Imaging prices at Dolly Parton Children’s Hospital
Knoxville, TN · every code in this section with a posted price and a Medicare benchmark.
255 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) range across 4 matching MRF lines |
$40.20–$307.20 | $67–$512 | varies |
| Abdomen 2 views (74019) range across 4 matching MRF lines |
$49.80–$406.80 | $83–$678 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $854.40 | $1,424 | 2.4× |
| Ankle 2 views (73600) | $43.80 | $73 | 0.6× |
| Aortography thoracic w/o serialography rs&i (75600) | $732.60 | $1,221 | 0.3× |
| Arthrogram hip (73525) | $420.60 | $701 | 1.3× |
| Bone age studies (77072) | $243.60 | $406 | 2.6× |
| Bone Imaging 3 Phase (78315) | $1,732.20 | $2,887 | 4.8× |
| Bone Imaging Limited Area (78300) | $616.80 | $1,028 | 1.7× |
| Bone Imaging Whole Body (78306) | $1,486.80 | $2,478 | 4.1× |
| Bone survey infant (77076) | $231.60 | $386 | 2.4× |
| Brain Image W/Flow < 4 Views (78601) | $795.60 | $1,326 | 2.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $989.40 | $1,649 | 2.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,362.60 | $2,271 | 4.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $836.40 | $1,394 | 1.7× |
| Cerebrospinal Fluid Scan (78630) | $1,554.60 | $2,591 | 3.2× |
| Chest 1 view (71045) range across 5 matching MRF lines |
$35.40–$252 | $59–$420 | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$45.60–$288 | $76–$480 | varies |
| Chest 3 views (71047) | $324 | $540 | 4.1× |
| Chest 4 or more views (71048) | $360 | $600 | 3.8× |
| Cholecystography Oral Contrast (74290) | $201.60 | $336 | 1.3× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$43.20–$243.60 | $72–$406 | varies |
| Contrast X-Ray Bladder (74430) | $271.80 | $453 | 0.9× |
| Contrast X-Ray Of Knee Joint (73580) | $1,366.20 | $2,277 | 4.3× |
| CT abdomen and pelvis without and with contrast (74178) | $4,230.60 | $7,051 | 13.4× |
| CT abdomen and pelvis without contrast (74176) | $2,848.20 | $4,747 | 13.2× |
| CT abdomen w contrast (74160) | $2,390.40 | $3,984 | 15.0× |
| CT abdomen w wo contrast (74170) | $2,961.60 | $4,936 | 18.6× |
| CT abdomen w/o contrast (74150) | $1,982.40 | $3,304 | 20.9× |
| CT Angio Abdomen and Pelvis (74174) | $2,353.20 | $3,922 | 7.4× |
| CT Angio Chest (71275) | $2,353.20 | $3,922 | 14.8× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$556.80–$1,746 | $928–$2,910 | varies |
| CT angio hrt w/3d image (75574) | $2,353.20 | $3,922 | 7.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,440 | $2,400 | 9.0× |
| CT Angio Neck (70498) | $1,746 | $2,910 | 11.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,314.60 | $2,191 | 8.3× |
| CT cervical spine w/ contrast (72126) | $1,785 | $2,975 | 5.6× |
| CT cervical spine w/o contrast (72125) | $1,142.40 | $1,904 | 12.0× |
| CT cervical spine w/wo cont (72127) | $2,284.20 | $3,807 | 14.4× |
| CT chest w contrast (71260) | $2,097 | $3,495 | 13.2× |
| CT chest w/wo contrast (71270) | $2,434.80 | $4,058 | 15.3× |
| CT head/brain with contrast (70460) | $4,109.40 | $6,849 | 25.8× |
| CT head/brain without and with contrast (70470) | $4,644.60 | $7,741 | 29.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,353.20 | $3,922 | 7.4× |
| CT hrt w/3d image congen (75573) | $2,353.20 | $3,922 | 7.4× |
| CT iac w contrast (70481) | $1,725.60 | $2,876 | 10.8× |
| CT l-spine w&w/o contrast (72133) | $2,434.80 | $4,058 | 15.3× |
| CT lower ext w/o (73700) | $1,824.60 | $3,041 | 19.2× |
| CT lower extremity w/contrast material (73701) | $2,179.20 | $3,632 | 13.7× |
| CT lumbar spine w contrast (72132) | $1,948.80 | $3,248 | 6.2× |
| CT lumbar spine w/o contrast (72131) | $1,632.60 | $2,721 | 17.2× |
| CT maxillofacial w contrast (70487) | $1,725.60 | $2,876 | 10.8× |
| CT maxillofacial wo contrast (70486) | $1,440 | $2,400 | 15.2× |
| CT neck tissue combo (70492) | $1,446 | $2,410 | 9.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,153.40 | $3,589 | 13.5× |
| CT orbits w/o contrast (70480) | $1,440 | $2,400 | 15.2× |
| CT pelvis w&w/o contrast (72194) | $2,853.60 | $4,756 | 17.9× |
| CT pelvis w/o contrast (72192) | $1,996.80 | $3,328 | 21.1× |
| CT scan of leg combo (73702) | $2,728.20 | $4,547 | 17.1× |
| CT scans face/jaw combo (70488) | $2,153.40 | $3,589 | 13.5× |
| CT soft tissue neck w contrast (70491) | $1,159.80 | $1,933 | 7.3× |
| CT soft tissue neck w/o contrast (70490) | $969 | $1,615 | 10.2× |
| CT thoracic spine w contrast (72129) | $2,360.40 | $3,934 | 14.8× |
| CT thoracic spine w/o contrast (72128) | $1,978.20 | $3,297 | 20.9× |
| CT thoracic spine w/wo cont (72130) | $2,947.20 | $4,912 | 18.5× |
| CT thorax w/o contrast (71250) | $1,632.60 | $2,721 | 17.2× |
| CT unlisted procedure (76497) | $253.20 | $422 | 3.2× |
| CT upper ext wo (73200) | $1,368.60 | $2,281 | 14.4× |
| CT upper extremity w/o & w/contrast material (73202) | $2,044.80 | $3,408 | 12.8× |
| CT upper extremity with contrast (73201) | $1,632.60 | $2,721 | 5.2× |
| Cta Abdomen (74175) | $2,353.20 | $3,922 | 14.8× |
| CTA pelvis (72191) | $2,353.20 | $3,922 | 14.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $388.20 | $647 | 4.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 3 matching MRF lines |
$36–$1,320 | $60–$2,200 | varies |
| Dxa bone density study (77085) | $142.80 | $238 | 1.5× |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$105–$879 | $175–$1,465 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,320 | $2,200 | 6.1× |
| Esophageal Motility Study (78258) | $902.40 | $1,504 | 2.5× |
| Esophagram (74220) | $348 | $580 | 2.2× |
| Fluoroscopy up to 1 hr (76000) | $651 | $1,085 | 3.0× |
| Foot 2 views (73620) | $38.40 | $64 | 0.5× |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$39.60–$243.60 | $66–$406 | varies |
| Gastric emptying imaging study (78264) | $1,431.60 | $2,386 | 3.9× |
| Gastroesophageal Reflux Exam (78262) | $1,033.80 | $1,723 | 2.9× |
| Gated Heart Planar Single (78472) | $1,345.80 | $2,243 | 3.7× |
| Hand 2 views (73120) | $42 | $70 | 0.4× |
| Hepatobil Syst Image W/Drug (78227) | $2,353.80 | $3,923 | 4.8× |
| Hepatobiliary System Imaging (78226) | $1,177.20 | $1,962 | 3.2× |
| Ht Muscle Image Spect Sing (78451) | $2,868.60 | $4,781 | 2.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $455.40 | $759 | 5.8× |
| Joint Survey Single View (77077) | $325.80 | $543 | 3.4× |
| K Flow/Funct Image Multiple (78709) | $1,518 | $2,530 | 3.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,518 | $2,530 | 3.1× |
| Kidney Imaging Morphol (78700) | $436.80 | $728 | 1.2× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$54–$282.60 | $90–$471 | varies |
| Liver & Spleen Imaging Static Only (78215) | $880.80 | $1,468 | 2.4× |
| Lung perfusion differential (78597) | $1,720.20 | $2,867 | 4.7× |
| Lymph System Imaging (78195) | $579.60 | $966 | 1.2× |
| Magnetic Image Jaw Joint (70336) | $1,524.60 | $2,541 | 7.0× |
| Meckels Divert Exam (78290) | $1,444.80 | $2,408 | 4.0× |
| Mra Head W/O & W/Contrast Material (70546) | $3,274.80 | $5,458 | 10.3× |
| MRA head w/o contrast (70544) | $1,475.40 | $2,459 | 6.8× |
| MRA neck w contrast (70548) | $1,475.40 | $2,459 | 4.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,582.40 | $4,304 | 8.2× |
| MRA neck w/o contrast (70547) | $1,404 | $2,340 | 6.5× |
| MRI abdomen w contrast (74182) | $2,364 | $3,940 | 7.5× |
| MRI abdomen w/o contrast (74181) | $1,524.60 | $2,541 | 7.0× |
| MRI any jt lower extrem w/contrast material (73722) | $2,657.40 | $4,429 | 3.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,000 | $5,000 | 9.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,657.40 | $4,429 | 3.7× |
| MRI bone marrow blood supply (77084) | $1,524.60 | $2,541 | 7.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $819 | $1,365 | 3.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $824.40 | $1,374 | 3.8× |
| MRI cardiac w/o contrast (75557) | $1,425 | $2,375 | 6.6× |
| MRI cervical spine w contrast (72142) | $1,997.40 | $3,329 | 6.3× |
| MRI cervical spine w/o cont (72141) | $1,665 | $2,775 | 7.7× |
| MRI chest w/o contrast (71550) | $1,524.60 | $2,541 | 7.0× |
| MRI chest with contrast (71551) | $1,606.20 | $2,677 | 2.3× |
| MRI chest wo w contrast (71552) | $2,120.40 | $3,534 | 6.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,589 | $4,315 | 8.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,147 | $5,245 | 9.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,818 | $3,030 | 8.4× |
| MRI lumbar spine w contrast (72149) | $1,828.80 | $3,048 | 5.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,696 | $6,160 | 11.7× |
| MRI orbit face &/neck w/o contrast (70540) | $3,120 | $5,200 | 14.4× |
| MRI orbit face neck w contrast (70542) | $1,554.60 | $2,591 | 4.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,052 | $3,420 | 6.5× |
| MRI pelvis w contrast (72196) | $1,606.20 | $2,677 | 5.1× |
| MRI pelvis w/o & w contrast (72197) | $3,383.40 | $5,639 | 10.7× |
| MRI pelvis w/o contrast (72195) | $1,524.60 | $2,541 | 7.0× |
| MRI spectroscopy (76390) | $1,700.40 | $2,834 | 21.5× |
| MRI thoracic spine w/o contrast (72146) | $1,688.40 | $2,814 | 7.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,524.60 | $2,541 | 7.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,292.20 | $5,487 | 10.4× |
| MRI, abdomen, combo (74183) | $3,383.40 | $5,639 | 10.7× |
| MRI, dorsal spine combo (72157) | $3,383.40 | $5,639 | 10.7× |
| MRI, dorsal spine contrast (72147) | $1,828.80 | $3,048 | 5.8× |
| MRI, joint upper extrem (73221) | $1,524.60 | $2,541 | 7.0× |
| MRI, joint upper extrem combo (73223) | $3,000 | $5,000 | 9.5× |
| MRI, lumbar spine combo (72158) | $3,383.40 | $5,639 | 10.7× |
| Myelogram cervical (72240) | $1,121.40 | $1,869 | 1.6× |
| Myelogram Lumbar (72265) | $961.80 | $1,603 | 1.4× |
| Myelography thoracic (72255) | $961.80 | $1,603 | 1.4× |
| Myelograpy 2/more regions rs&i (72270) | $1,438.20 | $2,397 | 2.0× |
| Myocardial Spect Multiple Studies (78452) | $2,868.60 | $4,781 | 2.4× |
| Neck soft tissue (70360) range across 4 matching MRF lines |
$42.60–$210 | $71–$350 | varies |
| Nm csf leak detection (78650) | $1,130.40 | $1,884 | 1.0× |
| Nonvascular Shunt X-Ray (75809) | $475.80 | $793 | 5.0× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $54 | $90 | 0.4× |
| Optic foramina (70190) | $194.40 | $324 | 2.5× |
| Parathyroid Planar Imaging (78070) | $451.20 | $752 | 1.2× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$13.20–$242.40 | $22–$404 | varies |
| PET image w/CT, full body (78816) | $2,162.40 | $3,604 | 1.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,162.40 | $3,604 | 1.7× |
| Proton tx delivery simple w/o compensation (77520) | $5,802.60 | $9,671 | 11.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,068.60 | $1,781 | 2.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $577.80 | $963 | 6.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $285.60 | $476 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$48–$345.60 | $80–$576 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$39–$150.60 | $65–$251 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$42.60–$268.20 | $71–$447 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$63.60–$363 | $106–$605 | varies |
| Radex fingr minimum 2 views (73140) range across 7 matching MRF lines |
$48.60–$330.60 | $81–$551 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$45.60–$248.40 | $76–$414 | varies |
| Radex Hand Minimum 3 Views (73130) range across 6 matching MRF lines |
$48–$103.80 | $80–$173 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $242.40 | $404 | 2.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$49.80–$243.60 | $83–$406 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $348 | $580 | 4.4× |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$16.80–$179.40 | $28–$299 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$45.60–$268.20 | $76–$447 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 4 matching MRF lines |
$42.60–$290.40 | $71–$484 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$33.60–$273 | $56–$455 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$42.60–$303 | $71–$505 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $262.80 | $438 | 3.3× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$38.40–$199.80 | $64–$333 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $156.60 | $261 | 1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$53.40–$248.40 | $89–$414 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $194.40 | $324 | 2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$19.80–$441.60 | $33–$736 | varies |
| Radiologic exam colon double contrast study (74280) | $712.80 | $1,188 | 4.5× |
| Radiologic exam colon single contrast study (74270) | $549.60 | $916 | 3.5× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$60.60–$377.40 | $101–$629 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $310.80 | $518 | 3.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $520.20 | $867 | 3.3× |
| Radiologic exam swallow function contrast study (74230) | $348 | $580 | 2.2× |
| Radiologic exam teeth complete full mouth (70320) | $225.60 | $376 | 1.0× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $88.80 | $148 | 0.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $438.60 | $731 | 2.8× |
| Radiologic examination femur 1 view (73551) | $40.20 | $67 | 0.5× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$47.40–$268.20 | $79–$447 | varies |
| Radiologic examination knee 1/2 views (73560) range across 9 matching MRF lines |
$46.20–$243.60 | $77–$406 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$42–$222 | $70–$370 | varies |
| Ribs bilateral 3 views (71110) | $242.40 | $404 | 2.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,853.60 | $4,756 | 5.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,714.40 | $4,524 | 5.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,081 | $5,135 | 6.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,300 | $5,500 | 2.8× |
| Salivary Gland Imaging (78230) | $897.60 | $1,496 | 2.5× |
| Scapula (73010) range across 4 matching MRF lines |
$38.40–$243.60 | $64–$406 | varies |
| Shoulder 1 view (73020) | $29.40 | $49 | 0.4× |
| Skull less than 4 views (70250) range across 5 matching MRF lines |
$49.20–$277.80 | $82–$463 | varies |
| Speech evaluation, complex (70371) | $348 | $580 | 1.6× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$55.80–$219.60 | $93–$366 | varies |
| Testicular Imaging W/Flow (78761) | $414.60 | $691 | 1.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $726.60 | $1,211 | 4.6× |
| Thoracic spine 2 views (72070) range across 4 matching MRF lines |
$15–$303 | $25–$505 | varies |
| Thoracic spine 3 views (72072) | $17.40 | $29 | 0.2× |
| Thoracolumbar 2 views (72080) | $283.20 | $472 | 3.6× |
| Thyroid Imaging With Vascular Flow (78013) | $583.20 | $972 | 1.6× |
| Ultrasound Breast Limited (76642) | $256.80 | $428 | 3.3× |
| Ultrasound Elastography Parenchyma (76981) | $374.40 | $624 | 3.9× |
| Ultrasound, abdomen limited (76705) | $828.60 | $1,381 | 8.7× |
| Unlisted Dx Radiographic Procedure (76499) | $6.60 | $11 | 0.1× |
| Unlisted magnetic resonance procedure (76498) | $2,700 | $4,500 | 34.2× |
| Upper gi w/o kub (74240) | $428.40 | $714 | 2.7× |
| Ureteral Reflux Study (78740) | $1,304.40 | $2,174 | 3.6× |
| Urethrocystogram voiding (74455) | $630 | $1,050 | 2.9× |
| Urethrocystography retrograde (74450) | $581.40 | $969 | 2.7× |
| Us breast unilateral complete (76641) | $338.40 | $564 | 3.6× |
| Us chest (76604) | $801.60 | $1,336 | 8.5× |
| Us complete joint (76881) | $374.40 | $624 | 3.9× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$130.80–$344.40 | $218–$574 | varies |
| Us head (76506) | $526.20 | $877 | 5.5× |
| Us kidney transplant (76776) | $387.60 | $646 | 4.1× |
| Us pelvic non ob complete (76856) | $451.20 | $752 | 4.8× |
| Us retroperitoneal complete (76770) range across 4 matching MRF lines |
$138–$582 | $230–$970 | varies |
| Us retroperitoneal limited (76775) | $126 | $210 | 1.3× |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$112.80–$455.40 | $188–$759 | varies |
| Us spinal canal and contents (76800) | $526.20 | $877 | 5.5× |
| Us thyroid (76536) | $414 | $690 | 4.4× |
| Wrist 2 views (73100) | $45 | $75 | 0.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $298.80 | $498 | 3.8× |
| X-ray antegrade pyelogram tube (74425) | $348 | $580 | 1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $39.60 | $66 | 0.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $43.80 | $73 | 0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$62.40–$300.60 | $104–$501 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 6 matching MRF lines |
$55.20–$300.60 | $92–$501 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $82.20 | $137 | 0.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$52.80–$273 | $88–$455 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $549 | $915 | 5.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $57 | $95 | 0.6× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$43.20–$268.20 | $72–$447 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$120–$675.60 | $200–$1,126 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 4 matching MRF lines |
$52.80–$310.80 | $88–$518 | varies |
| X-ray nose-rectum child f.b. (76010) range across 7 matching MRF lines |
$40.20–$142.20 | $67–$237 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $163.20 | $272 | 1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 4 matching MRF lines |
$13.20–$268.20 | $22–$447 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$51–$363 | $85–$605 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $399 | $665 | 4.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $762 | $1,270 | 2.4× |
| X-Rays Bone Length Studies (77073) | $363 | $605 | 3.8× |
| X-Rays Bone Survey Complete (77075) | $445.20 | $742 | 4.7× |
| Xr c-spine 4 or 5 views (72050) | $503.40 | $839 | 5.3× |
| Xr myelogram posterior fossa (70010) | $1,107 | $1,845 | 3.5× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$64.80–$349.20 | $108–$582 | varies |
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.