Imaging prices at Mountrail County Medical Center Inc
Stanley, ND · every code in this section with a posted price and a Medicare benchmark.
280 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) | $203 | $225 | 2.3× |
| Abdomen 2 views (74019) | $227 | $252 | 2.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,094 | $1,215 | 2.7× |
| Adrenal Cortex & Medulla Img (78075) | $3,104 | $3,449 | 2.3× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$203–$408 | $225–$453 | varies |
| Arthrogram ankle (73615) | $2,369 | $2,632 | 6.6× |
| Arthrogram hip (73525) | $2,369 | $2,632 | 6.6× |
| Arthrogram Wrist (73115) | $1,311 | $1,457 | 3.7× |
| Bone Imaging 3 Phase (78315) | $1,169 | $1,299 | 2.9× |
| Bone Imaging Limited Area (78300) | $415 | $461 | 1.0× |
| Bone Imaging Multiple Areas (78305) | $790 | $878 | 1.9× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$801–$992 | $890–$1,102 | varies |
| Bone survey infant (77076) | $712 | $791 | 6.7× |
| Brain Image W/Flow < 4 Views (78601) | $719 | $799 | 1.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $863 | $959 | 1.6× |
| Cardiac Shunt Detection (78428) | $685 | $761 | 1.7× |
| Cat Scan Follow-Up Study (76380) | $447 | $497 | 5.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $770 | $856 | 1.4× |
| Cerebrospinal Fluid Scan (78630) | $1,398 | $1,553 | 2.5× |
| Chest 1 view (71045) range across 8 matching MRF lines |
$93–$177 | $103–$197 | varies |
| Chest 2 views (71046) | $220 | $244 | 2.5× |
| Chest 3 views (71047) | $185 | $206 | 2.1× |
| Chest 4 or more views (71048) | $185 | $206 | 1.7× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$222–$445 | $247–$494 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $712 | $791 | 6.7× |
| Contrast X-Ray Bladder (74430) | $1,311 | $1,457 | 3.7× |
| Contrast X-Ray Of Elbow (73085) | $2,369 | $2,632 | 6.6× |
| Contrast X-Ray Of Knee Joint (73580) | $2,369 | $2,632 | 6.6× |
| CT abdomen and pelvis without and with contrast (74178) | $2,257 | $2,508 | 6.3× |
| CT abdomen and pelvis without contrast (74176) | $1,718 | $1,909 | 7.0× |
| CT abdomen w contrast (74160) | $1,391 | $1,545 | 7.8× |
| CT abdomen w wo contrast (74170) | $1,854 | $2,060 | 10.3× |
| CT abdomen w/o contrast (74150) | $927 | $1,030 | 8.7× |
| CT Angio Abdomen and Pelvis (74174) | $2,535 | $2,817 | 7.1× |
| CT Angio Chest (71275) | $2,417 | $2,686 | 13.5× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,345–$2,665 | $1,494–$2,961 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$678–$1,400 | $753–$1,555 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,132–$2,860 | $2,369–$3,178 | varies |
| CT Angio Neck (70498) | $2,131 | $2,368 | 11.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$2,216–$3,365 | $2,462–$3,739 | varies |
| CT cervical spine w/ contrast (72126) | $1,449 | $1,610 | 4.1× |
| CT cervical spine w/o contrast (72125) | $986 | $1,095 | 9.2× |
| CT cervical spine w/wo cont (72127) | $1,913 | $2,125 | 10.7× |
| CT chest w contrast (71260) | $1,676 | $1,862 | 9.4× |
| CT chest w/wo contrast (71270) | $2,139 | $2,377 | 11.9× |
| CT head/brain with contrast (70460) | $1,439 | $1,599 | 8.0× |
| CT head/brain without and with contrast (70470) | $1,923 | $2,137 | 10.7× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$56–$335 | $62–$372 | varies |
| CT iac w contrast (70481) | $1,528 | $1,698 | 8.5× |
| CT l-spine w&w/o contrast (72133) | $1,938 | $2,153 | 10.8× |
| CT lower ext w/o (73700) range across 21 matching MRF lines |
$1,011–$1,425 | $1,123–$1,583 | varies |
| CT lower extremity w/contrast material (73701) range across 21 matching MRF lines |
$1,474–$2,624 | $1,638–$2,915 | varies |
| CT lumbar spine w contrast (72132) | $1,474 | $1,638 | 4.1× |
| CT lumbar spine w/o contrast (72131) | $1,011 | $1,123 | 9.5× |
| CT maxillofacial w contrast (70487) | $1,434 | $1,593 | 8.0× |
| CT maxillofacial wo contrast (70486) | $970 | $1,078 | 9.1× |
| CT neck tissue combo (70492) | $1,429 | $1,588 | 8.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,992 | $2,213 | 11.1× |
| CT orbits w/o contrast (70480) | $1,065 | $1,183 | 10.0× |
| CT pelvis w&w/o contrast (72194) | $1,938 | $2,153 | 10.8× |
| CT pelvis w/o contrast (72192) | $1,011 | $1,123 | 9.5× |
| CT scan of leg combo (73702) range across 21 matching MRF lines |
$1,474–$2,624 | $1,638–$2,915 | varies |
| CT scans face/jaw combo (70488) | $1,897 | $2,108 | 10.6× |
| CT soft tissue neck w contrast (70491) | $1,390 | $1,544 | 7.8× |
| CT soft tissue neck w/o contrast (70490) | $970 | $1,078 | 9.1× |
| CT thoracic spine w contrast (72129) | $1,474 | $1,638 | 8.2× |
| CT thoracic spine w/o contrast (72128) | $1,011 | $1,123 | 9.5× |
| CT thoracic spine w/wo cont (72130) | $1,474 | $1,638 | 8.2× |
| CT thorax w/o contrast (71250) range across 4 matching MRF lines |
$712–$1,212 | $791–$1,347 | varies |
| CT upper ext wo (73200) range across 21 matching MRF lines |
$1,011–$1,425 | $1,123–$1,583 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 21 matching MRF lines |
$1,841–$2,624 | $2,045–$2,915 | varies |
| CT upper extremity with contrast (73201) range across 21 matching MRF lines |
$1,474–$2,624 | $1,638–$2,915 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,535 | $2,817 | 14.1× |
| Cta Abdomen (74175) | $2,132 | $2,369 | 11.9× |
| CTA pelvis (72191) | $2,216 | $2,462 | 12.4× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $1,724 | $1,915 | 7.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $204 | $227 | 2.3× |
| Echo exam uterus (76831) | $1,724 | $1,915 | 7.1× |
| Echo Guide For Artery Repair (76936) | $1,125 | $1,250 | 5.1× |
| Esophagram (74220) | $1,311 | $1,457 | 7.3× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$712–$1,620 | $791–$1,800 | varies |
| Foot 2 views (73620) range across 6 matching MRF lines |
$204–$445 | $227–$494 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$203–$445 | $225–$494 | varies |
| Gastric emptying imaging study (78264) | $882 | $980 | 2.2× |
| Gated Heart Planar Single (78472) | $998 | $1,109 | 2.4× |
| Gated Heart, Multiple (78473) | $1,441 | $1,601 | 3.5× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$232–$603 | $258–$670 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,112 | $1,235 | 2.0× |
| Hepatobiliary System Imaging (78226) | $1,112 | $1,235 | 2.7× |
| Ht Muscle Image Spect Sing (78451) | $2,307 | $2,563 | 1.7× |
| Hysterosalpingogram (74740) | $1,724 | $1,915 | 7.1× |
| Infant hip ultrasound, limited static exam (76886) | $212 | $236 | 2.4× |
| Joint Survey Single View (77077) | $712 | $791 | 6.7× |
| K Flow/Funct Image Multiple (78709) | $1,036 | $1,151 | 1.9× |
| K Flow/Funct Image W/Drug (78708) | $1,150 | $1,278 | 2.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,150 | $1,278 | 2.1× |
| Kidney Imaging Morphol (78700) | $765 | $850 | 1.9× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$243–$485 | $270–$539 | varies |
| Leveen/Shunt Patency Exam (78291) | $734 | $815 | 1.8× |
| Liver & Spleen Imaging Static Only (78215) | $781 | $868 | 1.9× |
| Lung Ventilat&Perfus Imaging (78582) | $1,779 | $1,977 | 3.2× |
| Lymph System Imaging (78195) | $1,177 | $1,308 | 2.1× |
| Magnetic Image Jaw Joint (70336) | $1,126 | $1,251 | 4.6× |
| Meckels Divert Exam (78290) | $1,103 | $1,226 | 2.7× |
| Mra Head W/O & W/Contrast Material (70546) | $2,369 | $2,632 | 6.6× |
| MRA head w/o contrast (70544) | $1,724 | $1,915 | 7.1× |
| MRA neck w contrast (70548) | $1,635 | $1,817 | 4.6× |
| MRA neck w/o contrast (70547) | $1,724 | $1,915 | 7.1× |
| MRI abdomen w contrast (74182) | $2,369 | $2,632 | 6.6× |
| MRI abdomen w/o contrast (74181) | $1,724 | $1,915 | 7.1× |
| MRI any jt lower extrem w/contrast material (73722) range across 9 matching MRF lines |
$2,080–$3,120 | $2,311–$3,467 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 12 matching MRF lines |
$2,543–$4,739 | $2,826–$5,265 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 8 matching MRF lines |
$2,123–$2,187 | $2,359–$2,430 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,724 | $1,915 | 7.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,724 | $1,915 | 7.1× |
| MRI cardiac w/o contrast (75557) | $1,724 | $1,915 | 7.1× |
| MRI cervical spine w contrast (72142) | $2,257 | $2,508 | 6.3× |
| MRI cervical spine w/o cont (72141) | $1,794 | $1,993 | 7.4× |
| MRI chest w/o contrast (71550) | $2,343 | $2,603 | 9.6× |
| MRI chest wo w contrast (71552) | $3,195 | $3,550 | 9.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 12 matching MRF lines |
$2,080–$3,199 | $2,311–$3,554 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 12 matching MRF lines |
$2,543–$4,739 | $2,826–$5,265 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 12 matching MRF lines |
$1,616–$3,447 | $1,796–$3,830 | varies |
| MRI lumbar spine w contrast (72149) | $2,257 | $2,508 | 6.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,721 | $3,023 | 7.6× |
| MRI orbit face &/neck w/o contrast (70540) | $1,724 | $1,915 | 7.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,986 | $3,318 | 8.4× |
| MRI pelvis w contrast (72196) | $2,725 | $3,028 | 7.6× |
| MRI pelvis w/o & w contrast (72197) | $2,986 | $3,318 | 8.4× |
| MRI pelvis w/o contrast (72195) | $2,262 | $2,513 | 9.3× |
| MRI thoracic spine w/o contrast (72146) | $2,080 | $2,311 | 8.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 12 matching MRF lines |
$2,187–$4,739 | $2,430–$5,265 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 12 matching MRF lines |
$1,724–$3,447 | $1,915–$3,830 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 12 matching MRF lines |
$2,651–$4,739 | $2,945–$5,265 | varies |
| MRI, abdomen, combo (74183) | $2,986 | $3,318 | 8.4× |
| MRI, dorsal spine combo (72157) | $2,721 | $3,023 | 7.6× |
| MRI, dorsal spine contrast (72147) | $2,257 | $2,508 | 6.3× |
| MRI, joint upper extrem (73221) range across 12 matching MRF lines |
$1,660–$3,447 | $1,844–$3,830 | varies |
| MRI, joint upper extrem combo (73223) range across 12 matching MRF lines |
$2,587–$4,739 | $2,874–$5,265 | varies |
| MRI, lumbar spine combo (72158) | $2,721 | $3,023 | 7.6× |
| Musculoskeletal Nuclear Exam (78399) | $852 | $947 | 2.1× |
| Myelogram cervical (72240) | $3,541 | $3,934 | 4.4× |
| Myelogram Lumbar (72265) | $3,541 | $3,934 | 4.4× |
| Myelography thoracic (72255) | $3,541 | $3,934 | 4.4× |
| Myelograpy 2/more regions rs&i (72270) | $3,541 | $3,934 | 4.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $806 | $896 | 2.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,695 | $4,105 | 2.8× |
| Myocardial Spect Multiple Studies (78452) | $2,424 | $2,693 | 1.8× |
| Neck soft tissue (70360) | $229 | $254 | 2.6× |
| Nervous system nuclear exam (78699) | $852 | $947 | 2.1× |
| Nm csf leak detection (78650) | $1,371 | $1,523 | 1.0× |
| Nm myocard infarct spect (78469) | $2,637 | $2,930 | 4.8× |
| Nm red cell survival study (78130) range across 2 matching MRF lines |
$15–$76 | $17–$84 | varies |
| Nm unlisted gi procedure (78299) | $852 | $947 | 2.1× |
| Nm whole blood volume (78122) | $689 | $766 | 1.2× |
| Nuclear Rx Oral Admin (79005) range across 3 matching MRF lines |
$1,303–$1,304 | $1,448–$1,449 | varies |
| Panoramic X-ray of jaws (70355) | $204 | $227 | 2.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $878 | $975 | 1.6× |
| Parathyroid Planar Imaging (78070) | $720 | $800 | 1.8× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$303–$712 | $337–$791 | varies |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) | $2 | $2 | 0.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,020 | $1,133 | 2.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $253 | $281 | 2.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$233–$464 | $259–$516 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$222–$445 | $247–$494 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$233–$464 | $259–$516 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $712 | $791 | 6.7× |
| Radex fingr minimum 2 views (73140) | $222 | $247 | 2.5× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$233–$464 | $259–$516 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$343–$649 | $381–$721 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$204–$408 | $227–$453 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $1,425 | $1,583 | 13.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $229 | $254 | 2.6× |
| Radex Ribs Unilateral 2 Views (71100) | $253 | $281 | 2.8× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$222–$445 | $247–$494 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $204 | $227 | 2.3× |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$185–$204 | $206–$227 | varies |
| Radex Sternum Minimum 2 Views (71120) | $209 | $232 | 2.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $204 | $227 | 2.3× |
| Radex Toe Minimum 2 Views (73660) | $204 | $227 | 2.3× |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$204–$408 | $227–$453 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$343–$696 | $381–$773 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $712 | $791 | 6.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $185 | $206 | 1.7× |
| Radiologic exam colon single contrast study (74270) | $1,311 | $1,457 | 7.3× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$712–$1,425 | $791–$1,583 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $712 | $791 | 6.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $712 | $791 | 4.0× |
| Radiologic exam swallow function contrast study (74230) | $712 | $791 | 4.0× |
| Radiologic exam teeth complete full mouth (70320) | $1,724 | $1,915 | 7.1× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $1,724 | $1,915 | 7.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,311 | $1,457 | 7.3× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$204–$408 | $227–$453 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$222–$408 | $247–$453 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$222–$445 | $247–$494 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $712 | $791 | 6.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$209–$445 | $232–$494 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) | $204 | $227 | 2.3× |
| Ribs bilateral 3 views (71110) | $371 | $412 | 3.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $724 | $804 | 3.0× |
| Rp Therapy Intravenous Administration (79101) | $660 | $733 | 2.8× |
| Salivary Gland Function Study (78232) | $550 | $611 | 1.3× |
| Salivary Gland Imaging Serial Images (78231) | $494 | $549 | 1.2× |
| Scapula (73010) range across 3 matching MRF lines |
$255–$464 | $283–$515 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $82 | $91 | 3.5× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$255–$464 | $283–$515 | varies |
| Shoulder Arthrography (73040) | $2,369 | $2,632 | 6.6× |
| Sialogram (70390) | $1,724 | $1,915 | 7.1× |
| Skull less than 4 views (70250) | $712 | $791 | 6.7× |
| Sternoclavicular joints (71130) | $185 | $206 | 2.1× |
| Testicular Imaging W/Flow (78761) | $678 | $753 | 1.7× |
| Thoracic spine 2 views (72070) | $213 | $237 | 2.0× |
| Thoracic spine 3 views (72072) | $303 | $337 | 2.8× |
| Thoracolumbar 2 views (72080) | $209 | $232 | 2.4× |
| Thyroid Imaging With Vascular Flow (78013) | $867 | $963 | 2.1× |
| Thyroid Met Imaging Body (78018) | $1,262 | $1,402 | 2.3× |
| Thyroid Uptake Measurement (78012) | $828 | $920 | 2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $791 | $879 | 1.9× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$204–$233 | $227–$259 | varies |
| Ultrasound Exam Aaa Screen (76706) | $316 | $351 | 3.0× |
| Ultrasound, abdomen limited (76705) range across 7 matching MRF lines |
$347–$712 | $385–$791 | varies |
| Umbilical-artery Doppler (OB) (76820) | $712 | $791 | 6.7× |
| Upper gi w/o kub (74240) | $1,311 | $1,457 | 7.3× |
| Ureteral Reflux Study (78740) | $626 | $696 | 1.5× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$712–$776 | $791–$862 | varies |
| Us chest (76604) | $712 | $791 | 6.7× |
| Us exam, pelvic, limited (76857) | $712 | $791 | 6.7× |
| Us head (76506) | $712 | $791 | 6.7× |
| Us kidney transplant (76776) | $712 | $791 | 6.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$204–$336 | $227–$373 | varies |
| Us ob detailed single fetus (76811) | $712 | $791 | 2.9× |
| Us ob limited 1 or more fetuses (76815) | $712 | $791 | 6.7× |
| Us ob transvaginal (76817) | $712 | $791 | 6.7× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$354–$712 | $393–$791 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $776 | $862 | 7.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$712–$776 | $791–$862 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$363–$712 | $403–$791 | varies |
| Us retroperitoneal limited (76775) | $175 | $194 | 1.6× |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$423–$712 | $470–$791 | varies |
| Us spinal canal and contents (76800) | $712 | $791 | 6.7× |
| Us thyroid (76536) | $414 | $460 | 3.9× |
| Us transrectal (76872) | $712 | $791 | 6.7× |
| Vascular Flow Imaging (78445) | $667 | $741 | 1.6× |
| Vasogram (74440) | $1,724 | $1,915 | 7.1× |
| Venography extremity bilateral rs&i (75822) | $2,312 | $2,569 | 1.4× |
| Venography extremity unilateral rs&i (75820) | $1,683 | $1,870 | 1.0× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$232–$603 | $258–$670 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $204 | $227 | 2.3× |
| X-Ray Bend Only L-S Spine (72120) | $338 | $376 | 3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$203–$408 | $225–$453 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $209 | $232 | 2.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$185–$209 | $206–$232 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $278 | $309 | 2.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $306 | $340 | 3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 5 matching MRF lines |
$204–$649 | $227–$721 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 4 matching MRF lines |
$445–$1,425 | $494–$1,583 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $603 | $670 | 5.6× |
| X-Ray Exam L-S Spine Bending (72114) | $338 | $376 | 3.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$185–$203 | $206–$225 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $185 | $206 | 1.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $303 | $337 | 2.8× |
| X-ray eye for foreign body (70030) | $204 | $227 | 2.3× |
| X-ray humerus (73060) range across 6 matching MRF lines |
$203–$445 | $225–$494 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,311 | $1,457 | 7.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $229 | $254 | 2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $204 | $227 | 2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $303 | $337 | 2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $603 | $670 | 5.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $712 | $791 | 6.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $712 | $791 | 6.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $222 | $247 | 2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $229 | $254 | 2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $712 | $791 | 6.7× |
| X-Ray Tmj Unilat (70328) | $204 | $227 | 2.3× |
| X-Rays Bone Length Studies (77073) | $712 | $791 | 6.7× |
| X-Rays Bone Survey Complete (77075) | $712 | $791 | 6.7× |
| Xr c-spine 4 or 5 views (72050) | $185 | $206 | 1.7× |
| Xr facial bones less than 3 views (70140) | $229 | $254 | 2.6× |
| Xr orbits complete 4 views (70200) | $712 | $791 | 6.7× |
| Xr Tomogram Single Plane (76100) | $712 | $791 | 6.7× |
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.