Imaging prices at Mercy General Hospital
Sacramento, CA · every code in this section with a posted price and a Medicare benchmark.
260 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) | $229.78 | $1,054 | 2.0× |
| Abdomen 2 views (74019) | $255.06 | $1,170 | 1.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $914.08 | $4,193 | 1.8× |
| Angio internal mammary (75756) | $1,324.79 | $6,077 | 0.3× |
| Angio pulmonary bilat (75743) | $1,953.50 | $8,961 | 0.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $1,614.51 | $7,406 | 0.4× |
| Angiography extremity bilateral rs&i (75716) | $2,154.28 | $9,882 | 0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$1,758.17–$1,855.84 | $8,065–$8,513 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$1,435.32–$1,439.46 | $6,584–$6,603 | varies |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,392.12 | $10,973 | 0.3× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,285.52 | $10,484 | 0.3× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$1,870.44 | $8,580 | 0.3× |
| Bone Imaging 3 Phase (78315) | $1,109.41 | $5,089 | 2.1× |
| Bone Imaging Limited Area (78300) | $1,109.41 | $5,089 | 2.1× |
| Bone Imaging Multiple Areas (78305) | $1,109.41 | $5,089 | 2.1× |
| Bone Imaging Whole Body (78306) | $1,098.51 | $5,039 | 2.1× |
| Bone marrow imaging limited area (78102) | $1,051.20 | $4,822 | 2.0× |
| Bone marrow imaging; whole body (78104) | $1,051.20 | $4,822 | 2.0× |
| Bone survey infant (77076) | $294.52 | $1,351 | 2.2× |
| Brain Flow Imaging Only (78610) | $1,383.87 | $6,348 | 2.0× |
| Brain Image W/Flow < 4 Views (78601) | $1,106.57 | $5,076 | 2.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,401.09 | $6,427 | 0.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,106.57 | $5,076 | 2.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,040.48 | $9,360 | 4.5× |
| Cardiac Shunt Detection (78428) | $1,010.43 | $4,635 | 1.9× |
| Cat Scan Follow-Up Study (76380) | $516.66 | $2,370 | 4.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,330.02 | $6,101 | 1.9× |
| Cerebrospinal Fluid Scan (78630) | $1,330.02 | $6,101 | 1.9× |
| Chest 1 view (71045) | $229.78 | $1,054 | 2.0× |
| Chest 2 views (71046) | $229.78 | $1,054 | 2.0× |
| Chest 3 views (71047) | $229.78 | $1,054 | 2.0× |
| Chest 4 or more views (71048) | $255.06 | $1,170 | 1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $541.73 | $2,485 | 4.0× |
| Contrast Exam Abdominl Aorta (75625) | $1,832.29 | $8,405 | 0.4× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$253.10–$263.57 | $1,161–$1,209 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $2,042.01 | $9,367 | 4.5× |
| CT abdomen and pelvis without contrast (74176) | $1,368.17 | $6,276 | 4.4× |
| CT abdomen w contrast (74160) | $1,551.95 | $7,119 | 6.8× |
| CT abdomen w wo contrast (74170) | $1,551.95 | $7,119 | 6.8× |
| CT abdomen w/o contrast (74150) | $1,024.39 | $4,699 | 7.6× |
| CT Angio Abdomen and Pelvis (74174) | $2,042.01 | $9,367 | 4.5× |
| CT Angio Chest (71275) | $1,617.13 | $7,418 | 7.1× |
| CT Angio Head (70496) | $1,617.13 | $7,418 | 7.1× |
| CT angio hrt w/3d image (75574) | $1,547.59 | $7,099 | 3.4× |
| CT Angio Neck (70498) | $1,617.13 | $7,418 | 7.1× |
| CT cervical spine w/ contrast (72126) | $2,134.44 | $9,791 | 4.7× |
| CT cervical spine w/o contrast (72125) | $1,078.01 | $4,945 | 7.9× |
| CT cervical spine w/wo cont (72127) | $1,617.13 | $7,418 | 7.1× |
| CT chest w contrast (71260) | $1,547.59 | $7,099 | 6.8× |
| CT chest w/wo contrast (71270) | $1,547.59 | $7,099 | 6.8× |
| CT head/brain with contrast (70460) | $1,547.59 | $7,099 | 6.8× |
| CT head/brain without and with contrast (70470) | $1,547.59 | $7,099 | 6.8× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,547.59 | $7,099 | 3.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $541.73 | $2,485 | 4.8× |
| CT hrt w/3d image congen (75573) | $1,547.59 | $7,099 | 3.4× |
| CT iac w contrast (70481) | $1,547.59 | $7,099 | 6.8× |
| CT l-spine w&w/o contrast (72133) | $1,617.13 | $7,418 | 7.1× |
| CT lumbar spine w contrast (72132) | $2,134.44 | $9,791 | 4.7× |
| CT lumbar spine w/o contrast (72131) | $1,078.01 | $4,945 | 7.9× |
| CT maxillofacial w contrast (70487) | $1,547.59 | $7,099 | 6.8× |
| CT maxillofacial wo contrast (70486) | $1,031.80 | $4,733 | 7.6× |
| CT neck tissue combo (70492) | $1,547.59 | $7,099 | 6.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,547.59 | $7,099 | 6.8× |
| CT orbits w/o contrast (70480) | $1,036.81 | $4,756 | 7.6× |
| CT pelvis w&w/o contrast (72194) | $1,547.59 | $7,099 | 6.8× |
| CT pelvis w/o contrast (72192) | $1,031.80 | $4,733 | 7.6× |
| CT scans face/jaw combo (70488) | $1,547.59 | $7,099 | 6.8× |
| CT soft tissue neck w contrast (70491) | $1,547.59 | $7,099 | 6.8× |
| CT soft tissue neck w/o contrast (70490) | $1,036.81 | $4,756 | 7.6× |
| CT thoracic spine w contrast (72129) | $1,569.60 | $7,200 | 6.9× |
| CT thoracic spine w/o contrast (72128) | $1,046.40 | $4,800 | 7.7× |
| CT thoracic spine w/wo cont (72130) | $1,569.60 | $7,200 | 6.9× |
| CT thorax w/o contrast (71250) | $1,036.81 | $4,756 | 7.6× |
| CT unlisted procedure (76497) | $732.70 | $3,361 | 6.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,617.13 | $7,418 | 7.1× |
| Cta Abdomen (74175) | $1,551.95 | $7,119 | 6.8× |
| CTA pelvis (72191) | $1,543.66 | $7,081 | 6.8× |
| Dilation ureters/urethra rs&i (74485) | $696.95 | $3,197 | 0.3× |
| Diskography lumbar (72295) | $1,306.48 | $5,993 | 0.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $429.03 | $1,968 | 3.2× |
| Dxa Bone Density Axial (77080) | $256.15 | $1,175 | 1.9× |
| Echo Guide For Artery Repair (76936) | $449.30 | $2,061 | 1.6× |
| Esophageal Motility Study (78258) | $1,106.57 | $5,076 | 2.1× |
| Esophagram (74220) | $379.76 | $1,742 | 1.7× |
| Fetal Biophys Profile W/Nst (76818) | $469.79 | $2,155 | 3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $469.79 | $2,155 | 3.5× |
| Fluoroscopy up to 1 hr (76000) | $531.05 | $2,436 | 1.7× |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$787.42–$828.84 | $3,612–$3,802 | varies |
| Gastric emptying imaging study (78264) | $962.26 | $4,414 | 1.9× |
| Gastroesophageal Reflux Exam (78262) | $1,010.43 | $4,635 | 1.9× |
| Gated Heart Planar Single (78472) | $962.26 | $4,414 | 1.9× |
| Gated Heart, Multiple (78473) | $1,106.57 | $5,076 | 2.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,492.43 | $6,846 | 0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,492.43 | $6,846 | 0.4× |
| Hepatobil Syst Image W/Drug (78227) | $1,266.58 | $5,810 | 1.8× |
| Hepatobiliary System Imaging (78226) | $962.69 | $4,416 | 1.9× |
| Ht Muscle Image Spect Sing (78451) | $1,842.98 | $8,454 | 1.1× |
| Hysterosalpingogram (74740) | $323.30 | $1,483 | 1.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $322.86 | $1,481 | 2.9× |
| Interstitial radiation source applic complex (77778) | $872.88 | $4,004 | 1.0× |
| K Flow/Funct Image Multiple (78709) | $1,456.68 | $6,682 | 2.1× |
| K Flow/Funct Image W/Drug (78708) | $1,266.58 | $5,810 | 1.8× |
| K Flow/Funct Image W/O Drug (78707) | $1,266.58 | $5,810 | 1.8× |
| Kidney Imaging Morphol (78700) | $1,101.99 | $5,055 | 2.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,101.99 | $5,055 | 2.1× |
| Liver & Spleen Imaging Static Only (78215) | $1,106.57 | $5,076 | 2.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,106.57 | $5,076 | 2.1× |
| Lung Perf&Ventilat Diferentl (78598) | $1,456.68 | $6,682 | 2.1× |
| Lung perfusion differential (78597) | $962.26 | $4,414 | 1.9× |
| Lung Ventilat&Perfus Imaging (78582) | $1,266.58 | $5,810 | 1.8× |
| Lung Ventilation Imaging (78579) | $1,101.99 | $5,055 | 2.1× |
| Lymph System Imaging (78195) | $1,266.58 | $5,810 | 1.8× |
| Magnetic Image Jaw Joint (70336) | $1,165.65 | $5,347 | 3.8× |
| Meckels Divert Exam (78290) | $1,106.57 | $5,076 | 2.1× |
| Mra Head W/O & W/Contrast Material (70546) | $2,370.54 | $10,874 | 5.2× |
| MRA head w/o contrast (70544) | $1,549.33 | $7,107 | 5.0× |
| MRA head with contrast (70545) | $2,370.54 | $10,874 | 5.2× |
| MRA neck w contrast (70548) | $1,872.41 | $8,589 | 4.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,872.41 | $8,589 | 4.1× |
| MRA neck w/o contrast (70547) | $1,217.10 | $5,583 | 3.9× |
| MRI abdomen w contrast (74182) | $1,929.30 | $8,850 | 4.3× |
| MRI abdomen w/o contrast (74181) | $1,254.16 | $5,753 | 4.1× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,105.26 | $5,070 | 3.6× |
| MRI cardiac w/o contrast (75557) | $1,326.32 | $6,084 | 4.3× |
| MRI cervical spine w contrast (72142) | $1,834.47 | $8,415 | 4.1× |
| MRI cervical spine w/o cont (72141) | $1,199 | $5,500 | 3.9× |
| MRI chest w/o contrast (71550) | $1,050.11 | $4,817 | 3.4× |
| MRI chest with contrast (71551) | $1,663.78 | $7,632 | 1.6× |
| MRI chest wo w contrast (71552) | $1,615.38 | $7,410 | 3.6× |
| MRI lumbar spine w contrast (72149) | $1,736.37 | $7,965 | 3.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,834.47 | $8,415 | 4.1× |
| MRI orbit face &/neck w/o contrast (70540) | $1,386.05 | $6,358 | 4.5× |
| MRI orbit face neck w contrast (70542) | $2,132.26 | $9,781 | 4.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,132.26 | $9,781 | 4.7× |
| MRI pelvis w contrast (72196) | $2,077.54 | $9,530 | 4.6× |
| MRI pelvis w/o & w contrast (72197) | $2,077.54 | $9,530 | 4.6× |
| MRI pelvis w/o contrast (72195) | $1,350.51 | $6,195 | 4.4× |
| MRI thoracic spine w/o contrast (72146) | $1,187.23 | $5,446 | 3.8× |
| MRI, abdomen, combo (74183) | $1,929.30 | $8,850 | 4.3× |
| MRI, dorsal spine combo (72157) | $1,826.41 | $8,378 | 4.0× |
| MRI, dorsal spine contrast (72147) | $1,881.13 | $8,629 | 4.2× |
| MRI, lumbar spine combo (72158) | $1,736.37 | $7,965 | 3.8× |
| Myelogram cervical (72240) | $745.35 | $3,419 | 0.7× |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$815.98–$856.74 | $3,743–$3,930 | varies |
| Myelograpy 2/more regions rs&i (72270) | $745.35 | $3,419 | 0.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,109.59 | $9,677 | 1.3× |
| Myocardial Spect Multiple Studies (78452) | $2,220.55 | $10,186 | 1.3× |
| Neck soft tissue (70360) | $229.78 | $1,054 | 2.0× |
| Nm myocard infarct spect (78469) | $1,330.02 | $6,101 | 1.9× |
| Nonvascular Shunt X-Ray (75809) | $156.75 | $719 | 1.2× |
| Nuclear Rx Intra-Arterial (79445) | $519.06 | $2,381 | 1.7× |
| Nuclear Rx Oral Admin (79005) | $546.31 | $2,506 | 1.8× |
| Ob us nuchal meas 1 gest (76813) | $408.54 | $1,874 | 3.0× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $120.99 | $555 | 0.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $134.29 | $616 | 1.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,266.58 | $5,810 | 1.8× |
| Parathyroid Planar Imaging (78070) | $911.68 | $4,182 | 1.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,101.99 | $5,055 | 2.1× |
| Pelvis 1 or 2 views (72170) | $256.15 | $1,175 | 1.9× |
| Peritoneogram Rs&I (74190) | $515.14 | $2,363 | 0.7× |
| PET image w/CT, full body (78816) | $899.69 | $4,127 | 0.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,614.51 | $7,406 | 0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $962.69 | $4,416 | 1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $255.06 | $1,170 | 1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $515.14 | $2,363 | 0.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $231.96 | $1,064 | 1.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $252.67 | $1,159 | 2.2× |
| Radex Sinuses Paransl < 3 Views (70210) | $241.33 | $1,107 | 2.1× |
| Radex Spine 1 View Specify Level (72020) | $229.78 | $1,054 | 2.0× |
| Radex Sternum Minimum 2 Views (71120) | $229.78 | $1,054 | 2.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $241.33 | $1,107 | 2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $280.57 | $1,287 | 2.1× |
| Radiologic exam colon double contrast study (74280) | $368.21 | $1,689 | 1.6× |
| Radiologic exam colon single contrast study (74270) | $368.21 | $1,689 | 1.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $342.70 | $1,572 | 1.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $256.15 | $1,175 | 1.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $417.69 | $1,916 | 1.8× |
| Radiologic exam swallow function contrast study (74230) | $379.76 | $1,742 | 1.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $342.70 | $1,572 | 1.5× |
| Radiologic Examination Osseous Survey Limited (77074) | $294.52 | $1,351 | 2.2× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $423.80 | $1,944 | 1.4× |
| Ribs bilateral 3 views (71110) | $256.15 | $1,175 | 1.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,268.98 | $5,821 | 2.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,268.98 | $5,821 | 2.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,018.25 | $9,258 | 2.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,148.21 | $5,267 | 1.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,208.60 | $5,544 | 1.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $894.46 | $4,103 | 0.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,003.24 | $4,602 | 0.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,208.60 | $5,544 | 0.7× |
| Rp Therapy Intravenous Administration (79101) | $295.18 | $1,354 | 1.0× |
| Skull less than 4 views (70250) | $256.15 | $1,175 | 1.9× |
| Special Physics Consult (77370) | $184 | $844 | 1.1× |
| Speech evaluation, complex (70371) | $531.05 | $2,436 | 1.7× |
| Thoracic spine 2 views (72070) | $256.15 | $1,175 | 1.9× |
| Thoracic spine 3 views (72072) | $256.15 | $1,175 | 1.9× |
| Thoracolumbar 2 views (72080) | $229.78 | $1,054 | 2.0× |
| Thyroid Met Imaging Body (78018) | $1,209.90 | $5,550 | 1.7× |
| Thyroid Uptake Measurement (78012) | $1,106.57 | $5,076 | 2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $446.90 | $2,050 | 0.9× |
| Ultrasound Exam Aaa Screen (76706) | $388.04 | $1,780 | 2.9× |
| Ultrasound, abdomen limited (76705) | $408.54 | $1,874 | 3.0× |
| Umbilical-artery Doppler (OB) (76820) | $429.03 | $1,968 | 3.2× |
| Upper gi w/o kub (74240) | $379.76 | $1,742 | 1.7× |
| Urethrocystogram voiding (74455) | $531.05 | $2,436 | 1.7× |
| Urethrocystography retrograde (74450) | $531.05 | $2,436 | 1.7× |
| Us chest (76604) | $408.54 | $1,874 | 3.0× |
| Us exam, pelvic, limited (76857) | $179.85 | $825 | 1.3× |
| Us head (76506) | $469.79 | $2,155 | 3.5× |
| Us kidney transplant (76776) | $419.44 | $1,924 | 3.1× |
| Us ob detailed single fetus (76811) | $608.88 | $2,793 | 2.0× |
| Us ob limited 1 or more fetuses (76815) | $408.54 | $1,874 | 3.0× |
| Us ob transvaginal (76817) | $408.54 | $1,874 | 3.0× |
| Us pelvic non ob complete (76856) | $408.54 | $1,874 | 3.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $408.54 | $1,874 | 3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $408.54 | $1,874 | 3.0× |
| Us retroperitoneal complete (76770) | $408.54 | $1,874 | 3.0× |
| Us retroperitoneal limited (76775) | $408.54 | $1,874 | 3.0× |
| Us scrotum and contents (76870) | $408.54 | $1,874 | 3.0× |
| Us spinal canal and contents (76800) | $469.79 | $2,155 | 3.5× |
| Us thyroid (76536) | $408.54 | $1,874 | 3.0× |
| Vascular Flow Imaging (78445) | $407.01 | $1,867 | 0.8× |
| Vein X-Ray Chest (75827) | $445.38 | $2,043 | 0.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,614.51 | $7,406 | 0.4× |
| Vein X-Ray Spleen/Liver (75810) | $1,335.25 | $6,125 | 0.3× |
| Venogram Sinus/Jugular (75860) | $1,614.51 | $7,406 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $1,391.93 | $6,385 | 0.3× |
| Venography extremity bilateral rs&i (75822) | $721.15 | $3,308 | 0.4× |
| Venography Renal Bilateral (75833) | $1,614.51 | $7,406 | 0.4× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,306.48 | $5,993 | 0.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $241.33 | $1,107 | 2.1× |
| X-Ray Aorta Leg Arteries (75630) | $2,207.47 | $10,126 | 0.5× |
| X-Ray Bend Only L-S Spine (72120) | $256.15 | $1,175 | 1.9× |
| X-Ray Exam Breast Specimen (76098) | $383.68 | $1,760 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $229.99 | $1,055 | 2.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $255.50 | $1,172 | 1.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $255.50 | $1,172 | 1.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $255.06 | $1,170 | 1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $255.06 | $1,170 | 1.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $255.06 | $1,170 | 1.9× |
| X-Ray Exam L-S Spine Bending (72114) | $256.15 | $1,175 | 1.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $229.78 | $1,054 | 2.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $255.06 | $1,170 | 1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $252.45 | $1,158 | 2.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $243.51 | $1,117 | 2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $256.15 | $1,175 | 1.9× |
| X-ray nose-rectum child f.b. (76010) | $229.78 | $1,054 | 2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $256.15 | $1,175 | 1.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $255.06 | $1,170 | 1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $229.78 | $1,054 | 2.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $241.33 | $1,107 | 2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $256.15 | $1,175 | 1.9× |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$217.79–$229.12 | $999–$1,051 | varies |
| X-ray thoracic spine 4 vw (72074) | $256.15 | $1,175 | 1.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $606.70 | $2,783 | 1.3× |
| X-Rays Bone Length Studies (77073) | $269.02 | $1,234 | 2.0× |
| X-Rays Bone Survey Complete (77075) | $294.52 | $1,351 | 2.2× |
| Xr c-spine 4 or 5 views (72050) | $255.06 | $1,170 | 1.9× |
| Xr facial bones less than 3 views (70140) | $208.85 | $958 | 1.8× |
| Xr orbits complete 4 views (70200) | $282.53 | $1,296 | 2.1× |
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.