Imaging prices at Holyoke Medical Center

Holyoke, MA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $167 $167 1.6×
Abdomen 2 views (74019) $205 $205 1.6×
Acute Gastrointestinal Blood Loss Imaging (78278) $703 $703 1.5×
Angiography extremity bilateral rs&i (75716) $1,528 $1,528 0.4×
Angiography extremity unilateral rs&i (75710) $4,707 $4,707 1.2×
Ankle 2 views (73600)
range across 3 matching MRF lines		 $176–$450 $176–$450 varies
Aortography thoracic serialography rs&i (75605) $14,994 $14,994 2.2×
Artery X-Rays Abdomen (75726) $14,994 $14,994 2.2×
Artery X-Rays Pelvis (75736) $14,994 $14,994 2.2×
Arthrogram hip (73525)
range across 3 matching MRF lines		 $627–$1,425 $627–$1,425 varies
Arthrogram Wrist (73115) $627 $627 1.5×
Bone age studies (77072) $250 $250 2.0×
Bone Imaging 3 Phase (78315) $829 $829 1.7×
Bone Imaging Limited Area (78300) $607 $607 1.3×
Bone Imaging Whole Body (78306) $986 $986 2.1×
Bone marrow imaging; whole body (78104) $924 $924 1.9×
Bone survey infant (77076) $414 $414 3.3×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $598 $598 0.9×
Cardiac Shunt Detection (78428) $370 $370 0.8×
Cat Scan Follow-Up Study (76380) $435 $435 4.2×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $260 $260 0.4×
Cerebrospinal Fluid Scan (78630) $1,067 $1,067 1.6×
Chest 1 view (71045) $192 $192 1.8×
Chest 2 views (71046) $253 $253 2.4×
Chest 3 views (71047) $397 $397 3.8×
Chest 4 or more views (71048) $430 $430 3.4×
Clavicle complete (73000)
range across 3 matching MRF lines		 $143–$215 $143–$215 varies
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $920 $920 7.3×
Contrast Exam Abdominl Aorta (75625) $5,018 $5,018 1.3×
Contrast X-Ray Bladder (74430) $486 $486 1.2×
Contrast X-Ray Of Elbow (73085) $1,049 $1,049 2.5×
Contrast X-Ray Of Knee Joint (73580) $474 $474 1.1×
CT abdomen and pelvis without and with contrast (74178) $1,900 $1,900 4.5×
CT abdomen and pelvis without contrast (74176) $569 $569 2.0×
CT abdomen w contrast (74160) $658 $658 3.1×
CT abdomen w wo contrast (74170) $815 $815 3.9×
CT abdomen w/o contrast (74150) $880 $880 7.0×
CT Angio Abdomen and Pelvis (74174) $1,590 $1,590 3.8×
CT Angio Chest (71275) $1,496 $1,496 7.1×
CT Angio Head (70496) $1,121 $1,121 5.3×
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 3 matching MRF lines		 $1,233–$1,849.50 $1,233–$1,849.50 varies
CT Angio Neck (70498) $1,121 $1,121 5.3×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,116 $1,116 5.3×
CT cervical spine w/ contrast (72126) $700 $700 1.7×
CT cervical spine w/o contrast (72125) $450 $450 3.6×
CT cervical spine w/wo cont (72127) $900 $900 4.3×
CT chest w contrast (71260) $1,151 $1,151 5.5×
CT chest w/wo contrast (71270) $1,352 $1,352 6.4×
CT colonography screening (74263) $842 $842 2.9×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $968 $968 4.6×
CT colonogrphy dx image postprocess w/o contrast (74261) $842 $842 6.7×
CT head/brain with contrast (70460) $1,106 $1,106 5.3×
CT head/brain without and with contrast (70470) $1,156 $1,156 5.5×
CT heart no contrast quant eval coronry calcium (75571) $248 $248 2.4×
CT iac w contrast (70481) $883 $883 4.2×
CT l-spine w&w/o contrast (72133) $900 $900 4.3×
CT lower ext w/o (73700) $1,003 $1,003 8.0×
CT lower extremity w/contrast material (73701) $1,234 $1,234 5.9×
CT lumbar spine w contrast (72132) $700 $700 1.7×
CT lumbar spine w/o contrast (72131) $500 $500 4.0×
CT maxillofacial w contrast (70487) $1,007 $1,007 4.8×
CT maxillofacial wo contrast (70486) $917 $917 7.3×
CT neck tissue combo (70492) $992 $992 4.7×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,087 $1,087 5.2×
CT orbits w/o contrast (70480) $781 $781 6.2×
CT pelvis w&w/o contrast (72194) $1,437 $1,437 6.8×
CT pelvis w/o contrast (72192) $1,170 $1,170 9.3×
CT scan of leg combo (73702) $1,350 $1,350 6.4×
CT scans face/jaw combo (70488) $1,144 $1,144 5.4×
CT soft tissue neck w contrast (70491) $965 $965 4.6×
CT soft tissue neck w/o contrast (70490) $765 $765 6.1×
CT thoracic spine w contrast (72129) $700 $700 3.3×
CT thoracic spine w/o contrast (72128) $500 $500 4.0×
CT thoracic spine w/wo cont (72130) $438 $438 2.1×
CT thorax w/o contrast (71250) $968 $968 7.7×
CT unlisted procedure (76497) $178.35 $178.35 1.7×
CT upper ext wo (73200) $1,003 $1,003 8.0×
CT upper extremity w/o & w/contrast material (73202) $1,174 $1,174 5.6×
CT upper extremity with contrast (73201) $1,097 $1,097 2.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,116 $1,116 5.3×
Cta Abdomen (74175) $1,116 $1,116 5.3×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $535 $535 1.3×
CTA pelvis (72191) $1,350 $1,350 6.4×
Dilation ureters/urethra rs&i (74485) $2,764 $2,764 1.1×
Diskography lumbar (72295) $296 $296 0.1×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $276 $276 2.2×
Doppler Echo Fetal Spectral Display Complete (76827) $458 $458 3.7×
Doppler Fetal Mid Cerebral Artery (76821) $182 $182 1.5×
Dxa Bone Density Axial (77080) $345 $345 2.8×
Dxa bone density study (77085) $345 $345 2.8×
Dxa bone density study 1/>sites appendiclr skel (77081) $171 $171 1.6×
Echo exam of fetal heart (76825) $510 $510 0.8×
Echo exam uterus (76831) $604 $604 2.1×
Echo Guide For Artery Repair (76936) $642 $642 2.5×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $391 $391 1.4×
Esophagram (74220) $398 $398 1.9×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $350 $350 2.8×
Fluoroscopy up to 1 hr (76000) $359 $359 1.3×
Follow-Up Angiography (75898) $3,000 $3,000 0.8×
Foot 2 views (73620)
range across 3 matching MRF lines		 $211–$317 $211–$317 varies
Forearm 2 views (73090)
range across 3 matching MRF lines		 $216–$324 $216–$324 varies
Gastric emptying imaging study (78264) $850 $850 1.8×
Gastroesophageal Reflux Exam (78262) $598 $598 1.2×
Gated Heart Planar Single (78472) $1,131 $1,131 2.4×
Hand 2 views (73120)
range across 3 matching MRF lines		 $275–$413 $275–$413 varies
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $8,697 $8,697 2.3×
Hepatobil Syst Image W/Drug (78227) $1,129 $1,129 1.7×
Hepatobiliary System Imaging (78226) $830 $830 1.7×
Ht Muscle Image Spect Sing (78451) $1,644 $1,644 1.1×
Hysterosalpingogram (74740) $592 $592 2.1×
K Flow/Funct Image Multiple (78709) $936 $936 1.4×
K Flow/Funct Image W/Drug (78708) $851 $851 1.3×
Kidney Imaging Morphol (78700) $649 $649 1.4×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $714 $714 1.5×
Knee 3 Views (73562)
range across 3 matching MRF lines		 $272–$408 $272–$408 varies
Leveen/Shunt Patency Exam (78291) $777 $777 1.6×
Liver & Spleen Imaging Static Only (78215) $773 $773 1.6×
Liver imaging w/vascular flow (78202) $904 $904 1.4×
Lung Perf&Ventilat Diferentl (78598) $1,290 $1,290 2.0×
Lung perfusion differential (78597) $675 $675 1.4×
Lung Ventilat&Perfus Imaging (78582) $968 $968 1.5×
Lung Ventilation Imaging (78579) $675 $675 1.4×
Lymph System Imaging (78195) $836 $836 1.3×
Magnetic Image Jaw Joint (70336) $1,919 $1,919 6.7×
Meckels Divert Exam (78290) $774 $774 1.6×
Mra Head W/O & W/Contrast Material (70546) $1,200 $1,200 2.9×
MRA head w/o contrast (70544) $854 $854 3.0×
MRA head with contrast (70545) $1,000 $1,000 2.4×
MRA neck w contrast (70548) $1,000 $1,000 2.4×
Mra Neck W/O &W/Contrast Material (70549) $1,200 $1,200 2.9×
MRA neck w/o contrast (70547) $800 $800 2.8×
MRI abdomen w contrast (74182) $2,076 $2,076 5.0×
MRI abdomen w/o contrast (74181) $1,535 $1,535 5.4×
MRI any jt lower extrem w/contrast material (73722) $1,973 $1,973 2.1×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,400 $3,400 8.1×
MRI any jt upper extremity w/contrast matrl (73222) $2,076 $2,076 2.2×
MRI Breast W/O Contrast Bilateral (77047) $3,000 $3,000 10.5×
MRI Breast Without Contrast Material Unilateral (77046) $2,000 $2,000 7.0×
MRI cervical spine w contrast (72142) $2,101 $2,101 5.0×
MRI cervical spine w/o cont (72141) $1,862 $1,862 6.5×
MRI chest w/o contrast (71550) $1,535 $1,535 5.4×
MRI chest with contrast (71551) $2,075 $2,075 2.2×
MRI chest wo w contrast (71552) $3,248 $3,248 7.8×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,900 $1,900 4.5×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,500 $2,500 6.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,751 $1,751 6.1×
MRI lumbar spine w contrast (72149) $2,427 $2,427 5.8×
Mri Neck Spine W/O & W/Dye (72156) $2,825 $2,825 6.8×
MRI orbit face &/neck w/o contrast (70540) $1,686 $1,686 5.9×
MRI orbit face neck w contrast (70542) $1,708 $1,708 4.1×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,040 $3,040 7.3×
MRI pelvis w contrast (72196) $1,751 $1,751 4.2×
MRI pelvis w/o & w contrast (72197) $3,250 $3,250 7.8×
MRI pelvis w/o contrast (72195) $1,533 $1,533 5.4×
MRI thoracic spine w/o contrast (72146) $1,740 $1,740 6.1×
MRI upper extremity oth than jt w/contr matrl (73219) $1,634 $1,634 3.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,516 $1,516 5.3×
Mri Uppr Extremity W/O&W/Dye (73220) $1,876 $1,876 4.5×
MRI, abdomen, combo (74183) $2,800 $2,800 6.7×
MRI, dorsal spine combo (72157) $3,074 $3,074 7.4×
MRI, dorsal spine contrast (72147) $2,460 $2,460 5.9×
MRI, joint upper extrem (73221) $1,770 $1,770 6.2×
MRI, joint upper extrem combo (73223) $3,400 $3,400 8.1×
MRI, lumbar spine combo (72158) $3,074 $3,074 7.4×
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $489 $489 1.0×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $3,982 $3,982 2.6×
Myocardial Spect Multiple Studies (78452) $2,994 $2,994 1.9×
Neck soft tissue (70360) $195 $195 1.9×
Nm csf leak detection (78650) $3,982 $3,982 2.6×
Nonvascular Shunt X-Ray (75809) $180 $180 1.4×
Nuclear Rx Oral Admin (79005) $517 $517 1.8×
Ob us nuchal meas 1 gest (76813) $350 $350 2.8×
Ophthalmic Ultrasonic Foreign Body Localization (76529) $255 $255 2.4×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $185 $185 1.5×
Parathyroid imaging w/tomographic spect & CT (78072)
range across 2 matching MRF lines		 $902–$1,088 $902–$1,088 varies
Parathyroid Planar Imaging (78070) $649 $649 1.4×
Parathyroid planar imaging w/wo subtraction (78071) $790 $790 1.6×
Pelvis 1 or 2 views (72170) $205 $205 1.6×
Peritoneogram Rs&I (74190) $1,505 $1,505 2.3×
Pulmonary Perfusion Imaging Particulate (78580) $558 $558 1.2×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $288 $288 2.3×
Radex abscess/fistula/sinus tract rs&i (76080) $316 $316 0.5×
Radex Ankle Complete Minimum 3 Views (73610)
range across 3 matching MRF lines		 $227–$341 $227–$341 varies
Radex Calcaneus Minimum 2 Views (73650)
range across 3 matching MRF lines		 $170–$255 $170–$255 varies
Radex elbow complete minimum 3 views (73080)
range across 3 matching MRF lines		 $224–$336 $224–$336 varies
Radex Facial Bones Complete Minimum 3 Views (70150) $433 $433 3.5×
Radex fingr minimum 2 views (73140) $183 $183 1.8×
Radex foot complete minimum 3 views (73630)
range across 3 matching MRF lines		 $224–$314 $224–$314 varies
Radex Hand Minimum 3 Views (73130)
range across 3 matching MRF lines		 $300–$450 $300–$450 varies
Radex lower extremity infant minimum 2 views (73592)
range across 3 matching MRF lines		 $143–$215 $143–$215 varies
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $282 $282 2.3×
Radex Nasal Bones Complete Minimum 3 Views (70160) $217 $217 2.1×
Radex Ribs Unilateral 2 Views (71100)
range across 3 matching MRF lines		 $274–$411 $274–$411 varies
Radex shoulder complete minimum 2 views (73030)
range across 3 matching MRF lines		 $222–$333 $222–$333 varies
Radex Sinuses Paransl < 3 Views (70210) $214 $214 2.1×
Radex Spine 1 View Specify Level (72020) $168 $168 1.6×
Radex Sternum Minimum 2 Views (71120) $268 $268 2.6×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $191 $191 1.8×
Radex Toe Minimum 2 Views (73660) $170 $170 1.6×
Radex upper extremity infant minimum 2 views (73092)
range across 4 matching MRF lines		 $150–$225 $150–$225 varies
Radex Wrist Complete Minimum 3 Views (73110)
range across 3 matching MRF lines		 $222–$333 $222–$333 varies
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $220 $220 1.8×
Radiolog exam mandible compl minimum 4 views (70110) $335 $335 2.7×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $226 $226 1.8×
Radiologic exam colon double contrast study (74280) $583 $583 2.8×
Radiologic exam colon single contrast study (74270) $470 $470 2.2×
Radiologic Exam Esophagus Double Contrast Study (74221) $541 $541 2.6×
Radiologic exam knee complete 4/more views (73564)
range across 3 matching MRF lines		 $286–$429 $286–$429 varies
Radiologic exam pelvis compl minimum 3 views (72190) $226 $226 1.8×
Radiologic Exam Small Int Single Contrast Study (74250) $399 $399 1.9×
Radiologic exam swallow function contrast study (74230) $302 $302 1.4×
Radiologic exam upr gi trc double contrast study (74246) $510 $510 2.4×
Radiologic examination femur 1 view (73551)
range across 3 matching MRF lines		 $180–$270 $180–$270 varies
Radiologic examination femur minimum 2 views (73552)
range across 3 matching MRF lines		 $118–$177 $118–$177 varies
Radiologic examination knee 1/2 views (73560)
range across 3 matching MRF lines		 $216–$324 $216–$324 varies
Radiologic examination tibia & fibula 2 views (73590)
range across 3 matching MRF lines		 $222–$333 $222–$333 varies
Red Cell Volume Determination Spx Mult Samplings (78121) $1,383 $1,383 2.1×
Ribs bilateral 3 views (71110) $448 $448 3.6×
Rp loclzj tum plnr 1 area single day imaging (78800) $675 $675 1.4×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $2,146 $2,146 3.3×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $998 $998 1.5×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $1,601 $1,601 2.5×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $1,985 $1,985 1.3×
Salivary Gland Imaging Serial Images (78231) $611 $611 1.3×
Scapula (73010) $193 $193 1.5×
Screening Digital Breast Tomosynthesis Bi (77063) $210 $210 9.0×
Sella turcica (70240) $67 $67 0.6×
Shoulder 1 view (73020)
range across 3 matching MRF lines		 $166–$249 $166–$249 varies
Shoulder Arthrography (73040)
range across 3 matching MRF lines		 $704–$1,500 $704–$1,500 varies
Sialogram (70390) $440 $440 1.5×
Skull less than 4 views (70250) $272 $272 2.2×
Sternoclavicular joints (71130) $197 $197 1.9×
Testicular Imaging W/Flow (78761) $589 $589 1.2×
Thoracic spine 2 views (72070) $230 $230 1.8×
Thoracic spine 3 views (72072) $280 $280 2.2×
Thoracolumbar 2 views (72080) $278 $278 2.7×
Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) $523 $523 1.1×
Thyroid Imaging With Vascular Flow (78013) $378 $378 0.8×
Thyroid Met Imaging Body (78018) $489 $489 0.8×
Thyroid Uptake Measurement (78012) $384 $384 0.8×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $522 $522 1.1×
Ultrasound Breast Limited (76642)
range across 4 matching MRF lines		 $330–$495 $330–$495 varies
Ultrasound Elastography Parenchyma (76981) $198 $198 1.6×
Ultrasound Exam Aaa Screen (76706) $534 $534 4.3×
Ultrasound, abdomen limited (76705) $205 $205 1.6×
Umbilical-artery Doppler (OB) (76820) $344 $344 2.7×
Upper gi w/o kub (74240) $397 $397 1.9×
Ureteral Reflux Study (78740) $727 $727 1.5×
Urethrocystogram voiding (74455) $486 $486 1.7×
Urethrocystography retrograde (74450) $364 $364 1.3×
Us breast unilateral complete (76641)
range across 4 matching MRF lines		 $347–$521 $347–$521 varies
Us chest (76604) $681 $681 5.4×
Us complete joint (76881) $320 $320 2.6×
Us exam, pelvic, limited (76857) $205 $205 1.6×
Us head (76506) $320 $320 2.6×
Us kidney transplant (76776) $321 $321 2.6×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $294 $294 2.3×
Us ob detailed single fetus (76811) $658 $658 2.3×
Us ob limited 1 or more fetuses (76815) $350 $350 2.8×
Us ob transvaginal (76817) $350 $350 2.8×
Us pelvic non ob complete (76856) $226 $226 1.8×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $556 $556 4.4×
Us preg uterus real time f/u trnsabdl per fetus (76816)
range across 2 matching MRF lines		 $170–$295 $170–$295 varies
Us retroperitoneal complete (76770) $453 $453 3.6×
Us retroperitoneal limited (76775) $408 $408 3.3×
Us scrotum and contents (76870) $372 $372 3.0×
Us spinal canal and contents (76800) $518 $518 4.1×
Us thyroid (76536) $347 $347 2.8×
Us transrectal (76872) $367 $367 2.9×
Vein X-Ray Chest (75827) $1,546 $1,546 0.8×
Venography caval inferior serialography rs&i (75825) $5,736 $5,736 1.5×
Venography extremity bilateral rs&i (75822) $4,370 $4,370 2.3×
Venography extremity unilateral rs&i (75820) $2,194 $2,194 1.2×
Venography Renal Bilateral (75833) $8,697 $8,697 2.3×
Venography Renal Unilateral (75831) $8,697 $8,697 2.3×
Venous sampling by catheter (75893) $9,851 $9,851 1.5×
Venous thrombosis imaging (78457) $325 $325 0.5×
Venous Thrombosis Imaging Venogram Bilateral (78458) $649 $649 1.4×
Vertebral fracture assessment via dxa (77086) $397 $397 3.8×
Wrist 2 views (73100)
range across 3 matching MRF lines		 $188–$282 $188–$282 varies
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $268 $268 2.6×
X-ray antegrade pyelogram tube (74425) $595 $595 1.4×
X-Ray Aorta Leg Arteries (75630) $5,520 $5,520 1.5×
X-Ray Bend Only L-S Spine (72120) $246 $246 2.0×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 3 matching MRF lines		 $195–$293 $195–$293 varies
X-Ray Exam Entire Spi 1 Vw (72081) $335 $335 3.2×
X-Ray Exam Entire Spi 2/3 Vw (72082) $350 $350 2.8×
X-Ray Exam Hip Uni 1 View (73501) $128 $128 1.2×
X-Ray Exam Hip Uni 2-3 Views (73502) $172 $172 1.6×
X-Ray Exam Hip Uni 4/> Views (73503) $180 $180 1.4×
X-Ray Exam Hips Bi 2 Views (73521) $350 $350 2.8×
X-Ray Exam Hips Bi 3-4 Views (73522) $443 $443 3.5×
X-Ray Exam Hips Bi 5/> Views (73523) $183 $183 1.5×
X-Ray Exam L-S Spine Bending (72114) $400 $400 3.2×
X-Ray Exam Neck Spine 2-3 Vw (72040) $239 $239 2.3×
X-Ray Exam Neck Spine 6/>Vws (72052) $420 $420 3.4×
X-Ray Exam Unilat Ribs/Chest (71101) $420 $420 3.4×
X-ray eye for foreign body (70030) $228 $228 2.2×
X-ray humerus (73060)
range across 3 matching MRF lines		 $212–$318 $212–$318 varies
X-ray IV pyelogram (ivp) (74400) $434 $434 2.1×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $161 $161 1.5×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $216 $216 2.1×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $285 $285 2.3×
X-ray nose-rectum child f.b. (76010) $227 $227 2.2×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $482 $482 3.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $218 $218 1.7×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $173 $173 1.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $247 $247 2.4×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $331 $331 3.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $573 $573 4.6×
X-Ray Stress View (77071) $150 $150 1.4×
X-Ray Tmj Unilat (70328) $169 $169 1.6×
X-Ray Urinary Tract Exam With Contrast Material (74420) $595 $595 1.4×
X-Rays Bone Length Studies (77073) $390 $390 3.1×
X-Rays Bone Survey Complete (77075) $388 $388 3.1×
Xr c-spine 4 or 5 views (72050) $381 $381 3.0×
Xr facial bones less than 3 views (70140) $219 $219 2.1×
XR Mastoids < 3 Views Bilateral (70120) $175 $175 1.4×
Xr orbits complete 4 views (70200) $382 $382 3.0×
Xr Tomogram Single Plane (76100) $437 $437 3.5×

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.