Imaging prices at Iberia Medical Center
New Iberia, LA · every code in this section with a posted price and a Medicare benchmark.
249 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 3 matching MRF lines |
$153–$262.80 | $255–$438 | varies |
| Abdomen 2 views (74019) | $228.60 | $381 | 2.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $767.40 | $1,279 | 2.1× |
| Angio internal mammary (75756) | $1,089 | $1,815 | 0.4× |
| Angio pulmonary bilat (75743) | $2,722.80 | $4,538 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $2,722.80 | $4,538 | 1.0× |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$2,178–$2,613.60 | $3,630–$4,356 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,178 | $3,630 | 0.8× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,884 | $3,140 | 0.4× |
| Aortography thoracic w/o serialography rs&i (75600) | $2,110.20 | $3,517 | 0.7× |
| Artery X-Rays Abdomen (75726) | $2,722.80 | $4,538 | 0.5× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,178 | $3,630 | 0.4× |
| Arthrogram hip (73525) | $340.20 | $567 | 1.1× |
| Bone age studies (77072) | $146.40 | $244 | 1.5× |
| Bone Imaging 3 Phase (78315) | $1,830 | $3,050 | 5.1× |
| Bone Imaging Whole Body (78306) | $927.60 | $1,546 | 2.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $547.80 | $913 | 1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 3 matching MRF lines |
$96.60–$3,340.20 | $161–$5,567 | varies |
| Cat Scan Follow-Up Study (76380) | $234 | $390 | 3.0× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$36–$184.80 | $60–$308 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$156.60–$210 | $261–$350 | varies |
| Chest 4 or more views (71048) | $228.60 | $381 | 2.4× |
| Cholecystography Oral Contrast (74290) | $207 | $345 | 1.3× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$138.60–$233.40 | $231–$389 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,102.20 | $1,837 | 11.6× |
| Contrast Exam Abdominl Aorta (75625) | $3,267 | $5,445 | 1.1× |
| Contrast X-Ray Bladder (74430) | $240 | $400 | 0.8× |
| Contrast X-Ray Of Knee Joint (73580) | $340.20 | $567 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) | $2,596.80 | $4,328 | 8.2× |
| CT abdomen and pelvis without contrast (74176) | $2,385.60 | $3,976 | 11.0× |
| CT abdomen w contrast (74160) | $1,339.80 | $2,233 | 8.4× |
| CT abdomen w wo contrast (74170) | $1,363.20 | $2,272 | 8.6× |
| CT abdomen w/o contrast (74150) | $1,262.40 | $2,104 | 13.3× |
| CT Angio Abdomen and Pelvis (74174) | $2,769 | $4,615 | 8.8× |
| CT Angio Chest (71275) | $1,960.20 | $3,267 | 12.3× |
| CT Angio Head (70496) | $1,846.20 | $3,077 | 11.6× |
| CT angio hrt w/3d image (75574) | $1,960.20 | $3,267 | 6.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$1,060.80–$1,557.60 | $1,768–$2,596 | varies |
| CT Angio Neck (70498) | $1,797 | $2,995 | 11.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,060.80 | $1,768 | 6.7× |
| CT cervical spine w/ contrast (72126) | $1,706.40 | $2,844 | 5.4× |
| CT cervical spine w/o contrast (72125) | $1,595.40 | $2,659 | 16.9× |
| CT cervical spine w/wo cont (72127) | $1,706.40 | $2,844 | 10.7× |
| CT chest w contrast (71260) | $1,179 | $1,965 | 7.4× |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$1,179–$1,458.60 | $1,965–$2,431 | varies |
| CT head/brain with contrast (70460) | $1,363.20 | $2,272 | 8.6× |
| CT head/brain without and with contrast (70470) | $1,427.40 | $2,379 | 9.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $59.40 | $99 | 0.8× |
| CT iac w contrast (70481) | $1,223.40 | $2,039 | 7.7× |
| CT l-spine w&w/o contrast (72133) | $1,706.40 | $2,844 | 10.7× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$795.60–$991.80 | $1,326–$1,653 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$795.60–$1,052.40 | $1,326–$1,754 | varies |
| CT lumbar spine w contrast (72132) | $1,706.40 | $2,844 | 5.4× |
| CT lumbar spine w/o contrast (72131) | $1,595.40 | $2,659 | 16.9× |
| CT maxillofacial w contrast (70487) | $1,191.60 | $1,986 | 7.5× |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$448.80–$1,158.60 | $748–$1,931 | varies |
| CT neck tissue combo (70492) | $1,402.20 | $2,337 | 8.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,518.60 | $2,531 | 9.6× |
| CT orbits w/o contrast (70480) | $1,225.80 | $2,043 | 12.9× |
| CT pelvis w&w/o contrast (72194) | $1,402.20 | $2,337 | 8.8× |
| CT pelvis w/o contrast (72192) | $1,123.80 | $1,873 | 11.9× |
| CT scan of leg combo (73702) range across 4 matching MRF lines |
$972.60–$1,225.80 | $1,621–$2,043 | varies |
| CT scans face/jaw combo (70488) | $1,402.20 | $2,337 | 8.8× |
| CT soft tissue neck w contrast (70491) | $1,113.60 | $1,856 | 7.0× |
| CT soft tissue neck w/o contrast (70490) | $1,108.20 | $1,847 | 11.7× |
| CT thoracic spine w contrast (72129) | $1,595.40 | $2,659 | 10.0× |
| CT thoracic spine w/o contrast (72128) | $1,595.40 | $2,659 | 16.9× |
| CT thoracic spine w/wo cont (72130) | $1,706.40 | $2,844 | 10.7× |
| CT thorax w/o contrast (71250) range across 6 matching MRF lines |
$1,102.20–$1,262.40 | $1,837–$2,104 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$991.80–$1,239.60 | $1,653–$2,066 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,225.80–$1,532.40 | $2,043–$2,554 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,052.40–$1,315.20 | $1,754–$2,192 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,846.20 | $3,077 | 11.6× |
| Cta Abdomen (74175) | $1,846.20 | $3,077 | 11.6× |
| CTA pelvis (72191) | $1,743 | $2,905 | 11.0× |
| Dxa Bone Density Axial (77080) | $157.80 | $263 | 1.7× |
| Echo Guide For Artery Repair (76936) | $592.80 | $988 | 3.0× |
| Esophagram (74220) | $340.20 | $567 | 2.1× |
| Fetal Biophys Profile W/Nst (76818) | $505.20 | $842 | 5.3× |
| Fluoroscopy up to 1 hr (76000) range across 5 matching MRF lines |
$265.80–$354 | $443–$590 | varies |
| Follow-Up Angiography (75898) | $1,089 | $1,815 | 0.4× |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$141–$270 | $235–$450 | varies |
| Gastric emptying imaging study (78264) | $702.60 | $1,171 | 1.9× |
| Gated Heart Planar Single (78472) | $1,084.20 | $1,807 | 3.0× |
| Hepatobil Syst Image W/Drug (78227) | $722.40 | $1,204 | 1.5× |
| Hepatobiliary System Imaging (78226) | $672.60 | $1,121 | 1.9× |
| Hysterosalpingogram (74740) | $226.80 | $378 | 1.0× |
| K Flow/Funct Image W/Drug (78708) | $1,503 | $2,505 | 3.1× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$168.60–$332.40 | $281–$554 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,011.60 | $1,686 | 2.8× |
| Lung Ventilat&Perfus Imaging (78582) | $1,570.80 | $2,618 | 3.2× |
| Lung Ventilation Imaging (78579) | $1,021.20 | $1,702 | 2.8× |
| Lymph System Imaging (78195) | $561 | $935 | 1.1× |
| Magnetic Image Jaw Joint (70336) | $2,124 | $3,540 | 9.8× |
| Mra Head W/O & W/Contrast Material (70546) | $2,361 | $3,935 | 7.5× |
| MRA head w/o contrast (70544) | $2,107.80 | $3,513 | 9.8× |
| MRA head with contrast (70545) | $2,277 | $3,795 | 7.2× |
| MRA neck w contrast (70548) | $2,361 | $3,935 | 7.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,521.20 | $4,202 | 8.0× |
| MRA neck w/o contrast (70547) | $2,790.60 | $4,651 | 12.9× |
| MRI abdomen w contrast (74182) | $627 | $1,045 | 2.0× |
| MRI abdomen w/o contrast (74181) | $2,124 | $3,540 | 9.8× |
| MRI any jt lower extrem w/contrast material (73722) | $1,432.80 | $2,388 | 2.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,432.80 | $2,388 | 4.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,432.80 | $2,388 | 2.0× |
| MRI cardiac w/o contrast (75557) | $2,124 | $3,540 | 9.8× |
| MRI cervical spine w contrast (72142) | $2,740.80 | $4,568 | 8.7× |
| MRI cervical spine w/o cont (72141) | $2,124 | $3,540 | 9.8× |
| MRI chest w/o contrast (71550) | $1,821.60 | $3,036 | 8.4× |
| MRI chest with contrast (71551) | $1,821.60 | $3,036 | 2.6× |
| MRI chest wo w contrast (71552) | $1,821.60 | $3,036 | 5.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,432.80 | $2,388 | 4.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,432.80 | $2,388 | 4.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,432.80 | $2,388 | 6.6× |
| MRI lumbar spine w contrast (72149) | $2,740.80 | $4,568 | 8.7× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$2,740.80–$2,790.60 | $4,568–$4,651 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $2,124 | $3,540 | 9.8× |
| MRI orbit face neck w contrast (70542) | $2,124 | $3,540 | 6.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$2,124–$2,599.80 | $3,540–$4,333 | varies |
| MRI pelvis w contrast (72196) | $2,124 | $3,540 | 6.7× |
| MRI pelvis w/o & w contrast (72197) | $2,124 | $3,540 | 6.7× |
| MRI pelvis w/o contrast (72195) | $2,124 | $3,540 | 9.8× |
| MRI thoracic spine w/o contrast (72146) | $2,124 | $3,540 | 9.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,432.80 | $2,388 | 4.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,432.80 | $2,388 | 6.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,432.80 | $2,388 | 4.5× |
| MRI, abdomen, combo (74183) | $627 | $1,045 | 2.0× |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$2,740.20–$2,790.60 | $4,567–$4,651 | varies |
| MRI, dorsal spine contrast (72147) | $2,740.20 | $4,567 | 8.7× |
| MRI, joint upper extrem (73221) | $1,432.80 | $2,388 | 6.6× |
| MRI, joint upper extrem combo (73223) | $1,432.80 | $2,388 | 4.5× |
| MRI, lumbar spine combo (72158) | $2,790.60 | $4,651 | 8.8× |
| Myelogram cervical (72240) | $1,114.20 | $1,857 | 1.6× |
| Myelogram Lumbar (72265) | $971.40 | $1,619 | 1.4× |
| Myelography thoracic (72255) | $1,035 | $1,725 | 1.5× |
| Myelograpy 2/more regions rs&i (72270) | $1,475.40 | $2,459 | 2.1× |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$1,774.20–$1,909.80 | $2,957–$3,183 | varies |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) range across 2 matching MRF lines |
$121.80–$3,340.20 | $203–$5,567 | varies |
| Neck soft tissue (70360) | $123 | $205 | 1.6× |
| Nuclear Rx Oral Admin (79005) | $759 | $1,265 | 3.6× |
| Parathyroid Planar Imaging (78070) | $862.20 | $1,437 | 2.4× |
| Pelvis 1 or 2 views (72170) | $180.60 | $301 | 1.9× |
| Pet Image Skull-Thigh (78812) | $127.80 | $213 | 0.1× |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$142.20–$3,518.40 | $237–$5,864 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$160.20–$3,518.40 | $267–$5,864 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 6 matching MRF lines |
$158.40–$3,518.40 | $264–$5,864 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $550.20 | $917 | 1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$205.80–$276.60 | $343–$461 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$126.60–$243 | $211–$405 | varies |
| Radex elbow complete minimum 3 views (73080) | $151.20 | $252 | 1.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $217.80 | $363 | 2.3× |
| Radex fingr minimum 2 views (73140) | $117 | $195 | 1.5× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$141–$270 | $235–$450 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$198–$243 | $330–$405 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $151.20 | $252 | 1.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $235.20 | $392 | 2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $141 | $235 | 1.8× |
| Radex Ribs Unilateral 2 Views (71100) | $196.80 | $328 | 2.5× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$154.20–$261 | $257–$435 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$120.60–$192.60 | $201–$321 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$106.20–$122.40 | $177–$204 | varies |
| Radex Sternum Minimum 2 Views (71120) | $172.80 | $288 | 2.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $220.20 | $367 | 2.8× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$122.40–$233.40 | $204–$389 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $126.60 | $211 | 1.3× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$141–$276.60 | $235–$461 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $182.40 | $304 | 1.9× |
| Radiologic exam colon double contrast study (74280) | $676.80 | $1,128 | 4.3× |
| Radiologic exam colon single contrast study (74270) | $502.20 | $837 | 3.2× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$215.40–$430.20 | $359–$717 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $305.40 | $509 | 3.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $363 | $605 | 2.3× |
| Radiologic exam swallow function contrast study (74230) | $383.40 | $639 | 2.4× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$151.20–$302.40 | $252–$504 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$139.20–$235.20 | $232–$392 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$130.80–$251.40 | $218–$419 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,439.40–$1,692 | $2,399–$2,820 | varies |
| Scapula (73010) range across 3 matching MRF lines |
$141–$233.40 | $235–$389 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $33 | $55 | 1.4× |
| Sella turcica (70240) | $127.20 | $212 | 1.6× |
| Shoulder 1 view (73020) | $154.20 | $257 | 2.0× |
| Shoulder Arthrography (73040) | $340.20 | $567 | 1.1× |
| Sialogram (70390) | $428.40 | $714 | 2.0× |
| Skull less than 4 views (70250) | $181.20 | $302 | 1.9× |
| Sternoclavicular joints (71130) | $122.40 | $204 | 1.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,014 | $1,690 | 6.4× |
| Thoracic spine 2 views (72070) | $177 | $295 | 1.9× |
| Thoracic spine 3 views (72072) | $250.20 | $417 | 2.6× |
| Thyroid Met Imaging Body (78018) | $999.60 | $1,666 | 2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $808.20 | $1,347 | 2.2× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$133.80–$193.80 | $223–$323 | varies |
| Ultrasound Exam Aaa Screen (76706) | $925.80 | $1,543 | 9.8× |
| Ultrasound, abdomen limited (76705) | $420 | $700 | 4.4× |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$21.60–$248.40 | $36–$414 | varies |
| Unlisted fluoroscopic procedure (76496) | $163.20 | $272 | 2.1× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$461.40–$682.80 | $769–$1,138 | varies |
| Urethrocystogram voiding (74455) | $379.20 | $632 | 1.8× |
| Urethrocystography retrograde (74450) | $461.40 | $769 | 2.1× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$253.80–$338.40 | $423–$564 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$276.60–$386.40 | $461–$644 | varies |
| Us complete joint (76881) | $420 | $700 | 4.4× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$271.20–$318.60 | $452–$531 | varies |
| Us kidney transplant (76776) | $1,128.60 | $1,881 | 11.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$351–$702 | $585–$1,170 | varies |
| Us ob limited 1 or more fetuses (76815) | $437.40 | $729 | 4.6× |
| Us ob transvaginal (76817) | $467.40 | $779 | 4.9× |
| Us pelvic non ob complete (76856) | $467.40 | $779 | 4.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,214.40 | $2,024 | 12.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $652.20 | $1,087 | 6.9× |
| Us retroperitoneal complete (76770) | $561 | $935 | 5.9× |
| Us retroperitoneal limited (76775) | $1,128.60 | $1,881 | 11.9× |
| Us scrotum and contents (76870) | $451.20 | $752 | 4.8× |
| Us thyroid (76536) | $411.60 | $686 | 4.3× |
| Vein X-Ray Chest (75827) | $863.40 | $1,439 | 0.6× |
| Venogram Sinus/Jugular (75860) | $1,352.40 | $2,254 | 0.5× |
| Venography caval inferior serialography rs&i (75825) | $1,089 | $1,815 | 0.4× |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$590.40–$2,722.80 | $984–$4,538 | varies |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$364.80–$2,178 | $608–$3,630 | varies |
| Venography Renal Bilateral (75833) | $3,432.60 | $5,721 | 1.2× |
| Venography Renal Unilateral (75831) | $3,432.60 | $5,721 | 1.2× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,089 | $1,815 | 0.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $182.40 | $304 | 2.3× |
| X-Ray Aorta Leg Arteries (75630) | $4,356 | $7,260 | 1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $243 | $405 | 3.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $199.80 | $333 | 2.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $133.80 | $223 | 1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $162.60 | $271 | 2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $220.20 | $367 | 2.3× |
| X-Ray Exam L-S Spine Bending (72114) | $411 | $685 | 4.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$168.60–$228.60 | $281–$381 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $403.80 | $673 | 4.3× |
| X-ray eye for foreign body (70030) | $123 | $205 | 1.6× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$126.60–$252.60 | $211–$421 | varies |
| X-ray IV pyelogram (ivp) (74400) | $414.60 | $691 | 2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $211.80 | $353 | 2.2× |
| X-ray nose-rectum child f.b. (76010) | $153 | $255 | 1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $380.40 | $634 | 4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $261 | $435 | 2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $211.80 | $353 | 2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $219 | $365 | 2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $256.20 | $427 | 2.7× |
| X-Ray Tmj Unilat (70328) | $139.20 | $232 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$579–$1,158.60 | $965–$1,931 | varies |
| X-Rays Bone Length Studies (77073) | $211.80 | $353 | 2.2× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$411–$483.60 | $685–$806 | varies |
| Xr c-spine 4 or 5 views (72050) | $322.80 | $538 | 3.4× |
| Xr facial bones less than 3 views (70140) | $166.80 | $278 | 2.1× |
| Xr orbits complete 4 views (70200) | $220.20 | $367 | 2.3× |
| Xr Tomogram Single Plane (76100) | $511.20 | $852 | 5.4× |
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.