Imaging prices at Evanston Regional Hospital
Evanston, WY · every code in this section with a posted price and a Medicare benchmark.
246 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) | $148.33 | $247.21 | 1.7× |
| Abdomen 2 views (74019) | $398.24 | $663.74 | 3.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $986.49 | $1,644.15 | 2.4× |
| Angiography extremity unilateral rs&i (75710) | $3,252.52 | $5,420.87 | 1.0× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$212.39–$562.76 | $353.98–$937.93 | varies |
| Arthrogram ankle (73615) | $612.70 | $1,021.16 | 1.7× |
| Arthrogram hip (73525) | $428.30 | $713.83 | 1.2× |
| Arthrogram Wrist (73115) | $447.46 | $745.76 | 1.3× |
| Bone age studies (77072) | $106.89 | $178.15 | 1.0× |
| Bone Imaging 3 Phase (78315) | $986.49 | $1,644.15 | 2.4× |
| Bone Imaging Limited Area (78300) | $986.49 | $1,644.15 | 2.4× |
| Bone Imaging Multiple Areas (78305) | $986.49 | $1,644.15 | 2.4× |
| Bone Imaging Whole Body (78306) | $986.49 | $1,644.15 | 2.4× |
| Bone survey infant (77076) | $859.72 | $1,432.86 | 8.0× |
| Cat Scan Follow-Up Study (76380) | $1,766.72 | $2,944.54 | 19.9× |
| Chest 1 view (71045) | $263.90 | $439.83 | 3.0× |
| Chest 2 views (71046) | $312.07 | $520.11 | 3.5× |
| Chest 3 views (71047) | $322.54 | $537.57 | 3.6× |
| Chest 4 or more views (71048) | $332.44 | $554.07 | 3.1× |
| Clavicle complete (73000) | $156.73 | $261.22 | 1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,246.78 | $2,077.97 | 11.7× |
| Contrast X-Ray Bladder (74430) | $332.78 | $554.63 | 0.9× |
| Contrast X-Ray Of Elbow (73085) | $856.75 | $1,427.92 | 2.4× |
| Contrast Xray Throat/Cerv Esopha (74210) | $404.81 | $674.68 | 2.3× |
| CT abdomen and pelvis without and with contrast (74178) | $3,163.04 | $5,271.74 | 8.9× |
| CT abdomen and pelvis without contrast (74176) | $3,223.94 | $5,373.23 | 13.2× |
| CT abdomen w contrast (74160) | $1,640.17 | $2,733.62 | 9.2× |
| CT abdomen w wo contrast (74170) | $1,530.79 | $2,551.31 | 8.5× |
| CT abdomen w/o contrast (74150) | $1,550.56 | $2,584.27 | 14.5× |
| CT Angio Abdomen and Pelvis (74174) | $3,223.94 | $5,373.23 | 9.0× |
| CT Angio Chest (71275) | $2,481.05 | $4,135.09 | 13.8× |
| CT Angio Head (70496) | $2,095.59 | $3,492.65 | 11.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,066.04–$1,508.56 | $1,776.74–$2,514.26 | varies |
| CT Angio Neck (70498) | $2,095.59 | $3,492.65 | 11.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,016.65–$1,438.66 | $1,694.41–$2,397.77 | varies |
| CT cervical spine w/ contrast (72126) | $2,693.13 | $4,488.55 | 7.6× |
| CT cervical spine w/o contrast (72125) | $2,779.04 | $4,631.73 | 26.0× |
| CT chest w contrast (71260) | $2,885.80 | $4,809.66 | 16.1× |
| CT chest w/wo contrast (71270) | $2,645.92 | $4,409.86 | 14.8× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | — | $1.15 | — |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $319.81 | $533.01 | 3.0× |
| CT head/brain with contrast (70460) | $1,443.04 | $2,405.06 | 8.1× |
| CT head/brain without and with contrast (70470) | $1,536.26 | $2,560.43 | 8.6× |
| CT iac w contrast (70481) | $1,443.04 | $2,405.06 | 8.1× |
| CT l-spine w&w/o contrast (72133) | $2,801.74 | $4,669.57 | 15.6× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$883.16–$1,249.77 | $1,471.94–$2,082.95 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$909.37–$1,286.84 | $1,515.61–$2,144.73 | varies |
| CT lumbar spine w contrast (72132) | $2,651.05 | $4,418.41 | 7.4× |
| CT lumbar spine w/o contrast (72131) | $3,420.96 | $5,701.60 | 32.0× |
| CT maxillofacial w contrast (70487) | $1,443.04 | $2,405.06 | 8.1× |
| CT maxillofacial wo contrast (70486) | $1,349.77 | $2,249.62 | 12.6× |
| CT neck tissue combo (70492) | $1,536.26 | $2,560.43 | 8.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,536.26 | $2,560.43 | 8.6× |
| CT orbits w/o contrast (70480) | $1,349.77 | $2,249.62 | 12.6× |
| CT pelvis w&w/o contrast (72194) | $1,632.76 | $2,721.26 | 9.1× |
| CT pelvis w/o contrast (72192) | $1,673.54 | $2,789.24 | 15.7× |
| CT scans face/jaw combo (70488) | $1,917.89 | $3,196.48 | 10.7× |
| CT soft tissue neck w contrast (70491) | $1,443.04 | $2,405.06 | 8.1× |
| CT soft tissue neck w/o contrast (70490) | $2,082.67 | $3,471.12 | 19.5× |
| CT thoracic spine w contrast (72129) | $2,104.01 | $3,506.68 | 11.7× |
| CT thoracic spine w/o contrast (72128) | $3,463.23 | $5,772.05 | 32.4× |
| CT thoracic spine w/wo cont (72130) | $2,801.74 | $4,669.57 | 15.6× |
| CT thorax w/o contrast (71250) | $1,277.35 | $2,128.92 | 12.0× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$787.21–$1,114 | $1,312.01–$1,856.66 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$896.40–$1,268.48 | $1,494–$2,114.14 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,095.59 | $3,492.65 | 11.7× |
| Cta Abdomen (74175) | $2,095.59 | $3,492.65 | 11.7× |
| CTA pelvis (72191) | $2,095.59 | $3,492.65 | 11.7× |
| Dxa Bone Density Axial (77080) | $465.81 | $776.35 | 4.4× |
| Echo exam of fetal heart (76825) | $633.73 | $1,056.21 | 1.1× |
| Esophagram (74220) | $404.81 | $674.68 | 2.3× |
| Fetal Biophys Profile W/Nst (76818) | $649.02 | $1,081.70 | 6.1× |
| Fluoroscopy up to 1 hr (76000) | $564.08 | $940.14 | 2.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$212.39–$562.76 | $353.98–$937.93 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$233.18–$382.10 | $388.64–$636.84 | varies |
| Gastric emptying imaging study (78264) | $828.49 | $1,380.81 | 2.0× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$279.61–$395.69 | $466.02–$659.48 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,510.04 | $2,516.74 | 2.7× |
| Hepatobiliary System Imaging (78226) | $958.39 | $1,597.32 | 2.3× |
| Ht Muscle Image Spect Sing (78451) | $1,305.92 | $2,176.54 | 1.0× |
| Hysterosalpingogram (74740) | $436.47 | $727.45 | 1.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $382.57 | $637.61 | 4.3× |
| Joint Survey Single View (77077) | $265.10 | $441.84 | 2.5× |
| K Flow/Funct Image W/O Drug (78707) | $504.96 | $841.60 | 0.9× |
| Kidney Imaging Morphol (78700) | $504.96 | $841.60 | 1.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $504.96 | $841.60 | 1.2× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$360.67–$510.38 | $601.12–$850.63 | varies |
| Liver & Spleen Imaging Static Only (78215) | $534.41 | $890.69 | 1.3× |
| Lung Ventilat&Perfus Imaging (78582) | $786.70 | $1,311.17 | 1.4× |
| Magnetic Image Jaw Joint (70336) | $1,016.83 | $1,694.72 | 4.2× |
| Meckels Divert Exam (78290) | $986.49 | $1,644.15 | 2.4× |
| Mra Head W/O & W/Contrast Material (70546) | $1,955.07 | $3,258.45 | 5.5× |
| MRA head w/o contrast (70544) | $1,394.02 | $2,323.37 | 5.7× |
| MRA head with contrast (70545) | $1,674.55 | $2,790.91 | 4.7× |
| MRA neck w contrast (70548) | $1,674.55 | $2,790.91 | 4.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,955.07 | $3,258.45 | 5.5× |
| MRA neck w/o contrast (70547) | $1,394.02 | $2,323.37 | 5.7× |
| MRI abdomen w contrast (74182) | $2,274.83 | $3,791.39 | 6.4× |
| MRI abdomen w/o contrast (74181) | $2,195.95 | $3,659.91 | 9.0× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,464.29–$4,445.78 | $4,107.15–$7,409.63 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,542.61–$5,085.36 | $4,237.69–$8,475.60 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,997.10–$4,299.06 | $3,328.50–$7,165.10 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $2,865.73 | $4,776.21 | 11.8× |
| MRI cervical spine w contrast (72142) | $2,445.29 | $4,075.48 | 6.9× |
| MRI cervical spine w/o cont (72141) | $2,396.63 | $3,994.38 | 9.8× |
| MRI chest w/o contrast (71550) | $1,220.81 | $2,034.69 | 5.0× |
| MRI chest with contrast (71551) | $1,574.46 | $2,624.10 | 2.0× |
| MRI chest wo w contrast (71552) | $1,928.11 | $3,213.52 | 5.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$2,464.29–$4,776.76 | $4,107.15–$7,961.27 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,542.61–$5,085.36 | $4,237.69–$8,475.60 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$2,385.94–$4,771.95 | $3,976.57–$7,953.25 | varies |
| MRI lumbar spine w contrast (72149) | $3,173.32 | $5,288.86 | 8.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,004.90 | $5,008.17 | 8.4× |
| MRI orbit face &/neck w/o contrast (70540) | $3,403.34 | $5,672.24 | 14.0× |
| MRI orbit face neck w contrast (70542) | $1,674.55 | $2,790.91 | 4.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,070.09 | $5,116.82 | 8.6× |
| MRI pelvis w contrast (72196) | $2,274.24 | $3,790.40 | 6.4× |
| MRI pelvis w/o & w contrast (72197) | $2,354.58 | $3,924.30 | 6.6× |
| MRI pelvis w/o contrast (72195) | $2,196.99 | $3,661.65 | 9.0× |
| MRI thoracic spine w/o contrast (72146) | $1,982.49 | $3,304.15 | 8.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$1,997.10–$4,445.94 | $3,328.50–$7,409.90 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,845.98–$4,771.54 | $3,076.63–$7,952.56 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$2,058.77–$5,085.56 | $3,431.28–$8,475.93 | varies |
| MRI, abdomen, combo (74183) | $2,353.73 | $3,922.88 | 6.6× |
| MRI, dorsal spine combo (72157) | $3,004.90 | $5,008.17 | 8.4× |
| MRI, dorsal spine contrast (72147) | $2,031.13 | $3,385.22 | 5.7× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,845.98–$4,775.83 | $3,076.63–$7,959.72 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$2,058.77–$4,871.73 | $3,431.28–$8,119.55 | varies |
| MRI, lumbar spine combo (72158) | $3,004.90 | $5,008.17 | 8.4× |
| Myocardial Spect Multiple Studies (78452) | $2,274.65 | $3,791.08 | 1.7× |
| Neck soft tissue (70360) | $144.75 | $241.25 | 1.6× |
| Nuclear Rx Oral Admin (79005) | $646.36 | $1,077.26 | 2.7× |
| Pelvis 1 or 2 views (72170) | $185.47 | $309.12 | 1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $604.59 | $1,007.65 | 1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $632.69 | $1,054.48 | 5.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $371.60 | $619.34 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$315.35–$446.25 | $525.59–$743.75 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$140.72–$199.15 | $234.54–$331.92 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$382.38–$541.10 | $637.30–$901.84 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $241.42 | $402.36 | 2.3× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$270.14–$382.29 | $450.24–$637.15 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$315.35–$446.25 | $525.59–$743.75 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$337.70–$477.88 | $562.84–$796.46 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$395.30–$559.39 | $658.83–$932.31 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $241.18 | $401.96 | 2.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $304.93 | $508.22 | 3.4× |
| Radex Ribs Unilateral 2 Views (71100) | $145.60 | $242.66 | 1.6× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$589.13–$833.67 | $981.88–$1,389.45 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $152.34 | $253.90 | 1.7× |
| Radex Spine 1 View Specify Level (72020) | $162.35 | $270.58 | 1.8× |
| Radex Sternum Minimum 2 Views (71120) | $145.60 | $242.66 | 1.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $304.93 | $508.22 | 3.4× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$140.72–$199.15 | $234.54–$331.92 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$382.38–$541.10 | $637.30–$901.84 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$382.38–$541.10 | $637.30–$901.84 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $811.25 | $1,352.09 | 7.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $201.18 | $335.30 | 1.9× |
| Radiologic exam colon double contrast study (74280) | $458.57 | $764.29 | 2.6× |
| Radiologic exam colon single contrast study (74270) | $458.57 | $764.29 | 2.6× |
| Radiologic exam knee complete 4/more views (73564) | $414.37 | $690.62 | 3.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $218.33 | $363.88 | 2.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $381.34 | $635.57 | 2.1× |
| Radiologic exam swallow function contrast study (74230) | $390.69 | $651.15 | 2.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $367.66 | $612.76 | 2.1× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$171.70–$381.95 | $286.16–$636.58 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$178.74–$497.96 | $297.90–$829.93 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$395.30–$559.39 | $658.83–$932.31 | varies |
| Ribs bilateral 3 views (71110) | $382.38 | $637.30 | 3.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $905.57 | $1,509.29 | 2.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $905.57 | $1,509.29 | 1.6× |
| Rp Therapy Intravenous Administration (79101) | $646.36 | $1,077.26 | 2.7× |
| Scapula (73010) | $156.73 | $261.22 | 1.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$34.78–$69.56 | $57.97–$115.93 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$223.91–$316.85 | $373.18–$528.08 | varies |
| Shoulder Arthrography (73040) | $612.70 | $1,021.16 | 1.7× |
| Skull less than 4 views (70250) | $152.34 | $253.90 | 1.4× |
| Speech evaluation, complex (70371) | $390.69 | $651.15 | 1.6× |
| Sternoclavicular joints (71130) | $145.60 | $242.66 | 1.6× |
| Thoracic spine 2 views (72070) | $276.91 | $461.52 | 2.6× |
| Thoracic spine 3 views (72072) | $430.91 | $718.18 | 4.0× |
| Thoracolumbar 2 views (72080) | $276.91 | $461.52 | 3.1× |
| Thyroid Imaging With Vascular Flow (78013) | $263.08 | $438.47 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $411.59 | $685.98 | 1.0× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$327.81–$477.01 | $546.35–$795.02 | varies |
| Ultrasound Exam Aaa Screen (76706) | $518.59 | $864.32 | 4.9× |
| Ultrasound, abdomen limited (76705) | $824.37 | $1,373.95 | 7.7× |
| Upper gi w/o kub (74240) | $334.22 | $557.04 | 1.9× |
| Urethrocystogram voiding (74455) | $337.88 | $563.13 | 1.4× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$327.81–$627.44 | $546.35–$1,045.73 | varies |
| Us chest (76604) | $524.06 | $873.43 | 4.9× |
| Us complete joint (76881) | $308.09 | $513.48 | 2.9× |
| Us exam, pelvic, limited (76857) | $264.10 | $440.17 | 2.5× |
| Us head (76506) | $594.58 | $990.96 | 5.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $211.82 | $353.04 | 2.0× |
| Us ob limited 1 or more fetuses (76815) | $479.93 | $799.88 | 4.5× |
| Us ob transvaginal (76817) | $287.32 | $478.87 | 2.7× |
| Us pelvic non ob complete (76856) | $751.85 | $1,253.09 | 7.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $406.77 | $677.95 | 3.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $181.79 | $302.98 | 1.7× |
| Us retroperitoneal complete (76770) | $684.95 | $1,141.59 | 6.4× |
| Us retroperitoneal limited (76775) | $291.20 | $485.33 | 2.7× |
| Us scrotum and contents (76870) | $301.57 | $502.61 | 2.8× |
| Us spinal canal and contents (76800) | $174.32 | $290.53 | 1.6× |
| Us thyroid (76536) | $672.40 | $1,120.67 | 6.3× |
| Us transrectal (76872) | $358.52 | $597.53 | 3.4× |
| Vascular Flow Imaging (78445) | $386.48 | $644.13 | 0.9× |
| Vertebral fracture assessment via dxa (77086) | $296.30 | $493.83 | 3.3× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$234.45–$304.95 | $390.75–$508.25 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $193.12 | $321.86 | 2.2× |
| X-Ray Bend Only L-S Spine (72120) | $196.67 | $327.79 | 1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$205.48–$290.79 | $342.46–$484.65 | varies |
| X-Ray Exam Breast Specimen (76098) | $371.60 | $619.34 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$300.48–$405.64 | $500.80–$676.06 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $405.64 | $676.06 | 3.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$405.78–$811.25 | $676.30–$1,352.09 | varies |
| X-Ray Exam Hip Uni 1 View (73501) | $164 | $273.33 | 1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$183.16–$183.25 | $305.27–$305.41 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$247.88–$275.14 | $413.13–$458.57 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$247.88–$405.96 | $413.13–$676.60 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $247.63 | $412.71 | 2.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $495.25 | $825.41 | 4.6× |
| X-Ray Exam L-S Spine Bending (72114) | $524.31 | $873.85 | 4.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $382.38 | $637.30 | 4.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $540.65 | $901.09 | 5.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $305.18 | $508.64 | 2.9× |
| X-ray eye for foreign body (70030) | $152.34 | $253.90 | 1.7× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$193.12–$382.16 | $321.86–$636.93 | varies |
| X-ray IV pyelogram (ivp) (74400) | $332.78 | $554.63 | 1.9× |
| X-ray IV pyelogram+tomography (74415) | $332.78 | $554.63 | 1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $152.34 | $253.90 | 1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $414.25 | $690.41 | 4.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $432.04 | $720.06 | 4.0× |
| X-ray nose-rectum child f.b. (76010) | $158.37 | $263.95 | 1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $382.57 | $637.62 | 3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $304.96 | $508.26 | 2.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $241.42 | $402.36 | 2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $241.42 | $402.36 | 2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $304.93 | $508.22 | 3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $241.42 | $402.36 | 2.3× |
| X-ray thoracic spine 4 vw (72074) | $276.91 | $461.52 | 2.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $332.78 | $554.63 | 0.9× |
| X-Rays Bone Survey Complete (77075) | $508.48 | $847.46 | 4.8× |
| Xr c-spine 4 or 5 views (72050) | $504.80 | $841.33 | 4.7× |
| Xr facial bones less than 3 views (70140) | $152.34 | $253.90 | 1.7× |
| Xr orbits complete 4 views (70200) | $304.93 | $508.22 | 2.9× |
| Xr Tomogram Single Plane (76100) | $114.74 | $191.24 | 1.1× |
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.