Imaging prices at Manchester Memorial Hospital
Manchester, CT · 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) | $310.57 | $310.57 | 3.0× |
| Abdomen 2 views (74019) | $385.81 | $385.81 | 3.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,248.45 | $1,248.45 | 2.6× |
| Angio pulmonary bilat (75743) | $10,649.18 | $10,649.18 | 2.8× |
| Angiography extremity bilateral rs&i (75716) | $10,649.18 | $10,649.18 | 2.8× |
| Angiography extremity unilateral rs&i (75710) | $10,649.18 | $10,649.18 | 2.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $10,649.18 | $10,649.18 | 2.8× |
| Ankle 2 views (73600) | $310.57 | $310.57 | 3.0× |
| Artery X-Rays Abdomen (75726) | $18,373.53 | $18,373.53 | 2.8× |
| Artery X-Rays Pelvis (75736) | $18,373.53 | $18,373.53 | 2.8× |
| Bone age studies (77072) | $385.81 | $385.81 | 3.1× |
| Bone Imaging 3 Phase (78315) | $1,582.96 | $1,582.96 | 3.3× |
| Bone Imaging Limited Area (78300) | $1,582.96 | $1,582.96 | 3.3× |
| Bone Imaging Whole Body (78306) | $1,582.96 | $1,582.96 | 3.3× |
| Bone marrow imaging limited area (78102) | $1,404.79 | $1,404.79 | 2.9× |
| Bone survey infant (77076) | $385.81 | $385.81 | 3.1× |
| Chest 1 view (71045) | $310.57 | $310.57 | 3.0× |
| Chest 2 views (71046) | $310.57 | $310.57 | 3.0× |
| Chest 3 views (71047) | $310.57 | $310.57 | 3.0× |
| Chest 4 or more views (71048) | $385.81 | $385.81 | 3.1× |
| Clavicle complete (73000) | $310.57 | $310.57 | 3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,831.60 | $1,831.60 | 14.6× |
| Contrast Exam Abdominl Aorta (75625) | $10,649.18 | $10,649.18 | 2.8× |
| Contrast X-Ray Bladder (74430) | $1,317.06 | $1,317.06 | 3.1× |
| CT abdomen and pelvis without and with contrast (74178) | $4,052.88 | $4,052.88 | 9.7× |
| CT abdomen and pelvis without contrast (74176) | $3,663.19 | $3,663.19 | 12.8× |
| CT abdomen w contrast (74160) | $2,257.14 | $2,257.14 | 10.7× |
| CT abdomen w wo contrast (74170) | $2,974.19 | $2,974.19 | 14.1× |
| CT abdomen w/o contrast (74150) | $1,831.60 | $1,831.60 | 14.6× |
| CT Angio Abdomen and Pelvis (74174) | $4,052.88 | $4,052.88 | 9.7× |
| CT Angio Chest (71275) | $3,438.72 | $3,438.72 | 16.4× |
| CT Angio Head (70496) | $3,999.88 | $3,999.88 | 19.0× |
| CT angio hrt w/3d image (75574) | $650.46 | $650.46 | 1.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,026.44 | $2,026.44 | 9.6× |
| CT Angio Neck (70498) | $3,999.88 | $3,999.88 | 19.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,026.44 | $2,026.44 | 9.6× |
| CT cervical spine w/ contrast (72126) | $2,176.09 | $2,176.09 | 5.2× |
| CT cervical spine w/o contrast (72125) | $1,831.60 | $1,831.60 | 14.6× |
| CT cervical spine w/wo cont (72127) | $2,026.44 | $2,026.44 | 9.6× |
| CT chest w contrast (71260) | $2,179.20 | $2,179.20 | 10.4× |
| CT chest w/wo contrast (71270) | $2,737.26 | $2,737.26 | 13.0× |
| CT colonography screening (74263) | $1,610.09 | $1,610.09 | 5.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,813.47 | $1,813.47 | 14.5× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,929.21–$1,948.50 | $1,929.21–$1,948.50 | varies |
| CT head/brain without and with contrast (70470) | $2,163.63 | $2,163.63 | 10.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $180 | $180 | 1.7× |
| CT iac w contrast (70481) | $2,232.20 | $2,232.20 | 10.6× |
| CT l-spine w&w/o contrast (72133) | $2,737.26 | $2,737.26 | 13.0× |
| CT lower ext w/o (73700) | $1,831.60 | $1,831.60 | 14.6× |
| CT lower extremity w/contrast material (73701) | $1,995.26 | $1,995.26 | 9.5× |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,309.87–$2,172.97 | $1,309.87–$2,172.97 | varies |
| CT lumbar spine w/o contrast (72131) | $1,831.60 | $1,831.60 | 14.6× |
| CT maxillofacial w contrast (70487) | $2,004.63 | $2,004.63 | 9.5× |
| CT maxillofacial wo contrast (70486) | $1,831.60 | $1,831.60 | 14.6× |
| CT neck tissue combo (70492) | $2,456.68 | $2,456.68 | 11.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$2,006.38–$2,026.44 | $2,006.38–$2,026.44 | varies |
| CT orbits w/o contrast (70480) | $1,879.93 | $1,879.93 | 15.0× |
| CT pelvis w&w/o contrast (72194) | $2,696.72 | $2,696.72 | 12.8× |
| CT pelvis w/o contrast (72192) | $1,831.60 | $1,831.60 | 14.6× |
| CT scan of leg combo (73702) | $2,618.77 | $2,618.77 | 12.5× |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$2,484.83–$2,509.67 | $2,484.83–$2,509.67 | varies |
| CT soft tissue neck w contrast (70491) | $1,948.50 | $1,948.50 | 9.3× |
| CT soft tissue neck w/o contrast (70490) | $1,831.60 | $1,831.60 | 14.6× |
| CT thoracic spine w contrast (72129) | $2,176.09 | $2,176.09 | 10.3× |
| CT thoracic spine w/o contrast (72128) | $1,831.60 | $1,831.60 | 14.6× |
| CT thoracic spine w/wo cont (72130) | $1,875.12 | $1,875.12 | 8.9× |
| CT thorax w/o contrast (71250) | $1,831.60 | $1,831.60 | 14.6× |
| CT upper ext wo (73200) | $1,831.60 | $1,831.60 | 14.6× |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$2,571.26–$2,596.98 | $2,571.26–$2,596.98 | varies |
| CT upper extremity with contrast (73201) | $1,989.03 | $1,989.03 | 4.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,338.21 | $2,338.21 | 11.1× |
| Cta Abdomen (74175) | $3,463.64 | $3,463.64 | 16.5× |
| CTA pelvis (72191) | $3,299.73 | $3,299.73 | 15.7× |
| Dxa Bone Density Axial (77080) | $385.81 | $385.81 | 3.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $310.57 | $310.57 | 3.0× |
| Echo Guide For Artery Repair (76936) | $1,069.09 | $1,069.09 | 4.1× |
| Esophagram (74220) | $644.66 | $644.66 | 3.1× |
| Fetal Biophys Profile W/Nst (76818) | $701.47 | $701.47 | 5.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $701.47 | $701.47 | 5.6× |
| Fluoroscopy up to 1 hr (76000) | $834.79 | $834.79 | 2.9× |
| Follow-Up Angiography (75898) | $11,251.63 | $11,251.63 | 3.0× |
| Foot 2 views (73620) | $310.57 | $310.57 | 3.0× |
| Forearm 2 views (73090) | $310.57 | $310.57 | 3.0× |
| Gastric emptying imaging study (78264) | $1,248.45 | $1,248.45 | 2.6× |
| Gated Heart Planar Single (78472) | $1,248.45 | $1,248.45 | 2.6× |
| Hand 2 views (73120) | $385.81 | $385.81 | 3.1× |
| Hepatobil Syst Image W/Drug (78227) | $1,620.69 | $1,620.69 | 2.5× |
| Hepatobiliary System Imaging (78226) | $1,311.13 | $1,311.13 | 2.7× |
| Ht Muscle Image Spect Sing (78451) | $4,245.85 | $4,245.85 | 2.7× |
| Hysterosalpingogram (74740) | $1,235.95 | $1,235.95 | 4.3× |
| K Flow/Funct Image W/Drug (78708) | $1,578.25 | $1,578.25 | 2.4× |
| K Flow/Funct Image W/O Drug (78707) | $1,620.70 | $1,620.70 | 2.5× |
| Knee 3 Views (73562) | $310.57 | $310.57 | 3.0× |
| Lung Perf&Ventilat Diferentl (78598) | $1,620.69 | $1,620.69 | 2.5× |
| Lung perfusion differential (78597) | $1,248.45 | $1,248.45 | 2.6× |
| Lung Ventilat&Perfus Imaging (78582) | $1,620.70 | $1,620.70 | 2.5× |
| Lung Ventilation Imaging (78579) | $1,298.55 | $1,298.55 | 2.7× |
| Lymph System Imaging (78195) | $1,620.70 | $1,620.70 | 2.5× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $5,454.88 | $5,454.88 | 2.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $10,856.67 | $10,856.67 | 2.9× |
| Magnetic Image Jaw Joint (70336) | $2,805.84 | $2,805.84 | 9.8× |
| Meckels Divert Exam (78290) | $1,248.45 | $1,248.45 | 2.6× |
| Mr safety determination physician/other qhp (76016) | $314.76 | $314.76 | 3.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $87.55 | $87.55 | 2.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $328.13 | $328.13 | 2.9× |
| Mr safety implt pos&/immoblj (76019) | $212.34 | $212.34 | 3.0× |
| Mra Head W/O & W/Contrast Material (70546) | $3,086.73 | $3,086.73 | 7.4× |
| MRA head w/o contrast (70544) | $2,182.32 | $2,182.32 | 7.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,117.59 | $3,117.59 | 7.5× |
| MRA neck w/o contrast (70547) | $2,182.32 | $2,182.32 | 7.6× |
| MRI abdomen w contrast (74182) | $2,469.39 | $2,469.39 | 5.9× |
| MRI abdomen w/o contrast (74181) | $2,264.02 | $2,264.02 | 7.9× |
| MRI any jt lower extrem w/contrast material (73722) | $2,648.03 | $2,648.03 | 2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,273.48 | $3,273.48 | 7.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,648.03 | $2,648.03 | 2.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,763.24 | $2,763.24 | 9.7× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,469.39 | $2,469.39 | 8.6× |
| MRI cervical spine w contrast (72142) | $2,494.08 | $2,494.08 | 6.0× |
| MRI cervical spine w/o cont (72141) | $2,182.32 | $2,182.32 | 7.6× |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$2,160.72–$2,182.32 | $2,160.72–$2,182.32 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$3,086.73–$3,117.59 | $3,086.73–$3,117.59 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,273.48 | $3,273.48 | 7.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,182.32 | $2,182.32 | 7.6× |
| MRI lumbar spine w contrast (72149) | $2,494.08 | $2,494.08 | 6.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,117.59 | $3,117.59 | 7.5× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$2,160.72–$2,182.32 | $2,160.72–$2,182.32 | varies |
| MRI orbit face neck w contrast (70542) | $2,307.84 | $2,307.84 | 5.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,117.59 | $3,117.59 | 7.5× |
| MRI pelvis w/o & w contrast (72197) | $3,273.48 | $3,273.48 | 7.8× |
| MRI pelvis w/o contrast (72195) | $2,182.32 | $2,182.32 | 7.6× |
| MRI thoracic spine w/o contrast (72146) | $2,182.32 | $2,182.32 | 7.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,182.32 | $2,182.32 | 7.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,117.59 | $3,117.59 | 7.5× |
| MRI, abdomen, combo (74183) | $4,413.02 | $4,413.02 | 10.6× |
| MRI, dorsal spine combo (72157) | $3,117.59 | $3,117.59 | 7.5× |
| MRI, joint upper extrem (73221) | $2,182.32 | $2,182.32 | 7.6× |
| MRI, joint upper extrem combo (73223) | $3,117.59 | $3,117.59 | 7.5× |
| MRI, lumbar spine combo (72158) | $3,117.59 | $3,117.59 | 7.5× |
| Myocardial Spect Multiple Studies (78452) | $4,327.93 | $4,327.93 | 2.8× |
| Neck soft tissue (70360) | $310.57 | $310.57 | 3.0× |
| Nuclear Rx Oral Admin (79005) | $961.50 | $961.50 | 3.4× |
| Parathyroid Planar Imaging (78070) | $1,248.45 | $1,248.45 | 2.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,404.79 | $1,404.79 | 2.9× |
| Pelvis 1 or 2 views (72170) | $385.81 | $385.81 | 3.1× |
| Pet Image Skull-Thigh (78812) | $6,640.11 | $6,640.11 | 3.9× |
| Pet Image W/Ct Lmtd (78814) | $6,640.11 | $6,640.11 | 3.9× |
| PET image w/CT, full body (78816) | $7,222.84 | $7,222.84 | 4.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$7,222.84–$23,248.35 | $7,222.84–$23,248.35 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $6,640.11 | $6,640.11 | 4.3× |
| PET whole body (78813) | $6,640.11 | $6,640.11 | 3.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,248.45 | $1,248.45 | 2.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $385.81 | $385.81 | 3.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,915.77 | $1,915.77 | 2.9× |
| Radex Ankle Complete Minimum 3 Views (73610) | $310.57 | $310.57 | 3.0× |
| Radex Calcaneus Minimum 2 Views (73650) | $310.57 | $310.57 | 3.0× |
| Radex elbow complete minimum 3 views (73080) | $310.57 | $310.57 | 3.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $385.81 | $385.81 | 3.1× |
| Radex fingr minimum 2 views (73140) | $310.57 | $310.57 | 3.0× |
| Radex foot complete minimum 3 views (73630) | $310.57 | $310.57 | 3.0× |
| Radex Hand Minimum 3 Views (73130) | $310.57 | $310.57 | 3.0× |
| Radex lower extremity infant minimum 2 views (73592) | $310.57 | $310.57 | 3.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $385.81 | $385.81 | 3.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $310.57 | $310.57 | 3.0× |
| Radex Ribs Unilateral 2 Views (71100) | $310.57 | $310.57 | 3.0× |
| Radex shoulder complete minimum 2 views (73030) | $310.57 | $310.57 | 3.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $310.57 | $310.57 | 3.0× |
| Radex Spine 1 View Specify Level (72020) | $310.57 | $310.57 | 3.0× |
| Radex Sternum Minimum 2 Views (71120) | $310.57 | $310.57 | 3.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $310.57 | $310.57 | 3.0× |
| Radex Toe Minimum 2 Views (73660) | $310.57 | $310.57 | 3.0× |
| Radex upper extremity infant minimum 2 views (73092) | $385.81 | $385.81 | 3.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $310.57 | $310.57 | 3.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $385.81 | $385.81 | 3.1× |
| Radiologic exam colon double contrast study (74280) | $828.12 | $828.12 | 3.9× |
| Radiologic exam colon single contrast study (74270) | $644.66 | $644.66 | 3.1× |
| Radiologic exam knee complete 4/more views (73564) | $385.81 | $385.81 | 3.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $385.81 | $385.81 | 3.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $644.66 | $644.66 | 3.1× |
| Radiologic exam swallow function contrast study (74230) | $644.66 | $644.66 | 3.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $838.41 | $838.41 | 4.0× |
| Radiologic examination femur 1 view (73551) | $310.57 | $310.57 | 3.0× |
| Radiologic examination femur minimum 2 views (73552) | $310.57 | $310.57 | 3.0× |
| Radiologic examination knee 1/2 views (73560) | $310.57 | $310.57 | 3.0× |
| Radiologic Examination Osseous Survey Limited (77074) | $385.81 | $385.81 | 3.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $310.57 | $310.57 | 3.0× |
| Ribs bilateral 3 views (71110) | $385.81 | $385.81 | 3.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,582.96 | $1,582.96 | 3.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $5,470.53 | $5,470.53 | 8.4× |
| Scapula (73010) | $382.09 | $382.09 | 3.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $61.44 | $61.44 | 2.6× |
| Shoulder 1 view (73020) | $310.57 | $310.57 | 3.0× |
| Skull less than 4 views (70250) | $385.81 | $385.81 | 3.1× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$253.78–$310.57 | $253.78–$310.57 | varies |
| Thoracic spine 2 views (72070) | $385.81 | $385.81 | 3.1× |
| Thoracic spine 3 views (72072) | $385.81 | $385.81 | 3.1× |
| Thyroid Uptake Measurement (78012) | $1,298.55 | $1,298.55 | 2.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,248.45 | $1,248.45 | 2.6× |
| Ultrasound Breast Limited (76642) | $375.21 | $375.21 | 3.6× |
| Ultrasound elastography first target lesion (76982) | $380.14 | $380.14 | 3.0× |
| Ultrasound Elastography Parenchyma (76981) | $380.14 | $380.14 | 3.0× |
| Ultrasound Exam Aaa Screen (76706) | $540.19 | $540.19 | 4.3× |
| Ultrasound, abdomen limited (76705) | $718.61 | $718.61 | 5.7× |
| Unlisted us procedure (76999) | $310.57 | $310.57 | 3.0× |
| Upper gi w/o kub (74240) | $838.41 | $838.41 | 4.0× |
| Urethrocystogram voiding (74455) | $1,483.97 | $1,483.97 | 5.2× |
| Urethrocystography retrograde (74450) | $834.79 | $834.79 | 2.9× |
| Us breast unilateral complete (76641) | $385.81 | $385.81 | 3.1× |
| Us chest (76604) | $584.55 | $584.55 | 4.7× |
| Us complete joint (76881) | $428.67 | $428.67 | 3.4× |
| Us exam, pelvic, limited (76857) | $467.64 | $467.64 | 3.7× |
| Us head (76506) | $385.81 | $385.81 | 3.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $385.81 | $385.81 | 3.1× |
| Us ob limited 1 or more fetuses (76815) | $385.81 | $385.81 | 3.1× |
| Us ob transvaginal (76817) | $385.81 | $385.81 | 3.1× |
| Us pelvic non ob complete (76856) | $467.64 | $467.64 | 3.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $385.81 | $385.81 | 3.1× |
| Us retroperitoneal complete (76770) | $718.61 | $718.61 | 5.7× |
| Us retroperitoneal limited (76775) | $545.59 | $545.59 | 4.4× |
| Us scrotum and contents (76870) | $389.70 | $389.70 | 3.1× |
| Us spinal canal and contents (76800) | $385.81 | $385.81 | 3.1× |
| Us thyroid (76536) | $438.03 | $438.03 | 3.5× |
| Venogram Sinus/Jugular (75860) | $10,649.18 | $10,649.18 | 2.8× |
| Venography extremity bilateral rs&i (75822) | $5,318.75 | $5,318.75 | 2.8× |
| Venography extremity unilateral rs&i (75820) | $5,318.75 | $5,318.75 | 2.8× |
| Venography Renal Unilateral (75831) | $10,649.18 | $10,649.18 | 2.8× |
| Wrist 2 views (73100) | $310.57 | $310.57 | 3.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $310.57 | $310.57 | 3.0× |
| X-Ray Aorta Leg Arteries (75630) | $10,649.18 | $10,649.18 | 2.8× |
| X-Ray Bend Only L-S Spine (72120) | $392.80 | $392.80 | 3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $310.57 | $310.57 | 3.0× |
| X-Ray Exam Breast Specimen (76098) | $1,798.60 | $1,798.60 | 2.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$310.57–$314.77 | $310.57–$314.77 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$309.51–$310.57 | $309.51–$310.57 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $310.57 | $310.57 | 3.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $382.09 | $382.09 | 3.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $385.81 | $385.81 | 3.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $385.81 | $385.81 | 3.1× |
| X-Ray Exam L-S Spine Bending (72114) | $428.67 | $428.67 | 3.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $310.57 | $310.57 | 3.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $385.81 | $385.81 | 3.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $385.81 | $385.81 | 3.1× |
| X-ray eye for foreign body (70030) | $310.57 | $310.57 | 3.0× |
| X-ray humerus (73060) | $310.57 | $310.57 | 3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $290.25 | $290.25 | 2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $310.57 | $310.57 | 3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $385.81 | $385.81 | 3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $385.81 | $385.81 | 3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $385.81 | $385.81 | 3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $310.57 | $310.57 | 3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $310.57 | $310.57 | 3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $385.81 | $385.81 | 3.1× |
| X-ray thoracic spine 4 vw (72074) | $380.13 | $380.13 | 3.0× |
| X-Ray Tmj Unilat (70328) | $310.57 | $310.57 | 3.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,317.06 | $1,317.06 | 3.1× |
| X-Rays Bone Length Studies (77073) | $385.81 | $385.81 | 3.1× |
| X-Rays Bone Survey Complete (77075) | $485.30 | $485.30 | 3.9× |
| Xr c-spine 4 or 5 views (72050) | $385.81 | $385.81 | 3.1× |
| Xr facial bones less than 3 views (70140) | $310.57 | $310.57 | 3.0× |
| Xr orbits complete 4 views (70200) | $385.81 | $385.81 | 3.1× |
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.