Imaging prices at Delaware Valley Hospital, Inc
Walton, NY · every code in this section with a posted price and a Medicare benchmark.
261 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) | $399 | $399 | 3.7× |
| Abdomen 2 views (74019) | $554 | $554 | 4.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,177 | $2,177 | 4.4× |
| Ankle 2 views (73600) | $375 | $375 | 3.5× |
| Bone age studies (77072) | $399 | $399 | 3.1× |
| Bone Imaging 3 Phase (78315) | $3,330 | $3,330 | 6.7× |
| Bone Imaging Limited Area (78300) | $1,556 | $1,556 | 3.1× |
| Bone Imaging Whole Body (78306) | $2,528 | $2,528 | 5.1× |
| Brain Image W/Flow < 4 Views (78601) | $2,120 | $2,120 | 4.2× |
| Brain imaging < 4 static views (78600) | $1,606 | $1,606 | 3.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,226 | $2,226 | 3.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $4,939 | $4,939 | 11.3× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $6,702 | $6,702 | 6.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,084 | $2,084 | 3.1× |
| Cerebrospinal Fluid Scan (78630) | $7,914 | $7,914 | 11.7× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$373–$434 | $373–$434 | varies |
| Chest 2 views (71046) | $475 | $475 | 4.4× |
| Chest 3 views (71047) range across 2 matching MRF lines |
$240–$570 | $240–$570 | varies |
| Chest 4 or more views (71048) | $598 | $598 | 4.6× |
| Clavicle complete (73000) | $797 | $797 | 7.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $3,315 | $3,315 | 25.4× |
| CT abdomen and pelvis without and with contrast (74178) | $6,708 | $6,708 | 15.4× |
| CT abdomen and pelvis without contrast (74176) | $4,421 | $4,421 | 14.8× |
| CT abdomen w contrast (74160) | $4,024 | $4,024 | 18.4× |
| CT abdomen w wo contrast (74170) | $5,088 | $5,088 | 23.2× |
| CT abdomen w/o contrast (74150) | $3,330 | $3,330 | 25.5× |
| CT Angio Abdomen and Pelvis (74174) | $7,526 | $7,526 | 17.3× |
| CT Angio Chest (71275) | $5,193 | $5,193 | 23.7× |
| CT Angio Head (70496) | $5,538 | $5,538 | 25.3× |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$2,309–$2,660 | $2,309–$2,660 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $4,740 | $4,740 | 21.6× |
| CT Angio Neck (70498) | $4,687 | $4,687 | 21.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $4,409 | $4,409 | 20.1× |
| CT cervical spine w/ contrast (72126) | $4,162 | $4,162 | 9.6× |
| CT cervical spine w/o contrast (72125) | $3,481 | $3,481 | 26.7× |
| CT cervical spine w/wo cont (72127) | $460 | $460 | 2.1× |
| CT chest w contrast (71260) | $4,162 | $4,162 | 19.0× |
| CT chest w/wo contrast (71270) | $5,193 | $5,193 | 23.7× |
| CT head/brain with contrast (70460) | $3,334 | $3,334 | 15.2× |
| CT head/brain without and with contrast (70470) | $4,559 | $4,559 | 20.8× |
| CT heart contrast eval cardiac structure&morph (75572) | $454 | $454 | 1.0× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$3,942–$4,413 | $3,942–$4,413 | varies |
| CT l-spine w&w/o contrast (72133) | $4,783 | $4,783 | 21.8× |
| CT lower ext w/o (73700) | $2,922 | $2,922 | 22.4× |
| CT lower extremity w/contrast material (73701) | $3,481 | $3,481 | 15.9× |
| CT lumbar spine w contrast (72132) | $4,162 | $4,162 | 9.6× |
| CT lumbar spine w/o contrast (72131) | $3,481 | $3,481 | 26.7× |
| CT maxillofacial w contrast (70487) | $3,305 | $3,305 | 15.1× |
| CT neck tissue combo (70492) | $4,162 | $4,162 | 19.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $6,719 | $6,719 | 30.7× |
| CT orbits w/o contrast (70480) | $2,779 | $2,779 | 21.3× |
| CT pelvis w&w/o contrast (72194) | $4,988 | $4,988 | 22.8× |
| CT pelvis w/o contrast (72192) | $3,481 | $3,481 | 26.7× |
| CT scan of leg combo (73702) | $3,108 | $3,108 | 14.2× |
| CT scans face/jaw combo (70488) | $4,136 | $4,136 | 18.9× |
| CT soft tissue neck w contrast (70491) | $3,330 | $3,330 | 15.2× |
| CT soft tissue neck w/o contrast (70490) | $2,796 | $2,796 | 21.4× |
| CT thoracic spine w contrast (72129) | $4,162 | $4,162 | 19.0× |
| CT thoracic spine w/o contrast (72128) | $3,481 | $3,481 | 26.7× |
| CT thorax w/o contrast (71250) | $3,481 | $3,481 | 26.7× |
| CT upper ext wo (73200) | $2,922 | $2,922 | 22.4× |
| CT upper extremity w/o & w/contrast material (73202) | $4,740 | $4,740 | 21.6× |
| CT upper extremity with contrast (73201) | $3,481 | $3,481 | 8.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $5,193 | $5,193 | 23.7× |
| Cta Abdomen (74175) | $5,018 | $5,018 | 22.9× |
| CTA pelvis (72191) | $4,988 | $4,988 | 22.8× |
| Dxa Bone Density Axial (77080) | $1,376 | $1,376 | 10.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $1,309 | $1,309 | 12.1× |
| Echo exam uterus (76831) | $790 | $790 | 2.7× |
| Echo Guide For Artery Repair (76936) | $1,914 | $1,914 | 7.1× |
| Esophagram (74220) | $908 | $908 | 4.1× |
| Fetal Biophys Profile W/Nst (76818) | $363 | $363 | 2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,417 | $1,417 | 10.9× |
| Foot 2 views (73620) | $375 | $375 | 3.5× |
| Forearm 2 views (73090) | $399 | $399 | 3.7× |
| Gastric emptying imaging study (78264) | $2,907 | $2,907 | 5.8× |
| Gastroesophageal Reflux Exam (78262) | $2,849 | $2,849 | 5.7× |
| Gated Heart Planar Single (78472) | $5,077 | $5,077 | 10.2× |
| Hand 2 views (73120) | $375 | $375 | 2.9× |
| Hepatobil Syst Image W/Drug (78227) | $2,903 | $2,903 | 4.3× |
| Hepatobiliary System Imaging (78226) | $2,922 | $2,922 | 5.9× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$2,026–$3,619 | $2,026–$3,619 | varies |
| Hysterosalpingogram (74740) | $977 | $977 | 3.3× |
| K Flow/Funct Image W/Drug (78708) | $3,856 | $3,856 | 5.7× |
| K Flow/Funct Image W/O Drug (78707) | $2,636 | $2,636 | 3.9× |
| Knee 3 Views (73562) | $425 | $425 | 3.9× |
| Liver & Spleen Imaging Static Only (78215) | $1,980 | $1,980 | 4.0× |
| Liver imaging static only (78201) | $2,084 | $2,084 | 3.1× |
| Lung Perf&Ventilat Diferentl (78598) | $5,590 | $5,590 | 8.2× |
| Lung Ventilat&Perfus Imaging (78582) | $5,252 | $5,252 | 7.7× |
| Lung Ventilation Imaging (78579) | $3,043 | $3,043 | 6.1× |
| Lymph System Imaging (78195) | $2,524 | $2,524 | 3.7× |
| Magnetic Image Jaw Joint (70336) | $3,473 | $3,473 | 11.7× |
| Meckels Divert Exam (78290) | $1,654 | $1,654 | 3.3× |
| Mra Head W/O & W/Contrast Material (70546) | $6,172 | $6,172 | 14.2× |
| MRA head w/o contrast (70544) | $3,594 | $3,594 | 12.1× |
| MRA head with contrast (70545) | $4,299 | $4,299 | 9.9× |
| MRA neck w contrast (70548) | $4,939 | $4,939 | 11.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $6,172 | $6,172 | 14.2× |
| MRA neck w/o contrast (70547) | $3,451 | $3,451 | 11.6× |
| MRI abdomen w contrast (74182) | $4,939 | $4,939 | 11.3× |
| MRI abdomen w/o contrast (74181) | $5,169 | $5,169 | 17.4× |
| MRI any jt lower extrem w/contrast material (73722) | $2,590 | $2,590 | 2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $6,159 | $6,159 | 14.1× |
| MRI bone marrow blood supply (77084) | $3,473 | $3,473 | 11.7× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,167 | $1,167 | 3.9× |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$678–$806 | $678–$806 | varies |
| MRI cardiac w/o cont stress (75559) | $3,473 | $3,473 | 5.1× |
| MRI cardiac w/o contrast (75557) | $3,473 | $3,473 | 11.7× |
| MRI cervical spine w contrast (72142) | $5,218 | $5,218 | 12.0× |
| MRI cervical spine w/o cont (72141) | $4,716 | $4,716 | 15.8× |
| MRI chest w/o contrast (71550) | $4,031 | $4,031 | 13.5× |
| MRI chest with contrast (71551) | $4,939 | $4,939 | 5.0× |
| MRI chest wo w contrast (71552) | $6,126 | $6,126 | 14.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,120 | $1,120 | 2.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,377 | $3,377 | 7.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $4,148 | $4,148 | 13.9× |
| MRI lumbar spine w contrast (72149) | $5,341 | $5,341 | 12.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $7,360 | $7,360 | 16.9× |
| MRI orbit face &/neck w/o contrast (70540) | $3,473 | $3,473 | 11.7× |
| MRI orbit face neck w contrast (70542) | $4,939 | $4,939 | 11.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$3,678–$5,806 | $3,678–$5,806 | varies |
| MRI pelvis w contrast (72196) | $4,939 | $4,939 | 11.3× |
| MRI pelvis w/o & w contrast (72197) | $6,172 | $6,172 | 14.2× |
| MRI pelvis w/o contrast (72195) | $3,988 | $3,988 | 13.4× |
| MRI thoracic spine w/o contrast (72146) | $4,799 | $4,799 | 16.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,209 | $2,209 | 7.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $6,962 | $6,962 | 16.0× |
| MRI, abdomen, combo (74183) | $5,782 | $5,782 | 13.3× |
| MRI, dorsal spine combo (72157) | $6,702 | $6,702 | 15.4× |
| MRI, dorsal spine contrast (72147) | $4,299 | $4,299 | 9.9× |
| MRI, joint upper extrem (73221) | $2,209 | $2,209 | 7.4× |
| MRI, joint upper extrem combo (73223) | $5,974 | $5,974 | 13.7× |
| MRI, lumbar spine combo (72158) | $6,812 | $6,812 | 15.6× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$2,753–$5,550 | $2,753–$5,550 | varies |
| Neck soft tissue (70360) | $324 | $324 | 3.0× |
| Nm csf leak detection (78650) | $4,277 | $4,277 | 2.6× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$249–$560 | $249–$560 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,226 | $2,226 | 3.3× |
| Parathyroid Planar Imaging (78070) | $1,528 | $1,528 | 3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,274 | $2,274 | 4.6× |
| Pelvis 1 or 2 views (72170) | $399 | $399 | 3.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,214 | $2,214 | 4.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $762 | $762 | 5.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $802 | $802 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) | $412 | $412 | 3.8× |
| Radex Calcaneus Minimum 2 Views (73650) | $370 | $370 | 3.4× |
| Radex elbow complete minimum 3 views (73080) | $449 | $449 | 4.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $602 | $602 | 4.6× |
| Radex fingr minimum 2 views (73140) | $324 | $324 | 3.0× |
| Radex foot complete minimum 3 views (73630) | $397 | $397 | 3.7× |
| Radex Hand Minimum 3 Views (73130) | $397 | $397 | 3.7× |
| Radex lower extremity infant minimum 2 views (73592) | $375 | $375 | 3.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $602 | $602 | 4.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $478 | $478 | 4.4× |
| Radex Ribs Unilateral 2 Views (71100) | $474 | $474 | 4.4× |
| Radex shoulder complete minimum 2 views (73030) | $449 | $449 | 4.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $475 | $475 | 4.4× |
| Radex Spine 1 View Specify Level (72020) | $324 | $324 | 3.0× |
| Radex Sternum Minimum 2 Views (71120) | $502 | $502 | 4.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $645 | $645 | 5.9× |
| Radex Toe Minimum 2 Views (73660) | $324 | $324 | 3.0× |
| Radex upper extremity infant minimum 2 views (73092) | $375 | $375 | 2.9× |
| Radex Wrist Complete Minimum 3 Views (73110) | $397 | $397 | 3.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $323 | $323 | 2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $506 | $506 | 3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $449 | $449 | 3.4× |
| Radiologic exam colon double contrast study (74280) | $1,714 | $1,714 | 7.8× |
| Radiologic exam colon single contrast study (74270) | $1,307 | $1,307 | 6.0× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$492–$588 | $492–$588 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $541 | $541 | 4.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $990 | $990 | 4.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,159 | $1,159 | 5.3× |
| Radiologic examination femur 1 view (73551) | $248 | $248 | 2.3× |
| Radiologic examination femur minimum 2 views (73552) | $449 | $449 | 4.1× |
| Radiologic examination knee 1/2 views (73560) | $399 | $399 | 3.7× |
| Radiologic Examination Osseous Survey Limited (77074) | $289 | $289 | 2.2× |
| Radiologic examination tibia & fibula 2 views (73590) | $399 | $399 | 3.7× |
| Ribs bilateral 3 views (71110) | $602 | $602 | 4.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,505 | $1,505 | 3.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,505 | $1,505 | 3.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,903 | $5,903 | 8.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,972 | $3,972 | 5.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,768 | $3,768 | 5.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,768 | $3,768 | 2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $5,557 | $5,557 | 3.4× |
| Rp Therapy Intravenous Administration (79101) | $447 | $447 | 1.5× |
| Scapula (73010) | $407 | $407 | 3.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$120–$173 | $120–$173 | varies |
| Shoulder 1 view (73020) | $350 | $350 | 3.2× |
| Skull less than 4 views (70250) | $475 | $475 | 3.6× |
| Sternoclavicular joints (71130) | $539 | $539 | 5.0× |
| Thoracic spine 2 views (72070) | $590 | $590 | 4.5× |
| Thoracic spine 3 views (72072) | $570 | $570 | 4.4× |
| Thoracolumbar 2 views (72080) | $501 | $501 | 4.6× |
| Thyroid Imaging With Vascular Flow (78013) | $2,241 | $2,241 | 4.5× |
| Thyroid Met Imaging Body (78018) | $4,269 | $4,269 | 6.3× |
| Thyroid Uptake Measurement (78012) | $1,606 | $1,606 | 3.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,544 | $1,544 | 3.1× |
| Ultrasound Breast Limited (76642) | $995 | $995 | 9.2× |
| Ultrasound Exam Aaa Screen (76706) | $985 | $985 | 7.5× |
| Ultrasound, abdomen limited (76705) | $1,125 | $1,125 | 8.6× |
| Umbilical-artery Doppler (OB) (76820) | $1,057 | $1,057 | 8.1× |
| Unlisted us procedure (76999) | $679 | $679 | 6.3× |
| Ureteral Reflux Study (78740) | $1,606 | $1,606 | 3.2× |
| Urethrocystogram voiding (74455) | $1,184 | $1,184 | 4.0× |
| Urethrocystography retrograde (74450) | $1,096 | $1,096 | 3.7× |
| Us breast unilateral complete (76641) | $995 | $995 | 7.6× |
| Us chest (76604) | $990 | $990 | 7.6× |
| Us complete joint (76881) range across 2 matching MRF lines |
$1,095–$1,142 | $1,095–$1,142 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$596–$992 | $596–$992 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$396–$454 | $396–$454 | varies |
| Us ob detailed single fetus (76811) | $1,528 | $1,528 | 5.1× |
| Us ob limited 1 or more fetuses (76815) | $647 | $647 | 5.0× |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$315–$1,164 | $315–$1,164 | varies |
| Us pelvic non ob complete (76856) | $1,220 | $1,220 | 9.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,095 | $1,095 | 8.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $852 | $852 | 6.5× |
| Us retroperitoneal complete (76770) | $1,130 | $1,130 | 8.7× |
| Us retroperitoneal limited (76775) | $807 | $807 | 6.2× |
| Us scrotum and contents (76870) | $807 | $807 | 6.2× |
| Us thyroid (76536) | $783 | $783 | 6.0× |
| Us transrectal (76872) range across 2 matching MRF lines |
$469–$1,540 | $469–$1,540 | varies |
| Vein X-Ray Chest (75827) | $2,834 | $2,834 | 1.4× |
| Venography extremity bilateral rs&i (75822) | $1,122 | $1,122 | 0.6× |
| Wrist 2 views (73100) | $375 | $375 | 3.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $517 | $517 | 4.8× |
| X-Ray Bend Only L-S Spine (72120) | $530 | $530 | 4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $399 | $399 | 3.7× |
| X-Ray Exam Breast Specimen (76098) | $1,381 | $1,381 | 2.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $517 | $517 | 4.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $983 | $983 | 7.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $296 | $296 | 2.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $351 | $351 | 3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $517 | $517 | 4.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $774 | $774 | 5.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,035 | $1,035 | 7.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $333 | $333 | 2.6× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$791–$1,717 | $791–$1,717 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $467 | $467 | 4.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $865 | $865 | 6.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $762 | $762 | 5.8× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$362–$897 | $362–$897 | varies |
| X-ray humerus (73060) | $449 | $449 | 4.1× |
| X-ray IV pyelogram (ivp) (74400) | $1,527 | $1,527 | 7.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $399 | $399 | 3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $1,056 | $1,056 | 9.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $517 | $517 | 4.0× |
| X-ray nose-rectum child f.b. (76010) | $114 | $114 | 1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $687 | $687 | 5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $475 | $475 | 3.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $277 | $277 | 2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $449 | $449 | 4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $600 | $600 | 5.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $702 | $702 | 5.4× |
| X-ray thoracic spine 4 vw (72074) | $704 | $704 | 5.4× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$174–$388 | $174–$388 | varies |
| X-Rays Bone Survey Complete (77075) | $362 | $362 | 2.8× |
| Xr c-spine 4 or 5 views (72050) | $741 | $741 | 5.7× |
| Xr facial bones less than 3 views (70140) | $475 | $475 | 4.4× |
| Xr orbits complete 4 views (70200) | $602 | $602 | 4.6× |
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.