Imaging prices at Ochsner St. Mary Hospital
Morgan City, LA · every code in this section with a posted price and a Medicare benchmark.
272 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) | $42 | $210 | 0.5× |
| Abdomen 2 views (74019) | $66.20 | $331 | 0.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $205.40 | $1,027 | 0.6× |
| Angio internal mammary (75756) | $503.60 | $2,518 | 0.2× |
| Angio pulmonary bilat (75743) | $461.60 | $2,308 | 0.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $574.60 | $2,873 | 0.2× |
| Angiography extremity bilateral rs&i (75716) | $564.80 | $2,824 | 0.2× |
| Angiography extremity unilateral rs&i (75710) | $498.60 | $2,493 | 0.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $440.20 | $2,201 | 0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $473.40 | $2,367 | 0.2× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$49.80–$99.60 | $249–$498 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$456.80 | $2,284 | 0.1× |
| Aortography thoracic w/o serialography rs&i (75600) | $674 | $3,370 | 0.2× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$490.80 | $2,454 | 0.1× |
| Artery X-Rays Adrenal Gland (75731) | $497.80 | $2,489 | 0.2× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$492.80 | $2,464 | 0.1× |
| Arthrogram ankle (73615) | $184.20 | $921 | 0.6× |
| Arthrogram hip (73525) | $174.40 | $872 | 0.6× |
| Arthrogram Wrist (73115) | $193.80 | $969 | 0.6× |
| Bone age studies (77072) | $35.20 | $176 | 0.4× |
| Bone Imaging 3 Phase (78315) | $231 | $1,155 | 0.6× |
| Bone Imaging Limited Area (78300) | $176.80 | $884 | 0.5× |
| Bone Imaging Whole Body (78306) | $179.80 | $899 | 0.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $748.40 | $3,742 | 0.6× |
| Chest 1 view (71045) | $38 | $190 | 0.5× |
| Chest 2 views (71046) | $51.60 | $258 | 0.7× |
| Chest 3 views (71047) | $51.60 | $258 | 0.7× |
| Chest 4 or more views (71048) | $78 | $390 | 0.8× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$49.80–$99.60 | $249–$498 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $63.60 | $318 | 0.7× |
| Contrast Exam Abdominl Aorta (75625) | $454.80 | $2,274 | 0.2× |
| Contrast X-Ray Bladder (74430) | $160.80 | $804 | 0.5× |
| Contrast X-Ray Of Elbow (73085) | $173.40 | $867 | 0.5× |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$242.60–$720 | $1,213–$3,600 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $554 | $2,770 | 1.8× |
| CT abdomen and pelvis without contrast (74176) | $313 | $1,565 | 1.4× |
| CT abdomen w contrast (74160) | $295.60 | $1,478 | 1.9× |
| CT abdomen w wo contrast (74170) | $380.80 | $1,904 | 2.4× |
| CT abdomen w/o contrast (74150) | $207.40 | $1,037 | 2.2× |
| CT Angio Abdomen and Pelvis (74174) | $552.60 | $2,763 | 1.7× |
| CT Angio Chest (71275) | $388.60 | $1,943 | 2.4× |
| CT Angio Head (70496) | $388.60 | $1,943 | 2.4× |
| CT angio hrt w/3d image (75574) | $307 | $1,535 | 1.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$388.60–$777.20 | $1,943–$3,886 | varies |
| CT Angio Neck (70498) | $388.60 | $1,943 | 2.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $388.60 | $1,943 | 2.4× |
| CT cervical spine w/ contrast (72126) | $274.40 | $1,372 | 0.9× |
| CT cervical spine w/o contrast (72125) | $221.80 | $1,109 | 2.3× |
| CT cervical spine w/wo cont (72127) | $345 | $1,725 | 2.2× |
| CT chest w contrast (71260) | $273.60 | $1,368 | 1.7× |
| CT chest w/wo contrast (71270) | $345.40 | $1,727 | 2.2× |
| CT head/brain with contrast (70460) | $220.60 | $1,103 | 1.4× |
| CT head/brain without and with contrast (70470) | $271.60 | $1,358 | 1.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $250.60 | $1,253 | 0.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $51.60 | $258 | 0.7× |
| CT iac w contrast (70481) | $318.60 | $1,593 | 2.0× |
| CT l-spine w&w/o contrast (72133) | $345.40 | $1,727 | 2.2× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$213–$426 | $1,065–$2,130 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$265.40–$530.80 | $1,327–$2,654 | varies |
| CT lumbar spine w contrast (72132) | $273.60 | $1,368 | 0.9× |
| CT lumbar spine w/o contrast (72131) | $220.60 | $1,103 | 2.3× |
| CT maxillofacial w contrast (70487) | $272.40 | $1,362 | 1.7× |
| CT maxillofacial wo contrast (70486) | $222.60 | $1,113 | 2.4× |
| CT neck tissue combo (70492) | $329.80 | $1,649 | 2.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $370 | $1,850 | 2.3× |
| CT orbits w/o contrast (70480) | $223 | $1,115 | 2.4× |
| CT pelvis w&w/o contrast (72194) | $346.60 | $1,733 | 2.2× |
| CT pelvis w/o contrast (72192) | $209.40 | $1,047 | 2.2× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$352.40–$704.80 | $1,762–$3,524 | varies |
| CT scans face/jaw combo (70488) | $340.40 | $1,702 | 2.1× |
| CT soft tissue neck w contrast (70491) | $262.20 | $1,311 | 1.7× |
| CT soft tissue neck w/o contrast (70490) | $211 | $1,055 | 2.2× |
| CT thoracic spine w contrast (72129) | $274.40 | $1,372 | 1.7× |
| CT thoracic spine w/o contrast (72128) | $221 | $1,105 | 2.3× |
| CT thoracic spine w/wo cont (72130) | $346.20 | $1,731 | 2.2× |
| CT thorax w/o contrast (71250) | $221 | $1,105 | 2.3× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$212.60–$425.20 | $1,063–$2,126 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$351.60–$703.20 | $1,758–$3,516 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$263–$526 | $1,315–$2,630 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $389 | $1,945 | 2.4× |
| Cta Abdomen (74175) | $388.60 | $1,943 | 2.4× |
| CTA pelvis (72191) | $388.60 | $1,943 | 2.4× |
| Dxa Bone Density Axial (77080) | $71.80 | $359 | 0.8× |
| Dxa bone density study (77085) | $51.80 | $259 | 0.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $37.80 | $189 | 0.5× |
| Esophagram (74220) | $165.60 | $828 | 1.0× |
| Fetal Biophys Profile W/Nst (76818) | $74.20 | $371 | 0.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $57.80 | $289 | 0.6× |
| Fluoroscopy up to 1 hr (76000) | $71 | $355 | 0.3× |
| Follow-Up Angiography (75898) | $105.60 | $528 | 0.0× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$47.80–$95.60 | $239–$478 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$49.80–$99.60 | $249–$498 | varies |
| Gastric emptying imaging study (78264) | $185.60 | $928 | 0.5× |
| Gated Heart Planar Single (78472) | $238.20 | $1,191 | 0.7× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$48.80–$97.60 | $244–$488 | varies |
| Heart Image (Pet) Multiple (78492) | $748.40 | $3,742 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $356.40 | $1,782 | 0.7× |
| Hepatobiliary System Imaging (78226) | $258.40 | $1,292 | 0.7× |
| Ht Muscle Image Spect Sing (78451) | $281.80 | $1,409 | 0.2× |
| Hysterosalpingogram (74740) | $150 | $750 | 0.7× |
| Joint Survey Single View (77077) | $45.20 | $226 | 0.5× |
| K Flow/Funct Image W/Drug (78708) | $247.40 | $1,237 | 0.5× |
| K Flow/Funct Image W/O Drug (78707) | $164.60 | $823 | 0.3× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$64.40–$128.80 | $322–$644 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $190.60 | $953 | 0.5× |
| Liver & Spleen Imaging Static Only (78215) | $189.20 | $946 | 0.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $173.80 | $869 | 0.5× |
| Lung Ventilat&Perfus Imaging (78582) | $239.20 | $1,196 | 0.5× |
| Lung Ventilation Imaging (78579) | $133.40 | $667 | 0.4× |
| Lymph System Imaging (78195) | $214.60 | $1,073 | 0.4× |
| Magnetic Image Jaw Joint (70336) | $362.60 | $1,813 | 1.7× |
| Mra Head W/O & W/Contrast Material (70546) | $555.60 | $2,778 | 1.8× |
| MRA head w/o contrast (70544) | $362.60 | $1,813 | 1.7× |
| MRA head with contrast (70545) | $440.20 | $2,201 | 1.4× |
| MRA neck w contrast (70548) | $440.20 | $2,201 | 1.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $555.60 | $2,778 | 1.8× |
| MRA neck w/o contrast (70547) | $362.60 | $1,813 | 1.7× |
| MRI abdomen w contrast (74182) | $440.20 | $2,201 | 1.4× |
| MRI abdomen w/o contrast (74181) | $362.60 | $1,813 | 1.7× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$439.80–$3,127.20 | $2,199–$15,636 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$555.60–$1,111.20 | $2,778–$5,556 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$439.80–$879.60 | $2,199–$4,398 | varies |
| MRI cervical spine w contrast (72142) | $439.80 | $2,199 | 1.4× |
| MRI cervical spine w/o cont (72141) | $362.60 | $1,813 | 1.7× |
| MRI chest w/o contrast (71550) | $362.60 | $1,813 | 1.7× |
| MRI chest wo w contrast (71552) | $555.60 | $2,778 | 1.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$439.80–$879.60 | $2,199–$4,398 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $555.60 | $2,778 | 1.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$362.60–$725.20 | $1,813–$3,626 | varies |
| MRI lumbar spine w contrast (72149) | $439.80 | $2,199 | 1.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $555.60 | $2,778 | 1.8× |
| MRI orbit face &/neck w/o contrast (70540) | $362.60 | $1,813 | 1.7× |
| MRI orbit face neck w contrast (70542) | $439.80 | $2,199 | 1.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $555.60 | $2,778 | 1.8× |
| MRI pelvis w/o & w contrast (72197) | $555.60 | $2,778 | 1.8× |
| MRI pelvis w/o contrast (72195) | $362.60 | $1,813 | 1.7× |
| MRI thoracic spine w/o contrast (72146) | $362.60 | $1,813 | 1.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$362.60–$725.20 | $1,813–$3,626 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $555.60 | $2,778 | 1.8× |
| MRI, abdomen, combo (74183) | $555.60 | $2,778 | 1.8× |
| MRI, dorsal spine combo (72157) | $555.60 | $2,778 | 1.8× |
| MRI, dorsal spine contrast (72147) | $433 | $2,165 | 1.4× |
| MRI, joint upper extrem (73221) | $362.60 | $1,813 | 1.7× |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$555.60–$1,111.20 | $2,778–$5,556 | varies |
| MRI, lumbar spine combo (72158) | $555.60 | $2,778 | 1.8× |
| Myelogram cervical (72240) | $263 | $1,315 | 0.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $741.20 | $3,706 | 0.6× |
| Myocardial Spect Multiple Studies (78452) | $412.40 | $2,062 | 0.4× |
| Neck soft tissue (70360) | $47.80 | $239 | 0.6× |
| Parathyroid Planar Imaging (78070) | $148.80 | $744 | 0.4× |
| Pelvis 1 or 2 views (72170) | $44.80 | $224 | 0.5× |
| Pet Image W/Ct Lmtd (78814) | $748.40 | $3,742 | 0.6× |
| PET image w/CT, full body (78816) | $748.40 | $3,742 | 0.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $748.40 | $3,742 | 0.6× |
| Pet Myocardial Sngl Study (78491) | $748.40 | $3,742 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $149.80 | $749 | 0.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $80.80 | $404 | 0.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $89.60 | $448 | 0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$58.40–$116.80 | $292–$584 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$48.80–$97.60 | $244–$488 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$66.20–$132.40 | $331–$662 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $74 | $370 | 0.8× |
| Radex fingr minimum 2 views (73140) | $58.40 | $292 | 0.7× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$57.60–$115.20 | $288–$576 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$57.60–$115.20 | $288–$576 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$53.60–$107.20 | $268–$536 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $60.40 | $302 | 0.8× |
| Radex Ribs Unilateral 2 Views (71100) | $54.60 | $273 | 0.7× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$51.60–$103.20 | $258–$516 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $54.60 | $273 | 0.7× |
| Radex Spine 1 View Specify Level (72020) | $41 | $205 | 0.5× |
| Radex Sternum Minimum 2 Views (71120) | $56.60 | $283 | 0.7× |
| Radex Toe Minimum 2 Views (73660) | $54.60 | $273 | 0.7× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$52.60–$105.20 | $263–$526 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$67.20–$134.40 | $336–$672 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $68.20 | $341 | 0.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $67.20 | $336 | 0.7× |
| Radiologic exam colon double contrast study (74280) | $264.40 | $1,322 | 1.7× |
| Radiologic exam colon single contrast study (74270) | $164 | $820 | 1.0× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$74–$148 | $370–$740 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $74 | $370 | 0.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $140.40 | $702 | 0.9× |
| Radiologic exam swallow function contrast study (74230) | $159.80 | $799 | 1.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $130.40 | $652 | 0.8× |
| Radiologic examination femur 1 view (73551) | $52.60 | $263 | 0.7× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$62.40–$124.80 | $312–$624 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$51.60–$103.20 | $258–$516 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $81 | $405 | 0.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$47.80–$95.60 | $239–$478 | varies |
| Ribs bilateral 3 views (71110) | $68.20 | $341 | 0.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $132.20 | $661 | 0.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $180 | $900 | 0.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $453.80 | $2,269 | 0.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $242.80 | $1,214 | 0.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $258 | $1,290 | 0.5× |
| Scapula (73010) range across 2 matching MRF lines |
$51.60–$103.20 | $258–$516 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $12 | $60 | 0.5× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$41–$82 | $205–$410 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$199.60–$399.20 | $998–$1,996 | varies |
| Skull less than 4 views (70250) | $61.40 | $307 | 0.6× |
| Sternoclavicular joints (71130) | $66.20 | $331 | 0.8× |
| Tbs technical calculation only (77091) | $65 | $325 | 0.8× |
| Thoracic spine 2 views (72070) | $56.60 | $283 | 0.6× |
| Thoracolumbar 2 views (72080) | $61.40 | $307 | 0.8× |
| Thyroid Imaging With Vascular Flow (78013) | $191.20 | $956 | 0.5× |
| Thyroid Met Imaging Body (78018) | $210.20 | $1,051 | 0.4× |
| Thyroid Uptake Measurement (78012) | $73.60 | $368 | 0.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $194 | $970 | 0.5× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$71–$142 | $355–$710 | varies |
| Ultrasound Exam Aaa Screen (76706) | $78 | $390 | 0.8× |
| Ultrasound, abdomen limited (76705) | $73.40 | $367 | 0.8× |
| Umbilical-artery Doppler (OB) (76820) | $44.40 | $222 | 0.5× |
| Upper gi w/o kub (74240) | $128.80 | $644 | 0.8× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$71–$142 | $355–$710 | varies |
| Us chest (76604) | $57.80 | $289 | 0.6× |
| Us complete joint (76881) | $105.20 | $526 | 1.1× |
| Us exam, pelvic, limited (76857) | $71.40 | $357 | 0.8× |
| Us head (76506) | $64.80 | $324 | 0.7× |
| Us kidney transplant (76776) | $75 | $375 | 0.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $55.20 | $276 | 0.6× |
| Us ob detailed single fetus (76811) | $59.20 | $296 | 0.3× |
| Us ob limited 1 or more fetuses (76815) | $51.60 | $258 | 0.5× |
| Us ob transvaginal (76817) | $70.20 | $351 | 0.7× |
| Us pelvic non ob complete (76856) | $94 | $470 | 1.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $63 | $315 | 0.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $58.40 | $292 | 0.6× |
| Us retroperitoneal complete (76770) | $73.80 | $369 | 0.8× |
| Us retroperitoneal limited (76775) | $79.80 | $399 | 0.8× |
| Us scrotum and contents (76870) | $95.20 | $476 | 1.0× |
| Us spinal canal and contents (76800) | $70.40 | $352 | 0.7× |
| Us thyroid (76536) | $84 | $420 | 0.9× |
| Vein X-Ray Chest (75827) | $437.40 | $2,187 | 0.3× |
| Venography Adrenal Unilateral (75840) | $434.40 | $2,172 | 0.2× |
| Venography caval inferior serialography rs&i (75825) | $432.40 | $2,162 | 0.2× |
| Venography extremity bilateral rs&i (75822) | $243.60 | $1,218 | 0.2× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$53.60–$107.20 | $268–$536 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $66.20 | $331 | 0.8× |
| X-Ray Aorta Leg Arteries (75630) | $468.40 | $2,342 | 0.2× |
| X-Ray Bend Only L-S Spine (72120) | $96.40 | $482 | 1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$50.60–$101.20 | $253–$506 | varies |
| X-Ray Exam Breast Specimen (76098) | $29.20 | $146 | 0.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $69.20 | $346 | 0.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $77.40 | $387 | 0.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $38.40 | $192 | 0.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $56.60 | $283 | 0.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $53.40 | $267 | 0.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $63.40 | $317 | 0.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $76.20 | $381 | 0.8× |
| X-Ray Exam L-S Spine Bending (72114) | $104.20 | $521 | 1.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $66.20 | $331 | 0.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $119.80 | $599 | 1.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $65.20 | $326 | 0.7× |
| X-ray humerus (73060) | $51.60 | $258 | 0.7× |
| X-ray IV pyelogram (ivp) (74400) | $216.20 | $1,081 | 1.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $56.60 | $283 | 0.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $57.60 | $288 | 0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $71.20 | $356 | 0.8× |
| X-ray nose-rectum child f.b. (76010) | $33 | $165 | 0.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $91.60 | $458 | 1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $63.40 | $317 | 0.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $52.60 | $263 | 0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $51.60 | $258 | 0.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $67.20 | $336 | 0.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $77 | $385 | 0.8× |
| X-ray thoracic spine 4 vw (72074) | $84.80 | $424 | 0.9× |
| X-Ray Tmj Unilat (70328) | $53.60 | $268 | 0.7× |
| X-Rays Bone Length Studies (77073) | $60.40 | $302 | 0.6× |
| X-Rays Bone Survey Complete (77075) | $86.40 | $432 | 0.9× |
| Xr c-spine 4 or 5 views (72050) | $92.60 | $463 | 1.0× |
| Xr facial bones less than 3 views (70140) | $50.60 | $253 | 0.6× |
| XR Mastoids < 3 Views Bilateral (70120) | $63.40 | $317 | 0.7× |
| Xr orbits complete 4 views (70200) | $75 | $375 | 0.8× |
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.