Imaging prices at HCA Florida Fort Walton-Destin Hospital
Fort Walton Beach, FL · every code in this section with a posted price and a Medicare benchmark.
305 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 3-Dimensional radiotherapy plan including dose-volume histograms (77295) | $6,042.65 | $6,042.65 | 4.2× |
| Acute gi blood loss imaging (78278) | $16,799.25 | $16,799.25 | 40.2× |
| Angio adrenal bilat select (75733) | $31,808.20 | $31,808.20 | 9.6× |
| Angio extremity unilateral (75710) | $22,724.70 | $22,724.70 | 6.9× |
| Angio pulmonary unilateral (75741) | $26,833.55 | $26,833.55 | 8.1× |
| Angiogram extremity bilateral (75716) | $26,269.90 | $26,269.90 | 8.0× |
| Angiogram pelvic (75736) | $27,870.90 | $27,870.90 | 4.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) | $29,834.10 | $29,834.10 | 9.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) | $24,308.65 | $24,308.65 | 4.2× |
| Angrph cath f-up std tcat other than thrombylsis (75898) | $2,268.75 | $2,268.75 | 0.7× |
| Ankle 2 views (73600) | $2,644 | $2,644 | 29.1× |
| Arthrography knee lt (73580) | $12,339.75 | $12,339.75 | 33.9× |
| Arthrography wrist lt (73115) | $12,339.75 | $12,339.75 | 33.9× |
| Barium enema (74270) | $7,033.45 | $7,033.45 | 38.4× |
| Basic dosimetry (77300) | $306.25 | $306.25 | 2.2× |
| Bone age studies (77072) | $1,258.80 | $1,258.80 | 11.5× |
| Bone imaging limited area (78300) | $18,358.50 | $18,358.50 | 44.0× |
| Bone survey complete (77075) | $746.02 | $746.02 | 6.8× |
| Bowel imaging (78290) | $11,839.80 | $11,839.80 | 28.4× |
| Brain image w/flow 4 + views (78606) | $14,460.60 | $14,460.60 | 25.5× |
| Card MRI w/stress img & dye (75563) | $2,472.10 | $2,472.10 | 3.0× |
| Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and… (78473) | $14,168.15 | $14,168.15 | 33.9× |
| Cardiac MRI w/stress img (75559) | $1,701 | $1,701 | 3.0× |
| Cardiac MRI w/wo contrast & further seq (75561) | $1,185.85 | $1,185.85 | 3.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) | $4,185.75 | $4,185.75 | 22.9× |
| Cisternogram (78630) | $12,015.20 | $12,015.20 | 21.2× |
| Clavicle complete (73000) | $2,916 | $2,916 | 32.1× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) | $19,700.28 | $19,700.28 | 107.6× |
| Continuing medical physics consltj pr wk (77336) | $682.05 | $682.05 | 4.9× |
| Contrast exam abdominl aorta (75625) | $28,870.30 | $28,870.30 | 8.8× |
| Contrast exam thoracic aorta (75605) | $28,131.78 | $28,131.78 | 4.8× |
| CT - st neck w&wo contr (70492) | $25,573.85 | $25,573.85 | 139.6× |
| CT abdomen and pelvis without and with contrast (74178) | $37,183.10 | $37,183.10 | 102.1× |
| CT abdomen and pelvis without contrast (74176) | $29,200.90 | $29,200.90 | 117.2× |
| CT abdomen w wo contrast (74170) | $25,573.85 | $25,573.85 | 139.6× |
| CT abdomen w/contrast (74160) | $22,954.90 | $22,954.90 | 125.3× |
| CT abdomen w/o contrast (74150) | $15,443 | $15,443 | 141.5× |
| CT angio abd&plvis cntrst mtrl w/wo cntrst imges (74174) | $37,151 | $37,151 | 102.0× |
| CT angio abdom w/o & w/dye (74175) | $13,653.85 | $13,653.85 | 74.5× |
| CT angio abdominal arteries (75635) | $16,806.95 | $16,806.95 | 91.8× |
| CT angio hrt w/3d image (75574) | $25,572.10 | $25,572.10 | 70.2× |
| CT angiograph pelv w/o&w/dye (72191) | $14,550 | $14,550 | 79.4× |
| CT cervical spine w/contrast (72126) | $23,294.70 | $23,294.70 | 63.9× |
| CT cervical spine w/o contrast (72125) | $16,767 | $16,767 | 153.6× |
| CT chest w/contrast (71260) | $22,530 | $22,530 | 123.0× |
| CT head/brain with contrast (70460) | $20,639 | $20,639 | 112.7× |
| CT head/brain without and with contrast (70470) | $23,294.70 | $23,294.70 | 127.2× |
| CT hrt w/3d image congen (75573) | $14,078.25 | $14,078.25 | 38.6× |
| CT limited/localized follow up study (76380) | $2,036.95 | $2,036.95 | 22.4× |
| CT lower ext w/wo contrast (73702) | $23,294.85 | $23,294.85 | 127.2× |
| CT lower extremity w contrast (73701) | $15,682 | $15,682 | 85.6× |
| CT lower extremity w/o contrast unilateral (73700) | $14,287.50 | $14,287.50 | 130.9× |
| CT lumbar spine w/contrast (72132) | $21,078 | $21,078 | 57.9× |
| CT lumbar spine w/o contrast (72131) | $16,736 | $16,736 | 153.3× |
| CT lumbar spine w/o then w/ con (72133) | $23,294.70 | $23,294.70 | 127.2× |
| CT maxillofacial area w/o contrast (70486) | $14,003.72 | $14,003.72 | 128.3× |
| CT maxillofacial w/contrast (70487) | $21,078 | $21,078 | 115.1× |
| CT maxillofacial w/o then w/ con (70488) | $35,372.70 | $35,372.70 | 193.1× |
| CT orbit sella ear w/o con (70480) | $14,299 | $14,299 | 131.0× |
| CT orbit/ear/fossa w/o then w/ con (70482) | $4,565.80 | $4,565.80 | 24.9× |
| CT pelvis w & w/o contrast (72194) | $23,294.70 | $23,294.70 | 127.2× |
| CT pelvis w/o contrast (72192) | $13,774.75 | $13,774.75 | 126.2× |
| CT soft tissue neck w/contrast (70491) | $25,177 | $25,177 | 137.5× |
| CT soft tissue neck w/o contrast (70490) | $14,301 | $14,301 | 131.0× |
| CT spine cervical w/wo contrast (72127) | $23,294.70 | $23,294.70 | 127.2× |
| CT thoracic spine w/contrast (72129) | $21,206 | $21,206 | 115.8× |
| CT thoracic spine w/o contrast (72128) | $14,354.82 | $14,354.82 | 131.5× |
| CT thoracic spine w/o then w/ con (72130) | $1,883.50 | $1,883.50 | 10.3× |
| CT thorax lung cancer scr c- (71271) | $461.45 | $461.45 | 4.2× |
| CT thorax w/o contrast (71250) | $14,299 | $14,299 | 131.0× |
| CT thorax w/o then w/ contrast (71270) | $25,573.85 | $25,573.85 | 139.6× |
| CT upper extremity w/dye (73201) | $14,287.50 | $14,287.50 | 39.2× |
| CT upper extremity w/o contrast rt (73200) | $14,247.25 | $14,247.25 | 130.5× |
| CTA chest w/wo contrast (71275) | $14,947 | $14,947 | 81.6× |
| CTA head w contrast (70496) | $13,653.85 | $13,653.85 | 74.5× |
| CTA lower extremity w/wo contrast unilateral (73706) | $30,025 | $30,025 | 163.9× |
| Cta Neck (70498) | $14,470 | $14,470 | 79.0× |
| CTA upper extremity w/wo contrast unilateral (73206) | $15,021 | $15,021 | 82.0× |
| Discography, cervical or thoracic, radiological supervision and interpretation Other Diagnostic Radiology FS (72285) | $13,338.60 | $13,338.60 | 6.5× |
| Diskography lumbar (72295) | $13,145.98 | $13,145.98 | 6.4× |
| Esophogram (74220) | $6,800.60 | $6,800.60 | 37.1× |
| Fetal biophysical profile non-stress testing (76818) | $946 | $946 | 8.7× |
| Fetal biophysical profile w/o nst (76819) | $2,353.95 | $2,353.95 | 21.6× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) | $2,691.25 | $2,691.25 | 10.8× |
| Gastric emptying study (78264) | $12,469.30 | $12,469.30 | 29.9× |
| Gated heart planar single (78472) | $13,072.65 | $13,072.65 | 31.3× |
| Hepatobil syst image w/drug (78227) | $22,957.90 | $22,957.90 | 40.5× |
| Hepatobiliary system imaging (78226) | $22,957.90 | $22,957.90 | 55.0× |
| Humerus min 2 views (73060) | $2,986.02 | $2,986.02 | 32.9× |
| Hysterosalpingography (74740) | $16,549.80 | $16,549.80 | 66.4× |
| Ivp (74400) | $11,859.38 | $11,859.38 | 64.7× |
| Ivp w tomography (74415) | $20,731.55 | $20,731.55 | 113.2× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) | $21,493.35 | $21,493.35 | 37.9× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) | $2,099.45 | $2,099.45 | 3.7× |
| Liver & spleen; static only (78215) | $11,482.20 | $11,482.20 | 27.5× |
| Lung perf&ventilat diferentl (78598) | $26,253 | $26,253 | 46.3× |
| Lung perfusion differential (78597) | $16,778.65 | $16,778.65 | 40.2× |
| Lung ventilat&perfus imaging (78582) | $26,253 | $26,253 | 46.3× |
| Lung ventilation imaging (78579) | $16,778.65 | $16,778.65 | 40.2× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) | $17,266.75 | $17,266.75 | 47.4× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) | $20,154.35 | $20,154.35 | 55.3× |
| Mammary ductogram multiple ducts (77054) | $5,014.85 | $5,014.85 | 20.1× |
| Mammary ductogram single (77053) | $4,379.10 | $4,379.10 | 17.6× |
| MRA head w & w/o contrast (70546) | $20,154.35 | $20,154.35 | 55.3× |
| MRA head w/o contrast (70544) | $13,999.75 | $13,999.75 | 56.2× |
| MRA neck w/o contrast (70547) | $13,999.75 | $13,999.75 | 56.2× |
| MRA neck w/wo contrast (70549) | $20,154.35 | $20,154.35 | 55.3× |
| MRI abdomen w/contrast (74182) | $14,562.70 | $14,562.70 | 40.0× |
| MRI abdomen w/o & w/contrast material (74183) | $20,154.35 | $20,154.35 | 55.3× |
| MRI abdomen w/o contrast (74181) | $13,999.75 | $13,999.75 | 56.2× |
| MRI any jnt lwr ext with con lt (73722) | $13,999.75 | $13,999.75 | 17.1× |
| MRI breast without contrast bilateral (77047) | $1,221.25 | $1,221.25 | 4.9× |
| MRI breast without contrast material unilateral (77046) | $1,221.25 | $1,221.25 | 4.9× |
| MRI cardiac w/o contrast (75557) | $13,999.75 | $13,999.75 | 56.2× |
| MRI cervical spine w/o contrast (72141) | $13,999.75 | $13,999.75 | 56.2× |
| MRI cervical spine with contrast (72142) | $14,562.70 | $14,562.70 | 40.0× |
| MRI chest w & w/o contrast (71552) | $20,154.35 | $20,154.35 | 55.3× |
| MRI chest w/o contrast (71550) | $13,999.75 | $13,999.75 | 56.2× |
| MRI joint upper ext w/contrast (73222) | $13,999.75 | $13,999.75 | 17.1× |
| MRI joint upr extr w/o&w/dye (73223) | $20,153.25 | $20,153.25 | 55.3× |
| MRI joint upr extrem w/o dye (73221) | $13,999.75 | $13,999.75 | 56.2× |
| Mri Lower Extremity W/O Dye (73718) | $13,999.75 | $13,999.75 | 56.2× |
| MRI lumbar spine with contrast (72149) | $14,562.70 | $14,562.70 | 40.0× |
| MRI lumbar w/wo contrast (72158) | $20,154.35 | $20,154.35 | 55.3× |
| MRI lwr ext w/o jnts with con rt (73719) | $13,999.75 | $13,999.75 | 38.4× |
| MRI orbit/face/neck w/contrast (70542) | $14,562.70 | $14,562.70 | 40.0× |
| MRI orbit/face/neck w/o & w/contrast (70543) | $20,154.35 | $20,154.35 | 55.3× |
| MRI orbit/face/neck w/o contrast (70540) | $13,999.75 | $13,999.75 | 56.2× |
| MRI pelvis w/ contrast (72196) | $17,369.55 | $17,369.55 | 47.7× |
| MRI pelvis w/o contrast (72195) | $13,999.75 | $13,999.75 | 56.2× |
| MRI pelvis w/wo contrast (72197) | $20,154.35 | $20,154.35 | 55.3× |
| MRI spectroscopy (76390) | $13,999.75 | $13,999.75 | 154.0× |
| MRI spine cervical wo/w contrast (72156) | $20,154.35 | $20,154.35 | 55.3× |
| MRI spine thoracic w/contrast (72147) | $14,562.70 | $14,562.70 | 40.0× |
| MRI thoracic spine w wo contrast (72157) | $20,154.35 | $20,154.35 | 55.3× |
| MRI thoracic spine w/o contrast (72146) | $13,999.75 | $13,999.75 | 56.2× |
| MRI tmj (70336) | $20,154.35 | $20,154.35 | 80.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $13,999.75 | $13,999.75 | 56.2× |
| Mri Upper Extremity W/Dye (73219) | $13,999.75 | $13,999.75 | 38.4× |
| MRI upr ext w/o jnts w/o-w/con rt (73220) | $20,154.35 | $20,154.35 | 55.3× |
| Myelogram thoracic (72255) | $22,044.45 | $22,044.45 | 26.9× |
| Myelography 2 or more regions (72270) | $27,985.90 | $27,985.90 | 34.2× |
| Myelography lumbosacral (72265) | $22,044.45 | $22,044.45 | 26.9× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) | $15,500.90 | $15,500.90 | 10.4× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) | $15,500.90 | $15,500.90 | 10.4× |
| Myocardial spect single study at rest or stress (78451) | $25,796.95 | $25,796.95 | 19.1× |
| Myocrd img PET metab eval single study (78459) | $15,500.90 | $15,500.90 | 11.5× |
| Nm bone 3 phase (78315) | $26,980.60 | $26,980.60 | 64.6× |
| Nm bone imaging whole body (78306) | $23,276.75 | $23,276.75 | 55.8× |
| Nm bone marrow scan limited (78102) | $2,498.90 | $2,498.90 | 6.0× |
| Nm heart perfusion spect stress rest (78452) | $60,799.90 | $60,799.90 | 45.0× |
| Nm kidney function (78725) | $19,860.70 | $19,860.70 | 47.6× |
| Nm lymph system (78195) | $16,562.45 | $16,562.45 | 29.2× |
| Nm myocard infarct spect (78469) | $9,717.45 | $9,717.45 | 17.1× |
| Nm thyroid imaging only (78013) | $14,047.35 | $14,047.35 | 33.6× |
| Nose to rectum for fb child (76010) | $468.95 | $468.95 | 5.2× |
| Nuclear rx IV admin (79101) | $2,424.80 | $2,424.80 | 10.0× |
| Ob us < 14 wks single fetus (76801) | $8,205.55 | $8,205.55 | 75.2× |
| Orthopantogram (70355) | $1,756.10 | $1,756.10 | 19.3× |
| Parathyroid imaging (78070) | $10,215 | $10,215 | 24.5× |
| PET brain metabolic eval (78608) | $15,500.90 | $15,500.90 | 10.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $15,500.90 | $15,500.90 | 10.4× |
| PET imaging for CT attenuation whole body (78816) | $15,500.90 | $15,500.90 | 10.4× |
| Pulmonary perfusion imaging particulate (78580) | $16,778.65 | $16,778.65 | 40.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $3,323.45 | $3,323.45 | 5.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) | $432.55 | $432.55 | 4.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) | $713.85 | $713.85 | 6.5× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) | $1,353.50 | $1,353.50 | 12.4× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) | $1,353.50 | $1,353.50 | 12.4× |
| Radex hip unilateral with pelvis 1 view (73501) | $432.55 | $432.55 | 4.8× |
| Radex hip unilateral with pelvis 2-3 views (73502) | $432.55 | $432.55 | 4.8× |
| Radex hip unilateral with pelvis minimum 4 views (73503) | $713.85 | $713.85 | 6.5× |
| Radex hips bilateral with pelvis 2 views (73521) | $713.65 | $713.65 | 6.5× |
| Radex hips bilateral with pelvis minimum 5 views (73523) | $1,353.50 | $1,353.50 | 12.4× |
| Radex spine cervical 2 or 3 views (72040) | $3,356.58 | $3,356.58 | 36.9× |
| Radex spine cervical 4 or 5 views (72050) | $5,002.22 | $5,002.22 | 45.8× |
| Radex spine cervical 6 or more views (72052) | $4,107.32 | $4,107.32 | 37.6× |
| Radiologic Exam Chest 4+ Views - Xr Chest 4+ Views (71048) | $698.60 | $698.60 | 6.4× |
| Radiologic exam esophagus double contrast study (74221) | $997.50 | $997.50 | 5.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $8,854.10 | $8,854.10 | 48.3× |
| Radiologic exam upr gi trc single contrast study (74240) | $899 | $899 | 4.9× |
| Radiologic Examination Femur 1 View - Xr Femur 1 Vw Right (73551) | $432.55 | $432.55 | 4.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) | $432.55 | $432.55 | 4.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $13,040.35 | $13,040.35 | 31.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $7,162.50 | $7,162.50 | 17.2× |
| Rp loclzj tum plnr whole body 2+ days imaging (78804) | $21,902.55 | $21,902.55 | 38.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) | $16,692.55 | $16,692.55 | 29.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) | $7,088.05 | $7,088.05 | 12.5× |
| Saline infused sonohysterogram (76831) | $2,788.30 | $2,788.30 | 11.2× |
| Screening digital breast tomosynthesis; bilateral (77063) | $368.25 | $368.25 | 15.8× |
| Shoulder arthrogram (73040) | $17,917.70 | $17,917.70 | 49.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) | $1,380.12 | $1,380.12 | 12.6× |
| Simulation complex (77290) | $1,329.15 | $1,329.15 | 3.4× |
| Simulation simple (77280) | $749.85 | $749.85 | 5.3× |
| Small bowel series (74250) | $7,023.25 | $7,023.25 | 38.3× |
| Special dosimetry (77331) | $701.40 | $701.40 | 5.0× |
| Special physics consult (77370) | $641.85 | $641.85 | 4.6× |
| Special treatment procedure (77470) | $2,272.95 | $2,272.95 | 3.9× |
| Testicular imaging w/flow (78761) | $1,497.30 | $1,497.30 | 3.6× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) | $18,556.50 | $18,556.50 | 44.4× |
| Treatment devices complex (77334) | $701.40 | $701.40 | 1.8× |
| Ultrasound breast limited (76642) | $645.75 | $645.75 | 7.1× |
| Ultrasound, abdomen limited (76705) | $6,140 | $6,140 | 56.2× |
| Unlisted diagnostic radiographic procedure (76499) | $559.30 | $559.30 | 6.2× |
| Unlisted fluoroscopic procedure (76496) | $976.30 | $976.30 | 10.7× |
| Ureteral reflux study (78740) | $16,558.35 | $16,558.35 | 39.7× |
| Urethrocystography retrograde rs&i (74450) | $4,989.10 | $4,989.10 | 20.0× |
| Urethrocystography voiding (74455) | $7,187.65 | $7,187.65 | 28.8× |
| Urography antegrade (74425) | $5,742.40 | $5,742.40 | 15.8× |
| Urography retrograde w/wo kub (74420) | $7,805.85 | $7,805.85 | 21.4× |
| Us abdominal aorta real time screen study aaa (76706) | $7,598.10 | $7,598.10 | 69.6× |
| Us breast uni real time with image complete (76641) | $645.75 | $645.75 | 5.9× |
| Us chest (76604) | $2,276.45 | $2,276.45 | 20.9× |
| Us compl joint r-t w/image documentation (76881) | $8,077.58 | $8,077.58 | 74.0× |
| Us encephalogram (76506) | $4,807.10 | $4,807.10 | 44.0× |
| Us guided compression repair (76936) | $7,492.35 | $7,492.35 | 33.2× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) | $6,638.45 | $6,638.45 | 73.0× |
| Us inft hips r-t img lmtd static phys/qhp manj (76886) | $8,077.58 | $8,077.58 | 88.9× |
| Us lmtd jt/fcl eval nonvasc xtr strux r-t w/img (76882) | $5,177.35 | $5,177.35 | 47.4× |
| Us ob detailed single fetus (76811) | $8,167 | $8,167 | 32.8× |
| Us ob followup per fetus (76816) | $1,509.12 | $1,509.12 | 13.8× |
| Us ob limited 1 or more fetuses (76815) | $1,495.82 | $1,495.82 | 13.7× |
| Us obstetric transvaginal (76817) | $3,773.68 | $3,773.68 | 34.6× |
| Us pelvic limited or f/u non-ob (76857) | $7,152.60 | $7,152.60 | 65.5× |
| Us pelvis complete (76856) | $9,054.25 | $9,054.25 | 82.9× |
| Us retroperitoneal complete (76770) | $7,038.20 | $7,038.20 | 64.5× |
| Us retroperitoneal limited (76775) | $7,631.88 | $7,631.88 | 69.9× |
| Us scrotum (76870) | $6,847.10 | $6,847.10 | 62.7× |
| Us soft tissue head/neck (76536) | $4,152.35 | $4,152.35 | 38.0× |
| Us spinal canal (76800) | $3,305.65 | $3,305.65 | 30.3× |
| Venogram extremity bilateral (75822) | $12,095 | $12,095 | 7.4× |
| Venogram ivc w serialography (75825) | $12,077.60 | $12,077.60 | 3.7× |
| Venogram svc w serialography (75827) | $12,077.60 | $12,077.60 | 7.3× |
| Venography ext unilateral (75820) | $8,189 | $8,189 | 5.0× |
| Venography venous sinus/jugular cath rs&i (75860) | $6,153.45 | $6,153.45 | 1.9× |
| Venous sampling by catheter (75893) | $10,291.30 | $10,291.30 | 1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $2,487.72 | $2,487.72 | 27.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) | $4,305.50 | $4,305.50 | 47.4× |
| X-ray aorta leg arteries (75630) | $40,779.60 | $40,779.60 | 12.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) | $9,460.25 | $9,460.25 | 51.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) | $4,155.50 | $4,155.50 | 45.7× |
| X-ray exam hips bi 3-4 views (73522) | $713.85 | $713.85 | 6.5× |
| X-ray exam of finger(s) (73140) | $2,458.35 | $2,458.35 | 27.1× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) | $12,439.60 | $12,439.60 | 67.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) | $2,668.75 | $2,668.75 | 29.4× |
| X-Ray Foot 2 Vw - Xr Foot 1-2 Views Right (73620) | $2,816 | $2,816 | 31.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) | $4,106 | $4,106 | 45.2× |
| X-Ray Hand 3+ Vw - Xr Hand 3+ Views Right (73130) | $3,358 | $3,358 | 36.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) | $2,633.50 | $2,633.50 | 29.0× |
| X-Ray Knee 3 View - Xr Knee 3 Views Right (73562) | $4,219 | $4,219 | 46.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) | $4,440.40 | $4,440.40 | 40.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,660.90 | $1,660.90 | 15.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) | $4,061.85 | $4,061.85 | 37.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) | $990.95 | $990.95 | 10.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $3,645.55 | $3,645.55 | 33.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $3,645.70 | $3,645.70 | 33.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $3,621.52 | $3,621.52 | 39.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) | $3,808.50 | $3,808.50 | 41.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $4,175.48 | $4,175.48 | 45.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $3,474.88 | $3,474.88 | 31.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) | $2,388.18 | $2,388.18 | 21.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) | $3,086.30 | $3,086.30 | 34.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) | $1,751.32 | $1,751.32 | 19.3× |
| X-Ray Wrist 2 Vw - Xr Wrist 1-2 Views Right (73100) | $904.98 | $904.98 | 10.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) | $1,863.98 | $1,863.98 | 20.5× |
| Xr abdomen 1 view (74018) | $363.80 | $363.80 | 4.0× |
| Xr abdomen 2 views (74019) | $698.60 | $698.60 | 6.4× |
| Xr abdomen 3 views (74021) | $698.60 | $698.60 | 6.4× |
| Xr arthrogram ankle (73615) | $12,339.75 | $12,339.75 | 33.9× |
| Xr arthrogram elbow (73085) | $12,339.75 | $12,339.75 | 33.9× |
| Xr arthrogram hip (73525) | $11,737.10 | $11,737.10 | 32.2× |
| Xr bone length study (77073) | $1,852.25 | $1,852.25 | 17.0× |
| Xr bone survey infant (77076) | $746.02 | $746.02 | 6.8× |
| Xr bone survey limited (77074) | $4,070 | $4,070 | 37.3× |
| Xr chest 1 view (71045) | $363.80 | $363.80 | 4.0× |
| Xr chest 2 views (71046) | $363.80 | $363.80 | 4.0× |
| Xr chest 3 views (71047) | $363.80 | $363.80 | 4.0× |
| Xr cystogram 3+ views (74430) | $4,934.45 | $4,934.45 | 13.5× |
| Xr eye foreign body (70030) | $2,406 | $2,406 | 26.5× |
| Xr facial bones 3 views (70150) | $4,067.02 | $4,067.02 | 37.3× |
| Xr lower extremity 2 views infant (73592) | $2,337.15 | $2,337.15 | 25.7× |
| Xr lumbar spine 4 views w/ flex ext (72120) | $749.15 | $749.15 | 6.9× |
| Xr mandible 4 views (70110) | $4,472.55 | $4,472.55 | 41.0× |
| Xr myelogram c-spine (72240) | $22,044.45 | $22,044.45 | 26.9× |
| Xr nasal bones (70160) | $2,780.75 | $2,780.75 | 30.6× |
| Xr pelvis 3 views (72190) | $2,672.80 | $2,672.80 | 24.5× |
| Xr spine 1 view (72020) | $3,100.40 | $3,100.40 | 34.1× |
| Xr sternum 2 views (71120) | $3,191.45 | $3,191.45 | 35.1× |
| Xr surgical specimen (76098) | $3,184 | $3,184 | 5.6× |
| Xr upper extremity 2 views infant (73092) | $1,656.40 | $1,656.40 | 15.2× |
| Xray elbow 2 views (73070) | $2,449.70 | $2,449.70 | 27.0× |
| Xray forearm 2 views (73090) | $3,257 | $3,257 | 35.8× |
| Xray knee 1 or 2 views rt (73560) | $2,376 | $2,376 | 26.1× |
| Xray neck soft tissue (70360) | $3,372.58 | $3,372.58 | 37.1× |
| Xray orbits complete min 4 views (70200) | $4,537.65 | $4,537.65 | 41.6× |
| Xray pelvis 1 or 2 views (72170) | $3,120.15 | $3,120.15 | 28.6× |
| Xray ribs bilateral 3 views (71110) | $3,776.75 | $3,776.75 | 34.6× |
| Xray ribs unilat w/ pa chest 3v rt (71101) | $343.45 | $343.45 | 3.1× |
| Xray scapula complete (73010) | $2,082.85 | $2,082.85 | 19.1× |
| Xray shoulder 1 view (73020) | $742.68 | $742.68 | 8.2× |
| Xray sinuses paranasal <3 views (70210) | $2,374.25 | $2,374.25 | 26.1× |
| Xray spine thoracic 2 views (72070) | $4,100 | $4,100 | 37.6× |
| Xray spine thoracic 3 views (72072) | $4,310.40 | $4,310.40 | 39.5× |
| Xray tibia-fibula 2 views bil (73590) | $4,219 | $4,219 | 46.4× |
| Xray tmj's bilateral open-clsc (70330) | $369.75 | $369.75 | 4.1× |