Imaging prices at Ochsner American Legion Hospital
Jennings, LA · every code in this section with a posted price and a Medicare benchmark.
269 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) range across 2 matching MRF lines |
$45.90–$56.70 | $135 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$83.64–$103.32 | $246 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $292.06 | $859 | 0.8× |
| Angio internal mammary (75756) | $1,973.70 | $5,805 | 0.7× |
| Angiography extremity bilateral rs&i (75716) | $2,051.22 | $6,033 | 0.7× |
| Angiography extremity unilateral rs&i (75710) | $2,051.22 | $6,033 | 0.7× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$45.90–$91.80 | $135–$270 | varies |
| Aortography thoracic serialography rs&i (75605) | $2,948.48 | $8,672 | 0.6× |
| Artery X-Rays Abdomen (75726) | $3,195.32 | $9,398 | 0.6× |
| Arthrogram hip (73525) | $399.50 | $1,175 | 1.3× |
| Bone age studies (77072) range across 2 matching MRF lines |
$83.98–$103.74 | $247 | varies |
| Bone Imaging 3 Phase (78315) | $326.06 | $959 | 0.9× |
| Bone Imaging Limited Area (78300) | $387.94 | $1,141 | 1.1× |
| Bone Imaging Multiple Areas (78305) | $292.06 | $859 | 0.8× |
| Bone Imaging Whole Body (78306) | $292.06 | $859 | 0.8× |
| Bone survey infant (77076) | $83.98 | $247 | 0.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $327.08 | $962 | 0.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $396.44 | $1,166 | 1.3× |
| Cerebrospinal Fluid Scan (78630) | $327.76 | $964 | 0.7× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$45.90–$56.70 | $135 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$46.24–$57.12 | $136 | varies |
| Chest 3 views (71047) | $45.90 | $135 | 0.6× |
| Chest 4 or more views (71048) | $90.10 | $265 | 1.0× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $83.98 | $247 | 0.9× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$45.90–$91.80 | $135–$270 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $102 | $300 | 1.1× |
| Contrast Exam Abdominl Aorta (75625) | $2,051.22 | $6,033 | 0.7× |
| Contrast X-Ray Bladder (74430) | $225.42 | $663 | 0.7× |
| CT abdomen and pelvis without and with contrast (74178) | $513.40 | $1,510 | 1.6× |
| CT abdomen and pelvis without contrast (74176) | $290.02 | $853 | 1.3× |
| CT abdomen w contrast (74160) | $307.70 | $905 | 1.9× |
| CT abdomen w wo contrast (74170) | $368.90 | $1,085 | 2.3× |
| CT abdomen w/o contrast (74150) | $228.48 | $672 | 2.4× |
| CT Angio Abdomen and Pelvis (74174) | $513.40 | $1,510 | 1.6× |
| CT Angio Chest (71275) | $360.74 | $1,061 | 2.3× |
| CT Angio Head (70496) | $360.74 | $1,061 | 2.3× |
| CT angio hrt w/3d image (75574) | $187 | $550 | 0.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$360.74–$721.48 | $1,061–$2,122 | varies |
| CT Angio Neck (70498) | $360.74 | $1,061 | 2.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $360.74 | $1,061 | 2.3× |
| CT bone density (77078) | $88.40 | $260 | 1.1× |
| CT cervical spine w/ contrast (72126) | $399.50 | $1,175 | 1.3× |
| CT cervical spine w/o contrast (72125) | $228.48 | $672 | 2.4× |
| CT cervical spine w/wo cont (72127) | $368.90 | $1,085 | 2.3× |
| CT chest w contrast (71260) | $310.08 | $912 | 2.0× |
| CT chest w/wo contrast (71270) | $368.90 | $1,085 | 2.3× |
| CT head/brain with contrast (70460) | $254.66 | $749 | 1.6× |
| CT head/brain without and with contrast (70470) | $317.90 | $935 | 2.0× |
| CT heart contrast eval cardiac structure&morph (75572) | $187 | $550 | 0.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $71.40 | $210 | 0.9× |
| CT hrt w/3d image congen (75573) | $187 | $550 | 0.6× |
| CT iac w contrast (70481) | $254.66 | $749 | 1.6× |
| CT l-spine w&w/o contrast (72133) | $368.90 | $1,085 | 2.3× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$222.36–$444.72 | $654–$1,308 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$265.88–$531.76 | $782–$1,564 | varies |
| CT lumbar spine w contrast (72132) | $399.50 | $1,175 | 1.3× |
| CT lumbar spine w/o contrast (72131) | $228.48 | $672 | 2.4× |
| CT maxillofacial w contrast (70487) | $254.66 | $749 | 1.6× |
| CT maxillofacial wo contrast (70486) | $212.50 | $625 | 2.2× |
| CT neck tissue combo (70492) | $317.90 | $935 | 2.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $317.90 | $935 | 2.0× |
| CT orbits w/o contrast (70480) | $212.50 | $625 | 2.2× |
| CT pelvis w&w/o contrast (72194) | $368.90 | $1,085 | 2.3× |
| CT pelvis w/o contrast (72192) | $228.48 | $672 | 2.4× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$333.88–$667.76 | $982–$1,964 | varies |
| CT scans face/jaw combo (70488) | $317.90 | $935 | 2.0× |
| CT soft tissue neck w contrast (70491) | $254.66 | $749 | 1.6× |
| CT soft tissue neck w/o contrast (70490) | $212.50 | $625 | 2.2× |
| CT thoracic spine w contrast (72129) | $310.08 | $912 | 2.0× |
| CT thoracic spine w/o contrast (72128) | $228.48 | $672 | 2.4× |
| CT thoracic spine w/wo cont (72130) | $368.90 | $1,085 | 2.3× |
| CT thorax w/o contrast (71250) | $228.48 | $672 | 2.4× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$222.36–$444.72 | $654–$1,308 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$333.88–$667.76 | $982–$1,964 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$265.88–$531.76 | $782–$1,564 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $360.74 | $1,061 | 2.3× |
| Cta Abdomen (74175) | $360.74 | $1,061 | 2.3× |
| CTA pelvis (72191) | $360.74 | $1,061 | 2.3× |
| Dxa Bone Density Axial (77080) | $90.10 | $265 | 1.0× |
| Esophagram (74220) | $182.92 | $538 | 1.2× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$78.54–$97.02 | $231 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$70.98–$170 | $169–$500 | varies |
| Fluoroscopy up to 1 hr (76000) | $170 | $500 | 0.8× |
| Follow-Up Angiography (75898) | $779.62 | $2,293 | 0.3× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$45.90–$91.80 | $135–$270 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$46.24–$92.48 | $135–$272 | varies |
| Gastric emptying imaging study (78264) | $292.06 | $859 | 0.8× |
| Gated Heart Planar Single (78472) | $360.06 | $1,059 | 1.0× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$83.64–$167.28 | $246–$492 | varies |
| Hepatobil Syst Image W/Drug (78227) | $333.88 | $982 | 0.7× |
| Hepatobiliary System Imaging (78226) | $251.60 | $740 | 0.7× |
| Ht Muscle Image Spect Sing (78451) | $1,079.16 | $3,174 | 0.9× |
| Hysterosalpingogram (74740) | $190.06 | $559 | 0.9× |
| K Flow/Funct Image W/Drug (78708) | $414.46 | $1,219 | 0.8× |
| K Flow/Funct Image W/O Drug (78707) | $326.40 | $960 | 0.7× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$46.24–$92.48 | $136–$272 | varies |
| Liver & Spleen Imaging Static Only (78215) | $251.94 | $741 | 0.7× |
| Lung Ventilat&Perfus Imaging (78582) | $363.46 | $1,069 | 0.7× |
| Lung Ventilation Imaging (78579) | $292.06 | $859 | 0.8× |
| Lymph System Imaging (78195) | $363.46 | $1,069 | 0.7× |
| Magnetic Image Jaw Joint (70336) | $368.56 | $1,084 | 1.7× |
| Mammary ductogram or galactogram single (77053) | $168.30 | $495 | 0.8× |
| Meckels Divert Exam (78290) | $251.94 | $741 | 0.7× |
| MRA head w/o contrast (70544) | $423.98 | $1,247 | 2.0× |
| MRA head with contrast (70545) | $199.24 | $586 | 0.6× |
| MRA neck w/o contrast (70547) | $423.98 | $1,247 | 2.0× |
| MRI abdomen w contrast (74182) | $450.50 | $1,325 | 1.4× |
| MRI abdomen w/o contrast (74181) | $423.98 | $1,247 | 2.0× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$640.22–$1,280.44 | $1,883–$3,766 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$614.72–$1,229.44 | $1,808–$3,616 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$536.86–$1,073.72 | $1,579–$3,158 | varies |
| MRI bone marrow blood supply (77084) | $368.56 | $1,084 | 1.7× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,074.06 | $3,159 | 5.0× |
| MRI cardiac w/o contrast (75557) | $396.44 | $1,166 | 1.8× |
| MRI cervical spine w contrast (72142) | $450.50 | $1,325 | 1.4× |
| MRI cervical spine w/o cont (72141) | $423.98 | $1,247 | 2.0× |
| MRI chest w/o contrast (71550) | $423.98 | $1,247 | 2.0× |
| MRI chest with contrast (71551) | $640.22 | $1,883 | 0.9× |
| MRI chest wo w contrast (71552) | $614.72 | $1,808 | 1.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$199.24–$398.48 | $586–$1,172 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $614.72 | $1,808 | 1.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$182.92–$365.84 | $538–$1,076 | varies |
| MRI lumbar spine w contrast (72149) | $450.50 | $1,325 | 1.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $614.72 | $1,808 | 1.9× |
| MRI orbit face &/neck w/o contrast (70540) | $423.98 | $1,247 | 2.0× |
| MRI orbit face neck w contrast (70542) | $423.98 | $1,247 | 1.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $544 | $1,600 | 1.7× |
| MRI pelvis w contrast (72196) | $450.50 | $1,325 | 1.4× |
| MRI pelvis w/o & w contrast (72197) | $614.72 | $1,808 | 1.9× |
| MRI pelvis w/o contrast (72195) | $423.98 | $1,247 | 2.0× |
| MRI thoracic spine w/o contrast (72146) | $423.98 | $1,247 | 2.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$476–$952 | $1,400–$2,800 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$323–$646 | $950–$1,900 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $614.72 | $1,808 | 1.9× |
| MRI, abdomen, combo (74183) | $614.72 | $1,808 | 1.9× |
| MRI, dorsal spine combo (72157) | $614.72 | $1,808 | 1.9× |
| MRI, dorsal spine contrast (72147) | $450.50 | $1,325 | 1.4× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$423.98–$847.96 | $1,247–$2,494 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$359.38–$718.76 | $1,057–$2,114 | varies |
| MRI, lumbar spine combo (72158) | $614.72 | $1,808 | 1.9× |
| Myelogram cervical (72240) | $902.36 | $2,654 | 1.3× |
| Myelogram Lumbar (72265) | $536.52 | $1,578 | 0.8× |
| Myelography thoracic (72255) | $536.52 | $1,578 | 0.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $292.06 | $859 | 0.8× |
| Myocardial Spect Multiple Studies (78452) | $1,163.48 | $3,422 | 1.0× |
| Neck soft tissue (70360) | $48.96 | $144 | 0.6× |
| Nuclear Rx Oral Admin (79005) | $360.74 | $1,061 | 1.7× |
| Parathyroid Planar Imaging (78070) | $292.06 | $859 | 0.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $275.06 | $809 | 0.8× |
| Pelvis 1 or 2 views (72170) | $83.64 | $246 | 0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $292.06 | $859 | 0.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $90.10 | $265 | 1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $194.14 | $571 | 0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$46.24–$92.48 | $135–$272 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$45.90–$91.80 | $135–$270 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$46.24–$92.48 | $136–$272 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $82.62 | $243 | 0.9× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$45.90–$56.70 | $135 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$46.24–$92.48 | $136–$272 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$45.90–$91.80 | $135–$270 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$48.96–$97.92 | $144–$288 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$45.22–$56.70 | $133–$135 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$44.88–$56.70 | $132–$135 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$46.24–$92.48 | $136–$272 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$45.90–$56.70 | $135 | varies |
| Radex Spine 1 View Specify Level (72020) | $45.90 | $135 | 0.6× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$45.90–$56.70 | $135 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $56.78 | $167 | 0.7× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$45.90–$56.70 | $135 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$90.10–$180.20 | $265–$530 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$45.90–$91.80 | $135–$270 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$82.28–$102.90 | $242–$245 | varies |
| Radiologic exam colon double contrast study (74280) | $182.24 | $536 | 1.1× |
| Radiologic exam colon single contrast study (74270) | $182.58 | $537 | 1.1× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$90.10–$180.20 | $245–$530 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$82.28–$102.90 | $242–$245 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $89.42 | $263 | 0.6× |
| Radiologic exam swallow function contrast study (74230) | $91.80 | $270 | 0.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $208.42 | $613 | 1.3× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$45.90–$91.80 | $135–$270 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$45.90–$91.80 | $135–$270 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$45.90–$91.80 | $135–$270 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $83.98 | $247 | 0.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$45.90–$91.80 | $135–$270 | varies |
| Renal Cyst Study (74470) | $194.14 | $571 | 0.4× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$82.62–$102.90 | $243–$245 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $255.68 | $752 | 0.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $292.06 | $859 | 0.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,084.26 | $3,189 | 2.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $864.28 | $2,542 | 1.8× |
| Scapula (73010) range across 3 matching MRF lines |
$83.64–$167.28 | $246–$492 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $25.50 | $75 | 1.1× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$48.96–$97.92 | $144–$288 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$348.50–$697 | $1,025–$2,050 | varies |
| Skull less than 4 views (70250) | $83.30 | $245 | 0.9× |
| Sternoclavicular joints (71130) | $45.90 | $135 | 0.6× |
| Testicular Imaging W/Flow (78761) | $326.06 | $959 | 0.9× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$82.62–$102.90 | $243–$245 | varies |
| Thoracic spine 3 views (72072) | $83.98 | $247 | 0.9× |
| Thoracolumbar 2 views (72080) | $48.96 | $144 | 0.6× |
| Thyroid Imaging With Vascular Flow (78013) | $292.06 | $859 | 0.8× |
| Thyroid Met Imaging Body (78018) | $326.06 | $959 | 0.7× |
| Thyroid Uptake Measurement (78012) | $275.06 | $809 | 0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $251.94 | $741 | 0.7× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$81.26–$162.52 | $239–$478 | varies |
| Ultrasound, abdomen limited (76705) | $83.98 | $247 | 0.9× |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$86.70–$95.20 | $255–$280 | varies |
| Upper gi w/o kub (74240) | $225.42 | $663 | 1.4× |
| Urethrocystogram voiding (74455) | $167.96 | $494 | 0.8× |
| Urethrocystography retrograde (74450) | $167.96 | $494 | 0.8× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$81.94–$163.88 | $241–$482 | varies |
| Us chest (76604) | $83.98 | $247 | 0.9× |
| Us complete joint (76881) | $97.58 | $287 | 1.0× |
| Us exam, pelvic, limited (76857) range across 5 matching MRF lines |
$59.64–$163.38 | $142–$389 | varies |
| Us head (76506) | $82.96 | $244 | 0.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $90.10 | $265 | 1.0× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$54.06–$66.78 | $159 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$76.44–$83.98 | $182–$247 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$83.98–$86.10 | $205–$247 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$95.20–$97.02 | $231–$280 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $71.40 | $170 | 0.8× |
| Us retroperitoneal complete (76770) | $89.08 | $262 | 0.9× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$83.98–$111.72 | $247–$266 | varies |
| Us scrotum and contents (76870) | $83.98 | $247 | 0.9× |
| Us spinal canal and contents (76800) | $83.98 | $247 | 0.9× |
| Us thyroid (76536) | $83.98 | $247 | 0.9× |
| Us transrectal (76872) | $90.78 | $267 | 1.0× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$510–$524.28 | $1,500–$1,542 | varies |
| Venography caval inferior serialography rs&i (75825) | $1,973.70 | $5,805 | 0.7× |
| Venography extremity bilateral rs&i (75822) | $932.62 | $2,743 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $507.28 | $1,492 | 0.4× |
| Venography Renal Bilateral (75833) | $1,973.70 | $5,805 | 0.7× |
| Venous thrombosis imaging (78457) | $863.94 | $2,541 | 1.8× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $292.06 | $859 | 0.8× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$45.90–$91.80 | $135–$270 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $46.24 | $136 | 0.6× |
| X-ray antegrade pyelogram tube (74425) | $183.26 | $539 | 0.6× |
| X-Ray Aorta Leg Arteries (75630) | $2,051.22 | $6,033 | 0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$45.90–$91.80 | $135–$270 | varies |
| X-Ray Exam Breast Specimen (76098) | $374 | $1,100 | 0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $56.70 | $135 | 0.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$83.64–$103.32 | $246 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $83.64 | $246 | 0.9× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$45.90–$56.70 | $135 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$45.90–$56.70 | $135 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$82.62–$102.90 | $243–$245 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $90.10 | $265 | 1.0× |
| X-Ray Exam L-S Spine Bending (72114) | $83.30 | $245 | 0.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$45.90–$56.70 | $135 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $83.30 | $245 | 0.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$83.64–$103.32 | $246 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$45.90–$56.70 | $135 | varies |
| X-ray IV pyelogram (ivp) (74400) | $183.26 | $539 | 1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $48.96 | $144 | 0.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$45.90–$56.70 | $135 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$82.62–$102.90 | $243–$245 | varies |
| X-ray nose-rectum child f.b. (76010) | $48.96 | $144 | 0.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $90.10 | $265 | 1.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $82.62 | $243 | 0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$45.22–$56.70 | $133–$135 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $45.22 | $133 | 0.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $83.64 | $246 | 0.9× |
| X-ray thoracic spine 4 vw (72074) | $90.10 | $265 | 1.0× |
| X-Ray Tmj Unilat (70328) | $48.96 | $144 | 0.6× |
| X-Rays Bone Length Studies (77073) | $82.28 | $242 | 0.9× |
| X-Rays Bone Survey Complete (77075) | $90.10 | $265 | 1.0× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$83.98–$103.74 | $247 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $85 | $250 | 0.9× |
| Xr orbits complete 4 views (70200) | $82.28 | $242 | 0.9× |
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.