Imaging prices at Lafayette Regional Health Center
Lexington, MO · every code in this section with a posted price and a Medicare benchmark.
274 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Abdomen 2 views (74019) | $1,171.96 | $1,171.96 | 11.2× |
| Acute gastrointestinal blood loss imaging (78278) | $4,781.61 | $4,781.61 | 11.9× |
| Ankle 2 views (73600) | $651.77 | $651.77 | 7.5× |
| Antegrade urography radiological supvj & interpj (74425) | $2,851.29 | $2,851.29 | 8.2× |
| Arthrogram elbow (73085) | $3,896.24 | $3,896.24 | 11.1× |
| Arthrogram hip (73525) | $4,187.19 | $4,187.19 | 12.0× |
| Arthrogram shoulder (73040) | $4,473.95 | $4,473.95 | 12.8× |
| Arthrogram wrist (73115) | $2,671.66 | $2,671.66 | 7.6× |
| Arthrography knee lt (73580) | $4,187.19 | $4,187.19 | 12.0× |
| Bone &/Joint Imaging Limited Area (78300) | $3,556.59 | $3,556.59 | 8.9× |
| Bone &/Joint Imaging Multiple Areas (78305) | $5,221.66 | $5,221.66 | 13.0× |
| Bone &/joint imaging whole body (78306) | $5,296.80 | $5,296.80 | 13.2× |
| Bone age studies (77072) | $425.19 | $425.19 | 4.1× |
| Bone Imaging 3 Phase (78315) | $4,910.41 | $4,910.41 | 12.3× |
| Bone Marrow Imaging Limited Area (78102) | $2,275.42 | $2,275.42 | 5.7× |
| Bone survey complete (77075) | $1,877.32 | $1,877.32 | 17.9× |
| Brain Imaging Minimum 4 Static Views (78605) | $3,021.38 | $3,021.38 | 5.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $19,223.41 | $19,223.41 | 13.4× |
| Brain Imaging Vascular Flow Only (78610) | $3,715.46 | $3,715.46 | 6.8× |
| Cervical spine 2 or 3 views (72040) | $912.18 | $912.18 | 10.5× |
| Chest 1 view (71045) | $510.46 | $510.46 | 5.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) | $1,802.28 | $1,802.28 | 10.3× |
| Clavicle complete (73000) | $912.18 | $912.18 | 10.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $3,498.81 | $3,498.81 | 33.4× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) | $1,396.22 | $1,396.22 | 7.9× |
| CT abdomen and pelvis without and with contrast (74178) | $14,690.22 | $14,690.22 | 42.0× |
| CT abdomen and pelvis without contrast (74176) | $8,562.63 | $8,562.63 | 35.8× |
| CT abdomen w contrast (74160) | $6,136.96 | $6,136.96 | 34.9× |
| CT abdomen w wo contrast (74170) | $9,166.68 | $9,166.68 | 52.2× |
| CT abdomen w/o contrast (74150) | $5,844.28 | $5,844.28 | 55.8× |
| CT c-spine w/o contrast (72125) | $5,772.12 | $5,772.12 | 55.1× |
| CT cervical spine w&w/o contrast (72127) | $5,772.12 | $5,772.12 | 32.9× |
| CT cervical spine with contrast (72126) | $5,841.62 | $5,841.62 | 16.7× |
| CT chest w/wo contrast (71270) | $8,571.97 | $8,571.97 | 48.8× |
| CT chest with contrast (71260) | $6,166.36 | $6,166.36 | 35.1× |
| CT head/brain with contrast (70460) | $5,226.84 | $5,226.84 | 29.8× |
| CT head/brain without and with contrast (70470) | $8,407.58 | $8,407.58 | 47.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $54.08 | $54.08 | 0.6× |
| CT iac w contrast (70481) | $5,662.52 | $5,662.52 | 32.2× |
| CT limited/localized follow up study (76380) | $3,498.81 | $3,498.81 | 40.1× |
| CT lower ext w/o (73700) | $5,841.62 | $5,841.62 | 55.8× |
| CT lower extremity w wo contrast (73702) | $8,584 | $8,584 | 48.9× |
| CT lower extremity with contrast (73701) | $6,166.36 | $6,166.36 | 35.1× |
| CT lumbar spine w & w/o contrast (72133) | $8,584 | $8,584 | 48.9× |
| CT lumbar spine w/o contrast (72131) | $4,902.08 | $4,902.08 | 46.8× |
| CT lumbar spine with contrast (72132) | $5,841.62 | $5,841.62 | 16.7× |
| CT maxillofacial w contrast (70487) | $6,166.36 | $6,166.36 | 35.1× |
| CT maxillofacial w/o contrast (70486) | $5,841.62 | $5,841.62 | 55.8× |
| CT maxillofacial w/wo contrast (70488) | $8,584 | $8,584 | 48.9× |
| CT neck soft tissue w contrast (70491) | $6,166.36 | $6,166.36 | 35.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) | $8,407.58 | $8,407.58 | 47.9× |
| CT orbits w/o contrast (70480) | $5,355.16 | $5,355.16 | 51.1× |
| CT pelvis w & w/o contrast (72194) | $8,584 | $8,584 | 48.9× |
| CT pelvis w/o contrast (72192) | $4,902.08 | $4,902.08 | 46.8× |
| CT soft tissue neck w/o & w/contrast material (70492) | $8,571.97 | $8,571.97 | 48.8× |
| CT soft tissue neck w/o contrast (70490) | $5,841.62 | $5,841.62 | 55.8× |
| CT thoracic spine w/contrast (72129) | $5,841.62 | $5,841.62 | 33.3× |
| CT thoracic spine w/o contrast (72128) | $5,772.12 | $5,772.12 | 55.1× |
| CT thoracic spine w/wo contrast (72130) | $8,584 | $8,584 | 48.9× |
| CT thorax w/o contrast (71250) | $5,844.28 | $5,844.28 | 55.8× |
| CT upper extremity w/o & w/contrast material (73202) | $8,584 | $8,584 | 48.9× |
| CT upper extremity w/o contrast rt (73200) | $5,464.72 | $5,464.72 | 52.2× |
| CT upper extremity with contrast (73201) | $5,772.12 | $5,772.12 | 16.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $6,650.16 | $6,650.16 | 37.9× |
| Cta Abdomen (74175) | $5,941.84 | $5,941.84 | 33.8× |
| CTA abdomen pelvis (74174) | $6,158.35 | $6,158.35 | 17.6× |
| CTA chest (71275) | $5,872.35 | $5,872.35 | 33.4× |
| Cta Head (70496) | $6,807.87 | $6,807.87 | 38.8× |
| Cta Neck (70498) | $7,331.75 | $7,331.75 | 41.7× |
| Cystography minimum 3 views rs&i (74430) | $2,217.19 | $2,217.19 | 6.3× |
| Dxa bone density study 1/> sites axial skel (77080) | $1,188.78 | $1,188.78 | 11.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $546.58 | $546.58 | 6.3× |
| Esophagus (74220) | $1,472.72 | $1,472.72 | 8.4× |
| Fetal biophysical profile non-stress testing (76818) | $2,762.25 | $2,762.25 | 26.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $2,522.31 | $2,522.31 | 24.1× |
| Fluoroscopy up to 1 hr (76000) | $625.29 | $625.29 | 2.6× |
| Foot 2 views (73620) | $651.77 | $651.77 | 7.5× |
| Forearm 2 views (73090) | $716.50 | $716.50 | 8.2× |
| Gated Heart Planar Single (78472) | $6,715.36 | $6,715.36 | 16.8× |
| Hand 2 views (73120) | $651.77 | $651.77 | 6.2× |
| Hand 3 views (73130) | $716.50 | $716.50 | 8.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) | $4,286.10 | $4,286.10 | 7.9× |
| Hepatobiliary syst imaging including gallbladder (78226) | $4,286.10 | $4,286.10 | 10.7× |
| Ht muscle image spect sing (78451) | $8,280.62 | $8,280.62 | 6.4× |
| Humerus Min 2 Views Left (73060) | $912.18 | $912.18 | 10.5× |
| Hysterosalpingogram (74740) | $2,025.92 | $2,025.92 | 8.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) | $4,337.97 | $4,337.97 | 8.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) | $5,277.12 | $5,277.12 | 9.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) | $8,674.17 | $8,674.17 | 15.9× |
| Knee 3 views (73562) | $716.50 | $716.50 | 8.2× |
| Liver & spleen imaging static only (78215) | $4,103.63 | $4,103.63 | 10.2× |
| Lung perf&ventilat diferentl (78598) | $4,654.59 | $4,654.59 | 8.6× |
| Lung perfusion differential (78597) | $4,012.40 | $4,012.40 | 10.0× |
| Lung Ventilation Imaging (78579) | $3,203.84 | $3,203.84 | 8.0× |
| Lymphoscintigraphy (78195) | $5,123.29 | $5,123.29 | 9.4× |
| Mammary ductogram or galactogram multiple (77054) | $3,820.85 | $3,820.85 | 16.0× |
| Mammary ductogram or galactogram single (77053) | $2,920.44 | $2,920.44 | 12.2× |
| Manual appl stress pfrmd phys/qhp joint films (77071) | $651.77 | $651.77 | 7.5× |
| Meckels Diverticulum (78290) | $3,851.40 | $3,851.40 | 9.6× |
| MRA head w & w/o contrast (70546) | $7,287.42 | $7,287.42 | 20.9× |
| MRA head w/o contrast (70544) | $6,052.45 | $6,052.45 | 25.3× |
| MRA head with contrast (70545) | $6,052.45 | $6,052.45 | 17.3× |
| MRA neck w contrast (70548) | $6,052.45 | $6,052.45 | 17.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $12,106.28 | $12,106.28 | 34.6× |
| MRA neck w/o contrast (70547) | $6,052.45 | $6,052.45 | 25.3× |
| MRI abdomen w contrast (74182) | $6,052.45 | $6,052.45 | 17.3× |
| MRI abdomen w/o & w/contrast material (74183) | $7,287.42 | $7,287.42 | 20.9× |
| MRI abdomen w/o contrast (74181) | $6,052.45 | $6,052.45 | 25.3× |
| MRI any jnt lwr ext with con lt (73722) | $6,052.45 | $6,052.45 | 7.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $6,052.45 | $6,052.45 | 7.7× |
| MRI breast w/o contrast unilat (77046) | $5,403.62 | $5,403.62 | 22.6× |
| MRI c-spine with contrast (72142) | $5,872.30 | $5,872.30 | 16.8× |
| MRI cervical spine w/o contrast (72141) | $6,892.74 | $6,892.74 | 28.8× |
| MRI chest w/o & w/contrast material (71552) | $8,816.69 | $8,816.69 | 25.2× |
| MRI chest w/o contrast (71550) | $7,287.42 | $7,287.42 | 30.5× |
| MRI chest with contrast (71551) | $8,009.43 | $8,009.43 | 10.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) | $6,052.45 | $6,052.45 | 17.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $6,052.45 | $6,052.45 | 17.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $6,052.45 | $6,052.45 | 25.3× |
| MRI orbit face &/neck w/o contrast (70540) | $6,052.45 | $6,052.45 | 25.3× |
| MRI orbit/face/neck w&w/o cont (70543) | $7,287.42 | $7,287.42 | 20.9× |
| MRI orbit/face/neck w/contrast (70542) | $6,052.45 | $6,052.45 | 17.3× |
| MRI pelvis w contrast (72196) | $6,052.45 | $6,052.45 | 17.3× |
| MRI pelvis w/o & w/contrast material (72197) | $7,446.95 | $7,446.95 | 21.3× |
| MRI pelvis w/o contrast (72195) | $6,052.45 | $6,052.45 | 25.3× |
| MRI scan of arm joint before and after contrast (73223) | $7,446.95 | $7,446.95 | 21.3× |
| MRI scan of leg joint before and after contrast (73723) | $7,446.95 | $7,446.95 | 21.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) | $7,446.95 | $7,446.95 | 21.3× |
| MRI spinal canal lumbar w/contrast material (72149) | $5,872.30 | $5,872.30 | 16.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) | $6,205.11 | $6,205.11 | 17.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) | $10,660.89 | $10,660.89 | 30.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) | $7,446.95 | $7,446.95 | 21.3× |
| MRI thoracic spine w/o contrast (72146) | $6,892.74 | $6,892.74 | 28.8× |
| MRI tmj (70336) | $7,287.42 | $7,287.42 | 30.5× |
| MRI upper ext joint w/o contrast (73221) | $6,892.74 | $6,892.74 | 28.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) | $7,446.95 | $7,446.95 | 21.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $6,052.45 | $6,052.45 | 25.3× |
| Myelogram Cervical (72240) | $4,609.43 | $4,609.43 | 5.9× |
| Myelogram Lumbar (72265) | $3,835.57 | $3,835.57 | 4.9× |
| Myelogram thoracic (72255) | $4,513.80 | $4,513.80 | 5.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $19,223.41 | $19,223.41 | 14.8× |
| Myocardial infarct spect (78469) | $3,973.04 | $3,973.04 | 7.3× |
| Myocardial Spect Multiple Studies (78452) | $8,309.24 | $8,309.24 | 6.4× |
| Neck soft tissue (70360) | $769.47 | $769.47 | 8.8× |
| Nm cisternogram (78630) | $4,452.44 | $4,452.44 | 8.2× |
| Nm gastric emptying study (78264) | $5,851.34 | $5,851.34 | 14.6× |
| Nuclear medicine of heart muscle at rest with stress (78454) | $8,309.24 | $8,309.24 | 6.4× |
| Nuclear medicine study of heart muscle at rest with stress (78453) | $6,119.67 | $6,119.67 | 4.7× |
| Nuclear medicine study of kidney and blood flow (78701) | $2,660.02 | $2,660.02 | 6.6× |
| Nuclear Rx Oral Admin (79005) | $7,345.93 | $7,345.93 | 31.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) | $1,256.55 | $1,256.55 | 12.0× |
| Osseous survey infant (77076) | $965.14 | $965.14 | 9.2× |
| Osseous survey limited (77074) | $1,425.65 | $1,425.65 | 13.6× |
| Parathyroid imaging (78070) | $2,788.82 | $2,788.82 | 7.0× |
| Pelvis 1 or 2 views (72170) | $716.50 | $716.50 | 6.8× |
| PET image w/CT, skull-thigh (78815) | $19,223.41 | $19,223.41 | 13.4× |
| PET imaging CT for attenuation limited area (78814) | $19,223.41 | $19,223.41 | 13.4× |
| PET imaging for CT attenuation whole body (78816) | $19,223.41 | $19,223.41 | 13.4× |
| PET imaging limited area chest head/neck (78811) | $22,576.24 | $22,576.24 | 17.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) | $7,446.95 | $7,446.95 | 21.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $3,747.66 | $3,747.66 | 9.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) | $6,599.09 | $6,599.09 | 12.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,066.65 | $1,066.65 | 1.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) | $482.57 | $482.57 | 5.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) | $642.95 | $642.95 | 6.1× |
| Radex hips bilateral with pelvis 2 views (73521) | $960.73 | $960.73 | 9.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,147.57 | $1,147.57 | 11.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,107.84 | $1,107.84 | 10.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) | $758.23 | $758.23 | 8.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) | $1,020.92 | $1,020.92 | 11.7× |
| Radiologic exam colon single contrast study (74270) | $1,605.15 | $1,605.15 | 9.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,009.28 | $1,009.28 | 5.7× |
| Radiologic exam upr gi trc single contrast study (74240) | $888.64 | $888.64 | 5.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) | $651.77 | $651.77 | 7.5× |
| Radiological examination surgical specimen (76098) | $756.96 | $756.96 | 1.4× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $2,846.08 | $2,846.08 | 5.2× |
| Ribs bilateral 3 views (71110) | $1,229.97 | $1,229.97 | 11.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) | $6,658.13 | $6,658.13 | 12.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) | $6,870.99 | $6,870.99 | 12.6× |
| Rp Therapy Intravenous Administration (79101) | $2,202.09 | $2,202.09 | 9.4× |
| Sacroiliac Joints < 3 Views (72200) | $716.50 | $716.50 | 6.8× |
| Scapula complete (73010) | $912.18 | $912.18 | 8.7× |
| Screening digital breast tomosynthesis (77063) | $92.26 | $92.26 | 3.9× |
| Small bowel series (74250) | $1,613.97 | $1,613.97 | 9.2× |
| Spine thoracic 3 views (72072) | $1,032.81 | $1,032.81 | 9.9× |
| Thoracolumbar 2 views (72080) | $1,613.97 | $1,613.97 | 18.5× |
| Thyroid carcinoma metastases img whole body (78018) | $5,983.73 | $5,983.73 | 11.0× |
| Thyroid Imaging With Vascular Flow (78013) | $2,495.47 | $2,495.47 | 6.2× |
| Thyroid uptake measurement (78012) | $4,985.54 | $4,985.54 | 12.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $5,425.61 | $5,425.61 | 13.5× |
| Tmj unilateral (70328) | $1,068.12 | $1,068.12 | 12.3× |
| Tomogram (76100) | $2,215.71 | $2,215.71 | 21.2× |
| Treatment devices simple (77332) | $177.85 | $177.85 | 1.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) | $3,085.77 | $3,085.77 | 7.7× |
| Ultrasound, abdomen limited (76705) | $2,497.71 | $2,497.71 | 23.9× |
| Upper Extremity Infant (73092) | $1,633.09 | $1,633.09 | 15.6× |
| Urethrocystography retrograde rs&i (74450) | $2,193.65 | $2,193.65 | 9.2× |
| Urethrocystography voiding (74455) | $2,411.38 | $2,411.38 | 10.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) | $2,295.15 | $2,295.15 | 13.1× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) | $2,295.15 | $2,295.15 | 13.1× |
| Us abdl aorta screen aaa (76706) | $1,795.84 | $1,795.84 | 17.2× |
| Us breast unilateral complete (76641) | $1,677.95 | $1,677.95 | 16.0× |
| Us breast unilateral limited (76642) | $1,191.95 | $1,191.95 | 13.7× |
| Us chest (76604) | $1,731.79 | $1,731.79 | 16.5× |
| Us compl joint r-t w/image documentation (76881) | $2,062.45 | $2,062.45 | 19.7× |
| Us ob transvaginal (76817) | $2,028.62 | $2,028.62 | 19.4× |
| Us pelvic non ob complete (76856) | $2,497.71 | $2,497.71 | 23.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) | $1,125.82 | $1,125.82 | 10.8× |
| Us pregnancy ltd (76815) | $2,028.62 | $2,028.62 | 19.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) | $2,028.62 | $2,028.62 | 19.4× |
| Us retroperitoneal complete (76770) | $2,297 | $2,297 | 21.9× |
| Us retroperitoneal limited (76775) | $1,241.16 | $1,241.16 | 11.9× |
| Us scrotum and contents (76870) | $2,497.71 | $2,497.71 | 23.9× |
| Us soft tissue head/neck (76536) | $1,256.55 | $1,256.55 | 12.0× |
| Us transrectal (76872) | $2,050.15 | $2,050.15 | 19.6× |
| Us xtr non-vasc lmtd (76882) | $1,033.53 | $1,033.53 | 9.9× |
| Vascular flow imaging (78445) | $3,193.09 | $3,193.09 | 8.0× |
| Venography extremity unilateral rs&i (75820) | $2,161.29 | $2,161.29 | 1.4× |
| Wrist 2 views (73100) | $651.77 | $651.77 | 7.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) | $1,418.29 | $1,418.29 | 13.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,107.84 | $1,107.84 | 12.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) | $716.50 | $716.50 | 8.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) | $1,613.97 | $1,613.97 | 9.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $651.77 | $651.77 | 7.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) | $912.18 | $912.18 | 10.5× |
| X-ray exam entire spi 4/5 vw (72083) | $1,147.57 | $1,147.57 | 11.0× |
| X-ray exam hip uni 1 view (73501) | $642.95 | $642.95 | 7.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $960.73 | $960.73 | 11.0× |
| X-ray exam hip uni 4/> views (73503) | $1,199.07 | $1,199.07 | 11.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,019.58 | $1,019.58 | 9.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,078.43 | $1,078.43 | 10.3× |
| X-ray exam of femur 1 (73551) | $482.57 | $482.57 | 5.5× |
| X-ray eye for foreign body (70030) | $1,005.60 | $1,005.60 | 11.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) | $909.96 | $909.96 | 8.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) | $482.57 | $482.57 | 5.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) | $716.50 | $716.50 | 8.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) | $716.50 | $716.50 | 8.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $651.77 | $651.77 | 7.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) | $1,232.90 | $1,232.90 | 11.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $1,296.17 | $1,296.17 | 14.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) | $1,633.09 | $1,633.09 | 18.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $912.18 | $912.18 | 8.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) | $2,118.61 | $2,118.61 | 20.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) | $1,613.97 | $1,613.97 | 15.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) | $965.14 | $965.14 | 11.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) | $716.50 | $716.50 | 8.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) | $1,107.84 | $1,107.84 | 10.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) | $1,199.07 | $1,199.07 | 11.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) | $1,605.15 | $1,605.15 | 4.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) | $965.14 | $965.14 | 11.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) | $1,346.19 | $1,346.19 | 12.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,513.91 | $1,513.91 | 14.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $919.49 | $919.49 | 8.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $716.50 | $716.50 | 8.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) | $965.14 | $965.14 | 11.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,540.41 | $1,540.41 | 17.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) | $523.76 | $523.76 | 6.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,296.17 | $1,296.17 | 12.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) | $482.57 | $482.57 | 4.6× |
| X-Ray Spine One View - Xr Spine (72020) | $715.03 | $715.03 | 8.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) | $1,035.75 | $1,035.75 | 11.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) | $720.90 | $720.90 | 8.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) | $848.90 | $848.90 | 8.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) | $1,147.57 | $1,147.57 | 11.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) | $651.77 | $651.77 | 7.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) | $716.50 | $716.50 | 8.2× |
| Xr arthrogram ankle (73615) | $3,896.24 | $3,896.24 | 11.1× |
| Xr c-spine 6 or more views (72052) | $1,540.41 | $1,540.41 | 14.7× |
| Xr finger(s) 2+ views (73140) | $651.77 | $651.77 | 7.5× |
| Xr shoulder 1 view (73020) | $425.19 | $425.19 | 4.9× |
| Xr spine cervical 4 or 5 views (72050) | $1,346.19 | $1,346.19 | 12.9× |
| Xr tibia/fibula 2 views (73590) | $769.47 | $769.47 | 8.8× |
| Xr tmj bilateral (70330) | $1,159.35 | $1,159.35 | 13.3× |
| Xray knee 1 or 2 views rt (73560) | $651.77 | $651.77 | 7.5× |