Imaging prices at LewisGale Hospital Pulaski
Pulaski, VA · every code in this section with a posted price and a Medicare benchmark.
250 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $23,535 | $23,535 | 17.4× |
| Abdomen 1 View (74018) | $1,189 | $1,189 | 14.0× |
| Abdomen 2 views (74019) | $1,497 | $1,497 | 14.7× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$1,587–$2,380 | $1,587–$2,380 | varies |
| Arthrogram hip (73525) | $2,267 | $2,267 | 6.7× |
| Arthrogram Wrist (73115) | $1,057 | $1,057 | 3.1× |
| Basic radiation dosimetry calculation (77300) | $2,449 | $2,449 | 18.7× |
| Bone age studies (77072) | $2,349 | $2,349 | 23.0× |
| Bone Imaging 3 Phase (78315) | $7,021 | $7,021 | 18.0× |
| Bone Imaging Limited Area (78300) | $4,951 | $4,951 | 12.7× |
| Bone Imaging Whole Body (78306) | $8,796 | $8,796 | 22.6× |
| Bone survey infant (77076) | $1,067 | $1,067 | 10.5× |
| Brachytx isodose complex (77318) | $6,897 | $6,897 | 18.9× |
| Brachytx isodose intermed (77317) | $2,559 | $2,559 | 7.0× |
| Brachytx Isodose Plan Simple (77316) | $1,717 | $1,717 | 4.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $19,021 | $19,021 | 13.6× |
| Cat Scan Follow-Up Study (76380) | $3,522 | $3,522 | 41.5× |
| Chest 1 view (71045) | $1,203 | $1,203 | 14.2× |
| Chest 2 views (71046) | $1,710 | $1,710 | 20.1× |
| Chest 3 views (71047) | $1,678 | $1,678 | 19.8× |
| Chest 4 or more views (71048) | $1,391 | $1,391 | 13.6× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$1,501–$2,247 | $1,501–$2,247 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $186 | $186 | 1.8× |
| Continuing medical physics consltj pr wk (77336) | $3,062 | $3,062 | 23.3× |
| Contrast X-Ray Of Elbow (73085) | $1,376 | $1,376 | 4.0× |
| Contrast X-Ray Of Knee Joint (73580) | $1,713 | $1,713 | 5.0× |
| CT abdomen and pelvis without and with contrast (74178) | $19,520 | $19,520 | 57.3× |
| CT abdomen and pelvis without contrast (74176) | $15,070 | $15,070 | 64.7× |
| CT abdomen w contrast (74160) | $11,060 | $11,060 | 64.6× |
| CT abdomen w wo contrast (74170) | $13,012 | $13,012 | 76.0× |
| CT abdomen w/o contrast (74150) | $10,047 | $10,047 | 98.5× |
| CT Angio Abdomen and Pelvis (74174) | $12,008 | $12,008 | 35.3× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$6,472–$6,604 | $6,472–$6,604 | varies |
| CT Angio Head (70496) | $6,517 | $6,517 | 38.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $4,501 | $4,501 | 26.3× |
| CT Angio Neck (70498) | $5,669 | $5,669 | 33.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $4,501 | $4,501 | 26.3× |
| CT cervical spine w/ contrast (72126) | $9,954 | $9,954 | 29.2× |
| CT cervical spine w/o contrast (72125) | $7,125 | $7,125 | 69.9× |
| CT chest w contrast (71260) | $10,914 | $10,914 | 63.8× |
| CT chest w/wo contrast (71270) | $12,107 | $12,107 | 70.7× |
| CT head/brain with contrast (70460) | $9,304 | $9,304 | 54.4× |
| CT head/brain without and with contrast (70470) | $11,678 | $11,678 | 68.2× |
| CT iac w contrast (70481) | $7,076 | $7,076 | 41.3× |
| CT l-spine w&w/o contrast (72133) | $13,746 | $13,746 | 80.3× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$5,981–$6,102 | $5,981–$6,102 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$7,327–$7,641 | $7,327–$7,641 | varies |
| CT lumbar spine w contrast (72132) | $10,036 | $10,036 | 29.5× |
| CT lumbar spine w/o contrast (72131) | $9,606 | $9,606 | 94.2× |
| CT maxillofacial w contrast (70487) | $10,824 | $10,824 | 63.2× |
| CT maxillofacial wo contrast (70486) | $9,019 | $9,019 | 88.4× |
| CT neck tissue combo (70492) | $10,602 | $10,602 | 61.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $7,379 | $7,379 | 43.1× |
| CT orbits w/o contrast (70480) | $5,947 | $5,947 | 58.3× |
| CT pelvis w&w/o contrast (72194) | $12,876 | $12,876 | 75.2× |
| CT pelvis w/o contrast (72192) | $8,864 | $8,864 | 86.9× |
| CT scan of leg combo (73702) | $7,914 | $7,914 | 46.2× |
| CT scans face/jaw combo (70488) | $11,082 | $11,082 | 64.8× |
| CT soft tissue neck w contrast (70491) | $9,976 | $9,976 | 58.3× |
| CT soft tissue neck w/o contrast (70490) | $9,890 | $9,890 | 97.0× |
| CT thoracic spine w contrast (72129) | $10,527 | $10,527 | 61.5× |
| CT thoracic spine w/o contrast (72128) | $10,101 | $10,101 | 99.0× |
| CT thoracic spine w/wo cont (72130) | $10,992 | $10,992 | 64.2× |
| CT thorax w/o contrast (71250) | $9,926 | $9,926 | 97.3× |
| CT upper ext wo (73200) | $4,675 | $4,675 | 45.8× |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$5,662–$6,058 | $5,662–$6,058 | varies |
| CT upper extremity with contrast (73201) | $5,243 | $5,243 | 15.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $6,975 | $6,975 | 40.8× |
| Cta Abdomen (74175) | $6,426 | $6,426 | 37.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $12,186 | $12,186 | 35.8× |
| CTA pelvis (72191) | $5,585 | $5,585 | 32.6× |
| Dxa Bone Density Axial (77080) | $2,000 | $2,000 | 19.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $364 | $364 | 4.3× |
| Esophagram (74220) | $2,462 | $2,462 | 14.4× |
| Fluoroscopy up to 1 hr (76000) | $3,056 | $3,056 | 13.1× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$1,587–$2,380 | $1,587–$2,380 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$1,754–$2,632 | $1,754–$2,632 | varies |
| Gastric emptying imaging study (78264) | $5,276 | $5,276 | 13.5× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$1,587–$2,380 | $1,587–$2,380 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $4,505 | $4,505 | 6.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $4,505 | $4,505 | 6.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $4,505 | $4,505 | 6.6× |
| Hepatobil Syst Image W/Drug (78227) | $6,156 | $6,156 | 11.6× |
| Hepatobiliary System Imaging (78226) | $6,156 | $6,156 | 15.8× |
| Ht Muscle Image Spect Sing (78451) | $6,156 | $6,156 | 4.9× |
| Interstitial radiation source applic complex (77778) | $25,602 | $25,602 | 37.7× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,963 | $1,963 | 5.0× |
| Lung Ventilat&Perfus Imaging (78582) | $9,240 | $9,240 | 17.4× |
| Lung Ventilation Imaging (78579) | $4,622 | $4,622 | 11.8× |
| Lymph System Imaging (78195) | $2,185 | $2,185 | 4.1× |
| Mlc imrt design & construction per imrt plan (77338) | $3,752 | $3,752 | 10.3× |
| Mr safety determination physician/other qhp (76016) | $218 | $218 | 2.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $25 | $25 | 0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $228 | $228 | 2.5× |
| Mr safety implt pos&/immoblj (76019) | $148 | $148 | 2.6× |
| Mr safety med physics xm customization plng&mntr (76017) | $598 | $598 | 2.6× |
| Mra Head W/O & W/Contrast Material (70546) | $14,491 | $14,491 | 42.6× |
| MRA head w/o contrast (70544) | $7,257 | $7,257 | 31.2× |
| MRA neck w contrast (70548) | $7,257 | $7,257 | 21.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $14,491 | $14,491 | 42.6× |
| MRI abdomen w contrast (74182) | $8,600 | $8,600 | 25.3× |
| MRI abdomen w/o contrast (74181) | $5,553 | $5,553 | 23.9× |
| MRI any jt lower extrem w/contrast material (73722) | $9,675 | $9,675 | 12.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $11,071 | $11,071 | 32.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $8,597 | $8,597 | 11.2× |
| MRI cervical spine w/o cont (72141) | $10,204 | $10,204 | 43.8× |
| MRI chest w/o contrast (71550) | $7,743 | $7,743 | 33.3× |
| MRI chest wo w contrast (71552) | $9,857 | $9,857 | 29.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $9,189 | $9,189 | 27.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $11,071 | $11,071 | 32.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $5,808 | $5,808 | 24.9× |
| MRI lumbar spine w contrast (72149) | $10,276 | $10,276 | 30.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $13,226 | $13,226 | 38.9× |
| MRI orbit face &/neck w/o contrast (70540) | $7,536 | $7,536 | 32.4× |
| MRI orbit face neck w contrast (70542) | $7,452 | $7,452 | 21.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $9,706 | $9,706 | 28.5× |
| MRI pelvis w contrast (72196) | $7,743 | $7,743 | 22.7× |
| MRI pelvis w/o & w contrast (72197) | $13,478 | $13,478 | 39.6× |
| MRI pelvis w/o contrast (72195) | $5,551 | $5,551 | 23.8× |
| MRI thoracic spine w/o contrast (72146) | $11,071 | $11,071 | 47.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $8,508 | $8,508 | 36.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $11,071 | $11,071 | 32.5× |
| MRI, abdomen, combo (74183) | $13,505 | $13,505 | 39.7× |
| MRI, dorsal spine combo (72157) | $13,226 | $13,226 | 38.9× |
| MRI, joint upper extrem (73221) | $8,508 | $8,508 | 36.5× |
| MRI, joint upper extrem combo (73223) | $11,071 | $11,071 | 32.5× |
| MRI, lumbar spine combo (72158) | $13,226 | $13,226 | 38.9× |
| Myelogram Lumbar (72265) | $2,648 | $2,648 | 3.5× |
| Myelography thoracic (72255) | $2,808 | $2,808 | 3.7× |
| Myocardial Spect Multiple Studies (78452) | $12,202 | $12,202 | 9.7× |
| Neck soft tissue (70360) | $1,313 | $1,313 | 15.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $32,558 | $32,558 | 24.1× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$942–$1,365 | $942–$1,365 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,939 | $1,939 | 3.7× |
| Parathyroid Planar Imaging (78070) | $1,497 | $1,497 | 3.8× |
| Pelvis 1 or 2 views (72170) | $1,869 | $1,869 | 18.3× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$23,037–$24,188 | $23,037–$24,188 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) | $22,788 | $22,788 | 16.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $4,622 | $4,622 | 11.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $2,840 | $2,840 | 27.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$1,710–$2,562 | $1,710–$2,562 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$1,454–$2,182 | $1,454–$2,182 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$1,889–$2,832 | $1,889–$2,832 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $2,612 | $2,612 | 25.6× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$1,355–$2,028 | $1,355–$2,028 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$1,710–$2,562 | $1,710–$2,562 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$1,710–$2,562 | $1,710–$2,562 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$1,649–$2,472 | $1,649–$2,472 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $1,501 | $1,501 | 17.7× |
| Radex Ribs Unilateral 2 Views (71100) | $2,230 | $2,230 | 26.3× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$1,785–$2,678 | $1,785–$2,678 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$1,092–$1,768 | $1,092–$1,768 | varies |
| Radex Sternum Minimum 2 Views (71120) | $1,754 | $1,754 | 20.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $2,121 | $2,121 | 25.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$1,182–$1,775 | $1,182–$1,775 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $1,471 | $1,471 | 14.4× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$1,905–$2,858 | $1,905–$2,858 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,339 | $1,339 | 13.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $54,841 | $54,841 | 7.6× |
| Radiation treatment delivery level 1 (77402) | $10,319.55 | $10,319.55 | 103.7× |
| Radiation treatment delivery level 2 (77407) | $12,221.75 | $12,221.75 | 32.5× |
| Radiation treatment delivery level 3 (77412) | $12,621.75 | $12,621.75 | 23.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $2,244 | $2,244 | 22.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $2,158 | $2,158 | 21.2× |
| Radiologic exam colon double contrast study (74280) | $4,459 | $4,459 | 26.1× |
| Radiologic exam colon single contrast study (74270) | $3,826 | $3,826 | 22.4× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$2,240–$3,360 | $2,240–$3,360 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $2,780 | $2,780 | 16.2× |
| Radiologic exam swallow function contrast study (74230) | $2,787 | $2,787 | 16.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $4,358 | $4,358 | 25.5× |
| Radiologic examination femur 1 view (73551) | $2,035 | $2,035 | 24.0× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$134–$2,035 | $134–$2,035 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$1,710–$2,562 | $1,710–$2,562 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$2,035–$3,056 | $2,035–$3,056 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $1,257 | $1,257 | 3.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $1,257 | $1,257 | 3.3× |
| Ribs bilateral 3 views (71110) | $2,267 | $2,267 | 22.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,633 | $4,633 | 8.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,686 | $3,686 | 7.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $4,684 | $4,684 | 8.8× |
| Rp Therapy Intravenous Administration (79101) | $1,268 | $1,268 | 5.6× |
| Scapula (73010) range across 3 matching MRF lines |
$1,587–$2,220 | $1,587–$2,220 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $73 | $73 | 3.1× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$1,057–$1,587 | $1,057–$1,587 | varies |
| Shoulder Arthrography (73040) | $1,708 | $1,708 | 5.0× |
| Skull less than 4 views (70250) | $1,587 | $1,587 | 15.6× |
| Special dosimetry (77331) | $1,786 | $1,786 | 13.6× |
| Special Physics Consult (77370) | $3,563 | $3,563 | 27.2× |
| Special teletherapy port plan (77321) | $9,932 | $9,932 | 27.2× |
| Special treatment procedure (77470) | $11,309 | $11,309 | 21.0× |
| Stereotactic Body Radiation Delivery (77373) | $39,174 | $39,174 | 22.5× |
| Sternoclavicular joints (71130) | $1,025 | $1,025 | 12.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $16,728 | $16,728 | 45.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $10,126 | $10,126 | 27.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $4,531 | $4,531 | 12.4× |
| Ther rad simulaj-aided field setting simple (77280) | $4,338 | $4,338 | 33.1× |
| Thoracic spine 3 views (72072) | $2,216 | $2,216 | 21.7× |
| Thoracolumbar 2 views (72080) | $2,216 | $2,216 | 26.1× |
| Thyroid Imaging With Vascular Flow (78013) | $3,564 | $3,564 | 9.1× |
| Thyroid Uptake Measurement (78012) | $3,850 | $3,850 | 9.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $5,766 | $5,766 | 14.8× |
| Tx Devices Design & Construction Complex (77334) | $4,714 | $4,714 | 12.9× |
| Tx devices design & construction intermediate (77333) | $2,349 | $2,349 | 17.9× |
| Tx devices design & construction simple (77332) | $1,546 | $1,546 | 11.8× |
| Ultrasound Breast Limited (76642) | $894 | $894 | 10.5× |
| Ultrasound Exam Aaa Screen (76706) | $2,219 | $2,219 | 21.8× |
| Ultrasound, abdomen limited (76705) | $3,294 | $3,294 | 32.3× |
| Upper gi w/o kub (74240) | $3,360 | $3,360 | 19.6× |
| Us breast unilateral complete (76641) | $1,279 | $1,279 | 12.5× |
| Us chest (76604) | $2,755 | $2,755 | 27.0× |
| Us complete joint (76881) | $1,686 | $1,686 | 16.5× |
| Us exam, pelvic, limited (76857) | $1,198 | $1,198 | 11.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,352 | $1,352 | 13.3× |
| Us ob limited 1 or more fetuses (76815) | $1,673 | $1,673 | 16.4× |
| Us ob transvaginal (76817) | $1,709 | $1,709 | 16.8× |
| Us pelvic non ob complete (76856) | $3,777 | $3,777 | 37.0× |
| Us retroperitoneal limited (76775) | $3,437 | $3,437 | 33.7× |
| Us scrotum and contents (76870) | $2,956 | $2,956 | 29.0× |
| Us thyroid (76536) | $3,089 | $3,089 | 30.3× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$1,587–$2,380 | $1,587–$2,380 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,891 | $1,891 | 22.3× |
| X-Ray Bend Only L-S Spine (72120) | $2,267 | $2,267 | 22.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$1,454–$2,182 | $1,454–$2,182 | varies |
| X-Ray Exam Breast Specimen (76098) | $913 | $913 | 1.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $424 | $424 | 5.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $702 | $702 | 6.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $2,230 | $2,230 | 26.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $2,230 | $2,230 | 26.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $2,230 | $2,230 | 21.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $2,079 | $2,079 | 20.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $2,079 | $2,079 | 20.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $2,079 | $2,079 | 20.4× |
| X-Ray Exam L-S Spine Bending (72114) | $3,124 | $3,124 | 30.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $2,085 | $2,085 | 24.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $3,092 | $3,092 | 30.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $2,337 | $2,337 | 22.9× |
| X-ray humerus (73060) | $1,419 | $1,419 | 16.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $1,251 | $1,251 | 14.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $2,660 | $2,660 | 26.1× |
| X-ray nose-rectum child f.b. (76010) | $849 | $849 | 10.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $3,212 | $3,212 | 31.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,710 | $1,710 | 16.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,710 | $1,710 | 20.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $2,205 | $2,205 | 26.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $2,253 | $2,253 | 22.1× |
| X-Rays Bone Length Studies (77073) | $1,966 | $1,966 | 19.3× |
| X-Rays Bone Survey Complete (77075) | $3,127 | $3,127 | 30.7× |
| Xr c-spine 4 or 5 views (72050) | $2,755 | $2,755 | 27.0× |
| Xr facial bones less than 3 views (70140) | $1,708 | $1,708 | 20.1× |
| Xr orbits complete 4 views (70200) | $2,230 | $2,230 | 21.9× |
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.