Imaging prices at Hedrick Medical Center
Chillicothe, MO · every code in this section with a posted price and a Medicare benchmark.
260 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) | $150.60 | $251 | 1.7× |
| Abdomen 2 views (74019) | $196.80 | $328 | 1.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $900 | $1,500 | 2.2× |
| Adrenal Cortex & Medulla Img (78075) | $750 | $1,250 | 0.6× |
| Ankle 2 views (73600) range across 12 matching MRF lines |
$234.60–$392.40 | $391–$654 | varies |
| Bone age studies (77072) | $159.60 | $266 | 1.5× |
| Bone Imaging 3 Phase (78315) | $1,038 | $1,730 | 2.6× |
| Bone Imaging Limited Area (78300) | $795 | $1,325 | 2.0× |
| Bone Imaging Whole Body (78306) | $1,050 | $1,750 | 2.6× |
| Bone marrow imaging limited area (78102) | $435 | $725 | 1.1× |
| Bone survey infant (77076) | $353.40 | $589 | 3.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $900 | $1,500 | 1.7× |
| Chest 1 view (71045) | $160.80 | $268 | 1.8× |
| Chest 2 views (71046) | $192.60 | $321 | 2.2× |
| Chest 3 views (71047) | $224.40 | $374 | 2.6× |
| Clavicle complete (73000) range across 8 matching MRF lines |
$183–$274.80 | $305–$458 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $144 | $240 | 1.4× |
| Contrast X-Ray Bladder (74430) | $521.40 | $869 | 1.5× |
| Contrast X-Ray Of Elbow (73085) | $436.20 | $727 | 1.2× |
| Contrast X-Ray Of Knee Joint (73580) | $700.20 | $1,167 | 2.0× |
| CT abdomen and pelvis without and with contrast (74178) | $2,346 | $3,910 | 6.7× |
| CT abdomen and pelvis without contrast (74176) | $1,926 | $3,210 | 8.1× |
| CT abdomen w contrast (74160) | $1,416 | $2,360 | 8.1× |
| CT abdomen w wo contrast (74170) | $1,716 | $2,860 | 9.8× |
| CT abdomen w/o contrast (74150) | $1,236 | $2,060 | 11.8× |
| CT Angio Abdomen and Pelvis (74174) | $2,583 | $4,305 | 7.4× |
| CT Angio Chest (71275) | $1,722 | $2,870 | 9.8× |
| CT Angio Head (70496) | $1,722 | $2,870 | 9.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$1,722–$2,583 | $2,870–$4,305 | varies |
| CT Angio Neck (70498) | $1,722 | $2,870 | 9.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,722 | $2,870 | 9.8× |
| CT cervical spine w/ contrast (72126) | $1,437.60 | $2,396 | 4.1× |
| CT cervical spine w/o contrast (72125) | $1,257.60 | $2,096 | 12.0× |
| CT cervical spine w/wo cont (72127) | $1,737.60 | $2,896 | 9.9× |
| CT chest w contrast (71260) | $1,407.60 | $2,346 | 8.0× |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$1,527.60–$1,767.60 | $2,546–$2,946 | varies |
| CT head/brain with contrast (70460) | $1,312.80 | $2,188 | 7.5× |
| CT head/brain without and with contrast (70470) | $1,612.80 | $2,688 | 9.2× |
| CT iac w contrast (70481) | $1,319.40 | $2,199 | 7.5× |
| CT l-spine w&w/o contrast (72133) | $1,737.60 | $2,896 | 9.9× |
| CT lower ext w/o (73700) range across 8 matching MRF lines |
$1,033.80–$3,102 | $1,723–$5,170 | varies |
| CT lower extremity w/contrast material (73701) range across 6 matching MRF lines |
$1,213.80–$1,821 | $2,023–$3,035 | varies |
| CT lumbar spine w contrast (72132) | $1,437.60 | $2,396 | 4.1× |
| CT lumbar spine w/o contrast (72131) | $1,257.60 | $2,096 | 12.0× |
| CT maxillofacial w contrast (70487) | $1,215 | $2,025 | 6.9× |
| CT maxillofacial wo contrast (70486) | $1,035 | $1,725 | 9.9× |
| CT neck tissue combo (70492) | $1,530 | $2,550 | 8.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,619.40 | $2,699 | 9.2× |
| CT orbits w/o contrast (70480) | $1,139.40 | $1,899 | 10.9× |
| CT pelvis w&w/o contrast (72194) | $1,680 | $2,800 | 9.6× |
| CT pelvis w/o contrast (72192) | $1,200 | $2,000 | 11.5× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,513.80–$2,271 | $2,523–$3,785 | varies |
| CT scans face/jaw combo (70488) | $1,515 | $2,525 | 8.6× |
| CT soft tissue neck w contrast (70491) | $1,230 | $2,050 | 7.0× |
| CT soft tissue neck w/o contrast (70490) | $1,050 | $1,750 | 10.0× |
| CT thoracic spine w contrast (72129) | $1,437.60 | $2,396 | 8.2× |
| CT thoracic spine w/o contrast (72128) | $1,257.60 | $2,096 | 12.0× |
| CT thoracic spine w/wo cont (72130) | $1,737.60 | $2,896 | 9.9× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$1,227.60–$1,347.60 | $2,046–$2,246 | varies |
| CT upper ext wo (73200) range across 6 matching MRF lines |
$1,033.80–$1,551 | $1,723–$2,585 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,513.80–$2,271 | $2,523–$3,785 | varies |
| CT upper extremity with contrast (73201) range across 6 matching MRF lines |
$1,213.80–$1,821 | $2,023–$3,035 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,722 | $2,870 | 9.8× |
| Cta Abdomen (74175) | $1,722 | $2,870 | 9.8× |
| CTA pelvis (72191) | $1,722 | $2,870 | 9.8× |
| Dxa Bone Density Axial (77080) | $268.80 | $448 | 2.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $109.80 | $183 | 1.3× |
| Echo Guide For Artery Repair (76936) | $1,062 | $1,770 | 4.9× |
| Esophagram (74220) | $348.60 | $581 | 2.0× |
| Fetal Biophys Profile W/Nst (76818) range across 6 matching MRF lines |
$336–$664.80 | $560–$1,108 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$222–$444 | $370–$740 | varies |
| Fluoroscopy up to 1 hr (76000) | $439.20 | $732 | 1.8× |
| Foot 2 views (73620) range across 30 matching MRF lines |
$174–$261 | $290–$435 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$180–$270 | $300–$450 | varies |
| Gastric emptying imaging study (78264) | $960 | $1,600 | 2.4× |
| Gastroesophageal Reflux Exam (78262) | $861 | $1,435 | 2.2× |
| Gated Heart Planar Single (78472) | $921 | $1,535 | 2.3× |
| Hand 2 views (73120) range across 12 matching MRF lines |
$192.60–$289.20 | $321–$482 | varies |
| Hepatobil Syst Image W/Drug (78227) | $960 | $1,600 | 1.8× |
| Hepatobiliary System Imaging (78226) | $900 | $1,500 | 2.2× |
| Ht Muscle Image Spect Sing (78451) | $3,321 | $5,535 | 2.6× |
| Hysterosalpingogram (74740) | $491.40 | $819 | 2.1× |
| Joint Survey Single View (77077) | $223.20 | $372 | 2.1× |
| K Flow/Funct Image Multiple (78709) | $1,596 | $2,660 | 2.9× |
| K Flow/Funct Image W/Drug (78708) | $1,011 | $1,685 | 1.9× |
| K Flow/Funct Image W/O Drug (78707) | $1,200 | $2,000 | 2.2× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$212.40–$318.60 | $354–$531 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,333.80 | $2,223 | 3.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $745.80 | $1,243 | 1.9× |
| Liver imaging static only (78201) | $1,032 | $1,720 | 1.9× |
| Lung Perf&Ventilat Diferentl (78598) | $2,007 | $3,345 | 3.7× |
| Lung perfusion differential (78597) | $822 | $1,370 | 2.1× |
| Lung Ventilat&Perfus Imaging (78582) | $1,611 | $2,685 | 3.0× |
| Magnetic Image Jaw Joint (70336) | $1,485 | $2,475 | 6.2× |
| Meckels Divert Exam (78290) | $720 | $1,200 | 1.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $110.40 | $184 | 1.2× |
| Mra Head W/O & W/Contrast Material (70546) | $2,001 | $3,335 | 5.7× |
| MRA head w/o contrast (70544) | $1,521 | $2,535 | 6.4× |
| MRA head with contrast (70545) | $1,701 | $2,835 | 4.9× |
| MRA neck w contrast (70548) | $1,773 | $2,955 | 5.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,073 | $3,455 | 5.9× |
| MRA neck w/o contrast (70547) | $1,593 | $2,655 | 6.7× |
| MRI abdomen w contrast (74182) | $1,830 | $3,050 | 5.2× |
| MRI abdomen w/o contrast (74181) | $1,650 | $2,750 | 6.9× |
| MRI any jt lower extrem w/contrast material (73722) | $1,722 | $2,870 | 2.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,022 | $3,370 | 5.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,722 | $2,870 | 2.2× |
| MRI cervical spine w contrast (72142) | $1,908 | $3,180 | 5.5× |
| MRI cervical spine w/o cont (72141) | $1,728 | $2,880 | 7.2× |
| MRI chest w/o contrast (71550) | $1,650 | $2,750 | 6.9× |
| MRI chest with contrast (71551) | $1,830 | $3,050 | 2.3× |
| MRI chest wo w contrast (71552) | $2,130 | $3,550 | 6.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$1,722–$2,583 | $2,870–$4,305 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,902–$2,853 | $3,170–$4,755 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 9 matching MRF lines |
$1,542–$2,313 | $2,570–$3,855 | varies |
| MRI lumbar spine w contrast (72149) | $1,908 | $3,180 | 5.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,208 | $3,680 | 6.3× |
| MRI orbit face &/neck w/o contrast (70540) | $1,356 | $2,260 | 5.7× |
| MRI orbit face neck w contrast (70542) | $1,536 | $2,560 | 4.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,836 | $3,060 | 5.3× |
| MRI pelvis w contrast (72196) | $1,833 | $3,055 | 5.2× |
| MRI pelvis w/o & w contrast (72197) | $2,133 | $3,555 | 6.1× |
| MRI pelvis w/o contrast (72195) | $1,653 | $2,755 | 6.9× |
| MRI spectroscopy (76390) | $126 | $210 | 1.4× |
| MRI thoracic spine w/o contrast (72146) | $1,728 | $2,880 | 7.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,722 | $2,870 | 4.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 10 matching MRF lines |
$1,542–$2,313 | $2,570–$3,855 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 10 matching MRF lines |
$2,022–$3,033 | $3,370–$5,055 | varies |
| MRI, abdomen, combo (74183) | $2,130 | $3,550 | 6.1× |
| MRI, dorsal spine combo (72157) | $2,208 | $3,680 | 6.3× |
| MRI, dorsal spine contrast (72147) | $1,908 | $3,180 | 5.5× |
| MRI, joint upper extrem (73221) range across 6 matching MRF lines |
$1,542–$2,313 | $2,570–$3,855 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$2,022–$3,033 | $3,370–$5,055 | varies |
| MRI, lumbar spine combo (72158) | $2,208 | $3,680 | 6.3× |
| Myocardial Spect Multiple Studies (78452) | $3,801 | $6,335 | 2.9× |
| Neck soft tissue (70360) | $174.60 | $291 | 2.0× |
| Nuclear Rx Oral Admin (79005) | $708 | $1,180 | 3.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,047 | $1,745 | 1.9× |
| Parathyroid Planar Imaging (78070) | $860.40 | $1,434 | 2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $933.60 | $1,556 | 2.3× |
| Pelvis 1 or 2 views (72170) | $179.40 | $299 | 1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $990 | $1,650 | 2.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $357.60 | $596 | 3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $534 | $890 | 1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 6 matching MRF lines |
$273.60–$410.40 | $456–$684 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$142.20–$213.60 | $237–$356 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$198–$297 | $330–$495 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $254.40 | $424 | 2.4× |
| Radex fingr minimum 2 views (73140) range across 12 matching MRF lines |
$152.40–$228.60 | $254–$381 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$193.20–$289.80 | $322–$483 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$193.80–$291 | $323–$485 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$146.40–$219.60 | $244–$366 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $208.20 | $347 | 2.4× |
| Radex Ribs Unilateral 2 Views (71100) | $189 | $315 | 2.2× |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$209.40–$314.40 | $349–$524 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $132.60 | $221 | 1.5× |
| Radex Spine 1 View Specify Level (72020) | $164.40 | $274 | 1.9× |
| Radex Sternum Minimum 2 Views (71120) | $206.40 | $344 | 2.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $206.40 | $344 | 2.4× |
| Radex Toe Minimum 2 Views (73660) range across 8 matching MRF lines |
$161.40–$242.40 | $269–$404 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$146.40–$219.60 | $244–$366 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$190.80–$286.20 | $318–$477 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $417.60 | $696 | 4.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $228.60 | $381 | 2.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $215.40 | $359 | 2.1× |
| Radiologic exam colon double contrast study (74280) | $538.20 | $897 | 3.1× |
| Radiologic exam colon single contrast study (74270) | $466.80 | $778 | 2.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $348.60 | $581 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) range across 9 matching MRF lines |
$238.20–$357.60 | $397–$596 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $243 | $405 | 2.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $498.60 | $831 | 2.8× |
| Radiologic exam swallow function contrast study (74230) | $334.20 | $557 | 1.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $676.80 | $1,128 | 3.9× |
| Radiologic examination femur 1 view (73551) | $118.80 | $198 | 1.4× |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$165–$247.80 | $275–$413 | varies |
| Radiologic examination knee 1/2 views (73560) range across 12 matching MRF lines |
$186.60–$280.20 | $311–$467 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $420.60 | $701 | 4.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$195.60–$293.40 | $326–$489 | varies |
| Ribs bilateral 3 views (71110) | $269.40 | $449 | 2.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,020 | $1,700 | 2.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,020 | $1,700 | 2.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,157 | $3,595 | 4.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,383 | $2,305 | 2.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,206 | $2,010 | 2.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,022 | $3,370 | 1.6× |
| Scapula (73010) range across 6 matching MRF lines |
$123.60–$185.40 | $206–$309 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $36 | $60 | 1.5× |
| Shoulder 1 view (73020) range across 6 matching MRF lines |
$154.80–$232.20 | $258–$387 | varies |
| Shoulder Arthrography (73040) | $700.20 | $1,167 | 2.0× |
| Skull less than 4 views (70250) | $168 | $280 | 1.6× |
| Sternoclavicular joints (71130) | $216 | $360 | 2.5× |
| Thoracic spine 2 views (72070) | $198.60 | $331 | 1.9× |
| Thoracic spine 3 views (72072) | $230.40 | $384 | 2.2× |
| Thoracolumbar 2 views (72080) | $233.40 | $389 | 2.7× |
| Thyroid Imaging With Vascular Flow (78013) | $516 | $860 | 1.3× |
| Thyroid Met Imaging Body (78018) | $1,517.40 | $2,529 | 2.8× |
| Thyroid Uptake Measurement (78012) | $516 | $860 | 1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $807 | $1,345 | 2.0× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$270–$405 | $450–$675 | varies |
| Ultrasound Exam Aaa Screen (76706) | $360 | $600 | 3.4× |
| Ultrasound, abdomen limited (76705) | $471 | $785 | 4.5× |
| Umbilical-artery Doppler (OB) (76820) | $279 | $465 | 2.7× |
| Upper gi w/o kub (74240) | $550.80 | $918 | 3.1× |
| Urethrocystogram voiding (74455) | $620.40 | $1,034 | 2.6× |
| Urethrocystography retrograde (74450) | $622.80 | $1,038 | 2.6× |
| Us breast unilateral complete (76641) range across 9 matching MRF lines |
$300–$450 | $500–$750 | varies |
| Us chest (76604) | $366 | $610 | 3.5× |
| Us complete joint (76881) | $414 | $690 | 4.0× |
| Us exam, pelvic, limited (76857) | $213 | $355 | 2.0× |
| Us kidney transplant (76776) | $600 | $1,000 | 5.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $297 | $495 | 2.8× |
| Us ob detailed single fetus (76811) | $492 | $820 | 2.1× |
| Us ob limited 1 or more fetuses (76815) | $327 | $545 | 3.1× |
| Us ob transvaginal (76817) | $363 | $605 | 3.5× |
| Us pelvic non ob complete (76856) | $510 | $850 | 4.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $405 | $675 | 3.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $366 | $610 | 3.5× |
| Us retroperitoneal complete (76770) | $489 | $815 | 4.7× |
| Us retroperitoneal limited (76775) | $405 | $675 | 3.9× |
| Us scrotum and contents (76870) | $426 | $710 | 4.1× |
| Us thyroid (76536) | $504 | $840 | 4.8× |
| Us transrectal (76872) | $492 | $820 | 4.7× |
| Venogram Sinus/Jugular (75860) | $3,169.80 | $5,283 | 1.0× |
| Wrist 2 views (73100) range across 10 matching MRF lines |
$176.40–$264.60 | $294–$441 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $223.20 | $372 | 2.6× |
| X-Ray Bend Only L-S Spine (72120) | $121.80 | $203 | 1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$174.60–$262.20 | $291–$437 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $104.40 | $174 | 1.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $208.80 | $348 | 2.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $313.20 | $522 | 3.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $154.80 | $258 | 1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $192 | $320 | 2.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $313.80 | $523 | 3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $355.80 | $593 | 3.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $397.80 | $663 | 3.8× |
| X-Ray Exam L-S Spine Bending (72114) | $432 | $720 | 4.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $224.40 | $374 | 2.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $401.40 | $669 | 3.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $275.40 | $459 | 2.6× |
| X-ray eye for foreign body (70030) | $124.80 | $208 | 1.4× |
| X-ray humerus (73060) range across 12 matching MRF lines |
$180.60–$271.20 | $301–$452 | varies |
| X-ray IV pyelogram (ivp) (74400) | $481.20 | $802 | 2.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $220.20 | $367 | 2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $130.20 | $217 | 1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $241.20 | $402 | 2.3× |
| X-ray nose-rectum child f.b. (76010) | $106.20 | $177 | 1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $390 | $650 | 3.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $180 | $300 | 1.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $141.60 | $236 | 1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $205.80 | $343 | 2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $261.60 | $436 | 3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $277.20 | $462 | 2.6× |
| X-ray thoracic spine 4 vw (72074) | $262.20 | $437 | 2.5× |
| X-Ray Tmj Unilat (70328) | $133.20 | $222 | 1.5× |
| X-Rays Bone Length Studies (77073) | $288.60 | $481 | 2.8× |
| X-Rays Bone Survey Complete (77075) | $402.60 | $671 | 3.8× |
| Xr c-spine 4 or 5 views (72050) | $328.20 | $547 | 3.1× |
| Xr facial bones less than 3 views (70140) | $163.20 | $272 | 1.9× |
| XR Mastoids < 3 Views Bilateral (70120) | $129 | $215 | 1.2× |
| Xr orbits complete 4 views (70200) | $190.80 | $318 | 1.8× |
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.