Imaging prices at Delta County Memorial Hospital
Delta, CO · every code in this section with a posted price and a Medicare benchmark.
252 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) | $218.10 | $363.50 | 2.4× |
| Abdomen 2 views (74019) | $259.05 | $431.75 | 2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,221 | $2,035 | 2.9× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$130.80–$210.10 | $218–$350.16 | varies |
| Arthrogram ankle (73615) | $440.23 | $733.72 | 1.2× |
| Arthrogram hip (73525) | $440.23 | $733.72 | 1.2× |
| Arthrogram Wrist (73115) | $440.23 | $733.72 | 1.2× |
| Bone age studies (77072) | $149.55 | $249.25 | 1.4× |
| Bone Imaging 3 Phase (78315) | $1,003.05 | $1,671.75 | 2.4× |
| Bone Imaging Limited Area (78300) | $1,012.95 | $1,688.25 | 2.4× |
| Bone Imaging Whole Body (78306) | $1,088.55 | $1,814.25 | 2.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $926.85 | $1,544.75 | 1.6× |
| Cat Scan Follow-Up Study (76380) range across 4 matching MRF lines |
$465.90–$700.80 | $776.50–$1,168 | varies |
| Cerebrospinal Fluid Scan (78630) | $2,011.80 | $3,353 | 3.5× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$90–$194.25 | $150–$323.75 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$146.10–$200.10 | $243.50–$333.50 | varies |
| Chest 3 views (71047) | $223.05 | $371.75 | 2.4× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$156.30–$312.45 | $260.50–$520.75 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $938.10 | $1,563.50 | 8.5× |
| Contrast X-Ray Bladder (74430) | $440.23 | $733.72 | 1.2× |
| Contrast X-Ray Of Elbow (73085) | $480.75 | $801.25 | 1.3× |
| Contrast X-Ray Of Knee Joint (73580) | $440.23 | $733.72 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) | $2,557.65 | $4,262.75 | 6.9× |
| CT abdomen and pelvis without contrast (74176) | $1,847.70 | $3,079.50 | 7.3× |
| CT abdomen w contrast (74160) | $1,198.05 | $1,996.75 | 6.5× |
| CT abdomen w wo contrast (74170) | $1,373.25 | $2,288.75 | 7.4× |
| CT abdomen w/o contrast (74150) | $1,023.15 | $1,705.25 | 9.3× |
| CT Angio Abdomen and Pelvis (74174) | $1,209.60 | $2,016 | 3.3× |
| CT Angio Chest (71275) | $1,209.90 | $2,016.50 | 6.5× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$882–$1,365 | $1,470–$2,275 | varies |
| CT angio hrt w/3d image (75574) | $898.80 | $1,498 | 2.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$527.84–$791.77 | $879.74–$1,319.61 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$567–$1,144.80 | $945–$1,908 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,241.85–$1,858.50 | $2,069.75–$3,097.50 | varies |
| CT cervical spine w/ contrast (72126) | $1,273.80 | $2,123 | 3.5× |
| CT cervical spine w/o contrast (72125) | $1,273.80 | $2,123 | 11.6× |
| CT cervical spine w/wo cont (72127) | $1,859.40 | $3,099 | 10.0× |
| CT chest w contrast (71260) | $1,151.10 | $1,918.50 | 6.2× |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$1,475.25–$1,618.20 | $2,458.75–$2,697 | varies |
| CT head/brain with contrast (70460) | $1,126.50 | $1,877.50 | 6.1× |
| CT head/brain without and with contrast (70470) | $1,268.25 | $2,113.75 | 6.9× |
| CT iac w contrast (70481) | $1,230.45 | $2,050.75 | 6.7× |
| CT l-spine w&w/o contrast (72133) | $1,497 | $2,495 | 8.1× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$952.65–$1,875.45 | $1,587.75–$3,125.75 | varies |
| CT lower extremity w/contrast material (73701) | $1,462.35 | $2,437.25 | 7.9× |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,287.15–$1,575.90 | $2,145.25–$2,626.50 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,061.55–$1,098.90 | $1,769.25–$1,831.50 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$750–$1,334.70 | $1,250–$2,224.50 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$720–$1,273.80 | $1,200–$2,123 | varies |
| CT neck tissue combo (70492) range across 3 matching MRF lines |
$1,144.80–$1,337.10 | $1,908–$2,228.50 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,509.60 | $2,516 | 8.2× |
| CT orbits w/o contrast (70480) | $995.70 | $1,659.50 | 9.0× |
| CT pelvis w&w/o contrast (72194) | $1,281.45 | $2,135.75 | 6.9× |
| CT pelvis w/o contrast (72192) | $918.15 | $1,530.25 | 8.3× |
| CT scans face/jaw combo (70488) | $780 | $1,300 | 4.2× |
| CT soft tissue neck w contrast (70491) | $1,010.55 | $1,684.25 | 5.5× |
| CT soft tissue neck w/o contrast (70490) | $660.30 | $1,100.50 | 6.0× |
| CT thoracic spine w contrast (72129) | $1,487.10 | $2,478.50 | 8.0× |
| CT thoracic spine w/o contrast (72128) | $1,273.80 | $2,123 | 11.6× |
| CT thoracic spine w/wo cont (72130) | $1,770.68 | $2,951.14 | 9.6× |
| CT thorax w/o contrast (71250) | $938.10 | $1,563.50 | 8.5× |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$824.40–$1,440 | $1,374–$2,400 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $824.40 | $1,374 | 4.5× |
| CT upper extremity with contrast (73201) range across 4 matching MRF lines |
$824.40–$1,361.55 | $1,374–$2,269.25 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,100.90 | $3,501.50 | 11.4× |
| Cta Abdomen (74175) | $1,209.90 | $2,016.50 | 6.5× |
| CTA pelvis (72191) | $527.84 | $879.74 | 2.9× |
| Dxa Bone Density Axial (77080) | $256.80 | $428 | 2.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $125.40 | $209 | 1.4× |
| Echo exam uterus (76831) | $616.35 | $1,027.25 | 2.4× |
| Echo Guide For Artery Repair (76936) | $316.25 | $527.09 | 1.4× |
| Esophagram (74220) | $297.75 | $496.25 | 1.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $293.85 | $489.75 | 2.7× |
| Fluoroscopy up to 1 hr (76000) range across 5 matching MRF lines |
$403.65–$524.70 | $672.75–$874.50 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$128.25–$256.50 | $213.75–$427.50 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$187.50–$374.85 | $312.50–$624.75 | varies |
| Gastric emptying imaging study (78264) | $951.60 | $1,586 | 2.3× |
| Gated Heart Planar Single (78472) | $1,469.40 | $2,449 | 3.5× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$130.31–$260.63 | $217.19–$434.38 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,033.05 | $1,721.75 | 1.8× |
| Hepatobiliary System Imaging (78226) | $571.35 | $952.25 | 1.4× |
| Hysterosalpingogram (74740) | $275.21 | $458.69 | 1.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $228.15 | $380.25 | 2.5× |
| K Flow/Funct Image W/Drug (78708) | $1,003.05 | $1,671.75 | 1.8× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$225–$449.85 | $375–$749.75 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $742.50 | $1,237.50 | 1.8× |
| Lung Perf&Ventilat Diferentl (78598) | $1,102.20 | $1,837 | 1.9× |
| Lymph System Imaging (78195) | $1,064.10 | $1,773.50 | 1.9× |
| Magnetic Image Jaw Joint (70336) | $2,020.05 | $3,366.75 | 8.0× |
| Mammary ductogram or galactogram multiple (77054) | $451.95 | $753.25 | 1.8× |
| Mammary ductogram or galactogram single (77053) | $451.95 | $753.25 | 1.8× |
| Meckels Divert Exam (78290) | $877.20 | $1,462 | 2.1× |
| Mra Head W/O & W/Contrast Material (70546) | $1,903.80 | $3,173 | 5.2× |
| MRA head w/o contrast (70544) | $1,735.35 | $2,892.25 | 6.9× |
| MRA head with contrast (70545) | $1,859.40 | $3,099 | 5.1× |
| MRA neck w contrast (70548) | $1,460.55 | $2,434.25 | 4.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,735.35 | $2,892.25 | 4.7× |
| MRA neck w/o contrast (70547) | $1,333.80 | $2,223 | 5.3× |
| MRI abdomen w contrast (74182) | $2,262.15 | $3,770.25 | 6.1× |
| MRI abdomen w/o contrast (74181) | $2,014.80 | $3,358 | 8.0× |
| MRI any jt lower extrem w/contrast material (73722) | $1,418.70 | $2,364.50 | 1.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 11 matching MRF lines |
$2,010.30–$4,020.45 | $3,350.50–$6,700.75 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,632.30 | $2,720.50 | 2.0× |
| MRI bone marrow blood supply (77084) | $1,552.50 | $2,587.50 | 6.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,908 | $3,180 | 7.6× |
| MRI cervical spine w contrast (72142) | $1,884 | $3,140 | 5.1× |
| MRI cervical spine w/o cont (72141) | $1,684.95 | $2,808.25 | 6.7× |
| MRI chest w/o contrast (71550) | $2,014.80 | $3,358 | 8.0× |
| MRI chest with contrast (71551) | $2,262.15 | $3,770.25 | 2.7× |
| MRI chest wo w contrast (71552) | $2,382.45 | $3,970.75 | 6.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 7 matching MRF lines |
$1,680–$1,702.50 | $2,800–$2,837.50 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 10 matching MRF lines |
$1,680–$4,109.25 | $2,800–$6,848.75 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 12 matching MRF lines |
$1,513.80–$3,027.60 | $2,523–$5,046 | varies |
| MRI lumbar spine w contrast (72149) | $2,010.45 | $3,350.75 | 5.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,259.45 | $3,765.75 | 6.1× |
| MRI orbit face &/neck w/o contrast (70540) | $1,901.70 | $3,169.50 | 7.6× |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$2,146.65–$2,348.70 | $3,577.75–$3,914.50 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,633.85 | $4,389.75 | 7.2× |
| MRI pelvis w contrast (72196) | $2,314.35 | $3,857.25 | 6.3× |
| MRI pelvis w/o & w contrast (72197) | $2,946.15 | $4,910.25 | 8.0× |
| MRI pelvis w/o contrast (72195) | $2,088 | $3,480 | 8.3× |
| MRI thoracic spine w/o contrast (72146) | $1,758.60 | $2,931 | 7.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,884 | $3,140 | 5.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,651.50 | $2,752.50 | 6.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,010.30 | $3,350.50 | 5.5× |
| MRI, abdomen, combo (74183) | $2,382.45 | $3,970.75 | 6.5× |
| MRI, dorsal spine combo (72157) | $2,011.35 | $3,352.25 | 5.5× |
| MRI, dorsal spine contrast (72147) | $1,864.80 | $3,108 | 5.1× |
| MRI, joint upper extrem (73221) range across 11 matching MRF lines |
$1,418.40–$3,241.35 | $2,364–$5,402.25 | varies |
| MRI, joint upper extrem combo (73223) range across 11 matching MRF lines |
$2,029.20–$4,057.95 | $3,382–$6,763.25 | varies |
| MRI, lumbar spine combo (72158) | $2,136.45 | $3,560.75 | 5.8× |
| Myelogram Lumbar (72265) | $1,388.40 | $2,314 | 1.7× |
| Myelograpy 2/more regions rs&i (72270) | $1,388.40 | $2,314 | 1.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,561.77 | $2,602.95 | 1.1× |
| Myocardial Spect Multiple Studies (78452) | $2,388.45 | $3,980.75 | 1.7× |
| Neck soft tissue (70360) | $147.30 | $245.50 | 1.6× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$282.90–$565.80 | $471.50–$943 | varies |
| Optic foramina (70190) | $160.35 | $267.25 | 1.7× |
| Parathyroid Planar Imaging (78070) | $1,079.40 | $1,799 | 2.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,190.70 | $1,984.50 | 2.8× |
| Pelvis 1 or 2 views (72170) | $149.55 | $249.25 | 1.4× |
| Pet Image W/Ct Lmtd (78814) | $5,017.20 | $8,362 | 3.3× |
| PET image w/CT, full body (78816) | $5,017.20 | $8,362 | 3.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,017.20 | $8,362 | 3.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $842.10 | $1,403.50 | 2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $296.85 | $494.75 | 2.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 3 matching MRF lines |
$577.49–$918.15 | $962.48–$1,530.25 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$192.15–$384 | $320.25–$640 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$202.65–$315 | $337.75–$525 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$190.20–$380.10 | $317–$633.50 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $320.70 | $534.50 | 2.9× |
| Radex fingr minimum 2 views (73140) | $140.25 | $233.75 | 1.5× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$202.65–$404.85 | $337.75–$674.75 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$202.65–$404.85 | $337.75–$674.75 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $137.40 | $229 | 1.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $175.20 | $292 | 1.9× |
| Radex Ribs Unilateral 2 Views (71100) | $259.05 | $431.75 | 2.8× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$209.10–$417.75 | $348.50–$696.25 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $96.75 | $161.25 | 1.1× |
| Radex Spine 1 View Specify Level (72020) | $117.60 | $196 | 1.3× |
| Radex Sternum Minimum 2 Views (71120) | $210.15 | $350.25 | 2.3× |
| Radex Toe Minimum 2 Views (73660) | $147.30 | $245.50 | 1.6× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$137.40–$210 | $229–$350 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$147.30–$294.30 | $245.50–$490.50 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $252.45 | $420.75 | 2.3× |
| Radiologic exam colon double contrast study (74280) | $546.45 | $910.75 | 3.0× |
| Radiologic exam colon single contrast study (74270) | $453.15 | $755.25 | 2.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $382.80 | $638 | 2.1× |
| Radiologic exam knee complete 4/more views (73564) | $264.45 | $440.75 | 2.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $245.70 | $409.50 | 2.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $453.15 | $755.25 | 2.4× |
| Radiologic exam swallow function contrast study (74230) | $218.05 | $363.42 | 1.2× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$456.45–$471.45 | $760.75–$785.75 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$150–$300 | $250–$500 | varies |
| Radiologic examination knee 1/2 views (73560) | $147.30 | $245.50 | 1.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $150 | $250 | 1.6× |
| Ribs bilateral 3 views (71110) | $320.10 | $533.50 | 2.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,079.40 | $1,799 | 2.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,651.20 | $2,752 | 2.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,561.77 | $2,602.95 | 2.7× |
| Scapula (73010) | $155.25 | $258.75 | 1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $52.20 | $87 | 2.2× |
| Sella turcica (70240) | $96.75 | $161.25 | 1.1× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$147.30–$294.60 | $245.50–$491 | varies |
| Shoulder Arthrography (73040) | $480.75 | $801.25 | 1.3× |
| Sialogram (70390) | $338.10 | $563.50 | 1.3× |
| Skull less than 4 views (70250) | $259.05 | $431.75 | 2.3× |
| Sternoclavicular joints (71130) | $214.20 | $357 | 2.3× |
| Thoracic spine 2 views (72070) | $183.45 | $305.75 | 1.7× |
| Thoracic spine 3 views (72072) | $225 | $375 | 2.0× |
| Thoracolumbar 2 views (72080) | $225 | $375 | 2.5× |
| Thyroid Met Imaging Body (78018) | $994.80 | $1,658 | 1.7× |
| Thyroid Uptake Measurement (78012) | $951.60 | $1,586 | 2.3× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$117.75–$235.20 | $196.25–$392 | varies |
| Ultrasound Exam Aaa Screen (76706) | $206.55 | $344.25 | 1.9× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$282.90–$372.54 | $471.50–$620.90 | varies |
| Umbilical-artery Doppler (OB) (76820) | $129.23 | $215.38 | 1.2× |
| Unlisted fluoroscopic procedure (76496) | $208.50 | $347.50 | 2.3× |
| Unlisted magnetic resonance procedure (76498) | $2,097.60 | $3,496 | 22.8× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $945 | $1,575 | 2.2× |
| Unlisted us procedure (76999) | $200.70 | $334.50 | 2.2× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$416.85–$445.95 | $694.75–$743.25 | varies |
| Ureteral Reflux Study (78740) | $702.45 | $1,170.75 | 1.7× |
| Urethrocystogram voiding (74455) | $839.40 | $1,399 | 3.3× |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$284.55–$322.20 | $474.25–$537 | varies |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$176.10–$351.90 | $293.50–$586.50 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$130.31–$239.10 | $217.19–$398.50 | varies |
| Us complete joint (76881) | $479.25 | $798.75 | 4.3× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$130.31–$383.55 | $217.19–$639.25 | varies |
| Us head (76506) | $315.30 | $525.50 | 2.9× |
| Us kidney transplant (76776) | $290.85 | $484.75 | 2.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$166.35–$332.70 | $277.25–$554.50 | varies |
| Us ob limited 1 or more fetuses (76815) range across 9 matching MRF lines |
$130.32–$282.90 | $217.20–$471.50 | varies |
| Us ob transvaginal (76817) | $369.75 | $616.25 | 3.4× |
| Us pelvic non ob complete (76856) | $512.40 | $854 | 4.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $409.35 | $682.25 | 3.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$130.32–$241.35 | $217.20–$402.25 | varies |
| Us retroperitoneal complete (76770) | $561.45 | $935.75 | 5.1× |
| Us retroperitoneal limited (76775) | $335.10 | $558.50 | 3.0× |
| Us scrotum and contents (76870) | $439.20 | $732 | 4.0× |
| Us spinal canal and contents (76800) | $316.05 | $526.75 | 2.9× |
| Us thyroid (76536) | $477 | $795 | 4.3× |
| Venography extremity unilateral rs&i (75820) | $1,681.60 | $2,802.66 | 1.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$96.75–$294.60 | $161.25–$491 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $209.10 | $348.50 | 2.3× |
| X-ray antegrade pyelogram tube (74425) | $488.55 | $814.25 | 1.3× |
| X-Ray Bend Only L-S Spine (72120) | $129.23 | $215.38 | 1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $128.25 | $213.75 | 1.4× |
| X-Ray Exam Breast Specimen (76098) | $577.49 | $962.48 | 1.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $192.15 | $320.25 | 1.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $90 | $150 | 1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 5 matching MRF lines |
$164.25–$383.70 | $273.75–$639.50 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $330 | $550 | 3.0× |
| X-Ray Exam L-S Spine Bending (72114) | $400.35 | $667.25 | 3.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $218.40 | $364 | 2.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $370.80 | $618 | 3.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$130.32–$259.05 | $217.20–$431.75 | varies |
| X-ray eye for foreign body (70030) | $160.35 | $267.25 | 1.7× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$202.65–$404.85 | $337.75–$674.75 | varies |
| X-ray IV pyelogram (ivp) (74400) | $451.35 | $752.25 | 2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $265.50 | $442.50 | 2.4× |
| X-ray nose-rectum child f.b. (76010) | $160.35 | $267.25 | 1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$130.32–$320.10 | $217.20–$533.50 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $275.10 | $458.50 | 2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $217.20 | $362 | 2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $255 | $425 | 2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $325.35 | $542.25 | 3.0× |
| X-Ray Tmj Unilat (70328) | $349.05 | $581.75 | 3.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $357 | $595 | 1.0× |
| X-Rays Bone Length Studies (77073) | $212.40 | $354 | 1.9× |
| X-Rays Bone Survey Complete (77075) | $709.20 | $1,182 | 6.4× |
| Xr c-spine 4 or 5 views (72050) | $336.15 | $560.25 | 3.0× |
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.