Imaging prices at Johnson Memorial Hospital
Franklin, IN · every code in this section with a posted price and a Medicare benchmark.
246 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) | $529.60 | $662 | 5.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,547.20 | $1,934 | 3.7× |
| Angiography extremity bilateral rs&i (75716) | $7,356 | $9,195 | 2.2× |
| Angiography extremity unilateral rs&i (75710) | $7,356 | $9,195 | 2.2× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$301.60–$312 | $377–$390 | varies |
| Arthrogram ankle (73615) | $910.40 | $1,138 | 2.5× |
| Arthrogram hip (73525) | $900.80 | $1,126 | 2.4× |
| Arthrogram Wrist (73115) | $910.40 | $1,138 | 2.5× |
| Bone age studies (77072) | $394.40 | $493 | 3.6× |
| Bone Imaging 3 Phase (78315) | $3,622.40 | $4,528 | 8.6× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,531.20–$1,661.60 | $1,914–$2,077 | varies |
| Bone marrow imaging limited area (78102) | $1,216 | $1,520 | 2.9× |
| Bone survey infant (77076) | $373.60 | $467 | 3.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $4,170.40 | $5,213 | 11.3× |
| Cat Scan Follow-Up Study (76380) | $950.40 | $1,188 | 10.3× |
| Chest 1 view (71045) | $311.20 | $389 | 3.4× |
| Chest 2 views (71046) range across 4 matching MRF lines |
$390.40–$584.80 | $488–$731 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$402.40–$430.40 | $503–$538 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$329.60–$584.80 | $412–$731 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $317.60 | $397 | 2.9× |
| Contrast Exam Abdominl Aorta (75625) | $7,356 | $9,195 | 2.2× |
| Contrast X-Ray Bladder (74430) | $402.40 | $503 | 1.1× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$910.40–$1,792.80 | $1,138–$2,241 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$851.20–$910.40 | $1,064–$1,138 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$1,767.20–$4,392.80 | $2,209–$5,491 | varies |
| CT abdomen and pelvis without contrast (74176) | $3,880.80 | $4,851 | 15.4× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,828–$1,828.80 | $2,285–$2,286 | varies |
| CT abdomen w wo contrast (74170) | $2,217.60 | $2,772 | 11.9× |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$2,092.80–$2,304 | $2,616–$2,880 | varies |
| CT Angio Abdomen and Pelvis (74174) | $3,824.80 | $4,781 | 10.4× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$2,551.20–$2,728.80 | $3,189–$3,411 | varies |
| CT Angio Head (70496) | $2,551.20 | $3,189 | 13.7× |
| CT angio hrt w/3d image (75574) | $2,177.60 | $2,722 | 5.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$3,566.40–$3,813.60 | $4,458–$4,767 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$2,551.20–$2,728.80 | $3,189–$3,411 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$3,813.60–$3,847.20 | $4,767–$4,809 | varies |
| CT cervical spine w/o contrast (72125) | $2,536.80 | $3,171 | 22.9× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$2,177.60–$2,328.80 | $2,722–$2,911 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$411.20–$3,455.20 | $514–$4,319 | varies |
| CT head/brain with contrast (70460) | $1,646.40 | $2,058 | 8.9× |
| CT head/brain without and with contrast (70470) | $2,708 | $3,385 | 14.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $388 | $485 | 1.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $39.20 | $49 | 0.4× |
| CT iac w contrast (70481) | $1,655.20 | $2,069 | 8.9× |
| CT lower ext w/o (73700) | $2,003.20 | $2,504 | 18.1× |
| CT lower extremity w/contrast material (73701) | $2,003.20 | $2,504 | 10.8× |
| CT lumbar spine w contrast (72132) | $2,387.20 | $2,984 | 6.5× |
| CT lumbar spine w/o contrast (72131) | $2,028.80 | $2,536 | 18.3× |
| CT maxillofacial w contrast (70487) | $1,564.80 | $1,956 | 8.4× |
| CT maxillofacial wo contrast (70486) | $1,770.40 | $2,213 | 16.0× |
| CT neck tissue combo (70492) | $2,609.60 | $3,262 | 14.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 4 matching MRF lines |
$2,148–$2,337.60 | $2,685–$2,922 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,655.20–$1,770.40 | $2,069–$2,213 | varies |
| CT pelvis w&w/o contrast (72194) | $2,217.60 | $2,772 | 11.9× |
| CT pelvis w/o contrast (72192) | $1,958.40 | $2,448 | 17.7× |
| CT scan of leg combo (73702) | $3,004 | $3,755 | 16.2× |
| CT scans face/jaw combo (70488) | $1,672.80 | $2,091 | 9.0× |
| CT soft tissue neck w contrast (70491) | $1,999.20 | $2,499 | 10.8× |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$2,138.40–$2,309.60 | $2,673–$2,887 | varies |
| CT thoracic spine w contrast (72129) | $2,324 | $2,905 | 12.5× |
| CT thoracic spine w/o contrast (72128) | $2,521.60 | $3,152 | 22.8× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$2,008–$2,255.20 | $2,510–$2,819 | varies |
| CT upper ext wo (73200) | $2,003.20 | $2,504 | 18.1× |
| CT upper extremity with contrast (73201) | $2,003.20 | $2,504 | 5.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,947.20 | $3,684 | 15.9× |
| Cta Abdomen (74175) range across 3 matching MRF lines |
$2,382.40–$2,728.80 | $2,978–$3,411 | varies |
| CTA pelvis (72191) | $2,728.80 | $3,411 | 14.7× |
| Dxa Bone Density Axial (77080) | $561.60 | $702 | 5.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $171.20 | $214 | 1.9× |
| Echo exam uterus (76831) | $252 | $315 | 1.0× |
| Esophagram (74220) | $732.80 | $916 | 3.9× |
| Fetal Biophys Profile W/Nst (76818) | $260.80 | $326 | 2.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$190.40–$1,118.40 | $238–$1,398 | varies |
| Fluoroscopy up to 1 hr (76000) range across 7 matching MRF lines |
$39.60–$1,456 | $49.50–$1,820 | varies |
| Foot 2 views (73620) range across 2 matching MRF lines |
$304–$360 | $380–$450 | varies |
| Forearm 2 views (73090) | $385.60 | $482 | 4.2× |
| Gastric emptying imaging study (78264) | $1,968 | $2,460 | 4.7× |
| Gated Heart Planar Single (78472) | $2,410.40 | $3,013 | 5.7× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$59.20–$276 | $74–$345 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,128.80 | $2,661 | 3.7× |
| Hepatobiliary System Imaging (78226) | $1,571.20 | $1,964 | 3.7× |
| Ht Muscle Image Spect Sing (78451) | $3,574.40 | $4,468 | 2.6× |
| Hysterosalpingogram (74740) range across 3 matching MRF lines |
$73.60–$473.60 | $92–$592 | varies |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$402.40–$443.20 | $503–$554 | varies |
| K Flow/Funct Image W/Drug (78708) | $1,767.20 | $2,209 | 3.1× |
| Knee 3 Views (73562) | $411.20 | $514 | 4.5× |
| Liver & Spleen Imaging Static Only (78215) | $1,446.40 | $1,808 | 3.4× |
| Lung Ventilat&Perfus Imaging (78582) | $2,750.40 | $3,438 | 4.8× |
| Lymph System Imaging (78195) | $1,171.20 | $1,464 | 2.0× |
| Magnetic Image Jaw Joint (70336) | $3,716.80 | $4,646 | 14.7× |
| Meckels Divert Exam (78290) | $920 | $1,150 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$2,546.40–$2,674.40 | $3,183–$3,343 | varies |
| MRA head w/o contrast (70544) | $2,500 | $3,125 | 9.9× |
| MRA head with contrast (70545) | $2,524 | $3,155 | 6.8× |
| MRA neck w contrast (70548) | $2,501.60 | $3,127 | 6.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,903.20 | $3,629 | 7.9× |
| MRA neck w/o contrast (70547) | $2,500 | $3,125 | 9.9× |
| MRI abdomen w contrast (74182) | $3,859.20 | $4,824 | 10.5× |
| MRI abdomen w/o contrast (74181) | $4,165.60 | $5,207 | 16.5× |
| MRI any jt lower extrem w/contrast material (73722) | $3,868.80 | $4,836 | 4.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,961.60 | $4,952 | 10.7× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$3,679.20–$7,569.60 | $4,599–$9,462 | varies |
| MRI cardiac w/o contrast (75557) | $3,983.20 | $4,979 | 15.8× |
| MRI cervical spine w contrast (72142) | $4,089.60 | $5,112 | 11.1× |
| MRI cervical spine w/o cont (72141) | $4,033.60 | $5,042 | 16.0× |
| MRI chest w/o contrast (71550) | $3,193.60 | $3,992 | 12.7× |
| MRI chest with contrast (71551) | $3,416.80 | $4,271 | 4.1× |
| MRI chest wo w contrast (71552) | $3,857.60 | $4,822 | 10.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$3,615.20–$3,868.80 | $4,519–$4,836 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,246.40 | $4,058 | 8.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,904 | $4,880 | 15.5× |
| MRI lumbar spine w contrast (72149) | $3,717.60 | $4,647 | 10.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,432 | $5,540 | 12.0× |
| MRI orbit face &/neck w/o contrast (70540) | $4,016.80 | $5,021 | 15.9× |
| MRI orbit face neck w contrast (70542) | $4,127.20 | $5,159 | 11.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$1,077.60–$3,850.40 | $1,347–$4,813 | varies |
| MRI pelvis w contrast (72196) | $3,980 | $4,975 | 10.8× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$3,634.40–$4,239.20 | $4,543–$5,299 | varies |
| MRI pelvis w/o contrast (72195) | $4,014.40 | $5,018 | 15.9× |
| MRI thoracic spine w/o contrast (72146) | $4,014.40 | $5,018 | 15.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$3,740–$3,930.40 | $4,675–$4,913 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,775.20 | $4,719 | 15.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$3,674.40–$7,565.60 | $4,593–$9,457 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$3,643.20–$3,674.40 | $4,554–$4,593 | varies |
| MRI, dorsal spine combo (72157) | $3,836.80 | $4,796 | 10.4× |
| MRI, dorsal spine contrast (72147) | $3,717.60 | $4,647 | 10.1× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$3,472–$7,428 | $4,340–$9,285 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$3,436–$7,717.60 | $4,295–$9,647 | varies |
| MRI, lumbar spine combo (72158) | $4,452 | $5,565 | 12.1× |
| Myelogram cervical (72240) | $1,291.20 | $1,614 | 1.6× |
| Myelogram Lumbar (72265) | $1,291.20 | $1,614 | 1.6× |
| Myelography thoracic (72255) | $1,291.20 | $1,614 | 1.6× |
| Myelograpy 2/more regions rs&i (72270) | $1,656 | $2,070 | 2.0× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $2,030.40 | $2,538 | 4.8× |
| Myocardial Spect Multiple Studies (78452) | $3,878.40 | $4,848 | 2.8× |
| Neck soft tissue (70360) | $332.80 | $416 | 3.6× |
| Nonvascular Shunt X-Ray (75809) | $444.80 | $556 | 4.0× |
| Nuclear Rx Oral Admin (79005) | $1,884.80 | $2,356 | 7.6× |
| Optic foramina (70190) | $430.40 | $538 | 4.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,654.40 | $2,068 | 3.9× |
| Pelvis 1 or 2 views (72170) | $459.20 | $574 | 4.2× |
| Pet Image W/Ct Lmtd (78814) | $9,393.60 | $11,742 | 6.2× |
| PET image w/CT, full body (78816) | $10,332 | $12,915 | 6.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,782.40 | $10,978 | 5.8× |
| PET whole body (78813) | $9,393.60 | $11,742 | 6.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,188.80 | $1,486 | 2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $514.40 | $643 | 0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$321.60–$360 | $402–$450 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$304–$311.20 | $380–$389 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$60.80–$361.60 | $76–$452 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $643.20 | $804 | 5.8× |
| Radex fingr minimum 2 views (73140) | $317.60 | $397 | 3.4× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$316.80–$360 | $396–$450 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$360–$361.60 | $450–$452 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $332.80 | $416 | 3.6× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $504 | $630 | 4.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $492 | $615 | 5.3× |
| Radex Ribs Unilateral 2 Views (71100) | $402.40 | $503 | 4.4× |
| Radex shoulder complete minimum 2 views (73030) | $428.80 | $536 | 4.7× |
| Radex Spine 1 View Specify Level (72020) | $298.40 | $373 | 3.2× |
| Radex Sternum Minimum 2 Views (71120) | $348 | $435 | 3.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $460 | $575 | 5.0× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$285.60–$306.40 | $357–$383 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$307.20–$608.80 | $384–$761 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) | $361.60 | $452 | 3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$457.60–$629.60 | $572–$787 | varies |
| Radiologic exam colon double contrast study (74280) | $1,061.60 | $1,327 | 5.7× |
| Radiologic exam colon single contrast study (74270) | $808 | $1,010 | 4.4× |
| Radiologic exam knee complete 4/more views (73564) | $467.20 | $584 | 4.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $549.60 | $687 | 3.0× |
| Radiologic exam swallow function contrast study (74230) | $462.40 | $578 | 2.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $792.80 | $991 | 4.3× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$424–$452.80 | $530–$566 | varies |
| Radiologic examination knee 1/2 views (73560) | $366.40 | $458 | 4.0× |
| Radiologic examination tibia & fibula 2 views (73590) | $385.60 | $482 | 4.2× |
| Ribs bilateral 3 views (71110) | $512 | $640 | 4.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,684 | $2,105 | 2.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines |
$1,655.20–$3,523.20 | $2,069–$4,404 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$53.60–$403.20 | $67–$504 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$119.20–$120 | $149–$150 | varies |
| Shoulder Arthrography (73040) | $1,973.60 | $2,467 | 5.3× |
| Sialogram (70390) | $641.60 | $802 | 2.5× |
| Skull less than 4 views (70250) | $499 | $623.75 | 4.5× |
| Sternoclavicular joints (71130) | $328 | $410 | 3.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $396 | $495 | 1.0× |
| Testicular Imaging W/Flow (78761) | $1,532.80 | $1,916 | 3.6× |
| Thoracic spine 3 views (72072) | $490.40 | $613 | 4.4× |
| Thoracolumbar 2 views (72080) | $227.20 | $284 | 2.5× |
| Thyroid Imaging With Vascular Flow (78013) | $881.60 | $1,102 | 2.1× |
| Thyroid Met Imaging Body (78018) | $1,330.40 | $1,663 | 2.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,083.20 | $1,354 | 2.6× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$188.80–$249.60 | $236–$312 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$57.60–$798.40 | $72–$998 | varies |
| Ultrasound, abdomen limited (76705) | $909.60 | $1,137 | 8.2× |
| Upper gi w/o kub (74240) | $730.40 | $913 | 3.9× |
| Urethrocystogram voiding (74455) | $430.40 | $538 | 1.7× |
| Urethrocystography retrograde (74450) | $600 | $750 | 2.4× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$640–$1,352.80 | $800–$1,691 | varies |
| Us chest (76604) | $715.20 | $894 | 6.5× |
| Us complete joint (76881) range across 5 matching MRF lines |
$76–$1,434.40 | $95–$1,793 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$92–$514.40 | $115–$643 | varies |
| Us head (76506) | $620.80 | $776 | 5.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 8 matching MRF lines |
$76.80–$728 | $96–$910 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$390.40–$390.80 | $488–$488.50 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$179.20–$728.80 | $224–$911 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$208–$583.20 | $260–$729 | varies |
| Us pelvic non ob complete (76856) range across 6 matching MRF lines |
$184–$979.20 | $230–$1,224 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$264–$681.60 | $330–$852 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $244.80 | $306 | 2.2× |
| Us retroperitoneal complete (76770) | $956 | $1,195 | 8.6× |
| Us retroperitoneal limited (76775) | $671.20 | $839 | 6.1× |
| Us scrotum and contents (76870) | $856 | $1,070 | 7.7× |
| Us spinal canal and contents (76800) | $830.40 | $1,038 | 7.5× |
| Us thyroid (76536) | $784.80 | $981 | 7.1× |
| Us transrectal (76872) | $778.40 | $973 | 7.0× |
| Venography extremity unilateral rs&i (75820) | $2,575.20 | $3,219 | 1.5× |
| Wrist 2 views (73100) | $280.80 | $351 | 3.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $339.20 | $424 | 3.7× |
| X-ray antegrade pyelogram tube (74425) | $804 | $1,005 | 2.2× |
| X-Ray Aorta Leg Arteries (75630) | $7,356 | $9,195 | 2.2× |
| X-Ray Bend Only L-S Spine (72120) | $537.60 | $672 | 4.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $54.40 | $68 | 0.6× |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$873.60–$935.20 | $1,092–$1,169 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $401.60 | $502 | 3.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$75.20–$391.20 | $94–$489 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$682.40–$729.60 | $853–$912 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $1,001.60 | $1,252 | 9.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $888 | $1,110 | 9.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $931.20 | $1,164 | 8.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $492.80 | $616 | 4.5× |
| X-ray eye for foreign body (70030) | $352.80 | $441 | 3.8× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$356–$384 | $445–$480 | varies |
| X-ray IV pyelogram (ivp) (74400) | $707.20 | $884 | 3.8× |
| X-ray IV pyelogram+tomography (74415) | $1,048.80 | $1,311 | 5.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $434.40 | $543 | 4.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $396 | $495 | 4.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $468.80 | $586 | 4.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $675.20 | $844 | 6.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $398.40 | $498 | 3.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $368.80 | $461 | 4.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $402.40 | $503 | 4.4× |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$121.60–$259.20 | $152–$324 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $624 | $780 | 1.7× |
| X-Rays Bone Length Studies (77073) | $460.80 | $576 | 4.2× |
| X-Rays Bone Survey Complete (77075) | $867.20 | $1,084 | 7.8× |
| Xr c-spine 4 or 5 views (72050) | $481.60 | $602 | 4.4× |
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.