Imaging prices at Mercy Medical Center
Springfield, MA · every code in this section with a posted price and a Medicare benchmark.
271 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $2,596.10 | $3,994 | 1.6× |
| Abdomen 1 View (74018) | $161.20 | — | 1.5× |
| Abdomen 2 views (74019) | $170.30 | $262 | 1.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $553.15 | $851 | 1.2× |
| Angio pulmonary bilat (75743) | $2,639 | $4,060 | 0.7× |
| Angiography extremity bilateral rs&i (75716) | $5,590.77 | — | 1.5× |
| Angiography extremity unilateral rs&i (75710) | $2,915.25 | $4,485 | 0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,639 | $4,060 | 0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,914.60 | $4,484 | 0.8× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$134.55–$202.15 | $207–$311 | varies |
| Aortography thoracic serialography rs&i (75605) | $5,006.95 | $7,703 | 0.8× |
| Artery X-Rays Abdomen (75726) | $5,006.95 | $7,703 | 0.8× |
| Artery X-Rays Pelvis (75736) | $5,006.95 | $7,703 | 0.8× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$536.25–$804.70 | $825–$1,238 | varies |
| Basic radiation dosimetry calculation (77300) | $217.75 | $335 | 1.4× |
| Bone age studies (77072) | $126.10 | $194 | 1.0× |
| Bone Imaging 3 Phase (78315) | $649.35 | $999 | 1.4× |
| Bone Imaging Limited Area (78300) | $512.20 | $788 | 1.1× |
| Bone Imaging Whole Body (78306) | $640.90 | $986 | 1.3× |
| Cat Scan Follow-Up Study (76380) | $246.35 | $379 | 2.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $498.55 | $767 | 0.8× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$7,008.50–$7,465.18 | — | varies |
| Chest 2 views (71046) | $179.40 | — | 1.7× |
| Chest 3 views (71047) | $196.95 | $303 | 1.9× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $168.35 | $259 | 1.3× |
| Clavicle complete (73000) range across 6 matching MRF lines |
$150.80–$226.20 | $232–$348 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $98.15 | $151 | 0.8× |
| Continuing medical physics consltj pr wk (77336) | $11,682.45 | — | 72.5× |
| Contrast Exam Abdominl Aorta (75625) | $2,915.25 | $4,485 | 0.8× |
| Contrast X-Ray Bladder (74430) | $425.75 | $655 | 1.0× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$560.30–$841.10 | $862–$1,294 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$536.25–$804.70 | $825–$1,238 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $1,027 | $1,580 | 2.5× |
| CT abdomen and pelvis without contrast (74176) | $599.30 | — | 2.1× |
| CT abdomen w contrast (74160) | $871 | $1,340 | 4.1× |
| CT abdomen w wo contrast (74170) | $1,262.30 | $1,942 | 6.0× |
| CT abdomen w/o contrast (74150) | $661.05 | $1,017 | 5.3× |
| CT Angio Abdomen and Pelvis (74174) | $1,008.15 | $1,551 | 2.4× |
| CT Angio Chest (71275) | $958.10 | $1,474 | 4.6× |
| CT Angio Head (70496) | $1,846.32 | — | 8.8× |
| CT angio hrt w/3d image (75574) | $707.85 | $1,089 | 1.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $981.17 | — | 4.7× |
| CT Angio Neck (70498) | $1,846.32 | — | 8.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $955.50 | $1,470 | 4.5× |
| CT cervical spine w/ contrast (72126) | $1,027 | $1,580 | 2.5× |
| CT cervical spine w/o contrast (72125) | $926.90 | $1,426 | 7.4× |
| CT chest w contrast (71260) | $1,756.62 | — | 8.4× |
| CT chest w/wo contrast (71270) | $161.20 | $248 | 0.8× |
| CT head/brain with contrast (70460) | $960.70 | $1,478 | 4.6× |
| CT head/brain without and with contrast (70470) | $1,033.50 | $1,590 | 4.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $584.35 | $899 | 1.4× |
| CT iac w contrast (70481) | $808.60 | $1,244 | 3.8× |
| CT l-spine w&w/o contrast (72133) | $1,085.50 | $1,670 | 5.2× |
| CT lower ext w/o (73700) | $759.20 | — | 6.1× |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$971.42–$1,412.12 | — | varies |
| CT lumbar spine w contrast (72132) | $985.40 | $1,516 | 2.4× |
| CT lumbar spine w/o contrast (72131) | $871 | $1,340 | 7.0× |
| CT maxillofacial w contrast (70487) | $869.70 | $1,338 | 4.1× |
| CT maxillofacial wo contrast (70486) | $742.95 | $1,143 | 5.9× |
| CT neck tissue combo (70492) | $1,033.50 | $1,590 | 4.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $161.20 | $248 | 0.8× |
| CT orbits w/o contrast (70480) | $743.60 | — | 5.9× |
| CT pelvis w/o contrast (72192) | $835.90 | $1,286 | 6.7× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,060.80–$1,590.55 | $1,632–$2,447 | varies |
| CT scans face/jaw combo (70488) | $954.85 | $1,469 | 4.5× |
| CT soft tissue neck w contrast (70491) | $882.70 | $1,358 | 4.2× |
| CT soft tissue neck w/o contrast (70490) | $620.75 | $955 | 5.0× |
| CT thoracic spine w contrast (72129) | $982.15 | $1,511 | 4.7× |
| CT thoracic spine w/o contrast (72128) | $900.90 | $1,386 | 7.2× |
| CT thoracic spine w/wo cont (72130) | $1,080.95 | $1,663 | 5.1× |
| CT thorax w/o contrast (71250) | $649.35 | $999 | 5.2× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$758.55–$1,138.15 | $1,167–$1,751 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$165.10–$247.65 | $254–$381 | varies |
| CT upper extremity with contrast (73201) | $959.72 | — | 2.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $958.10 | $1,474 | 4.6× |
| Cta Abdomen (74175) | $871 | $1,340 | 4.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,757.60 | $2,704 | 4.2× |
| CTA pelvis (72191) | $1,287.65 | $1,981 | 6.1× |
| Dxa Bone Density Axial (77080) | $275.60 | $424 | 2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $96.20 | $148 | 0.9× |
| Echo exam uterus (76831) | $341.90 | $526 | 1.2× |
| Esophagram (74220) | $267.15 | $411 | 1.3× |
| Fluoroscopy up to 1 hr (76000) | $1,349.12 | — | 4.7× |
| Foot 2 views (73620) range across 6 matching MRF lines |
$156.65–$235.30 | $241–$362 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$181.35–$272.35 | $279–$419 | varies |
| Gastric emptying imaging study (78264) | $582.40 | $896 | 1.2× |
| Gated Heart, Multiple (78473) | $529.10 | $814 | 1.1× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$130–$195 | $200–$300 | varies |
| Heart Image (Pet) Multiple (78492) | $3,541.85 | $5,449 | 2.1× |
| Hepatobil Syst Image W/Drug (78227) | $614.25 | $945 | 0.9× |
| Hepatobiliary System Imaging (78226) | $549.90 | $846 | 1.1× |
| Ht Muscle Image Spect Sing (78451) | $1,366.30 | $2,102 | 0.9× |
| Hysterosalpingogram (74740) | $502.45 | $773 | 1.8× |
| K Flow/Funct Image Multiple (78709) | $498.55 | $767 | 0.8× |
| K Flow/Funct Image W/Drug (78708) | $872.95 | $1,343 | 1.3× |
| K Flow/Funct Image W/O Drug (78707) | $696.15 | $1,071 | 1.1× |
| Knee 3 Views (73562) range across 6 matching MRF lines |
$187.20–$281.45 | $288–$433 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $549.90 | $846 | 1.1× |
| Liver imaging w/vascular flow (78202) | $1,101.75 | $1,695 | 1.7× |
| Lung Ventilat&Perfus Imaging (78582) | $653.90 | $1,006 | 1.0× |
| Lymph System Imaging (78195) | $550.55 | $847 | 0.8× |
| Mlc imrt design & construction per imrt plan (77338) | $10,158.20 | — | 22.6× |
| Mra Head W/O & W/Contrast Material (70546) | $1,654.25 | $2,545 | 4.0× |
| MRA head w/o contrast (70544) | $863.20 | $1,328 | 3.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,235 | $1,900 | 3.0× |
| MRA neck w/o contrast (70547) | $923.65 | $1,421 | 3.2× |
| MRI abdomen w/o contrast (74181) | $875.55 | $1,347 | 3.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$1,847.30–$2,770.95 | $2,842–$4,263 | varies |
| MRI cervical spine w/o cont (72141) | $1,286.35 | $1,979 | 4.5× |
| MRI chest wo w contrast (71552) | $330.85 | $509 | 0.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,277.25–$1,916.20 | $1,965–$2,948 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$854.10–$1,281.15 | $1,314–$1,971 | varies |
| MRI lumbar spine w contrast (72149) | $1,774.50 | $2,730 | 4.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,975.35 | $3,039 | 4.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,052.70 | $3,158 | 4.9× |
| MRI pelvis w/o & w contrast (72197) | $1,847.30 | $2,842 | 4.4× |
| MRI pelvis w/o contrast (72195) | $1,021.80 | $1,572 | 3.6× |
| MRI spectroscopy (76390) | $81.25 | $125 | 0.8× |
| MRI thoracic spine w/o contrast (72146) | $1,286.35 | $1,979 | 4.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$562.25–$843.70 | $865–$1,298 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$216.45–$325 | $333–$500 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$1,251.90–$1,877.85 | $1,926–$2,889 | varies |
| MRI, abdomen, combo (74183) | $1,255.80 | $1,932 | 3.0× |
| MRI, dorsal spine combo (72157) | $1,975.35 | $3,039 | 4.7× |
| MRI, dorsal spine contrast (72147) | $1,630.20 | $2,508 | 3.9× |
| MRI, joint upper extrem (73221) | $931.45 | $1,433 | 3.3× |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$1,847.30–$2,770.95 | $2,842–$4,263 | varies |
| MRI, lumbar spine combo (72158) | $1,977.95 | $3,043 | 4.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,245.40 | $1,916 | 0.8× |
| Myocardial Spect Multiple Studies (78452) | $1,379.30 | $2,122 | 0.9× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $2,083.90 | $3,206 | 0.8× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $1,807 | $2,780 | 0.7× |
| Neck soft tissue (70360) | $143.65 | $221 | 1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,553.20 | $3,928 | 1.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 4 matching MRF lines |
$214.50–$321.10 | $330–$494 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,108.25 | $1,705 | 1.7× |
| Parathyroid Planar Imaging (78070) | $388.05 | $597 | 0.8× |
| Pelvis 1 or 2 views (72170) | $17,607.09 | — | 140.5× |
| Pet Image W/Ct Lmtd (78814) | $2,677.35 | $4,119 | 1.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,744.95 | $4,223 | 1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $512.20 | $788 | 1.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $235.95 | $363 | 1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $522.60 | $804 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$187.20–$281.45 | — | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 6 matching MRF lines |
$145.60–$218.40 | $224–$336 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$196.95–$1,353.30 | — | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $228.80 | $352 | 1.8× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$139.75–$209.95 | — | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$196.95–$295.10 | — | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$215.15–$617.50 | — | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $196.95 | $303 | 1.9× |
| Radex Ribs Unilateral 2 Views (71100) | $166.40 | $256 | 1.6× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$186.55–$280.80 | — | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $154.70 | $238 | 1.5× |
| Radex Spine 1 View Specify Level (72020) | $12,136.49 | — | 116.4× |
| Radex Sternum Minimum 2 Views (71120) | $169.65 | $261 | 1.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $150.15 | $231 | 1.4× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$152.10–$228.15 | $234–$351 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$131.95–$198.25 | $203–$305 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$205.40–$308.75 | — | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,078.50 | $10,890 | 0.8× |
| Radiation treatment delivery level 1 (77402) | $258.70 | $398 | 2.1× |
| Radiation treatment delivery level 2 (77407) | $917.15 | $1,411 | 2.0× |
| Radiation treatment delivery level 3 (77412) | $426.40 | $656 | 0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $256.10 | $394 | 2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $186.55 | $287 | 1.5× |
| Radiologic exam colon double contrast study (74280) | $428.35 | $659 | 2.0× |
| Radiologic exam colon single contrast study (74270) | $350.35 | $539 | 1.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $173.55 | $267 | 0.8× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$250.90–$377 | $386–$580 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $226.85 | $349 | 1.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $362.70 | $558 | 1.7× |
| Radiologic exam swallow function contrast study (74230) | $235.95 | $363 | 1.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $358.15 | $551 | 1.7× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$109.20–$163.80 | $168–$252 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$132.60–$198.90 | $204–$306 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$334.75–$501.80 | — | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $228.80 | $352 | 1.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$182.65–$274.30 | $281–$422 | varies |
| Ribs bilateral 3 views (71110) | $236.60 | $364 | 1.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,712.10 | $2,634 | 2.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,175.85 | $1,809 | 1.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,175.85 | $1,809 | 1.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,211.60 | $1,864 | 0.8× |
| Scapula (73010) range across 3 matching MRF lines |
$154.70–$232.05 | $238–$357 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$133.25–$199.55 | $205–$307 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$133.25–$200.20 | $205–$308 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$592.80–$889.20 | $912–$1,368 | varies |
| Skull less than 4 views (70250) | $156.65 | $241 | 1.3× |
| Special dosimetry (77331) | $258.70 | $398 | 1.6× |
| Special Physics Consult (77370) | $346.45 | $533 | 2.2× |
| Special teletherapy port plan (77321) | $521.30 | $802 | 1.2× |
| Special treatment procedure (77470) | $759.20 | $1,168 | 1.1× |
| Stereotactic Body Radiation Delivery (77373) | $2,974.40 | $4,576 | 1.4× |
| Sternoclavicular joints (71130) | $217.10 | $334 | 2.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $338 | $520 | 0.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $292.50 | $450 | 0.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $737.10 | $1,134 | 1.6× |
| Ther rad simulaj-aided field setting simple (77280) | $358.80 | $552 | 2.2× |
| Thoracic spine 2 views (72070) | $214.50 | $330 | 1.7× |
| Thoracic spine 3 views (72072) | $225.55 | $347 | 1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $456.30 | $702 | 1.0× |
| Tx Devices Design & Construction Complex (77334) | $417.95 | $643 | 0.9× |
| Tx devices design & construction intermediate (77333) | $379.60 | $584 | 2.4× |
| Tx devices design & construction simple (77332) | $356.85 | $549 | 2.2× |
| Ultrasound Breast Limited (76642) range across 9 matching MRF lines |
$140.40–$210.60 | $216–$324 | varies |
| Ultrasound Elastography Parenchyma (76981) | $122.20 | $188 | 1.0× |
| Ultrasound Exam Aaa Screen (76706) | $163.80 | $252 | 1.3× |
| Ultrasound, abdomen limited (76705) | $439.40 | $676 | 3.5× |
| Upper gi w/o kub (74240) | $340.60 | $524 | 1.6× |
| Urethrocystogram voiding (74455) | $425.75 | $655 | 1.5× |
| Urethrocystography retrograde (74450) | $425.75 | $655 | 1.5× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$169.65–$254.15 | $261–$391 | varies |
| Us chest (76604) | $234.65 | $361 | 1.9× |
| Us complete joint (76881) | $238.55 | $367 | 1.9× |
| Us exam, pelvic, limited (76857) | $217.75 | $335 | 1.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $180.05 | $277 | 1.4× |
| Us ob limited 1 or more fetuses (76815) | $214.50 | $330 | 1.7× |
| Us ob transvaginal (76817) | $588.25 | $905 | 4.7× |
| Us pelvic non ob complete (76856) | $523.25 | $805 | 4.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $237.90 | $366 | 1.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $280.80 | $432 | 2.2× |
| Us retroperitoneal complete (76770) | $305.50 | $470 | 2.4× |
| Us retroperitoneal limited (76775) | $213.20 | $328 | 1.7× |
| Us scrotum and contents (76870) | $449.80 | $692 | 3.6× |
| Us spinal canal and contents (76800) | $531.70 | $818 | 4.2× |
| Us thyroid (76536) | $267.15 | $411 | 2.1× |
| Us transrectal (76872) | $285.35 | $439 | 2.3× |
| Vein X-Ray Chest (75827) | $1,491.75 | $2,295 | 0.8× |
| Venography caval inferior serialography rs&i (75825) | $3,691.35 | $5,679 | 1.0× |
| Venography extremity bilateral rs&i (75822) | $2,157.35 | $3,319 | 1.1× |
| Venography extremity unilateral rs&i (75820) | $1,438.45 | $2,213 | 0.8× |
| Venography Renal Unilateral (75831) | $2,915.25 | $4,485 | 0.8× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$156–$234.65 | $240–$361 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $162.50 | $250 | 1.6× |
| X-ray antegrade pyelogram tube (74425) | $475.80 | $732 | 1.1× |
| X-Ray Aorta Leg Arteries (75630) | $2,915.25 | $4,485 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $251.55 | $387 | 2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $167.70 | — | 1.6× |
| X-Ray Exam Breast Specimen (76098) | $475.80 | $732 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $107.90 | $166 | 1.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $208.65 | $321 | 1.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $107.25 | $165 | 1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $141.05 | — | 1.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $98.15 | $151 | 0.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $172.90 | $266 | 1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $230.10 | $354 | 1.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $313.95 | $483 | 2.5× |
| X-Ray Exam L-S Spine Bending (72114) | $347.75 | $535 | 2.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $214.50 | $330 | 2.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $358.15 | $551 | 2.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $259.35 | — | 2.1× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$147.55–$221 | $227–$340 | varies |
| X-ray humerus (73060) | $172.90 | — | 1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $188.50 | $290 | 1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $104 | $160 | 1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $247.65 | $381 | 2.0× |
| X-ray nose-rectum child f.b. (76010) | $96.20 | $148 | 0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $273.65 | $421 | 2.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $195 | $300 | 1.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $142.35 | $219 | 1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $187.20 | $288 | 1.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $258.70 | $398 | 2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $243.75 | $375 | 1.9× |
| X-ray thoracic spine 4 vw (72074) | $268.45 | $413 | 2.1× |
| X-Ray Tmj Unilat (70328) | $98.80 | $152 | 0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $475.80 | $732 | 1.1× |
| X-Rays Bone Survey Complete (77075) | $100.75 | $155 | 0.8× |
| Xr c-spine 4 or 5 views (72050) | $269.10 | $414 | 2.1× |
| Xr facial bones less than 3 views (70140) | $192.40 | $296 | 1.8× |
| Xr orbits complete 4 views (70200) | $214.50 | $330 | 1.7× |
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.