Imaging prices at Medical City Alliance
Fort Worth, TX · every code in this section with a posted price and a Medicare benchmark.
290 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Abdomen 2 views (74019) | $1,283.30 | $1,283.30 | 12.2× |
| Acute gastrointestinal blood loss imaging (78278) | $6,153.48 | $6,153.48 | 15.3× |
| Angiography extremity bilateral rs&i (75716) | $6,860.39 | $6,860.39 | 2.2× |
| Angiography extremity unilateral rs&i (75710) | $5,073.33 | $5,073.33 | 1.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) | $7,512.63 | $7,512.63 | 1.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) | $7,350.88 | $7,350.88 | 2.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $7,650.32 | $7,650.32 | 2.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) | $7,512.63 | $7,512.63 | 1.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) | $3,542.44 | $3,542.44 | 1.1× |
| Ankle 2 views (73600) | $1,133.57 | $1,133.57 | 12.9× |
| Antegrade urography radiological supvj & interpj (74425) | $1,602.79 | $1,602.79 | 4.6× |
| Aortogram thoracic (75605) | $7,512.63 | $7,512.63 | 1.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) | $7,350.88 | $7,350.88 | 2.3× |
| Aortography abdominal serialography rs&i (75625) | $7,350.88 | $7,350.88 | 2.3× |
| Arthrogram elbow (73085) | $1,609.46 | $1,609.46 | 4.6× |
| Arthrogram hip (73525) | $1,502.52 | $1,502.52 | 4.3× |
| Arthrogram shoulder (73040) | $1,462.43 | $1,462.43 | 4.2× |
| Arthrogram wrist (73115) | $2,045.26 | $2,045.26 | 5.8× |
| Arthrography knee lt (73580) | $1,654.91 | $1,654.91 | 4.7× |
| Bone &/Joint Imaging Limited Area (78300) | $3,886.30 | $3,886.30 | 9.7× |
| Bone &/joint imaging whole body (78306) | $7,173.60 | $7,173.60 | 17.8× |
| Bone age studies (77072) | $903.65 | $903.65 | 8.6× |
| Bone Imaging 3 Phase (78315) | $8,797.09 | $8,797.09 | 21.9× |
| Bone Marrow Imaging Limited Area (78102) | $3,838.65 | $3,838.65 | 9.5× |
| Bone survey complete (77075) | $3,280.43 | $3,280.43 | 31.2× |
| Brain image w/flow 4 + views (78606) | $5,450.69 | $5,450.69 | 10.0× |
| Cervical spine 2 or 3 views (72040) | $1,098.83 | $1,098.83 | 12.5× |
| Chest 1 view (71045) | $872.91 | $872.91 | 10.0× |
| Chest 3 views (71047) | $1,423.67 | $1,423.67 | 16.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) | $2,264.48 | $2,264.48 | 12.8× |
| Clavicle complete (73000) | $892.95 | $892.95 | 10.2× |
| CT abdomen and pelvis without and with contrast (74178) | $18,798.41 | $18,798.41 | 53.6× |
| CT abdomen and pelvis without contrast (74176) | $13,203.33 | $13,203.33 | 55.0× |
| CT abdomen w contrast (74160) | $8,859.50 | $8,859.50 | 50.2× |
| CT abdomen w wo contrast (74170) | $10,273.35 | $10,273.35 | 58.2× |
| CT abdomen w/o contrast (74150) | $7,470.56 | $7,470.56 | 71.0× |
| CT angiography upper extremity lt (73206) | $6,207.56 | $6,207.56 | 35.2× |
| CT c-spine w/o contrast (72125) | $5,950.49 | $5,950.49 | 56.6× |
| CT cervical spine w&w/o contrast (72127) | $7,481.07 | $7,481.07 | 42.4× |
| CT cervical spine with contrast (72126) | $7,094.17 | $7,094.17 | 20.2× |
| CT chest w/wo contrast (71270) | $7,643.70 | $7,643.70 | 43.3× |
| CT chest with contrast (71260) | $6,454.12 | $6,454.12 | 36.6× |
| CT head/brain with contrast (70460) | $6,927.59 | $6,927.59 | 39.3× |
| CT head/brain without and with contrast (70470) | $8,139.45 | $8,139.45 | 46.1× |
| CT iac w contrast (70481) | $6,122.31 | $6,122.31 | 34.7× |
| CT limited/localized follow up study (76380) | $1,318.11 | $1,318.11 | 15.1× |
| CT lower ext w/o (73700) | $5,505.88 | $5,505.88 | 52.3× |
| CT lower extremity w wo contrast (73702) | $6,952.51 | $6,952.51 | 39.4× |
| CT lower extremity with contrast (73701) | $9,586.10 | $9,586.10 | 54.3× |
| CT lumbar spine w & w/o contrast (72133) | $8,523.75 | $8,523.75 | 48.3× |
| CT lumbar spine w/o contrast (72131) | $5,950.49 | $5,950.49 | 56.6× |
| CT lumbar spine with contrast (72132) | $7,484.99 | $7,484.99 | 21.3× |
| CT maxillofacial w contrast (70487) | $6,603.64 | $6,603.64 | 37.4× |
| CT maxillofacial w/o contrast (70486) | $3,112.30 | $3,112.30 | 29.6× |
| CT maxillofacial w/wo contrast (70488) | $8,695.56 | $8,695.56 | 49.3× |
| CT neck soft tissue w contrast (70491) | $6,927.59 | $6,927.59 | 39.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) | $8,139.45 | $8,139.45 | 46.1× |
| CT orbits w/o contrast (70480) | $6,357.06 | $6,357.06 | 60.4× |
| CT pelvis w & w/o contrast (72194) | $8,527.67 | $8,527.67 | 48.3× |
| CT pelvis w/o contrast (72192) | $5,735.40 | $5,735.40 | 54.5× |
| CT soft tissue neck w/o & w/contrast material (70492) | $8,605.05 | $8,605.05 | 48.8× |
| CT soft tissue neck w/o contrast (70490) | $5,142.57 | $5,142.57 | 48.9× |
| CT thoracic spine w/contrast (72129) | $6,604.94 | $6,604.94 | 37.4× |
| CT thoracic spine w/o contrast (72128) | $5,950.49 | $5,950.49 | 56.6× |
| CT thoracic spine w/wo contrast (72130) | $7,094.17 | $7,094.17 | 40.2× |
| CT thorax w/o contrast (71250) | $5,640.96 | $5,640.96 | 53.6× |
| CT upper extremity w/o & w/contrast material (73202) | $7,431.22 | $7,431.22 | 42.1× |
| CT upper extremity w/o contrast rt (73200) | $5,999.01 | $5,999.01 | 57.0× |
| CT upper extremity with contrast (73201) | $6,952.51 | $6,952.51 | 19.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $7,807.64 | $7,807.64 | 44.2× |
| Cta Abdomen (74175) | $7,589.92 | $7,589.92 | 43.0× |
| CTA abdomen pelvis (74174) | $12,626.26 | $12,626.26 | 36.0× |
| CTA chest (71275) | $7,508.61 | $7,508.61 | 42.5× |
| Cta Head (70496) | $7,410.23 | $7,410.23 | 42.0× |
| CTA lwr ext w&w/o contrast (73706) | $8,210.28 | $8,210.28 | 46.5× |
| Cta Neck (70498) | $7,006.28 | $7,006.28 | 39.7× |
| Cta Pelvis (72191) | $7,912.56 | $7,912.56 | 44.8× |
| Cystography minimum 3 views rs&i (74430) | $1,582.68 | $1,582.68 | 4.5× |
| Diskography lumbar (72295) | $5,066.35 | $5,066.35 | 2.6× |
| Dxa bone density study 1/> sites axial skel (77080) | $677.46 | $677.46 | 6.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $426.42 | $426.42 | 4.9× |
| Dxa bone density study axial skeleton (77085) | $588.95 | $588.95 | 5.6× |
| Echoencephalography real time imaging (76506) | $2,691.28 | $2,691.28 | 25.6× |
| Esophagus (74220) | $1,928.97 | $1,928.97 | 10.9× |
| Fetal biophysical profile non-stress testing (76818) | $3,493.51 | $3,493.51 | 33.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $2,676.32 | $2,676.32 | 25.4× |
| Fluoroscopy up to 1 hr (76000) | $3,029.12 | $3,029.12 | 12.6× |
| Foot 2 views (73620) | $872.91 | $872.91 | 10.0× |
| Forearm 2 views (73090) | $860.87 | $860.87 | 9.8× |
| Gastric mucosa imaging (78261) | $4,036.95 | $4,036.95 | 10.0× |
| Gated Heart Planar Single (78472) | $5,390.76 | $5,390.76 | 13.4× |
| Hand 2 views (73120) | $799.38 | $799.38 | 7.6× |
| Hand 3 views (73130) | $903.65 | $903.65 | 10.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) | $7,650.32 | $7,650.32 | 2.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) | $6,556.62 | $6,556.62 | 12.0× |
| Hepatobiliary syst imaging including gallbladder (78226) | $6,503.49 | $6,503.49 | 16.2× |
| Ht muscle image spect sing (78451) | $11,183.31 | $11,183.31 | 8.6× |
| Humerus Min 2 Views Left (73060) | $1,555.99 | $1,555.99 | 17.8× |
| Hysterosalpingogram (74740) | $1,878.17 | $1,878.17 | 7.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) | $6,321 | $6,321 | 11.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) | $6,549.82 | $6,549.82 | 12.0× |
| Knee 3 views (73562) | $1,183.04 | $1,183.04 | 13.5× |
| Liver & spleen imaging static only (78215) | $2,140.15 | $2,140.15 | 5.3× |
| Lung Ventilation Imaging (78579) | $7,274.39 | $7,274.39 | 18.1× |
| Lymphoscintigraphy (78195) | $4,980.80 | $4,980.80 | 9.1× |
| Mammary ductogram or galactogram multiple (77054) | $2,088.04 | $2,088.04 | 8.7× |
| Mammary ductogram or galactogram single (77053) | $1,577.38 | $1,577.38 | 6.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $150 | $150 | 5.2× |
| MRA head w & w/o contrast (70546) | $8,685.41 | $8,685.41 | 24.7× |
| MRA head w/o contrast (70544) | $7,149.09 | $7,149.09 | 29.8× |
| MRA head with contrast (70545) | $8,678.60 | $8,678.60 | 24.7× |
| MRA neck w contrast (70548) | $8,656.81 | $8,656.81 | 24.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $9,257.46 | $9,257.46 | 26.4× |
| MRA neck w/o contrast (70547) | $6,533.47 | $6,533.47 | 27.2× |
| MRI abdomen w contrast (74182) | $10,953.14 | $10,953.14 | 31.2× |
| MRI abdomen w/o & w/contrast material (74183) | $14,129.29 | $14,129.29 | 40.2× |
| MRI abdomen w/o contrast (74181) | $9,732.79 | $9,732.79 | 40.5× |
| MRI any jnt lwr ext with con lt (73722) | $13,058.77 | $13,058.77 | 16.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $10,630.34 | $10,630.34 | 13.5× |
| MRI breast w/o contrast bilateral (77047) | $5,712.19 | $5,712.19 | 23.8× |
| MRI breast w/o contrast unilat (77046) | $4,241.25 | $4,241.25 | 17.7× |
| MRI c-spine with contrast (72142) | $10,507.76 | $10,507.76 | 29.9× |
| MRI cervical spine w/o contrast (72141) | $10,022.90 | $10,022.90 | 41.7× |
| MRI chest w/o & w/contrast material (71552) | $11,376.62 | $11,376.62 | 32.4× |
| MRI chest w/o contrast (71550) | $8,588.71 | $8,588.71 | 35.8× |
| MRI chest with contrast (71551) | $10,514.56 | $10,514.56 | 13.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) | $10,396.07 | $10,396.07 | 29.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $9,971.12 | $9,971.12 | 28.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $8,363.98 | $8,363.98 | 34.8× |
| MRI orbit face &/neck w/o contrast (70540) | $8,564.19 | $8,564.19 | 35.7× |
| MRI orbit/face/neck w&w/o cont (70543) | $12,162.57 | $12,162.57 | 34.6× |
| MRI orbit/face/neck w/contrast (70542) | $11,559.22 | $11,559.22 | 32.9× |
| MRI pelvis w contrast (72196) | $9,567.98 | $9,567.98 | 27.3× |
| MRI pelvis w/o & w/contrast material (72197) | $11,414.84 | $11,414.84 | 32.5× |
| MRI pelvis w/o contrast (72195) | $9,070.86 | $9,070.86 | 37.8× |
| MRI scan of arm joint before and after contrast (73223) | $13,058.77 | $13,058.77 | 37.2× |
| MRI scan of leg joint before and after contrast (73723) | $13,952.24 | $13,952.24 | 39.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) | $13,434.68 | $13,434.68 | 38.3× |
| MRI spinal canal lumbar w/contrast material (72149) | $10,464.17 | $10,464.17 | 29.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) | $12,618.85 | $12,618.85 | 35.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) | $9,427.70 | $9,427.70 | 26.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) | $13,418.33 | $13,418.33 | 38.2× |
| MRI thoracic spine w/o contrast (72146) | $9,762.75 | $9,762.75 | 40.7× |
| MRI tmj (70336) | $10,886.38 | $10,886.38 | 45.3× |
| MRI upper ext joint w/o contrast (73221) | $8,363.98 | $8,363.98 | 34.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) | $11,819.35 | $11,819.35 | 33.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $9,674.21 | $9,674.21 | 40.3× |
| Myelogram Cervical (72240) | $1,771.23 | $1,771.23 | 2.2× |
| Myelogram Lumbar (72265) | $3,625.32 | $3,625.32 | 4.6× |
| Myelogram thoracic (72255) | $3,967.53 | $3,967.53 | 5.0× |
| Myelography 2 or more regions (72270) | $3,805.78 | $3,805.78 | 4.8× |
| Myocardial Spect Multiple Studies (78452) | $19,831.94 | $19,831.94 | 15.2× |
| Neck soft tissue (70360) | $822.11 | $822.11 | 9.4× |
| Nm cisternogram (78630) | $2,039.19 | $2,039.19 | 3.7× |
| Nm gastric emptying study (78264) | $6,153.48 | $6,153.48 | 15.3× |
| Nuclear medicine of heart pumping function (78473) | $12,125.79 | $12,125.79 | 30.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) | $1,970.80 | $1,970.80 | 18.7× |
| Osseous survey infant (77076) | $1,411.63 | $1,411.63 | 13.4× |
| Osseous survey limited (77074) | $3,216.27 | $3,216.27 | 30.6× |
| Parathyrd planar w/spect&CT (78072) | $8,541.04 | $8,541.04 | 15.6× |
| Parathyroid imaging (78070) | $1,496.23 | $1,496.23 | 3.7× |
| Pelvis 1 or 2 views (72170) | $855.53 | $855.53 | 8.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) | $13,058.77 | $13,058.77 | 37.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $5,585.51 | $5,585.51 | 13.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) | $12,166.65 | $12,166.65 | 22.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,356.83 | $1,356.83 | 2.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) | $3,370.11 | $3,370.11 | 32.0× |
| Radex hips bilateral with pelvis 2 views (73521) | $1,177.68 | $1,177.68 | 11.2× |
| Radex mastoids compl minimum 3 views pr side (70130) | $1,232.50 | $1,232.50 | 11.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,220.48 | $1,220.48 | 11.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) | $867.56 | $867.56 | 9.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $2,501.10 | $2,501.10 | 23.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) | $1,150.95 | $1,150.95 | 13.1× |
| Radiologic exam colon single contrast study (74270) | $2,299.24 | $2,299.24 | 13.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $2,297.91 | $2,297.91 | 13.0× |
| Radiologic exam upr gi trc single contrast study (74240) | $2,078.68 | $2,078.68 | 11.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) | $1,014.61 | $1,014.61 | 11.6× |
| Radiological examination surgical specimen (76098) | $1,458.40 | $1,458.40 | 2.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) | $6,149.14 | $6,149.14 | 1.9× |
| Ribs bilateral 3 views (71110) | $1,330.10 | $1,330.10 | 12.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $5,589.62 | $5,589.62 | 13.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) | $7,422.85 | $7,422.85 | 13.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $8,227.32 | $8,227.32 | 6.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $9,222.49 | $9,222.49 | 6.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) | $1,616.69 | $1,616.69 | 1.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) | $1,889.08 | $1,889.08 | 7.9× |
| Scanogram (77073) | $636.05 | $636.05 | 6.0× |
| Scapula complete (73010) | $832.81 | $832.81 | 7.9× |
| Screening digital breast tomosynthesis (77063) | $251.97 | $251.97 | 10.8× |
| Sella turcica (70240) | $1,215.13 | $1,215.13 | 13.9× |
| Small bowel series (74250) | $2,859.36 | $2,859.36 | 16.2× |
| Spine thoracic 3 views (72072) | $1,616.14 | $1,616.14 | 15.4× |
| Therapeutic Enema (74283) | $2,640.13 | $2,640.13 | 15.0× |
| Thoracolumbar 2 views (72080) | $1,402.26 | $1,402.26 | 16.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $4,498.64 | $4,498.64 | 11.2× |
| Tmj unilateral (70328) | $930.39 | $930.39 | 10.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) | $12,229.31 | $12,229.31 | 22.4× |
| Ultrasound, abdomen limited (76705) | $2,504.71 | $2,504.71 | 23.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) | $399.70 | $399.70 | 4.6× |
| Unlisted Ultrasound Procedure (76999) | $415.41 | $415.41 | 4.7× |
| Upper Extremity Infant (73092) | $1,027.99 | $1,027.99 | 9.8× |
| Urethrocystography retrograde rs&i (74450) | $1,721.74 | $1,721.74 | 7.2× |
| Urethrocystography voiding (74455) | $1,638.18 | $1,638.18 | 6.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) | $3,232.30 | $3,232.30 | 18.3× |
| Us breast unilateral complete (76641) | $795.41 | $795.41 | 7.6× |
| Us breast unilateral limited (76642) | $533.91 | $533.91 | 6.1× |
| Us chest (76604) | $2,167.61 | $2,167.61 | 20.6× |
| Us compl joint r-t w/image documentation (76881) | $1,965.34 | $1,965.34 | 18.7× |
| Us guided compression repair (76936) | $2,758.03 | $2,758.03 | 12.7× |
| Us infant hips dynamic (76885) | $1,936.75 | $1,936.75 | 22.1× |
| Us infant hips limited static (76886) | $1,379.69 | $1,379.69 | 15.8× |
| Us kidney transplant (76776) | $2,911.93 | $2,911.93 | 27.7× |
| Us ob transvaginal (76817) | $2,032.77 | $2,032.77 | 19.3× |
| Us pelvic non ob complete (76856) | $2,393.02 | $2,393.02 | 22.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) | $1,791.02 | $1,791.02 | 17.0× |
| Us pregnancy ltd (76815) | $1,262.57 | $1,262.57 | 12.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) | $2,337.86 | $2,337.86 | 22.2× |
| Us retroperitoneal complete (76770) | $2,130.16 | $2,130.16 | 20.2× |
| Us retroperitoneal limited (76775) | $1,574.46 | $1,574.46 | 15.0× |
| Us scrotum and contents (76870) | $2,472.02 | $2,472.02 | 23.5× |
| Us soft tissue head/neck (76536) | $2,250.01 | $2,250.01 | 21.4× |
| Us spinal canal and contents (76800) | $2,499.26 | $2,499.26 | 23.8× |
| Us transrectal (76872) | $2,255.45 | $2,255.45 | 21.4× |
| Us xtr non-vasc lmtd (76882) | $2,132.20 | $2,132.20 | 20.3× |
| Vascular flow imaging (78445) | $390.83 | $390.83 | 1.0× |
| Venogram extremity bilateral (75822) | $4,360.83 | $4,360.83 | 2.8× |
| Venography caval inferior serialography rs&i (75825) | $7,650.32 | $7,650.32 | 2.4× |
| Venography caval superior serialography rs&i (75827) | $3,165.46 | $3,165.46 | 2.0× |
| Venography extremity unilateral rs&i (75820) | $2,924.26 | $2,924.26 | 1.8× |
| Venography Renal Bilateral (75833) | $4,456.79 | $4,456.79 | 1.4× |
| Venography venous sinus/jugular cath rs&i (75860) | $7,650.32 | $7,650.32 | 2.4× |
| Venous sampling thru cath w/wo angiography rs& (75893) | $12,679.25 | $12,679.25 | 2.3× |
| Vertebral fracture assessment via dxa (77086) | $418.47 | $418.47 | 4.8× |
| Wrist 2 views (73100) | $783.35 | $783.35 | 8.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) | $2,501.10 | $2,501.10 | 23.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,502.52 | $1,502.52 | 17.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) | $892.95 | $892.95 | 10.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $835.49 | $835.49 | 9.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) | $1,203.10 | $1,203.10 | 13.7× |
| X-ray exam hip uni 1 view (73501) | $1,134.92 | $1,134.92 | 13.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $860.87 | $860.87 | 9.8× |
| X-ray exam hip uni 4/> views (73503) | $903.65 | $903.65 | 8.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,263.25 | $1,263.25 | 12.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,220.48 | $1,220.48 | 11.6× |
| X-ray exam of femur 1 (73551) | $838.15 | $838.15 | 9.6× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) | $3,360.63 | $3,360.63 | 19.0× |
| X-ray eye for foreign body (70030) | $1,751.17 | $1,751.17 | 20.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) | $1,334.09 | $1,334.09 | 12.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) | $1,035.99 | $1,035.99 | 11.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) | $863.56 | $863.56 | 9.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) | $733.88 | $733.88 | 8.4× |
| X-ray IV pyelogram+drip infusn (74410) | $3,534.41 | $3,534.41 | 20.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $995.91 | $995.91 | 11.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) | $1,386.23 | $1,386.23 | 13.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $1,060.06 | $1,060.06 | 12.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) | $997.24 | $997.24 | 11.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,306.03 | $1,306.03 | 12.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) | $3,994.26 | $3,994.26 | 38.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) | $890.30 | $890.30 | 10.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) | $991.88 | $991.88 | 11.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) | $1,184.37 | $1,184.37 | 11.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) | $1,513.42 | $1,513.42 | 14.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) | $1,034.66 | $1,034.66 | 11.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) | $1,106.83 | $1,106.83 | 10.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,371.53 | $1,371.53 | 13.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,229.83 | $1,229.83 | 11.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,530.61 | $1,530.61 | 17.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) | $994.55 | $994.55 | 11.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,327.41 | $1,327.41 | 15.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) | $783.35 | $783.35 | 8.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,827.37 | $1,827.37 | 17.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) | $1,034.66 | $1,034.66 | 9.8× |
| X-Ray Spine One View - Xr Spine (72020) | $1,096.62 | $1,096.62 | 12.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) | $906.32 | $906.32 | 10.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) | $931.72 | $931.72 | 10.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) | $1,220.48 | $1,220.48 | 11.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) | $1,564.03 | $1,564.03 | 14.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) | $779.34 | $779.34 | 8.9× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) | $1,011.93 | $1,011.93 | 11.6× |
| Xr arthrogram ankle (73615) | $2,343.36 | $2,343.36 | 6.7× |
| Xr c-spine 6 or more views (72052) | $2,071.99 | $2,071.99 | 19.7× |
| Xr chest 4+ views (71048) | $2,122.79 | $2,122.79 | 20.2× |
| Xr finger(s) 2+ views (73140) | $671.06 | $671.06 | 7.7× |
| Xr internal auditory meati complete (70134) | $1,045.36 | $1,045.36 | 1.9× |
| Xr optic foramina (70190) | $1,386.23 | $1,386.23 | 15.8× |
| Xr shoulder 1 view (73020) | $820.78 | $820.78 | 9.4× |
| Xr spine cervical 4 or 5 views (72050) | $1,891.54 | $1,891.54 | 18.0× |
| Xr tibia/fibula 2 views (73590) | $931.72 | $931.72 | 10.6× |
| Xr tmj bilateral (70330) | $1,097.49 | $1,097.49 | 12.5× |
| Xray knee 1 or 2 views rt (73560) | $892.95 | $892.95 | 10.2× |