Imaging prices at Diley Ridge Medical Center
Canal Winchester, OH · every code in this section with a posted price and a Medicare benchmark.
240 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) | $265.85 | $409 | 3.2× |
| Abdomen 2 views (74019) | $278.85 | $429 | 2.8× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$285.35–$428.35 | $439–$659 | varies |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$596.70–$895.05 | $918–$1,377 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$753.35–$1,130.35 | $1,159–$1,739 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$659.75–$989.95 | $1,015–$1,523 | varies |
| Bone age studies (77072) | $228.15 | $351 | 2.3× |
| Bone Imaging 3 Phase (78315) | $1,784.25 | $2,745 | 4.6× |
| Bone Imaging Limited Area (78300) | $821.60 | $1,264 | 2.1× |
| Bone Imaging Multiple Areas (78305) | $1,085.50 | $1,670 | 2.8× |
| Bone Imaging Whole Body (78306) | $1,600.95 | $2,463 | 4.2× |
| Bone marrow imaging; multiple areas (78103) | $993.85 | $1,529 | 2.6× |
| Bone survey infant (77076) | $454.35 | $699 | 4.5× |
| Brain Flow Imaging Only (78610) | $497.90 | $766 | 1.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,151.15 | $1,771 | 3.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,275.95 | $1,963 | 1.7× |
| Cat Scan Follow-Up Study (76380) | $796.25 | $1,225 | 9.5× |
| Chest 1 view (71045) | $414.70 | — | 4.9× |
| Chest 2 views (71046) | $442 | $680 | 5.3× |
| Chest 3 views (71047) | $476.45 | $733 | 5.7× |
| Chest 4 or more views (71048) | $607.10 | $934 | 6.0× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $462.80 | $712 | 4.6× |
| Clavicle complete (73000) range across 6 matching MRF lines |
$198.90–$298.35 | $306–$459 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $538.20 | $828 | 5.3× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$440.05–$660.40 | $677–$1,016 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$637.65–$956.80 | $981–$1,472 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $2,334.80 | $3,592 | 6.9× |
| CT abdomen and pelvis without contrast (74176) | $1,851.20 | — | 8.0× |
| CT abdomen w contrast (74160) | $1,040.65 | $1,601 | 6.2× |
| CT abdomen w wo contrast (74170) | $1,170 | $1,800 | 6.9× |
| CT abdomen w/o contrast (74150) | $623.35 | $959 | 6.2× |
| CT Angio Abdomen and Pelvis (74174) | $2,451.80 | $3,772 | 7.3× |
| CT Angio Chest (71275) | $1,676.02 | — | 9.9× |
| CT Angio Head (70496) | $1,556.10 | $2,394 | 9.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$1,335.75–$2,003.95 | $2,055–$3,083 | varies |
| CT Angio Neck (70498) | $2,562.30 | $3,942 | 15.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,452.10 | $2,234 | 8.6× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,134.25 | $1,745 | 6.7× |
| CT cervical spine w/o contrast (72125) | $1,467.70 | $2,258 | 14.6× |
| CT cervical spine w/wo cont (72127) | $1,582.75 | $2,435 | 9.4× |
| CT chest w contrast (71260) | $1,418.30 | $2,182 | 8.4× |
| CT chest w/wo contrast (71270) | $1,511.90 | $2,326 | 8.9× |
| CT head/brain with contrast (70460) | $1,004.90 | $1,546 | 5.9× |
| CT head/brain without and with contrast (70470) | $1,055.60 | $1,624 | 6.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $366.60 | $564 | 4.4× |
| CT iac w contrast (70481) | $956.15 | $1,471 | 5.7× |
| CT lower ext w/o (73700) range across 6 matching MRF lines |
$650.65–$976.30 | $1,001–$1,502 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$923–$1,384.50 | $1,420–$2,130 | varies |
| CT lumbar spine w contrast (72132) | $1,387.10 | $2,134 | 4.1× |
| CT lumbar spine w/o contrast (72131) | $1,321.45 | $2,033 | 13.1× |
| CT maxillofacial w contrast (70487) | $949 | $1,460 | 5.6× |
| CT maxillofacial wo contrast (70486) | $887.90 | $1,366 | 8.8× |
| CT neck tissue combo (70492) | $1,723.80 | $2,652 | 10.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,069.25 | $1,645 | 6.3× |
| CT orbits w/o contrast (70480) | $691.60 | $1,064 | 6.9× |
| CT pelvis w&w/o contrast (72194) | $1,255.80 | $1,932 | 7.4× |
| CT pelvis w/o contrast (72192) | $788.45 | $1,213 | 7.8× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,136.85–$1,705.60 | $1,749–$2,624 | varies |
| CT scans face/jaw combo (70488) | $1,008.80 | $1,552 | 6.0× |
| CT soft tissue neck w contrast (70491) | $1,485.25 | $2,285 | 8.8× |
| CT soft tissue neck w/o contrast (70490) | $710.45 | $1,093 | 7.0× |
| CT thoracic spine w contrast (72129) | $1,140.75 | $1,755 | 6.7× |
| CT thoracic spine w/o contrast (72128) | $864.50 | $1,330 | 8.6× |
| CT thoracic spine w/wo cont (72130) | $1,251.25 | $1,925 | 7.4× |
| CT thorax w/o contrast (71250) | $1,018.55 | $1,567 | 10.1× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$779.35–$1,169.35 | $1,199–$1,799 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,129.70–$1,694.55 | $1,738–$2,607 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,100.45–$1,651 | $1,693–$2,540 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $757.25 | $1,165 | 4.5× |
| Cta Abdomen (74175) | $1,228.50 | $1,890 | 7.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $4,118.40 | $6,336 | 12.2× |
| Dxa Bone Density Axial (77080) | $206.70 | $318 | 2.1× |
| Dxa bone density study (77085) | $233.35 | $359 | 2.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $157.95 | $243 | 1.9× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$176.15–$264.55 | $271–$407 | varies |
| Forearm 2 views (73090) range across 9 matching MRF lines |
$198.90–$298.35 | $306–$459 | varies |
| Gated Heart, Multiple (78473) | $1,127.10 | $1,734 | 2.9× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$186.55–$280.15 | $287–$431 | varies |
| Hysterosalpingogram (74740) | $676 | $1,040 | 2.9× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$224.90–$337.35 | $346–$519 | varies |
| Leveen/Shunt Patency Exam (78291) | $993.85 | $1,529 | 2.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,291.60 | $5,064 | 1.1× |
| Magnetic Image Jaw Joint (70336) | $1,134.25 | $1,745 | 4.9× |
| Magnetic Resonance Elastography (76391) | $824.20 | $1,268 | 3.6× |
| Mr safety determination physician/other qhp (76016) | $65.65 | $101 | 0.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $16.25 | $25 | 0.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $115.70 | $178 | 1.3× |
| Mr safety implt pos&/immoblj (76019) | $176.15 | $271 | 3.1× |
| Mr safety med physics xm customization plng&mntr (76017) | $274.95 | $423 | 1.2× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$1,782.82–$2,061.08 | — | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,018.55–$1,344.20 | — | varies |
| MRA neck w contrast (70548) | $1,085.50 | $1,670 | 3.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,363.05 | $2,097 | 4.1× |
| MRA neck w/o contrast (70547) | $999.70 | $1,538 | 4.3× |
| MRI abdomen w contrast (74182) | $2,072.85 | $3,189 | 6.2× |
| MRI abdomen w/o contrast (74181) | $1,966.25 | $3,025 | 8.5× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$2,111.20–$3,166.80 | $3,248–$4,872 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$2,391.35–$3,587.35 | $3,679–$5,519 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$1,383.20–$2,074.80 | $2,128–$3,192 | varies |
| MRI cervical spine w/o cont (72141) | $1,127.10 | $1,734 | 4.9× |
| MRI chest w/o contrast (71550) | $1,347.45 | $2,073 | 5.9× |
| MRI chest wo w contrast (71552) | $1,521.65 | $2,341 | 4.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,929.20–$2,893.80 | $2,968–$4,452 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$1,344.20–$2,016.30 | $2,068–$3,102 | varies |
| MRI lumbar spine w contrast (72149) | $1,407.25 | $2,165 | 4.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,179.45 | $3,353 | 6.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,263.60 | $1,944 | 5.5× |
| MRI orbit face neck w contrast (70542) | $1,338.35 | $2,059 | 4.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,905.15 | $2,931 | 5.7× |
| MRI pelvis w contrast (72196) | $1,514.50 | $2,330 | 4.5× |
| MRI pelvis w/o & w contrast (72197) | $1,795.95 | $2,763 | 5.3× |
| MRI pelvis w/o contrast (72195) | $1,227.85 | $1,889 | 5.3× |
| MRI spectroscopy (76390) | $640.90 | $986 | 7.6× |
| MRI thoracic spine w/o contrast (72146) | $1,075.10 | $1,654 | 4.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,125.80–$1,688.70 | $1,732–$2,598 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$1,457.95–$2,187.25 | $2,243–$3,365 | varies |
| MRI, abdomen, combo (74183) | $2,648.75 | $4,075 | 7.9× |
| MRI, dorsal spine combo (72157) | $2,008.50 | $3,090 | 6.0× |
| MRI, dorsal spine contrast (72147) | $1,407.25 | $2,165 | 4.2× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$1,213.55–$1,820.65 | $1,867–$2,801 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$1,439.75–$2,159.95 | $2,215–$3,323 | varies |
| MRI, lumbar spine combo (72158) | $2,335.45 | $3,593 | 6.9× |
| Myelogram Lumbar (72265) | $874.25 | $1,345 | 1.2× |
| Myelography thoracic (72255) | $928.20 | $1,428 | 1.2× |
| Myocardial Spect Multiple Studies (78452) | $2,581.80 | $3,972 | 2.1× |
| Neck soft tissue (70360) | $187.85 | $289 | 2.2× |
| Nonvascular Shunt X-Ray (75809) | $486.85 | $749 | 4.8× |
| Nuclear Rx Intra-Arterial (79445) | $804.70 | $1,238 | 3.6× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $291.85 | $449 | 2.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,754.35 | $2,699 | 3.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,489.15 | $2,291 | 3.9× |
| Pelvis 1 or 2 views (72170) | $247.65 | $381 | 2.5× |
| Pet Myocardial Sngl Study (78491) | $1,900.60 | $2,924 | 1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $846.95 | $1,303 | 2.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $314.60 | $484 | 3.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 6 matching MRF lines |
$319.15–$479.05 | $491–$737 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$180.05–$270.40 | $277–$416 | varies |
| Radex elbow complete minimum 3 views (73080) range across 6 matching MRF lines |
$241.80–$362.70 | $372–$558 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $256.10 | $394 | 2.5× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$202.80–$304.20 | $312–$468 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$280.15–$420.55 | $431–$647 | varies |
| Radex Hand Minimum 3 Views (73130) range across 6 matching MRF lines |
$239.85–$360.10 | $369–$554 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$228.15–$342.55 | $351–$527 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$341.90–$512.85 | $526–$789 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $235.95 | $363 | 2.8× |
| Radex Ribs Unilateral 2 Views (71100) | $198.90 | $306 | 2.4× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$258.05–$668.20 | — | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $152.75 | $235 | 1.8× |
| Radex Spine 1 View Specify Level (72020) | $184.60 | $284 | 2.2× |
| Radex Sternum Minimum 2 Views (71120) | $198.90 | $306 | 2.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $380.90 | $586 | 4.5× |
| Radex Toe Minimum 2 Views (73660) range across 6 matching MRF lines |
$185.90–$278.85 | $286–$429 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$228.15–$342.55 | $351–$527 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$228.15–$702.65 | — | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $294.45 | $453 | 2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $292.50 | $450 | 2.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $473.85 | $729 | 2.8× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$308.10–$462.15 | $474–$711 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $320.45 | $493 | 3.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $382.85 | $589 | 2.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $490.75 | $755 | 2.9× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$178.10–$267.15 | $274–$411 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$223.60–$335.40 | $344–$516 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$187.20–$280.80 | — | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $270.40 | $416 | 2.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$213.20–$319.80 | $328–$492 | varies |
| Ribs bilateral 3 views (71110) | $323.05 | $497 | 3.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,006.20 | $1,548 | 2.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,074.45 | $1,653 | 2.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,500.85 | $2,309 | 2.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,677.65 | $2,581 | 3.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,815.15 | $4,331 | 2.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,099.20 | $4,768 | 2.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,438.15 | $3,751 | 2.0× |
| Scapula (73010) range across 3 matching MRF lines |
$198.90–$298.35 | $306–$459 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$37.70–$56.55 | $58–$87 | varies |
| Sella turcica (70240) | $264.55 | $407 | 3.2× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$221–$331.50 | $340–$510 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$653.25–$980.20 | $1,005–$1,508 | varies |
| Skull less than 4 views (70250) | $237.90 | $366 | 2.4× |
| Sternoclavicular joints (71130) | $250.25 | $385 | 3.0× |
| Superior sagittal sinus venogram (75870) | $2,700.75 | $4,155 | 0.9× |
| Thoracic spine 2 views (72070) | $215.15 | $331 | 2.1× |
| Thoracic spine 3 views (72072) | $246.35 | $379 | 2.4× |
| Thoracolumbar 2 views (72080) | $206.05 | $317 | 2.5× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$551.20–$826.80 | $848–$1,272 | varies |
| Ultrasound Exam Aaa Screen (76706) | $162.50 | $250 | 1.6× |
| Ultrasound, abdomen limited (76705) | $555.75 | $855 | 5.5× |
| Upper gi w/o kub (74240) | $449.80 | $692 | 2.7× |
| Urethrocystography retrograde (74450) | $494 | $760 | 2.1× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$85.80–$86.45 | $132–$133 | varies |
| Us chest (76604) | $290.55 | $447 | 2.9× |
| Us complete joint (76881) | $501.80 | $772 | 5.0× |
| Us exam, pelvic, limited (76857) | $219.05 | $337 | 2.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $385.45 | $593 | 3.8× |
| Us ob detailed single fetus (76811) | $631.15 | $971 | 2.7× |
| Us ob limited 1 or more fetuses (76815) | $288.60 | $444 | 2.9× |
| Us ob transvaginal (76817) | $337.35 | $519 | 3.3× |
| Us pelvic non ob complete (76856) | $317.85 | $489 | 3.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $392.60 | $604 | 3.9× |
| Us retroperitoneal complete (76770) | $1,040.65 | $1,601 | 10.3× |
| Us retroperitoneal limited (76775) | $452.40 | $696 | 4.5× |
| Us scrotum and contents (76870) | $439.40 | $676 | 4.4× |
| Us thyroid (76536) | $588.90 | $906 | 5.8× |
| Vertebral fracture assessment via dxa (77086) | $96.85 | $149 | 1.2× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$210.60–$315.90 | $324–$486 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $199.55 | $307 | 2.4× |
| X-Ray Bend Only L-S Spine (72120) | $278.85 | $429 | 2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$213.20–$319.80 | $328–$492 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $194.35 | $299 | 2.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $269.75 | $415 | 2.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $363.35 | $559 | 3.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $172.25 | $265 | 2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $215.80 | $332 | 2.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $251.55 | $387 | 2.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $220.35 | $339 | 2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $308.75 | $475 | 3.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $324.35 | $499 | 3.2× |
| X-Ray Exam L-S Spine Bending (72114) | $479.05 | $737 | 4.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $250.25 | $385 | 3.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $328.90 | $506 | 3.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $293.15 | $451 | 2.9× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$313.95–$471.25 | $483–$725 | varies |
| X-ray humerus (73060) | $198.90 | $306 | 2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $273 | $420 | 3.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $222.95 | $343 | 2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $414.05 | $637 | 4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $209.95 | $323 | 2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $172.25 | $265 | 1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $204.75 | $315 | 2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $270.40 | $416 | 3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $302.90 | $466 | 3.0× |
| X-ray thoracic spine 4 vw (72074) | $286.65 | $441 | 2.8× |
| X-Ray Tmj Unilat (70328) | $132.60 | $204 | 1.6× |
| X-Rays Bone Length Studies (77073) | $224.90 | $346 | 2.2× |
| X-Rays Bone Survey Complete (77075) | $440.70 | $678 | 4.4× |
| Xr c-spine 4 or 5 views (72050) | $316.55 | $487 | 3.1× |
| Xr facial bones less than 3 views (70140) | $141.70 | $218 | 1.7× |
| XR Mastoids < 3 Views Bilateral (70120) range across 3 matching MRF lines |
$213.20–$319.80 | $328–$492 | varies |
| Xr orbits complete 4 views (70200) | $493.35 | $759 | 4.9× |
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.