Imaging prices at Oklahoma Center for Orthopaedic & Multi-Specialty Surgery
Oklahoma City, OK · every code in this section with a posted price and a Medicare benchmark.
258 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $56.16 | $208 | 0.7× |
| Abdomen 2 views (74019) | $80.46 | $298 | 0.8× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$66.42–$133.65 | $246–$495 | varies |
| Arthrogram ankle (73615) range across 7 matching MRF lines |
$198.99–$397.71 | $737–$1,473 | varies |
| Arthrogram hip (73525) range across 9 matching MRF lines |
$198.99–$397.71 | $737–$1,473 | varies |
| Arthrogram Wrist (73115) range across 8 matching MRF lines |
$198.99–$397.71 | $737–$1,473 | varies |
| Bone age studies (77072) | $68.58 | $254 | 0.7× |
| Bone survey infant (77076) | $68.58 | $254 | 0.7× |
| Cat Scan Follow-Up Study (76380) | $297.81 | $1,103 | 3.6× |
| Chest 1 view (71045) | $53.73 | $199 | 0.6× |
| Chest 2 views (71046) | $66.42 | $246 | 0.8× |
| Chest 3 views (71047) | $191.70 | $710 | 2.3× |
| Chest 4 or more views (71048) | $103.41 | $383 | 1.0× |
| Cholecystography Oral Contrast (74290) | $107.46 | $398 | 0.6× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$40.50–$81.27 | $150–$301 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $135 | $500 | 1.3× |
| Contrast X-Ray Bladder (74430) | $333.18 | $1,234 | 1.0× |
| Contrast X-Ray Of Elbow (73085) range across 6 matching MRF lines |
$198.99–$397.71 | $737–$1,473 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 9 matching MRF lines |
$180.36–$397.71 | $668–$1,473 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $484.38 | $1,794 | 2.9× |
| CT abdomen and pelvis without and with contrast (74178) | $484.38 | $1,794 | 1.4× |
| CT abdomen and pelvis without contrast (74176) | $412.56 | $1,528 | 1.8× |
| CT abdomen w contrast (74160) | $351 | $1,300 | 2.1× |
| CT abdomen w wo contrast (74170) | $412.56 | $1,528 | 2.4× |
| CT abdomen w/o contrast (74150) | $291.06 | $1,078 | 2.9× |
| CT Angio Abdomen and Pelvis (74174) | $412.56 | $1,528 | 1.2× |
| CT Angio Chest (71275) | $412.56 | $1,528 | 2.4× |
| CT Angio Head (70496) | $351 | $1,300 | 2.1× |
| CT angio hrt w/3d image (75574) | $343.17 | $1,271 | 1.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 55 matching MRF lines |
$412.56–$824.31 | $1,528–$3,053 | varies |
| CT Angio Neck (70498) | $412.56 | $1,528 | 2.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 15 matching MRF lines |
$412.56–$824.31 | $1,528–$3,053 | varies |
| CT bone density (77078) | $108.81 | $403 | 1.3× |
| CT cervical spine w/ contrast (72126) | $291.06 | $1,078 | 0.9× |
| CT cervical spine w/o contrast (72125) | $412.56 | $1,528 | 4.1× |
| CT cervical spine w/wo cont (72127) | $412.56 | $1,528 | 2.4× |
| CT chest w contrast (71260) | $351 | $1,300 | 2.1× |
| CT chest w/wo contrast (71270) | $412.56 | $1,528 | 2.4× |
| CT head/brain with contrast (70460) | $351 | $1,300 | 2.1× |
| CT head/brain without and with contrast (70470) | $412.56 | $1,528 | 2.4× |
| CT iac w contrast (70481) range across 4 matching MRF lines |
$351–$702.54 | $1,300–$2,602 | varies |
| CT l-spine w&w/o contrast (72133) | $412.56 | $1,528 | 2.4× |
| CT lower ext w/o (73700) range across 19 matching MRF lines |
$291.06–$581.85 | $1,078–$2,155 | varies |
| CT lower extremity w/contrast material (73701) range across 19 matching MRF lines |
$351–$702.54 | $1,300–$2,602 | varies |
| CT lumbar spine w contrast (72132) | $351 | $1,300 | 1.0× |
| CT lumbar spine w/o contrast (72131) | $291.06 | $1,078 | 2.9× |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$341.01–$351 | $1,263–$1,300 | varies |
| CT maxillofacial wo contrast (70486) range across 5 matching MRF lines |
$281.88–$291.06 | $1,044–$1,078 | varies |
| CT neck tissue combo (70492) | $412.56 | $1,528 | 2.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 5 matching MRF lines |
$412.56–$824.31 | $1,528–$3,053 | varies |
| CT orbits w/o contrast (70480) | $291.06 | $1,078 | 2.9× |
| CT pelvis w&w/o contrast (72194) | $412.56 | $1,528 | 2.4× |
| CT pelvis w/o contrast (72192) | $291.06 | $1,078 | 2.9× |
| CT scan of leg combo (73702) range across 19 matching MRF lines |
$412.56–$824.31 | $1,528–$3,053 | varies |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$400.14–$412.56 | $1,482–$1,528 | varies |
| CT soft tissue neck w contrast (70491) | $351 | $1,300 | 2.1× |
| CT soft tissue neck w/o contrast (70490) | $291.06 | $1,078 | 2.9× |
| CT thoracic spine w contrast (72129) | $291.06 | $1,078 | 1.7× |
| CT thoracic spine w/o contrast (72128) | $291.06 | $1,078 | 2.9× |
| CT thoracic spine w/wo cont (72130) | $412.56 | $1,528 | 2.4× |
| CT thorax w/o contrast (71250) | $291.06 | $1,078 | 2.9× |
| CT unlisted procedure (76497) | $349.92 | $1,296 | 4.2× |
| CT upper ext wo (73200) range across 22 matching MRF lines |
$291.06–$581.85 | $1,078–$2,155 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 22 matching MRF lines |
$412.56–$824.31 | $1,528–$3,053 | varies |
| CT upper extremity with contrast (73201) range across 19 matching MRF lines |
$351–$702.54 | $1,300–$2,602 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $343.17 | $1,271 | 2.0× |
| Cta Abdomen (74175) | $412.56 | $1,528 | 2.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $763.56 | $2,828 | 2.3× |
| CTA pelvis (72191) | $634.77 | $2,351 | 3.8× |
| Discography Cerv/Thor Spine (72285) | $1,182.60 | $4,380 | 0.6× |
| Diskography lumbar (72295) | $1,182.60 | $4,380 | 0.6× |
| Dxa Bone Density Axial (77080) | $68.58 | $254 | 0.7× |
| Echograp Trans R Pros Study (76873) | $191.70 | $710 | 1.9× |
| Esophagram (74220) | $484.38 | $1,794 | 2.9× |
| Fetal Biophys Profile W/Nst (76818) | $191.70 | $710 | 1.9× |
| Fluoroscopy up to 1 hr (76000) | $472.23 | $1,749 | 2.1× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$66.42–$133.65 | $246–$495 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$66.42–$133.65 | $246–$495 | varies |
| Hand 2 views (73120) range across 8 matching MRF lines |
$66.42–$133.65 | $246–$495 | varies |
| Hysterosalpingogram (74740) | $343.17 | $1,271 | 1.5× |
| Interstitial radiation source applic complex (77778) | $731.16 | $2,708 | 1.1× |
| Joint Survey Single View (77077) | $68.58 | $254 | 0.7× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$56.43–$113.67 | $209–$421 | varies |
| Magnetic Image Jaw Joint (70336) | $581.04 | $2,152 | 2.5× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $73.71 | $273 | 0.1× |
| Mra Head W/O & W/Contrast Material (70546) | $634.77 | $2,351 | 1.9× |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$362.61–$363.15 | $1,343–$1,345 | varies |
| MRA head with contrast (70545) | $634.77 | $2,351 | 1.9× |
| MRA neck w contrast (70548) | $634.77 | $2,351 | 1.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $546.48 | $2,024 | 1.6× |
| MRA neck w/o contrast (70547) | $362.61 | $1,343 | 1.6× |
| MRI abdomen w contrast (74182) | $484.38 | $1,794 | 1.4× |
| MRI abdomen w/o contrast (74181) | $581.04 | $2,152 | 2.5× |
| MRI any jt lower extrem w/contrast material (73722) range across 10 matching MRF lines |
$852.39–$1,704.51 | $3,157–$6,313 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 10 matching MRF lines |
$852.39–$1,704.51 | $3,157–$6,313 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 10 matching MRF lines |
$852.39–$1,704.51 | $3,157–$6,313 | varies |
| MRI brain functional w/o physician admnistration (70554) | $362.61 | $1,343 | 1.6× |
| MRI cervical spine w contrast (72142) | $852.39 | $3,157 | 2.5× |
| MRI cervical spine w/o cont (72141) | $581.04 | $2,152 | 2.5× |
| MRI chest w/o contrast (71550) | $581.04 | $2,152 | 2.5× |
| MRI chest with contrast (71551) | $581.04 | $2,152 | 0.8× |
| MRI chest wo w contrast (71552) | $852.39 | $3,157 | 2.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 13 matching MRF lines |
$852.39–$1,704.51 | $3,157–$6,313 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 10 matching MRF lines |
$852.39–$1,704.51 | $3,157–$6,313 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 10 matching MRF lines |
$581.04–$1,162.89 | $2,152–$4,307 | varies |
| MRI lumbar spine w contrast (72149) | $852.39 | $3,157 | 2.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $852.39 | $3,157 | 2.5× |
| MRI orbit face &/neck w/o contrast (70540) | $581.04 | $2,152 | 2.5× |
| MRI orbit face neck w contrast (70542) | $852.39 | $3,157 | 2.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $852.39 | $3,157 | 2.5× |
| MRI pelvis w contrast (72196) | $852.39 | $3,157 | 2.5× |
| MRI pelvis w/o & w contrast (72197) | $852.39 | $3,157 | 2.5× |
| MRI pelvis w/o contrast (72195) | $581.04 | $2,152 | 2.5× |
| MRI thoracic spine w/o contrast (72146) | $581.04 | $2,152 | 2.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 10 matching MRF lines |
$731.16–$1,462.05 | $2,708–$5,415 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 16 matching MRF lines |
$581.04–$1,162.89 | $2,152–$4,307 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 19 matching MRF lines |
$852.39–$1,704.78 | $3,157–$6,314 | varies |
| MRI, abdomen, combo (74183) | $852.39 | $3,157 | 2.5× |
| MRI, dorsal spine combo (72157) | $852.39 | $3,157 | 2.5× |
| MRI, dorsal spine contrast (72147) | $852.39 | $3,157 | 2.5× |
| MRI, joint upper extrem (73221) range across 12 matching MRF lines |
$564.30–$1,162.89 | $2,090–$4,307 | varies |
| MRI, joint upper extrem combo (73223) range across 10 matching MRF lines |
$852.39–$1,704.51 | $3,157–$6,313 | varies |
| MRI, lumbar spine combo (72158) | $852.39 | $3,157 | 2.5× |
| Myelogram cervical (72240) | $84.24 | $312 | 0.1× |
| Myelogram Lumbar (72265) | $84.24 | $312 | 0.1× |
| Myelograpy 2/more regions rs&i (72270) | $84.24 | $312 | 0.1× |
| Neck soft tissue (70360) | $41.04 | $152 | 0.5× |
| Nonvascular Shunt X-Ray (75809) | $103.14 | $382 | 1.0× |
| Optic foramina (70190) | $28.62 | $106 | 0.3× |
| Pelvis 1 or 2 views (72170) | $84.24 | $312 | 0.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $104.22 | $386 | 1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$40.50–$81.27 | $150–$301 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 5 matching MRF lines |
$36.72–$73.98 | $136–$274 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$39.69–$79.65 | $147–$295 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $65.34 | $242 | 0.6× |
| Radex fingr minimum 2 views (73140) | $58.32 | $216 | 0.7× |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$39.69–$79.65 | $147–$295 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$58.32–$117.18 | $216–$434 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$69.39–$140.40 | $257–$520 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $63.18 | $234 | 0.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $58.32 | $216 | 0.7× |
| Radex Ribs Unilateral 2 Views (71100) range across 5 matching MRF lines |
$69.93–$73.98 | $259–$274 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$43.74–$88.02 | $162–$326 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $45.90 | $170 | 0.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $107.46 | $398 | 0.6× |
| Radex Spine 1 View Specify Level (72020) | $58.32 | $216 | 0.7× |
| Radex Sternum Minimum 2 Views (71120) | $66.42 | $246 | 0.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $144.18 | $534 | 1.7× |
| Radex Toe Minimum 2 Views (73660) | $36.18 | $134 | 0.4× |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$66.42–$133.65 | $246–$495 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$39.69–$79.65 | $147–$295 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $55.62 | $206 | 0.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $104.22 | $386 | 1.0× |
| Radiologic exam colon double contrast study (74280) | $107.46 | $398 | 0.6× |
| Radiologic exam colon single contrast study (74270) | $107.46 | $398 | 0.6× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$66.42–$133.65 | $246–$495 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $61.02 | $226 | 0.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $107.46 | $398 | 0.6× |
| Radiologic exam swallow function contrast study (74230) | $484.38 | $1,794 | 2.9× |
| Radiologic exam teeth complete full mouth (70320) | $72.09 | $267 | 0.3× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $72.09 | $267 | 0.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $107.46 | $398 | 0.6× |
| Radiologic examination femur 1 view (73551) | $92.07 | $341 | 1.1× |
| Radiologic examination femur minimum 2 views (73552) range across 7 matching MRF lines |
$84.24–$168.21 | $312–$623 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$58.32–$117.18 | $216–$434 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $68.58 | $254 | 0.7× |
| Radiologic Examination Salivary Gland Calculus (70380) range across 3 matching MRF lines |
$41.04–$81.81 | $152–$303 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$69.39–$140.40 | $257–$520 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $63.18 | $234 | 0.1× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $72.09 | $267 | 0.9× |
| Ribs bilateral 3 views (71110) | $73.98 | $274 | 0.7× |
| Scapula (73010) range across 3 matching MRF lines |
$71.28–$142.56 | $264–$528 | varies |
| Sella turcica (70240) | $63.99 | $237 | 0.8× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$69.39–$140.40 | $257–$520 | varies |
| Shoulder Arthrography (73040) range across 9 matching MRF lines |
$180.36–$397.71 | $668–$1,473 | varies |
| Skull less than 4 views (70250) | $48.06 | $178 | 0.5× |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$66.42–$133.65 | $246–$495 | varies |
| Superior sagittal sinus venogram (75870) | $343.17 | $1,271 | 0.1× |
| Thoracic spine 2 views (72070) | $76.14 | $282 | 0.8× |
| Thoracic spine 3 views (72072) | $78.57 | $291 | 0.8× |
| Thoracolumbar 2 views (72080) | $92.88 | $344 | 1.1× |
| Ultrasound Exam Aaa Screen (76706) | $176.85 | $655 | 1.8× |
| Ultrasound, abdomen limited (76705) | $191.70 | $710 | 1.9× |
| Unlisted Dx Radiographic Procedure (76499) | $349.92 | $1,296 | 4.2× |
| Unlisted fluoroscopic procedure (76496) | $349.92 | $1,296 | 4.2× |
| Unlisted magnetic resonance procedure (76498) | $941.22 | $3,486 | 11.2× |
| Unlisted us procedure (76999) | $412.83 | $1,529 | 4.9× |
| Upper gi w/o kub (74240) | $484.38 | $1,794 | 2.9× |
| Urethrocystogram voiding (74455) | $333.18 | $1,234 | 1.5× |
| Urethrocystography retrograde (74450) | $333.18 | $1,234 | 1.5× |
| Us bone density measurement (76977) | $412.83 | $1,529 | 4.1× |
| Us breast unilateral complete (76641) | $191.70 | $710 | 1.9× |
| Us chest (76604) | $191.70 | $710 | 1.9× |
| Us complete joint (76881) range across 8 matching MRF lines |
$191.70–$382.86 | $710–$1,418 | varies |
| Us exam, pelvic, limited (76857) | $191.70 | $710 | 1.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 9 matching MRF lines |
$176.85–$382.86 | $655–$1,418 | varies |
| Us ob detailed single fetus (76811) | $191.70 | $710 | 0.8× |
| Us ob limited 1 or more fetuses (76815) | $191.70 | $710 | 1.9× |
| Us ob transvaginal (76817) | $191.70 | $710 | 1.9× |
| Us pelvic non ob complete (76856) | $191.70 | $710 | 1.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $191.70 | $710 | 1.9× |
| Us retroperitoneal complete (76770) | $191.70 | $710 | 1.9× |
| Us retroperitoneal limited (76775) | $191.70 | $710 | 1.9× |
| Us scrotum and contents (76870) | $191.70 | $710 | 1.9× |
| Us spinal canal and contents (76800) | $191.70 | $710 | 1.9× |
| Us thyroid (76536) | $191.70 | $710 | 1.9× |
| Us transrectal (76872) | $191.70 | $710 | 1.9× |
| Vein X-Ray Chest (75827) | $343.17 | $1,271 | 0.2× |
| Vein X-Ray Skull Epidural (75872) | $343.17 | $1,271 | 0.6× |
| Venogram Sinus/Jugular (75860) | $343.17 | $1,271 | 0.1× |
| Venography Adrenal Unilateral (75840) | $343.17 | $1,271 | 0.1× |
| Venography caval inferior serialography rs&i (75825) | $343.17 | $1,271 | 0.1× |
| Venography extremity bilateral rs&i (75822) | $343.17 | $1,271 | 0.2× |
| Venography Orbital Rs&I (75880) | $343.17 | $1,271 | 0.6× |
| Venography Renal Bilateral (75833) | $343.17 | $1,271 | 0.1× |
| Venography Renal Unilateral (75831) | $343.17 | $1,271 | 0.1× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$77.49–$154.44 | $287–$572 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $43.74 | $162 | 0.5× |
| X-Ray Bend Only L-S Spine (72120) | $122.31 | $453 | 1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$66.42–$133.65 | $246–$495 | varies |
| X-Ray Exam Breast Specimen (76098) | $297.81 | $1,103 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $41.04 | $152 | 0.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $41.04 | $152 | 0.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $92.88 | $344 | 0.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $58.32 | $216 | 0.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $101.52 | $376 | 1.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $89.64 | $332 | 0.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $107.73 | $399 | 1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $107.46 | $398 | 1.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $107.73 | $399 | 1.1× |
| X-Ray Exam L-S Spine Bending (72114) | $122.31 | $453 | 1.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $76.41 | $283 | 0.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $122.31 | $453 | 1.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $73.98 | $274 | 0.7× |
| X-ray eye for foreign body (70030) | $41.58 | $154 | 0.5× |
| X-ray head for orthodontia (70350) | $581.04 | $2,152 | 6.9× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$66.42–$133.65 | $246–$495 | varies |
| X-ray IV pyelogram (ivp) (74400) | $333.18 | $1,234 | 2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $41.04 | $152 | 0.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $66.42 | $246 | 0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $84.24 | $312 | 0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $73.98 | $274 | 0.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 4 matching MRF lines |
$63.99–$127.71 | $237–$473 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 4 matching MRF lines |
$63.99–$127.71 | $237–$473 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $84.24 | $312 | 1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $63.99 | $237 | 0.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $72.09 | $267 | 0.7× |
| X-Ray Stress View (77071) | $66.15 | $245 | 0.8× |
| X-ray thoracic spine 4 vw (72074) | $92.88 | $344 | 0.9× |
| X-Ray Tmj Unilat (70328) | $72.09 | $267 | 0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $333.18 | $1,234 | 1.0× |
| X-Rays Bone Length Studies (77073) | $68.58 | $254 | 0.7× |
| X-Rays Bone Survey Complete (77075) | $68.58 | $254 | 0.7× |
| Xr c-spine 4 or 5 views (72050) | $85.32 | $316 | 0.8× |
| Xr facial bones less than 3 views (70140) | $44.55 | $165 | 0.5× |
| XR Mastoids < 3 Views Bilateral (70120) | $55.62 | $206 | 0.6× |
| Xr myelogram posterior fossa (70010) | $73.71 | $273 | 0.2× |
| Xr orbits complete 4 views (70200) range across 4 matching MRF lines |
$62.10–$95.85 | $230–$355 | varies |
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.