Imaging prices at Memorial Hospital of Texas County Authority
Guymon, OK · every code in this section with a posted price and a Medicare benchmark.
234 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) | $295.20 | $369 | 3.5× |
| Abdomen 2 views (74019) | $397.60 | $497 | 4.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,009.60 | $1,262 | 2.6× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$29.60–$233.60 | $37–$292 | varies |
| Arthrogram ankle (73615) | $790.40 | $988 | 2.4× |
| Arthrogram hip (73525) | $1,388.80 | $1,736 | 4.1× |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$105.60–$790.40 | $132–$988 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$36.80–$121.60 | $46–$152 | varies |
| Bone Imaging 3 Phase (78315) | $1,009.60 | $1,262 | 2.6× |
| Bone Imaging Limited Area (78300) | $1,009.60 | $1,262 | 2.6× |
| Bone Imaging Whole Body (78306) | $1,009.60 | $1,262 | 2.6× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$80.80–$348.80 | $101–$436 | varies |
| Brain Image W/Flow < 4 Views (78601) | $2,736 | $3,420 | 7.1× |
| Brain imaging < 4 static views (78600) | $2,622.40 | $3,278 | 6.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$1,544–$2,828.80 | $1,930–$3,536 | varies |
| Cat Scan Follow-Up Study (76380) | $408.80 | $511 | 4.9× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$80–$285.60 | $100–$357 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$120–$374.40 | $150–$468 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$179.20–$253.60 | $224–$317 | varies |
| Chest 4 or more views (71048) | $426.40 | $533 | 4.2× |
| Cholecystography Oral Contrast (74290) | $228 | $285 | 1.4× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$33.60–$239.20 | $42–$299 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$64–$554.40 | $80–$693 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$84–$1,388.80 | $105–$1,736 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$632–$1,852 | $790–$2,315 | varies |
| CT abdomen and pelvis without contrast (74176) | $1,202.40 | $1,503 | 5.2× |
| CT abdomen w contrast (74160) | $892 | $1,115 | 5.3× |
| CT abdomen w wo contrast (74170) | $991.20 | $1,239 | 5.9× |
| CT abdomen w/o contrast (74150) | $689.60 | $862 | 6.9× |
| CT Angio Abdomen and Pelvis (74174) | $1,722.40 | $2,153 | 5.1× |
| CT Angio Chest (71275) | $1,336 | $1,670 | 7.9× |
| CT Angio Head (70496) | $1,180 | $1,475 | 7.0× |
| CT angio hrt w/3d image (75574) | $1,336 | $1,670 | 4.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,290.40 | $2,863 | 13.6× |
| CT Angio Neck (70498) | $1,177.60 | $1,472 | 7.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,128.80 | $1,411 | 6.7× |
| CT cervical spine w/ contrast (72126) | $1,555.20 | $1,944 | 4.6× |
| CT cervical spine w/o contrast (72125) | $851.20 | $1,064 | 8.5× |
| CT cervical spine w/wo cont (72127) | $1,808.80 | $2,261 | 10.7× |
| CT chest w contrast (71260) | $892 | $1,115 | 5.3× |
| CT chest w/wo contrast (71270) | $991.20 | $1,239 | 5.9× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $689.60 | $862 | 6.9× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$849.60–$892 | $1,062–$1,115 | varies |
| CT head/brain without and with contrast (70470) | $991.20 | $1,239 | 5.9× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$40–$80 | $50–$100 | varies |
| CT l-spine w&w/o contrast (72133) | $1,848.80 | $2,311 | 11.0× |
| CT lower ext w/o (73700) | $1,246.40 | $1,558 | 12.4× |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,409.60–$2,140.80 | $1,762–$2,676 | varies |
| CT lumbar spine w contrast (72132) | $1,555.20 | $1,944 | 4.6× |
| CT lumbar spine w/o contrast (72131) | $845.60 | $1,057 | 8.4× |
| CT maxillofacial w contrast (70487) | $892 | $1,115 | 5.3× |
| CT maxillofacial wo contrast (70486) | $568.80 | $711 | 5.7× |
| CT neck tissue combo (70492) | $991.20 | $1,239 | 5.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $991.20 | $1,239 | 5.9× |
| CT orbits w/o contrast (70480) | $628.80 | $786 | 6.3× |
| CT pelvis w&w/o contrast (72194) | $1,044.80 | $1,306 | 6.2× |
| CT pelvis w/o contrast (72192) | $752 | $940 | 7.5× |
| CT scan of leg combo (73702) | $1,831.20 | $2,289 | 10.9× |
| CT scans face/jaw combo (70488) | $991.20 | $1,239 | 5.9× |
| CT soft tissue neck w contrast (70491) | $892 | $1,115 | 5.3× |
| CT soft tissue neck w/o contrast (70490) | $568.80 | $711 | 5.7× |
| CT thoracic spine w contrast (72129) | $1,020 | $1,275 | 6.0× |
| CT thoracic spine w/o contrast (72128) | $848.80 | $1,061 | 8.4× |
| CT thoracic spine w/wo cont (72130) | $1,248.80 | $1,561 | 7.4× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$687.20–$768 | $859–$960 | varies |
| CT upper ext wo (73200) | $568.80 | $711 | 5.7× |
| CT upper extremity w/o & w/contrast material (73202) | $991.20 | $1,239 | 5.9× |
| CT upper extremity with contrast (73201) | $892 | $1,115 | 2.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,515.20 | $1,894 | 9.0× |
| Cta Abdomen (74175) | $1,257.60 | $1,572 | 7.5× |
| CTA pelvis (72191) | $1,364.80 | $1,706 | 8.1× |
| Dxa Bone Density Axial (77080) | $392.80 | $491 | 3.9× |
| Esophagram (74220) range across 2 matching MRF lines |
$78.40–$640 | $98–$800 | varies |
| Fetal Biophys Profile W/Nst (76818) | $443.20 | $554 | 4.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $384 | $480 | 3.8× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$18.40–$581.60 | $23–$727 | varies |
| Foot 2 views (73620) range across 2 matching MRF lines |
$29.60–$276 | $37–$345 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$32.80–$283.20 | $41–$354 | varies |
| Gastric emptying imaging study (78264) | $1,073.60 | $1,342 | 2.8× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$144–$1,432 | $180–$1,790 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$30.40–$383.20 | $38–$479 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$144.80–$1,376 | $181–$1,720 | varies |
| Ht Musc Image Planar Mult (78454) | $3,484.80 | $4,356 | 2.8× |
| Ht Muscle Image Spect Sing (78451) range across 3 matching MRF lines |
$157.60–$3,476.80 | $197–$4,346 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$116.80–$676 | $146–$845 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $430.40 | $538 | 5.1× |
| K Flow/Funct Image Multiple (78709) | $1,783.20 | $2,229 | 3.4× |
| K Flow/Funct Image W/Drug (78708) | $1,763.20 | $2,204 | 3.4× |
| K Flow/Funct Image W/O Drug (78707) | $1,720 | $2,150 | 3.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 2 matching MRF lines |
$86.40–$1,009.60 | $108–$1,262 | varies |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$35.20–$312.80 | $44–$391 | varies |
| Liver & Spleen Imaging Static Only (78215) | $984.80 | $1,231 | 2.6× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$148–$1,309.60 | $185–$1,637 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$56–$1,009.60 | $70–$1,262 | varies |
| Mammary ductogram or galactogram multiple (77054) | $644 | $805 | 2.8× |
| Mammary ductogram or galactogram single (77053) | $676 | $845 | 2.9× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$117.60–$1,009.60 | $147–$1,262 | varies |
| Mra Head W/O & W/Contrast Material (70546) | $2,624.80 | $3,281 | 7.8× |
| MRA head w/o contrast (70544) | $1,820 | $2,275 | 7.9× |
| MRA head with contrast (70545) | $2,022.40 | $2,528 | 6.0× |
| MRA neck w contrast (70548) | $1,844 | $2,305 | 5.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,624.80 | $3,281 | 7.8× |
| MRA neck w/o contrast (70547) | $1,792 | $2,240 | 7.8× |
| MRI abdomen w contrast (74182) | $1,753.60 | $2,192 | 5.2× |
| MRI abdomen w/o contrast (74181) | $1,468 | $1,835 | 6.4× |
| MRI any jt lower extrem w/contrast material (73722) | $1,338.40 | $1,673 | 1.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,683.20 | $2,104 | 5.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,075.20 | $2,594 | 2.8× |
| MRI cervical spine w contrast (72142) | $1,927.20 | $2,409 | 5.7× |
| MRI cervical spine w/o cont (72141) | $1,716 | $2,145 | 7.5× |
| MRI chest w/o contrast (71550) | $757.60 | $947 | 3.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,352.80 | $1,691 | 4.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,713.60 | $2,142 | 5.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,188 | $1,485 | 5.2× |
| MRI lumbar spine w contrast (72149) | $406.40 | $508 | 1.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,499.20 | $3,124 | 7.4× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,929.60–$2,026.40 | $2,412–$2,533 | varies |
| MRI orbit face neck w contrast (70542) | $2,352 | $2,940 | 7.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,944.80 | $3,681 | 8.8× |
| MRI pelvis w contrast (72196) | $2,002.40 | $2,503 | 6.0× |
| MRI pelvis w/o & w contrast (72197) | $2,552 | $3,190 | 7.6× |
| MRI pelvis w/o contrast (72195) | $1,811.20 | $2,264 | 7.9× |
| MRI thoracic spine w/o contrast (72146) | $1,866.40 | $2,333 | 8.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$208–$1,088.80 | $260–$1,361 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,636.80 | $2,046 | 4.9× |
| MRI, abdomen, combo (74183) | $2,070.40 | $2,588 | 6.2× |
| MRI, dorsal spine combo (72157) | $2,632 | $3,290 | 7.8× |
| MRI, dorsal spine contrast (72147) | $406.40 | $508 | 1.2× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,176–$1,235.20 | $1,470–$1,544 | varies |
| MRI, joint upper extrem combo (73223) | $1,837.60 | $2,297 | 5.5× |
| MRI, lumbar spine combo (72158) | $2,617.60 | $3,272 | 7.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $3,476.80 | $4,346 | 2.8× |
| Myocardial Spect Multiple Studies (78452) range across 4 matching MRF lines |
$235.20–$3,553.60 | $294–$4,442 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$40–$236 | $50–$295 | varies |
| Nuclear Rx Oral Admin (79005) | $1,616 | $2,020 | 7.2× |
| Optic foramina (70190) | $188.80 | $236 | 2.3× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$116–$1,136.80 | $145–$1,421 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$44.80–$304.80 | $56–$381 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,009.60 | $1,262 | 2.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$66.40–$600.80 | $83–$751 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$32.80–$283.20 | $41–$354 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$29.60–$264.80 | $37–$331 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$35.20–$272 | $44–$340 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$50.40–$392 | $63–$490 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$24.80–$194.40 | $31–$243 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$32.80–$285.60 | $41–$357 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$35.20–$304.80 | $44–$381 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$28–$197.60 | $35–$247 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$68–$364.80 | $85–$456 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$53.60–$212 | $67–$265 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$38.40–$397.60 | $48–$497 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$41.60–$304.80 | $52–$381 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$24.80–$212 | $31–$265 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$35.20–$308.80 | $44–$386 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$111.20–$256 | $139–$320 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$24.80–$194.40 | $31–$243 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$28–$260.80 | $35–$326 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$36–$324.80 | $45–$406 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$50.40–$389.60 | $63–$487 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$173.60–$904 | $217–$1,130 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$123.20–$589.60 | $154–$737 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$44–$341.60 | $55–$427 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$52–$384.80 | $65–$481 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 3 matching MRF lines |
$161.60–$622.40 | $202–$778 | varies |
| Radiologic examination femur minimum 2 views (73552) | $324.80 | $406 | 3.9× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$32.80–$242.40 | $41–$303 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $348.80 | $436 | 3.5× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$32.80–$283.20 | $41–$354 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$47.20–$378.40 | $59–$473 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$41.60–$389.60 | $52–$487 | varies |
| Sella turcica (70240) range across 2 matching MRF lines |
$35.20–$188.80 | $44–$236 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$29.60–$212 | $37–$265 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$95.20–$1,034.40 | $119–$1,293 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$44.80–$331.20 | $56–$414 | varies |
| Sternoclavicular joints (71130) | $308.80 | $386 | 3.7× |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$120–$1,009.60 | $150–$1,262 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$35.20–$389.60 | $44–$487 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$36.80–$364 | $46–$455 | varies |
| Thyroid Uptake Measurement (78012) range across 4 matching MRF lines |
$64–$1,009.60 | $80–$1,262 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$92–$1,016.80 | $115–$1,271 | varies |
| Ultrasound Breast Limited (76642) | $140.80 | $176 | 1.7× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$734.40–$771.20 | $918–$964 | varies |
| Umbilical-artery Doppler (OB) (76820) | $257.60 | $322 | 2.6× |
| Unlisted us procedure (76999) | $382.40 | $478 | 4.6× |
| Upper gi w/o kub (74240) | $506.40 | $633 | 3.0× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$101.60–$554.40 | $127–$693 | varies |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$388.80–$588.80 | $486–$736 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$382.40–$602.40 | $478–$753 | varies |
| Us exam, pelvic, limited (76857) | $384 | $480 | 3.8× |
| Us head (76506) | $372.80 | $466 | 3.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $308.80 | $386 | 3.1× |
| Us ob detailed single fetus (76811) | $819.20 | $1,024 | 3.6× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$641.60–$169,100.80 | $802–$211,376 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$116–$389.60 | $145–$487 | varies |
| Us pelvic non ob complete (76856) | $816.80 | $1,021 | 8.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $819.20 | $1,024 | 8.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $464 | $580 | 4.6× |
| Us retroperitoneal complete (76770) | $792.80 | $991 | 7.9× |
| Us scrotum and contents (76870) | $712.80 | $891 | 7.1× |
| Us thyroid (76536) | $586.40 | $733 | 5.8× |
| Venography extremity bilateral rs&i (75822) | $1,894.40 | $2,368 | 1.3× |
| Venography extremity unilateral rs&i (75820) | $1,894.40 | $2,368 | 1.3× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$32–$283.20 | $40–$354 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$41.60–$188.80 | $52–$236 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$30.40–$239.20 | $38–$299 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$86.40–$1,069.60 | $108–$1,337 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$72–$331.20 | $90–$414 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $304.80 | $381 | 3.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $419.20 | $524 | 4.2× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$60.80–$551.20 | $76–$689 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$36.80–$298.40 | $46–$373 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$56.80–$524.80 | $71–$656 | varies |
| X-ray eye for foreign body (70030) | $247.20 | $309 | 3.0× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$36–$264.80 | $45–$331 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 4 matching MRF lines |
$96.80–$554.40 | $121–$693 | varies |
| X-ray IV pyelogram+tomography (74415) | $100 | $125 | 0.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$32.80–$180 | $41–$225 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $65.60 | $82 | 0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$35.20–$368 | $44–$460 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$188.80–$2,695.20 | $236–$3,369 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$54.40–$259.20 | $68–$324 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$42.40–$331.20 | $53–$414 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$42.40–$296 | $53–$370 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$56.80–$412 | $71–$515 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$64–$331.20 | $80–$414 | varies |
| X-ray thoracic spine 4 vw (72074) | $427.20 | $534 | 4.2× |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$47.20–$175.20 | $59–$219 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $554.40 | $693 | 1.7× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$66.40–$844 | $83–$1,055 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$50.40–$464.80 | $63–$581 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$50.40–$155.20 | $63–$194 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $348.80 | $436 | 3.5× |
| Xr orbits complete 4 views (70200) range across 4 matching MRF lines |
$53.60–$54,320.80 | $67–$67,901 | varies |
| Xr Tomogram Single Plane (76100) | $416.80 | $521 | 4.1× |
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.