Imaging prices at Osf Saint Luke Medical Center
Kewanee, IL · every code in this section with a posted price and a Medicare benchmark.
260 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) | $1,854.40 | $2,318 | 4.3× |
| Angio pulmonary bilat (75743) | $2,644 | $3,305 | 0.8× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$304.80–$551.20 | $381–$689 | varies |
| Bone age studies (77072) | $285.60 | $357 | 2.5× |
| Bone Imaging 3 Phase (78315) | $1,588 | $1,985 | 3.7× |
| Bone Imaging Limited Area (78300) | $1,165.60 | $1,457 | 2.7× |
| Bone Imaging Multiple Areas (78305) | $1,606.40 | $2,008 | 3.7× |
| Bone Imaging Whole Body (78306) | $1,600.80 | $2,001 | 3.7× |
| Bone survey infant (77076) | $507.20 | $634 | 4.5× |
| 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) range across 3 matching MRF lines |
$426.40–$470.40 | $533–$588 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$316–$567.20 | $395–$709 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $235.20 | $294 | 2.1× |
| Contrast X-Ray Bladder (74430) | $686.40 | $858 | 1.8× |
| CT abdomen and pelvis without and with contrast (74178) | $3,792 | $4,740 | 10.1× |
| CT abdomen and pelvis without contrast (74176) | $2,835.20 | $3,544 | 11.1× |
| CT abdomen w contrast (74160) | $2,205.60 | $2,757 | 11.7× |
| CT abdomen w wo contrast (74170) | $2,605.60 | $3,257 | 13.9× |
| CT abdomen w/o contrast (74150) | $1,931.20 | $2,414 | 17.2× |
| CT Angio Abdomen and Pelvis (74174) | $2,404 | $3,005 | 6.4× |
| CT Angio Chest (71275) | $3,024.80 | $3,781 | 16.1× |
| CT Angio Head (70496) | $2,729.60 | $3,412 | 14.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$3,490.40–$5,235.20 | $4,363–$6,544 | varies |
| CT Angio Neck (70498) | $2,893.60 | $3,617 | 15.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$2,824–$4,236 | $3,530–$5,295 | varies |
| CT cervical spine w/ contrast (72126) | $2,495.20 | $3,119 | 6.7× |
| CT cervical spine w/o contrast (72125) | $2,266.40 | $2,833 | 20.2× |
| CT cervical spine w/wo cont (72127) | $2,767.20 | $3,459 | 14.7× |
| CT chest w contrast (71260) | $2,375.20 | $2,969 | 12.6× |
| CT chest w/wo contrast (71270) | $2,536 | $3,170 | 13.5× |
| CT head/brain with contrast (70460) | $2,156.80 | $2,696 | 11.5× |
| CT head/brain without and with contrast (70470) | $2,214.40 | $2,768 | 11.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $156 | $195 | 1.7× |
| CT iac w contrast (70481) | $2,110.40 | $2,638 | 11.2× |
| CT l-spine w&w/o contrast (72133) | $3,083.20 | $3,854 | 16.4× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$2,016–$3,024 | $2,520–$3,780 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$2,380–$3,571.20 | $2,975–$4,464 | varies |
| CT lumbar spine w contrast (72132) | $2,778.40 | $3,473 | 7.4× |
| CT lumbar spine w/o contrast (72131) | $2,476.80 | $3,096 | 22.1× |
| CT maxillofacial w contrast (70487) | $2,087.20 | $2,609 | 11.1× |
| CT maxillofacial wo contrast (70486) | $1,933.60 | $2,417 | 17.3× |
| CT neck tissue combo (70492) | $2,581.60 | $3,227 | 13.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,354.40 | $2,943 | 12.5× |
| CT orbits w/o contrast (70480) | $1,962.40 | $2,453 | 17.5× |
| CT pelvis w&w/o contrast (72194) | $2,711.20 | $3,389 | 14.4× |
| CT pelvis w/o contrast (72192) | $1,980.80 | $2,476 | 17.7× |
| CT scan of leg combo (73702) | $2,533.60 | $3,167 | 13.5× |
| CT scans face/jaw combo (70488) | $2,217.60 | $2,772 | 11.8× |
| CT soft tissue neck w contrast (70491) | $2,065.60 | $2,582 | 11.0× |
| CT soft tissue neck w/o contrast (70490) | $1,848 | $2,310 | 16.5× |
| CT thoracic spine w contrast (72129) | $2,624.80 | $3,281 | 14.0× |
| CT thoracic spine w/o contrast (72128) | $2,214.40 | $2,768 | 19.8× |
| CT thoracic spine w/wo cont (72130) | $2,804 | $3,505 | 14.9× |
| CT thorax w/o contrast (71250) | $1,970.40 | $2,463 | 17.6× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,808–$2,712.80 | $2,260–$3,391 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,412.80–$3,619.20 | $3,016–$4,524 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$2,108.80–$3,164 | $2,636–$3,955 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,545.60 | $3,182 | 13.5× |
| Cta Abdomen (74175) | $2,524 | $3,155 | 13.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,550.40 | $3,188 | 6.8× |
| CTA pelvis (72191) | $3,085.60 | $3,857 | 16.4× |
| Dxa Bone Density Axial (77080) | $504.80 | $631 | 4.5× |
| Dxa bone density study (77085) | $276.80 | $346 | 2.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $421.60 | $527 | 4.5× |
| Esophagram (74220) | $640.80 | $801 | 3.4× |
| Fetal Biophys Profile W/Nst (76818) | $911.20 | $1,139 | 8.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $796.80 | $996 | 7.1× |
| Fluoroscopy up to 1 hr (76000) | $455.20 | $569 | 1.8× |
| Follow-Up Angiography (75898) | $2,644 | $3,305 | 0.8× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$315.20–$565.60 | $394–$707 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$324–$581.60 | $405–$727 | varies |
| Gastric emptying imaging study (78264) | $1,423.20 | $1,779 | 3.3× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $2,721.60 | $3,402 | 6.4× |
| Gated Heart Planar Single (78472) | $1,882.40 | $2,353 | 4.4× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$332.80–$596.80 | $416–$746 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,423.20 | $1,779 | 2.4× |
| Hepatobiliary System Imaging (78226) | $1,791.20 | $2,239 | 4.2× |
| Ht Muscle Image Spect Sing (78451) | $2,795.20 | $3,494 | 2.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,037.60 | $1,297 | 11.1× |
| Joint Survey Single View (77077) | $163.20 | $204 | 1.5× |
| K Flow/Funct Image Multiple (78709) | $1,739.20 | $2,174 | 3.0× |
| K Flow/Funct Image W/Drug (78708) | $2,531.20 | $3,164 | 4.4× |
| K Flow/Funct Image W/O Drug (78707) | $2,559.20 | $3,199 | 4.4× |
| Kidney Imaging Morphol (78700) | $1,439.20 | $1,799 | 3.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,532 | $1,915 | 3.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$463.20–$832.80 | $579–$1,041 | varies |
| Lung perfusion differential (78597) | $1,132 | $1,415 | 2.6× |
| Lung Ventilat&Perfus Imaging (78582) | $2,586.40 | $3,233 | 4.4× |
| Lymph System Imaging (78195) | $1,462.40 | $1,828 | 2.5× |
| Magnetic Image Jaw Joint (70336) | $2,315.20 | $2,894 | 9.1× |
| Meckels Divert Exam (78290) | $3,468 | $4,335 | 8.1× |
| 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) | $3,525.60 | $4,407 | 9.4× |
| MRA head w/o contrast (70544) | $2,801.60 | $3,502 | 11.0× |
| MRA head with contrast (70545) | $3,280.80 | $4,101 | 8.8× |
| MRA neck w contrast (70548) | $2,936 | $3,670 | 7.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,883.20 | $4,854 | 10.4× |
| MRA neck w/o contrast (70547) | $2,911.20 | $3,639 | 11.4× |
| MRI abdomen w contrast (74182) | $3,440 | $4,300 | 9.2× |
| MRI abdomen w/o contrast (74181) | $2,880 | $3,600 | 11.3× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$3,198.40–$4,798.40 | $3,998–$5,998 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,760 | $4,700 | 10.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,096 | $3,870 | 3.7× |
| MRI cervical spine w contrast (72142) | $3,367.20 | $4,209 | 9.0× |
| MRI cervical spine w/o cont (72141) | $3,022.40 | $3,778 | 11.8× |
| MRI chest w/o contrast (71550) | $2,937.60 | $3,672 | 11.5× |
| MRI chest with contrast (71551) | $3,415.20 | $4,269 | 4.1× |
| MRI chest wo w contrast (71552) | $3,877.60 | $4,847 | 10.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$3,014.40–$4,522.40 | $3,768–$5,653 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$4,436.80–$6,655.20 | $5,546–$8,319 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,800–$4,200 | $3,500–$5,250 | varies |
| MRI lumbar spine w contrast (72149) | $3,350.40 | $4,188 | 9.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,738.40 | $4,673 | 10.0× |
| MRI orbit face &/neck w/o contrast (70540) | $2,997.60 | $3,747 | 11.7× |
| MRI orbit face neck w contrast (70542) | $3,330.40 | $4,163 | 8.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,673.60 | $4,592 | 9.8× |
| MRI pelvis w contrast (72196) | $3,381.60 | $4,227 | 9.0× |
| MRI pelvis w/o & w contrast (72197) | $3,572 | $4,465 | 9.6× |
| MRI pelvis w/o contrast (72195) | $2,826.40 | $3,533 | 11.1× |
| MRI thoracic spine w/o contrast (72146) | $2,951.20 | $3,689 | 11.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,133.60 | $3,917 | 12.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,816.80 | $4,771 | 10.2× |
| MRI, abdomen, combo (74183) | $3,673.60 | $4,592 | 9.8× |
| MRI, dorsal spine combo (72157) | $3,752 | $4,690 | 10.0× |
| MRI, dorsal spine contrast (72147) | $4,972 | $6,215 | 13.3× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,634.40–$3,951.20 | $3,293–$4,939 | varies |
| MRI, joint upper extrem combo (73223) | $3,352.80 | $4,191 | 9.0× |
| MRI, lumbar spine combo (72158) | $3,752 | $4,690 | 10.0× |
| Myocardial Spect Multiple Studies (78452) | $4,445.60 | $5,557 | 3.2× |
| Neck soft tissue (70360) | $330.40 | $413 | 3.5× |
| Parathyroid Planar Imaging (78070) | $1,063.20 | $1,329 | 2.5× |
| Pelvis 1 or 2 views (72170) | $324 | $405 | 2.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,644 | $3,305 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,492.80 | $1,866 | 3.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $648.80 | $811 | 5.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$354.40–$532 | $443–$665 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$310.40–$560.80 | $388–$701 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$388.80–$700.80 | $486–$876 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $580.80 | $726 | 5.2× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$264.80–$469.60 | $331–$587 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$377.60–$529.60 | $472–$662 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$349.60–$630.40 | $437–$788 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$374.40–$729.60 | $468–$912 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$436–$653.60 | $545–$817 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $361.60 | $452 | 3.9× |
| Radex Ribs Unilateral 2 Views (71100) | $423.20 | $529 | 4.5× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$412.80–$744.80 | $516–$931 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $530.40 | $663 | 5.7× |
| 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) | $391.20 | $489 | 4.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $554.40 | $693 | 5.9× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$253.60–$487.20 | $317–$609 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$234.40–$352.80 | $293–$441 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$344.80–$620 | $431–$775 | 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) | $525.60 | $657 | 4.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $441.60 | $552 | 3.9× |
| Radiologic exam colon double contrast study (74280) | $1,041.60 | $1,302 | 5.5× |
| Radiologic exam colon single contrast study (74270) | $852.80 | $1,066 | 4.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $964 | $1,205 | 5.1× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$463.20–$832.80 | $579–$1,041 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $424 | $530 | 3.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $712.80 | $891 | 3.8× |
| Radiologic exam swallow function contrast study (74230) | $657.60 | $822 | 3.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,029.60 | $1,287 | 5.5× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$415.20–$625.60 | $519–$782 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$416.80–$627.20 | $521–$784 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$430.40–$775.20 | $538–$969 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $586.40 | $733 | 5.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$356–$641.60 | $445–$802 | varies |
| Ribs bilateral 3 views (71110) | $637.60 | $797 | 5.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,030.40 | $2,538 | 3.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,155.20 | $1,444 | 2.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,579.20 | $1,974 | 1.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,105.60 | $2,632 | 1.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,404 | $1,755 | 1.0× |
| Scapula (73010) range across 3 matching MRF lines |
$403.20–$723.20 | $504–$904 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $107.20 | $134 | 4.6× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$287.20–$513.60 | $359–$642 | varies |
| Skull less than 4 views (70250) | $360.80 | $451 | 3.2× |
| Sternoclavicular joints (71130) | $364 | $455 | 3.9× |
| Testicular Imaging W/Flow (78761) | $1,567.20 | $1,959 | 3.7× |
| 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) | $989.60 | $1,237 | 2.3× |
| Thyroid Uptake Measurement (78012) | $1,327.20 | $1,659 | 3.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,105.60 | $1,382 | 2.6× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$520.80–$935.20 | $651–$1,169 | varies |
| Ultrasound Exam Aaa Screen (76706) | $659.20 | $824 | 5.9× |
| Ultrasound, abdomen limited (76705) | $820.80 | $1,026 | 7.3× |
| Unlisted us procedure (76999) | $473.60 | $592 | 5.1× |
| Upper gi w/o kub (74240) | $1,038.40 | $1,298 | 5.5× |
| Urethrocystogram voiding (74455) | $660.80 | $826 | 2.6× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$554.40–$996 | $693–$1,245 | varies |
| Us chest (76604) | $636.80 | $796 | 5.7× |
| Us complete joint (76881) range across 3 matching MRF lines |
$1,123.20–$1,684.80 | $1,404–$2,106 | varies |
| Us exam, pelvic, limited (76857) | $473.60 | $592 | 4.2× |
| Us head (76506) | $981.60 | $1,227 | 8.8× |
| Us kidney transplant (76776) | $1,022.40 | $1,278 | 9.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$473.60–$709.60 | $592–$887 | varies |
| Us ob detailed single fetus (76811) | $925.60 | $1,157 | 3.6× |
| Us ob limited 1 or more fetuses (76815) | $790.40 | $988 | 7.1× |
| Us ob transvaginal (76817) | $555.20 | $694 | 5.0× |
| Us pelvic non ob complete (76856) | $898.40 | $1,123 | 8.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $604 | $755 | 5.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $736 | $920 | 6.6× |
| Us retroperitoneal complete (76770) | $828 | $1,035 | 7.4× |
| Us retroperitoneal limited (76775) | $832 | $1,040 | 7.4× |
| Us scrotum and contents (76870) | $862.40 | $1,078 | 7.7× |
| Us thyroid (76536) | $796.80 | $996 | 7.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,644 | $3,305 | 0.8× |
| Venogram Sinus/Jugular (75860) | $2,644 | $3,305 | 0.8× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$278.40–$501.60 | $348–$627 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $425.60 | $532 | 4.6× |
| X-ray antegrade pyelogram tube (74425) | $1,175.20 | $1,469 | 3.1× |
| 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 |
$353.60–$635.20 | $442–$794 | 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) | $329.60 | $412 | 3.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $468.80 | $586 | 5.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $510.40 | $638 | 4.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $589.60 | $737 | 5.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $592 | $740 | 5.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $640.80 | $801 | 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) | $525.60 | $657 | 4.7× |
| X-ray eye for foreign body (70030) | $356.80 | $446 | 3.8× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$353.60–$635.20 | $442–$794 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $525.60 | $657 | 5.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $383.20 | $479 | 4.1× |
| 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) | $339.20 | $424 | 3.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $660 | $825 | 5.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $427.20 | $534 | 3.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $452 | $565 | 4.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $435.20 | $544 | 4.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $530.40 | $663 | 5.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $609.60 | $762 | 5.4× |
| X-ray thoracic spine 4 vw (72074) | $569.60 | $712 | 5.1× |
| X-Ray Tmj Unilat (70328) | $289.60 | $362 | 3.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $795.20 | $994 | 2.1× |
| X-Rays Bone Length Studies (77073) | $353.60 | $442 | 3.2× |
| X-Rays Bone Survey Complete (77075) | $984.80 | $1,231 | 8.8× |
| Xr c-spine 4 or 5 views (72050) | $577.60 | $722 | 5.2× |
| Xr facial bones less than 3 views (70140) | $580.80 | $726 | 6.2× |
| Xr orbits complete 4 views (70200) | $468.80 | $586 | 4.2× |
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.