Imaging prices at Lawrence Memorial Hospital
Walnut Ridge, AR · every code in this section with a posted price and a Medicare benchmark.
267 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) | $113.75 | $175 | 1.4× |
| Abdomen 2 views (74019) | $149.50 | $230 | 1.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $513.50 | $790 | 1.4× |
| Adrenal Cortex & Medulla Img (78075) | $402.35 | $619 | 0.3× |
| Ankle 2 views (73600) | $113.75 | $175 | 1.4× |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$122.20–$185.25 | $188–$285 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$118.30–$177.45 | $182–$273 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$144.30–$217.75 | $222–$335 | varies |
| Bone age studies (77072) range across 3 matching MRF lines |
$40.95–$136.50 | $63–$210 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$500.50–$734.50 | $770–$1,130 | varies |
| Bone Imaging Limited Area (78300) | $199.55 | $307 | 0.5× |
| Bone Imaging Multiple Areas (78305) | $276.25 | $425 | 0.8× |
| Bone Imaging Whole Body (78306) | $464.75 | $715 | 1.3× |
| Bone survey infant (77076) | $91 | $140 | 1.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $669.50 | $1,030 | 1.4× |
| Brain Imaging Minimum 4 Static Views (78605) | $268.45 | $413 | 0.5× |
| Cat Scan Follow-Up Study (76380) | $261.95 | $403 | 3.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $273 | $420 | 0.6× |
| Cerebrospinal Fluid Scan (78630) | $386.10 | $594 | 0.8× |
| Chest 1 view (71045) | $113.75 | $175 | 1.4× |
| Chest 2 views (71046) | $113.75 | $175 | 1.4× |
| Chest 3 views (71047) | $113.75 | $175 | 1.4× |
| Chest 4 or more views (71048) | $149.50 | $230 | 1.6× |
| Cholecystography Oral Contrast (74290) | $53.95 | $83 | 0.3× |
| Cisternography Positive Contrast Rs&I (70015) | $118.30 | $182 | 0.2× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$65–$113.75 | $100–$175 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $136.50 | $210 | 1.4× |
| Contrast X-Ray Bladder (74430) | $78 | $120 | 0.2× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$129.35–$196.30 | $199–$302 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$155.35–$232.70 | $239–$358 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$364–$477.75 | $560–$735 | varies |
| CT abdomen and pelvis without contrast (74176) | $406.25 | $625 | 1.9× |
| CT abdomen w contrast (74160) | $299 | $460 | 1.9× |
| CT abdomen w wo contrast (74170) | $409.50 | $630 | 2.6× |
| CT abdomen w/o contrast (74150) | $208 | $320 | 2.2× |
| CT Angio Abdomen and Pelvis (74174) | $477.75 | $735 | 1.5× |
| CT Angio Chest (71275) | $419.25 | $645 | 2.6× |
| CT Angio Head (70496) | $555.75 | $855 | 3.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $422.50 | $650 | 2.6× |
| CT Angio Neck (70498) | $568.75 | $875 | 3.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $884.65 | $1,361 | 5.5× |
| CT cervical spine w/ contrast (72126) | $416 | $640 | 1.3× |
| CT cervical spine w/o contrast (72125) | $347.75 | $535 | 3.7× |
| CT cervical spine w/wo cont (72127) | $344.50 | $530 | 2.2× |
| CT chest w contrast (71260) | $386.75 | $595 | 2.4× |
| CT chest w/wo contrast (71270) | $344.50 | $530 | 2.2× |
| CT head/brain with contrast (70460) | $230.75 | $355 | 1.4× |
| CT head/brain without and with contrast (70470) | $273 | $420 | 1.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $553.80 | $852 | 1.7× |
| CT iac w contrast (70481) | $409.50 | $630 | 2.6× |
| CT l-spine w&w/o contrast (72133) | $344.50 | $530 | 2.2× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$214.50–$429 | $330–$660 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$269.75–$539.50 | $415–$830 | varies |
| CT lumbar spine w contrast (72132) | $559 | $860 | 1.8× |
| CT lumbar spine w/o contrast (72131) | $221 | $340 | 2.3× |
| CT maxillofacial w contrast (70487) | $276.25 | $425 | 1.7× |
| CT maxillofacial wo contrast (70486) | $227.50 | $350 | 2.4× |
| CT neck tissue combo (70492) | $331.50 | $510 | 2.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $512.85 | $789 | 3.2× |
| CT orbits w/o contrast (70480) | $276.25 | $425 | 2.9× |
| CT pelvis w&w/o contrast (72194) | $347.75 | $535 | 2.2× |
| CT pelvis w/o contrast (72192) | $208 | $320 | 2.2× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$538.85–$715 | $829–$1,100 | varies |
| CT scans face/jaw combo (70488) | $512.85 | $789 | 3.2× |
| CT soft tissue neck w contrast (70491) | $266.50 | $410 | 1.7× |
| CT soft tissue neck w/o contrast (70490) | $214.50 | $330 | 2.3× |
| CT thoracic spine w contrast (72129) | $328.25 | $505 | 2.1× |
| CT thoracic spine w/o contrast (72128) | $221 | $340 | 2.3× |
| CT thoracic spine w/wo cont (72130) | $642.20 | $988 | 4.0× |
| CT thorax w/o contrast (71250) | $312 | $480 | 3.3× |
| CT upper ext wo (73200) | $214.50 | $330 | 2.3× |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$354.25–$708.50 | $545–$1,090 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$477.75–$533 | $735–$820 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,135.55 | $1,747 | 7.1× |
| Cta Abdomen (74175) | $863.20 | $1,328 | 5.4× |
| CTA pelvis (72191) | $863.20 | $1,328 | 5.4× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$19.50–$136.50 | $30–$210 | varies |
| Esophagram (74220) | $208 | $320 | 1.3× |
| Fetal Biophys Profile W/Nst (76818) | $149.50 | $230 | 1.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $146.25 | $225 | 1.5× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$123.50–$129.35 | $190–$199 | varies |
| Foot 2 views (73620) | $113.75 | $175 | 1.4× |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$104–$113.75 | $160–$175 | varies |
| Gastric emptying imaging study (78264) range across 3 matching MRF lines |
$313.30–$641.55 | $482–$987 | varies |
| Gastroesophageal Reflux Exam (78262) | $442.65 | $681 | 1.2× |
| Gated Heart Planar Single (78472) | $527.80 | $812 | 1.5× |
| Hand 2 views (73120) | $97.50 | $150 | 1.0× |
| Ht Muscle Image Spect Sing (78451) range across 11 matching MRF lines |
$280.15–$823.55 | $431–$1,267 | varies |
| Hysterosalpingogram (74740) range across 3 matching MRF lines |
$89.05–$133.25 | $137–$205 | varies |
| Infusion Ivp (74410) | $140.40 | $216 | 0.9× |
| K Flow/Funct Image Multiple (78709) | $548.60 | $844 | 1.1× |
| K Flow/Funct Image W/Drug (78708) | $548.60 | $844 | 1.1× |
| Kidney Imaging Morphol (78700) | $432.25 | $665 | 1.2× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$113.75–$162.50 | $175–$250 | varies |
| Liver & Spleen Imaging Static Only (78215) | $235.30 | $362 | 0.6× |
| Lymph System Imaging (78195) | $332.80 | $512 | 0.7× |
| Magnetic Image Jaw Joint (70336) | $1,327.30 | $2,042 | 6.1× |
| Meckels Divert Exam (78290) | $243.75 | $375 | 0.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $32.50 | $50 | 1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $120.25 | $185 | 1.4× |
| MRA head w/o contrast (70544) | $536.25 | $825 | 2.5× |
| MRA neck w contrast (70548) | $863.20 | $1,328 | 2.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $841.75 | $1,295 | 2.6× |
| MRA neck w/o contrast (70547) | $833.30 | $1,282 | 3.8× |
| MRI abdomen w contrast (74182) | $591.50 | $910 | 1.9× |
| MRI abdomen w/o contrast (74181) | $737.10 | $1,134 | 3.4× |
| MRI any jt lower extrem w/contrast material (73722) | $991.25 | $1,525 | 1.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $653.25 | $1,005 | 2.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $991.25 | $1,525 | 1.4× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,547 | $2,380 | 7.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,346.15 | $2,071 | 6.2× |
| MRI cardiac w/o contrast (75557) | $811.20 | $1,248 | 3.7× |
| MRI cervical spine w contrast (72142) | $899.60 | $1,384 | 2.8× |
| MRI cervical spine w/o cont (72141) | $617.50 | $950 | 2.8× |
| MRI chest w/o contrast (71550) | $840.45 | $1,293 | 3.9× |
| MRI chest with contrast (71551) | $991.25 | $1,525 | 1.4× |
| MRI chest wo w contrast (71552) | $1,437.80 | $2,212 | 4.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $526.50 | $810 | 1.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$695.50–$1,391 | $1,070–$2,140 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $679.25 | $1,045 | 3.1× |
| MRI lumbar spine w contrast (72149) | $899.60 | $1,384 | 2.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $656.50 | $1,010 | 2.1× |
| MRI orbit face &/neck w/o contrast (70540) | $811.20 | $1,248 | 3.7× |
| MRI orbit face neck w contrast (70542) | $884.65 | $1,361 | 2.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $685.75 | $1,055 | 2.2× |
| MRI pelvis w contrast (72196) | $884.65 | $1,361 | 2.8× |
| MRI pelvis w/o & w contrast (72197) | $692.25 | $1,065 | 2.2× |
| MRI pelvis w/o contrast (72195) | $679.25 | $1,045 | 3.1× |
| MRI thoracic spine w/o contrast (72146) | $607.75 | $935 | 2.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $884.65 | $1,361 | 2.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $494 | $760 | 2.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,349.40 | $2,076 | 4.2× |
| MRI, abdomen, combo (74183) | $695.50 | $1,070 | 2.2× |
| MRI, dorsal spine combo (72157) | $607.75 | $935 | 1.9× |
| MRI, dorsal spine contrast (72147) | $474.50 | $730 | 1.5× |
| MRI, joint upper extrem (73221) | $461.50 | $710 | 2.1× |
| MRI, joint upper extrem combo (73223) | $1,327.30 | $2,042 | 4.2× |
| MRI, lumbar spine combo (72158) | $653.25 | $1,005 | 2.1× |
| Myelogram cervical (72240) | $221.65 | $341 | 0.3× |
| Myelogram Lumbar (72265) | $196.30 | $302 | 0.3× |
| Myelography thoracic (72255) | $196.30 | $302 | 0.3× |
| Neck soft tissue (70360) | $113.75 | $175 | 1.4× |
| Nm csf leak detection (78650) | $349.05 | $537 | 0.3× |
| Nuclear Rx Oral Admin (79005) | $297.05 | $457 | 1.4× |
| Panoramic X-ray of jaws (70355) | $44.85 | $69 | 0.6× |
| Parathyroid Planar Imaging (78070) | $430.95 | $663 | 1.2× |
| Pelvis 1 or 2 views (72170) | $136.50 | $210 | 1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $280.15 | $431 | 0.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $136.50 | $210 | 1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$74.10–$122.20 | $114–$188 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$113.75–$162.50 | $175–$250 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$35.75–$113.75 | $55–$175 | varies |
| Radex elbow complete minimum 3 views (73080) | $113.75 | $175 | 1.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $136.50 | $210 | 1.4× |
| Radex fingr minimum 2 views (73140) | $113.75 | $175 | 1.4× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$104–$113.75 | $160–$175 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$104–$113.75 | $160–$175 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $42.90 | $66 | 0.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$55.90–$136.50 | $86–$210 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $113.75 | $175 | 1.4× |
| Radex Ribs Unilateral 2 Views (71100) | $113.75 | $175 | 1.4× |
| Radex shoulder complete minimum 2 views (73030) | $113.75 | $175 | 1.4× |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$51.35–$113.75 | $79–$175 | varies |
| Radex Spine 1 View Specify Level (72020) range across 5 matching MRF lines |
$52–$113.75 | $80–$175 | varies |
| Radex Sternum Minimum 2 Views (71120) | $113.75 | $175 | 1.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $113.75 | $175 | 1.4× |
| Radex Toe Minimum 2 Views (73660) | $113.75 | $175 | 1.4× |
| Radex upper extremity infant minimum 2 views (73092) | $42.90 | $66 | 0.5× |
| Radex Wrist Complete Minimum 3 Views (73110) | $113.75 | $175 | 1.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $178.75 | $275 | 1.9× |
| Radiolog exam mandible compl minimum 4 views (70110) | $136.50 | $210 | 1.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $149.50 | $230 | 1.6× |
| Radiologic exam colon double contrast study (74280) | $211.25 | $325 | 1.3× |
| Radiologic exam colon single contrast study (74270) | $208 | $320 | 1.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $237.25 | $365 | 1.5× |
| Radiologic exam knee complete 4/more views (73564) | $136.50 | $210 | 1.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $159.25 | $245 | 1.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $123.50 | $190 | 0.8× |
| Radiologic exam swallow function contrast study (74230) | $114.40 | $176 | 0.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $208 | $320 | 1.3× |
| Radiologic examination femur minimum 2 views (73552) | $113.75 | $175 | 1.4× |
| Radiologic examination knee 1/2 views (73560) range across 7 matching MRF lines |
$32.50–$113.75 | $50–$175 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $139.75 | $215 | 1.5× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$104–$113.75 | $160–$175 | varies |
| Ribs bilateral 3 views (71110) | $178.75 | $275 | 1.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$284.70–$477.75 | $438–$735 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $345.80 | $532 | 1.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,095.25 | $1,685 | 2.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 5 matching MRF lines |
$426.40–$1,654.25 | $656–$2,545 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 8 matching MRF lines |
$648.70–$1,654.25 | $998–$2,545 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,875.25 | $2,885 | 1.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,654.25 | $2,545 | 1.4× |
| Rp Therapy Intravenous Administration (79101) | $227.50 | $350 | 1.1× |
| Scapula (73010) range across 3 matching MRF lines |
$104–$136.50 | $160–$210 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $39 | $60 | 1.7× |
| Sella turcica (70240) range across 2 matching MRF lines |
$29.90–$113.75 | $46–$175 | varies |
| Shoulder 1 view (73020) | $113.75 | $175 | 1.4× |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$129.35–$247 | $199–$380 | varies |
| Sialogram (70390) | $129.35 | $199 | 0.6× |
| Skull less than 4 views (70250) | $136.50 | $210 | 1.4× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$52–$113.75 | $80–$175 | varies |
| Temporomandble Jt Arthrography Rs&I (70332) range across 3 matching MRF lines |
$100.10–$152.10 | $154–$234 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $147.55 | $227 | 0.9× |
| Thoracic spine 2 views (72070) | $136.50 | $210 | 1.4× |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$97.50–$136.50 | $150–$210 | varies |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$52–$113.75 | $80–$175 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$113.75–$214.50 | $175–$330 | varies |
| Ultrasound Exam Aaa Screen (76706) | $146.25 | $225 | 1.5× |
| Ultrasound, abdomen limited (76705) | $133.25 | $205 | 1.4× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$152.75–$208 | $235–$320 | varies |
| Ureteral Reflux Study (78740) | $432.25 | $665 | 1.2× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$126.10–$136.50 | $194–$210 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$107.90–$113.75 | $166–$175 | varies |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$136.50–$292.50 | $210–$450 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$84.50–$121.55 | $130–$187 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$122.85–$146.25 | $189–$225 | varies |
| Us kidney transplant (76776) range across 3 matching MRF lines |
$156–$230.75 | $240–$355 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $136.50 | $210 | 1.4× |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$217.75–$265.85 | $335–$409 | varies |
| Us ob limited 1 or more fetuses (76815) | $136.50 | $210 | 1.4× |
| Us ob transvaginal (76817) | $133.25 | $205 | 1.4× |
| Us pelvic non ob complete (76856) | $133.25 | $205 | 1.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $133.25 | $205 | 1.4× |
| Us retroperitoneal complete (76770) | $133.25 | $205 | 1.4× |
| Us retroperitoneal limited (76775) | $129.35 | $199 | 1.4× |
| Us scrotum and contents (76870) | $133.25 | $205 | 1.4× |
| Us thyroid (76536) | $133.25 | $205 | 1.4× |
| Venography extremity bilateral rs&i (75822) | $864.50 | $1,330 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $78 | $120 | 0.1× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$52–$113.75 | $80–$175 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$91–$113.75 | $140–$175 | varies |
| X-ray antegrade pyelogram tube (74425) range across 12 matching MRF lines |
$63.70–$169 | $98–$260 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$52–$113.75 | $80–$175 | varies |
| X-Ray Exam Breast Specimen (76098) | $39.65 | $61 | 0.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $52 | $80 | 0.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $97.50 | $150 | 1.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $178.75 | $275 | 1.9× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$71.50–$113.75 | $110–$175 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$65–$113.75 | $100–$175 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$45.50–$136.50 | $70–$210 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $136.50 | $210 | 1.4× |
| X-Ray Exam L-S Spine Bending (72114) | $136.50 | $210 | 1.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $113.75 | $175 | 1.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $136.50 | $210 | 1.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $136.50 | $210 | 1.4× |
| X-ray humerus (73060) | $113.75 | $175 | 1.4× |
| X-ray IV pyelogram (ivp) (74400) | $137.80 | $212 | 0.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $117 | $180 | 1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$71.50–$113.75 | $110–$175 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $136.50 | $210 | 1.4× |
| X-ray nose-rectum child f.b. (76010) | $48.10 | $74 | 0.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $97.50 | $150 | 1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $136.50 | $210 | 1.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $48.10 | $74 | 0.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $113.75 | $175 | 1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $113.75 | $175 | 1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$97.50–$136.50 | $150–$210 | varies |
| X-Ray Stress View (77071) range across 3 matching MRF lines |
$84.50–$113.75 | $130–$175 | varies |
| X-ray thoracic spine 4 vw (72074) | $66.95 | $103 | 0.7× |
| X-Ray Tmj Unilat (70328) | $113.75 | $175 | 1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $191.75 | $295 | 0.6× |
| X-Rays Bone Length Studies (77073) | $59.15 | $91 | 0.6× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$130–$136.50 | $200–$210 | varies |
| Xr c-spine 4 or 5 views (72050) | $136.50 | $210 | 1.4× |
| Xr facial bones less than 3 views (70140) | $55.25 | $85 | 0.7× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$70.20–$136.50 | $108–$210 | varies |
| Xr Tomogram Single Plane (76100) | $121.55 | $187 | 1.3× |
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.