Imaging prices at Kootenai Health

Coeur d'Alene, ID · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $1,286.25 $1,715 0.9×
Abdomen 1 View (74018) $210.75 $281 2.3×
Abdomen 2 views (74019) $224.25 $299 2.1×
Acute Gastrointestinal Blood Loss Imaging (78278) $2,777.25 $3,703 6.7×
Angio internal mammary (75756) $3,045 $4,060 0.9×
Angio pulmonary bilat (75743) $4,226.25 $5,635 1.3×
Angiography extremity bilateral rs&i (75716) $4,463.25 $5,951 1.4×
Angiography extremity unilateral rs&i (75710) $3,375 $4,500 1.0×
Angiography pulmonary unilateral slctv rs&i (75741) $3,258.75 $4,345 1.0×
Ankle 2 views (73600) $231 $308 2.6×
Aortography thoracic serialography rs&i (75605) $3,758.25 $5,011 0.7×
Artery X-Rays Abdomen (75726) $6,348 $8,464 1.1×
Artery X-Rays Pelvis (75736) $3,864 $5,152 0.7×
Artery X-Rays Spine (75705) $4,113 $5,484 0.7×
Arthrogram hip (73525) $871.50 $1,162 2.4×
Arthrogram Wrist (73115) $869.25 $1,159 2.4×
Basic radiation dosimetry calculation (77300) $175.50 $234 1.3×
Bone age studies (77072) $263.25 $351 2.4×
Bone Imaging 3 Phase (78315) $1,792.50 $2,390 4.3×
Bone Imaging Limited Area (78300) $1,838.25 $2,451 4.4×
Bone Imaging Whole Body (78306) $1,961.25 $2,615 4.7×
Bone marrow imaging limited area (78102) $1,149 $1,532 2.8×
Bone survey infant (77076) $300.75 $401 2.8×
Brain Flow Imaging Only (78610) $1,100.25 $1,467 2.0×
Brain Image W/Flow < 4 Views (78601) $1,100.25 $1,467 2.7×
Brain Imaging Pet Metabolic Evaluation (78608) $4,885.50 $6,514 3.3×
Cardiac MRI w/w/o contrast & further seq (75561) $2,059.50 $2,746 5.7×
Cat Scan Follow-Up Study (76380) $568.50 $758 6.3×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $1,075.50 $1,434 1.9×
Cerebrospinal Fluid Scan (78630) $2,016.75 $2,689 3.6×
Chest 1 view (71045) $181.50 $242 2.0×
Chest 2 views (71046) $210.75 $281 2.3×
Chest 3 views (71047) $242.25 $323 2.7×
Chest 4 or more views (71048) $265.50 $354 2.5×
Clavicle complete (73000) $231 $308 2.6×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $244.50 $326 2.3×
Continuing medical physics consltj pr wk (77336) $201 $268 1.4×
Contrast Exam Abdominl Aorta (75625) $3,108.75 $4,145 1.0×
Contrast X-Ray Bladder (74430) $813 $1,084 2.3×
Contrast X-Ray Of Elbow (73085) $848.25 $1,131 2.4×
Contrast X-Ray Of Knee Joint (73580) $948 $1,264 2.6×
CT abdomen and pelvis without and with contrast (74178) $2,625 $3,500 7.3×
CT abdomen and pelvis without contrast (74176) $1,762.50 $2,350 7.1×
CT abdomen w contrast (74160) $1,282.50 $1,710 7.1×
CT abdomen w wo contrast (74170) $1,431 $1,908 7.9×
CT abdomen w/o contrast (74150) $1,062.75 $1,417 9.8×
CT Angio Abdomen and Pelvis (74174) $2,754 $3,672 7.6×
CT Angio Chest (71275) $1,612.50 $2,150 8.9×
CT Angio Head (70496) $1,575 $2,100 8.7×
CT angio hrt w/3d image (75574) $1,725 $2,300 4.8×
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 2 matching MRF lines		 $1,267.50–$1,901.25 $1,690–$2,535 varies
CT Angio Neck (70498) $1,575 $2,100 8.7×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,782 $2,376 9.8×
CT cervical spine w/ contrast (72126) $1,070.25 $1,427 3.0×
CT cervical spine w/o contrast (72125) $862.50 $1,150 8.0×
CT cervical spine w/wo cont (72127) $1,125 $1,500 6.2×
CT chest w contrast (71260) $1,362.75 $1,817 7.5×
CT chest w/wo contrast (71270) $1,425 $1,900 7.9×
CT head/brain with contrast (70460) $1,282.50 $1,710 7.1×
CT head/brain without and with contrast (70470) $1,314 $1,752 7.2×
CT heart contrast eval cardiac structure&morph (75572) $1,425 $1,900 4.0×
CT heart no contrast quant eval coronry calcium (75571) $174.75 $233 1.9×
CT iac w contrast (70481) $1,530 $2,040 8.4×
CT l-spine w&w/o contrast (72133) $1,492.50 $1,990 8.2×
CT lower ext w/o (73700)
range across 2 matching MRF lines		 $934.50–$1,401.75 $1,246–$1,869 varies
CT lower extremity w/contrast material (73701)
range across 2 matching MRF lines		 $1,362.75–$2,044.13 $1,817–$2,725.50 varies
CT lumbar spine w contrast (72132) $1,422 $1,896 3.9×
CT lumbar spine w/o contrast (72131) $881.25 $1,175 8.2×
CT maxillofacial w contrast (70487) $1,387.50 $1,850 7.7×
CT maxillofacial wo contrast (70486) $1,167 $1,556 10.8×
CT neck tissue combo (70492) $1,638.75 $2,185 9.0×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,620 $2,160 8.9×
CT orbits w/o contrast (70480) $1,260 $1,680 11.7×
CT pelvis w&w/o contrast (72194) $1,462.50 $1,950 8.1×
CT pelvis w/o contrast (72192) $1,181.25 $1,575 10.9×
CT scan of leg combo (73702) $1,564.50 $2,086 8.6×
CT scans face/jaw combo (70488) $1,500 $2,000 8.3×
CT soft tissue neck w contrast (70491) $1,574.25 $2,099 8.7×
CT soft tissue neck w/o contrast (70490) $1,080 $1,440 10.0×
CT thoracic spine w contrast (72129) $1,402.50 $1,870 7.7×
CT thoracic spine w/o contrast (72128) $881.25 $1,175 8.2×
CT thoracic spine w/wo cont (72130) $1,477.50 $1,970 8.1×
CT thorax w/o contrast (71250) $900 $1,200 8.3×
CT unlisted procedure (76497) $487.50 $650 5.4×
CT upper ext wo (73200) $1,116 $1,488 10.3×
CT upper extremity w/o & w/contrast material (73202) $1,500 $2,000 8.3×
CT upper extremity with contrast (73201) $1,425 $1,900 4.0×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,938.75 $2,585 10.7×
Cta Abdomen (74175) $1,515.75 $2,021 8.4×
CTA pelvis (72191) $1,237.50 $1,650 6.8×
Dilation ureters/urethra rs&i (74485) $904.50 $1,206 0.4×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $410.25 $547 3.8×
Doppler Echo Fetal Spectral Display Complete (76827) $1,154.25 $1,539 10.7×
Doppler Fetal Mid Cerebral Artery (76821) $215.25 $287 2.0×
Dxa Bone Density Axial (77080) $266.25 $355 2.5×
Dxa bone density study 1/>sites appendiclr skel (77081) $217.50 $290 2.4×
Echo exam of fetal heart (76825) $1,019.25 $1,359 1.8×
Echo exam uterus (76831) $617.25 $823 2.5×
Echo Guide For Artery Repair (76936) $973.50 $1,298 4.4×
Esophagram (74220) $404.25 $539 2.2×
Fetal Biophys Profile W/Nst (76818) $640.50 $854 5.9×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $408 $544 3.8×
Fluoroscopy up to 1 hr (76000) $570 $760 2.3×
Follow-Up Angiography (75898) $1,503 $2,004 0.5×
Foot 2 views (73620) $228 $304 2.5×
Forearm 2 views (73090) $236.25 $315 2.6×
Gastric emptying imaging study (78264) $1,764.75 $2,353 4.3×
Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) $1,401.75 $1,869 3.4×
Gated Heart Planar Single (78472) $1,725 $2,300 4.2×
Hand 2 views (73120) $241.50 $322 2.2×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $3,954 $5,272 1.2×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $3,766.50 $5,022 1.2×
Hepatobil Syst Image W/Drug (78227) $1,884.75 $2,513 3.4×
Hepatobiliary System Imaging (78226) $1,488 $1,984 3.6×
Ht Muscle Image Spect Sing (78451) $2,727 $3,636 2.0×
Hysterosalpingogram (74740) $904.50 $1,206 3.7×
Infant hip ultrasound, limited static exam (76886) $475.50 $634 5.3×
K Flow/Funct Image W/Drug (78708) $1,785 $2,380 3.2×
K Flow/Funct Image W/O Drug (78707) $1,920 $2,560 3.4×
Knee 3 Views (73562) $231 $308 2.6×
Liver & Spleen Imaging Static Only (78215) $1,228.50 $1,638 3.0×
Liver & Spleen Imaging W/Vascular Flow (78216) $1,944 $2,592 4.7×
Lung Ventilat&Perfus Imaging (78582) $1,983.75 $2,645 3.5×
Lymph System Imaging (78195) $2,777.25 $3,703 4.9×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $2,208 $2,944 0.7×
Magnetic Image Jaw Joint (70336) $1,384.50 $1,846 5.6×
Meckels Divert Exam (78290) $1,016.25 $1,355 2.5×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $46.50 $62 1.6×
Mr safety implt electronics prepj supvj phys/qhp (76018) $174 $232 1.8×
Mra Head W/O & W/Contrast Material (70546) $2,364.75 $3,153 6.6×
MRA head w/o contrast (70544) $1,503 $2,004 6.1×
MRA head with contrast (70545) $1,763.25 $2,351 4.9×
MRA neck w contrast (70548) $1,994.25 $2,659 5.5×
Mra Neck W/O &W/Contrast Material (70549) $2,439 $3,252 6.8×
MRA neck w/o contrast (70547) $1,384.50 $1,846 5.6×
MRI abdomen w contrast (74182) $1,662.75 $2,217 4.6×
MRI abdomen w/o contrast (74181) $1,595.25 $2,127 6.5×
MRI any jt lower extrem w/contrast material (73722) $2,233.50 $2,978 2.8×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,483.25 $3,311 6.9×
MRI any jt upper extremity w/contrast matrl (73222) $2,034 $2,712 2.5×
MRI bone marrow blood supply (77084) $1,273.50 $1,698 5.2×
MRI Breast W/O Contrast Bilateral (77047) $2,577 $3,436 10.4×
MRI Breast Without Contrast Material Unilateral (77046) $1,946.25 $2,595 7.9×
MRI cardiac w/o contrast (75557) $1,519.50 $2,026 6.2×
MRI cervical spine w contrast (72142) $1,815 $2,420 5.0×
MRI cervical spine w/o cont (72141) $1,595.25 $2,127 6.5×
MRI chest w/o contrast (71550) $1,519.50 $2,026 6.2×
MRI chest with contrast (71551) $2,487.75 $3,317 3.1×
MRI chest wo w contrast (71552) $2,156.25 $2,875 6.0×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,980.75 $2,641 5.5×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,237.25 $2,983 6.2×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,445.25 $1,927 5.9×
MRI lumbar spine w contrast (72149) $1,763.25 $2,351 4.9×
Mri Neck Spine W/O & W/Dye (72156) $2,483.25 $3,311 6.9×
MRI orbit face &/neck w/o contrast (70540) $1,424.25 $1,899 5.8×
MRI orbit face neck w contrast (70542) $1,869.75 $2,493 5.2×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,268 $3,024 6.3×
MRI pelvis w contrast (72196) $1,803 $2,404 5.0×
MRI pelvis w/o & w contrast (72197) $2,726.25 $3,635 7.6×
MRI pelvis w/o contrast (72195) $1,595.25 $2,127 6.5×
MRI spectroscopy (76390) $1,811.25 $2,415 20.1×
MRI thoracic spine w/o contrast (72146) $1,595.25 $2,127 6.5×
MRI upper extremity oth than jt w/contr matrl (73219) $1,980.75 $2,641 5.5×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,445.25 $1,927 5.9×
Mri Uppr Extremity W/O&W/Dye (73220) $2,856 $3,808 7.9×
MRI, abdomen, combo (74183) $2,229.75 $2,973 6.2×
MRI, dorsal spine combo (72157) $2,483.25 $3,311 6.9×
MRI, dorsal spine contrast (72147) $1,763.25 $2,351 4.9×
MRI, joint upper extrem (73221) $1,595.25 $2,127 6.5×
MRI, joint upper extrem combo (73223) $2,364.75 $3,153 6.6×
MRI, lumbar spine combo (72158) $2,364.75 $3,153 6.6×
Myocardial Spect Multiple Studies (78452) $3,795 $5,060 2.8×
Neck soft tissue (70360) $315.75 $421 3.5×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $695.25 $927 1.7×
Nonvascular Shunt X-Ray (75809) $243.75 $325 2.3×
Nuclear Rx Intra-Arterial (79445) $864.75 $1,153 3.6×
Nuclear Rx Oral Admin (79005) $1,031.25 $1,375 4.3×
Ob us nuchal meas 1 gest (76813) $271.50 $362 2.5×
Ophthalmic Ultrasonic Foreign Body Localization (76529) $234 $312 2.6×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512)
range across 2 matching MRF lines		 $358.50–$537.75 $478–$717 varies
Parathyroid Planar Imaging (78070) $1,289.25 $1,719 3.1×
Pelvis 1 or 2 views (72170) $241.50 $322 2.2×
Peritoneogram Rs&I (74190) $475.50 $634 0.8×
Pet Image W/Ct Lmtd (78814) $5,268.75 $7,025 3.6×
PET image w/CT, full body (78816) $5,634 $7,512 3.8×
PET imaging CT attenuation skull base mid-thigh (78815) $5,291.25 $7,055 3.6×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $4,069.50 $5,426 1.2×
Pulmonary Perfusion Imaging Particulate (78580) $1,002.75 $1,337 2.4×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $354.75 $473 3.3×
Radex abscess/fistula/sinus tract rs&i (76080) $679.50 $906 1.2×
Radex Ankle Complete Minimum 3 Views (73610) $273 $364 3.0×
Radex Calcaneus Minimum 2 Views (73650) $231 $308 2.6×
Radex elbow complete minimum 3 views (73080) $252.75 $337 2.8×
Radex Facial Bones Complete Minimum 3 Views (70150) $316.50 $422 2.9×
Radex fingr minimum 2 views (73140) $208.50 $278 2.3×
Radex foot complete minimum 3 views (73630) $249 $332 2.8×
Radex Hand Minimum 3 Views (73130)
range across 2 matching MRF lines		 $252.75–$379.13 $337–$505.50 varies
Radex lower extremity infant minimum 2 views (73592) $221.25 $295 2.5×
Radex Nasal Bones Complete Minimum 3 Views (70160) $348.75 $465 3.9×
Radex Ribs Unilateral 2 Views (71100) $285.75 $381 3.2×
Radex shoulder complete minimum 2 views (73030) $249 $332 2.8×
Radex Sinuses Paransl < 3 Views (70210) $265.50 $354 3.0×
Radex Spine 1 View Specify Level (72020) $236.25 $315 2.6×
Radex Sternum Minimum 2 Views (71120) $265.50 $354 3.0×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $242.25 $323 2.7×
Radex Toe Minimum 2 Views (73660) $173.25 $231 1.9×
Radex upper extremity infant minimum 2 views (73092) $318.75 $425 3.0×
Radex Wrist Complete Minimum 3 Views (73110) $273 $364 3.0×
Radiation treatment delivery level 3 (77412) $686.25 $915 1.2×
Radiolog exam mandible compl minimum 4 views (70110) $241.50 $322 2.2×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $351.75 $469 3.3×
Radiologic exam colon double contrast study (74280) $600 $800 3.3×
Radiologic exam colon single contrast study (74270) $487.50 $650 2.7×
Radiologic Exam Esophagus Double Contrast Study (74221) $414 $552 2.3×
Radiologic exam knee complete 4/more views (73564)
range across 2 matching MRF lines		 $247.50–$371.25 $330–$495 varies
Radiologic exam pelvis compl minimum 3 views (72190) $171.75 $229 1.6×
Radiologic Exam Small Int Single Contrast Study (74250) $444 $592 2.4×
Radiologic exam swallow function contrast study (74230) $391.50 $522 2.2×
Radiologic exam upr gi trc double contrast study (74246) $545.25 $727 3.0×
Radiologic examination femur minimum 2 views (73552) $192.75 $257 2.1×
Radiologic examination knee 1/2 views (73560) $225.75 $301 2.5×
Radiologic examination tibia & fibula 2 views (73590) $210.75 $281 2.3×
Ribs bilateral 3 views (71110) $201 $268 1.9×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,644.75 $2,193 4.0×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $3,570.75 $4,761 6.4×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $2,836.50 $3,782 5.1×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $2,777.25 $3,703 4.9×
Rp Therapy Intravenous Administration (79101) $1,091.25 $1,455 4.5×
Scapula (73010) $252.75 $337 2.3×
Screening Digital Breast Tomosynthesis Bi (77063) $57.75 $77 2.5×
Shoulder 1 view (73020) $213 $284 2.4×
Shoulder Arthrography (73040) $795 $1,060 2.2×
Skull less than 4 views (70250) $318.75 $425 3.0×
Special dosimetry (77331) $139.50 $186 1.0×
Special treatment procedure (77470) $288.75 $385 0.5×
Stereotactic Body Radiation Delivery (77373) $2,305.50 $3,074 1.2×
Sternoclavicular joints (71130) $219.75 $293 2.4×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $1,286.25 $1,715 3.3×
Ther rad simulaj-aided field setting simple (77280) $665.25 $887 4.8×
Thoracic spine 2 views (72070) $171.75 $229 1.6×
Thoracic spine 3 views (72072) $259.50 $346 2.4×
Thoracolumbar 2 views (72080) $240.75 $321 2.7×
Thyroid Imaging With Vascular Flow (78013) $576 $768 1.4×
Thyroid Met Imaging Body (78018) $1,380 $1,840 2.5×
Thyroid Uptake Measurement (78012) $576 $768 1.4×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,488 $1,984 3.6×
Tx Devices Design & Construction Complex (77334) $336.75 $449 0.9×
Tx devices design & construction intermediate (77333) $252 $336 1.8×
Ultrasound Breast Limited (76642)
range across 2 matching MRF lines		 $299.25–$448.88 $399–$598.50 varies
Ultrasound Elastography Parenchyma (76981) $271.50 $362 2.5×
Ultrasound Exam Aaa Screen (76706) $409.50 $546 3.8×
Ultrasound, abdomen limited (76705) $475.50 $634 4.4×
Umbilical-artery Doppler (OB) (76820) $215.25 $287 2.0×
Unlisted Dx Radiographic Procedure (76499)
range across 2 matching MRF lines		 $71.25–$187.50 $95–$250 varies
Upper gi w/o kub (74240) $496.50 $662 2.7×
Urethrocystogram voiding (74455) $648.75 $865 2.6×
Urethrocystography retrograde (74450) $741.75 $989 3.0×
Us breast unilateral complete (76641)
range across 2 matching MRF lines		 $327–$490.50 $436–$654 varies
Us chest (76604) $358.50 $478 3.3×
Us complete joint (76881) $594 $792 5.5×
Us exam, pelvic, limited (76857) $385.50 $514 3.6×
Us head (76506) $384.75 $513 3.6×
Us kidney transplant (76776) $493.50 $658 4.6×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $378.75 $505 3.5×
Us ob detailed single fetus (76811) $588.75 $785 2.4×
Us ob limited 1 or more fetuses (76815) $269.25 $359 2.5×
Us ob transvaginal (76817) $315 $420 2.9×
Us pelvic non ob complete (76856) $498 $664 4.6×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $362.25 $483 3.4×
Us preg uterus real time f/u trnsabdl per fetus (76816) $222 $296 2.1×
Us retroperitoneal complete (76770) $475.50 $634 4.4×
Us retroperitoneal limited (76775) $461.25 $615 4.3×
Us scrotum and contents (76870) $372.75 $497 3.4×
Us spinal canal and contents (76800) $475.50 $634 4.4×
Us thyroid (76536) $480 $640 4.4×
Vein X-Ray Chest (75827) $1,674.75 $2,233 1.0×
Vein X-Ray Liver W/O Hemodyn (75887) $1,401 $1,868 0.4×
Venogram Sinus/Jugular (75860) $2,361 $3,148 0.7×
Venography caval inferior serialography rs&i (75825) $3,037.50 $4,050 0.9×
Venography extremity bilateral rs&i (75822) $1,315.50 $1,754 0.8×
Venography extremity unilateral rs&i (75820) $1,182.75 $1,577 0.7×
Venography Renal Unilateral (75831) $511.50 $682 0.2×
Wrist 2 views (73100) $240 $320 2.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $196.50 $262 2.2×
X-ray antegrade pyelogram tube (74425) $666.75 $889 1.8×
X-Ray Aorta Leg Arteries (75630) $3,870 $5,160 1.2×
X-Ray Bend Only L-S Spine (72120) $241.50 $322 2.2×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $210 $280 2.3×
X-Ray Exam Breast Specimen (76098) $434.25 $579 0.8×
X-Ray Exam Entire Spi 2/3 Vw (72082) $254.25 $339 2.4×
X-Ray Exam Hip Uni 1 View (73501) $192 $256 2.1×
X-Ray Exam Hip Uni 2-3 Views (73502) $192.75 $257 2.1×
X-Ray Exam Hip Uni 4/> Views (73503) $221.25 $295 2.0×
X-Ray Exam Hips Bi 2 Views (73521) $312.75 $417 2.9×
X-Ray Exam Hips Bi 3-4 Views (73522) $330.75 $441 3.1×
X-Ray Exam Hips Bi 5/> Views (73523) $525 $700 4.9×
X-Ray Exam L-S Spine Bending (72114) $381 $508 3.5×
X-Ray Exam Neck Spine 2-3 Vw (72040) $192 $256 2.1×
X-Ray Exam Neck Spine 6/>Vws (72052) $409.50 $546 3.8×
X-Ray Exam Unilat Ribs/Chest (71101) $295.50 $394 2.7×
X-ray eye for foreign body (70030) $184.50 $246 2.1×
X-ray humerus (73060) $192.75 $257 2.1×
X-ray IV pyelogram (ivp) (74400) $639 $852 3.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $282.75 $377 3.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $232.50 $310 2.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $192 $256 1.8×
X-ray nose-rectum child f.b. (76010) $315.75 $421 3.5×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $472.50 $630 4.4×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $318.75 $425 3.0×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $271.50 $362 2.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $209.25 $279 2.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $265.50 $354 3.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $384 $512 3.6×
X-ray thoracic spine 4 vw (72074) $344.25 $459 3.2×
X-Ray Urinary Tract Exam With Contrast Material (74420) $793.50 $1,058 2.2×
X-Rays Bone Length Studies (77073) $231 $308 2.1×
X-Rays Bone Survey Complete (77075) $373.50 $498 3.5×
Xr c-spine 4 or 5 views (72050) $324.75 $433 3.0×
Xr facial bones less than 3 views (70140) $241.50 $322 2.7×
Xr orbits complete 4 views (70200) $265.50 $354 2.5×
Xr Tomogram Single Plane (76100) $323.25 $431 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.