Imaging prices at Henry County Hospital, Inc
Napoleon, OH · every code in this section with a posted price and a Medicare benchmark.
247 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) range across 2 matching MRF lines |
$15.75–$247.50 | $21–$330 | varies |
| Abdomen 2 views (74019) | $300 | $400 | 3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,657.50 | $2,210 | 4.4× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$281.25–$6,993.75 | $375–$9,325 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$256.50–$5,265 | $342–$7,020 | varies |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| Artery X-Rays Abdomen (75726) | $5,527.50 | $7,370 | 1.0× |
| Artery X-Rays Pelvis (75736) | $5,178.75 | $6,905 | 1.0× |
| Arthrogram hip (73525) | $1,005 | $1,340 | 3.0× |
| Bone age studies (77072) | $300 | $400 | 3.0× |
| Bone Imaging 3 Phase (78315) | $1,657.50 | $2,210 | 4.4× |
| Bone Imaging Limited Area (78300) | $1,657.50 | $2,210 | 4.4× |
| Bone Imaging Multiple Areas (78305) | $1,657.50 | $2,210 | 4.4× |
| Bone Imaging Whole Body (78306) | $1,657.50 | $2,210 | 4.4× |
| Bone survey infant (77076) | $300 | $400 | 3.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,220 | $2,960 | 4.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,250 | $7,000 | 3.9× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$15.75–$131.25 | $21–$175 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$18.75–$191.25 | $25–$255 | varies |
| Chest 3 views (71047) | $131.25 | $175 | 1.6× |
| Chest 4 or more views (71048) | $161.25 | $215 | 1.6× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $956.25 | $1,275 | 9.7× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$217.50–$5,748.75 | $290–$7,665 | varies |
| Contrast X-Ray Bladder (74430) | $1,005 | $1,340 | 3.0× |
| Contrast X-Ray Of Knee Joint (73580) | $1,005 | $1,340 | 3.0× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$168–$6,427.50 | $224–$8,570 | varies |
| CT abdomen and pelvis without contrast (74176) | $2,175 | $2,900 | 9.6× |
| CT abdomen w contrast (74160) | $1,601.25 | $2,135 | 9.6× |
| CT abdomen w wo contrast (74170) | $3,202.50 | $4,270 | 19.3× |
| CT abdomen w/o contrast (74150) | $956.25 | $1,275 | 9.7× |
| CT Angio Abdomen and Pelvis (74174) | $6,427.50 | $8,570 | 19.5× |
| CT Angio Chest (71275) | $3,202.50 | $4,270 | 19.3× |
| CT Angio Head (70496) | $2,602.50 | $3,470 | 15.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$1,601.25–$2,002.50 | $2,135–$2,670 | varies |
| CT Angio Neck (70498) | $2,602.50 | $3,470 | 15.7× |
| CT cervical spine w/ contrast (72126) | $3,213.75 | $4,285 | 9.7× |
| CT cervical spine w/o contrast (72125) | $956.25 | $1,275 | 9.7× |
| CT cervical spine w/wo cont (72127) | $3,202.50 | $4,270 | 19.3× |
| CT chest w contrast (71260) | $1,601.25 | $2,135 | 9.6× |
| CT chest w/wo contrast (71270) | $3,202.50 | $4,270 | 19.3× |
| CT head/brain with contrast (70460) | $1,301.25 | $1,735 | 7.8× |
| CT head/brain without and with contrast (70470) | $2,602.50 | $3,470 | 15.7× |
| CT iac w contrast (70481) | $1,301.25 | $1,735 | 7.8× |
| CT l-spine w&w/o contrast (72133) | $3,202.50 | $4,270 | 19.3× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$956.25–$1,196.25 | $1,275–$1,595 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,601.25–$2,002.50 | $2,135–$2,670 | varies |
| CT lumbar spine w contrast (72132) | $3,213.75 | $4,285 | 9.7× |
| CT lumbar spine w/o contrast (72131) | $956.25 | $1,275 | 9.7× |
| CT maxillofacial w contrast (70487) | $1,301.25 | $1,735 | 7.8× |
| CT maxillofacial wo contrast (70486) | $900 | $1,200 | 9.1× |
| CT neck tissue combo (70492) | $2,602.50 | $3,470 | 15.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,602.50 | $3,470 | 15.7× |
| CT orbits w/o contrast (70480) | $900 | $1,200 | 9.1× |
| CT pelvis w&w/o contrast (72194) | $3,202.50 | $4,270 | 19.3× |
| CT pelvis w/o contrast (72192) | $956.25 | $1,275 | 9.7× |
| CT scans face/jaw combo (70488) | $2,602.50 | $3,470 | 15.7× |
| CT soft tissue neck w contrast (70491) | $1,301.25 | $1,735 | 7.8× |
| CT soft tissue neck w/o contrast (70490) | $900 | $1,200 | 9.1× |
| CT thoracic spine w contrast (72129) | $1,601.25 | $2,135 | 9.6× |
| CT thoracic spine w/o contrast (72128) | $956.25 | $1,275 | 9.7× |
| CT thorax w/o contrast (71250) | $1,050 | $1,400 | 10.6× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$956.25–$1,196.25 | $1,275–$1,595 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,526.25–$1,912.50 | $2,035–$2,550 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,275 | $1,700 | 7.7× |
| Cta Abdomen (74175) | $3,937.50 | $5,250 | 23.7× |
| Dxa Bone Density Axial (77080) | $300 | $400 | 3.0× |
| Dxa bone density study (77085) | $300 | $400 | 3.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $247.50 | $330 | 3.0× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$193.50–$900 | $258–$1,200 | varies |
| Esophagram (74220) | $502.50 | $670 | 3.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $600 | $800 | 6.1× |
| Fluoroscopy up to 1 hr (76000) | $678.75 | $905 | 3.0× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| Gastric emptying imaging study (78264) | $1,657.50 | $2,210 | 4.4× |
| Gated Heart Planar Single (78472) | $1,657.50 | $2,210 | 4.4× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$300–$375 | $400–$500 | varies |
| Heart Image (Pet) Multiple (78492) | $5,250 | $7,000 | 3.9× |
| Hepatobil Syst Image W/Drug (78227) | $2,220 | $2,960 | 4.3× |
| Hepatobiliary System Imaging (78226) | $1,657.50 | $2,210 | 4.4× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$102.75–$2,216.25 | $137–$2,955 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$152.25–$678.75 | $203–$905 | varies |
| Joint Survey Single View (77077) | $300 | $400 | 3.0× |
| K Flow/Funct Image Multiple (78709) | $2,220 | $2,960 | 4.3× |
| K Flow/Funct Image W/Drug (78708) | $2,220 | $2,960 | 4.3× |
| K Flow/Funct Image W/O Drug (78707) | $2,220 | $2,960 | 4.3× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$15–$311.25 | $20–$415 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,657.50 | $2,210 | 4.4× |
| Lung Ventilat&Perfus Imaging (78582) | $2,220 | $2,960 | 4.3× |
| Lung Ventilation Imaging (78579) | $1,657.50 | $2,210 | 4.4× |
| Lymph System Imaging (78195) | $2,220 | $2,960 | 4.3× |
| Mammary ductogram or galactogram multiple (77054) | $678.75 | $905 | 3.0× |
| Mammary ductogram or galactogram single (77053) | $678.75 | $905 | 3.0× |
| Meckels Divert Exam (78290) | $1,657.50 | $2,210 | 4.4× |
| Mra Head W/O & W/Contrast Material (70546) | $3,682.50 | $4,910 | 11.2× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$369.75–$2,493.75 | $493–$3,325 | varies |
| MRA head with contrast (70545) | $3,682.50 | $4,910 | 11.2× |
| MRA neck w contrast (70548) | $3,682.50 | $4,910 | 11.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,682.50 | $4,910 | 11.2× |
| MRA neck w/o contrast (70547) | $2,493.75 | $3,325 | 11.0× |
| MRI abdomen w contrast (74182) | $2,880 | $3,840 | 8.7× |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$337.50–$1,950 | $450–$2,600 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$534.75–$3,351.75 | $713–$4,469 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$2,880–$3,600 | $3,840–$4,800 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$531.75–$3,656.25 | $709–$4,875 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$329.25–$1,995 | $439–$2,660 | varies |
| MRI chest w/o contrast (71550) | $1,950 | $2,600 | 8.6× |
| MRI chest with contrast (71551) | $2,400 | $3,200 | 3.2× |
| MRI chest wo w contrast (71552) | $2,880 | $3,840 | 8.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 4 matching MRF lines |
$450.75–$3,600 | $601–$4,800 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 4 matching MRF lines |
$579–$3,600 | $772–$4,800 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$381.75–$2,437.50 | $509–$3,250 | varies |
| MRI lumbar spine w contrast (72149) | $2,947.50 | $3,930 | 8.9× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$552–$2,947.50 | $736–$3,930 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $1,950 | $2,600 | 8.6× |
| MRI orbit face neck w contrast (70542) | $1,950 | $2,600 | 5.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,250 | $3,000 | 6.8× |
| MRI pelvis w contrast (72196) | $2,880 | $3,840 | 8.7× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$579–$2,880 | $772–$3,840 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$392.25–$1,950 | $523–$2,600 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$330–$1,995 | $440–$2,660 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$2,880–$3,600 | $3,840–$4,800 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,950–$2,437.50 | $2,600–$3,250 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$2,880–$3,600 | $3,840–$4,800 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$581.25–$2,880 | $775–$3,840 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$552.75–$2,947.50 | $737–$3,930 | varies |
| MRI, dorsal spine contrast (72147) | $2,947.50 | $3,930 | 8.9× |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$350.25–$2,437.50 | $467–$3,250 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$2,880–$3,600 | $3,840–$4,800 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$550.50–$2,508.75 | $734–$3,345 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$141.75–$2,955 | $189–$3,940 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$15.75–$247.50 | $21–$330 | varies |
| Nonvascular Shunt X-Ray (75809) | $300 | $400 | 3.0× |
| Ob us nuchal meas 1 gest (76813) | $600 | $800 | 6.1× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$15–$300 | $20–$400 | varies |
| Pet Image W/Ct Lmtd (78814) | $5,250 | $7,000 | 3.9× |
| PET image w/CT, full body (78816) | $5,250 | $7,000 | 3.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,250 | $7,000 | 3.9× |
| Pet Myocardial Sngl Study (78491) | $5,250 | $7,000 | 3.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,657.50 | $2,210 | 4.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $300 | $400 | 3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,541.25 | $2,055 | 3.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$15–$311.25 | $20–$415 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$15–$311.25 | $20–$415 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$21.75–$300 | $29–$400 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$15–$311.25 | $20–$415 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$15–$311.25 | $20–$415 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $300 | $400 | 3.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$15–$247.50 | $20–$330 | varies |
| Radex Ribs Unilateral 2 Views (71100) | $247.50 | $330 | 3.0× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$15–$311.25 | $20–$415 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $247.50 | $330 | 3.0× |
| Radex Spine 1 View Specify Level (72020) | $247.50 | $330 | 3.0× |
| Radex Sternum Minimum 2 Views (71120) | $247.50 | $330 | 3.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $311.25 | $415 | 3.8× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$300–$375 | $400–$500 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$15–$311.25 | $20–$415 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $300 | $400 | 3.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $300 | $400 | 3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $300 | $400 | 3.0× |
| Radiologic exam colon double contrast study (74280) | $502.50 | $670 | 3.0× |
| Radiologic exam colon single contrast study (74270) | $502.50 | $670 | 3.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $502.50 | $670 | 3.0× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$300–$375 | $400–$500 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $502.50 | $670 | 3.0× |
| Radiologic exam swallow function contrast study (74230) | $502.50 | $670 | 3.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $502.50 | $670 | 3.0× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,912.50 | $2,550 | 3.7× |
| Scapula (73010) range across 3 matching MRF lines |
$300–$375 | $400–$500 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $37.50 | $50 | 1.6× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| Shoulder Arthrography (73040) | $1,005 | $1,340 | 3.0× |
| Skull less than 4 views (70250) | $300 | $400 | 3.0× |
| Sternoclavicular joints (71130) | $247.50 | $330 | 3.0× |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$18.75–$300 | $25–$400 | varies |
| Thoracolumbar 2 views (72080) | $247.50 | $330 | 3.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,657.50 | $2,210 | 4.4× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$360–$450 | $480–$600 | varies |
| Ultrasound Exam Aaa Screen (76706) | $600 | $800 | 6.1× |
| Ultrasound, abdomen limited (76705) | $600 | $800 | 6.1× |
| Upper gi w/o kub (74240) | $502.50 | $670 | 3.0× |
| Urethrocystogram voiding (74455) | $678.75 | $905 | 3.0× |
| Urethrocystography retrograde (74450) | $678.75 | $905 | 3.0× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$450–$562.50 | $600–$750 | varies |
| Us chest (76604) | $600 | $800 | 6.1× |
| Us exam, pelvic, limited (76857) | $600 | $800 | 6.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$480–$600 | $640–$800 | varies |
| Us ob limited 1 or more fetuses (76815) | $600 | $800 | 6.1× |
| Us ob transvaginal (76817) | $600 | $800 | 6.1× |
| Us pelvic non ob complete (76856) | $600 | $800 | 6.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $600 | $800 | 6.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $600 | $800 | 6.1× |
| Us retroperitoneal complete (76770) | $600 | $800 | 6.1× |
| Us retroperitoneal limited (76775) | $600 | $800 | 6.1× |
| Us scrotum and contents (76870) | $600 | $800 | 6.1× |
| Us thyroid (76536) | $600 | $800 | 6.1× |
| Us transrectal (76872) | $600 | $800 | 6.1× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$201.75–$6,802.50 | $269–$9,070 | varies |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$196.50–$4,012.50 | $262–$5,350 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$228.75–$2,812.50 | $305–$3,750 | varies |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$182.25–$2,265 | $243–$3,020 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$253.50–$17,231.25 | $338–$22,975 | varies |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$205.50–$3,551.25 | $274–$4,735 | varies |
| Vertebral fracture assessment via dxa (77086) | $247.50 | $330 | 3.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $311.25 | $415 | 3.8× |
| X-Ray Aorta Leg Arteries (75630) | $7,237.50 | $9,650 | 2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| X-Ray Exam Breast Specimen (76098) | $73.50 | $98 | 0.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $247.50 | $330 | 3.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $300 | $400 | 3.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$30–$300 | $40–$400 | varies |
| X-Ray Exam Hip Uni 1 View (73501) | $247.50 | $330 | 3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$18.75–$247.50 | $25–$330 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $300 | $400 | 3.0× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$18.75–$300 | $25–$400 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $375 | $500 | 3.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $375 | $500 | 3.8× |
| X-Ray Exam L-S Spine Bending (72114) | $300 | $400 | 3.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$18.75–$247.50 | $25–$330 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $300 | $400 | 3.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$22.50–$300 | $30–$400 | varies |
| X-ray eye for foreign body (70030) | $311.25 | $415 | 3.8× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$247.50–$311.25 | $330–$415 | varies |
| X-ray IV pyelogram (ivp) (74400) | $502.50 | $670 | 3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $311.25 | $415 | 3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$18.75–$300 | $25–$400 | varies |
| X-ray nose-rectum child f.b. (76010) | $247.50 | $330 | 3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $375 | $500 | 3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $300 | $400 | 3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $247.50 | $330 | 3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $247.50 | $330 | 3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $300 | $400 | 3.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,005 | $1,340 | 3.0× |
| X-Rays Bone Length Studies (77073) | $300 | $400 | 3.0× |
| X-Rays Bone Survey Complete (77075) | $300 | $400 | 3.0× |
| Xr c-spine 4 or 5 views (72050) | $300 | $400 | 3.0× |
| Xr orbits complete 4 views (70200) | $300 | $400 | 3.0× |
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.