Imaging prices at Mitchell County Hospital Health Systems
Beloit, KS · every code in this section with a posted price and a Medicare benchmark.
257 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) | $214.20 | $238 | 2.7× |
| Abdomen 2 views (74019) | $308.70 | $343 | 3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,115.10 | $1,239 | 3.0× |
| Ankle 2 views (73600) | $177.30 | $197 | 2.2× |
| Arthrogram hip (73525) | $612 | $680 | 1.9× |
| Bone age studies (77072) | $194.40 | $216 | 2.0× |
| Bone Imaging 3 Phase (78315) | $1,278.90 | $1,421 | 3.5× |
| Bone Imaging Limited Area (78300) | $691.20 | $768 | 1.9× |
| Bone Imaging Multiple Areas (78305) | $839.70 | $933 | 2.3× |
| Bone Imaging Whole Body (78306) | $1,204.20 | $1,338 | 3.3× |
| Bone survey infant (77076) | $419.40 | $466 | 4.4× |
| Brain Flow Imaging Only (78610) | $1,348.20 | $1,498 | 2.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,348.20 | $1,498 | 2.7× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,348.20 | $1,498 | 2.7× |
| Cat Scan Follow-Up Study (76380) | $885.60 | $984 | 11.1× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$212.40–$297.90 | $236–$331 | varies |
| Chest 2 views (71046) | $265.50 | $295 | 3.3× |
| Chest 3 views (71047) | $304.20 | $338 | 3.8× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$373.50–$432.90 | $415–$481 | varies |
| Clavicle complete (73000) | $208.80 | $232 | 2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $617.40 | $686 | 6.4× |
| Contrast X-Ray Bladder (74430) | $411.30 | $457 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) | $3,918.60 | $4,354 | 12.2× |
| CT abdomen and pelvis without contrast (74176) | $3,110.40 | $3,456 | 14.2× |
| CT abdomen w contrast (74160) | $1,859.40 | $2,066 | 11.5× |
| CT abdomen w wo contrast (74170) | $2,188.80 | $2,432 | 13.6× |
| CT abdomen w/o contrast (74150) | $1,668.60 | $1,854 | 17.4× |
| CT Angio Abdomen and Pelvis (74174) | $2,276.10 | $2,529 | 7.1× |
| CT Angio Chest (71275) | $2,297.70 | $2,553 | 14.2× |
| CT Angio Head (70496) | $1,721.70 | $1,913 | 10.7× |
| CT Angio Neck (70498) | $1,721.70 | $1,913 | 10.7× |
| CT cervical spine w/ contrast (72126) | $1,668.60 | $1,854 | 5.2× |
| CT cervical spine w/o contrast (72125) | $1,559.70 | $1,733 | 16.2× |
| CT cervical spine w/wo cont (72127) | $1,696.50 | $1,885 | 10.5× |
| CT chest w contrast (71260) | $1,833.30 | $2,037 | 11.4× |
| CT chest w/wo contrast (71270) | $1,970.10 | $2,189 | 12.2× |
| CT head/brain with contrast (70460) | $1,395 | $1,550 | 8.6× |
| CT head/brain without and with contrast (70470) | $1,696.50 | $1,885 | 10.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $166.50 | $185 | 2.1× |
| CT iac w contrast (70481) | $1,532.70 | $1,703 | 9.5× |
| CT lower ext w/o (73700) | $1,422.90 | $1,581 | 14.8× |
| CT lower extremity w/contrast material (73701) | $1,532.70 | $1,703 | 9.5× |
| CT lumbar spine w contrast (72132) | $1,668.60 | $1,854 | 5.2× |
| CT lumbar spine w/o contrast (72131) | $1,696.50 | $1,885 | 17.6× |
| CT maxillofacial w contrast (70487) | $1,395 | $1,550 | 8.6× |
| CT maxillofacial wo contrast (70486) | $1,286.10 | $1,429 | 13.4× |
| CT neck tissue combo (70492) | $1,696.50 | $1,885 | 10.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,833.30 | $2,037 | 11.4× |
| CT orbits w/o contrast (70480) | $1,559.70 | $1,733 | 16.2× |
| CT pelvis w&w/o contrast (72194) | $1,970.10 | $2,189 | 12.2× |
| CT pelvis w/o contrast (72192) | $1,559.70 | $1,733 | 16.2× |
| CT scan of leg combo (73702) | $1,668.60 | $1,854 | 10.3× |
| CT scans face/jaw combo (70488) | $1,532.70 | $1,703 | 9.5× |
| CT soft tissue neck w contrast (70491) | $1,559.70 | $1,733 | 9.7× |
| CT soft tissue neck w/o contrast (70490) | $1,395 | $1,550 | 14.5× |
| CT thoracic spine w contrast (72129) | $1,668.60 | $1,854 | 10.3× |
| CT thoracic spine w/o contrast (72128) | $1,532.70 | $1,703 | 15.9× |
| CT thoracic spine w/wo cont (72130) | $1,806.30 | $2,007 | 11.2× |
| CT thorax w/o contrast (71250) | $1,696.50 | $1,885 | 17.6× |
| CT upper ext wo (73200) | $1,422.90 | $1,581 | 14.8× |
| CT upper extremity w/o & w/contrast material (73202) | $1,668.60 | $1,854 | 10.3× |
| CT upper extremity with contrast (73201) | $1,532.70 | $1,703 | 4.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,297.70 | $2,553 | 14.2× |
| Cta Abdomen (74175) | $1,602.90 | $1,781 | 9.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,443.40 | $3,826 | 10.7× |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$299.70–$2,032.20 | $333–$2,258 | varies |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$261–$2,032.20 | $290–$2,258 | varies |
| Esophagram (74220) | $504 | $560 | 3.1× |
| Fetal Biophys Profile W/Nst (76818) | $352.80 | $392 | 3.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $554.40 | $616 | 5.8× |
| Fluoroscopy up to 1 hr (76000) | $483.30 | $537 | 2.2× |
| Foot 2 views (73620) | $191.70 | $213 | 2.4× |
| Forearm 2 views (73090) | $206.10 | $229 | 2.6× |
| Gastric emptying imaging study (78264) | $1,116.90 | $1,241 | 3.0× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,386.90 | $1,541 | 3.8× |
| Gated Heart Planar Single (78472) | $1,233.90 | $1,371 | 3.4× |
| Hand 2 views (73120) | $181.80 | $202 | 1.9× |
| Hepatobil Syst Image W/Drug (78227) | $1,204.20 | $1,338 | 2.4× |
| Hepatobiliary System Imaging (78226) | $745.20 | $828 | 2.0× |
| Ht Muscle Image Spect Sing (78451) | $2,024.10 | $2,249 | 1.7× |
| Joint Survey Single View (77077) | $195.30 | $217 | 2.0× |
| K Flow/Funct Image W/O Drug (78707) | $944.10 | $1,049 | 1.9× |
| Kidney Imaging Morphol (78700) | $952.20 | $1,058 | 2.6× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $741.60 | $824 | 2.0× |
| Knee 3 Views (73562) | $239.40 | $266 | 3.0× |
| Liver & Spleen Imaging Static Only (78215) | $1,124.10 | $1,249 | 3.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,124.10 | $1,249 | 3.1× |
| Liver imaging static only (78201) | $1,124.10 | $1,249 | 2.3× |
| Liver imaging w/vascular flow (78202) | $1,124.10 | $1,249 | 2.3× |
| Lung Ventilat&Perfus Imaging (78582) | $1,485.90 | $1,651 | 3.0× |
| Lymph System Imaging (78195) | $1,172.70 | $1,303 | 2.3× |
| Magnetic Image Jaw Joint (70336) | $1,641.60 | $1,824 | 7.5× |
| Meckels Divert Exam (78290) | $801.90 | $891 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) | $2,517.30 | $2,797 | 7.8× |
| MRA head w/o contrast (70544) | $2,407.50 | $2,675 | 11.0× |
| MRA head with contrast (70545) | $2,352.60 | $2,614 | 7.3× |
| MRA neck w contrast (70548) | $2,407.50 | $2,675 | 7.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,379.60 | $2,644 | 7.4× |
| MRA neck w/o contrast (70547) | $2,052.90 | $2,281 | 9.4× |
| MRI abdomen w contrast (74182) | $2,489.40 | $2,766 | 7.8× |
| MRI abdomen w/o contrast (74181) | $2,326.50 | $2,585 | 10.6× |
| MRI any jt lower extrem w/contrast material (73722) | $1,806.30 | $2,007 | 2.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,970.10 | $2,189 | 6.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,806.30 | $2,007 | 2.5× |
| MRI cervical spine w contrast (72142) | $2,352.60 | $2,614 | 7.3× |
| MRI cervical spine w/o cont (72141) | $2,407.50 | $2,675 | 11.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,806.30 | $2,007 | 5.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,243.70 | $2,493 | 7.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,915.20 | $2,128 | 8.7× |
| MRI lumbar spine w contrast (72149) | $2,352.60 | $2,614 | 7.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,736 | $3,040 | 8.5× |
| MRI orbit face &/neck w/o contrast (70540) | $2,188.80 | $2,432 | 10.0× |
| MRI orbit face neck w contrast (70542) | $2,352.60 | $2,614 | 7.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,517.30 | $2,797 | 7.8× |
| MRI pelvis w contrast (72196) | $2,489.40 | $2,766 | 7.8× |
| MRI pelvis w/o & w contrast (72197) | $2,736 | $3,040 | 8.5× |
| MRI pelvis w/o contrast (72195) | $2,407.50 | $2,675 | 11.0× |
| MRI thoracic spine w/o contrast (72146) | $2,407.50 | $2,675 | 11.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,806.30 | $2,007 | 5.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,641.60 | $1,824 | 7.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,970.10 | $2,189 | 6.1× |
| MRI, abdomen, combo (74183) | $2,653.20 | $2,948 | 8.3× |
| MRI, dorsal spine combo (72157) | $2,736 | $3,040 | 8.5× |
| MRI, dorsal spine contrast (72147) | $2,352.60 | $2,614 | 7.3× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,641.60–$1,915.20 | $1,824–$2,128 | varies |
| MRI, joint upper extrem combo (73223) | $1,970.10 | $2,189 | 6.1× |
| MRI, lumbar spine combo (72158) | $2,736 | $3,040 | 8.5× |
| Myelogram cervical (72240) | $3,155.40 | $3,506 | 4.4× |
| Myelogram Lumbar (72265) | $3,329.10 | $3,699 | 4.6× |
| Myelography thoracic (72255) | $3,155.40 | $3,506 | 4.4× |
| Myocardial Spect Multiple Studies (78452) | $2,730.60 | $3,034 | 2.3× |
| Neck soft tissue (70360) | $244.80 | $272 | 3.1× |
| Nuclear Rx Oral Admin (79005) | $944.10 | $1,049 | 4.4× |
| Optic foramina (70190) | $167.40 | $186 | 2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,250 | $2,500 | 6.1× |
| Pelvis 1 or 2 views (72170) | $209.70 | $233 | 2.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $754.20 | $838 | 2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $431.10 | $479 | 4.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $567 | $630 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $233.10 | $259 | 2.9× |
| Radex Calcaneus Minimum 2 Views (73650) | $185.40 | $206 | 2.3× |
| Radex elbow complete minimum 3 views (73080) | $234 | $260 | 2.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $248.40 | $276 | 2.6× |
| Radex fingr minimum 2 views (73140) | $176.40 | $196 | 2.2× |
| Radex foot complete minimum 3 views (73630) | $234 | $260 | 2.9× |
| Radex Hand Minimum 3 Views (73130) | $234.90 | $261 | 2.9× |
| Radex lower extremity infant minimum 2 views (73592) | $236.70 | $263 | 3.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $248.40 | $276 | 2.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $244.80 | $272 | 3.1× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $380.70 | $423 | 4.8× |
| Radex Ribs Unilateral 2 Views (71100) | $236.70 | $263 | 3.0× |
| Radex shoulder complete minimum 2 views (73030) | $252 | $280 | 3.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $206.10 | $229 | 2.6× |
| Radex Spine 1 View Specify Level (72020) | $203.40 | $226 | 2.5× |
| Radex Sternum Minimum 2 Views (71120) | $246.60 | $274 | 3.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $252 | $280 | 3.1× |
| Radex Toe Minimum 2 Views (73660) | $185.40 | $206 | 2.3× |
| Radex upper extremity infant minimum 2 views (73092) | $206.10 | $229 | 2.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $223.20 | $248 | 2.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $262.80 | $292 | 2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $431.10 | $479 | 4.5× |
| Radiologic exam colon double contrast study (74280) | $761.40 | $846 | 4.7× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$530.10–$1,206 | $589–$1,340 | varies |
| Radiologic exam knee complete 4/more views (73564) | $255.60 | $284 | 2.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $307.80 | $342 | 3.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$501.30–$502.20 | $557–$558 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$549.90–$822.60 | $611–$914 | varies |
| Radiologic examination femur 1 view (73551) | $198.90 | $221 | 2.5× |
| Radiologic examination femur minimum 2 views (73552) | $253.80 | $282 | 3.2× |
| Radiologic examination knee 1/2 views (73560) | $219.60 | $244 | 2.7× |
| Radiologic Examination Osseous Survey Limited (77074) | $657 | $730 | 6.8× |
| Radiologic examination tibia & fibula 2 views (73590) | $236.70 | $263 | 3.0× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $260.10 | $289 | 0.5× |
| Ribs bilateral 3 views (71110) | $320.40 | $356 | 3.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,124.10–$1,170.90 | $1,249–$1,301 | varies |
| Scapula (73010) | $219.60 | $244 | 2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $85.50 | $95 | 3.7× |
| Sella turcica (70240) | $215.10 | $239 | 2.7× |
| Shoulder 1 view (73020) | $171.90 | $191 | 2.1× |
| Shoulder Arthrography (73040) | $612 | $680 | 1.9× |
| Sialogram (70390) | $471.60 | $524 | 2.1× |
| Skull less than 4 views (70250) | $226.80 | $252 | 2.4× |
| Spleen Imaging (78185) | $1,072.80 | $1,192 | 2.9× |
| Sternoclavicular joints (71130) | $201.60 | $224 | 2.5× |
| Testicular Imaging W/Flow (78761) | $952.20 | $1,058 | 2.6× |
| Thoracic spine 2 views (72070) | $276.30 | $307 | 2.9× |
| Thoracic spine 3 views (72072) | $283.50 | $315 | 2.9× |
| Thoracolumbar 2 views (72080) | $276.30 | $307 | 3.5× |
| Thyroid Imaging With Vascular Flow (78013) | $455.40 | $506 | 1.2× |
| Thyroid Met Imaging Body (78018) | $1,245.60 | $1,384 | 2.5× |
| Thyroid Uptake Measurement (78012) | $441 | $490 | 1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $591.30 | $657 | 1.6× |
| Ultrasound Breast Limited (76642) | $170.10 | $189 | 2.1× |
| Ultrasound Exam Aaa Screen (76706) | $589.50 | $655 | 6.1× |
| Ultrasound, abdomen limited (76705) | $483.30 | $537 | 5.0× |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$434.70–$787.50 | $483–$875 | varies |
| Ureteral Reflux Study (78740) | $952.20 | $1,058 | 2.6× |
| Urethrocystogram voiding (74455) | $416.70 | $463 | 1.9× |
| Us breast unilateral complete (76641) | $337.50 | $375 | 3.5× |
| Us chest (76604) | $459 | $510 | 4.8× |
| Us complete joint (76881) | $479.70 | $533 | 5.0× |
| Us exam, pelvic, limited (76857) | $191.70 | $213 | 2.0× |
| Us head (76506) | $468 | $520 | 4.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $383.40 | $426 | 4.0× |
| Us ob detailed single fetus (76811) | $436.50 | $485 | 2.0× |
| Us ob limited 1 or more fetuses (76815) | $305.10 | $339 | 3.2× |
| Us ob transvaginal (76817) | $382.50 | $425 | 4.0× |
| Us pelvic non ob complete (76856) | $507.60 | $564 | 5.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $323.10 | $359 | 3.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $260.10 | $289 | 2.7× |
| Us retroperitoneal complete (76770) | $589.50 | $655 | 6.1× |
| Us retroperitoneal limited (76775) | $425.70 | $473 | 4.4× |
| Us scrotum and contents (76870) | $440.10 | $489 | 4.6× |
| Us spinal canal and contents (76800) | $401.40 | $446 | 4.2× |
| Us thyroid (76536) | $543.60 | $604 | 5.7× |
| Us transrectal (76872) | $459.90 | $511 | 4.8× |
| Venography extremity bilateral rs&i (75822) | $1,113.30 | $1,237 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $789.30 | $877 | 0.5× |
| Venous thrombosis imaging (78457) | $590.40 | $656 | 1.2× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $558.90 | $621 | 1.5× |
| Wrist 2 views (73100) | $176.40 | $196 | 2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $236.70 | $263 | 3.0× |
| X-Ray Bend Only L-S Spine (72120) | $294.30 | $327 | 3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $199.80 | $222 | 2.5× |
| X-Ray Exam Breast Specimen (76098) | $116.10 | $129 | 0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $259.20 | $288 | 3.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $458.10 | $509 | 4.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $176.40 | $196 | 2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $233.10 | $259 | 2.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $233.10 | $259 | 2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $389.70 | $433 | 4.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $404.10 | $449 | 4.2× |
| X-Ray Exam L-S Spine Bending (72114) | $454.50 | $505 | 4.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $249.30 | $277 | 3.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $448.20 | $498 | 4.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $318.60 | $354 | 3.3× |
| X-ray humerus (73060) | $233.10 | $259 | 2.9× |
| X-ray IV pyelogram (ivp) (74400) | $640.80 | $712 | 4.0× |
| X-ray IV pyelogram+tomography (74415) | $738.90 | $821 | 4.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $203.40 | $226 | 2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $201.60 | $224 | 2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $294.30 | $327 | 3.1× |
| X-ray nose-rectum child f.b. (76010) | $208.80 | $232 | 2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $400.50 | $445 | 4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $269.10 | $299 | 2.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $249.30 | $277 | 2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $215.10 | $239 | 2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $252.90 | $281 | 3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $285.30 | $317 | 3.0× |
| X-ray thoracic spine 4 vw (72074) | $289.80 | $322 | 3.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $486.90 | $541 | 1.5× |
| X-Rays Bone Survey Complete (77075) | $1,392.30 | $1,547 | 14.5× |
| Xr c-spine 4 or 5 views (72050) | $397.80 | $442 | 4.1× |
| Xr facial bones less than 3 views (70140) | $209.70 | $233 | 2.6× |
| XR Mastoids < 3 Views Bilateral (70120) | $215.10 | $239 | 2.2× |
| Xr orbits complete 4 views (70200) | $284.40 | $316 | 3.0× |
| Xr Tomogram Single Plane (76100) | $460.80 | $512 | 4.8× |
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.