Imaging prices at Hill Country Memorial Hospital

Fredericksburg, TX · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $1,133.27 $1,133.27 13.0×
Abdomen 2 views (74019) $1,214.18 $1,214.18 11.6×
Acute Gastrointestinal Blood Loss Imaging (78278) $7,636.15 $7,636.15 19.0×
Angio internal mammary (75756) $9,331.51 $9,331.51 2.9×
Angio pulmonary bilat (75743)
range across 2 matching MRF lines
$10,809.58–$14,937.86 $10,809.58–$14,937.86 varies
Angiography Adrenal Bilateral Slctv Rs&I (75733) $14,937.86 $14,937.86 4.7×
Angiography extremity bilateral rs&i (75716) $14,937.86 $14,937.86 4.7×
Angiography extremity unilateral rs&i (75710) $14,937.86 $14,937.86 4.7×
Angiography pulmonary unilateral slctv rs&i (75741) $14,937.86 $14,937.86 4.7×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $9,331.51 $9,331.51 2.9×
Ankle 2 views (73600) $890.41 $890.41 10.2×
Aortography thoracic serialography rs&i (75605) $14,937.86 $14,937.86 2.7×
Aortography thoracic w/o serialography rs&i (75600) $8,939.73 $8,939.73 2.8×
Artery X-Rays Abdomen (75726) $14,937.86 $14,937.86 2.7×
Artery X-Rays Adrenal Gland (75731) $14,937.86 $14,937.86 4.7×
Artery X-Rays Pelvis (75736) $14,937.86 $14,937.86 2.7×
Artery X-Rays Spine (75705) $14,937.86 $14,937.86 2.7×
Arthrogram hip (73525) $3,202.25 $3,202.25 9.1×
Arthrogram Wrist (73115) $2,315.06 $2,315.06 6.6×
Basic radiation dosimetry calculation (77300) $1,040.19 $1,040.19 7.7×
Bone age studies (77072) $914.69 $914.69 8.7×
Bone Imaging 3 Phase (78315) $8,959.62 $8,959.62 22.3×
Bone Imaging Whole Body (78306) $7,165.30 $7,165.30 17.8×
Chest 1 view (71045) $1,133.27 $1,133.27 13.0×
Chest 2 views (71046) $1,254.67 $1,254.67 14.4×
Chest 3 views (71047) $1,295.15 $1,295.15 14.8×
Chest 4 or more views (71048) $1,651.30 $1,651.30 15.7×
Clavicle complete (73000) $1,183.44 $1,183.44 13.5×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $558.97 $558.97 5.3×
Continuing medical physics consltj pr wk (77336) $1,040.19 $1,040.19 7.7×
Contrast Exam Abdominl Aorta (75625) $14,937.86 $14,937.86 4.7×
Contrast X-Ray Bladder (74430) $1,858.53 $1,858.53 5.3×
Contrast X-Ray Of Elbow (73085) $2,315.06 $2,315.06 6.6×
Contrast X-Ray Of Knee Joint (73580) $2,366.88 $2,366.88 6.8×
CT abdomen and pelvis without and with contrast (74178) $16,804.68 $16,804.68 48.0×
CT abdomen and pelvis without contrast (74176) $11,369.37 $11,369.37 47.4×
CT abdomen w contrast (74160) $8,798.40 $8,798.40 49.9×
CT abdomen w wo contrast (74170) $9,967.30 $9,967.30 56.6×
CT abdomen w/o contrast (74150) $6,547.08 $6,547.08 62.3×
CT Angio Abdomen and Pelvis (74174) $12,813.12 $12,813.12 36.6×
CT Angio Chest (71275) $11,749.21 $11,749.21 66.7×
CT Angio Head (70496) $11,749.21 $11,749.21 66.7×
CT angio hrt w/3d image (75574) $7,245.01 $7,245.01 20.7×
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 2 matching MRF lines
$6,729.29–$13,457.02 $6,729.29–$13,457.02 varies
CT Angio Neck (70498) $11,749.21 $11,749.21 66.7×
Ct Angio Upr Extrm W/O&W/Dye (73206) $5,875.38 $5,875.38 33.3×
CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) $6,741.70 $6,741.70 38.3×
CT cervical spine w/ contrast (72126) $8,795.31 $8,795.31 25.1×
CT cervical spine w/o contrast (72125) $7,856.50 $7,856.50 74.8×
CT cervical spine w/wo cont (72127) $10,617.39 $10,617.39 60.3×
CT chest w contrast (71260) $8,690.33 $8,690.33 49.3×
CT colonogrphy dx image postprocess w/o contrast (74261) $1,599.71 $1,599.71 15.2×
CT head/brain with contrast (70460) $6,743.18 $6,743.18 38.3×
CT head/brain without and with contrast (70470) $8,863.26 $8,863.26 50.3×
CT heart contrast eval cardiac structure&morph (75572) $2,725.37 $2,725.37 7.8×
CT heart no contrast quant eval coronry calcium (75571) $767.43 $767.43 8.8×
CT hrt w/3d image congen (75573) $2,259.06 $2,259.06 6.4×
CT iac w contrast (70481) $9,148.92 $9,148.92 51.9×
CT l-spine w&w/o contrast (72133) $10,617.39 $10,617.39 60.3×
CT lower ext w/o (73700) $6,249.06 $6,249.06 59.5×
CT lower extremity w/contrast material (73701) $6,639.72 $6,639.72 37.7×
CT lumbar spine w contrast (72132) $8,795.31 $8,795.31 25.1×
CT lumbar spine w/o contrast (72131) $7,856.50 $7,856.50 74.8×
CT maxillofacial w contrast (70487) $7,433.40 $7,433.40 42.2×
CT maxillofacial wo contrast (70486) $7,113.77 $7,113.77 67.7×
CT neck tissue combo (70492) $9,768.12 $9,768.12 55.4×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $10,378.02 $10,378.02 58.9×
CT orbits w/o contrast (70480) $8,542.09 $8,542.09 81.3×
CT pelvis w&w/o contrast (72194) $6,842.01 $6,842.01 38.8×
CT pelvis w/o contrast (72192) $4,822.30 $4,822.30 45.9×
CT scan of leg combo (73702) $7,031.93 $7,031.93 39.9×
CT scans face/jaw combo (70488) $7,742.23 $7,742.23 43.9×
CT soft tissue neck w contrast (70491) $8,795.31 $8,795.31 49.9×
CT soft tissue neck w/o contrast (70490) $6,639.72 $6,639.72 63.2×
CT thoracic spine w contrast (72129) $8,795.31 $8,795.31 49.9×
CT thoracic spine w/o contrast (72128) $7,856.50 $7,856.50 74.8×
CT thoracic spine w/wo cont (72130) $10,617.39 $10,617.39 60.3×
CT thorax w/o contrast (71250) $6,686.04 $6,686.04 63.7×
CT upper ext wo (73200) $6,249.06 $6,249.06 59.5×
CT upper extremity w/o & w/contrast material (73202)
range across 3 matching MRF lines
$7,031.93–$14,076.23 $7,031.93–$14,076.23 varies
CT upper extremity with contrast (73201) $6,639.72 $6,639.72 18.9×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $11,749.21 $11,749.21 66.7×
Cta Abdomen (74175) $13,457.02 $13,457.02 76.4×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $17,873.72 $17,873.72 51.0×
CTA pelvis (72191) $10,132.52 $10,132.52 57.5×
Dilation ureters/urethra rs&i (74485) $5,027.66 $5,027.66 2.4×
Discography Cerv/Thor Spine (72285) $11,576.96 $11,576.96 5.9×
Diskography lumbar (72295) $8,493.40 $8,493.40 4.3×
Echo exam uterus (76831) $2,905.40 $2,905.40 12.1×
Echo Guide For Artery Repair (76936) $5,436.98 $5,436.98 25.1×
Esophagram (74220) $2,308.58 $2,308.58 13.1×
Fetal Biophys Profile W/Nst (76818) $2,905.40 $2,905.40 27.7×
Fluoroscopy up to 1 hr (76000) $2,043.08 $2,043.08 8.5×
Follow-Up Angiography (75898) $4,100.72 $4,100.72 1.3×
Foot 2 views (73620) $1,040.98 $1,040.98 11.9×
Forearm 2 views (73090)
range across 3 matching MRF lines
$1,152.68–$2,292.40 $1,152.68–$2,292.40 varies
Gastric emptying imaging study (78264) $6,744.11 $6,744.11 16.8×
Hand 2 views (73120) $1,201.23 $1,201.23 11.4×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $12,001.12 $12,001.12 3.8×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $10,251.06 $10,251.06 3.2×
Hepatobil Syst Image W/Drug (78227) $6,497.59 $6,497.59 11.9×
Hysterosalpingogram (74740) $2,580.56 $2,580.56 10.8×
K Flow/Funct Image Multiple (78709) $3,924.42 $3,924.42 7.2×
Knee 3 Views (73562)
range across 3 matching MRF lines
$1,248.21–$2,491.54 $1,248.21–$2,491.54 varies
Lung Ventilat&Perfus Imaging (78582) $7,014.62 $7,014.62 12.9×
Lung Ventilation Imaging (78579) $4,477.27 $4,477.27 11.1×
Lymph System Imaging (78195) $8,177.19 $8,177.19 15.0×
Lymphangiography Extremity Only Bilateral Rs&I (75803) $5,047.01 $5,047.01 3.2×
Lymphangiography extremity only unilateral rs&i (75801) $1,979.70 $1,979.70 3.1×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $3,951.81 $3,951.81 1.2×
Lymphangiography, pelvic/abdominal, unilateral (75805) $3,679.81 $3,679.81 1.2×
Meckels Divert Exam (78290) $5,936 $5,936 14.8×
Mra Head W/O & W/Contrast Material (70546) $8,730.24 $8,730.24 24.9×
MRA head w/o contrast (70544) $7,743.41 $7,743.41 32.3×
Mra Neck W/O &W/Contrast Material (70549) $8,730.24 $8,730.24 24.9×
MRA neck w/o contrast (70547) $7,743.41 $7,743.41 32.3×
MRI abdomen w/o contrast (74181) $10,466.93 $10,466.93 43.7×
MRI any jt lower extrem w/contrast material (73722) $6,645.88 $6,645.88 8.4×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $7,897.72 $7,897.72 22.5×
MRI any jt upper extremity w/contrast matrl (73222) $9,872.93 $9,872.93 12.5×
MRI Breast W/O Contrast Bilateral (77047) $3,830.61 $3,830.61 16.0×
MRI cervical spine w/o cont (72141) $8,501.05 $8,501.05 35.5×
MRI chest w/o contrast (71550) $9,366.27 $9,366.27 39.1×
MRI chest wo w contrast (71552) $11,893.37 $11,893.37 33.9×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $12,113.19 $12,113.19 34.6×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $9,366.27 $9,366.27 39.1×
MRI lumbar spine w contrast (72149) $12,417.18 $12,417.18 35.4×
Mri Neck Spine W/O & W/Dye (72156) $11,893.37 $11,893.37 33.9×
MRI orbit face &/neck w/o contrast (70540) $9,464.50 $9,464.50 39.5×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $10,395.21 $10,395.21 29.7×
MRI pelvis w/o & w contrast (72197) $7,267.92 $7,267.92 20.7×
MRI pelvis w/o contrast (72195) $6,237.44 $6,237.44 26.0×
MRI thoracic spine w/o contrast (72146) $10,716.35 $10,716.35 44.7×
MRI upper extremity oth than jt w/o contr matrl (73218) $9,366.27 $9,366.27 39.1×
Mri Uppr Extremity W/O&W/Dye (73220) $11,232.36 $11,232.36 32.1×
MRI, abdomen, combo (74183) $13,856.12 $13,856.12 39.5×
MRI, dorsal spine combo (72157) $14,105.55 $14,105.55 40.2×
MRI, dorsal spine contrast (72147) $12,417.18 $12,417.18 35.4×
MRI, joint upper extrem (73221) $8,929.78 $8,929.78 37.3×
MRI, joint upper extrem combo (73223) $10,816.13 $10,816.13 30.9×
MRI, lumbar spine combo (72158) $14,105.55 $14,105.55 40.2×
Myelogram Lumbar (72265) $6,542.09 $6,542.09 8.3×
Myelograpy 2/more regions rs&i (72270) $11,653.06 $11,653.06 14.8×
Myocardial Spect Multiple Studies (78452) $13,200.59 $13,200.59 10.2×
N-invas est c ffr sw aly CTA (75580) $6,725.25 $6,725.25 7.8×
Neck soft tissue (70360) $958.42 $958.42 11.0×
Nonvascular Shunt X-Ray (75809) $149.51 $149.51 1.4×
Parathyroid planar imaging w/wo subtraction (78071) $2,838.73 $2,838.73 7.1×
Pelvis 1 or 2 views (72170) $1,028.02 $1,028.02 9.8×
Peritoneogram Rs&I (74190) $3,202.25 $3,202.25 5.8×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $12,001.12 $12,001.12 3.8×
Pulmonary Perfusion Imaging Particulate (78580) $4,615.93 $4,615.93 11.5×
Radex abscess/fistula/sinus tract rs&i (76080) $1,691.77 $1,691.77 3.1×
Radex Ankle Complete Minimum 3 Views (73610)
range across 3 matching MRF lines
$1,275.73–$2,546.57 $1,275.73–$2,546.57 varies
Radex Calcaneus Minimum 2 Views (73650) $935.74 $935.74 10.7×
Radex elbow complete minimum 3 views (73080) $1,361.52 $1,361.52 15.6×
Radex Facial Bones Complete Minimum 3 Views (70150) $1,725.78 $1,725.78 16.4×
Radex fingr minimum 2 views (73140) $836.99 $836.99 9.6×
Radex foot complete minimum 3 views (73630)
range across 3 matching MRF lines
$1,275.73–$2,546.57 $1,275.73–$2,546.57 varies
Radex Hand Minimum 3 Views (73130)
range across 3 matching MRF lines
$1,361.52–$2,716.56 $1,361.52–$2,716.56 varies
Radex Nasal Bones Complete Minimum 3 Views (70160) $1,028.02 $1,028.02 11.8×
Radex Ribs Unilateral 2 Views (71100) $1,132.52 $1,132.52 13.0×
Radex shoulder complete minimum 2 views (73030) $1,324.28 $1,324.28 15.1×
Radex Sinuses Paransl < 3 Views (70210) $785.17 $785.17 9.0×
Radex Spine 1 View Specify Level (72020) $858.03 $858.03 9.8×
Radex Sternum Minimum 2 Views (71120) $1,351.82 $1,351.82 15.5×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $1,745.20 $1,745.20 20.0×
Radex Toe Minimum 2 Views (73660) $840.23 $840.23 9.6×
Radex Wrist Complete Minimum 3 Views (73110) $1,361.52 $1,361.52 15.6×
Radiolog exam mandible compl minimum 4 views (70110) $1,745.20 $1,745.20 16.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $1,156.39 $1,156.39 11.0×
Radiologic exam colon double contrast study (74280) $3,969.62 $3,969.62 22.5×
Radiologic exam colon single contrast study (74270) $3,059.78 $3,059.78 17.4×
Radiologic exam knee complete 4/more views (73564) $1,390.68 $1,390.68 13.2×
Radiologic exam pelvis compl minimum 3 views (72190) $1,667.49 $1,667.49 15.9×
Radiologic Exam Small Int Single Contrast Study (74250) $3,079.21 $3,079.21 17.5×
Radiologic exam swallow function contrast study (74230) $2,349.06 $2,349.06 13.3×
Radiologic exam upr gi trc double contrast study (74246) $3,632.88 $3,632.88 20.6×
Radiologic examination femur minimum 2 views (73552)
range across 3 matching MRF lines
$1,220.67–$1,830.15 $1,220.67–$1,830.15 varies
Radiologic examination knee 1/2 views (73560)
range across 3 matching MRF lines
$1,117.05–$1,858.53 $1,117.05–$1,858.53 varies
Radiologic examination tibia & fibula 2 views (73590)
range across 3 matching MRF lines
$1,113.82–$2,216.31 $1,113.82–$2,216.31 varies
Ribs bilateral 3 views (71110) $778.91 $778.91 7.4×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $7,757.71 $7,757.71 14.2×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $6,951.28 $6,951.28 12.7×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $4,615.93 $4,615.93 8.5×
Scapula (73010) $1,301.62 $1,301.62 12.4×
Screening Digital Breast Tomosynthesis Bi (77063) $114.93 $114.93 4.9×
Shoulder 1 view (73020) $725.28 $725.28 8.3×
Shoulder Arthrography (73040) $1,648.79 $1,648.79 4.7×
Skull less than 4 views (70250) $1,117.05 $1,117.05 10.6×
Special treatment procedure (77470) $3,813.01 $3,813.01 6.9×
Sternoclavicular joints (71130) $1,361.52 $1,361.52 15.6×
Superior sagittal sinus venogram (75870) $4,511.96 $4,511.96 1.4×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $1,882.36 $1,882.36 5.0×
Thoracic spine 2 views (72070) $1,635.12 $1,635.12 15.6×
Thoracic spine 3 views (72072) $1,725.78 $1,725.78 16.4×
Thyroid Uptake Measurement (78012) $1,008.44 $1,008.44 2.5×
Ultrasound Breast Limited (76642)
range across 4 matching MRF lines
$442.38–$747.72 $442.38–$747.72 varies
Ultrasound Exam Aaa Screen (76706) $862.12 $862.12 8.2×
Ultrasound, abdomen limited (76705) $2,994.03 $2,994.03 28.5×
Unlisted Dx Radiographic Procedure (76499) $9,331.51 $9,331.51 106.7×
Upper gi w/o kub (74240) $3,225.82 $3,225.82 18.3×
Urethrocystogram voiding (74455) $2,043.08 $2,043.08 8.5×
Urethrocystography retrograde (74450) $2,455.92 $2,455.92 10.2×
Us breast unilateral complete (76641)
range across 4 matching MRF lines
$587.08–$1,298.82 $587.08–$1,298.82 varies
Us chest (76604) $2,309.17 $2,309.17 22.0×
Us complete joint (76881) $10,993.22 $10,993.22 104.7×
Us exam, pelvic, limited (76857) $1,830.59 $1,830.59 17.4×
Us head (76506) $2,760.39 $2,760.39 26.3×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines
$826.05–$2,602.48 $826.05–$2,602.48 varies
Us ob limited 1 or more fetuses (76815) $1,940.17 $1,940.17 18.5×
Us pelvic non ob complete (76856) $3,060.11 $3,060.11 29.1×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $3,060.11 $3,060.11 29.1×
Us retroperitoneal limited (76775) $1,060.33 $1,060.33 10.1×
Us scrotum and contents (76870) $2,484.83 $2,484.83 23.7×
Us spinal canal and contents (76800) $2,994.03 $2,994.03 28.5×
Us thyroid (76536) $2,934.41 $2,934.41 27.9×
Us transrectal (76872) $1,164.24 $1,164.24 11.1×
Vein X-Ray Chest (75827) $9,331.51 $9,331.51 5.9×
Vein X-Ray Liver W/O Hemodyn (75887) $10,251.06 $10,251.06 3.2×
Vein X-Ray Skull Epidural (75872)
range across 2 matching MRF lines
$1,558.16–$1,710.09 $1,558.16–$1,710.09 varies
Vein X-Ray Spleen/Liver (75810) $8,339.11 $8,339.11 2.6×
Venogram Sinus/Jugular (75860) $9,331.51 $9,331.51 2.9×
Venography Adrenal Unilateral (75840) $14,937.86 $14,937.86 4.7×
Venography caval inferior serialography rs&i (75825) $14,937.86 $14,937.86 4.7×
Venography extremity bilateral rs&i (75822) $9,331.51 $9,331.51 5.9×
Venography extremity unilateral rs&i (75820) $9,331.51 $9,331.51 5.9×
Venography Orbital Rs&I (75880) $1,979.70 $1,979.70 3.1×
Venography Renal Bilateral (75833) $14,937.86 $14,937.86 4.7×
Venography Renal Unilateral (75831) $14,937.86 $14,937.86 4.7×
Venous sampling by catheter (75893) $14,937.86 $14,937.86 2.7×
Wrist 2 views (73100) $1,117.05 $1,117.05 12.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $1,288.66 $1,288.66 14.7×
X-ray antegrade pyelogram tube (74425) $2,544.96 $2,544.96 7.3×
X-Ray Aorta Leg Arteries (75630) $14,937.86 $14,937.86 4.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $1,013.44 $1,013.44 11.6×
X-Ray Exam Breast Specimen (76098) $827.26 $827.26 1.5×
X-Ray Exam Entire Spi 1 Vw (72081) $1,000.49 $1,000.49 11.4×
X-Ray Exam Entire Spi 2/3 Vw (72082) $2,001.01 $2,001.01 19.1×
X-Ray Exam Hip Uni 1 View (73501) $760.89 $760.89 8.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $1,180.18 $1,180.18 13.5×
X-Ray Exam Hips Bi 5/> Views (73523) $2,130.51 $2,130.51 20.3×
X-Ray Exam L-S Spine Bending (72114) $2,554.67 $2,554.67 24.3×
X-Ray Exam Neck Spine 2-3 Vw (72040) $1,332.40 $1,332.40 15.2×
X-Ray Exam Neck Spine 6/>Vws (72052) $3,017.68 $3,017.68 28.7×
X-Ray Exam Unilat Ribs/Chest (71101) $1,589.79 $1,589.79 15.1×
X-ray humerus (73060) $1,183.44 $1,183.44 13.5×
X-ray IV pyelogram (ivp) (74400) $2,721.42 $2,721.42 15.4×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $858.03 $858.03 9.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $1,821.30 $1,821.30 17.3×
X-ray nose-rectum child f.b. (76010) $1,201.23 $1,201.23 13.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $2,156.41 $2,156.41 20.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $1,201.23 $1,201.23 13.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $1,593.04 $1,593.04 18.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $1,811.59 $1,811.59 17.2×
X-Ray Urinary Tract Exam With Contrast Material (74420) $2,648.58 $2,648.58 7.6×
X-Rays Bone Survey Complete (77075) $2,964.28 $2,964.28 28.2×
Xr c-spine 4 or 5 views (72050) $2,331.27 $2,331.27 22.2×
Xr facial bones less than 3 views (70140) $678.34 $678.34 7.8×
Xr orbits complete 4 views (70200) $1,351.82 $1,351.82 12.9×

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.