Imaging prices at Osf Saint Clare Medical Center
Princeton, IL · 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) | $314.40 | $393 | 3.4× |
| Abdomen 2 views (74019) | $383.20 | $479 | 3.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,499.20 | $1,874 | 3.5× |
| Angio pulmonary bilat (75743) | $2,644 | $3,305 | 0.8× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$304.80–$457.60 | $381–$572 | varies |
| Arthrogram ankle (73615) | $964 | $1,205 | 2.6× |
| Arthrogram hip (73525) | $865.60 | $1,082 | 2.3× |
| Arthrogram Wrist (73115) | $852.80 | $1,066 | 2.3× |
| Bone age studies (77072) | $310.40 | $388 | 2.8× |
| Bone Imaging 3 Phase (78315) | $1,763.20 | $2,204 | 4.1× |
| Bone Imaging Limited Area (78300) | $1,143.20 | $1,429 | 2.7× |
| Bone Imaging Multiple Areas (78305) | $1,632.80 | $2,041 | 3.8× |
| Bone Imaging Whole Body (78306) | $1,748.80 | $2,186 | 4.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,564.80 | $1,956 | 2.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,382.40 | $6,728 | 3.5× |
| Chest 1 view (71045) | $268.80 | $336 | 2.9× |
| Chest 2 views (71046) | $316.80 | $396 | 3.4× |
| Chest 3 views (71047) | $376.80 | $471 | 4.0× |
| Chest 4 or more views (71048) | $426.40 | $533 | 3.8× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$292.80–$518.40 | $366–$648 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $235.20 | $294 | 2.1× |
| Contrast X-Ray Bladder (74430) | $630.40 | $788 | 1.7× |
| Contrast X-Ray Of Elbow (73085) | $904 | $1,130 | 2.4× |
| Contrast X-Ray Of Knee Joint (73580) | $1,150.40 | $1,438 | 3.1× |
| CT abdomen and pelvis without and with contrast (74178) | $5,698.40 | $7,123 | 15.2× |
| CT abdomen and pelvis without contrast (74176) | $3,988.80 | $4,986 | 15.6× |
| CT abdomen w contrast (74160) | $3,048 | $3,810 | 16.2× |
| CT abdomen w wo contrast (74170) | $3,652.80 | $4,566 | 19.4× |
| CT abdomen w/o contrast (74150) | $2,852 | $3,565 | 25.5× |
| CT Angio Abdomen and Pelvis (74174) | $4,182.40 | $5,228 | 11.2× |
| CT Angio Chest (71275) | $3,076.80 | $3,846 | 16.4× |
| CT Angio Head (70496) | $2,891.20 | $3,614 | 15.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $3,512 | $4,390 | 18.7× |
| CT Angio Neck (70498) | $2,912 | $3,640 | 15.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$2,841.60–$4,263.20 | $3,552–$5,329 | varies |
| CT cervical spine w/o contrast (72125) | $2,412 | $3,015 | 21.5× |
| CT cervical spine w/wo cont (72127) | $3,460 | $4,325 | 18.4× |
| CT chest w contrast (71260) | $2,549.60 | $3,187 | 13.6× |
| CT chest w/wo contrast (71270) | $2,783.20 | $3,479 | 14.8× |
| CT head/brain with contrast (70460) | $2,171.20 | $2,714 | 11.6× |
| CT head/brain without and with contrast (70470) | $2,549.60 | $3,187 | 13.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $156 | $195 | 1.7× |
| CT iac w contrast (70481) | $2,186.40 | $2,733 | 11.6× |
| CT l-spine w&w/o contrast (72133) | $3,460 | $4,325 | 18.4× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$2,028.80–$3,043.20 | $2,536–$3,804 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$2,118.40–$3,176.80 | $2,648–$3,971 | varies |
| CT lumbar spine w contrast (72132) | $2,572 | $3,215 | 6.9× |
| CT lumbar spine w/o contrast (72131) | $2,420 | $3,025 | 21.6× |
| CT maxillofacial w contrast (70487) | $2,405.60 | $3,007 | 12.8× |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$1,683.20–$2,220.80 | $2,104–$2,776 | varies |
| CT neck tissue combo (70492) | $2,598.40 | $3,248 | 13.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,950.40 | $3,688 | 15.7× |
| CT orbits w/o contrast (70480) | $2,023.20 | $2,529 | 18.1× |
| CT pelvis w&w/o contrast (72194) | $2,916 | $3,645 | 15.5× |
| CT pelvis w/o contrast (72192) | $2,052.80 | $2,566 | 18.3× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,408.80–$3,614.40 | $3,011–$4,518 | varies |
| CT scans face/jaw combo (70488) | $2,596 | $3,245 | 13.8× |
| CT soft tissue neck w contrast (70491) | $2,548 | $3,185 | 13.6× |
| CT soft tissue neck w/o contrast (70490) | $1,961.60 | $2,452 | 17.5× |
| CT thoracic spine w/o contrast (72128) | $2,154.40 | $2,693 | 19.2× |
| CT thorax w/o contrast (71250) | $2,141.60 | $2,677 | 19.1× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$2,139.20–$3,208.80 | $2,674–$4,011 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,686.40–$4,028.80 | $3,358–$5,036 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$2,416.80–$3,626.40 | $3,021–$4,533 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,765.60 | $3,457 | 14.7× |
| Cta Abdomen (74175) | $2,649.60 | $3,312 | 14.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,550.40 | $3,188 | 6.8× |
| Dxa Bone Density Axial (77080) | $565.60 | $707 | 5.0× |
| Dxa bone density study (77085) | $297.60 | $372 | 2.7× |
| Esophagram (74220) | $584.80 | $731 | 3.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $589.60 | $737 | 5.3× |
| Fluoroscopy up to 1 hr (76000) | $494.40 | $618 | 1.9× |
| Follow-Up Angiography (75898) | $2,644 | $3,305 | 0.8× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$338.40–$439.20 | $423–$549 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$304.80–$570.40 | $381–$713 | varies |
| Gastric emptying imaging study (78264) | $1,499.20 | $1,874 | 3.5× |
| Gated Heart Planar Single (78472) | $1,688.80 | $2,111 | 3.9× |
| Gated Heart, Multiple (78473) | $2,060.80 | $2,576 | 4.8× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$344–$644.80 | $430–$806 | varies |
| Heart first pass single,planar (78481) | $1,648.80 | $2,061 | 2.8× |
| Hepatobil Syst Image W/Drug (78227) | $1,912.80 | $2,391 | 3.3× |
| Hepatobiliary System Imaging (78226) | $1,724 | $2,155 | 4.0× |
| Ht Musc Image Planar Mult (78454) | $2,376.80 | $2,971 | 1.7× |
| Ht Muscle Image Spect Sing (78451) | $2,340.80 | $2,926 | 1.7× |
| Hysterosalpingogram (74740) | $1,167.20 | $1,459 | 4.6× |
| Joint Survey Single View (77077) | $206.40 | $258 | 1.8× |
| K Flow/Funct Image W/Drug (78708) | $1,592.80 | $1,991 | 2.7× |
| K Flow/Funct Image W/O Drug (78707) | $1,508 | $1,885 | 2.6× |
| Kidney Imaging Morphol (78700) | $1,085.60 | $1,357 | 2.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,285.60 | $1,607 | 3.0× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$373.60–$571.20 | $467–$714 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,062.40 | $1,328 | 2.5× |
| Liver imaging w/vascular flow (78202) | $1,005.60 | $1,257 | 1.7× |
| Lung Perf&Ventilat Diferentl (78598) | $1,353.60 | $1,692 | 2.3× |
| Lung Ventilat&Perfus Imaging (78582) | $1,277.60 | $1,597 | 2.2× |
| Lung Ventilation Imaging (78579) | $908 | $1,135 | 2.1× |
| Lymph System Imaging (78195) | $1,365.60 | $1,707 | 2.3× |
| Mammary ductogram or galactogram single (77053) | $753.60 | $942 | 2.9× |
| Meckels Divert Exam (78290) | $3,524.80 | $4,406 | 8.2× |
| Mr safety determination physician/other qhp (76016) | $152 | $190 | 1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $43.20 | $54 | 1.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $159.20 | $199 | 1.6× |
| Mr safety implt pos&/immoblj (76019) | $102.40 | $128 | 1.6× |
| Mr safety med physics xm customization plng&mntr (76017) | $419.20 | $524 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $3,485.60 | $4,357 | 9.3× |
| MRA head w/o contrast (70544) | $3,453.60 | $4,317 | 13.5× |
| MRA head with contrast (70545) | $3,380 | $4,225 | 9.0× |
| MRA neck w contrast (70548) | $3,380 | $4,225 | 9.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,555.20 | $4,444 | 9.5× |
| MRA neck w/o contrast (70547) | $3,274.40 | $4,093 | 12.8× |
| MRI abdomen w/o contrast (74181) | $2,898.40 | $3,623 | 11.3× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$3,531.20–$5,297.60 | $4,414–$6,622 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,983.20–$5,974.40 | $4,979–$7,468 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$3,267.20–$4,901.60 | $4,084–$6,127 | varies |
| MRI cervical spine w contrast (72142) | $3,704 | $4,630 | 9.9× |
| MRI cervical spine w/o cont (72141) | $3,224.80 | $4,031 | 12.6× |
| MRI chest w/o contrast (71550) | $2,755.20 | $3,444 | 10.8× |
| MRI chest with contrast (71551) | $3,204.80 | $4,006 | 3.8× |
| MRI chest wo w contrast (71552) | $3,960.80 | $4,951 | 10.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$3,491.20–$5,237.60 | $4,364–$6,547 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$3,618.40–$5,428 | $4,523–$6,785 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$3,329.60–$4,994.40 | $4,162–$6,243 | varies |
| MRI lumbar spine w contrast (72149) | $3,513.60 | $4,392 | 9.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,408.80 | $5,511 | 11.8× |
| MRI orbit face &/neck w/o contrast (70540) | $2,988.80 | $3,736 | 11.7× |
| MRI orbit face neck w contrast (70542) | $3,344.80 | $4,181 | 8.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,291.20 | $5,364 | 11.5× |
| MRI pelvis w contrast (72196) | $3,547.20 | $4,434 | 9.5× |
| MRI pelvis w/o & w contrast (72197) | $4,120 | $5,150 | 11.0× |
| MRI pelvis w/o contrast (72195) | $3,557.60 | $4,447 | 13.9× |
| MRI thoracic spine w/o contrast (72146) | $3,106.40 | $3,883 | 12.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$3,101.60–$4,652.80 | $3,877–$5,816 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,823.20–$4,235.20 | $3,529–$5,294 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$3,760.80–$5,642.40 | $4,701–$7,053 | varies |
| MRI, abdomen, combo (74183) | $4,656 | $5,820 | 12.5× |
| MRI, dorsal spine combo (72157) | $4,394.40 | $5,493 | 11.8× |
| MRI, dorsal spine contrast (72147) | $3,726.40 | $4,658 | 10.0× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,980–$4,470.40 | $3,725–$5,588 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$3,691.20–$5,537.60 | $4,614–$6,922 | varies |
| MRI, lumbar spine combo (72158) | $4,408.80 | $5,511 | 11.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $972.80 | $1,216 | 2.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,958.40 | $6,198 | 3.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,243.20 | $1,554 | 0.9× |
| Myocardial Spect Multiple Studies (78452) | $3,117.60 | $3,897 | 2.2× |
| Neck soft tissue (70360) | $327.20 | $409 | 3.5× |
| Nonvascular Shunt X-Ray (75809) | $633.60 | $792 | 5.7× |
| Pelvis 1 or 2 views (72170) | $344 | $430 | 3.1× |
| Pet Image W/Ct Lmtd (78814) | $5,676 | $7,095 | 3.7× |
| PET image w/CT, full body (78816) | $6,069.60 | $7,587 | 4.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,988.80 | $7,486 | 3.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,644 | $3,305 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $954.40 | $1,193 | 2.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $579.20 | $724 | 5.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$400.80–$639.20 | $501–$799 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$299.20–$508.80 | $374–$636 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$362.40–$591.20 | $453–$739 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $479.20 | $599 | 4.3× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$298.40–$503.20 | $373–$629 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$420.80–$575.20 | $526–$719 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$424.80–$744 | $531–$930 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $298.40 | $373 | 3.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$477.60–$716.80 | $597–$896 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $379.20 | $474 | 4.1× |
| Radex Ribs Unilateral 2 Views (71100) | $383.20 | $479 | 4.1× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$403.20–$739.20 | $504–$924 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $275.20 | $344 | 3.0× |
| Radex Spine 1 View Specify Level (72020) range across 6 matching MRF lines |
$341.60–$366.40 | $427–$458 | varies |
| Radex Sternum Minimum 2 Views (71120) | $360 | $450 | 3.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $465.60 | $582 | 5.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$281.60–$372 | $352–$465 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$247.20–$371.20 | $309–$464 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$385.60–$706.40 | $482–$883 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $436.80 | $546 | 3.9× |
| Radiolog exam mandible compl minimum 4 views (70110) | $477.60 | $597 | 4.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $441.60 | $552 | 3.9× |
| Radiologic exam colon double contrast study (74280) | $1,024 | $1,280 | 5.4× |
| Radiologic exam colon single contrast study (74270) | $764 | $955 | 4.1× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$476.80–$797.60 | $596–$997 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $404.80 | $506 | 3.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $721.60 | $902 | 3.8× |
| Radiologic exam swallow function contrast study (74230) | $596.80 | $746 | 3.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $891.20 | $1,114 | 4.7× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$448–$674.40 | $560–$843 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$359.20–$512 | $449–$640 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$328.80–$499.20 | $411–$624 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $1,789.60 | $2,237 | 16.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$376.80–$634.40 | $471–$793 | varies |
| Ribs bilateral 3 views (71110) | $499.20 | $624 | 4.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,070.40 | $3,838 | 5.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,630.40 | $4,538 | 6.2× |
| Salivary Gland Imaging Serial Images (78231) | $819.20 | $1,024 | 1.9× |
| Scapula (73010) range across 3 matching MRF lines |
$307.20–$596.80 | $384–$746 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $88.80 | $111 | 3.8× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$281.60–$542.40 | $352–$678 | varies |
| Shoulder Arthrography (73040) | $864 | $1,080 | 2.3× |
| Skull less than 4 views (70250) | $364.80 | $456 | 3.3× |
| Spleen Imaging (78185) | $828.80 | $1,036 | 1.9× |
| Sternoclavicular joints (71130) | $321.60 | $402 | 3.4× |
| Testicular Imaging W/Flow (78761) | $1,001.60 | $1,252 | 2.3× |
| Thoracic spine 2 views (72070) | $459.20 | $574 | 4.1× |
| Thoracic spine 3 views (72072) | $527.20 | $659 | 4.7× |
| Thoracolumbar 2 views (72080) | $224 | $280 | 2.4× |
| Thyroid Imaging With Vascular Flow (78013) | $338.40 | $423 | 0.8× |
| Thyroid Uptake Measurement (78012) | $608.80 | $761 | 1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $342.40 | $428 | 0.8× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$560.80–$737.60 | $701–$922 | varies |
| Ultrasound Exam Aaa Screen (76706) | $707.20 | $884 | 6.3× |
| Ultrasound, abdomen limited (76705) | $730.40 | $913 | 6.5× |
| Upper gi w/o kub (74240) | $900.80 | $1,126 | 4.8× |
| Urethrocystogram voiding (74455) | $784 | $980 | 3.1× |
| Urethrocystography retrograde (74450) | $664.80 | $831 | 2.6× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$596.80–$832 | $746–$1,040 | varies |
| Us chest (76604) | $818.40 | $1,023 | 7.3× |
| Us complete joint (76881) range across 3 matching MRF lines |
$512–$1,023.20 | $640–$1,279 | varies |
| Us exam, pelvic, limited (76857) | $584.80 | $731 | 5.2× |
| Us kidney transplant (76776) | $936 | $1,170 | 8.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$656–$1,023.20 | $820–$1,279 | varies |
| Us ob detailed single fetus (76811) | $1,029.60 | $1,287 | 4.0× |
| Us ob limited 1 or more fetuses (76815) | $488.80 | $611 | 4.4× |
| Us ob transvaginal (76817) | $613.60 | $767 | 5.5× |
| Us pelvic non ob complete (76856) | $1,060.80 | $1,326 | 9.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $920.80 | $1,151 | 8.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $613.60 | $767 | 5.5× |
| Us retroperitoneal complete (76770) | $1,188.80 | $1,486 | 10.6× |
| Us retroperitoneal limited (76775) | $777.60 | $972 | 6.9× |
| Us scrotum and contents (76870) | $952.80 | $1,191 | 8.5× |
| Us thyroid (76536) | $677.60 | $847 | 6.0× |
| Vascular Flow Imaging (78445) | $676 | $845 | 1.6× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,644 | $3,305 | 0.8× |
| Venogram Sinus/Jugular (75860) | $2,644 | $3,305 | 0.8× |
| Venography extremity bilateral rs&i (75822) | $1,619.20 | $2,024 | 1.0× |
| Venography extremity unilateral rs&i (75820) | $1,404 | $1,755 | 0.8× |
| Vertebral fracture assessment via dxa (77086) | $255.20 | $319 | 2.7× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$291.20–$379.20 | $364–$474 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $344 | $430 | 3.7× |
| X-ray antegrade pyelogram tube (74425) | $549.60 | $687 | 1.5× |
| X-Ray Bend Only L-S Spine (72120) | $471.20 | $589 | 4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$323.20–$529.60 | $404–$662 | varies |
| X-Ray Exam Breast Specimen (76098) | $460.80 | $576 | 0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $295.20 | $369 | 3.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $341.60 | $427 | 3.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $379.20 | $474 | 3.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $275.20 | $344 | 3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $373.60 | $467 | 4.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $505.60 | $632 | 4.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $444.80 | $556 | 4.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $640 | $800 | 5.7× |
| X-Ray Exam L-S Spine Bending (72114) | $612.80 | $766 | 5.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $468 | $585 | 5.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $635.20 | $794 | 5.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $464 | $580 | 4.1× |
| X-ray eye for foreign body (70030) | $352.80 | $441 | 3.8× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$329.60–$549.60 | $412–$687 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,092 | $1,365 | 5.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $353.60 | $442 | 3.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $360 | $450 | 3.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $471.20 | $589 | 4.2× |
| X-ray nose-rectum child f.b. (76010) | $113.60 | $142 | 1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $448.80 | $561 | 4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $392.80 | $491 | 3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $373.60 | $467 | 4.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $454.40 | $568 | 4.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $581.60 | $727 | 5.2× |
| X-ray thoracic spine 4 vw (72074) | $569.60 | $712 | 5.1× |
| X-Ray Tmj Unilat (70328) | $311.20 | $389 | 3.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $791.20 | $989 | 2.1× |
| X-Rays Bone Length Studies (77073) | $438.40 | $548 | 3.9× |
| X-Rays Bone Survey Complete (77075) | $206.40 | $258 | 1.8× |
| Xr c-spine 4 or 5 views (72050) | $577.60 | $722 | 5.2× |
| Xr facial bones less than 3 views (70140) | $329.60 | $412 | 3.5× |
| Xr orbits complete 4 views (70200) | $474.40 | $593 | 4.2× |
| Xr Tomogram Single Plane (76100) | $766.40 | $958 | 6.8× |
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.