Imaging prices at Northwest Health- Starke
Knox, IN · every code in this section with a posted price and a Medicare benchmark.
241 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) | $121.53 | $450.10 | 1.3× |
| Abdomen 2 views (74019) | $104.97 | $388.77 | 0.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $745 | $2,759.26 | 1.8× |
| Ankle 2 views (73600) | $99.44 | $368.30 | 1.1× |
| Arthrogram ankle (73615) | $292 | $1,081.48 | 0.8× |
| Arthrogram hip (73525) | $316.48 | $1,172.14 | 0.9× |
| Arthrogram Wrist (73115) | $316.48 | $1,172.14 | 0.9× |
| Bone age studies (77072) | $110.49 | $409.21 | 1.0× |
| Bone Imaging 3 Phase (78315) | $1,159.33 | $4,293.83 | 2.7× |
| Bone Imaging Whole Body (78306) | $1,070.15 | $3,963.51 | 2.5× |
| Bone survey infant (77076) | $107.33 | $397.51 | 1.0× |
| Chest 1 view (71045) range across 7 matching MRF lines |
$13.50–$93.91 | $50–$347.80 | varies |
| Chest 2 views (71046) | $149.15 | $552.41 | 1.6× |
| Chest 3 views (71047) | $157.05 | $581.67 | 1.7× |
| Chest 4 or more views (71048) | $172.84 | $640.14 | 1.6× |
| Clavicle complete (73000) | $121.53 | $450.10 | 1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $125.48 | $464.74 | 1.1× |
| Contrast X-Ray Bladder (74430) | $286.87 | $1,062.48 | 0.8× |
| Contrast X-Ray Of Elbow (73085) | $275.42 | $1,020.09 | 0.7× |
| Contrast X-Ray Of Knee Joint (73580) | $316.48 | $1,172.14 | 0.9× |
| Contrast Xray Throat/Cerv Esopha (74210) | $204.01 | $755.59 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) | $1,041.35 | $3,856.86 | 2.8× |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$63.05–$832.99 | $233.52–$3,085.14 | varies |
| CT abdomen w contrast (74160) | $937.17 | $3,471.01 | 5.0× |
| CT abdomen w wo contrast (74170) | $1,041.35 | $3,856.86 | 5.6× |
| CT abdomen w/o contrast (74150) | $832.99 | $3,085.14 | 7.5× |
| CT Angio Abdomen and Pelvis (74174) | $1,041.35 | $3,856.86 | 2.8× |
| CT Angio Chest (71275) | $1,041.35 | $3,856.86 | 5.6× |
| CT Angio Head (70496) | $1,041.35 | $3,856.86 | 5.6× |
| CT angio hrt w/3d image (75574) | $1,041.35 | $3,856.86 | 2.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,041.35 | $3,856.86 | 5.6× |
| CT Angio Neck (70498) | $1,041.35 | $3,856.86 | 5.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,041.35 | $3,856.86 | 5.6× |
| CT cervical spine w/ contrast (72126) | $937.17 | $3,471.01 | 2.5× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$28.86–$832.99 | $106.88–$3,085.14 | varies |
| CT cervical spine w/wo cont (72127) | $1,041.35 | $3,856.86 | 5.6× |
| CT chest w contrast (71260) | $937.17 | $3,471.01 | 5.0× |
| CT chest w/wo contrast (71270) | $1,041.35 | $3,856.86 | 5.6× |
| CT head/brain with contrast (70460) | $993.59 | $3,679.96 | 5.4× |
| CT head/brain without and with contrast (70470) | $1,041.35 | $3,856.86 | 5.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $78.12 | $289.35 | 0.8× |
| CT iac w contrast (70481) | $937.17 | $3,471.01 | 5.0× |
| CT l-spine w&w/o contrast (72133) | $1,041.35 | $3,856.86 | 5.6× |
| CT lower ext w/o (73700) | $832.99 | $3,085.14 | 7.5× |
| CT lower extremity w/contrast material (73701) | $937.17 | $3,471.01 | 5.0× |
| CT lumbar spine w contrast (72132) | $937.17 | $3,471.01 | 2.5× |
| CT lumbar spine w/o contrast (72131) | $832.99 | $3,085.14 | 7.5× |
| CT maxillofacial w contrast (70487) | $937.17 | $3,471.01 | 5.0× |
| CT maxillofacial wo contrast (70486) | $832.99 | $3,085.14 | 7.5× |
| CT neck tissue combo (70492) | $1,041.35 | $3,856.86 | 5.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,041.35 | $3,856.86 | 5.6× |
| CT orbits w/o contrast (70480) | $832.99 | $3,085.14 | 7.5× |
| CT pelvis w/o contrast (72192) | $832.99 | $3,085.14 | 7.5× |
| CT scan of leg combo (73702) | $1,041.35 | $3,856.86 | 5.6× |
| CT scans face/jaw combo (70488) | $1,041.35 | $3,856.86 | 5.6× |
| CT soft tissue neck w contrast (70491) | $937.17 | $3,471.01 | 5.0× |
| CT soft tissue neck w/o contrast (70490) | $832.99 | $3,085.14 | 7.5× |
| CT thoracic spine w contrast (72129) | $937.17 | $3,471.01 | 5.0× |
| CT thoracic spine w/o contrast (72128) | $832.99 | $3,085.14 | 7.5× |
| CT thorax w/o contrast (71250) range across 4 matching MRF lines |
$45.57–$832.99 | $168.77–$3,085.14 | varies |
| CT upper ext wo (73200) | $832.99 | $3,085.14 | 7.5× |
| CT upper extremity w/o & w/contrast material (73202) | $1,040.95 | $3,855.36 | 5.6× |
| CT upper extremity with contrast (73201) | $937.17 | $3,471.01 | 2.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,041.35 | $3,856.86 | 5.6× |
| Cta Abdomen (74175) | $1,041.35 | $3,856.86 | 5.6× |
| Dxa Bone Density Axial (77080) | $213.87 | $792.12 | 1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $98.09 | $363.29 | 1.1× |
| Echo exam uterus (76831) | $378.81 | $1,403.01 | 1.5× |
| Echo Guide For Artery Repair (76936) | $305.42 | $1,131.17 | 1.3× |
| Esophagram (74220) | $198.88 | $736.61 | 1.1× |
| Fetal Biophys Profile W/Nst (76818) | $535.48 | $1,983.25 | 4.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $329.49 | $1,220.32 | 3.0× |
| Fluoroscopy up to 1 hr (76000) | $132.59 | $491.07 | 0.5× |
| Foot 2 views (73620) | $116.02 | $429.69 | 1.3× |
| Forearm 2 views (73090) | $127.06 | $470.60 | 1.4× |
| Gastric emptying imaging study (78264) | $785.25 | $2,908.33 | 1.9× |
| Gated Heart Planar Single (78472) | $487.33 | $1,804.93 | 1.2× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$28.20–$88.40 | $104.44–$327.39 | varies |
| Hepatobil Syst Image W/Drug (78227) | $982.16 | $3,637.63 | 1.7× |
| Hepatobiliary System Imaging (78226) | $1,030.29 | $3,815.89 | 2.4× |
| Ht Muscle Image Spect Sing (78451) | $743.42 | $2,753.39 | 0.5× |
| Hysterosalpingogram (74740) range across 3 matching MRF lines |
$236.12–$325.54 | $874.50–$1,205.69 | varies |
| K Flow/Funct Image W/O Drug (78707) | $490.09 | $1,815.14 | 0.9× |
| Knee 3 Views (73562) range across 6 matching MRF lines |
$16.82–$127.06 | $62.30–$470.60 | varies |
| Lung Ventilat&Perfus Imaging (78582) | $2,010.08 | $7,444.73 | 3.5× |
| Lymph System Imaging (78195) | $227.67 | $843.24 | 0.4× |
| MRA head w/o contrast (70544) | $1,041.35 | $3,856.86 | 4.1× |
| MRA neck w contrast (70548) | $1,249.70 | $4,628.51 | 3.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,249.70 | $4,628.51 | 3.4× |
| MRI abdomen w contrast (74182) | $1,145.52 | $4,242.65 | 3.1× |
| MRI abdomen w/o contrast (74181) | $1,041.35 | $3,856.86 | 4.1× |
| MRI any jt lower extrem w/contrast material (73722) | $1,145.52 | $4,242.65 | 1.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,249.70 | $4,628.51 | 3.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,145.52 | $4,242.65 | 1.4× |
| MRI cervical spine w/o cont (72141) | $1,041.35 | $3,856.86 | 4.1× |
| MRI chest w/o contrast (71550) | $1,041.35 | $3,856.86 | 4.1× |
| MRI chest with contrast (71551) | $1,249.70 | $4,628.51 | 1.5× |
| MRI chest wo w contrast (71552) | $1,249.70 | $4,628.51 | 3.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,249.70 | $4,628.51 | 3.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,041.35 | $3,856.86 | 4.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,249.70 | $4,628.51 | 3.4× |
| MRI orbit face &/neck w/o contrast (70540) | $1,041.35 | $3,856.86 | 4.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,249.70 | $4,628.51 | 3.4× |
| MRI pelvis w contrast (72196) | $1,249.70 | $4,628.51 | 3.4× |
| MRI pelvis w/o & w contrast (72197) | $1,249.70 | $4,628.51 | 3.4× |
| MRI pelvis w/o contrast (72195) | $1,041.35 | $3,856.86 | 4.1× |
| MRI thoracic spine w/o contrast (72146) | $1,041.35 | $3,856.86 | 4.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,041.35 | $3,856.86 | 4.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,249.70 | $4,628.51 | 3.4× |
| MRI, abdomen, combo (74183) | $1,249.70 | $4,628.51 | 3.4× |
| MRI, dorsal spine combo (72157) | $1,249.70 | $4,628.51 | 3.4× |
| MRI, joint upper extrem (73221) | $1,041.35 | $3,856.86 | 4.1× |
| MRI, joint upper extrem combo (73223) | $1,249.70 | $4,628.51 | 3.4× |
| MRI, lumbar spine combo (72158) | $1,249.70 | $4,628.51 | 3.4× |
| Myocardial Spect Multiple Studies (78452) | $1,316.39 | $4,875.51 | 1.0× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $1,577.60 | $5,842.98 | 1.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $1,577.60 | $5,842.98 | 1.0× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $1,577.60 | $5,842.98 | 0.7× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $1,577.60 | $5,842.98 | 0.7× |
| Neck soft tissue (70360) | $110.49 | $409.21 | 1.2× |
| Parathyroid Planar Imaging (78070) | $646.76 | $2,395.39 | 1.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,104.48 | $4,090.66 | 2.6× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$28.20–$104.97 | $104.44–$388.77 | varies |
| Pet Image W/Ct Lmtd (78814) | $1,577.60 | $5,842.98 | 1.0× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$1,577.60–$1,952.46 | $5,842.98–$7,231.35 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$1,533.81–$1,577.60 | $5,680.77–$5,842.98 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,227.59 | $4,546.63 | 0.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $41.83 | $154.93 | 0.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $219.76 | $813.93 | 0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) | $127.06 | $470.60 | 1.4× |
| Radex Calcaneus Minimum 2 Views (73650) | $116.02 | $429.69 | 1.3× |
| Radex elbow complete minimum 3 views (73080) range across 5 matching MRF lines |
$21.84–$99.44 | $80.90–$368.30 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $104.97 | $388.77 | 0.9× |
| Radex fingr minimum 2 views (73140) | $104.97 | $388.77 | 1.1× |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$16.82–$127.06 | $62.30–$470.60 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$21.55–$116.02 | $79.80–$429.69 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $121.53 | $450.10 | 1.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $135.35 | $501.28 | 1.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $127.06 | $470.60 | 1.4× |
| Radex Ribs Unilateral 2 Views (71100) | $143.64 | $531.99 | 1.6× |
| Radex shoulder complete minimum 2 views (73030) | $143.64 | $531.99 | 1.6× |
| Radex Sinuses Paransl < 3 Views (70210) | $104.97 | $388.77 | 1.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $358.69 | $1,328.48 | 1.9× |
| Radex Spine 1 View Specify Level (72020) | $116.02 | $429.69 | 1.3× |
| Radex Sternum Minimum 2 Views (71120) | $138.11 | $511.51 | 1.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $165.73 | $613.80 | 1.8× |
| Radex Toe Minimum 2 Views (73660) | $99.44 | $368.30 | 1.1× |
| Radex upper extremity infant minimum 2 views (73092) | $93.91 | $347.80 | 0.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $116.40 | $431.12 | 1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$22.56–$181.92 | $83.55–$673.76 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $165.73 | $613.80 | 1.5× |
| Radiologic exam colon double contrast study (74280) | $529.95 | $1,962.77 | 2.9× |
| Radiologic exam colon single contrast study (74270) | $413.93 | $1,533.08 | 2.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $198.88 | $736.59 | 1.1× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$12.90–$127.06 | $47.76–$470.60 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $116.02 | $429.69 | 1.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $386.31 | $1,430.78 | 2.1× |
| Radiologic exam swallow function contrast study (74230) | $232.03 | $859.37 | 1.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $363.03 | $1,344.55 | 2.0× |
| Radiologic examination femur 1 view (73551) | $116.02 | $429.69 | 1.3× |
| Radiologic examination femur minimum 2 views (73552) | $138.11 | $511.51 | 1.5× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$16.82–$116.02 | $62.30–$429.69 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $82.87 | $306.92 | 0.7× |
| Radiologic examination tibia & fibula 2 views (73590) | $127.06 | $470.60 | 1.4× |
| Ribs bilateral 3 views (71110) | $127.06 | $470.60 | 1.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $681.87 | $2,525.46 | 1.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,004.25 | $3,719.45 | 2.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,317.18 | $4,878.44 | 2.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,572.07 | $5,822.48 | 2.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,004.25 | $3,719.44 | 1.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,317.17 | $4,878.41 | 1.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,317.17 | $4,878.41 | 0.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,004.25 | $3,719.45 | 0.7× |
| Scapula (73010) | $127.06 | $470.60 | 1.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 6 matching MRF lines |
$16.08–$20.91 | $59.55–$77.46 | varies |
| Shoulder 1 view (73020) | $110.49 | $409.21 | 1.2× |
| Shoulder Arthrography (73040) | $316.48 | $1,172.14 | 0.9× |
| Skull less than 4 views (70250) | $170.85 | $632.79 | 1.5× |
| Sternoclavicular joints (71130) | $140.48 | $520.29 | 1.5× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$22.56–$154.68 | $83.55–$572.89 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$22.56–$181.92 | $83.55–$673.76 | varies |
| Thoracolumbar 2 views (72080) | $154.29 | $571.46 | 1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $837.73 | $3,102.70 | 2.0× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$128.24–$221.55 | $474.95–$820.56 | varies |
| Ultrasound Exam Aaa Screen (76706) | $109.70 | $406.29 | 1.0× |
| Ultrasound, abdomen limited (76705) | $428.93 | $1,588.63 | 3.9× |
| Umbilical-artery Doppler (OB) (76820) | $325.94 | $1,207.20 | 2.9× |
| Upper gi w/o kub (74240) range across 4 matching MRF lines |
$72.20–$363.03 | $267.42–$1,344.55 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$208.07–$286.87 | $770.62–$1,062.48 | varies |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$288.85–$499.05 | $1,069.83–$1,848.32 | varies |
| Us chest (76604) | $315.29 | $1,167.73 | 2.9× |
| Us complete joint (76881) | $345.28 | $1,278.80 | 3.1× |
| Us exam, pelvic, limited (76857) | $306.20 | $1,134.07 | 2.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $300.29 | $1,112.17 | 2.7× |
| Us ob detailed single fetus (76811) | $477.46 | $1,768.38 | 1.9× |
| Us ob limited 1 or more fetuses (76815) | $333.44 | $1,234.97 | 3.0× |
| Us ob transvaginal (76817) | $419.06 | $1,552.08 | 3.8× |
| Us pelvic non ob complete (76856) | $475.09 | $1,759.60 | 4.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $473.51 | $1,753.75 | 4.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $382.36 | $1,416.15 | 3.5× |
| Us retroperitoneal complete (76770) | $460.10 | $1,704.06 | 4.2× |
| Us retroperitoneal limited (76775) | $400.13 | $1,481.96 | 3.6× |
| Us scrotum and contents (76870) | $418.27 | $1,549.15 | 3.8× |
| Us thyroid (76536) | $394.99 | $1,462.91 | 3.6× |
| Wrist 2 views (73100) | $93.91 | $347.80 | 1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $132.59 | $491.07 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $160.21 | $593.38 | 1.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $88.40 | $327.39 | 1.0× |
| X-Ray Exam Breast Specimen (76098) | $84.06 | $311.33 | 0.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$22.56–$142.06 | $83.55–$526.14 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $176.77 | $654.71 | 1.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $221.37 | $819.89 | 2.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $116.02 | $429.69 | 1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $116.02 | $429.69 | 1.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $194.14 | $719.04 | 1.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $174.02 | $644.50 | 1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $290.82 | $1,077.12 | 2.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $290.82 | $1,077.12 | 2.6× |
| X-Ray Exam L-S Spine Bending (72114) | $286.87 | $1,062.48 | 2.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $143.64 | $531.99 | 1.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $259.25 | $960.18 | 2.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $176.77 | $654.71 | 1.6× |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$77.35–$104.85 | $286.48–$388.32 | varies |
| X-ray humerus (73060) | $121.53 | $450.10 | 1.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $110.49 | $409.21 | 1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $66.29 | $245.50 | 0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $160.21 | $593.38 | 1.4× |
| X-ray nose-rectum child f.b. (76010) | $114.43 | $423.83 | 1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $232.03 | $859.37 | 2.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $138.11 | $511.51 | 1.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $93.91 | $347.80 | 0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $138.11 | $511.51 | 1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $181.92 | $673.76 | 2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$28.20–$215.46 | $104.44–$797.99 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$22.56–$170.85 | $83.55–$632.79 | varies |
| X-Ray Tmj Unilat (70328) | $154.68 | $572.89 | 1.7× |
| X-Rays Bone Length Studies (77073) | $237.95 | $881.29 | 2.2× |
| X-Rays Bone Survey Complete (77075) | $345.66 | $1,280.23 | 3.1× |
| Xr c-spine 4 or 5 views (72050) | $217.43 | $805.28 | 2.0× |
| Xr facial bones less than 3 views (70140) | $138.11 | $511.51 | 1.5× |
| Xr orbits complete 4 views (70200) | $170.85 | $632.79 | 1.5× |
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.