Imaging prices at Lakeview Hospital
Bountiful, UT · every code in this section with a posted price and a Medicare benchmark.
244 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) | $300.48 | $300.48 | 3.4× |
| Abdomen 2 views (74019) | $574.42 | $574.42 | 5.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $3,929.18 | $3,929.18 | 9.7× |
| Angio pulmonary bilat (75743) | $19,393.98 | $19,393.98 | 6.1× |
| Angiography extremity bilateral rs&i (75716) | $15,878.78 | $15,878.78 | 5.0× |
| Angiography extremity unilateral rs&i (75710) range across 5 matching MRF lines |
$2,250.79–$18,296.20 | $2,250.79–$18,296.20 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 3 matching MRF lines |
$6,227.18–$8,855.21 | $6,227.18–$8,855.21 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$6,286.47–$8,855.21 | $6,286.47–$8,855.21 | varies |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Aortography thoracic serialography rs&i (75605) | $9,664.47 | $9,664.47 | 1.7× |
| Artery X-Rays Abdomen (75726) | $19,393.98 | $19,393.98 | 3.4× |
| Artery X-Rays Pelvis (75736) | $14,594.21 | $14,594.21 | 2.6× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$2,092.36–$3,243.18 | $2,092.36–$3,243.18 | varies |
| Arthrogram hip (73525) | $1,594.17 | $1,594.17 | 4.5× |
| Arthrogram Wrist (73115) | $1,594.17 | $1,594.17 | 4.5× |
| Bone age studies (77072) | $615.12 | $615.12 | 5.8× |
| Bone Imaging 3 Phase (78315) | $4,215.93 | $4,215.93 | 10.4× |
| Bone Imaging Limited Area (78300) | $3,940.12 | $3,940.12 | 9.7× |
| Bone Imaging Whole Body (78306) | $4,215.93 | $4,215.93 | 10.4× |
| Bone survey infant (77076) | $580.30 | $580.30 | 5.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $4,667.06 | $4,667.06 | 8.5× |
| Cerebrospinal Fluid Scan (78630) | $3,511.37 | $3,511.37 | 6.4× |
| Chest 1 view (71045) | $300.48 | $300.48 | 3.4× |
| Chest 2 views (71046) | $300.48 | $300.48 | 3.4× |
| Chest 4 or more views (71048) | $574.42 | $574.42 | 5.4× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Contrast Exam Abdominl Aorta (75625) | $15,878.78 | $15,878.78 | 5.0× |
| Contrast X-Ray Bladder (74430) | $2,093.63 | $2,093.63 | 5.9× |
| Contrast X-Ray Of Elbow (73085) | $1,594.17 | $1,594.17 | 4.5× |
| Contrast X-Ray Of Knee Joint (73580) | $3,437.77 | $3,437.77 | 9.7× |
| CT abdomen and pelvis without and with contrast (74178) | $12,071.09 | $12,071.09 | 34.2× |
| CT abdomen and pelvis without contrast (74176) | $7,594.42 | $7,594.42 | 31.4× |
| CT abdomen w contrast (74160) | $5,090.59 | $5,090.59 | 28.7× |
| CT abdomen w wo contrast (74170) | $6,035.56 | $6,035.56 | 34.0× |
| CT abdomen w/o contrast (74150) | $3,853.56 | $3,853.56 | 36.4× |
| CT Angio Abdomen and Pelvis (74174) | $9,003.11 | $9,003.11 | 25.5× |
| CT Angio Chest (71275) | $6,053.97 | $6,053.97 | 34.1× |
| CT Angio Head (70496) | $3,924.81 | $3,924.81 | 22.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$3,568.44–$7,136.88 | $3,568.44–$7,136.88 | varies |
| CT Angio Neck (70498) | $3,924.81 | $3,924.81 | 22.1× |
| CT cervical spine w/ contrast (72126) | $5,090.59 | $5,090.59 | 14.4× |
| CT cervical spine w/o contrast (72125) | $3,853.56 | $3,853.56 | 36.4× |
| CT chest w contrast (71260) | $5,090.59 | $5,090.59 | 28.7× |
| CT chest w/wo contrast (71270) | $6,035.56 | $6,035.56 | 34.0× |
| CT head/brain with contrast (70460) | $5,090.59 | $5,090.59 | 28.7× |
| CT head/brain without and with contrast (70470) | $6,035.56 | $6,035.56 | 34.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $1,264.58 | $1,264.58 | 14.4× |
| CT iac w contrast (70481) | $3,908.73 | $3,908.73 | 22.0× |
| CT l-spine w&w/o contrast (72133) | $4,635.33 | $4,635.33 | 26.1× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$3,853.56–$7,707.11 | $3,853.56–$7,707.11 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$3,896.22–$10,181.10 | $3,896.22–$10,181.10 | varies |
| CT lumbar spine w contrast (72132) | $5,090.59 | $5,090.59 | 14.4× |
| CT lumbar spine w/o contrast (72131) | $3,853.56 | $3,853.56 | 36.4× |
| CT maxillofacial w contrast (70487) | $3,908.73 | $3,908.73 | 22.0× |
| CT maxillofacial wo contrast (70486) | $2,959.15 | $2,959.15 | 28.0× |
| CT neck tissue combo (70492) | $6,035.56 | $6,035.56 | 34.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $6,035.56 | $6,035.56 | 34.0× |
| CT orbits w/o contrast (70480) | $3,853.56 | $3,853.56 | 36.4× |
| CT pelvis w&w/o contrast (72194) | $6,035.56 | $6,035.56 | 34.0× |
| CT pelvis w/o contrast (72192) | $3,853.56 | $3,853.56 | 36.4× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,463.47–$2,926.94 | $1,463.47–$2,926.94 | varies |
| CT scans face/jaw combo (70488) | $3,639.78 | $3,639.78 | 20.5× |
| CT soft tissue neck w contrast (70491) | $5,090.59 | $5,090.59 | 28.7× |
| CT soft tissue neck w/o contrast (70490) | $3,853.56 | $3,853.56 | 36.4× |
| CT thoracic spine w contrast (72129) | $5,090.59 | $5,090.59 | 28.7× |
| CT thoracic spine w/o contrast (72128) | $3,853.56 | $3,853.56 | 36.4× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$2,959.15–$3,853.56 | $2,959.15–$3,853.56 | varies |
| CT upper ext wo (73200) | $3,853.56 | $3,853.56 | 36.4× |
| CT upper extremity w/o & w/contrast material (73202) | $4,372.95 | $4,372.95 | 24.6× |
| CT upper extremity with contrast (73201) | $3,896.22 | $3,896.22 | 11.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,248.83 | $3,248.83 | 18.3× |
| Cta Abdomen (74175) | $3,568.44 | $3,568.44 | 20.1× |
| Dxa Bone Density Axial (77080) | $1,095.82 | $1,095.82 | 10.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $315.89 | $315.89 | 3.6× |
| Esophagram (74220) | $1,239.32 | $1,239.32 | 7.0× |
| Fetal Biophys Profile W/Nst (76818) | $1,398.55 | $1,398.55 | 13.2× |
| Fluoroscopy up to 1 hr (76000) | $1,118.58 | $1,118.58 | 4.6× |
| Follow-Up Angiography (75898) | $2,089.87 | $2,089.87 | 0.7× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Gastric emptying imaging study (78264) | $3,929.18 | $3,929.18 | 9.7× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$660.68–$1,321.34 | $660.68–$1,321.34 | varies |
| Hepatobil Syst Image W/Drug (78227) | $4,709.55 | $4,709.55 | 8.6× |
| Hepatobiliary System Imaging (78226) | $4,709.55 | $4,709.55 | 11.6× |
| Hysterosalpingogram (74740) | $2,562.94 | $2,562.94 | 10.6× |
| K Flow/Funct Image W/Drug (78708) | $4,345.55 | $4,345.55 | 7.9× |
| K Flow/Funct Image W/O Drug (78707) | $3,679.86 | $3,679.86 | 6.7× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Leveen/Shunt Patency Exam (78291) | $2,230.69 | $2,230.69 | 5.5× |
| Liver & Spleen Imaging Static Only (78215) | $4,401.45 | $4,401.45 | 10.9× |
| Lung Ventilat&Perfus Imaging (78582) | $3,420.61 | $3,420.61 | 6.2× |
| Lymph System Imaging (78195) | $4,203.42 | $4,203.42 | 7.6× |
| Magnetic Image Jaw Joint (70336) | $3,656.87 | $3,656.87 | 15.1× |
| Meckels Divert Exam (78290) | $3,672.13 | $3,672.13 | 9.1× |
| Mra Head W/O & W/Contrast Material (70546) | $3,932.71 | $3,932.71 | 11.1× |
| MRA head w/o contrast (70544) | $3,932.71 | $3,932.71 | 16.3× |
| MRA head with contrast (70545) | $3,932.71 | $3,932.71 | 11.1× |
| MRA neck w contrast (70548) | $3,932.71 | $3,932.71 | 11.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,932.71 | $3,932.71 | 11.1× |
| MRA neck w/o contrast (70547) | $3,932.71 | $3,932.71 | 16.3× |
| MRI abdomen w contrast (74182) | $4,244.07 | $4,244.07 | 12.0× |
| MRI abdomen w/o contrast (74181) | $3,932.71 | $3,932.71 | 16.3× |
| MRI any jt lower extrem w/contrast material (73722) | $5,214.28 | $5,214.28 | 6.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $6,911 | $6,911 | 19.6× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$4,003.84–$4,919.13 | $4,003.84–$4,919.13 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $3,806.34 | $3,806.34 | 15.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $3,209.87 | $3,209.87 | 13.3× |
| MRI cervical spine w contrast (72142) | $4,244.07 | $4,244.07 | 12.0× |
| MRI cervical spine w/o cont (72141) | $3,932.71 | $3,932.71 | 16.3× |
| MRI chest w/o contrast (71550) | $4,832.97 | $4,832.97 | 20.0× |
| MRI chest with contrast (71551) | $5,914.96 | $5,914.96 | 7.5× |
| MRI chest wo w contrast (71552) | $5,833.25 | $5,833.25 | 16.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$4,244.07–$5,214.28 | $4,244.07–$5,214.28 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$5,606.89–$11,213.74 | $5,606.89–$11,213.74 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$3,932.71–$4,832.97 | $3,932.71–$4,832.97 | varies |
| MRI lumbar spine w contrast (72149) | $4,244.07 | $4,244.07 | 12.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,624.92 | $5,624.92 | 15.9× |
| MRI orbit face &/neck w/o contrast (70540) | $3,932.71 | $3,932.71 | 16.3× |
| MRI orbit face neck w contrast (70542) | $4,003.84 | $4,003.84 | 11.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,624.92 | $5,624.92 | 15.9× |
| MRI pelvis w contrast (72196) | $4,003.84 | $4,003.84 | 11.3× |
| MRI pelvis w/o & w contrast (72197) | $5,624.92 | $5,624.92 | 15.9× |
| MRI pelvis w/o contrast (72195) | $3,932.71 | $3,932.71 | 16.3× |
| MRI thoracic spine w/o contrast (72146) | $3,932.71 | $3,932.71 | 16.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $4,003.84 | $4,003.84 | 11.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $4,832.97 | $4,832.97 | 20.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $6,911 | $6,911 | 19.6× |
| MRI, abdomen, combo (74183) | $5,624.92 | $5,624.92 | 15.9× |
| MRI, dorsal spine combo (72157) | $5,624.92 | $5,624.92 | 15.9× |
| MRI, dorsal spine contrast (72147) | $5,214.28 | $5,214.28 | 14.8× |
| MRI, joint upper extrem (73221) | $4,832.97 | $4,832.97 | 20.0× |
| MRI, joint upper extrem combo (73223) | $6,911 | $6,911 | 19.6× |
| MRI, lumbar spine combo (72158) | $5,624.92 | $5,624.92 | 15.9× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $2,520.85 | $2,520.85 | 6.2× |
| Myocardial Spect Multiple Studies (78452) | $10,241.84 | $10,241.84 | 7.8× |
| Neck soft tissue (70360) | $615.12 | $615.12 | 7.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $1,756.94 | $1,756.94 | 4.3× |
| Nuclear Rx Oral Admin (79005) | $1,027.73 | $1,027.73 | 4.3× |
| Parathyroid Planar Imaging (78070) | $2,921.96 | $2,921.96 | 7.2× |
| Pelvis 1 or 2 views (72170) | $660.68 | $660.68 | 6.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $3,420.61 | $3,420.61 | 8.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,059.34 | $1,059.34 | 10.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,469.45 | $1,469.45 | 2.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $615.12 | $615.12 | 5.8× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $615.12 | $615.12 | 7.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $615.12 | $615.12 | 7.0× |
| Radex Ribs Unilateral 2 Views (71100) | $615.12 | $615.12 | 7.0× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $660.68 | $660.68 | 7.5× |
| Radex Spine 1 View Specify Level (72020) | $615.12 | $615.12 | 7.0× |
| Radex Sternum Minimum 2 Views (71120) | $615.12 | $615.12 | 7.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $615.12 | $615.12 | 7.0× |
| Radex Toe Minimum 2 Views (73660) | $615.12 | $615.12 | 7.0× |
| Radex upper extremity infant minimum 2 views (73092) | $615.12 | $615.12 | 5.8× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $659.30 | $659.30 | 6.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $615.12 | $615.12 | 5.8× |
| Radiologic exam colon double contrast study (74280) | $1,920.50 | $1,920.50 | 10.8× |
| Radiologic exam colon single contrast study (74270) | $1,239.32 | $1,239.32 | 7.0× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,239.32 | $1,239.32 | 7.0× |
| Radiologic exam swallow function contrast study (74230) | $1,239.32 | $1,239.32 | 7.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,169.17 | $1,169.17 | 6.6× |
| Radiologic examination femur minimum 2 views (73552) | $343.07 | $343.07 | 3.9× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$660.68–$1,321.34 | $660.68–$1,321.34 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Ribs bilateral 3 views (71110) | $615.12 | $615.12 | 5.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $7,297.68 | $7,297.68 | 13.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$2,844.56–$4,444.05 | $2,844.56–$4,444.05 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $4,295.68 | $4,295.68 | 7.8× |
| Scapula (73010) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $89.10 | $89.10 | 3.8× |
| Shoulder 1 view (73020) | $334.08 | $334.08 | 3.8× |
| Shoulder Arthrography (73040) | $1,594.17 | $1,594.17 | 4.5× |
| Skull less than 4 views (70250) | $615.12 | $615.12 | 5.8× |
| Sternoclavicular joints (71130) | $504.55 | $504.55 | 5.7× |
| Thoracic spine 2 views (72070) | $615.12 | $615.12 | 5.8× |
| Thoracic spine 3 views (72072) | $615.12 | $615.12 | 5.8× |
| Thoracolumbar 2 views (72080) | $615.12 | $615.12 | 7.0× |
| Thyroid Uptake Measurement (78012) | $1,552.67 | $1,552.67 | 3.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,520.56 | $2,520.56 | 6.2× |
| Ultrasound Exam Aaa Screen (76706) | $602.43 | $602.43 | 5.7× |
| Ultrasound, abdomen limited (76705) | $890.39 | $890.39 | 8.4× |
| Unlisted fluoroscopic procedure (76496) | $685.36 | $685.36 | 7.8× |
| Unlisted us procedure (76999) | $1.46 | $1.46 | 0.0× |
| Upper gi w/o kub (74240) | $1,239.32 | $1,239.32 | 7.0× |
| Urethrocystogram voiding (74455) | $2,093.63 | $2,093.63 | 8.7× |
| Urethrocystography retrograde (74450) | $2,250.79 | $2,250.79 | 9.3× |
| Us breast unilateral complete (76641) | $559.88 | $559.88 | 5.3× |
| Us chest (76604) | $890.39 | $890.39 | 8.4× |
| Us complete joint (76881) | $801.84 | $801.84 | 7.6× |
| Us exam, pelvic, limited (76857) | $890.39 | $890.39 | 8.4× |
| Us head (76506) | $727.02 | $727.02 | 6.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $508.15 | $508.15 | 4.8× |
| Us ob limited 1 or more fetuses (76815) | $890.39 | $890.39 | 8.4× |
| Us ob transvaginal (76817) | $596.82 | $596.82 | 5.6× |
| Us pelvic non ob complete (76856) | $1,398.55 | $1,398.55 | 13.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $630.14 | $630.14 | 6.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $890.39 | $890.39 | 8.4× |
| Us retroperitoneal complete (76770) | $1,398.55 | $1,398.55 | 13.2× |
| Us scrotum and contents (76870) | $1,398.55 | $1,398.55 | 13.2× |
| Us thyroid (76536) | $1,398.55 | $1,398.55 | 13.2× |
| Vascular Flow Imaging (78445) | $2,434.90 | $2,434.90 | 6.0× |
| Vein X-Ray Chest (75827) | $5,579.71 | $5,579.71 | 3.5× |
| Venography caval inferior serialography rs&i (75825) | $15,878.78 | $15,878.78 | 5.0× |
| Venography extremity bilateral rs&i (75822) | $5,565.56 | $5,565.56 | 3.5× |
| Venography extremity unilateral rs&i (75820) range across 5 matching MRF lines |
$1,921.36–$8,855.21 | $1,921.36–$8,855.21 | varies |
| Venography Renal Bilateral (75833) | $12,394.66 | $12,394.66 | 3.9× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$660.68–$1,321.34 | $660.68–$1,321.34 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $615.12 | $615.12 | 7.0× |
| X-ray antegrade pyelogram tube (74425) | $2,250.79 | $2,250.79 | 6.4× |
| X-Ray Aorta Leg Arteries (75630) | $15,878.78 | $15,878.78 | 5.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$660.68–$929.19 | $660.68–$929.19 | varies |
| X-Ray Exam Breast Specimen (76098) | $660.68 | $660.68 | 1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $343.07 | $343.07 | 3.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $568.17 | $568.17 | 5.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $761.76 | $761.76 | 7.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $615.12 | $615.12 | 7.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $568.17 | $568.17 | 5.4× |
| X-Ray Exam L-S Spine Bending (72114) | $1,059.34 | $1,059.34 | 10.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $615.12 | $615.12 | 7.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $615.12 | $615.12 | 5.8× |
| X-ray eye for foreign body (70030) | $580.30 | $580.30 | 6.6× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$615.12–$1,230.20 | $615.12–$1,230.20 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $615.12 | $615.12 | 5.8× |
| X-ray nose-rectum child f.b. (76010) | $615.12 | $615.12 | 7.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,059.34 | $1,059.34 | 10.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $615.12 | $615.12 | 5.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $615.12 | $615.12 | 7.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $615.12 | $615.12 | 7.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,059.34 | $1,059.34 | 10.0× |
| X-Ray Tmj Unilat (70328) | $580.30 | $580.30 | 6.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,093.63 | $2,093.63 | 5.9× |
| X-Rays Bone Length Studies (77073) | $615.12 | $615.12 | 5.8× |
| X-Rays Bone Survey Complete (77075) | $1,059.34 | $1,059.34 | 10.0× |
| Xr c-spine 4 or 5 views (72050) | $1,059.34 | $1,059.34 | 10.0× |
| Xr facial bones less than 3 views (70140) | $615.12 | $615.12 | 7.0× |
| Xr orbits complete 4 views (70200) | $615.12 | $615.12 | 5.8× |
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.