475.32 | $3,782.88 | 4.6× |
| MRI, dorsal spine combo (72157) | $2,184.27 | $5,600.70 | 6.9× |
| MRI, dorsal spine contrast (72147) | $1,507.74 | $3,866 | 4.7× |
| MRI, joint upper extrem (73221) | $1,279.86 | $3,281.70 | 5.9× |
| MRI, joint upper extrem combo (73223) | $1,191.84 | $3,056 | 3.8× |
| MRI, lumbar spine combo (72158) | $1,966.10 | $5,041.28 | 6.2× |
| Myocardial Spect Multiple Studies (78452) | $1,070.55 | $2,745 | 0.9× |
| Neck soft tissue (70360) | $111.06 | $284.78 | 1.4× |
| Nonvascular Shunt X-Ray (75809) | $124.37 | $318.90 | 1.3× |
| Nuclear Rx Oral Admin (79005) | $1,142.15 | $2,928.60 | 5.4× |
| Parathyroid Planar Imaging (78070) | $891.89 | $2,286.90 | 2.5× |
| Pelvis 1 or 2 views (72170) | $124.37 | $318.90 | 1.3× |
| Peritoneogram Rs&I (74190) | $251.55 | $645 | 0.5× |
| PET image w/CT, full body (78816) | $1,812.21 | $4,646.70 | 1.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,737.45 | $4,455 | 1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $270.27 | $693 | 0.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $261.21 | $669.77 | 2.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $637.47 | $1,634.55 | 1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) | $176.85 | $453.46 | 2.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $102.45 | $262.68 | 1.3× |
| Radex elbow complete minimum 3 views (73080) | $156.27 | $400.68 | 2.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $128.48 | $329.43 | 1.3× |
| Radex fingr minimum 2 views (73140) | $102.45 | $262.68 | 1.3× |
| Radex foot complete minimum 3 views (73630) | $171.43 | $439.57 | 2.2× |
| Radex Hand Minimum 3 Views (73130) | $158.66 | $406.82 | 2.0× |
| Radex lower extremity infant minimum 2 views (73592) | $102.45 | $262.68 | 1.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $111.84 | $286.77 | 1.4× |
| Radex Ribs Unilateral 2 Views (71100) | $165.24 | $423.70 | 2.1× |
| Radex shoulder complete minimum 2 views (73030) | $170.27 | $436.59 | 2.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $102.45 | $262.68 | 1.3× |
| Radex Spine 1 View Specify Level (72020) | $167.32 | $429.03 | 2.1× |
| Radex Sternum Minimum 2 Views (71120) | $102.45 | $262.68 | 1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $133.42 | $342.09 | 1.7× |
| Radex Toe Minimum 2 Views (73660) | $119.96 | $307.60 | 1.5× |
| Radex upper extremity infant minimum 2 views (73092) | $78.27 | $200.70 | 0.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $172.59 | $442.54 | 2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $124.37 | $318.90 | 1.3× |
| Radiologic exam colon double contrast study (74280) | $353.31 | $905.93 | 2.2× |
| Radiologic exam colon single contrast study (74270) | $337.83 | $866.24 | 2.1× |
| Radiologic exam knee complete 4/more views (73564) | $150.37 | $385.56 | 1.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $134.28 | $344.32 | 1.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $433.03 | $1,110.33 | 2.7× |
| Radiologic exam swallow function contrast study (74230) | $205.63 | $527.25 | 1.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $566.46 | $1,452.47 | 3.5× |
| Radiologic examination femur 1 view (73551) | $102.45 | $262.68 | 1.3× |
| Radiologic examination femur minimum 2 views (73552) | $110.67 | $283.78 | 1.4× |
| Radiologic examination knee 1/2 views (73560) | $141.63 | $363.16 | 1.8× |
| Radiologic examination tibia & fibula 2 views (73590) | $164.08 | $420.71 | 2.1× |
| Ribs bilateral 3 views (71110) | $124.37 | $318.90 | 1.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $931.55 | $2,388.60 | 1.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,146.72 | $2,940.30 | 2.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,362.23 | $3,492.90 | 1.2× |
| Scapula (73010) | $124.37 | $318.90 | 1.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $35.49 | $91 | 1.5× |
| Shoulder 1 view (73020) | $139.31 | $357.21 | 1.8× |
| Shoulder Arthrography (73040) | $437.31 | $1,121.31 | 1.4× |
| Skull less than 4 views (70250) | $124.37 | $318.90 | 1.3× |
| Sternoclavicular joints (71130) | $102.45 | $262.68 | 1.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $142.35 | $365 | 0.9× |
| Thoracic spine 2 views (72070) | $190.39 | $488.19 | 2.0× |
| Thoracic spine 3 views (72072) | $190.54 | $488.57 | 2.0× |
| Thoracolumbar 2 views (72080) | $102.45 | $262.68 | 1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $538.08 | $1,379.70 | 1.5× |
| Ultrasound Breast Limited (76642) | $156.51 | $401.31 | 2.0× |
| Ultrasound, abdomen limited (76705) | $337.83 | $866.24 | 3.5× |
| Upper gi w/o kub (74240) | $392.87 | $1,007.37 | 2.5× |
| Urethrocystogram voiding (74455) | $281.16 | $720.93 | 1.3× |
| Urethrocystography retrograde (74450) | $208.14 | $533.70 | 1.0× |
| Us breast unilateral complete (76641) | $206.39 | $529.20 | 2.2× |
| Us chest (76604) | $124.37 | $318.90 | 1.3× |
| Us complete joint (76881) | $270.02 | $692.37 | 2.8× |
| Us exam, pelvic, limited (76857) | $81.78 | $209.70 | 0.9× |
| Us head (76506) | $205.69 | $527.40 | 2.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $255.41 | $654.89 | 2.7× |
| Us ob limited 1 or more fetuses (76815) | $124.37 | $318.90 | 1.3× |
| Us pelvic non ob complete (76856) | $378.85 | $971.42 | 4.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $124.37 | $318.90 | 1.3× |
| Us retroperitoneal limited (76775) | $380.01 | $974.39 | 4.0× |
| Us scrotum and contents (76870) | $350.22 | $897.99 | 3.7× |
| Us spinal canal and contents (76800) | $133.73 | $342.90 | 1.4× |
| Us thyroid (76536) | $316.55 | $811.66 | 3.3× |
| Vein X-Ray Chest (75827) | $1,120.08 | $2,872 | 0.8× |
| Venogram Sinus/Jugular (75860) | $2,455.05 | $6,295 | 0.9× |
| Venography caval inferior serialography rs&i (75825) | $2,455.05 | $6,295 | 0.9× |
| Venography extremity bilateral rs&i (75822) | $1,120.08 | $2,872 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $1,120.08 | $2,872 | 0.8× |
| Venography Renal Unilateral (75831) | $2,060.39 | $5,283.04 | 0.7× |
| Venous sampling by catheter (75893) | $4,066.53 | $10,427 | 0.8× |
| Wrist 2 views (73100) | $138.21 | $354.38 | 1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $102.45 | $262.68 | 1.3× |
| X-ray antegrade pyelogram tube (74425) | $437.31 | $1,121.31 | 1.4× |
| X-Ray Aorta Leg Arteries (75630) | $2,455.05 | $6,295 | 0.9× |
| X-Ray Bend Only L-S Spine (72120) | $228.32 | $585.43 | 2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $119.19 | $305.61 | 1.5× |
| X-Ray Exam Breast Specimen (76098) | $419.25 | $1,075 | 0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $126.93 | $325.46 | 1.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $181.10 | $464.37 | 1.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $102.45 | $262.68 | 1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $102.45 | $262.68 | 1.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $124.37 | $318.90 | 1.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $124.37 | $318.90 | 1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $152.47 | $390.95 | 1.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $186.12 | $477.23 | 2.0× |
| X-Ray Exam L-S Spine Bending (72114) | $228.32 | $585.43 | 2.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $155.18 | $397.90 | 2.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $195.43 | $501.09 | 2.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $222.51 | $570.55 | 2.3× |
| X-ray eye for foreign body (70030) | $107.50 | $275.63 | 1.4× |
| X-ray humerus (73060) | $153.24 | $392.93 | 1.9× |
| X-ray IV pyelogram (ivp) (74400) | $479.49 | $1,229.45 | 3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $121.90 | $312.56 | 1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $177.63 | $455.45 | 1.9× |
| X-ray nose-rectum child f.b. (76010) | $102.45 | $262.68 | 1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $124.37 | $318.90 | 1.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $124.37 | $318.90 | 1.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $124.37 | $318.90 | 1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $146.28 | $375.07 | 1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $188.07 | $482.23 | 2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $163.30 | $418.73 | 1.7× |
| X-ray thoracic spine 4 vw (72074) | $203.44 | $521.64 | 2.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $437.31 | $1,121.31 | 1.4× |
| X-Rays Bone Length Studies (77073) | $914.28 | $2,344.30 | 9.6× |
| X-Rays Bone Survey Complete (77075) | $237.99 | $610.24 | 2.5× |
| Xr c-spine 4 or 5 views (72050) | $189.24 | $485.22 | 2.0× |
| Xr facial bones less than 3 views (70140) | $102.45 | $262.68 | 1.3× |
| Xr orbits complete 4 views (70200) | $140.08 | $359.19 | 1.5× |