34 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| Abdomen 2 views (74019) |
$195 |
$325 |
1.9× |
| Cervical spine 2 or 3 views (72040) |
$195 |
$325 |
2.3× |
| Chest 1 view (71045) |
$72.60 |
$121 |
0.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,338.80 |
$3,898 |
7.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,165.80 |
$1,943 |
5.1× |
| CT c-spine w/o contrast (72125) |
$1,047.60 |
$1,746 |
10.4× |
| CT chest with contrast (71260) |
$1,617 |
$2,695 |
9.6× |
| CT lower ext w/o (73700) |
$1,047.60 |
$1,746 |
10.4× |
| CT maxillofacial w/o contrast (70486) |
$1,047.60 |
$1,746 |
10.4× |
| CT thorax w/o contrast (71250) |
$1,047.60 |
$1,746 |
10.4× |
| CTA chest (71275) |
$1,804.20 |
$3,007 |
10.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$181.20 |
$302 |
1.8× |
| Forearm 2 views (73090) |
$195 |
$325 |
2.3× |
| Hand 3 views (73130) |
$195 |
$325 |
2.3× |
| Humerus Min 2 Views Left (73060) |
$195 |
$325 |
2.3× |
| Knee 3 views (73562) |
$195 |
$325 |
2.3× |
| MRI cervical spine w/o contrast (72141) |
$1,323.60 |
$2,206 |
5.8× |
| Pelvis 1 or 2 views (72170) |
$195 |
$325 |
1.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$133.80 |
$223 |
1.6× |
| Spine thoracic 3 views (72072) |
$195 |
$325 |
1.9× |
| Ultrasound, abdomen limited (76705) |
$463.80 |
$773 |
4.6× |
| Us pelvic non ob complete (76856) |
$463.80 |
$773 |
4.6× |
| Us soft tissue head/neck (76536) |
$463.80 |
$773 |
4.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$195 |
$325 |
2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$195 |
$325 |
2.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$195 |
$325 |
2.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$195 |
$325 |
2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$195 |
$325 |
1.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$195 |
$325 |
2.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$195 |
$325 |
2.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$195 |
$325 |
2.3× |
| Xr finger(s) 2+ views (73140) |
$195 |
$325 |
2.3× |
| Xr tibia/fibula 2 views (73590) |
$195 |
$325 |
2.3× |
| Xray knee 1 or 2 views rt (73560) |
$195 |
$325 |
2.3× |