Imaging prices at Lone Peak Hospital
Draper, UT · every code in this section with a posted price and a Medicare benchmark.
259 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) | $592.94 | $592.94 | 6.7× |
| Abdomen 2 views (74019) | $828.38 | $828.38 | 7.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,289.96 | $2,289.96 | 5.7× |
| Angio internal mammary (75756) | $12,056.37 | $12,056.37 | 3.8× |
| Angio pulmonary bilat (75743) | $12,056.37 | $12,056.37 | 3.8× |
| Angiography extremity bilateral rs&i (75716) | $12,056.37 | $12,056.37 | 3.8× |
| Angiography extremity unilateral rs&i (75710) | $12,056.37 | $12,056.37 | 3.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $12,056.37 | $12,056.37 | 3.8× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$579.31–$1,158.59 | $579.31–$1,158.59 | varies |
| Aortography thoracic serialography rs&i (75605) | $20,627.92 | $20,627.92 | 3.7× |
| Artery X-Rays Abdomen (75726) | $20,627.92 | $20,627.92 | 3.7× |
| Artery X-Rays Pelvis (75736) | $20,627.92 | $20,627.92 | 3.7× |
| Artery X-Rays Spine (75705) | $20,627.92 | $20,627.92 | 3.7× |
| Arthrogram ankle (73615) | $1,289.21 | $1,289.21 | 3.6× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$998.20–$1,996.38 | $998.20–$1,996.38 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$998.20–$1,996.38 | $998.20–$1,996.38 | varies |
| Basic radiation dosimetry calculation (77300) | $634.18 | $634.18 | 4.7× |
| Bone age studies (77072) | $652.89 | $652.89 | 6.2× |
| Bone Imaging 3 Phase (78315) | $5,131.08 | $5,131.08 | 12.7× |
| Bone Imaging Limited Area (78300) | $2,471.56 | $2,471.56 | 6.1× |
| Bone Imaging Whole Body (78306) | $4,462.45 | $4,462.45 | 11.0× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$1,949.86–$2,105.85 | $1,949.86–$2,105.85 | varies |
| Cat Scan Follow-Up Study (76380) | $3,095.76 | $3,095.76 | 35.1× |
| Cerebrospinal Fluid Scan (78630) | $2,283.58 | $2,283.58 | 4.2× |
| Chest 1 view (71045) | $566.09 | $566.09 | 6.4× |
| Chest 2 views (71046) | $675.52 | $675.52 | 7.7× |
| Chest 3 views (71047) | $856.66 | $856.66 | 9.7× |
| Chest 4 or more views (71048) | $793.20 | $793.20 | 7.5× |
| Clavicle complete (73000) | $579.31 | $579.31 | 6.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $336.31 | $336.31 | 3.2× |
| Contrast Exam Abdominl Aorta (75625) | $12,056.37 | $12,056.37 | 3.8× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$1,385.04–$1,421.29 | $1,385.04–$1,421.29 | varies |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$998.20–$1,996.38 | $998.20–$1,996.38 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$866.10–$1,732.23 | $866.10–$1,732.23 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $10,181.86 | $10,181.86 | 28.8× |
| CT abdomen and pelvis without contrast (74176) | $7,906.43 | $7,906.43 | 32.7× |
| CT abdomen w contrast (74160) | $4,517.46 | $4,517.46 | 25.4× |
| CT abdomen w wo contrast (74170) | $4,966.59 | $4,966.59 | 28.0× |
| CT abdomen w/o contrast (74150) | $4,220.48 | $4,220.48 | 39.9× |
| CT Angio Abdomen and Pelvis (74174) | $11,612.81 | $11,612.81 | 32.9× |
| CT Angio Chest (71275) | $5,805.45 | $5,805.45 | 32.7× |
| CT Angio Head (70496) | $5,805.45 | $5,805.45 | 32.7× |
| CT angio hrt w/3d image (75574) | $1,169.13 | $1,169.13 | 3.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$4,840.35–$4,843.59 | $4,840.35–$4,843.59 | varies |
| CT Angio Neck (70498) | $5,805.45 | $5,805.45 | 32.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$5,368.56–$5,798.04 | $5,368.56–$5,798.04 | varies |
| CT cervical spine w/ contrast (72126) | $4,135.13 | $4,135.13 | 11.7× |
| CT cervical spine w/o contrast (72125) | $3,700.83 | $3,700.83 | 35.0× |
| CT chest w contrast (71260) | $3,975.49 | $3,975.49 | 22.4× |
| CT chest w/wo contrast (71270) | $4,682.62 | $4,682.62 | 26.4× |
| CT head/brain with contrast (70460) | $4,287.30 | $4,287.30 | 24.1× |
| CT head/brain without and with contrast (70470) | $4,569.42 | $4,569.42 | 25.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $4,840.35 | $4,840.35 | 54.9× |
| CT iac w contrast (70481) | $3,752.79 | $3,752.79 | 21.1× |
| CT l-spine w&w/o contrast (72133) | $2,661.92 | $2,661.92 | 15.0× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$3,316.62–$6,631.41 | $3,316.62–$6,631.41 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$3,602.44–$7,206.74 | $3,602.44–$7,206.74 | varies |
| CT lumbar spine w contrast (72132) | $4,192.62 | $4,192.62 | 11.9× |
| CT lumbar spine w/o contrast (72131) | $3,700.83 | $3,700.83 | 35.0× |
| CT maxillofacial w contrast (70487) | $3,758.34 | $3,758.34 | 21.2× |
| CT maxillofacial wo contrast (70486) | $1,891.21 | $1,891.21 | 17.9× |
| CT neck tissue combo (70492) | $4,840.35 | $4,840.35 | 27.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,490.69 | $3,490.69 | 19.7× |
| CT orbits w/o contrast (70480) | $3,427.98 | $3,427.98 | 32.4× |
| CT pelvis w/o contrast (72192) | $3,685.95 | $3,685.95 | 34.8× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$4,840.35–$8,963.67 | $4,840.35–$8,963.67 | varies |
| CT scans face/jaw combo (70488) | $4,613.97 | $4,613.97 | 26.0× |
| CT soft tissue neck w contrast (70491) | $3,606.13 | $3,606.13 | 20.3× |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$3,041.73–$3,285.07 | $3,041.73–$3,285.07 | varies |
| CT thoracic spine w contrast (72129) | $4,129.52 | $4,129.52 | 23.3× |
| CT thoracic spine w/o contrast (72128) | $3,700.83 | $3,700.83 | 35.0× |
| CT thoracic spine w/wo cont (72130) | $2,677.43 | $2,677.43 | 15.1× |
| CT thorax w/o contrast (71250) | $3,685.95 | $3,685.95 | 34.8× |
| CT upper ext wo (73200) | $3,316.62 | $3,316.62 | 31.3× |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$4,840.35–$9,680.76 | $4,840.35–$9,680.76 | varies |
| CT upper extremity with contrast (73201) | $3,602.44 | $3,602.44 | 10.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,750.54 | $2,750.54 | 15.5× |
| Cta Abdomen (74175) | $5,805.45 | $5,805.45 | 32.7× |
| CTA pelvis (72191) | $5,805.45 | $5,805.45 | 32.7× |
| Dilation ureters/urethra rs&i (74485) | $8,201.34 | $8,201.34 | 3.9× |
| Discography Cerv/Thor Spine (72285) | $13,433.95 | $13,433.95 | 6.8× |
| Diskography lumbar (72295) | $14,725.07 | $14,725.07 | 7.4× |
| Dxa Bone Density Axial (77080) | $573.63 | $573.63 | 5.4× |
| Dxa bone density study (77085) | $1,420.64 | $1,420.64 | 13.4× |
| Echo exam uterus (76831) | $922.87 | $922.87 | 3.8× |
| Echo Guide For Artery Repair (76936) | $721.36 | $721.36 | 3.3× |
| Esophagram (74220) | $907.63 | $907.63 | 5.1× |
| Fetal Biophys Profile W/Nst (76818) | $991.41 | $991.41 | 9.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,045.79 | $1,045.79 | 9.9× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$1,247.22–$1,335.95 | $1,247.22–$1,335.95 | varies |
| Follow-Up Angiography (75898) | $6,656.67 | $6,656.67 | 2.1× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$579.31–$1,158.62 | $579.31–$1,158.62 | varies |
| Forearm 2 views (73090) | $579.31 | $579.31 | 6.6× |
| Gastric emptying imaging study (78264) | $3,481.95 | $3,481.95 | 8.6× |
| Hand 2 views (73120) | $579.31 | $579.31 | 5.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $12,056.37 | $12,056.37 | 3.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $12,056.37 | $12,056.37 | 3.8× |
| Hepatobiliary System Imaging (78226) | $2,627.49 | $2,627.49 | 6.5× |
| Ht Muscle Image Spect Sing (78451) | $6,226.93 | $6,226.93 | 4.8× |
| Hysterosalpingogram (74740) | $1,520.89 | $1,520.89 | 6.3× |
| K Flow/Funct Image W/Drug (78708) | $1,570.86 | $1,570.86 | 2.9× |
| Knee 3 Views (73562) | $756.68 | $756.68 | 8.6× |
| Lung Perf&Ventilat Diferentl (78598) | $1,390.53 | $1,390.53 | 2.5× |
| Lung Ventilat&Perfus Imaging (78582) | $5,225.08 | $5,225.08 | 9.5× |
| Magnetic Image Jaw Joint (70336) | $3,000.14 | $3,000.14 | 12.4× |
| Meckels Divert Exam (78290) | $2,396.77 | $2,396.77 | 5.9× |
| Medical physics dose eval radiation expos w/rprt (76145) | $1,307.01 | $1,307.01 | 3.5× |
| Mra Head W/O & W/Contrast Material (70546) | $5,528.53 | $5,528.53 | 15.7× |
| MRA head w/o contrast (70544) | $5,858.41 | $5,858.41 | 24.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $6,046.37 | $6,046.37 | 17.1× |
| MRA neck w/o contrast (70547) | $4,210.91 | $4,210.91 | 17.4× |
| MRI abdomen w/o contrast (74181) | $5,257.63 | $5,257.63 | 21.8× |
| MRI any jt lower extrem w/contrast material (73722) | $5,257.63 | $5,257.63 | 6.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $5,257.63 | $5,257.63 | 14.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $5,257.63 | $5,257.63 | 6.6× |
| MRI Breast W/O Contrast Bilateral (77047) | $4,022.02 | $4,022.02 | 16.6× |
| MRI cervical spine w/o cont (72141) | $5,257.63 | $5,257.63 | 21.8× |
| MRI chest w/o contrast (71550) | $5,257.63 | $5,257.63 | 21.8× |
| MRI chest wo w contrast (71552) | $5,858.41 | $5,858.41 | 16.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $5,257.63 | $5,257.63 | 14.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $5,257.63 | $5,257.63 | 21.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,858.41 | $5,858.41 | 16.6× |
| MRI orbit face &/neck w/o contrast (70540) | $5,257.63 | $5,257.63 | 21.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $7,680.98 | $7,680.98 | 21.7× |
| MRI pelvis w/o & w contrast (72197) | $5,858.41 | $5,858.41 | 16.6× |
| MRI pelvis w/o contrast (72195) | $5,257.63 | $5,257.63 | 21.8× |
| MRI thoracic spine w/o contrast (72146) | $3,956.58 | $3,956.58 | 16.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$5,257.63–$10,515.27 | $5,257.63–$10,515.27 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $5,257.63 | $5,257.63 | 21.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $5,257.63 | $5,257.63 | 14.9× |
| MRI, abdomen, combo (74183) | $6,046.37 | $6,046.37 | 17.1× |
| MRI, dorsal spine combo (72157) | $5,858.41 | $5,858.41 | 16.6× |
| MRI, joint upper extrem (73221) | $5,257.63 | $5,257.63 | 21.8× |
| MRI, joint upper extrem combo (73223) | $5,257.63 | $5,257.63 | 14.9× |
| MRI, lumbar spine combo (72158) | $5,858.41 | $5,858.41 | 16.6× |
| Myocardial Spect Multiple Studies (78452) | $6,226.93 | $6,226.93 | 4.8× |
| Neck soft tissue (70360) | $756.68 | $756.68 | 8.6× |
| Nuclear Rx Intra-Arterial (79445) | $1,437.57 | $1,437.57 | 6.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $4,449.23 | $4,449.23 | 8.1× |
| Parathyroid Planar Imaging (78070) | $3,127.35 | $3,127.35 | 7.7× |
| Pelvis 1 or 2 views (72170) | $620.79 | $620.79 | 5.9× |
| Peritoneogram Rs&I (74190) | $1,111.43 | $1,111.43 | 2.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $12,056.37 | $12,056.37 | 3.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,860.32 | $2,860.32 | 7.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $566.51 | $566.51 | 5.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,185.02 | $1,185.02 | 2.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $718.93 | $718.93 | 8.2× |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$569.88–$1,139.72 | $569.88–$1,139.72 | varies |
| Radex elbow complete minimum 3 views (73080) | $718.93 | $718.93 | 8.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,101.97 | $1,101.97 | 10.4× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$588.72–$1,092 | $588.72–$1,092 | varies |
| Radex foot complete minimum 3 views (73630) | $718.93 | $718.93 | 8.2× |
| Radex Hand Minimum 3 Views (73130) | $652.89 | $652.89 | 7.4× |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$471.74–$509.48 | $471.74–$509.48 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $741.58 | $741.58 | 8.4× |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$757.11–$883.09 | $757.11–$883.09 | varies |
| Radex shoulder complete minimum 2 views (73030) | $764.22 | $764.22 | 8.7× |
| Radex Spine 1 View Specify Level (72020) | $564.20 | $564.20 | 6.4× |
| Radex Sternum Minimum 2 Views (71120) | $652.89 | $652.89 | 7.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $920.86 | $920.86 | 10.5× |
| Radex Toe Minimum 2 Views (73660) | $242.05 | $242.05 | 2.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $652.89 | $652.89 | 7.4× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$975.54–$1,784.79 | $975.54–$1,784.79 | varies |
| Radiologic exam colon double contrast study (74280) | $2,049.20 | $2,049.20 | 11.5× |
| Radiologic exam colon single contrast study (74270) | $1,452.93 | $1,452.93 | 8.2× |
| Radiologic exam knee complete 4/more views (73564) | $828.38 | $828.38 | 7.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $907.63 | $907.63 | 8.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,343.50 | $1,343.50 | 7.6× |
| Radiologic exam swallow function contrast study (74230) | $1,111.43 | $1,111.43 | 6.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,539.78 | $1,539.78 | 8.7× |
| Radiologic examination femur minimum 2 views (73552) | $327.65 | $327.65 | 3.7× |
| Radiologic examination knee 1/2 views (73560) | $652.89 | $652.89 | 7.4× |
| Radiologic Examination Osseous Survey Limited (77074) | $673.62 | $673.62 | 6.4× |
| Radiologic examination tibia & fibula 2 views (73590) | $688.74 | $688.74 | 7.8× |
| Ribs bilateral 3 views (71110) | $1,149.15 | $1,149.15 | 10.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,778.91 | $3,778.91 | 6.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $4,802.08 | $4,802.08 | 8.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $4,576.18 | $4,576.18 | 3.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $5,343.80 | $5,343.80 | 4.1× |
| Scapula (73010) | $718.93 | $718.93 | 6.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $96.88 | $96.88 | 4.1× |
| Shoulder 1 view (73020) | $534.01 | $534.01 | 6.1× |
| Shoulder Arthrography (73040) range across 4 matching MRF lines |
$1,193.71–$3,336.15 | $1,193.71–$3,336.15 | varies |
| Skull less than 4 views (70250) | $883.09 | $883.09 | 8.3× |
| Sternoclavicular joints (71130) | $788.76 | $788.76 | 9.0× |
| Superior sagittal sinus venogram (75870) | $11,048.79 | $11,048.79 | 3.5× |
| Thoracic spine 2 views (72070) | $884.98 | $884.98 | 8.4× |
| Thoracic spine 3 views (72072) | $992.52 | $992.52 | 9.4× |
| Thoracolumbar 2 views (72080) | $866.10 | $866.10 | 9.8× |
| Thyroid Uptake Measurement (78012) | $845.56 | $845.56 | 2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $5,605.31 | $5,605.31 | 13.8× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$640.79–$1,102.22 | $640.79–$1,102.22 | varies |
| Ultrasound Exam Aaa Screen (76706) | $619.41 | $619.41 | 5.9× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $1,447.86 | $1,447.86 | 4.1× |
| Ultrasound, abdomen limited (76705) | $1,146.55 | $1,146.55 | 10.8× |
| Umbilical-artery Doppler (OB) (76820) | $858.38 | $858.38 | 8.1× |
| Upper gi w/o kub (74240) | $975.54 | $975.54 | 5.5× |
| Urethrocystogram voiding (74455) | $1,385.04 | $1,385.04 | 5.7× |
| Urethrocystography retrograde (74450) | $1,385.04 | $1,385.04 | 5.7× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$640.79–$1,102.22 | $640.79–$1,102.22 | varies |
| Us chest (76604) | $922.87 | $922.87 | 8.7× |
| Us complete joint (76881) | $1,269.46 | $1,269.46 | 12.0× |
| Us exam, pelvic, limited (76857) | $922.87 | $922.87 | 8.7× |
| Us head (76506) | $1,539.49 | $1,539.49 | 14.5× |
| Us kidney transplant (76776) | $453 | $453 | 4.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,057.88 | $1,057.88 | 10.0× |
| Us ob limited 1 or more fetuses (76815) | $836.24 | $836.24 | 7.9× |
| Us ob transvaginal (76817) | $584.36 | $584.36 | 5.5× |
| Us pelvic non ob complete (76856) | $1,513.29 | $1,513.29 | 14.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $584.36 | $584.36 | 5.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,047.81 | $1,047.81 | 9.9× |
| Us retroperitoneal complete (76770) | $1,211.03 | $1,211.03 | 11.4× |
| Us retroperitoneal limited (76775) | $922.87 | $922.87 | 8.7× |
| Us scrotum and contents (76870) | $1,211.03 | $1,211.03 | 11.4× |
| Us spinal canal and contents (76800) | $922.87 | $922.87 | 8.7× |
| Us thyroid (76536) | $1,102.22 | $1,102.22 | 10.4× |
| Vein X-Ray Chest (75827) | $5,765.36 | $5,765.36 | 3.6× |
| Venogram Sinus/Jugular (75860) | $15,573.03 | $15,573.03 | 4.9× |
| Venography Adrenal Unilateral (75840) | $11,721.48 | $11,721.48 | 3.7× |
| Venography caval inferior serialography rs&i (75825) | $12,056.37 | $12,056.37 | 3.8× |
| Venography extremity bilateral rs&i (75822) | $6,656.67 | $6,656.67 | 4.2× |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$3,388.99–$3,474.88 | $3,388.99–$3,474.88 | varies |
| Venography Renal Bilateral (75833) | $13,359.02 | $13,359.02 | 4.2× |
| Venography Renal Unilateral (75831) | $13,147.82 | $13,147.82 | 4.1× |
| Venous sampling by catheter (75893) | $20,627.92 | $20,627.92 | 3.7× |
| Vertebral fracture assessment via dxa (77086) | $1,415.22 | $1,415.22 | 16.1× |
| Wrist 2 views (73100) | $579.31 | $579.31 | 6.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $884.98 | $884.98 | 10.0× |
| X-ray antegrade pyelogram tube (74425) | $1,369.05 | $1,369.05 | 3.9× |
| X-Ray Aorta Leg Arteries (75630) | $12,056.37 | $12,056.37 | 3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $579.31 | $579.31 | 6.6× |
| X-Ray Exam Breast Specimen (76098) | $492.50 | $492.50 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $327.65 | $327.65 | 3.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $542.66 | $542.66 | 5.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $327.65 | $327.65 | 3.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $327.65 | $327.65 | 3.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $542.66 | $542.66 | 5.1× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$502.46–$542.66 | $502.46–$542.66 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $1,458.59 | $1,458.59 | 13.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $564.20 | $564.20 | 6.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,343.50 | $1,343.50 | 12.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,026.52 | $1,026.52 | 9.7× |
| X-ray humerus (73060) | $579.31 | $579.31 | 6.6× |
| X-ray IV pyelogram (ivp) (74400) | $1,977.53 | $1,977.53 | 11.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $686.65 | $686.65 | 7.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$555.61–$600.06 | $555.61–$600.06 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $862.33 | $862.33 | 8.1× |
| X-ray nose-rectum child f.b. (76010) | $688.74 | $688.74 | 7.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$1,121.13–$1,307.69 | $1,121.13–$1,307.69 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $756.68 | $756.68 | 7.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $756.68 | $756.68 | 8.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,026.52 | $1,026.52 | 11.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,120.88 | $1,120.88 | 10.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,649.22 | $1,649.22 | 4.7× |
| X-Rays Bone Length Studies (77073) | $1,001.96 | $1,001.96 | 9.5× |
| X-Rays Bone Survey Complete (77075) | $2,105.85 | $2,105.85 | 19.9× |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$1,029.10–$1,745.70 | $1,029.10–$1,745.70 | varies |
| Xr facial bones less than 3 views (70140) | $741.58 | $741.58 | 8.4× |
| Xr orbits complete 4 views (70200) | $975.54 | $975.54 | 9.2× |
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.