Imaging prices at Mark Twain Medical Center
San Andreas, CA · every code in this section with a posted price and a Medicare benchmark.
261 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) | $87.25 | $131 | 0.8× |
| Abdomen 2 views (74019) | $154.52 | $232 | 1.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,670.66 | $4,010 | 5.2× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $2,664.67 | $4,001 | 1.6× |
| Adrenal Cortex & Medulla Img (78075) | $3,475.86 | $5,219 | 2.1× |
| Bone age studies (77072) | $66.60 | $100 | 0.5× |
| Bone Imaging 3 Phase (78315) | $3,004.33 | $4,511 | 5.8× |
| Bone Imaging Limited Area (78300) | $1,491.84 | $2,240 | 2.9× |
| Bone Imaging Multiple Areas (78305) | $1,954.05 | $2,934 | 3.8× |
| Bone Imaging Whole Body (78306) | $2,101.23 | $3,155 | 4.1× |
| Bone survey infant (77076) | $337 | $506 | 2.5× |
| Brain Flow Imaging Only (78610) | $1,390.61 | $2,088 | 2.0× |
| Brain Image W/Flow < 4 Views (78601) | $1,669.67 | $2,507 | 3.2× |
| Brain imaging < 4 static views (78600) | $1,407.26 | $2,113 | 2.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,696.64 | $4,049 | 3.9× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,495.84 | $2,246 | 2.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,383.62 | $3,579 | 1.3× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,622.38 | $2,436 | 3.2× |
| Cardiac Shunt Detection (78428) | $1,305.36 | $1,960 | 2.5× |
| Cat Scan Follow-Up Study (76380) | $563.44 | $846 | 5.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,639.36 | $3,963 | 3.8× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $1,461.87 | $2,195 | 2.1× |
| Cerebrospinal Fluid Scan (78630) | $1,458.54 | $2,190 | 2.1× |
| Chest 1 view (71045) | $85.25 | $128 | 0.8× |
| Chest 2 views (71046) | $115.89 | $174 | 1.0× |
| Chest 3 views (71047) | $143.19 | $215 | 1.3× |
| Chest 4 or more views (71048) | $170.50 | $256 | 1.3× |
| Cholecystography Oral Contrast (74290) | $491.51 | $738 | 2.2× |
| Cisternography Positive Contrast Rs&I (70015) | $434.90 | $653 | 0.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $561.44 | $843 | 4.2× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$29.31–$225.11 | $44–$338 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $291.05 | $437 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) | $2,102.57 | $3,157 | 4.7× |
| CT abdomen and pelvis without contrast (74176) | $797.87 | $1,198 | 2.6× |
| CT abdomen w contrast (74160) | $1,414.59 | $2,124 | 6.3× |
| CT abdomen w wo contrast (74170) | $1,964.04 | $2,949 | 8.7× |
| CT abdomen w/o contrast (74150) | $943.06 | $1,416 | 7.0× |
| CT Angio Abdomen and Pelvis (74174) | $3,164.84 | $4,752 | 7.1× |
| CT Angio Chest (71275) | $1,864.80 | $2,800 | 8.3× |
| CT Angio Head (70496) | $2,545.46 | $3,822 | 11.3× |
| CT angio hrt w/3d image (75574) | $1,644.36 | $2,469 | 3.7× |
| CT Angio Neck (70498) | $2,656.68 | $3,989 | 11.8× |
| CT bone density (77078) | $584.09 | $877 | 5.2× |
| CT cervical spine w/ contrast (72126) | $1,216.79 | $1,827 | 2.7× |
| CT cervical spine w/o contrast (72125) | $991.68 | $1,489 | 7.4× |
| CT cervical spine w/wo cont (72127) | $1,532.47 | $2,301 | 6.8× |
| CT chest w contrast (71260) | $1,235.43 | $1,855 | 5.5× |
| CT chest w/wo contrast (71270) | $1,516.49 | $2,277 | 6.7× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $2,256.41 | $3,388 | 10.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,998 | $3,000 | 14.9× |
| CT head/brain with contrast (70460) | $996.34 | $1,496 | 4.4× |
| CT head/brain without and with contrast (70470) | $1,202.80 | $1,806 | 5.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,042.29 | $1,565 | 2.3× |
| CT iac w contrast (70481) | $1,230.77 | $1,848 | 5.5× |
| CT l-spine w&w/o contrast (72133) | $1,298.04 | $1,949 | 5.8× |
| CT lumbar spine w contrast (72132) | $1,208.79 | $1,815 | 2.7× |
| CT lumbar spine w/o contrast (72131) | $985.02 | $1,479 | 7.3× |
| CT maxillofacial w contrast (70487) | $1,106.23 | $1,661 | 4.9× |
| CT maxillofacial wo contrast (70486) | $1,057.61 | $1,588 | 7.9× |
| CT neck tissue combo (70492) | $1,505.16 | $2,260 | 6.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,385.28 | $2,080 | 6.1× |
| CT orbits w/o contrast (70480) | $1,025.64 | $1,540 | 7.6× |
| CT pelvis w&w/o contrast (72194) | $1,336 | $2,006 | 5.9× |
| CT pelvis w/o contrast (72192) | $918.42 | $1,379 | 6.8× |
| CT scans face/jaw combo (70488) | $1,346.66 | $2,022 | 6.0× |
| CT soft tissue neck w contrast (70491) | $1,226.78 | $1,842 | 5.4× |
| CT soft tissue neck w/o contrast (70490) | $947.72 | $1,423 | 7.0× |
| CT thoracic spine w contrast (72129) | $1,214.12 | $1,823 | 5.4× |
| CT thoracic spine w/o contrast (72128) | $989.01 | $1,485 | 7.4× |
| CT thoracic spine w/wo cont (72130) | $1,304.03 | $1,958 | 5.8× |
| CT thorax w/o contrast (71250) | $955.05 | $1,434 | 7.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,685.65 | $2,531 | 7.5× |
| Cta Abdomen (74175) | $1,898.77 | $2,851 | 8.4× |
| CTA pelvis (72191) | $1,400.60 | $2,103 | 6.2× |
| Discography Cerv/Thor Spine (72285) | $1,467.20 | $2,203 | 0.6× |
| Diskography lumbar (72295) | $1,467.20 | $2,203 | 0.6× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$17.32–$528.14 | $26–$793 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$13.32–$528.14 | $20–$793 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$19.32–$116.55 | $29–$175 | varies |
| Echo exam of fetal heart (76825) | $3,066.27 | $4,604 | 4.4× |
| Echo exam uterus (76831) | $436.90 | $656 | 1.4× |
| Echo Guide For Artery Repair (76936) | $940.40 | $1,412 | 3.4× |
| Esophageal Motility Study (78258) | $1,723.61 | $2,588 | 3.4× |
| Esophagram (74220) | $429.57 | $645 | 1.9× |
| Fetal Biophys Profile W/Nst (76818) | $335 | $503 | 2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $452.88 | $680 | 3.4× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$542.79 | $17–$815 | 1.8× |
| Gastric emptying imaging study (78264) | $2,221.11 | $3,335 | 4.3× |
| Gastroesophageal Reflux Exam (78262) | $1,888.11 | $2,835 | 3.7× |
| Gated Heart Planar Single (78472) | $1,653.68 | $2,483 | 3.2× |
| Gated Heart, Multiple (78473) | $2,009.33 | $3,017 | 3.9× |
| Heart first pass single,planar (78481) | $1,213.46 | $1,822 | 1.7× |
| Hepatobil Syst Image W/Drug (78227) | $1,792.21 | $2,691 | 2.6× |
| Hepatobiliary System Imaging (78226) | $1,792.21 | $2,691 | 3.5× |
| Ht Musc Image Planar Mult (78454) | $3,348.65 | $5,028 | 2.0× |
| Ht Muscle Image Spect Sing (78451) | $2,566.77 | $3,854 | 1.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $543.46 | $816 | 4.9× |
| Infant hip ultrasound, limited static exam (76886) | $463.54 | $696 | 4.1× |
| Infusion Ivp (74410) | $418.25 | $628 | 1.9× |
| Joint Survey Single View (77077) | $114.56 | $172 | 0.9× |
| K Flow/Funct Image Multiple (78709) | $2,683.32 | $4,029 | 3.8× |
| K Flow/Funct Image W/Drug (78708) | $941.06 | $1,413 | 1.3× |
| K Flow/Funct Image W/O Drug (78707) | $1,635.03 | $2,455 | 2.3× |
| Kidney Imaging Morphol (78700) | $1,349.99 | $2,027 | 2.6× |
| Leveen/Shunt Patency Exam (78291) | $1,900.77 | $2,854 | 3.7× |
| Liver & Spleen Imaging Static Only (78215) | $1,495.84 | $2,246 | 2.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $811.19 | $1,218 | 1.6× |
| Liver imaging static only (78201) | $1,514.49 | $2,274 | 2.2× |
| Liver imaging w/vascular flow (78202) | $1,555.78 | $2,336 | 2.2× |
| Lung Perf&Ventilat Diferentl (78598) | $3,294.71 | $4,947 | 4.7× |
| Lung perfusion differential (78597) | $3,294.71 | $4,947 | 6.4× |
| Lung Ventilat&Perfus Imaging (78582) | $2,986.35 | $4,484 | 4.3× |
| Lung Ventilation Imaging (78579) | $2,855.81 | $4,288 | 5.6× |
| Lymph System Imaging (78195) | $2,676.66 | $4,019 | 3.8× |
| Magnetic Image Jaw Joint (70336) | $2,480.85 | $3,725 | 8.1× |
| Meckels Divert Exam (78290) | $2,676.66 | $4,019 | 5.2× |
| Mra Head W/O & W/Contrast Material (70546) | $3,320.01 | $4,985 | 7.4× |
| MRA head w/o contrast (70544) | $2,213.12 | $3,323 | 7.2× |
| MRA head with contrast (70545) | $2,213.12 | $3,323 | 4.9× |
| MRA neck w contrast (70548) | $2,398.94 | $3,602 | 5.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,331.34 | $5,002 | 7.4× |
| MRA neck w/o contrast (70547) | $2,221.11 | $3,335 | 7.2× |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$2,393.61–$2,522.15 | $3,594–$3,787 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,673–$1,775.56 | $2,512–$2,666 | varies |
| MRI bone marrow blood supply (77084) | $1,757.58 | $2,639 | 5.7× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,602.73 | $3,908 | 8.5× |
| MRI cervical spine w contrast (72142) | $2,176.49 | $3,268 | 4.9× |
| MRI cervical spine w/o cont (72141) | $1,674.33 | $2,514 | 5.5× |
| MRI chest w/o contrast (71550) | $1,934.73 | $2,905 | 6.3× |
| MRI chest with contrast (71551) | $2,181.15 | $3,275 | 2.2× |
| MRI chest wo w contrast (71552) | $2,672.66 | $4,013 | 6.0× |
| MRI lumbar spine w contrast (72149) | $2,141.19 | $3,215 | 4.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,410.92 | $3,620 | 5.4× |
| MRI orbit face &/neck w/o contrast (70540) | $1,661.67 | $2,495 | 5.4× |
| MRI orbit face neck w contrast (70542) | $1,858.81 | $2,791 | 4.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,217.78 | $3,330 | 4.9× |
| MRI pelvis w contrast (72196) | $2,127.21 | $3,194 | 4.7× |
| MRI pelvis w/o & w contrast (72197) | $2,562.77 | $3,848 | 5.7× |
| MRI pelvis w/o contrast (72195) | $1,948.05 | $2,925 | 6.3× |
| MRI thoracic spine w/o contrast (72146) | $1,679.66 | $2,522 | 5.5× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$2,573.43–$2,727.94 | $3,864–$4,096 | varies |
| MRI, dorsal spine combo (72157) | $2,200.47 | $3,304 | 4.9× |
| MRI, dorsal spine contrast (72147) | $1,881.45 | $2,825 | 4.2× |
| MRI, lumbar spine combo (72158) | $2,392.28 | $3,592 | 5.3× |
| Myelogram Lumbar (72265) | $410.93 | $617 | 0.4× |
| Myelography thoracic (72255) | $422.25 | $634 | 0.4× |
| Myelograpy 2/more regions rs&i (72270) | $632.70 | $950 | 0.6× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $1,448.55 | $2,175 | 2.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,284.38 | $3,430 | 1.4× |
| Myocardial Spect Multiple Studies (78452) | $3,728.94 | $5,599 | 2.2× |
| Neck soft tissue (70360) | $115.89 | $174 | 1.0× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $498.17 | $748 | 1.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $312.36 | $469 | 0.6× |
| Nm csf leak detection (78650) | $1,441.23 | $2,164 | 0.9× |
| Nuclear Rx Oral Admin (79005) | $402.93 | $605 | 1.3× |
| Optic foramina (70190) | $121.88 | $183 | 1.1× |
| Panoramic X-ray of jaws (70355) | $56.61 | $85 | 0.5× |
| Parathyroid Planar Imaging (78070) | $995.01 | $1,494 | 1.9× |
| Pelvis 1 or 2 views (72170) | $116.55 | $175 | 0.9× |
| Pet Image W/Ct Lmtd (78814) | $6,073.92 | $9,120 | 3.3× |
| PET image w/CT, full body (78816) | $6,414.92 | $9,632 | 3.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,414.92 | $9,632 | 3.5× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $1,068.27 | $1,604 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,552.45 | $2,331 | 3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $201.80 | $303 | 1.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $304.37 | $457 | 0.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $155.18 | $233 | 1.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $194.48 | $292 | 1.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $122.55 | $184 | 1.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $142.53 | $214 | 1.3× |
| Radex Spine 1 View Specify Level (72020) | $89.25 | $134 | 0.8× |
| Radex Sternum Minimum 2 Views (71120) | $101.24 | $152 | 0.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $172.50 | $259 | 1.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $243.76 | $366 | 1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $128.54 | $193 | 1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $181.82 | $273 | 1.4× |
| Radiologic exam colon double contrast study (74280) | $938.40 | $1,409 | 4.2× |
| Radiologic exam colon single contrast study (74270) | $681.32 | $1,023 | 3.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $209.79 | $315 | 1.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $424.91 | $638 | 1.9× |
| Radiologic exam swallow function contrast study (74230) | $697.97 | $1,048 | 3.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $450.22 | $676 | 2.0× |
| Radiologic Examination Osseous Survey Limited (77074) | $223.11 | $335 | 1.7× |
| Radiologic Examination Salivary Gland Calculus (70380) | $152.52 | $229 | 1.4× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $568.10 | $853 | 1.9× |
| Ribs bilateral 3 views (71110) | $169.83 | $255 | 1.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,361.97 | $2,045 | 2.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,904.10 | $2,859 | 3.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,590.08 | $6,892 | 6.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,493.51 | $3,744 | 3.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,547.45 | $3,825 | 3.6× |
| Rp Therapy Intravenous Administration (79101) | $428.24 | $643 | 1.4× |
| Salivary Gland Function Study (78232) | $659.34 | $990 | 1.3× |
| Salivary Gland Imaging Serial Images (78231) | $852.48 | $1,280 | 1.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $82.59 | $124 | 3.5× |
| Skull less than 4 views (70250) | $120.55 | $181 | 0.9× |
| Sternoclavicular joints (71130) | $123.88 | $186 | 1.1× |
| Testicular Imaging W/Flow (78761) | $1,583.75 | $2,378 | 3.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $504.17 | $757 | 2.2× |
| Thoracic spine 2 views (72070) | $147.19 | $221 | 1.1× |
| Thoracic spine 3 views (72072) | $173.83 | $261 | 1.3× |
| Thoracolumbar 2 views (72080) | $143.19 | $215 | 1.3× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,653.68 | $2,483 | 3.2× |
| Thyroid Met Imaging Body (78018) | $2,420.25 | $3,634 | 3.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,297.37 | $1,948 | 2.5× |
| Ultrasound, abdomen limited (76705) | $409.59 | $615 | 3.0× |
| Upper gi w/o kub (74240) | $527.48 | $792 | 2.3× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $282.39 | $424 | 25.5× |
| Urea breath test c-14 isotopic analysis (78268) | $428.91 | $644 | 4.5× |
| Ureteral Reflux Study (78740) | $1,790.21 | $2,688 | 3.5× |
| Urethrocystogram voiding (74455) | $627.38 | $942 | 2.0× |
| Urethrocystography retrograde (74450) | $362.97 | $545 | 1.2× |
| Us chest (76604) | $289.71 | $435 | 2.2× |
| Us exam, pelvic, limited (76857) | $443.56 | $666 | 3.3× |
| Us head (76506) | $438.23 | $658 | 3.3× |
| Us kidney transplant (76776) | $553.45 | $831 | 4.1× |
| Us ob detailed single fetus (76811) | $434.90 | $653 | 1.4× |
| Us ob limited 1 or more fetuses (76815) | $321.68 | $483 | 2.4× |
| Us ob transvaginal (76817) | $360.31 | $541 | 2.7× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$71.93–$521.48 | $108–$783 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $374.30 | $562 | 2.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $411.59 | $618 | 3.1× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$164.51–$547.46 | $247–$822 | varies |
| Us retroperitoneal limited (76775) | $448.89 | $674 | 3.3× |
| Us scrotum and contents (76870) | $458.21 | $688 | 3.4× |
| Us spinal canal and contents (76800) | $410.26 | $616 | 3.1× |
| Us thyroid (76536) | $511.49 | $768 | 3.8× |
| Us transrectal (76872) range across 3 matching MRF lines |
$61.94–$470.87 | $93–$707 | varies |
| Vascular Flow Imaging (78445) | $1,322.01 | $1,985 | 2.6× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,232.77 | $1,851 | 2.4× |
| Vertebral fracture assessment via dxa (77086) | $107.23 | $161 | 1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $139.20 | $209 | 1.2× |
| X-Ray Bend Only L-S Spine (72120) | $275.73 | $414 | 2.1× |
| X-Ray Exam Breast Specimen (76098) | $422.25 | $634 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $255.08 | $383 | 2.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $386.95 | $581 | 2.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $271.07 | $407 | 2.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $171.83 | $258 | 1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $692.64 | $1,040 | 5.2× |
| X-Ray Exam L-S Spine Bending (72114) | $378.96 | $569 | 2.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$167.17–$186.48 | $251–$280 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $327.01 | $491 | 2.4× |
| X-ray IV pyelogram (ivp) (74400) | $418.25 | $628 | 1.9× |
| X-ray IV pyelogram+tomography (74415) | $536.80 | $806 | 2.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $123.88 | $186 | 1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $169.83 | $255 | 1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $198.47 | $298 | 1.5× |
| X-ray nose-rectum child f.b. (76010) | $84.59 | $127 | 0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $235.77 | $354 | 1.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $155.18 | $233 | 1.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $131.87 | $198 | 1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $127.88 | $192 | 1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $167.84 | $252 | 1.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $269.73 | $405 | 2.0× |
| X-ray thoracic spine 4 vw (72074) | $215.12 | $323 | 1.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $641.36 | $963 | 1.4× |
| X-Rays Bone Length Studies (77073) | $114.56 | $172 | 0.9× |
| X-Rays Bone Survey Complete (77075) | $364.97 | $548 | 2.7× |
| Xr c-spine 4 or 5 views (72050) | $245.09 | $368 | 1.8× |
| Xr facial bones less than 3 views (70140) | $105.90 | $159 | 0.9× |
| Xr orbits complete 4 views (70200) | $141.86 | $213 | 1.1× |
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.