Imaging prices at Munson Healthcare Charlevoix Hospital
Charlevoix, MI · every code in this section with a posted price and a Medicare benchmark.
247 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) | $108.80 | $128 | 1.3× |
| Abdomen 2 views (74019) | $164.90 | $194 | 1.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $622.20 | $732 | 1.6× |
| Ankle 2 views (73600) | $101.15 | $119 | 1.2× |
| Arthrogram hip (73525) | $488.75 | $575 | 1.4× |
| Bone age studies (77072) | $178.50 | $210 | 1.7× |
| Bone Imaging 3 Phase (78315) | $645.15 | $759 | 1.6× |
| Bone Imaging Whole Body (78306) | $630.70 | $742 | 1.6× |
| Bone survey infant (77076) | $183.60 | $216 | 1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $6,282.35 | $7,391 | 4.4× |
| Chest 1 view (71045) range across 10 matching MRF lines |
$87.55–$91.80 | $103–$108 | varies |
| Chest 2 views (71046) | $138.55 | $163 | 1.6× |
| Chest 3 views (71047) | $138.55 | $163 | 1.6× |
| Chest 4 or more views (71048) | $102.85 | $121 | 1.0× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $294.10 | $346 | 2.8× |
| Clavicle complete (73000) | $108.80 | $128 | 1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $363.80 | $428 | 3.5× |
| Contrast X-Ray Bladder (74430) | $163.20 | $192 | 0.5× |
| Contrast X-Ray Of Knee Joint (73580) | $483.65 | $569 | 1.4× |
| CT abdomen and pelvis without and with contrast (74178) | $2,376.60 | $2,796 | 6.8× |
| CT abdomen and pelvis without contrast (74176) | $1,984.75 | $2,335 | 8.3× |
| CT abdomen w contrast (74160) | $1,103.30 | $1,298 | 6.3× |
| CT abdomen w wo contrast (74170) | $1,188.30 | $1,398 | 6.8× |
| CT abdomen w/o contrast (74150) | $924.80 | $1,088 | 8.9× |
| CT Angio Abdomen and Pelvis (74174) | $3,125.45 | $3,677 | 9.0× |
| CT Angio Chest (71275) | $1,937.15 | $2,279 | 11.1× |
| CT Angio Head (70496) | $1,652.40 | $1,944 | 9.5× |
| CT angio hrt w/3d image (75574) | $1,418.65 | $1,669 | 4.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,770.55 | $2,083 | 10.1× |
| CT Angio Neck (70498) | $1,822.40 | $2,144 | 10.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,877.65 | $2,209 | 10.7× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $228.65 | $269 | 1.3× |
| CT cervical spine w/ contrast (72126) | $1,281.80 | $1,508 | 3.7× |
| CT cervical spine w/o contrast (72125) | $1,112.65 | $1,309 | 10.7× |
| CT cervical spine w/wo cont (72127) | $1,289.45 | $1,517 | 7.4× |
| CT chest w contrast (71260) | $1,058.25 | $1,245 | 6.1× |
| CT chest w/wo contrast (71270) | $1,058.25 | $1,245 | 6.1× |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$1,049.75–$1,050.60 | $1,235–$1,236 | varies |
| CT head/brain without and with contrast (70470) | $1,142.40 | $1,344 | 6.5× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,441.20 | $2,872 | 7.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $255 | $300 | 2.9× |
| CT iac w contrast (70481) | $954.55 | $1,123 | 5.5× |
| CT l-spine w&w/o contrast (72133) | $1,366.80 | $1,608 | 7.8× |
| CT lower ext w/o (73700) | $759.90 | $894 | 7.3× |
| CT lower extremity w/contrast material (73701) | $935.85 | $1,101 | 5.4× |
| CT lumbar spine w contrast (72132) | $1,281.80 | $1,508 | 3.7× |
| CT lumbar spine w/o contrast (72131) | $1,112.65 | $1,309 | 10.7× |
| CT maxillofacial w contrast (70487) | $944.35 | $1,111 | 5.4× |
| CT maxillofacial wo contrast (70486) | $767.55 | $903 | 7.4× |
| CT neck tissue combo (70492) | $1,041.25 | $1,225 | 6.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,976.25 | $2,325 | 11.3× |
| CT orbits w/o contrast (70480) | $788.80 | $928 | 7.6× |
| CT pelvis w/o contrast (72192) range across 5 matching MRF lines |
$923.95–$924.80 | $1,087–$1,088 | varies |
| CT scans face/jaw combo (70488) | $1,021.70 | $1,202 | 5.8× |
| CT soft tissue neck w contrast (70491) range across 5 matching MRF lines |
$935–$963.05 | $1,100–$1,133 | varies |
| CT soft tissue neck w/o contrast (70490) range across 5 matching MRF lines |
$765.85–$788.80 | $901–$928 | varies |
| CT thoracic spine w contrast (72129) | $1,269.90 | $1,494 | 7.3× |
| CT thoracic spine w/o contrast (72128) | $1,112.65 | $1,309 | 10.7× |
| CT thorax w/o contrast (71250) | $886.55 | $1,043 | 8.5× |
| CT unlisted procedure (76497) | $707.20 | $832 | 8.2× |
| CT upper ext wo (73200) | $759.90 | $894 | 7.3× |
| CT upper extremity with contrast (73201) | $935.85 | $1,101 | 2.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,125.45 | $3,677 | 17.9× |
| Cta Abdomen (74175) | $1,984.75 | $2,335 | 11.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,737.40 | $2,044 | 5.0× |
| CTA pelvis (72191) | $1,964.35 | $2,311 | 11.2× |
| Dxa Bone Density Axial (77080) | $172.55 | $203 | 1.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $357 | $420 | 4.1× |
| Esophagram (74220) | $207.40 | $244 | 1.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $680 | $800 | 6.5× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$183.60–$776.90 | $216–$914 | varies |
| Foot 2 views (73620) | $84.15 | $99 | 1.0× |
| Forearm 2 views (73090) | $108.80 | $128 | 1.3× |
| Gastric emptying imaging study (78264) | $622.20 | $732 | 1.6× |
| Gastroesophageal Reflux Exam (78262) | $622.20 | $732 | 1.6× |
| Gated Heart Planar Single (78472) range across 5 matching MRF lines |
$124.10–$764.15 | $146–$899 | varies |
| Hand 2 views (73120) | $78.20 | $92 | 0.8× |
| Hepatobil Syst Image W/Drug (78227) | $630.70 | $742 | 1.2× |
| Hepatobiliary System Imaging (78226) | $1,763.75 | $2,075 | 4.4× |
| Ht Muscle Image Spect Sing (78451) | $734.40 | $864 | 0.6× |
| Hysterosalpingogram (74740) | $1,039.55 | $1,223 | 4.4× |
| K Flow/Funct Image Multiple (78709) range across 3 matching MRF lines |
$327.25–$592.45 | $385–$697 | varies |
| K Flow/Funct Image W/Drug (78708) range across 5 matching MRF lines |
$327.25–$1,088.85 | $385–$1,281 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $327.25 | $385 | 0.8× |
| Knee 3 Views (73562) | $79.90 | $94 | 0.9× |
| Liver & Spleen Imaging Static Only (78215) | $391 | $460 | 1.0× |
| Lung Ventilat&Perfus Imaging (78582) | $511.70 | $602 | 0.9× |
| Lymph System Imaging (78195) | $669.80 | $788 | 1.2× |
| Magnetic Image Jaw Joint (70336) | $2,022.15 | $2,379 | 8.5× |
| Mammary ductogram or galactogram multiple (77054) | $600.95 | $707 | 2.5× |
| Mammary ductogram or galactogram single (77053) | $498.95 | $587 | 2.1× |
| Meckels Divert Exam (78290) | $411.40 | $484 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $3,952.50 | $4,650 | 11.4× |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$1,736.55–$2,042.55 | $2,043–$2,403 | varies |
| MRA head with contrast (70545) | $2,658.80 | $3,128 | 7.6× |
| MRA neck w contrast (70548) | $2,658.80 | $3,128 | 7.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,122.05 | $3,673 | 9.0× |
| MRA neck w/o contrast (70547) | $1,712.75 | $2,015 | 7.2× |
| MRI abdomen w contrast (74182) | $2,832.20 | $3,332 | 8.1× |
| MRI abdomen w/o contrast (74181) | $2,042.55 | $2,403 | 8.6× |
| MRI any jt lower extrem w/contrast material (73722) | $2,442.05 | $2,873 | 3.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,726.40 | $4,384 | 10.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,442.05 | $2,873 | 3.1× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,215.10 | $2,606 | 9.3× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,456.05 | $1,713 | 6.1× |
| MRI cervical spine w contrast (72142) | $2,861.10 | $3,366 | 8.2× |
| MRI cervical spine w/o cont (72141) | $2,092.70 | $2,462 | 8.8× |
| MRI chest w/o contrast (71550) | $2,042.55 | $2,403 | 8.6× |
| MRI chest with contrast (71551) | $2,832.20 | $3,332 | 3.6× |
| MRI chest wo w contrast (71552) | $3,090.60 | $3,636 | 8.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,302.65 | $2,709 | 6.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,875.15 | $4,559 | 11.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,068.90 | $2,434 | 8.7× |
| MRI lumbar spine w contrast (72149) | $2,189.60 | $2,576 | 6.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,444.65 | $5,229 | 12.8× |
| MRI orbit face &/neck w/o contrast (70540) | $1,712.75 | $2,015 | 7.2× |
| MRI orbit face neck w contrast (70542) | $2,832.20 | $3,332 | 8.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,122.05 | $3,673 | 9.0× |
| MRI pelvis w contrast (72196) | $2,366.40 | $2,784 | 6.8× |
| MRI pelvis w/o & w contrast (72197) | $3,392.35 | $3,991 | 9.8× |
| MRI pelvis w/o contrast (72195) | $2,042.55 | $2,403 | 8.6× |
| MRI thoracic spine w/o contrast (72146) | $2,079.95 | $2,447 | 8.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,492.20 | $2,932 | 7.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,059.55 | $2,423 | 8.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,952.50 | $4,650 | 11.4× |
| MRI, abdomen, combo (74183) | $3,201.95 | $3,767 | 9.2× |
| MRI, dorsal spine combo (72157) | $4,371.55 | $5,143 | 12.6× |
| MRI, dorsal spine contrast (72147) | $2,832.20 | $3,332 | 8.1× |
| MRI, joint upper extrem (73221) | $2,068.90 | $2,434 | 8.7× |
| MRI, joint upper extrem combo (73223) | $3,726.40 | $4,384 | 10.7× |
| MRI, lumbar spine combo (72158) | $4,222.80 | $4,968 | 12.1× |
| Myocardial Spect Multiple Studies (78452) | $1,484.10 | $1,746 | 1.2× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $1,212.95 | $1,427 | 0.9× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $4,606.15 | $5,419 | 2.1× |
| Neck soft tissue (70360) | $84.15 | $99 | 1.0× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $702.10 | $826 | 5.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$315.35–$335.75 | $371–$395 | varies |
| Parathyroid Planar Imaging (78070) | $527.85 | $621 | 1.3× |
| Pelvis 1 or 2 views (72170) | $108.80 | $128 | 1.0× |
| PET image w/CT, full body (78816) | $5,884.55 | $6,923 | 4.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,884.55 | $6,923 | 4.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $511.70 | $602 | 1.3× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,211.25 | $1,425 | 1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $203.15 | $239 | 2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,061.25 | $2,425 | 3.8× |
| Radex Ankle Complete Minimum 3 Views (73610) | $134.30 | $158 | 1.5× |
| Radex Calcaneus Minimum 2 Views (73650) | $108.80 | $128 | 1.3× |
| Radex elbow complete minimum 3 views (73080) | $134.30 | $158 | 1.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $207.40 | $244 | 2.0× |
| Radex fingr minimum 2 views (73140) | $84.15 | $99 | 1.0× |
| Radex foot complete minimum 3 views (73630) | $134.30 | $158 | 1.5× |
| Radex Hand Minimum 3 Views (73130) | $107.10 | $126 | 1.2× |
| Radex lower extremity infant minimum 2 views (73592) | $162.35 | $191 | 1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $163.20 | $192 | 1.9× |
| Radex Ribs Unilateral 2 Views (71100) | $163.20 | $192 | 1.9× |
| Radex shoulder complete minimum 2 views (73030) | $163.20 | $192 | 1.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $89.25 | $105 | 1.0× |
| Radex Spine 1 View Specify Level (72020) | $146.20 | $172 | 1.7× |
| Radex Sternum Minimum 2 Views (71120) | $138.55 | $163 | 1.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $204.85 | $241 | 2.4× |
| Radex Toe Minimum 2 Views (73660) | $84.15 | $99 | 1.0× |
| Radex Wrist Complete Minimum 3 Views (73110) | $134.30 | $158 | 1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $207.40 | $244 | 2.0× |
| Radiologic exam colon double contrast study (74280) | $476 | $560 | 2.7× |
| Radiologic exam colon single contrast study (74270) range across 5 matching MRF lines |
$417.35–$438.60 | $491–$516 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $478.55 | $563 | 2.7× |
| Radiologic exam knee complete 4/more views (73564) | $134.30 | $158 | 1.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $164.90 | $194 | 1.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $264.35 | $311 | 1.5× |
| Radiologic exam swallow function contrast study (74230) | $391.85 | $461 | 2.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $810.90 | $954 | 4.6× |
| Radiologic examination femur minimum 2 views (73552) | $163.20 | $192 | 1.9× |
| Radiologic examination knee 1/2 views (73560) | $84.15 | $99 | 1.0× |
| Radiologic examination tibia & fibula 2 views (73590) | $108.80 | $128 | 1.3× |
| Ribs bilateral 3 views (71110) | $207.40 | $244 | 2.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $507.45 | $597 | 1.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,643.90 | $1,934 | 3.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines |
$129.20–$646.85 | $152–$761 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,852.20 | $4,532 | 3.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $4,709 | $5,540 | 3.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 4 matching MRF lines |
$122.40–$2,603.55 | $144–$3,063 | varies |
| Scapula (73010) | $164.90 | $194 | 1.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $161.50 | $190 | 6.9× |
| Shoulder 1 view (73020) | $128.35 | $151 | 1.5× |
| Shoulder Arthrography (73040) | $496.40 | $584 | 1.4× |
| Skull less than 4 views (70250) | $207.40 | $244 | 2.0× |
| Sternoclavicular joints (71130) | $176.80 | $208 | 2.0× |
| Thoracic spine 2 views (72070) | $163.20 | $192 | 1.6× |
| Thoracic spine 3 views (72072) | $183.60 | $216 | 1.8× |
| Thoracolumbar 2 views (72080) | $163.20 | $192 | 1.9× |
| Thyroid Imaging With Vascular Flow (78013) | $267.75 | $315 | 0.7× |
| Thyroid Uptake Measurement (78012) | $224.40 | $264 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $433.50 | $510 | 1.1× |
| Ultrasound Breast Limited (76642) | $498.10 | $586 | 5.7× |
| Ultrasound elastography first target lesion (76982) | $538.05 | $633 | 5.2× |
| Ultrasound Elastography Parenchyma (76981) | $597.55 | $703 | 5.7× |
| Ultrasound Exam Aaa Screen (76706) | $564.40 | $664 | 5.4× |
| Ultrasound, abdomen limited (76705) range across 11 matching MRF lines |
$446.25–$734.40 | $525–$864 | varies |
| Umbilical-artery Doppler (OB) (76820) | $181.05 | $213 | 1.7× |
| Unlisted us procedure (76999) | $384.20 | $452 | 4.4× |
| Upper gi w/o kub (74240) | $442.85 | $521 | 2.5× |
| Urethrocystogram voiding (74455) | $337.45 | $397 | 1.4× |
| Urethrocystography retrograde (74450) | $679.15 | $799 | 2.9× |
| Us breast unilateral complete (76641) | $498.10 | $586 | 4.8× |
| Us chest (76604) range across 6 matching MRF lines |
$299.20–$650.25 | $352–$765 | varies |
| Us exam, pelvic, limited (76857) | $430.10 | $506 | 4.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 11 matching MRF lines |
$453.05–$538.05 | $533–$633 | varies |
| Us ob detailed single fetus (76811) | $564.40 | $664 | 2.4× |
| Us ob limited 1 or more fetuses (76815) | $242.25 | $285 | 2.3× |
| Us pelvic non ob complete (76856) | $494.70 | $582 | 4.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $436.05 | $513 | 4.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 19 matching MRF lines |
$606.05–$623.90 | $713–$734 | varies |
| Us retroperitoneal complete (76770) | $564.40 | $664 | 5.4× |
| Us retroperitoneal limited (76775) | $446.25 | $525 | 4.3× |
| Us scrotum and contents (76870) | $503.20 | $592 | 4.8× |
| Us thyroid (76536) | $453.05 | $533 | 4.3× |
| Us transrectal (76872) | $935.85 | $1,101 | 9.0× |
| Wrist 2 views (73100) | $84.15 | $99 | 1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $163.20 | $192 | 1.9× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$198.90–$536.35 | $234–$631 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $84.15 | $99 | 1.0× |
| X-Ray Exam Breast Specimen (76098) | $702.95 | $827 | 1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $96.90 | $114 | 1.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $360.40 | $424 | 3.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $163.20 | $192 | 1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $164.90 | $194 | 1.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $181.90 | $214 | 1.7× |
| X-Ray Exam L-S Spine Bending (72114) | $207.40 | $244 | 2.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$158.10–$198.90 | $186–$234 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $207.40 | $244 | 2.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $183.60 | $216 | 1.8× |
| X-ray humerus (73060) | $108.80 | $128 | 1.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $107.10 | $126 | 1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $161.50 | $190 | 1.6× |
| X-ray nose-rectum child f.b. (76010) | $776.90 | $914 | 9.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $222.70 | $262 | 2.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $163.20 | $192 | 1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $163.20 | $192 | 1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $207.40 | $244 | 2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $207.40 | $244 | 2.0× |
| X-ray thoracic spine 4 vw (72074) | $536.35 | $631 | 5.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $490.45 | $577 | 1.4× |
| X-Rays Bone Length Studies (77073) | $176.80 | $208 | 1.7× |
| X-Rays Bone Survey Complete (77075) | $273.70 | $322 | 2.6× |
| Xr c-spine 4 or 5 views (72050) | $198.90 | $234 | 1.9× |
| Xr facial bones less than 3 views (70140) | $253.30 | $298 | 2.9× |
| Xr orbits complete 4 views (70200) | $163.20 | $192 | 1.6× |
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.