Imaging prices at Grand Island Regional Medical Center
Grand Island, NE · 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) | $201 | $335 | 2.2× |
| Abdomen 2 views (74019) | $264 | $440 | 2.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,288.20 | $2,147 | 3.1× |
| Angio internal mammary (75756) | $2,193.60 | $3,656 | 0.7× |
| Angio pulmonary bilat (75743) | $1,993.20 | $3,322 | 0.6× |
| Angiography extremity bilateral rs&i (75716) | $2,763.60 | $4,606 | 0.8× |
| Angiography extremity unilateral rs&i (75710) | $2,451.60 | $4,086 | 0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,993.20 | $3,322 | 0.6× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$177.60–$178.80 | $296–$298 | varies |
| Artery X-Rays Abdomen (75726) | $3,917.40 | $6,529 | 0.7× |
| Artery X-Rays Pelvis (75736) | $3,108.60 | $5,181 | 0.5× |
| Artery X-Rays Spine (75705) | $3,438 | $5,730 | 0.6× |
| Arthrogram hip (73525) | $593.40 | $989 | 1.6× |
| Bone Imaging 3 Phase (78315) | $1,497.60 | $2,496 | 3.6× |
| Bone Imaging Limited Area (78300) | $861.60 | $1,436 | 2.1× |
| Bone Imaging Multiple Areas (78305) | $842.40 | $1,404 | 2.0× |
| Bone Imaging Whole Body (78306) | $1,347 | $2,245 | 3.2× |
| Bone marrow imaging; whole body (78104) | $1,127.40 | $1,879 | 2.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,630 | $6,050 | 2.4× |
| Cat Scan Follow-Up Study (76380) | $616.80 | $1,028 | 6.8× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$150–$198 | $250–$330 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$154.80–$216 | $258–$360 | varies |
| Chest 3 views (71047) | $282 | $470 | 3.1× |
| Clavicle complete (73000) | $228 | $380 | 2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $934.80 | $1,558 | 8.6× |
| Contrast Exam Abdominl Aorta (75625) | $2,455.80 | $4,093 | 0.7× |
| Contrast X-Ray Bladder (74430) | $408 | $680 | 1.1× |
| Contrast Xray Throat/Cerv Esopha (74210) | $418.80 | $698 | 2.3× |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$3,322.80–$3,738 | $5,538–$6,230 | varies |
| CT abdomen and pelvis without contrast (74176) | $2,002.80 | $3,338 | 8.1× |
| CT abdomen w contrast (74160) | $1,794 | $2,990 | 9.8× |
| CT abdomen w wo contrast (74170) | $2,131.80 | $3,553 | 11.7× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,120.20–$1,354.20 | $1,867–$2,257 | varies |
| CT Angio Abdomen and Pelvis (74174) | $2,839.20 | $4,732 | 7.8× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,660.80–$1,852.80 | $2,768–$3,088 | varies |
| CT Angio Head (70496) | $1,715.40 | $2,859 | 9.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,510.80 | $2,518 | 8.3× |
| CT Angio Neck (70498) | $2,188.80 | $3,648 | 12.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,702.20 | $2,837 | 9.3× |
| CT bone density (77078) | $468 | $780 | 5.2× |
| CT cervical spine w/ contrast (72126) | $1,633.80 | $2,723 | 4.5× |
| CT cervical spine w/o contrast (72125) | $1,299.60 | $2,166 | 12.0× |
| CT cervical spine w/wo cont (72127) | $1,734 | $2,890 | 9.5× |
| CT chest w contrast (71260) | $1,504.80 | $2,508 | 8.3× |
| CT chest w/wo contrast (71270) | $1,715.40 | $2,859 | 9.4× |
| CT head/brain with contrast (70460) | $1,310.40 | $2,184 | 7.2× |
| CT head/brain without and with contrast (70470) | $1,581 | $2,635 | 8.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $57 | $95 | 0.6× |
| CT l-spine w&w/o contrast (72133) | $1,638 | $2,730 | 9.0× |
| CT lower ext w/o (73700) | $1,030.80 | $1,718 | 9.5× |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,362–$1,455.60 | $2,270–$2,426 | varies |
| CT lumbar spine w contrast (72132) | $1,667.40 | $2,779 | 4.6× |
| CT lumbar spine w/o contrast (72131) | $1,419 | $2,365 | 13.1× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,440.60–$1,531.20 | $2,401–$2,552 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$806.40–$1,189.80 | $1,344–$1,983 | varies |
| CT neck tissue combo (70492) | $1,936.20 | $3,227 | 10.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,863.60 | $3,106 | 10.2× |
| CT orbits w/o contrast (70480) | $1,530.60 | $2,551 | 14.1× |
| CT pelvis w&w/o contrast (72194) | $1,881.60 | $3,136 | 10.3× |
| CT pelvis w/o contrast (72192) | $1,096.80 | $1,828 | 10.1× |
| CT scan of leg combo (73702) | $1,635 | $2,725 | 9.0× |
| CT scans face/jaw combo (70488) | $1,470.60 | $2,451 | 8.1× |
| CT soft tissue neck w contrast (70491) | $1,566 | $2,610 | 8.6× |
| CT soft tissue neck w/o contrast (70490) | $1,275.60 | $2,126 | 11.8× |
| CT thoracic spine w contrast (72129) | $1,674 | $2,790 | 9.2× |
| CT thoracic spine w/o contrast (72128) | $1,280.40 | $2,134 | 11.8× |
| CT thoracic spine w/wo cont (72130) | $1,586.40 | $2,644 | 8.7× |
| CT thorax w/o contrast (71250) | $1,023.60 | $1,706 | 9.4× |
| CT upper ext wo (73200) | $1,329 | $2,215 | 12.2× |
| CT upper extremity w/o & w/contrast material (73202) | $1,849.80 | $3,083 | 10.2× |
| CT upper extremity with contrast (73201) | $1,446.60 | $2,411 | 4.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,251.20 | $3,752 | 12.4× |
| Cta Abdomen (74175) | $2,113.20 | $3,522 | 11.6× |
| CTA pelvis (72191) | $983.40 | $1,639 | 5.4× |
| Dilation ureters/urethra rs&i (74485) | $1,241.40 | $2,069 | 0.6× |
| Diskography lumbar (72295) | $3,598.80 | $5,998 | 1.8× |
| Esophagram (74220) | $467.40 | $779 | 2.6× |
| Fetal Biophys Profile W/Nst (76818) | $322.20 | $537 | 3.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $223.80 | $373 | 2.1× |
| Fluoroscopy up to 1 hr (76000) | $472.20 | $787 | 1.9× |
| Foot 2 views (73620) | $209.40 | $349 | 2.3× |
| Forearm 2 views (73090) | $239.40 | $399 | 2.6× |
| Gastric emptying imaging study (78264) | $1,409.40 | $2,349 | 3.4× |
| Hand 2 views (73120) | $250.20 | $417 | 2.3× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,110.80 | $3,518 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $1,420.20 | $2,367 | 2.5× |
| Hepatobiliary System Imaging (78226) | $1,194 | $1,990 | 2.9× |
| Ht Muscle Image Spect Sing (78451) | $2,838 | $4,730 | 2.1× |
| Hysterosalpingogram (74740) | $529.80 | $883 | 2.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $417.60 | $696 | 4.6× |
| Infant hip ultrasound, limited static exam (76886) | $189 | $315 | 2.1× |
| Joint Survey Single View (77077) | $223.80 | $373 | 2.1× |
| K Flow/Funct Image W/Drug (78708) | $1,401 | $2,335 | 2.5× |
| K Flow/Funct Image W/O Drug (78707) | $1,326.60 | $2,211 | 2.4× |
| Knee 3 Views (73562) | $339.60 | $566 | 3.8× |
| Lung Perf&Ventilat Diferentl (78598) | $1,501.80 | $2,503 | 2.7× |
| Lung Ventilat&Perfus Imaging (78582) | $1,702.80 | $2,838 | 3.0× |
| Lymph System Imaging (78195) | $1,338.60 | $2,231 | 2.4× |
| Magnetic Image Jaw Joint (70336) | $1,561.80 | $2,603 | 6.3× |
| Meckels Divert Exam (78290) | $838.20 | $1,397 | 2.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $50.40 | $84 | 1.7× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$2,639.40–$3,124.80 | $4,399–$5,208 | varies |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$1,870.20–$18,718.20 | $3,117–$31,197 | varies |
| MRA head with contrast (70545) | $2,209.20 | $3,682 | 6.1× |
| MRA neck w contrast (70548) | $2,107.80 | $3,513 | 5.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,708.40 | $4,514 | 7.5× |
| MRA neck w/o contrast (70547) | $1,648.80 | $2,748 | 6.7× |
| MRI abdomen w contrast (74182) | $2,277 | $3,795 | 6.3× |
| MRI abdomen w/o contrast (74181) | $1,678.20 | $2,797 | 6.8× |
| MRI any jt lower extrem w/contrast material (73722) | $1,999.80 | $3,333 | 2.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,277 | $3,795 | 6.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,670.40 | $2,784 | 2.1× |
| MRI Breast W/O Contrast Bilateral (77047) | $600 | $1,000 | 2.4× |
| MRI cervical spine w/o cont (72141) | $2,097.60 | $3,496 | 8.5× |
| MRI chest w/o contrast (71550) | $2,375.40 | $3,959 | 9.6× |
| MRI chest wo w contrast (71552) | $2,818.20 | $4,697 | 7.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,850.40 | $3,084 | 5.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,990.20 | $3,317 | 5.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,704 | $2,840 | 6.9× |
| MRI lumbar spine w contrast (72149) | $2,355 | $3,925 | 6.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,913.60 | $4,856 | 8.0× |
| MRI orbit face &/neck w/o contrast (70540) | $2,850.60 | $4,751 | 11.5× |
| MRI orbit face neck w contrast (70542) | $2,948.40 | $4,914 | 8.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$2,556–$3,120 | $4,260–$5,200 | varies |
| MRI pelvis w contrast (72196) | $2,284.20 | $3,807 | 6.3× |
| MRI pelvis w/o & w contrast (72197) | $2,445 | $4,075 | 6.7× |
| MRI pelvis w/o contrast (72195) | $1,931.40 | $3,219 | 7.8× |
| MRI thoracic spine w/o contrast (72146) | $2,179.80 | $3,633 | 8.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,554 | $2,590 | 6.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,982.40 | $3,304 | 5.5× |
| MRI, abdomen, combo (74183) | $2,557.80 | $4,263 | 7.1× |
| MRI, dorsal spine combo (72157) | $2,583.60 | $4,306 | 7.1× |
| MRI, joint upper extrem (73221) | $1,456.20 | $2,427 | 5.9× |
| MRI, joint upper extrem combo (73223) | $2,084.40 | $3,474 | 5.8× |
| MRI, lumbar spine combo (72158) | $1,650.60 | $2,751 | 4.6× |
| Myelogram Lumbar (72265) | $1,012.80 | $1,688 | 1.2× |
| Myocardial Spect Multiple Studies (78452) | $2,964 | $4,940 | 2.2× |
| Neck soft tissue (70360) | $203.40 | $339 | 2.3× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$655.20–$997.20 | $1,092–$1,662 | varies |
| Ob us nuchal meas 1 gest (76813) | $223.80 | $373 | 2.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,366.80 | $2,278 | 2.4× |
| Parathyroid Planar Imaging (78070) | $978.60 | $1,631 | 2.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $999 | $1,665 | 2.4× |
| Pelvis 1 or 2 views (72170) | $492 | $820 | 4.5× |
| PET image w/CT, full body (78816) | $4,929.60 | $8,216 | 3.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,789.20 | $7,982 | 3.2× |
| PET whole body (78813) | $4,550.40 | $7,584 | 3.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,057.20 | $1,762 | 2.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $357 | $595 | 3.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $880.20 | $1,467 | 1.6× |
| Radex Ankle Complete Minimum 3 Views (73610) | $270.60 | $451 | 3.0× |
| Radex Calcaneus Minimum 2 Views (73650) | $166.80 | $278 | 1.8× |
| Radex elbow complete minimum 3 views (73080) | $282.60 | $471 | 3.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $343.20 | $572 | 3.2× |
| Radex fingr minimum 2 views (73140) | $184.80 | $308 | 2.0× |
| Radex foot complete minimum 3 views (73630) | $282.60 | $471 | 3.1× |
| Radex Hand Minimum 3 Views (73130) | $267 | $445 | 3.0× |
| Radex lower extremity infant minimum 2 views (73592) | $166.80 | $278 | 1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $225.60 | $376 | 2.5× |
| Radex Ribs Unilateral 2 Views (71100) | $246 | $410 | 2.7× |
| Radex shoulder complete minimum 2 views (73030) | $309.60 | $516 | 3.4× |
| Radex Sinuses Paransl < 3 Views (70210) | $218.40 | $364 | 2.4× |
| Radex Spine 1 View Specify Level (72020) | $199.20 | $332 | 2.2× |
| Radex Sternum Minimum 2 Views (71120) | $166.80 | $278 | 1.8× |
| Radex Toe Minimum 2 Views (73660) | $184.20 | $307 | 2.0× |
| Radex upper extremity infant minimum 2 views (73092) | $223.80 | $373 | 2.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $267 | $445 | 3.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $265.20 | $442 | 2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $309.60 | $516 | 2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $253.20 | $422 | 2.3× |
| Radiologic exam colon double contrast study (74280) | $771 | $1,285 | 4.2× |
| Radiologic exam colon single contrast study (74270) | $618 | $1,030 | 3.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $367.20 | $612 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) | $355.80 | $593 | 3.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $223.80 | $373 | 2.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $454.20 | $757 | 2.5× |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$396–$418.80 | $660–$698 | varies |
| Radiologic exam upr gi trc double contrast study (74246) | $543 | $905 | 3.0× |
| Radiologic examination femur 1 view (73551) | $166.80 | $278 | 1.8× |
| Radiologic examination femur minimum 2 views (73552) | $168 | $280 | 1.9× |
| Radiologic examination knee 1/2 views (73560) | $247.80 | $413 | 2.7× |
| Radiologic Examination Osseous Survey Limited (77074) | $264.60 | $441 | 2.4× |
| Radiologic examination tibia & fibula 2 views (73590) | $252 | $420 | 2.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,520.40 | $2,534 | 2.7× |
| Scapula (73010) | $223.80 | $373 | 2.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$21.60–$51.60 | $36–$86 | varies |
| Shoulder 1 view (73020) | $190.80 | $318 | 2.1× |
| Shoulder Arthrography (73040) | $754.80 | $1,258 | 2.1× |
| Skull less than 4 views (70250) | $223.80 | $373 | 2.1× |
| Sternoclavicular joints (71130) | $170.40 | $284 | 1.9× |
| Thoracic spine 2 views (72070) | $261 | $435 | 2.4× |
| Thoracic spine 3 views (72072) | $333 | $555 | 3.1× |
| Thoracolumbar 2 views (72080) | $238.20 | $397 | 2.6× |
| Thyroid Uptake Measurement (78012) | $459 | $765 | 1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $883.80 | $1,473 | 2.1× |
| Ultrasound Breast Limited (76642) | $267.60 | $446 | 3.0× |
| Ultrasound Exam Aaa Screen (76706) | $297.60 | $496 | 2.7× |
| Ultrasound, abdomen limited (76705) | $339.60 | $566 | 3.1× |
| Upper gi w/o kub (74240) | $408.60 | $681 | 2.2× |
| Urethrocystography retrograde (74450) | $594 | $990 | 2.4× |
| Us breast unilateral complete (76641) | $314.40 | $524 | 2.9× |
| Us chest (76604) | $270 | $450 | 2.5× |
| Us complete joint (76881) | $471.60 | $786 | 4.3× |
| Us exam, pelvic, limited (76857) | $223.80 | $373 | 2.1× |
| Us head (76506) | $480.60 | $801 | 4.4× |
| Us kidney transplant (76776) | $269.40 | $449 | 2.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $303.60 | $506 | 2.8× |
| Us ob detailed single fetus (76811) | $587.40 | $979 | 2.4× |
| Us ob limited 1 or more fetuses (76815) | $271.80 | $453 | 2.5× |
| Us ob transvaginal (76817) | $375.60 | $626 | 3.5× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$223.80–$384.60 | $373–$641 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $330 | $550 | 3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $282.60 | $471 | 2.6× |
| Us retroperitoneal complete (76770) | $503.40 | $839 | 4.6× |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$336–$376.80 | $560–$628 | varies |
| Us scrotum and contents (76870) | $504.60 | $841 | 4.6× |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$329.40–$392.40 | $549–$654 | varies |
| Us thyroid (76536) | $480 | $800 | 4.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,993.20 | $3,322 | 0.6× |
| Venography caval inferior serialography rs&i (75825) | $2,292 | $3,820 | 0.7× |
| Venography extremity bilateral rs&i (75822) | $2,882.40 | $4,804 | 1.8× |
| Venography extremity unilateral rs&i (75820) | $1,009.20 | $1,682 | 0.6× |
| Wrist 2 views (73100) | $186 | $310 | 2.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $238.80 | $398 | 2.6× |
| X-Ray Aorta Leg Arteries (75630) | $2,501.40 | $4,169 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $309 | $515 | 2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $178.80 | $298 | 2.0× |
| X-Ray Exam Breast Specimen (76098) | $358.80 | $598 | 0.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $303 | $505 | 2.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $254.40 | $424 | 2.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $166.80 | $278 | 1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $166.80 | $278 | 1.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $223.80 | $373 | 2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $223.80 | $373 | 2.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $266.40 | $444 | 2.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $240.60 | $401 | 2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $492 | $820 | 4.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $328.80 | $548 | 3.0× |
| X-ray eye for foreign body (70030) | $166.80 | $278 | 1.8× |
| X-ray humerus (73060) | $258.60 | $431 | 2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $166.80 | $278 | 1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $186 | $310 | 2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $303.60 | $506 | 2.8× |
| X-ray nose-rectum child f.b. (76010) | $258 | $430 | 2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $407.40 | $679 | 3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $267 | $445 | 2.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $223.80 | $373 | 2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $231 | $385 | 2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $307.80 | $513 | 3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $322.20 | $537 | 3.0× |
| X-ray thoracic spine 4 vw (72074) | $286.80 | $478 | 2.6× |
| X-Rays Bone Survey Complete (77075) | $591 | $985 | 5.4× |
| Xr c-spine 4 or 5 views (72050) | $369 | $615 | 3.4× |
| Xr facial bones less than 3 views (70140) | $166.80 | $278 | 1.8× |
| Xr orbits complete 4 views (70200) | $359.40 | $599 | 3.3× |
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.