Imaging prices at MyMichigan Medical Center Clare
Clare, MI · every code in this section with a posted price and a Medicare benchmark.
300 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) | $124.80 | $208 | 1.4× |
| Abdomen 2 views (74019) | $126.60 | $211 | 1.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $612 | $1,020 | 1.5× |
| Angio pulmonary bilat (75743) | $902.40 | $1,504 | 0.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $702 | $1,170 | 0.2× |
| Angiography extremity bilateral rs&i (75716) | $874.20 | $1,457 | 0.3× |
| Angiography extremity unilateral rs&i (75710) | $1,564.80 | $2,608 | 0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $673.20 | $1,122 | 0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $743.40 | $1,239 | 0.2× |
| Ankle 2 views (73600) | $118.80 | $198 | 1.4× |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$874.20 | $1,457 | 0.2× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$874.20 | $1,457 | 0.2× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$902.40 | $1,504 | 0.2× |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$421.80–$723.60 | $703–$1,206 | varies |
| Arthrogram ankle (73615) | $307.20 | $512 | 0.9× |
| Arthrogram hip (73525) | $303.60 | $506 | 0.9× |
| Arthrogram Wrist (73115) | $272.40 | $454 | 0.8× |
| Bone age studies (77072) | $124.80 | $208 | 1.2× |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$942.60–$1,020 | $1,571–$1,700 | varies |
| Bone Imaging Limited Area (78300) | $558 | $930 | 1.4× |
| Bone Imaging Whole Body (78306) | $1,014.60 | $1,691 | 2.5× |
| Bone marrow imaging limited area (78102) | $543.60 | $906 | 1.4× |
| Bone marrow imaging; multiple areas (78103) | $546.60 | $911 | 1.4× |
| Bone marrow imaging; whole body (78104) | $703.80 | $1,173 | 1.8× |
| Bone survey infant (77076) | $124.80 | $208 | 1.2× |
| Cat Scan Follow-Up Study (76380) | $361.20 | $602 | 4.2× |
| Chest 1 view (71045) | $162 | $270 | 1.9× |
| Chest 2 views (71046) range across 3 matching MRF lines |
$71.40–$206.40 | $119–$344 | varies |
| Chest 3 views (71047) | $229.80 | $383 | 2.7× |
| Chest 4 or more views (71048) | $215.40 | $359 | 2.1× |
| Clavicle complete (73000) | $104.40 | $174 | 1.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,481.40 | $2,469 | 14.2× |
| Contrast Exam Abdominl Aorta (75625) | $874.20 | $1,457 | 0.3× |
| Contrast X-Ray Bladder (74430) | $248.40 | $414 | 0.7× |
| Contrast X-Ray Of Elbow (73085) | $302.40 | $504 | 0.9× |
| Contrast X-Ray Of Knee Joint (73580) | $361.20 | $602 | 1.0× |
| CT abdomen and pelvis without and with contrast (74178) | $1,773 | $2,955 | 5.1× |
| CT abdomen and pelvis without contrast (74176) | $1,773 | $2,955 | 7.5× |
| CT abdomen w contrast (74160) | $1,156.20 | $1,927 | 6.6× |
| CT abdomen w wo contrast (74170) | $1,300.80 | $2,168 | 7.4× |
| CT abdomen w/o contrast (74150) | $1,012.20 | $1,687 | 9.7× |
| CT Angio Abdomen and Pelvis (74174) | $2,529.60 | $4,216 | 7.3× |
| CT Angio Chest (71275) | $1,372.80 | $2,288 | 7.9× |
| CT Angio Head (70496) | $1,228.80 | $2,048 | 7.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,156.20 | $1,927 | 6.6× |
| CT Angio Neck (70498) | $1,228.80 | $2,048 | 7.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,300.80 | $2,168 | 7.4× |
| CT cervical spine w/ contrast (72126) | $1,084.80 | $1,808 | 3.1× |
| CT cervical spine w/o contrast (72125) | $1,156.20 | $1,927 | 11.1× |
| CT cervical spine w/wo cont (72127) | $1,156.20 | $1,927 | 6.6× |
| CT chest w contrast (71260) | $1,084.80 | $1,808 | 6.2× |
| CT chest w/wo contrast (71270) | $1,228.80 | $2,048 | 7.0× |
| CT head/brain with contrast (70460) | $1,012.20 | $1,687 | 5.8× |
| CT head/brain without and with contrast (70470) | $1,228.80 | $2,048 | 7.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $59.40 | $99 | 0.7× |
| CT iac w contrast (70481) | $1,084.80 | $1,808 | 6.2× |
| CT l-spine w&w/o contrast (72133) | $1,156.20 | $1,927 | 6.6× |
| CT lower ext w/o (73700) | $1,012.20 | $1,687 | 9.7× |
| CT lower extremity w/contrast material (73701) | $1,012.20 | $1,687 | 5.8× |
| CT lumbar spine w contrast (72132) | $1,084.80 | $1,808 | 3.1× |
| CT lumbar spine w/o contrast (72131) | $1,084.80 | $1,808 | 10.4× |
| CT maxillofacial w contrast (70487) | $1,012.20 | $1,687 | 5.8× |
| CT maxillofacial wo contrast (70486) | $867 | $1,445 | 8.3× |
| CT neck tissue combo (70492) | $1,156.20 | $1,927 | 6.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,228.80 | $2,048 | 7.0× |
| CT orbits w/o contrast (70480) | $1,012.20 | $1,687 | 9.7× |
| CT pelvis w&w/o contrast (72194) | $1,300.80 | $2,168 | 7.4× |
| CT pelvis w/o contrast (72192) | $1,228.80 | $2,048 | 11.8× |
| CT scan of leg combo (73702) | $1,273.20 | $2,122 | 7.3× |
| CT scans face/jaw combo (70488) | $1,446.60 | $2,411 | 8.3× |
| CT soft tissue neck w contrast (70491) | $1,012.20 | $1,687 | 5.8× |
| CT soft tissue neck w/o contrast (70490) | $1,156.20 | $1,927 | 11.1× |
| CT thoracic spine w contrast (72129) | $1,084.80 | $1,808 | 6.2× |
| CT thoracic spine w/o contrast (72128) | $1,084.80 | $1,808 | 10.4× |
| CT thoracic spine w/wo cont (72130) | $1,156.20 | $1,927 | 6.6× |
| CT thorax w/o contrast (71250) | $1,012.20 | $1,687 | 9.7× |
| CT upper ext wo (73200) | $1,012.20 | $1,687 | 9.7× |
| CT upper extremity w/o & w/contrast material (73202) | $1,084.80 | $1,808 | 6.2× |
| CT upper extremity with contrast (73201) | $1,084.80 | $1,808 | 3.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,300.80 | $2,168 | 7.4× |
| Cta Abdomen (74175) | $1,300.80 | $2,168 | 7.4× |
| CTA pelvis (72191) | $1,300.80 | $2,168 | 7.4× |
| Discography Cerv/Thor Spine (72285) | $2,797.20 | $4,662 | 1.4× |
| Diskography lumbar (72295) | $2,797.20 | $4,662 | 1.4× |
| Dxa Bone Density Axial (77080) | $266.40 | $444 | 2.6× |
| Dxa bone density study (77085) | $266.40 | $444 | 2.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $58.20 | $97 | 0.7× |
| Echo Guide For Artery Repair (76936) | $280.80 | $468 | 1.3× |
| Esophagram (74220) | $286.20 | $477 | 1.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $232.20 | $387 | 2.2× |
| Fluoroscopy up to 1 hr (76000) | $159.60 | $266 | 0.7× |
| Follow-Up Angiography (75898) | $960.60 | $1,601 | 0.3× |
| Foot 2 views (73620) | $118.80 | $198 | 1.4× |
| Forearm 2 views (73090) | $130.20 | $217 | 1.5× |
| Gastric emptying imaging study (78264) | $623.40 | $1,039 | 1.6× |
| Gated Heart Planar Single (78472) | $1,273.20 | $2,122 | 3.2× |
| Hand 2 views (73120) | $112.20 | $187 | 1.1× |
| Heart first pass single,planar (78481) | $610.80 | $1,018 | 1.1× |
| Hepatobil Syst Image W/Drug (78227) | $744.60 | $1,241 | 1.4× |
| Hepatobiliary System Imaging (78226) | $675.60 | $1,126 | 1.7× |
| Ht Muscle Image Spect Sing (78451) | $1,719 | $2,865 | 1.3× |
| Hysterosalpingogram (74740) | $153.60 | $256 | 0.6× |
| Interstitial radiation source applic complex (77778) | $1,582.80 | $2,638 | 2.3× |
| K Flow/Funct Image W/Drug (78708) | $730.80 | $1,218 | 1.4× |
| K Flow/Funct Image W/O Drug (78707) | $1,212 | $2,020 | 2.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $489 | $815 | 1.2× |
| Knee 3 Views (73562) | $166.20 | $277 | 1.9× |
| Liver & Spleen Imaging Static Only (78215) | $759.60 | $1,266 | 1.9× |
| Lung perfusion differential (78597) | $577.80 | $963 | 1.5× |
| Lung Ventilat&Perfus Imaging (78582) | $1,121.40 | $1,869 | 2.1× |
| Lung Ventilation Imaging (78579) | $489 | $815 | 1.2× |
| Lymph System Imaging (78195) | $588 | $980 | 1.1× |
| Magnetic Image Jaw Joint (70336) | $1,300.80 | $2,168 | 5.5× |
| Meckels Divert Exam (78290) | $672 | $1,120 | 1.7× |
| Mr safety determination physician/other qhp (76016) | $137.40 | $229 | 1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $37.20 | $62 | 1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $140.40 | $234 | 1.5× |
| Mr safety implt pos&/immoblj (76019) | $90.60 | $151 | 1.5× |
| Mr safety med physics xm customization plng&mntr (76017) | $371.40 | $619 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $1,228.80 | $2,048 | 3.5× |
| MRA head w/o contrast (70544) | $1,228.80 | $2,048 | 5.2× |
| MRA head with contrast (70545) | $1,228.80 | $2,048 | 3.5× |
| MRA neck w contrast (70548) | $1,228.80 | $2,048 | 3.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,228.80 | $2,048 | 3.5× |
| MRA neck w/o contrast (70547) | $1,228.80 | $2,048 | 5.2× |
| MRI abdomen w contrast (74182) | $1,590 | $2,650 | 4.6× |
| MRI abdomen w/o contrast (74181) | $1,300.80 | $2,168 | 5.5× |
| MRI any jt lower extrem w/contrast material (73722) | $1,446.60 | $2,411 | 1.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,662.60 | $2,771 | 4.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,446.60 | $2,411 | 1.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,951.20 | $3,252 | 8.2× |
| MRI cervical spine w contrast (72142) | $1,300.80 | $2,168 | 3.7× |
| MRI cervical spine w/o cont (72141) | $1,084.80 | $1,808 | 4.6× |
| MRI chest w/o contrast (71550) | $1,300.80 | $2,168 | 5.5× |
| MRI chest with contrast (71551) | $1,446.60 | $2,411 | 1.9× |
| MRI chest wo w contrast (71552) | $1,590 | $2,650 | 4.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,446.60 | $2,411 | 4.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,662.60 | $2,771 | 4.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,156.20 | $1,927 | 4.9× |
| MRI lumbar spine w contrast (72149) | $1,300.80 | $2,168 | 3.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,662.60 | $2,771 | 4.8× |
| MRI orbit face &/neck w/o contrast (70540) | $1,228.80 | $2,048 | 5.2× |
| MRI orbit face neck w contrast (70542) | $1,518 | $2,530 | 4.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,734.60 | $2,891 | 5.0× |
| MRI pelvis w contrast (72196) | $1,446.60 | $2,411 | 4.2× |
| MRI pelvis w/o & w contrast (72197) | $1,662.60 | $2,771 | 4.8× |
| MRI pelvis w/o contrast (72195) | $1,228.80 | $2,048 | 5.2× |
| MRI thoracic spine w/o contrast (72146) | $1,084.80 | $1,808 | 4.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,815 | $3,025 | 5.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,156.20–$1,436.40 | $1,927–$2,394 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$1,662.60–$2,080.80 | $2,771–$3,468 | varies |
| MRI, abdomen, combo (74183) | $1,807.20 | $3,012 | 5.2× |
| MRI, dorsal spine combo (72157) | $1,807.20 | $3,012 | 5.2× |
| MRI, dorsal spine contrast (72147) | $1,300.80 | $2,168 | 3.7× |
| MRI, joint upper extrem (73221) | $1,084.80 | $1,808 | 4.6× |
| MRI, joint upper extrem combo (73223) | $1,662.60 | $2,771 | 4.8× |
| MRI, lumbar spine combo (72158) | $1,662.60 | $2,771 | 4.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $876 | $1,460 | 2.2× |
| Myocardial Spect Multiple Studies (78452) | $2,069.40 | $3,449 | 1.6× |
| Neck soft tissue (70360) | $126.60 | $211 | 1.5× |
| Nm myocard infarct spect (78469) | $666 | $1,110 | 1.2× |
| Nuclear Rx Intra-Arterial (79445) | $518.40 | $864 | 2.2× |
| Nuclear Rx Oral Admin (79005) | $690.60 | $1,151 | 3.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $783 | $1,305 | 1.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $393 | $655 | 1.0× |
| Pelvis 1 or 2 views (72170) | $112.20 | $187 | 1.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,459.40 | $4,099 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $489 | $815 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $202.20 | $337 | 1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$205.80–$838.20 | $343–$1,397 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $141 | $235 | 1.6× |
| Radex Calcaneus Minimum 2 Views (73650) | $130.20 | $217 | 1.5× |
| Radex elbow complete minimum 3 views (73080) | $130.20 | $217 | 1.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $178.20 | $297 | 1.7× |
| Radex fingr minimum 2 views (73140) | $104.40 | $174 | 1.2× |
| Radex foot complete minimum 3 views (73630) | $154.20 | $257 | 1.8× |
| Radex Hand Minimum 3 Views (73130) | $130.20 | $217 | 1.5× |
| Radex lower extremity infant minimum 2 views (73592) | $104.40 | $174 | 1.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $244.20 | $407 | 2.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $118.80 | $198 | 1.4× |
| Radex Ribs Unilateral 2 Views (71100) | $155.40 | $259 | 1.8× |
| Radex shoulder complete minimum 2 views (73030) | $165 | $275 | 1.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $157.20 | $262 | 1.8× |
| Radex Spine 1 View Specify Level (72020) | $97.20 | $162 | 1.1× |
| Radex Sternum Minimum 2 Views (71120) | $126.60 | $211 | 1.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $121.80 | $203 | 1.4× |
| Radex Toe Minimum 2 Views (73660) | $104.40 | $174 | 1.2× |
| Radex upper extremity infant minimum 2 views (73092) | $112.20 | $187 | 1.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $138.60 | $231 | 1.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $178.20 | $297 | 1.7× |
| Radiologic exam colon double contrast study (74280) | $477.60 | $796 | 2.7× |
| Radiologic exam colon single contrast study (74270) | $376.20 | $627 | 2.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $283.80 | $473 | 1.6× |
| Radiologic exam knee complete 4/more views (73564) | $183 | $305 | 1.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $183 | $305 | 1.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $244.20 | $407 | 1.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $457.80 | $763 | 2.6× |
| Radiologic examination femur 1 view (73551) | $106.20 | $177 | 1.2× |
| Radiologic examination femur minimum 2 views (73552) | $175.80 | $293 | 2.0× |
| Radiologic examination knee 1/2 views (73560) | $118.80 | $198 | 1.4× |
| Radiologic Examination Osseous Survey Limited (77074) | $377.40 | $629 | 3.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $137.40 | $229 | 1.6× |
| Ribs bilateral 3 views (71110) | $219.60 | $366 | 2.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$445.20–$1,845 | $742–$3,075 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $591.60 | $986 | 1.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$723–$2,043.60 | $1,205–$3,406 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $957 | $1,595 | 1.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 8 matching MRF lines |
$592.80–$2,043.60 | $988–$3,406 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,043.60 | $3,406 | 1.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,319 | $3,865 | 1.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 8 matching MRF lines |
$1,956–$2,043.60 | $3,260–$3,406 | varies |
| Scapula (73010) | $124.80 | $208 | 1.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $40.80 | $68 | 1.7× |
| Shoulder 1 view (73020) | $106.20 | $177 | 1.2× |
| Shoulder Arthrography (73040) | $313.20 | $522 | 0.9× |
| Skull less than 4 views (70250) | $171 | $285 | 1.6× |
| Speech evaluation, complex (70371) | $259.20 | $432 | 1.1× |
| Sternoclavicular joints (71130) | $118.80 | $198 | 1.4× |
| Tbs technical calculation only (77091) | $135 | $225 | 1.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $448.20 | $747 | 2.6× |
| Thoracic spine 2 views (72070) | $140.40 | $234 | 1.3× |
| Thoracic spine 3 views (72072) | $178.20 | $297 | 1.7× |
| Thyroid Met Imaging Body (78018) | $823.80 | $1,373 | 1.5× |
| Thyroid Uptake Measurement (78012) | $574.20 | $957 | 1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $493.20 | $822 | 1.2× |
| Ultrasound Breast Limited (76642) | $261 | $435 | 3.0× |
| Ultrasound Elastography Parenchyma (76981) | $190.20 | $317 | 1.8× |
| Ultrasound Exam Aaa Screen (76706) | $565.80 | $943 | 5.4× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$157.80–$477.60 | $263–$796 | varies |
| Umbilical-artery Doppler (OB) (76820) | $144.60 | $241 | 1.4× |
| Unlisted Dx Radiographic Procedure (76499) | $98.40 | $164 | 1.1× |
| Unlisted fluoroscopic procedure (76496) | $106.20 | $177 | 1.2× |
| Upper gi w/o kub (74240) | $406.80 | $678 | 2.3× |
| Ureteral Reflux Study (78740) | $565.20 | $942 | 1.4× |
| Urethrocystogram voiding (74455) | $248.40 | $414 | 1.0× |
| Us breast unilateral complete (76641) | $343.80 | $573 | 3.3× |
| Us chest (76604) | $201.60 | $336 | 1.9× |
| Us complete joint (76881) | $501.60 | $836 | 4.8× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$202.80–$516.60 | $338–$861 | varies |
| Us head (76506) | $430.80 | $718 | 4.1× |
| Us kidney transplant (76776) | $529.20 | $882 | 5.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $501.60 | $836 | 4.8× |
| Us ob limited 1 or more fetuses (76815) | $227.40 | $379 | 2.2× |
| Us ob transvaginal (76817) | $282 | $470 | 2.7× |
| Us pelvic non ob complete (76856) | $554.40 | $924 | 5.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $621 | $1,035 | 6.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $141 | $235 | 1.4× |
| Us retroperitoneal complete (76770) | $565.20 | $942 | 5.4× |
| Us retroperitoneal limited (76775) | $529.20 | $882 | 5.1× |
| Us scrotum and contents (76870) | $519 | $865 | 5.0× |
| Us thyroid (76536) | $394.80 | $658 | 3.8× |
| Us transrectal (76872) | $420 | $700 | 4.0× |
| Vein X-Ray Chest (75827) | $978.60 | $1,631 | 0.6× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $743.40 | $1,239 | 0.2× |
| Vein X-Ray Spleen/Liver (75810) | $2,459.40 | $4,099 | 0.8× |
| Venography Adrenal Unilateral (75840) | $902.40 | $1,504 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $978.60 | $1,631 | 0.3× |
| Venography extremity bilateral rs&i (75822) | $846.60 | $1,411 | 0.5× |
| Venography extremity unilateral rs&i (75820) | $846.60 | $1,411 | 0.5× |
| Venography Renal Bilateral (75833) | $693.60 | $1,156 | 0.2× |
| Venography Renal Unilateral (75831) | $659.40 | $1,099 | 0.2× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$587.40 | $979 | 0.1× |
| Vertebral fracture assessment via dxa (77086) | $63.60 | $106 | 0.7× |
| Wrist 2 views (73100) | $112.20 | $187 | 1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $130.20 | $217 | 1.5× |
| X-ray antegrade pyelogram tube (74425) | $421.80 | $703 | 1.2× |
| X-Ray Aorta Leg Arteries (75630) | $874.20 | $1,457 | 0.3× |
| X-Ray Bend Only L-S Spine (72120) | $95.40 | $159 | 0.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $118.80 | $198 | 1.4× |
| X-Ray Exam Breast Specimen (76098) | $124.80 | $208 | 0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $154.80 | $258 | 1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $415.20 | $692 | 4.0× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$205.80–$410.40 | $343–$684 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $208.20 | $347 | 2.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $208.20 | $347 | 2.0× |
| X-Ray Exam L-S Spine Bending (72114) | $280.20 | $467 | 2.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $178.20 | $297 | 2.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $215.40 | $359 | 2.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $166.20 | $277 | 1.6× |
| X-ray eye for foreign body (70030) | $145.20 | $242 | 1.7× |
| X-ray humerus (73060) | $118.80 | $198 | 1.4× |
| X-ray IV pyelogram (ivp) (74400) | $493.20 | $822 | 2.8× |
| X-ray IV pyelogram+tomography (74415) | $667.80 | $1,113 | 3.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $155.40 | $259 | 1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $117.60 | $196 | 1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $178.20 | $297 | 1.7× |
| X-ray nose-rectum child f.b. (76010) | $124.80 | $208 | 1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $244.20 | $407 | 2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $117.60 | $196 | 1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $137.40 | $229 | 1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $227.40 | $379 | 2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $234.60 | $391 | 2.3× |
| X-Ray Tmj Unilat (70328) | $135 | $225 | 1.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $346.80 | $578 | 1.0× |
| X-Rays Bone Length Studies (77073) | $124.80 | $208 | 1.2× |
| X-Rays Bone Survey Complete (77075) | $294.60 | $491 | 2.8× |
| Xr c-spine 4 or 5 views (72050) | $197.40 | $329 | 1.9× |
| Xr facial bones less than 3 views (70140) | $157.20 | $262 | 1.8× |
| Xr orbits complete 4 views (70200) | $197.40 | $329 | 1.9× |
| Xr Tomogram Single Plane (76100) | $294.60 | $491 | 2.8× |
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.