Imaging prices at Memorial Medical Center
Port Lavaca, TX · 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) | $242.90 | $347 | 2.8× |
| Abdomen 2 views (74019) | $336.70 | $481 | 3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,171.10 | $1,673 | 2.9× |
| Ankle 2 views (73600) | $237.30 | $339 | 2.7× |
| Arthrogram hip (73525) | $459.20 | $656 | 1.3× |
| Arthrogram Wrist (73115) | $348.60 | $498 | 1.0× |
| Bone age studies (77072) | $175.70 | $251 | 1.7× |
| Bone Imaging 3 Phase (78315) | $1,456 | $2,080 | 3.6× |
| Bone Imaging Limited Area (78300) | $840 | $1,200 | 2.1× |
| Bone Imaging Whole Body (78306) | $1,300.60 | $1,858 | 3.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $716.80 | $1,024 | 1.3× |
| Brain Imaging Minimum 4 Static Views (78605) | $406.70 | $581 | 0.7× |
| Cat Scan Follow-Up Study (76380) | $376.60 | $538 | 4.3× |
| Cerebrospinal Fluid Scan (78630) | $1,113.70 | $1,591 | 2.0× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$14–$210 | $20–$300 | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$28–$253.40 | $40–$362 | varies |
| Chest 3 views (71047) | $316.40 | $452 | 3.6× |
| Cholecystography Oral Contrast (74290) | $273.70 | $391 | 1.6× |
| Clavicle complete (73000) | $249.90 | $357 | 2.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $837.90 | $1,197 | 8.0× |
| Contrast X-Ray Bladder (74430) | $388.50 | $555 | 1.1× |
| Contrast X-Ray Of Elbow (73085) | $348.60 | $498 | 1.0× |
| Contrast X-Ray Of Knee Joint (73580) | $793.80 | $1,134 | 2.3× |
| CT abdomen and pelvis without and with contrast (74178) | $3,803.80 | $5,434 | 10.9× |
| CT abdomen and pelvis without contrast (74176) | $3,177.30 | $4,539 | 13.3× |
| CT abdomen w contrast (74160) | $2,006.20 | $2,866 | 11.4× |
| CT abdomen w wo contrast (74170) | $2,110.50 | $3,015 | 12.0× |
| CT abdomen w/o contrast (74150) | $1,608.60 | $2,298 | 15.3× |
| CT Angio Abdomen and Pelvis (74174) | $4,182.50 | $5,975 | 11.9× |
| CT Angio Chest (71275) | $2,499 | $3,570 | 14.2× |
| CT Angio Head (70496) | $2,793 | $3,990 | 15.9× |
| CT angio hrt w/3d image (75574) | $2,534 | $3,620 | 7.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,184 | $3,120 | 12.4× |
| CT Angio Neck (70498) | $2,464 | $3,520 | 14.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,472.40 | $3,532 | 14.0× |
| CT cervical spine w/ contrast (72126) | $2,149 | $3,070 | 6.1× |
| CT cervical spine w/o contrast (72125) | $1,580.60 | $2,258 | 15.1× |
| CT cervical spine w/wo cont (72127) | $2,762.90 | $3,947 | 15.7× |
| CT chest w contrast (71260) | $1,800.40 | $2,572 | 10.2× |
| CT chest w/wo contrast (71270) | $2,068.50 | $2,955 | 11.7× |
| CT head/brain with contrast (70460) | $1,834 | $2,620 | 10.4× |
| CT head/brain without and with contrast (70470) | $2,346.40 | $3,352 | 13.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $266 | $380 | 3.0× |
| CT iac w contrast (70481) | $1,756.30 | $2,509 | 10.0× |
| CT l-spine w&w/o contrast (72133) | $2,277.10 | $3,253 | 12.9× |
| CT lower ext w/o (73700) | $1,429.40 | $2,042 | 13.6× |
| CT lower extremity w/contrast material (73701) | $1,724.10 | $2,463 | 9.8× |
| CT lumbar spine w contrast (72132) | $1,936.90 | $2,767 | 5.5× |
| CT lumbar spine w/o contrast (72131) | $1,669.50 | $2,385 | 15.9× |
| CT maxillofacial w contrast (70487) | $1,900.50 | $2,715 | 10.8× |
| CT maxillofacial wo contrast (70486) | $1,437.80 | $2,054 | 13.7× |
| CT neck tissue combo (70492) | $2,098.60 | $2,998 | 11.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,044.70 | $2,921 | 11.6× |
| CT orbits w/o contrast (70480) | $1,607.90 | $2,297 | 15.3× |
| CT pelvis w&w/o contrast (72194) | $2,263.10 | $3,233 | 12.8× |
| CT pelvis w/o contrast (72192) | $1,568.70 | $2,241 | 14.9× |
| CT scan of leg combo (73702) | $1,906.80 | $2,724 | 10.8× |
| CT scans face/jaw combo (70488) | $2,027.20 | $2,896 | 11.5× |
| CT soft tissue neck w contrast (70491) | $1,809.50 | $2,585 | 10.3× |
| CT soft tissue neck w/o contrast (70490) | $1,470.70 | $2,101 | 14.0× |
| CT thoracic spine w contrast (72129) | $2,395.40 | $3,422 | 13.6× |
| CT thoracic spine w/o contrast (72128) | $1,524.60 | $2,178 | 14.5× |
| CT thoracic spine w/wo cont (72130) | $3,024.70 | $4,321 | 17.2× |
| CT thorax w/o contrast (71250) | $1,504.30 | $2,149 | 14.3× |
| CT upper ext wo (73200) | $1,281 | $1,830 | 12.2× |
| CT upper extremity w/o & w/contrast material (73202) | $2,691.50 | $3,845 | 15.3× |
| CT upper extremity with contrast (73201) | $2,354.80 | $3,364 | 6.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,576.70 | $3,681 | 14.6× |
| Cta Abdomen (74175) | $2,496.20 | $3,566 | 14.2× |
| CTA pelvis (72191) | $2,748.20 | $3,926 | 15.6× |
| Dxa Bone Density Axial (77080) | $329.70 | $471 | 3.1× |
| Echo exam of fetal heart (76825) | $395.50 | $565 | 0.7× |
| Echo exam uterus (76831) | $514.50 | $735 | 2.1× |
| Esophageal Motility Study (78258) | $417.20 | $596 | 1.0× |
| Esophagram (74220) | $732.20 | $1,046 | 4.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$144.90–$386.40 | $207–$552 | varies |
| Fluoroscopy up to 1 hr (76000) | $438.90 | $627 | 1.8× |
| Foot 2 views (73620) | $226.10 | $323 | 2.6× |
| Forearm 2 views (73090) | $238.70 | $341 | 2.7× |
| Gastric emptying imaging study (78264) | $1,152.20 | $1,646 | 2.9× |
| Gastric Mucosa Imaging (78261) | $415.10 | $593 | 1.0× |
| Gastroesophageal Reflux Exam (78262) | $553 | $790 | 1.4× |
| Gated Heart Planar Single (78472) | $1,700.30 | $2,429 | 4.2× |
| Hand 2 views (73120) | $244.30 | $349 | 2.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,431.50 | $2,045 | 2.6× |
| Hepatobiliary System Imaging (78226) | $1,338.40 | $1,912 | 3.3× |
| Ht Musc Image Planar Mult (78454) | $1,139.60 | $1,628 | 0.9× |
| Ht Muscle Image Spect Sing (78451) | $1,605.80 | $2,294 | 1.2× |
| Hysterosalpingogram (74740) | $613.90 | $877 | 2.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $163.10 | $233 | 1.9× |
| K Flow/Funct Image Multiple (78709) | $955.50 | $1,365 | 1.8× |
| K Flow/Funct Image W/Drug (78708) | $1,130.50 | $1,615 | 2.1× |
| K Flow/Funct Image W/O Drug (78707) | $661.50 | $945 | 1.2× |
| Kidney Imaging Morphol (78700) | $588 | $840 | 1.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $625.10 | $893 | 1.6× |
| Knee 3 Views (73562) | $277.90 | $397 | 3.2× |
| Liver & Spleen Imaging Static Only (78215) | $895.30 | $1,279 | 2.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $772.10 | $1,103 | 1.9× |
| Liver imaging w/vascular flow (78202) | $625.10 | $893 | 1.1× |
| Lung Ventilat&Perfus Imaging (78582) | $1,641.50 | $2,345 | 3.0× |
| Lymph System Imaging (78195) | $1,190 | $1,700 | 2.2× |
| Magnetic Image Jaw Joint (70336) | $1,998.50 | $2,855 | 8.3× |
| Mammary ductogram or galactogram multiple (77054) | $171.50 | $245 | 0.7× |
| Meckels Divert Exam (78290) | $698.60 | $998 | 1.7× |
| Mr safety determination physician/other qhp (76016) | $154 | $220 | 1.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $42.70 | $61 | 1.5× |
| MRA head w/o contrast (70544) | $1,712.90 | $2,447 | 7.1× |
| MRA neck w contrast (70548) | $2,310 | $3,300 | 6.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,815.40 | $4,022 | 8.0× |
| MRA neck w/o contrast (70547) | $2,095.80 | $2,994 | 8.7× |
| MRI abdomen w contrast (74182) | $2,255.40 | $3,222 | 6.4× |
| MRI abdomen w/o contrast (74181) | $1,983.10 | $2,833 | 8.3× |
| MRI any jt lower extrem w/contrast material (73722) | $2,458.40 | $3,512 | 3.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,881.20 | $4,116 | 8.2× |
| MRI cervical spine w contrast (72142) | $2,695.70 | $3,851 | 7.7× |
| MRI cervical spine w/o cont (72141) | $2,024.40 | $2,892 | 8.4× |
| MRI chest w/o contrast (71550) | $2,451.40 | $3,502 | 10.2× |
| MRI chest wo w contrast (71552) | $2,955.40 | $4,222 | 8.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,734.20 | $3,906 | 7.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,131.50 | $3,045 | 8.9× |
| MRI lumbar spine w contrast (72149) | $2,352 | $3,360 | 6.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,889.60 | $4,128 | 8.2× |
| MRI orbit face &/neck w/o contrast (70540) | $2,249.80 | $3,214 | 9.4× |
| MRI orbit face neck w contrast (70542) | $2,520 | $3,600 | 7.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,698.80 | $5,284 | 10.6× |
| MRI pelvis w contrast (72196) | $2,695.70 | $3,851 | 7.7× |
| MRI pelvis w/o & w contrast (72197) | $2,869.30 | $4,099 | 8.2× |
| MRI pelvis w/o contrast (72195) | $2,058.70 | $2,941 | 8.6× |
| MRI thoracic spine w/o contrast (72146) | $2,081.10 | $2,973 | 8.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,286.20 | $3,266 | 9.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,053.40 | $4,362 | 8.7× |
| MRI, abdomen, combo (74183) | $2,747.50 | $3,925 | 7.8× |
| MRI, dorsal spine combo (72157) | $3,207.40 | $4,582 | 9.2× |
| MRI, dorsal spine contrast (72147) | $2,352 | $3,360 | 6.7× |
| MRI, joint upper extrem (73221) | $2,286.20 | $3,266 | 9.5× |
| MRI, joint upper extrem combo (73223) | $2,769.20 | $3,956 | 7.9× |
| MRI, lumbar spine combo (72158) | $2,797.90 | $3,997 | 8.0× |
| Myelogram cervical (72240) | $1,317.40 | $1,882 | 1.7× |
| Myelogram Lumbar (72265) | $1,879.50 | $2,685 | 2.4× |
| Myelography thoracic (72255) | $1,253 | $1,790 | 1.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $956.90 | $1,367 | 0.7× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$236.60–$3,581.90 | $338–$5,117 | varies |
| Neck soft tissue (70360) | $237.30 | $339 | 2.7× |
| Nonvascular Shunt X-Ray (75809) | $198.80 | $284 | 1.9× |
| Ob us nuchal meas 1 gest (76813) | $245 | $350 | 2.3× |
| Optic foramina (70190) | $108.50 | $155 | 1.2× |
| Parathyroid Planar Imaging (78070) | $1,027.60 | $1,468 | 2.6× |
| Pelvis 1 or 2 views (72170) | $285.60 | $408 | 2.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $850.50 | $1,215 | 2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $385.70 | $551 | 3.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $395.50 | $565 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) | $268.80 | $384 | 3.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $210.70 | $301 | 2.4× |
| Radex elbow complete minimum 3 views (73080) | $271.60 | $388 | 3.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $371.70 | $531 | 3.5× |
| Radex fingr minimum 2 views (73140) | $214.20 | $306 | 2.5× |
| Radex foot complete minimum 3 views (73630) | $275.80 | $394 | 3.2× |
| Radex Hand Minimum 3 Views (73130) | $281.40 | $402 | 3.2× |
| Radex lower extremity infant minimum 2 views (73592) | $117.60 | $168 | 1.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $190.40 | $272 | 1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $274.40 | $392 | 3.1× |
| Radex Ribs Unilateral 2 Views (71100) | $271.60 | $388 | 3.1× |
| Radex shoulder complete minimum 2 views (73030) | $270.90 | $387 | 3.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $187.60 | $268 | 2.1× |
| Radex Spine 1 View Specify Level (72020) | $247.80 | $354 | 2.8× |
| Radex Sternum Minimum 2 Views (71120) | $214.90 | $307 | 2.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $427 | $610 | 4.9× |
| Radex Toe Minimum 2 Views (73660) | $236.60 | $338 | 2.7× |
| Radex upper extremity infant minimum 2 views (73092) | $117.60 | $168 | 1.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $262.50 | $375 | 3.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $387.80 | $554 | 3.7× |
| Radiologic exam colon double contrast study (74280) | $856.10 | $1,223 | 4.9× |
| Radiologic exam colon single contrast study (74270) | $625.10 | $893 | 3.5× |
| Radiologic exam knee complete 4/more views (73564) | $349.30 | $499 | 3.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $543.90 | $777 | 3.1× |
| Radiologic exam swallow function contrast study (74230) | $445.90 | $637 | 2.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $970.20 | $1,386 | 5.5× |
| Radiologic examination femur 1 view (73551) | $205.80 | $294 | 2.4× |
| Radiologic examination femur minimum 2 views (73552) | $242.90 | $347 | 2.8× |
| Radiologic examination knee 1/2 views (73560) | $234.50 | $335 | 2.7× |
| Radiologic Examination Osseous Survey Limited (77074) | $464.80 | $664 | 4.4× |
| Radiologic examination tibia & fibula 2 views (73590) | $242.20 | $346 | 2.8× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $395.50 | $565 | 0.7× |
| Ribs bilateral 3 views (71110) | $419.30 | $599 | 4.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $450.80 | $644 | 1.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $856.10 | $1,223 | 2.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,227.80 | $1,754 | 2.3× |
| Scapula (73010) | $307.30 | $439 | 2.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $86.80 | $124 | 3.7× |
| Sella turcica (70240) | $102.20 | $146 | 1.2× |
| Shoulder 1 view (73020) | $210 | $300 | 2.4× |
| Shoulder Arthrography (73040) | $900.90 | $1,287 | 2.6× |
| Sialogram (70390) | $189.70 | $271 | 0.8× |
| Skull less than 4 views (70250) | $343.70 | $491 | 3.3× |
| Spleen Imaging (78185) | $551.60 | $788 | 1.4× |
| Sternoclavicular joints (71130) | $198.80 | $284 | 2.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $173.60 | $248 | 1.0× |
| Thoracic spine 2 views (72070) | $329.70 | $471 | 3.1× |
| Thoracic spine 3 views (72072) | $420.70 | $601 | 4.0× |
| Thyroid Imaging With Vascular Flow (78013) | $961.10 | $1,373 | 2.4× |
| Thyroid Met Imaging Body (78018) | $1,554.70 | $2,221 | 2.9× |
| Thyroid Uptake Measurement (78012) | $422.80 | $604 | 1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,157.80 | $1,654 | 2.9× |
| Ultrasound Breast Limited (76642) | $372.40 | $532 | 4.3× |
| Ultrasound, abdomen limited (76705) | $485.10 | $693 | 4.6× |
| Unlisted us procedure (76999) | $182 | $260 | 2.1× |
| Upper gi w/o kub (74240) | $728 | $1,040 | 4.1× |
| Ureteral Reflux Study (78740) | $496.30 | $709 | 1.2× |
| Urethrocystogram voiding (74455) | $496.30 | $709 | 2.1× |
| Us breast unilateral complete (76641) | $413.70 | $591 | 3.9× |
| Us chest (76604) | $382.20 | $546 | 3.6× |
| Us complete joint (76881) | $597.80 | $854 | 5.7× |
| Us exam, pelvic, limited (76857) | $319.20 | $456 | 3.0× |
| Us head (76506) | $333.90 | $477 | 3.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $455 | $650 | 4.3× |
| Us ob detailed single fetus (76811) | $605.50 | $865 | 2.5× |
| Us ob limited 1 or more fetuses (76815) | $399 | $570 | 3.8× |
| Us ob transvaginal (76817) | $557.20 | $796 | 5.3× |
| Us pelvic non ob complete (76856) | $624.40 | $892 | 5.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $651 | $930 | 6.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $605.50 | $865 | 5.8× |
| Us retroperitoneal complete (76770) | $648.20 | $926 | 6.2× |
| Us retroperitoneal limited (76775) | $503.30 | $719 | 4.8× |
| Us scrotum and contents (76870) | $529.90 | $757 | 5.0× |
| Us thyroid (76536) | $518 | $740 | 4.9× |
| Us transrectal (76872) | $298.20 | $426 | 2.8× |
| Vascular Flow Imaging (78445) | $478.10 | $683 | 1.2× |
| Venography extremity bilateral rs&i (75822) | $1,137.50 | $1,625 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $1,537.90 | $2,197 | 1.0× |
| Wrist 2 views (73100) | $218.40 | $312 | 2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $294.70 | $421 | 3.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $241.50 | $345 | 2.8× |
| X-Ray Exam Breast Specimen (76098) | $563.50 | $805 | 1.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $319.20 | $456 | 3.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $225.40 | $322 | 2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $248.50 | $355 | 2.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $389.90 | $557 | 3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $395.50 | $565 | 3.8× |
| X-Ray Exam L-S Spine Bending (72114) | $525 | $750 | 5.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $290.50 | $415 | 3.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $397.60 | $568 | 3.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $437.50 | $625 | 4.2× |
| X-ray eye for foreign body (70030) | $146.30 | $209 | 1.7× |
| X-ray humerus (73060) | $233.80 | $334 | 2.7× |
| X-ray IV pyelogram (ivp) (74400) | $872.20 | $1,246 | 5.0× |
| X-ray IV pyelogram+tomography (74415) | $469 | $670 | 2.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $198.80 | $284 | 2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $274.40 | $392 | 3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $327.60 | $468 | 3.1× |
| X-ray nose-rectum child f.b. (76010) | $130.90 | $187 | 1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $443.10 | $633 | 4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $328.30 | $469 | 3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $291.20 | $416 | 3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $338.80 | $484 | 3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $437.50 | $625 | 4.2× |
| X-Rays Bone Length Studies (77073) | $346.50 | $495 | 3.3× |
| X-Rays Bone Survey Complete (77075) | $616 | $880 | 5.9× |
| Xr facial bones less than 3 views (70140) | $347.20 | $496 | 4.0× |
| XR Mastoids < 3 Views Bilateral (70120) | $118.30 | $169 | 1.1× |
| Xr orbits complete 4 views (70200) | $311.50 | $445 | 3.0× |
| Xr Tomogram Single Plane (76100) | $309.40 | $442 | 2.9× |
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.