Imaging prices at MercyOne Dubuque Medical Center
Dubuque, IA · every code in this section with a posted price and a Medicare benchmark.
246 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) | $5,294.25 | $8,145 | 3.8× |
| Abdomen 1 View (74018) | $20,696.92 | — | 239.2× |
| Abdomen 2 views (74019) | $271.70 | $418 | 2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,019.85 | $1,569 | 2.6× |
| Angio internal mammary (75756) | $5,850 | $9,000 | 1.9× |
| Angiography extremity bilateral rs&i (75716) | $18,552.49 | — | 5.9× |
| Angiography extremity unilateral rs&i (75710) | $15,810.48 | — | 5.0× |
| Ankle 2 views (73600) | $25,625.21 | — | 296.2× |
| Aortography thoracic serialography rs&i (75605) | $9,995.05 | $15,377 | 1.8× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$812.50–$1,218.75 | $1,250–$1,875 | varies |
| Basic radiation dosimetry calculation (77300) | $456.30 | $702 | 3.4× |
| Bone age studies (77072) | $271.70 | $418 | 2.6× |
| Bone Imaging 3 Phase (78315) | $560.95 | $863 | 1.4× |
| Bone Imaging Limited Area (78300) | $560.95 | $863 | 1.4× |
| Bone Imaging Whole Body (78306) | $560.95 | $863 | 1.4× |
| Bone survey infant (77076) | $175.50 | $270 | 1.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $2,269.15 | $3,491 | 5.7× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $1,592.50 | $2,450 | 3.0× |
| Cat Scan Follow-Up Study (76380) | $668.85 | $1,029 | 7.7× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$5,145.32–$20,752.41 | — | varies |
| Chest 2 views (71046) | $18,409.96 | — | 212.8× |
| Chest 3 views (71047) | $271.70 | $418 | 3.1× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$243.75–$365.95 | $375–$563 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $310.70 | $478 | 3.0× |
| Continuing medical physics consltj pr wk (77336) | $28,681.25 | — | 214.7× |
| Contrast Exam Abdominl Aorta (75625) | $4,097.60 | $6,304 | 1.3× |
| Contrast X-Ray Bladder (74430) | $704.60 | $1,084 | 2.0× |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$795.60–$1,193.40 | $1,224–$1,836 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $3,944.20 | $6,068 | 11.4× |
| CT abdomen and pelvis without contrast (74176) | $3,138.20 | — | 13.2× |
| CT abdomen w contrast (74160) | $1,578.85 | $2,429 | 9.1× |
| CT abdomen w wo contrast (74170) | $1,792.70 | $2,758 | 10.3× |
| CT abdomen w/o contrast (74150) | $1,104.35 | $1,699 | 10.6× |
| CT Angio Abdomen and Pelvis (74174) | $2,707.90 | $4,166 | 7.8× |
| CT Angio Chest (71275) | $7,231.54 | — | 41.5× |
| CT Angio Head (70496) | $2,692.30 | $4,142 | 15.4× |
| CT angio hrt w/3d image (75574) | $2,482.35 | $3,819 | 7.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 6 matching MRF lines |
$2,117.05–$3,175.90 | $3,257–$4,886 | varies |
| CT Angio Neck (70498) | $2,692.95 | $4,143 | 15.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,164.15 | $1,791 | 6.7× |
| CT cervical spine w/ contrast (72126) | $1,972.75 | $3,035 | 5.7× |
| CT cervical spine w/o contrast (72125) | $1,955.20 | $3,008 | 18.8× |
| CT cervical spine w/wo cont (72127) | $1,478.10 | $2,274 | 8.5× |
| CT chest w contrast (71260) | $1,873.95 | $2,883 | 10.7× |
| CT head/brain with contrast (70460) | $1,563.90 | $2,406 | 9.0× |
| CT head/brain without and with contrast (70470) | $2,004.60 | $3,084 | 11.5× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,639.30 | $2,522 | 4.7× |
| CT iac w contrast (70481) | $1,444.95 | $2,223 | 8.3× |
| CT l-spine w&w/o contrast (72133) | $1,717.95 | $2,643 | 9.9× |
| CT lower ext w/o (73700) range across 6 matching MRF lines |
$1,426.75–$2,139.80 | $2,195–$3,292 | varies |
| CT lower extremity w/contrast material (73701) range across 6 matching MRF lines |
$1,511.25–$2,266.55 | $2,325–$3,487 | varies |
| CT lumbar spine w contrast (72132) | $1,626.95 | $2,503 | 4.7× |
| CT lumbar spine w/o contrast (72131) | $1,507.35 | — | 14.5× |
| CT maxillofacial w contrast (70487) | $1,660.10 | $2,554 | 9.5× |
| CT maxillofacial wo contrast (70486) | $1,281.80 | $1,972 | 12.3× |
| CT neck tissue combo (70492) | $1,641.90 | $2,526 | 9.4× |
| CT orbits w/o contrast (70480) | $1,392.95 | $2,143 | 13.4× |
| CT pelvis w&w/o contrast (72194) | $1,831.05 | $2,817 | 10.5× |
| CT pelvis w/o contrast (72192) | $1,524.90 | — | 14.7× |
| CT scan of leg combo (73702) range across 6 matching MRF lines |
$1,197.95–$1,797.25 | $1,843–$2,765 | varies |
| CT scans face/jaw combo (70488) | $1,593.80 | $2,452 | 9.1× |
| CT soft tissue neck w contrast (70491) | $1,573 | $2,420 | 9.0× |
| CT soft tissue neck w/o contrast (70490) | $1,237.60 | $1,904 | 11.9× |
| CT thoracic spine w contrast (72129) | $1,623.05 | $2,497 | 9.3× |
| CT thoracic spine w/o contrast (72128) | $1,530.75 | $2,355 | 14.7× |
| CT thoracic spine w/wo cont (72130) | $1,646.45 | $2,533 | 9.4× |
| CT thorax w/o contrast (71250) | $1,783.60 | — | 17.2× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,431.30–$2,146.95 | $2,202–$3,303 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$760.50–$1,140.75 | $1,170–$1,755 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,498.25–$2,247.70 | $2,305–$3,458 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,071.90 | $4,726 | 17.6× |
| Cta Abdomen (74175) | $2,322.45 | $3,573 | 13.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,914.25 | $2,945 | 5.5× |
| Echo Guide For Artery Repair (76936) | $754 | $1,160 | 3.5× |
| Esophagram (74220) | $415.58 | — | 2.4× |
| Fetal Biophys Profile W/Nst (76818) | $516.75 | $795 | 5.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $447.85 | $689 | 4.3× |
| Fluoroscopy up to 1 hr (76000) | $414.05 | $637 | 1.7× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$237.25–$356.20 | $365–$548 | varies |
| Forearm 2 views (73090) | $28,031.80 | — | 324.0× |
| Gastric emptying imaging study (78264) | $1,613.30 | $2,482 | 4.1× |
| Gated Heart Planar Single (78472) | $956.80 | $1,472 | 2.4× |
| Gated Heart, Multiple (78473) | $1,006.85 | $1,549 | 2.5× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$228.15–$341.90 | $351–$526 | varies |
| Heart first pass single,planar (78481) | $732.55 | $1,127 | 1.4× |
| Hepatobil Syst Image W/Drug (78227) | $1,694.55 | $2,607 | 3.1× |
| Hepatobiliary System Imaging (78226) | $1,522.95 | $2,343 | 3.8× |
| K Flow/Funct Image Multiple (78709) | $1,285.70 | $1,978 | 2.4× |
| K Flow/Funct Image W/Drug (78708) | $1,255.15 | $1,931 | 2.3× |
| K Flow/Funct Image W/O Drug (78707) | $885.95 | $1,363 | 1.6× |
| Knee 3 Views (73562) range across 6 matching MRF lines |
$315.25–$473.20 | $485–$728 | varies |
| Lung Ventilat&Perfus Imaging (78582) | $1,546.35 | $2,379 | 2.9× |
| Lymph System Imaging (78195) | $1,810.25 | $2,785 | 3.4× |
| Magnetic Image Jaw Joint (70336) | $1,686.75 | $2,595 | 7.1× |
| Meckels Divert Exam (78290) | $746.85 | $1,149 | 1.9× |
| Mlc imrt design & construction per imrt plan (77338) | $33,122.05 | — | 89.0× |
| Mra Head W/O & W/Contrast Material (70546) | $8,395.20 | — | 24.2× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$4,592.25–$5,094.05 | — | varies |
| Mra Neck W/O &W/Contrast Material (70549) | $3,019.25 | $4,645 | 8.7× |
| MRA neck w/o contrast (70547) | $2,229.50 | $3,430 | 9.4× |
| MRI abdomen w/o contrast (74181) | $2,458.95 | $3,783 | 10.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,510–$5,265.65 | $5,400–$8,101 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$3,539.25–$5,309.20 | $5,445–$8,168 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,797.25 | $2,765 | 7.6× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,391.65 | $2,141 | 5.9× |
| MRI cervical spine w/o cont (72141) | $3,367 | $5,180 | 14.2× |
| MRI chest w/o contrast (71550) | $2,861.30 | $4,402 | 12.1× |
| MRI chest wo w contrast (71552) | $2,691 | $4,140 | 7.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$3,932.50–$5,898.75 | $6,050–$9,075 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,899–$4,349.15 | $4,460–$6,691 | varies |
| Mri Neck Spine W/O & W/Dye (72156) | $4,189.25 | $6,445 | 12.1× |
| MRI orbit face &/neck w/o contrast (70540) | $1,742 | $2,680 | 7.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,925.65 | $4,501 | 8.4× |
| MRI pelvis w/o & w contrast (72197) | $3,649.75 | $5,615 | 10.5× |
| MRI pelvis w/o contrast (72195) | $2,894.45 | $4,453 | 12.2× |
| MRI thoracic spine w/o contrast (72146) | $2,915.90 | $4,486 | 12.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,439.45–$3,658.85 | $3,753–$5,629 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$2,837.25–$4,256.20 | $4,365–$6,548 | varies |
| MRI, abdomen, combo (74183) | $4,909.45 | $7,553 | 14.2× |
| MRI, dorsal spine combo (72157) | $4,609.15 | $7,091 | 13.3× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$3,011.45–$4,516.85 | $4,633–$6,949 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$3,976.05–$5,964.40 | $6,117–$9,176 | varies |
| MRI, lumbar spine combo (72158) | $4,841.20 | $7,448 | 14.0× |
| Myelogram Lumbar (72265) | $1,424.80 | $2,192 | 1.8× |
| Neck soft tissue (70360) | $226.20 | $348 | 2.6× |
| Nonvascular Shunt X-Ray (75809) | $167.70 | $258 | 1.6× |
| Ntsty modul radthx pln dose-vol histos (77301) | $6,325.80 | $9,732 | 4.6× |
| Nuclear Rx Oral Admin (79005) | $975 | $1,500 | 4.2× |
| Panoramic X-ray of jaws (70355) | $252.85 | $389 | 2.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $725.40 | $1,116 | 1.3× |
| Parathyroid Planar Imaging (78070) | $880.75 | $1,355 | 2.2× |
| Parathyroid planar imaging w/wo subtraction (78071) | $729.30 | $1,122 | 1.8× |
| Pelvis 1 or 2 views (72170) | $2,374.45 | — | 22.8× |
| PET image w/CT, full body (78816) | $7,618.78 | — | 5.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $7,999.68 | — | 5.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $349.70 | $538 | 3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $529.75 | $815 | 1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$389.35–$26,996.11 | — | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$165.75–$248.95 | $255–$383 | varies |
| Radex elbow complete minimum 3 views (73080) | $40,229.89 | — | 465.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $288.60 | $444 | 2.8× |
| Radex fingr minimum 2 views (73140) | $248.95 | — | 2.9× |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$257.40–$386.10 | $396–$594 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$269.75–$404.95 | — | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 6 matching MRF lines |
$251.55–$378.30 | $387–$582 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $231.40 | $356 | 2.7× |
| Radex Ribs Unilateral 2 Views (71100) | $314.60 | $484 | 3.6× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$290.55–$436.15 | — | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$31,140.57–$42,588.11 | — | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$222.30–$333.45 | $342–$513 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 6 matching MRF lines |
$177.45–$266.50 | $273–$410 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) | $22,887.75 | — | 264.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $16,142.75 | $24,835 | 2.2× |
| Radiation treatment delivery level 1 (77402) | $1,670.50 | $2,570 | 16.5× |
| Radiation treatment delivery level 2 (77407) | $1,754.35 | $2,699 | 4.6× |
| Radiation treatment delivery level 3 (77412) | $1,837.55 | $2,827 | 3.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $352.95 | $543 | 3.4× |
| Radiologic exam colon double contrast study (74280) | $560.30 | $862 | 3.2× |
| Radiologic exam colon single contrast study (74270) | $505.05 | $777 | 2.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $373.75 | $575 | 2.1× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$343.85–$516.10 | $529–$794 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $251.55 | $387 | 2.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $574.60 | $884 | 3.3× |
| Radiologic exam swallow function contrast study (74230) | $423.80 | $652 | 2.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $471.25 | $725 | 2.7× |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$282.75–$423.80 | $435–$652 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$373.75–$39,351.34 | — | varies |
| Radiologic examination tibia & fibula 2 views (73590) | $485.55 | — | 5.6× |
| Ribs bilateral 3 views (71110) | $283.40 | $436 | 2.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,939.60 | $2,984 | 3.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,200.25 | $3,385 | 1.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,939.60 | $2,984 | 1.5× |
| Scapula (73010) range across 3 matching MRF lines |
$247–$370.50 | $380–$570 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$38.35–$57.20 | $59–$88 | varies |
| Shoulder 1 view (73020) | $42,541.71 | — | 491.8× |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$782.60–$1,173.90 | $1,204–$1,806 | varies |
| Skull less than 4 views (70250) | $183.30 | $282 | 1.8× |
| Special dosimetry (77331) | $370.50 | $570 | 2.8× |
| Special Physics Consult (77370) | $21,743.15 | — | 162.7× |
| Special teletherapy port plan (77321) | $683.80 | $1,052 | 1.8× |
| Special treatment procedure (77470) | $1,665.95 | $2,563 | 3.0× |
| Stereotactic Body Radiation Delivery (77373) | $5,836.35 | $8,979 | 3.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $718.90 | $1,106 | 1.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,550.90 | $2,386 | 4.2× |
| Ther rad simulaj-aided field setting simple (77280) | $19,449.95 | — | 145.6× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$29,128.50–$52,641.78 | — | varies |
| Thoracic spine 3 views (72072) | $387.40 | $596 | 3.7× |
| Thoracolumbar 2 views (72080) | $252.85 | $389 | 2.9× |
| Thyroid Met Imaging Body (78018) | $1,679.60 | $2,584 | 3.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $690.30 | $1,062 | 1.7× |
| Tx Devices Design & Construction Complex (77334) | $893.10 | $1,374 | 2.4× |
| Tx devices design & construction intermediate (77333) | $683.15 | $1,051 | 5.1× |
| Tx devices design & construction simple (77332) | $541.45 | $833 | 4.1× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$374.40–$562.25 | $576–$865 | varies |
| Ultrasound Exam Aaa Screen (76706) | $313.95 | $483 | 3.0× |
| Ultrasound, abdomen limited (76705) | $592.15 | $911 | 5.7× |
| Umbilical-artery Doppler (OB) (76820) | $239.20 | $368 | 2.3× |
| Upper gi w/o kub (74240) | $433.55 | $667 | 2.5× |
| Urethrocystogram voiding (74455) | $787.80 | $1,212 | 3.3× |
| Us chest (76604) | $276.25 | $425 | 2.7× |
| Us complete joint (76881) | $208 | $320 | 2.0× |
| Us exam, pelvic, limited (76857) | $344.50 | $530 | 3.3× |
| Us head (76506) | $657.15 | $1,011 | 6.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $475.80 | $732 | 4.6× |
| Us ob limited 1 or more fetuses (76815) | $434.20 | $668 | 4.2× |
| Us ob transvaginal (76817) | $671.45 | $1,033 | 6.5× |
| Us pelvic non ob complete (76856) | $742.30 | — | 7.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $475.80 | $732 | 4.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $325.65 | $501 | 3.1× |
| Us retroperitoneal complete (76770) | $853.45 | $1,313 | 8.2× |
| Us retroperitoneal limited (76775) | $543.40 | $836 | 5.2× |
| Us scrotum and contents (76870) | $672.10 | — | 6.5× |
| Us spinal canal and contents (76800) | $742.95 | $1,143 | 7.1× |
| Us thyroid (76536) | $514.80 | $792 | 5.0× |
| Venography extremity unilateral rs&i (75820) | $1,006.20 | $1,548 | 0.6× |
| Wrist 2 views (73100) | $22,392.96 | — | 258.8× |
| X-ray antegrade pyelogram tube (74425) | $345.15 | $531 | 1.0× |
| X-Ray Aorta Leg Arteries (75630) | $3,902.60 | $6,004 | 1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$219.70–$329.55 | $338–$507 | varies |
| X-Ray Exam Breast Specimen (76098) | $23,323.13 | — | 42.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $159.90 | $246 | 1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $341.25 | $525 | 3.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $42,689.96 | — | 493.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $360.75 | $555 | 4.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $410.80 | $632 | 4.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $410.80 | $632 | 4.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $452.40 | $696 | 4.4× |
| X-Ray Exam L-S Spine Bending (72114) | $397.80 | $612 | 3.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $3,684.85 | — | 42.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $479.05 | $737 | 4.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $445.90 | $686 | 4.3× |
| X-ray eye for foreign body (70030) range across 6 matching MRF lines |
$171.60–$257.40 | $264–$396 | varies |
| X-ray humerus (73060) | $249.60 | — | 2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $161.85 | $249 | 1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$28,025.19–$29,106.71 | — | varies |
| X-ray nose-rectum child f.b. (76010) | $317.20 | $488 | 3.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $415.35 | $639 | 4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $201.50 | $310 | 1.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $329.55 | $507 | 3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $216.45 | $333 | 2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $347.10 | $534 | 4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $274.30 | $422 | 2.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $505.05 | $777 | 1.5× |
| X-Rays Bone Length Studies (77073) | $140.40 | $216 | 1.4× |
| X-Rays Bone Survey Complete (77075) | $40.95 | $63 | 0.4× |
| Xr c-spine 4 or 5 views (72050) | $414.70 | $638 | 4.0× |
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.