Imaging prices at Fisher-Titus Hospital

Norwalk, OH · every code in this section with a posted price and a Medicare benchmark.

306 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $3,622.50 $4,025 2.8×
Abdomen 1 View (74018) $229.50 $255 2.8×
Abdomen 2 views (74019) $243 $270 2.5×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,035 $1,150 2.7×
Angio pulmonary bilat (75743) $3,852 $4,280 1.3×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $3,852 $4,280 1.3×
Angiography extremity bilateral rs&i (75716) $2,682 $2,980 0.9×
Angiography extremity unilateral rs&i (75710) $2,835 $3,150 0.9×
Angiography pulmonary unilateral slctv rs&i (75741) $3,195 $3,550 1.1×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $3,195 $3,550 1.1×
Ankle 2 views (73600) $229.50 $255 2.8×
Aortography thoracic serialography rs&i (75605) $7,124.40 $7,916 1.4×
Artery X-Rays Abdomen (75726) $5,130 $5,700 1.0×
Artery X-Rays Adrenal Gland (75731) $3,195 $3,550 1.1×
Artery X-Rays Pelvis (75736) $4,869 $5,410 0.9×
Arthrogram ankle (73615) $771.30 $857 2.3×
Arthrogram hip (73525) $868.50 $965 2.6×
Arthrogram Wrist (73115) $1,152 $1,280 3.5×
Bone age studies (77072) $229.50 $255 2.3×
Bone Imaging 3 Phase (78315) $918 $1,020 2.4×
Bone Imaging Limited Area (78300) $918 $1,020 2.4×
Bone Imaging Whole Body (78306) $1,534.50 $1,705 4.1×
Bone marrow imaging limited area (78102) $1,786.50 $1,985 4.7×
Bone survey infant (77076) $306 $340 3.1×
Brachytx isodose complex (77318) $1,107 $1,230 3.1×
Brain Imaging Pet Metabolic Evaluation (78608) $3,448.80 $3,832 2.5×
Cat Scan Follow-Up Study (76380) $876.60 $974 10.6×
Chest 1 view (71045) $198 $220 2.4×
Chest 2 views (71046) $211.50 $235 2.6×
Chest 3 views (71047) $220.50 $245 2.7×
Chest 4 or more views (71048) $229.50 $255 2.3×
Cholecystography Oral Contrast (74290) $423 $470 2.5×
Clavicle complete (73000) $243 $270 3.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,152 $1,280 11.6×
Continuing medical physics consltj pr wk (77336) $396 $440 3.1×
Contrast Exam Abdominl Aorta (75625) $5,130 $5,700 1.7×
Contrast X-Ray Bladder (74430) $839.70 $933 2.5×
Contrast X-Ray Of Elbow (73085) $1,003.50 $1,115 3.0×
Contrast X-Ray Of Knee Joint (73580) $1,152 $1,280 3.5×
CT abdomen and pelvis without and with contrast (74178) $3,415.50 $3,795 10.3×
CT abdomen and pelvis without contrast (74176) $3,066.30 $3,407 13.6×
CT abdomen w contrast (74160) $1,309.50 $1,455 7.9×
CT abdomen w wo contrast (74170) $1,705.50 $1,895 10.3×
CT abdomen w/o contrast (74150) $1,215 $1,350 12.3×
CT Angio Abdomen and Pelvis (74174) $2,358 $2,620 7.1×
CT Angio Chest (71275) $1,566 $1,740 9.4×
CT Angio Head (70496) $1,381.50 $1,535 8.3×
CT angio hrt w/3d image (75574) $2,061 $2,290 6.2×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,566 $1,740 9.4×
CT Angio Neck (70498) $1,381.50 $1,535 8.3×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,566 $1,740 9.4×
CT cervical spine w/ contrast (72126) $1,309.50 $1,455 4.0×
CT cervical spine w/o contrast (72125) $1,210.50 $1,345 12.2×
CT cervical spine w/wo cont (72127) $1,705.50 $1,895 10.3×
CT chest w contrast (71260) $1,390.50 $1,545 8.4×
CT chest w/wo contrast (71270) $1,705.50 $1,895 10.3×
CT head/brain with contrast (70460) $1,575 $1,750 9.5×
CT head/brain without and with contrast (70470) $1,800 $2,000 10.8×
CT heart no contrast quant eval coronry calcium (75571) $126 $140 1.5×
CT iac w contrast (70481) $877.50 $975 5.3×
CT l-spine w&w/o contrast (72133) $1,705.50 $1,895 10.3×
CT lower ext w/o (73700) $1,003.50 $1,115 10.1×
CT lower extremity w/contrast material (73701) $1,084.50 $1,205 6.5×
CT lumbar spine w contrast (72132) $1,309.50 $1,455 4.0×
CT lumbar spine w/o contrast (72131) $1,210.50 $1,345 12.2×
CT maxillofacial w contrast (70487) $1,575 $1,750 9.5×
CT maxillofacial wo contrast (70486) $1,350 $1,500 13.6×
CT neck tissue combo (70492) $1,246.50 $1,385 7.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,138.50 $1,265 6.9×
CT orbits w/o contrast (70480) $810 $900 8.2×
CT pelvis w&w/o contrast (72194) $1,705.50 $1,895 10.3×
CT pelvis w/o contrast (72192) $1,215 $1,350 12.3×
CT scan of leg combo (73702) $1,408.50 $1,565 8.5×
CT scans face/jaw combo (70488) $1,800 $2,000 10.8×
CT soft tissue neck w contrast (70491) $958.50 $1,065 5.8×
CT soft tissue neck w/o contrast (70490) $886.50 $985 9.0×
CT thoracic spine w contrast (72129) $1,309.50 $1,455 7.9×
CT thoracic spine w/o contrast (72128) $1,210.50 $1,345 12.2×
CT thoracic spine w/wo cont (72130) $1,705.50 $1,895 10.3×
CT thorax w/o contrast (71250) $1,215 $1,350 12.3×
CT upper ext wo (73200) $1,003.50 $1,115 10.1×
CT upper extremity w/o & w/contrast material (73202) $1,408.50 $1,565 8.5×
CT upper extremity with contrast (73201) $1,084.50 $1,205 3.3×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,566 $1,740 9.4×
Cta Abdomen (74175) $1,566 $1,740 9.4×
CTA pelvis (72191) $1,566 $1,740 9.4×
Discography Cerv/Thor Spine (72285) $4,393.80 $4,882 2.4×
Diskography lumbar (72295) $4,393.80 $4,882 2.4×
Doppler Fetal Mid Cerebral Artery (76821) $380.70 $423 3.8×
Dxa Bone Density Axial (77080) $279 $310 2.8×
Dxa bone density study 1/>sites appendiclr skel (77081) $121.50 $135 1.5×
Echo Guide For Artery Repair (76936) $702 $780 3.4×
Echograp Trans R Pros Study (76873) $400.50 $445 4.0×
Esophagram (74220) $423 $470 2.5×
Fetal Biophys Profile W/Nst (76818) $400.50 $445 4.0×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $373.50 $415 3.8×
Fluoroscopy up to 1 hr (76000) $544.50 $605 2.4×
Follow-Up Angiography (75898) $4,563.90 $5,071 1.5×
Foot 2 views (73620) $229.50 $255 2.8×
Forearm 2 views (73090) $229.50 $255 2.8×
Gastric emptying imaging study (78264) $1,201.50 $1,335 3.2×
Gated Heart Planar Single (78472) $1,620 $1,800 4.3×
Hand 2 views (73120)
range across 3 matching MRF lines		 $229.50–$344.70 $255–$383 varies
Hepatobil Syst Image W/Drug (78227) $1,363.50 $1,515 2.7×
Hepatobiliary System Imaging (78226) $1,315.80 $1,462 3.5×
Ht Muscle Image Spect Sing (78451)
range across 3 matching MRF lines		 $2,041.20–$3,313.80 $2,268–$3,682 varies
Hysterosalpingogram (74740) $1,001.70 $1,113 4.4×
Interstitial radiation source applic complex (77778) $2,608.20 $2,898 4.0×
K Flow/Funct Image Multiple (78709) $2,296.80 $2,552 4.5×
K Flow/Funct Image W/Drug (78708) $2,296.80 $2,552 4.5×
K Flow/Funct Image W/O Drug (78707) $1,417.50 $1,575 2.8×
Knee 3 Views (73562) $261 $290 3.2×
Liver & Spleen Imaging Static Only (78215) $1,129.50 $1,255 3.0×
Lung Ventilat&Perfus Imaging (78582) $1,530 $1,700 3.0×
Lung Ventilation Imaging (78579) $918 $1,020 2.4×
Lymph System Imaging (78195) $1,381.50 $1,535 2.7×
Magnetic Image Jaw Joint (70336) $2,218.50 $2,465 9.8×
Mammary ductogram or galactogram multiple (77054) $505.80 $562 2.2×
Meckels Divert Exam (78290) $999 $1,110 2.6×
Mra Head W/O & W/Contrast Material (70546) $2,673 $2,970 8.1×
MRA head w/o contrast (70544) $1,903.50 $2,115 8.4×
MRA head with contrast (70545) $2,056.50 $2,285 6.2×
MRA neck w contrast (70548) $2,056.50 $2,285 6.2×
Mra Neck W/O &W/Contrast Material (70549) $2,673 $2,970 8.1×
MRA neck w/o contrast (70547) $1,903.50 $2,115 8.4×
MRI abdomen w contrast (74182) $2,578.50 $2,865 7.8×
MRI abdomen w/o contrast (74181) $2,385 $2,650 10.6×
MRI any jt lower extrem w/contrast material (73722) $2,434.50 $2,705 3.3×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,168 $3,520 9.6×
MRI any jt upper extremity w/contrast matrl (73222) $2,434.50 $2,705 3.3×
MRI Breast W/O Contrast Bilateral (77047) $1,372.50 $1,525 6.1×
MRI Breast Without Contrast Material Unilateral (77046) $1,309.50 $1,455 5.8×
MRI cervical spine w contrast (72142) $2,835 $3,150 8.6×
MRI cervical spine w/o cont (72141) $2,623.50 $2,915 11.6×
MRI chest w/o contrast (71550) $1,948.50 $2,165 8.6×
MRI chest with contrast (71551) $2,106 $2,340 2.8×
MRI chest wo w contrast (71552) $2,740.50 $3,045 8.3×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,434.50 $2,705 7.4×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $3,168 $3,520 9.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,254.50 $2,505 10.0×
MRI lumbar spine w contrast (72149) $2,848.50 $3,165 8.6×
Mri Neck Spine W/O & W/Dye (72156) $3,685.50 $4,095 11.2×
MRI orbit face &/neck w/o contrast (70540) $1,795.50 $1,995 8.0×
MRI orbit face neck w contrast (70542) $1,939.50 $2,155 5.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,520 $2,800 7.6×
MRI pelvis w contrast (72196) $2,578.50 $2,865 7.8×
MRI pelvis w/o & w contrast (72197) $3,352.50 $3,725 10.2×
MRI pelvis w/o contrast (72195) $2,385 $2,650 10.6×
MRI thoracic spine w/o contrast (72146) $2,637 $2,930 11.7×
MRI upper extremity oth than jt w/contr matrl (73219) $2,434.50 $2,705 7.4×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,254.50 $2,505 10.0×
Mri Uppr Extremity W/O&W/Dye (73220) $3,168 $3,520 9.6×
MRI, abdomen, combo (74183) $3,352.50 $3,725 10.2×
MRI, dorsal spine combo (72157) $3,708 $4,120 11.2×
MRI, dorsal spine contrast (72147) $2,848.50 $3,165 8.6×
MRI, joint upper extrem (73221) $2,254.50 $2,505 10.0×
MRI, joint upper extrem combo (73223) $3,168 $3,520 9.6×
MRI, lumbar spine combo (72158) $3,708 $4,120 11.2×
Myocardial Imaging Pet Metabolic Evaluation (78459) $3,313.80 $3,682 2.7×
Myocardial Spect Multiple Studies (78452)
range across 4 matching MRF lines		 $2,866.50–$5,400 $3,185–$6,000 varies
Neck soft tissue (70360) $243 $270 3.0×
Nuclear Rx Oral Admin (79005)
range across 4 matching MRF lines		 $594.54–$864 $660.60–$960 varies
Optic foramina (70190) $243 $270 3.0×
Parathyroid Planar Imaging (78070) $999 $1,110 2.6×
Parathyroid planar imaging w/wo subtraction (78071) $1,786.50 $1,985 4.7×
Pelvis 1 or 2 views (72170) $243 $270 2.5×
Pet Image W/Ct Lmtd (78814) $5,143.50 $5,715 3.8×
PET image w/CT, full body (78816) $5,593.50 $6,215 4.1×
PET imaging CT attenuation skull base mid-thigh (78815) $5,368.50 $5,965 4.0×
Pet Myocardial Sngl Study (78491) $3,448.80 $3,832 2.5×
PET whole body (78813) $5,143.50 $5,715 3.8×
Pulmonary Perfusion Imaging Particulate (78580) $918 $1,020 2.4×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $342 $380 3.5×
Radex abscess/fistula/sinus tract rs&i (76080) $1,458 $1,620 2.8×
Radex Ankle Complete Minimum 3 Views (73610) $261 $290 3.2×
Radex Calcaneus Minimum 2 Views (73650) $229.50 $255 2.8×
Radex elbow complete minimum 3 views (73080) $261 $290 3.2×
Radex Facial Bones Complete Minimum 3 Views (70150) $306 $340 3.1×
Radex fingr minimum 2 views (73140) $243 $270 3.0×
Radex foot complete minimum 3 views (73630) $261 $290 3.2×
Radex Hand Minimum 3 Views (73130) $261 $290 3.2×
Radex lower extremity infant minimum 2 views (73592) $243 $270 3.0×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $261 $290 2.6×
Radex Nasal Bones Complete Minimum 3 Views (70160) $261 $290 3.2×
Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) $243 $270 3.0×
Radex Ribs Unilateral 2 Views (71100) $274.50 $305 3.3×
Radex shoulder complete minimum 2 views (73030) $261 $290 3.2×
Radex Sinuses Paransl < 3 Views (70210) $243 $270 3.0×
Radex Spine 1 View Specify Level (72020) $229.50 $255 2.8×
Radex Sternum Minimum 2 Views (71120) $243 $270 3.0×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $243 $270 3.0×
Radex Toe Minimum 2 Views (73660) $243 $270 3.0×
Radex upper extremity infant minimum 2 views (73092) $306 $340 3.1×
Radex Wrist Complete Minimum 3 Views (73110) $261 $290 3.2×
Radiolog exam mandible compl minimum 4 views (70110) $306 $340 3.1×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $261 $290 2.6×
Radiologic exam colon double contrast study (74280) $1,152 $1,280 6.9×
Radiologic exam colon single contrast study (74270) $859.50 $955 5.2×
Radiologic exam knee complete 4/more views (73564)
range across 6 matching MRF lines		 $292.50–$309.38 $325–$343.75 varies
Radiologic exam pelvis compl minimum 3 views (72190) $261 $290 2.6×
Radiologic Exam Small Int Single Contrast Study (74250) $459 $510 2.8×
Radiologic exam swallow function contrast study (74230) $423 $470 2.5×
Radiologic exam upr gi trc double contrast study (74246) $904.50 $1,005 5.5×
Radiologic examination femur 1 view (73551) $220.50 $245 2.7×
Radiologic examination femur minimum 2 views (73552) $256.50 $285 3.1×
Radiologic examination knee 1/2 views (73560) $229.50 $255 2.8×
Radiologic Examination Osseous Survey Limited (77074) $306 $340 3.1×
Radiologic examination tibia & fibula 2 views (73590) $229.50 $255 2.8×
Ribs bilateral 3 views (71110) $396 $440 4.0×
Rp loclzj tum plnr 1 area single day imaging (78800) $958.50 $1,065 2.5×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,026 $1,140 2.7×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $2,974.50 $3,305 5.8×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $2,133 $2,370 4.2×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 3 matching MRF lines		 $1,171.53–$2,772.90 $1,301.70–$3,081 varies
Rp Therapy Intravenous Administration (79101) $603 $670 2.7×
Scapula (73010) $229.50 $255 2.3×
Screening Digital Breast Tomosynthesis Bi (77063) $32.40 $36 1.4×
Sella turcica (70240) $261 $290 3.2×
Shoulder 1 view (73020) $229.50 $255 2.8×
Shoulder Arthrography (73040) $868.50 $965 2.6×
Skull less than 4 views (70250) $261 $290 2.6×
Special treatment procedure (77470) $607.50 $675 1.2×
Sternoclavicular joints (71130) $243 $270 3.0×
Testicular Imaging W/Flow (78761) $1,075.50 $1,195 2.8×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $1,107 $1,230 3.1×
Thoracic spine 2 views (72070) $252 $280 2.5×
Thoracic spine 3 views (72072) $270 $300 2.7×
Thoracolumbar 2 views (72080) $270 $300 3.3×
Thyroid Imaging With Vascular Flow (78013) $846 $940 2.2×
Thyroid Met Imaging Body (78018) $1,084.50 $1,205 2.1×
Thyroid Uptake Measurement (78012)
range across 2 matching MRF lines		 $135.05–$612 $150.05–$680 varies
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,026 $1,140 2.7×
Tx devices design & construction simple (77332) $369 $410 2.9×
Ultrasound Breast Limited (76642) $531 $590 6.4×
Ultrasound Elastography Parenchyma (76981) $433.80 $482 4.4×
Ultrasound Exam Aaa Screen (76706) $580.50 $645 5.9×
Ultrasound, abdomen limited (76705) $580.50 $645 5.9×
Umbilical-artery Doppler (OB) (76820) $380.70 $423 3.8×
Unlisted magnetic resonance procedure (76498) $211.50 $235 2.6×
Upper gi w/o kub (74240) $873 $970 5.3×
Urethrocystogram voiding (74455) $880.20 $978 3.9×
Urethrocystography retrograde (74450) $880.20 $978 3.9×
Us breast unilateral complete (76641) $553.50 $615 5.6×
Us chest (76604) $364.50 $405 3.7×
Us complete joint (76881) $584.10 $649 5.9×
Us exam, pelvic, limited (76857) $306 $340 3.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $400.50 $445 4.0×
Us ob limited 1 or more fetuses (76815) $400.50 $445 4.0×
Us ob transvaginal (76817) $693 $770 7.0×
Us pelvic non ob complete (76856) $616.50 $685 6.2×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $693 $770 7.0×
Us preg uterus real time f/u trnsabdl per fetus (76816) $288 $320 2.9×
Us retroperitoneal complete (76770) $990 $1,100 10.0×
Us retroperitoneal limited (76775) $454.50 $505 4.6×
Us scrotum and contents (76870) $580.50 $645 5.9×
Us spinal canal and contents (76800) $495 $550 5.0×
Us thyroid (76536) $580.50 $645 5.9×
Us transrectal (76872) $531 $590 5.4×
Vein X-Ray Chest (75827) $2,430 $2,700 1.6×
Venogram Sinus/Jugular (75860) $4,123.80 $4,582 1.4×
Venography caval inferior serialography rs&i (75825) $4,370.40 $4,856 1.5×
Venography extremity bilateral rs&i (75822) $2,651.40 $2,946 1.8×
Venography extremity unilateral rs&i (75820) $2,430 $2,700 1.6×
Venography Renal Unilateral (75831) $4,123.80 $4,582 1.4×
Venous Thrombosis Imaging Venogram Bilateral (78458) $1,085.90 $1,206.55 2.9×
Wrist 2 views (73100) $229.50 $255 2.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $229.50 $255 2.8×
X-ray antegrade pyelogram tube (74425) $360 $400 1.1×
X-Ray Aorta Leg Arteries (75630) $5,130 $5,700 1.7×
X-Ray Bend Only L-S Spine (72120) $306 $340 3.1×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $229.50 $255 2.8×
X-Ray Exam Breast Specimen (76098) $679.50 $755 1.3×
X-Ray Exam Entire Spi 1 Vw (72081) $270 $300 3.3×
X-Ray Exam Entire Spi 2/3 Vw (72082) $337.50 $375 3.4×
X-Ray Exam Hip Uni 1 View (73501) $243 $270 3.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $283.50 $315 3.4×
X-Ray Exam Hip Uni 4/> Views (73503) $324 $360 3.3×
X-Ray Exam Hips Bi 2 Views (73521) $243 $270 2.5×
X-Ray Exam Hips Bi 3-4 Views (73522) $337.50 $375 3.4×
X-Ray Exam Hips Bi 5/> Views (73523) $369 $410 3.7×
X-Ray Exam L-S Spine Bending (72114) $450 $500 4.5×
X-Ray Exam Neck Spine 2-3 Vw (72040) $306 $340 3.7×
X-Ray Exam Neck Spine 6/>Vws (72052) $499.50 $555 5.1×
X-Ray Exam Unilat Ribs/Chest (71101) $369 $410 3.7×
X-ray eye for foreign body (70030) $243 $270 3.0×
X-ray humerus (73060) $243 $270 3.0×
X-ray IV pyelogram (ivp) (74400) $929.70 $1,033 5.6×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $261 $290 3.2×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $243 $270 3.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $306 $340 3.1×
X-ray nose-rectum child f.b. (76010) $243 $270 3.0×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $396 $440 4.0×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $292.50 $325 3.0×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $261 $290 3.2×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $270 $300 3.3×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $288 $320 2.9×
X-Ray Stress View (77071) $203.40 $226 2.5×
X-ray thoracic spine 4 vw (72074) $306 $340 3.1×
X-Ray Urinary Tract Exam With Contrast Material (74420)
range across 3 matching MRF lines		 $1,045.80–$1,568.70 $1,162–$1,743 varies
X-Rays Bone Length Studies (77073) $229.50 $255 2.3×
X-Rays Bone Survey Complete (77075) $504 $560 5.1×
Xr c-spine 4 or 5 views (72050) $405 $450 4.1×
Xr facial bones less than 3 views (70140) $243 $270 3.0×
XR Mastoids < 3 Views Bilateral (70120) $225 $250 2.3×
Xr orbits complete 4 views (70200) $288 $320 2.9×
Xr Tomogram Single Plane (76100) $372.60 $414 3.8×

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.