Imaging prices at Marshall Medical Center

Lewisburg, TN · every code in this section with a posted price and a Medicare benchmark.

296 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $140.22 $342 1.8×
Abdomen 2 views (74019) $140.22 $342 1.5×
Acute Gastrointestinal Blood Loss Imaging (78278) $347.68 $848 1.0×
Angio pulmonary bilat (75743) $277.98 $678 0.1×
Angiography extremity bilateral rs&i (75716) $272.65 $665 0.1×
Angiography extremity unilateral rs&i (75710) $266.91 $651 0.1×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $305.86 $746 0.1×
Ankle 2 views (73600) $90.61 $221 1.1×
Artery X-Rays Abdomen (75726)
likely a partial charge, not the full procedure
$296.43 $723 0.1×
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure
$2,039.34 $4,974 0.4×
Arthrogram ankle (73615) $168.51 $411 0.5×
Arthrogram hip (73525) $186.55 $455 0.6×
Arthrogram Wrist (73115) $289.05 $705 0.9×
Bone age studies (77072) $97.99 $239 1.0×
Bone Imaging 3 Phase (78315) $615.82 $1,502 1.7×
Bone Imaging Limited Area (78300) $367.36 $896 1.0×
Bone Imaging Whole Body (78306) $486.67 $1,187 1.3×
Bone survey infant (77076) $234.11 $571 2.5×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $619.51 $1,511 1.3×
Cerebrospinal Fluid Scan (78630) $771.62 $1,882 1.6×
Chest 1 view (71045)
range across 3 matching MRF lines
$84.46–$140.22 $206–$342 varies
Chest 2 views (71046)
range across 2 matching MRF lines
$108.24–$140.22 $264–$342 varies
Chest 3 views (71047) $81.18 $198 1.0×
Chest 4 or more views (71048) $184.50 $450 1.9×
Clavicle complete (73000) $109.06 $266 1.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $758.09 $1,849 8.0×
Contrast Exam Abdominl Aorta (75625) $236.57 $577 0.1×
Contrast X-Ray Bladder (74430) $160.72 $392 0.5×
Contrast X-Ray Of Elbow (73085) $226.73 $553 0.7×
Contrast X-Ray Of Knee Joint (73580) $184.09 $449 0.6×
CT abdomen and pelvis without and with contrast (74178) $1,700.68 $4,148 5.4×
CT abdomen and pelvis without contrast (74176) $1,266.49 $3,089 5.9×
CT abdomen w contrast (74160) $715.04 $1,744 4.5×
CT abdomen w wo contrast (74170) $879.86 $2,146 5.5×
CT abdomen w/o contrast (74150) $655.18 $1,598 6.9×
CT Angio Abdomen and Pelvis (74174) $2,053.69 $5,009 6.5×
CT Angio Chest (71275) $797.45 $1,945 5.0×
CT Angio Head (70496) $797.86 $1,946 5.0×
CT angio hrt w/3d image (75574) $1,002.45 $2,445 3.2×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,039.76 $2,536 6.5×
CT Angio Neck (70498) $797.86 $1,946 5.0×
Ct Angio Upr Extrm W/O&W/Dye (73206) $833.12 $2,032 5.2×
CT cervical spine w/ contrast (72126) $724.88 $1,768 2.3×
CT cervical spine w/o contrast (72125) $714.63 $1,743 7.5×
CT cervical spine w/wo cont (72127) $735.13 $1,793 4.6×
CT chest w contrast (71260)
range across 4 matching MRF lines
$682.65–$1,026.23 $1,665–$2,503 varies
CT chest w/wo contrast (71270)
range across 2 matching MRF lines
$794.99–$905.28 $1,939–$2,208 varies
CT head/brain with contrast (70460) $599.01 $1,461 3.8×
CT head/brain without and with contrast (70470) $811.39 $1,979 5.1×
CT heart contrast eval cardiac structure&morph (75572) $840.50 $2,050 2.7×
CT heart no contrast quant eval coronry calcium (75571) $379.25 $925 4.8×
CT iac w contrast (70481) $647.39 $1,579 4.1×
CT l-spine w&w/o contrast (72133) $1,004.09 $2,449 6.3×
CT lower ext w/o (73700) $620.33 $1,513 6.5×
CT lower extremity w/contrast material (73701) $789.66 $1,926 5.0×
CT lumbar spine w contrast (72132) $856.08 $2,088 2.7×
CT lumbar spine w/o contrast (72131) $750.71 $1,831 7.9×
CT maxillofacial w contrast (70487) $712.17 $1,737 4.5×
CT maxillofacial wo contrast (70486) $633.86 $1,546 6.7×
CT neck tissue combo (70492) $756.04 $1,844 4.8×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $801.55 $1,955 5.0×
CT orbits w/o contrast (70480) $633.86 $1,546 6.7×
CT pelvis w&w/o contrast (72194) $820.82 $2,002 5.2×
CT pelvis w/o contrast (72192) $611.31 $1,491 6.4×
CT scan of leg combo (73702)
range across 15 matching MRF lines
$852.80–$975.39 $2,080–$2,379 varies
CT scans face/jaw combo (70488) $742.92 $1,812 4.7×
CT soft tissue neck w contrast (70491) $718.73 $1,753 4.5×
CT soft tissue neck w/o contrast (70490) $477.65 $1,165 5.0×
CT thoracic spine w contrast (72129) $819.18 $1,998 5.1×
CT thoracic spine w/o contrast (72128) $665.02 $1,622 7.0×
CT thoracic spine w/wo cont (72130) $809.75 $1,975 5.1×
CT thorax w/o contrast (71250)
range across 7 matching MRF lines
$628.12–$715.04 $1,532–$1,744 varies
CT upper ext wo (73200) $620.33 $1,513 6.5×
CT upper extremity w/o & w/contrast material (73202)
range across 16 matching MRF lines
$775.31–$887.24 $1,891–$2,164 varies
CT upper extremity with contrast (73201) $789.25 $1,925 2.5×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $895.44 $2,184 5.6×
Cta Abdomen (74175) $889.70 $2,170 5.6×
CTA pelvis (72191) $824.10 $2,010 5.2×
Dilation ureters/urethra rs&i (74485) $251.33 $613 0.1×
Diskography lumbar (72295) $660.51 $1,611 0.4×
Dxa Bone Density Axial (77080) $160.31 $391 1.7×
Dxa bone density study (77085) $132.02 $322 1.4×
Echo exam uterus (76831) $269.78 $658 1.2×
Esophagram (74220) $103.73 $253 0.7×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $216.07 $527 2.3×
Fluoroscopy up to 1 hr (76000) $90.20 $220 0.4×
Follow-Up Angiography (75898) $571.13 $1,393 0.2×
Foot 2 views (73620)
range across 4 matching MRF lines
$90.61–$116.03 $221–$283 varies
Forearm 2 views (73090) $140.22 $342 1.8×
Gastric emptying imaging study (78264) $464.53 $1,133 1.3×
Gated Heart Planar Single (78472) $561.29 $1,369 1.5×
Hand 2 views (73120)
range across 4 matching MRF lines
$99.63–$140.22 $243–$342 varies
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $656.41 $1,601 0.2×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $656.41 $1,601 0.2×
Hepatobil Syst Image W/Drug (78227) $861.82 $2,102 1.7×
Hepatobiliary System Imaging (78226) $567.85 $1,385 1.6×
Ht Muscle Image Spect Sing (78451) $714.22 $1,742 0.6×
Hysterosalpingogram (74740) $258.30 $630 1.2×
Infant hip ultrasound with hip movement (dynamic) (76885) $367.77 $897 4.7×
Infant hip ultrasound, limited static exam (76886) $256.25 $625 3.2×
K Flow/Funct Image Multiple (78709) $578.92 $1,412 1.2×
K Flow/Funct Image W/Drug (78708) $473.14 $1,154 1.0×
K Flow/Funct Image W/O Drug (78707) $394.42 $962 0.8×
Knee 3 Views (73562) $140.22 $342 1.8×
Liver & Spleen Imaging Static Only (78215) $437.88 $1,068 1.2×
Lung perfusion differential (78597) $439.93 $1,073 1.2×
Lung Ventilat&Perfus Imaging (78582) $523.98 $1,278 1.1×
Lung Ventilation Imaging (78579) $308.32 $752 0.9×
Lymph System Imaging (78195) $525.62 $1,282 1.1×
Magnetic Image Jaw Joint (70336) $891.75 $2,175 4.1×
Mammary ductogram or galactogram multiple (77054) $248.05 $605 1.1×
Mammary ductogram or galactogram single (77053) $201.31 $491 0.9×
Meckels Divert Exam (78290) $305.04 $744 0.8×
Mra Head W/O & W/Contrast Material (70546) $1,211.96 $2,956 3.8×
MRA head w/o contrast (70544) $815.08 $1,988 3.8×
MRA head with contrast (70545) $990.56 $2,416 3.1×
MRA neck w contrast (70548) $896.67 $2,187 2.8×
Mra Neck W/O &W/Contrast Material (70549) $1,211.96 $2,956 3.8×
MRA neck w/o contrast (70547) $763.83 $1,863 3.5×
MRI abdomen w contrast (74182) $961.45 $2,345 3.0×
MRI abdomen w/o contrast (74181) $895.85 $2,185 4.1×
MRI any jt lower extrem w/contrast material (73722) $1,009.83 $2,463 1.4×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $1,221.39 $2,979 3.9×
MRI any jt upper extremity w/contrast matrl (73222) $1,011.88 $2,468 1.4×
MRI Breast W/O Contrast Bilateral (77047) $1,054.93 $2,573 4.9×
MRI Breast Without Contrast Material Unilateral (77046) $966.78 $2,358 4.5×
MRI cervical spine w contrast (72142) $1,069.28 $2,608 3.4×
MRI cervical spine w/o cont (72141) $973.75 $2,375 4.5×
MRI chest w/o contrast (71550) $763.01 $1,861 3.5×
MRI chest with contrast (71551) $903.64 $2,204 1.3×
MRI chest wo w contrast (71552) $1,089.78 $2,658 3.4×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $1,052.47 $2,567 3.3×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $1,282.48 $3,128 4.1×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $884.37 $2,157 4.1×
MRI lumbar spine w contrast (72149) $1,024.18 $2,498 3.2×
Mri Neck Spine W/O & W/Dye (72156) $1,388.26 $3,386 4.4×
MRI orbit face &/neck w/o contrast (70540) $945.87 $2,307 4.4×
MRI orbit face neck w contrast (70542) $1,271.82 $3,102 4.0×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $1,193.51 $2,911 3.8×
MRI pelvis w contrast (72196) $847.47 $2,067 2.7×
MRI pelvis w/o & w contrast (72197) $1,327.58 $3,238 4.2×
MRI pelvis w/o contrast (72195) $795.40 $1,940 3.7×
MRI thoracic spine w/o contrast (72146) $941.77 $2,297 4.4×
MRI upper extremity oth than jt w/contr matrl (73219) $949.56 $2,316 3.0×
MRI upper extremity oth than jt w/o contr matrl (73218) $905.69 $2,209 4.2×
Mri Uppr Extremity W/O&W/Dye (73220)
range across 6 matching MRF lines
$1,088.96–$1,120.94 $2,656–$2,734 varies
MRI, abdomen, combo (74183) $1,247.22 $3,042 3.9×
MRI, dorsal spine combo (72157) $1,381.29 $3,369 4.4×
MRI, dorsal spine contrast (72147) $1,025 $2,500 3.2×
MRI, joint upper extrem (73221) $887.65 $2,165 4.1×
MRI, joint upper extrem combo (73223) $1,640.41 $4,001 5.2×
MRI, lumbar spine combo (72158) $1,340.70 $3,270 4.2×
Myocardial Spect Multiple Studies (78452) $928.65 $2,265 0.8×
N-invas est c ffr sw aly CTA (75580) $3,451.38 $8,418 4.4×
Neck soft tissue (70360) $100.04 $244 1.3×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $186.55 $455 0.5×
Nonvascular Shunt X-Ray (75809) $332.92 $812 3.5×
Nuclear Rx Oral Admin (79005) $460.02 $1,122 2.2×
Optic foramina (70190) $63.14 $154 0.8×
Parathyroid Planar Imaging (78070) $401.39 $979 1.1×
Pelvis 1 or 2 views (72170) $82.41 $201 0.9×
Peritoneogram Rs&I (74190) $210.74 $514 0.4×
Pet Image W/Ct Lmtd (78814) $2,367.34 $5,774 1.8×
PET image w/CT, full body (78816) $2,503.05 $6,105 1.9×
PET imaging CT attenuation skull base mid-thigh (78815) $2,503.05 $6,105 1.9×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $279.21 $681 0.1×
Pulmonary Perfusion Imaging Particulate (78580) $308.32 $752 0.9×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $145.55 $355 1.5×
Radex abscess/fistula/sinus tract rs&i (76080) $113.57 $277 0.2×
Radex Ankle Complete Minimum 3 Views (73610) $140.22 $342 1.8×
Radex Calcaneus Minimum 2 Views (73650) $89.38 $218 1.1×
Radex elbow complete minimum 3 views (73080) $103.32 $252 1.3×
Radex Facial Bones Complete Minimum 3 Views (70150) $138.17 $337 1.5×
Radex fingr minimum 2 views (73140) $140.22 $342 1.8×
Radex foot complete minimum 3 views (73630) $140.22 $342 1.8×
Radex Hand Minimum 3 Views (73130) $140.22 $342 1.8×
Radex lower extremity infant minimum 2 views (73592) $83.23 $203 1.1×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $113.16 $276 1.2×
Radex Nasal Bones Complete Minimum 3 Views (70160) $114.39 $279 1.4×
Radex Ribs Unilateral 2 Views (71100) $82 $200 1.0×
Radex shoulder complete minimum 2 views (73030) $140.22 $342 1.8×
Radex Sinuses Paransl < 3 Views (70210) $68.88 $168 0.9×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $1,184.08 $2,888 7.4×
Radex Spine 1 View Specify Level (72020) $106.19 $259 1.3×
Radex Sternum Minimum 2 Views (71120) $133.66 $326 1.7×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $105.78 $258 1.3×
Radex Toe Minimum 2 Views (73660) $73.80 $180 0.9×
Radex upper extremity infant minimum 2 views (73092) $83.23 $203 0.9×
Radex Wrist Complete Minimum 3 Views (73110) $140.22 $342 1.8×
Radiolog exam mandible compl minimum 4 views (70110) $153.34 $374 1.6×
Radiologic exam colon double contrast study (74280) $239.44 $584 1.5×
Radiologic exam colon single contrast study (74270) $111.93 $273 0.7×
Radiologic Exam Esophagus Double Contrast Study (74221) $103.73 $253 0.7×
Radiologic exam knee complete 4/more views (73564) $156.21 $381 1.6×
Radiologic exam pelvis compl minimum 3 views (72190) $98.40 $240 1.0×
Radiologic Exam Small Int Single Contrast Study (74250) $105.78 $258 0.7×
Radiologic exam swallow function contrast study (74230) $123.82 $302 0.8×
Radiologic exam upr gi trc double contrast study (74246) $227.55 $555 1.4×
Radiologic examination femur minimum 2 views (73552) $73.39 $179 0.9×
Radiologic examination knee 1/2 views (73560) $140.22 $342 1.8×
Radiologic Examination Osseous Survey Limited (77074) $56.99 $139 0.6×
Radiologic examination tibia & fibula 2 views (73590) $119.72 $292 1.5×
Radiologic examination, internal auditory meati, complete Non-Facility (70134) $210.74 $514 0.4×
Renal Cyst Study (74470) $199.26 $486 0.4×
Ribs bilateral 3 views (71110) $103.32 $252 1.1×
Rp loclzj tum plnr 1 area single day imaging (78800)
range across 3 matching MRF lines
$228.37–$508.40 $557–$1,240 varies
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804)
range across 3 matching MRF lines
$855.67–$1,047.14 $2,087–$2,554 varies
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $639.60 $1,560 1.3×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 3 matching MRF lines
$586.30–$717.91 $1,430–$1,751 varies
Scapula (73010) $128.33 $313 1.4×
Screening Digital Breast Tomosynthesis Bi (77063) $45.92 $112 2.0×
Sella turcica (70240) $68.88 $168 0.9×
Shoulder 1 view (73020) $109.06 $266 1.4×
Shoulder Arthrography (73040) $319.80 $780 1.0×
Sialogram (70390) $184.09 $449 0.9×
Skull less than 4 views (70250) $86.51 $211 0.9×
Sternoclavicular joints (71130) $50.02 $122 0.6×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $151.29 $369 1.0×
Thoracic spine 2 views (72070) $120.95 $295 1.3×
Thoracic spine 3 views (72072) $172.20 $420 1.8×
Thyroid Imaging With Vascular Flow (78013) $250.51 $611 0.7×
Thyroid Met Imaging Body (78018) $653.13 $1,593 1.3×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $381.71 $931 1.1×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines
$169.33–$338.66 $413–$826 varies
Ultrasound Elastography Parenchyma (76981) $241.08 $588 2.5×
Ultrasound Exam Aaa Screen (76706) $90.20 $220 1.0×
Ultrasound, abdomen limited (76705)
range across 5 matching MRF lines
$183.68–$336.61 $448–$821 varies
Umbilical-artery Doppler (OB) (76820) $74.21 $181 0.8×
Unlisted Dx Radiographic Procedure (76499) $225.91 $551 2.9×
Upper gi w/o kub (74240) $227.55 $555 1.4×
Urethrocystogram voiding (74455) $231.65 $565 1.1×
Urethrocystography retrograde (74450) $194.34 $474 0.9×
Us breast unilateral complete (76641)
range across 3 matching MRF lines
$243.95–$581.79 $595–$1,419 varies
Us chest (76604) $175.89 $429 1.9×
Us complete joint (76881) $162.36 $396 1.7×
Us exam, pelvic, limited (76857) $189.83 $463 2.0×
Us head (76506) $286.59 $699 3.0×
Us kidney transplant (76776) $406.72 $992 4.3×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $142.68 $348 1.5×
Us ob limited 1 or more fetuses (76815) $142.68 $348 1.5×
Us ob transvaginal (76817) $198.85 $485 2.1×
Us pelvic non ob complete (76856) $238.21 $581 2.5×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $200.90 $490 2.1×
Us preg uterus real time f/u trnsabdl per fetus (76816) $139.40 $340 1.5×
Us retroperitoneal complete (76770) $142.68 $348 1.5×
Us retroperitoneal limited (76775) $142.68 $348 1.5×
Us scrotum and contents (76870) $209.51 $511 2.2×
Us spinal canal and contents (76800) $291.51 $711 3.1×
Us thyroid (76536) $197.62 $482 2.1×
Us transrectal (76872) $280.44 $684 3.0×
Vein X-Ray Chest (75827) $499.79 $1,219 0.3×
Venography Adrenal Unilateral (75840) $1,225.90 $2,990 0.4×
Venography caval inferior serialography rs&i (75825) $1,189 $2,900 0.4×
Venography extremity bilateral rs&i (75822) $720.37 $1,757 0.5×
Venography extremity unilateral rs&i (75820) $560.88 $1,368 0.4×
Venography Renal Bilateral (75833) $1,225.90 $2,990 0.4×
Venous sampling by catheter (75893)
likely a partial charge, not the full procedure
$590.40 $1,440 0.1×
Wrist 2 views (73100) $140.22 $342 1.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $78.72 $192 1.0×
X-ray antegrade pyelogram tube (74425)
range across 2 matching MRF lines
$202.54–$231.65 $494–$565 varies
X-Ray Aorta Leg Arteries (75630) $250.10 $610 0.1×
X-Ray Bend Only L-S Spine (72120) $120.95 $295 1.3×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $86.92 $212 1.1×
X-Ray Exam Breast Specimen (76098) $87.33 $213 0.2×
X-Ray Exam Entire Spi 1 Vw (72081) $150.88 $368 1.9×
X-Ray Exam Entire Spi 2/3 Vw (72082) $176.30 $430 1.9×
X-Ray Exam Hip Uni 1 View (73501) $53.30 $130 0.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $58.22 $142 0.7×
X-Ray Exam Hips Bi 3-4 Views (73522) $101.68 $248 1.1×
X-Ray Exam Hips Bi 5/> Views (73523) $98.40 $240 1.0×
X-Ray Exam L-S Spine Bending (72114) $228.37 $557 2.4×
X-Ray Exam Neck Spine 2-3 Vw (72040) $140.22 $342 1.8×
X-Ray Exam Neck Spine 6/>Vws (72052) $204.59 $499 2.2×
X-Ray Exam Unilat Ribs/Chest (71101) $140.22 $342 1.5×
X-ray eye for foreign body (70030) $72.98 $178 0.9×
X-ray humerus (73060) $105.78 $258 1.3×
X-ray IV pyelogram (ivp) (74400) $243.13 $593 1.5×
X-ray IV pyelogram+tomography (74415) $282.90 $690 1.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $95.12 $232 1.2×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $94.71 $231 1.2×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $140.22 $342 1.5×
X-ray nose-rectum child f.b. (76010) $91.02 $222 1.2×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $140.22 $342 1.5×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $91.02 $222 1.0×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $140.22 $342 1.8×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $103.73 $253 1.3×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $141.04 $344 1.5×
X-Ray Stress View (77071) $70.52 $172 0.9×
X-Ray Tmj Unilat (70328) $43.46 $106 0.6×
X-Ray Urinary Tract Exam With Contrast Material (74420) $170.56 $416 0.5×
X-Rays Bone Length Studies (77073)
range across 2 matching MRF lines
$151.70–$239.85 $370–$585 varies
X-Rays Bone Survey Complete (77075) $161.54 $394 1.7×
Xr c-spine 4 or 5 views (72050) $176.71 $431 1.9×
Xr facial bones less than 3 views (70140) $109.88 $268 1.4×
Xr orbits complete 4 views (70200) $112.34 $274 1.2×
Xr Tomogram Single Plane (76100)
range across 2 matching MRF lines
$132.43–$229.19 $323–$559 varies

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.