Imaging prices at Parkview Lagrange Hospital
Lagrange, IN · every code in this section with a posted price and a Medicare benchmark.
278 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) | $195.50 | $391 | 2.1× |
| Abdomen 2 views (74019) | $283.50 | $567 | 2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,202 | $2,404 | 2.8× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$155.50–$242 | $311–$484 | varies |
| Arthrogram hip (73525) | $1,007 | $2,014 | 2.7× |
| Basic radiation dosimetry calculation (77300) | $559.50 | $1,119 | 3.9× |
| Bone age studies (77072) | $106.50 | $213 | 1.0× |
| Bone Imaging 3 Phase (78315) | $1,516 | $3,032 | 3.6× |
| Bone Imaging Limited Area (78300) | $1,050 | $2,100 | 2.5× |
| Bone Imaging Multiple Areas (78305) | $1,297 | $2,594 | 3.1× |
| Bone Imaging Whole Body (78306) | $1,603 | $3,206 | 3.8× |
| Bone survey infant (77076) | $427.50 | $855 | 3.9× |
| Brain Flow Imaging Only (78610) | $1,092.50 | $2,185 | 1.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,033.50 | $2,067 | 2.8× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,240.50 | $2,481 | 1.5× |
| Cat Scan Follow-Up Study (76380) | $279.50 | $559 | 3.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,127.50 | $2,255 | 2.0× |
| Cerebrospinal Fluid Scan (78630) | $1,227 | $2,454 | 2.1× |
| Chest 1 view (71045) | $156 | $312 | 1.7× |
| Chest 2 views (71046) | $206.50 | $413 | 2.2× |
| Chest 3 views (71047) | $256.50 | $513 | 2.8× |
| Chest 4 or more views (71048) | $334.50 | $669 | 3.0× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$159.50–$239.50 | $319–$479 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $49.50 | $99 | 0.4× |
| Contrast X-Ray Bladder (74430) | $486.50 | $973 | 1.3× |
| Contrast X-Ray Of Knee Joint (73580) | $956.50 | $1,913 | 2.6× |
| CT abdomen and pelvis without and with contrast (74178) | $1,634.50 | $3,269 | 4.4× |
| CT abdomen and pelvis without contrast (74176) | $842 | $1,684 | 3.3× |
| CT abdomen w contrast (74160) | $778 | $1,556 | 4.2× |
| CT abdomen w wo contrast (74170) | $903 | $1,806 | 4.9× |
| CT abdomen w/o contrast (74150) | $643.50 | $1,287 | 5.8× |
| CT Angio Abdomen and Pelvis (74174) | $1,901.50 | $3,803 | 5.2× |
| CT Angio Chest (71275) | $941.50 | $1,883 | 5.1× |
| CT Angio Head (70496) | $789 | $1,578 | 4.3× |
| CT angio hrt w/3d image (75574) | $822.50 | $1,645 | 2.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$753.50–$1,130.50 | $1,507–$2,261 | varies |
| CT Angio Neck (70498) | $788.50 | $1,577 | 4.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$851.50–$1,192.50 | $1,703–$2,385 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $461.50 | $923 | 2.5× |
| CT cervical spine w/ contrast (72126) | $746.50 | $1,493 | 2.0× |
| CT cervical spine w/o contrast (72125) | $547 | $1,094 | 4.9× |
| CT cervical spine w/wo cont (72127) | $780 | $1,560 | 4.2× |
| CT chest w contrast (71260) | $763.50 | $1,527 | 4.1× |
| CT chest w/wo contrast (71270) | $962 | $1,924 | 5.2× |
| CT colonography screening (74263) | $499 | $998 | 2.0× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,043.50 | $2,087 | 5.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $499 | $998 | 4.5× |
| CT head/brain with contrast (70460) | $615.50 | $1,231 | 3.3× |
| CT head/brain without and with contrast (70470) | $721.50 | $1,443 | 3.9× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$49.50–$284.50 | $99–$569 | varies |
| CT hrt w/3d image congen (75573) | $795.50 | $1,591 | 2.2× |
| CT iac w contrast (70481) | $731.50 | $1,463 | 3.9× |
| CT l-spine w&w/o contrast (72133) | $988 | $1,976 | 5.3× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$550–$824.50 | $1,100–$1,649 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$778–$1,089.50 | $1,556–$2,179 | varies |
| CT lumbar spine w contrast (72132) | $808.50 | $1,617 | 2.2× |
| CT lumbar spine w/o contrast (72131) | $693 | $1,386 | 6.3× |
| CT maxillofacial w contrast (70487) | $628.50 | $1,257 | 3.4× |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$394–$514 | $788–$1,028 | varies |
| CT neck tissue combo (70492) | $778 | $1,556 | 4.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $850.50 | $1,701 | 4.6× |
| CT orbits w/o contrast (70480) | $606.50 | $1,213 | 5.5× |
| CT pelvis w&w/o contrast (72194) | $962 | $1,924 | 5.2× |
| CT pelvis w/o contrast (72192) | $569 | $1,138 | 5.1× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$979.50–$1,031.50 | $1,959–$2,063 | varies |
| CT scans face/jaw combo (70488) | $742 | $1,484 | 4.0× |
| CT soft tissue neck w contrast (70491) | $616.50 | $1,233 | 3.3× |
| CT soft tissue neck w/o contrast (70490) | $522 | $1,044 | 4.7× |
| CT thoracic spine w contrast (72129) | $831.50 | $1,663 | 4.5× |
| CT thoracic spine w/o contrast (72128) | $711.50 | $1,423 | 6.4× |
| CT thoracic spine w/wo cont (72130) | $1,047 | $2,094 | 5.6× |
| CT thorax w/o contrast (71250) | $547 | $1,094 | 4.9× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$661.50–$992.50 | $1,323–$1,985 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$782.50–$1,089.50 | $1,565–$2,179 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,220 | $2,440 | 6.6× |
| Cta Abdomen (74175) | $843.50 | $1,687 | 4.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,153.50 | $2,307 | 3.1× |
| CTA pelvis (72191) | $889 | $1,778 | 4.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $378 | $756 | 3.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $398 | $796 | 3.6× |
| Dxa Bone Density Axial (77080) | $275.50 | $551 | 2.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $144 | $288 | 1.6× |
| Echo exam of fetal heart (76825) | $378 | $756 | 0.7× |
| Echo exam uterus (76831) | $455.50 | $911 | 1.8× |
| Echo Guide For Artery Repair (76936) | $636 | $1,272 | 2.8× |
| Esophagram (74220) | $463 | $926 | 2.5× |
| Fetal Biophys Profile W/Nst (76818) | $465.50 | $931 | 4.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $405 | $810 | 3.7× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $732.50 | $1,465 | 2.9× |
| Fluoroscopy up to 1 hr (76000) | $613 | $1,226 | 2.4× |
| Foot 2 views (73620) range across 7 matching MRF lines |
$129.50–$242 | $259–$484 | varies |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$156.50–$240 | $313–$480 | varies |
| Gastric emptying imaging study (78264) | $1,325.50 | $2,651 | 3.1× |
| Gated Heart Planar Single (78472) | $1,675.50 | $3,351 | 4.0× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$154–$231.50 | $308–$463 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,662 | $3,324 | 2.9× |
| Hepatobiliary System Imaging (78226) | $1,324 | $2,648 | 3.1× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$708.50–$3,135.50 | $1,417–$6,271 | varies |
| Hysterosalpingogram (74740) | $722.50 | $1,445 | 2.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $592 | $1,184 | 6.4× |
| Joint Survey Single View (77077) | $240 | $480 | 2.2× |
| K Flow/Funct Image W/Drug (78708) | $1,058 | $2,116 | 1.8× |
| K Flow/Funct Image W/O Drug (78707) | $1,442.50 | $2,885 | 2.5× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$199.50–$286 | $399–$572 | varies |
| Liver imaging static only (78201) | $910.50 | $1,821 | 1.6× |
| Lung Perf&Ventilat Diferentl (78598) | $2,058.50 | $4,117 | 3.6× |
| Lung perfusion differential (78597) | $1,127.50 | $2,255 | 2.7× |
| Lung Ventilat&Perfus Imaging (78582) | $2,058.50 | $4,117 | 3.6× |
| Lung Ventilation Imaging (78579) | $564 | $1,128 | 1.3× |
| Lymph System Imaging (78195) | $1,269 | $2,538 | 2.2× |
| Magnetic Image Jaw Joint (70336) | $664 | $1,328 | 2.6× |
| Meckels Divert Exam (78290) | $918.50 | $1,837 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) | $1,032.50 | $2,065 | 2.8× |
| MRA head w/o contrast (70544) | $773 | $1,546 | 3.1× |
| MRA head with contrast (70545) | $999.50 | $1,999 | 2.7× |
| MRA neck w contrast (70548) | $927 | $1,854 | 2.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $937 | $1,874 | 2.5× |
| MRA neck w/o contrast (70547) | $510.50 | $1,021 | 2.0× |
| MRI abdomen w contrast (74182) | $887 | $1,774 | 2.4× |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$494–$831.50 | $988–$1,663 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$785.50–$1,142 | $1,571–$2,284 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$913–$1,369.50 | $1,826–$2,739 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 5 matching MRF lines |
$768.50–$1,142 | $1,537–$2,284 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,078 | $2,156 | 4.3× |
| MRI Breast Without Contrast Material Unilateral (77046) | $757 | $1,514 | 3.0× |
| MRI cardiac w/o contrast (75557) | $790 | $1,580 | 3.1× |
| MRI cervical spine w contrast (72142) | $928 | $1,856 | 2.5× |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$237.50–$753 | $475–$1,506 | varies |
| MRI chest w/o contrast (71550) | $722 | $1,444 | 2.9× |
| MRI chest wo w contrast (71552) | $943 | $1,886 | 2.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $869 | $1,738 | 2.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$938.50–$1,332 | $1,877–$2,664 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$660–$951.50 | $1,320–$1,903 | varies |
| MRI lumbar spine w contrast (72149) | $879 | $1,758 | 2.4× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$333–$1,329.50 | $666–$2,659 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $646.50 | $1,293 | 2.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $888 | $1,776 | 2.4× |
| MRI pelvis w contrast (72196) | $898 | $1,796 | 2.4× |
| MRI pelvis w/o & w contrast (72197) | $1,059.50 | $2,119 | 2.9× |
| MRI pelvis w/o contrast (72195) | $732.50 | $1,465 | 2.9× |
| MRI spectroscopy (76390) | $817 | $1,634 | 8.9× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$264–$814.50 | $528–$1,629 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $790.50 | $1,581 | 2.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$672–$951.50 | $1,344–$1,903 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$909–$1,332 | $1,818–$2,664 | varies |
| MRI, abdomen, combo (74183) | $1,025.50 | $2,051 | 2.8× |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$333–$1,027 | $666–$2,054 | varies |
| MRI, dorsal spine contrast (72147) | $907.50 | $1,815 | 2.5× |
| MRI, joint upper extrem (73221) range across 6 matching MRF lines |
$652–$951.50 | $1,304–$1,903 | varies |
| MRI, joint upper extrem combo (73223) range across 5 matching MRF lines |
$890.50–$1,332 | $1,781–$2,664 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$333–$991 | $666–$1,982 | varies |
| Myelogram cervical (72240) | $1,579 | $3,158 | 1.9× |
| Myelogram Lumbar (72265) | $927 | $1,854 | 1.1× |
| Myelograpy 2/more regions rs&i (72270) | $2,062.50 | $4,125 | 2.5× |
| Myocardial Spect Multiple Studies (78452) | $4,275.50 | $8,551 | 3.1× |
| N-invas est c ffr sw aly CTA (75580) | $2,673.50 | $5,347 | 2.9× |
| Neck soft tissue (70360) | $159 | $318 | 1.7× |
| Nuclear Rx Oral Admin (79005) | $2,057.50 | $4,115 | 8.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $337.50 | $675 | 3.1× |
| Parathyroid Planar Imaging (78070) | $870 | $1,740 | 2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $913 | $1,826 | 2.2× |
| Pelvis 1 or 2 views (72170) | $193 | $386 | 1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,123.50 | $2,247 | 2.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $380 | $760 | 3.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$191–$273 | $382–$546 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$169.50–$254 | $339–$508 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$199.50–$263.50 | $399–$527 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $238 | $476 | 2.2× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$106–$154 | $212–$308 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$197–$295.50 | $394–$591 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$191.50–$263.50 | $383–$527 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$147–$243 | $294–$486 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $199.50 | $399 | 2.2× |
| Radex Ribs Unilateral 2 Views (71100) | $193.50 | $387 | 2.1× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$200–$277.50 | $400–$555 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $186.50 | $373 | 2.0× |
| Radex Spine 1 View Specify Level (72020) | $158.50 | $317 | 1.7× |
| Radex Sternum Minimum 2 Views (71120) | $192.50 | $385 | 2.1× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$106–$153 | $212–$306 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$147–$243 | $294–$486 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 8 matching MRF lines |
$169.50–$254 | $339–$508 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $262 | $524 | 2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $312 | $624 | 2.8× |
| Radiologic exam colon double contrast study (74280) | $875.50 | $1,751 | 4.7× |
| Radiologic exam colon single contrast study (74270) | $524 | $1,048 | 2.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $512 | $1,024 | 2.8× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$217–$317.50 | $434–$635 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $241.50 | $483 | 2.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $534 | $1,068 | 2.9× |
| Radiologic exam swallow function contrast study (74230) | $441.50 | $883 | 2.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $575 | $1,150 | 3.1× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$68–$102.50 | $136–$205 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$199–$316 | $398–$632 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$166.50–$241 | $333–$482 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $392.50 | $785 | 3.5× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$193–$286 | $386–$572 | varies |
| Ribs bilateral 3 views (71110) | $227 | $454 | 2.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $696.50 | $1,393 | 1.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,501.50 | $3,003 | 3.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,624.50 | $3,249 | 2.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,637 | $5,274 | 1.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,987.50 | $3,975 | 1.5× |
| Rp Therapy Intravenous Administration (79101) | $1,295 | $2,590 | 5.2× |
| Scapula (73010) range across 3 matching MRF lines |
$190–$272 | $380–$544 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $39.50 | $79 | 1.7× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$130.50–$197.50 | $261–$395 | varies |
| Shoulder Arthrography (73040) | $909 | $1,818 | 2.5× |
| Skull less than 4 views (70250) | $194.50 | $389 | 1.8× |
| Special Physics Consult (77370) | $1,100.50 | $2,201 | 7.7× |
| Special treatment procedure (77470) | $2,701 | $5,402 | 4.6× |
| Sternoclavicular joints (71130) | $160.50 | $321 | 1.7× |
| Thoracic spine 2 views (72070) | $214.50 | $429 | 1.9× |
| Thoracic spine 3 views (72072) | $258.50 | $517 | 2.3× |
| Thoracolumbar 2 views (72080) | $229 | $458 | 2.5× |
| Thyroid Met Imaging Body (78018) | $1,552 | $3,104 | 2.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $935.50 | $1,871 | 2.2× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$345–$482.50 | $690–$965 | varies |
| Ultrasound Elastography Parenchyma (76981) | $205.50 | $411 | 1.9× |
| Ultrasound Exam Aaa Screen (76706) | $259.50 | $519 | 2.3× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$361–$439.50 | $722–$879 | varies |
| Umbilical-artery Doppler (OB) (76820) | $374.50 | $749 | 3.4× |
| Unlisted us procedure (76999) | $409.50 | $819 | 4.4× |
| Upper gi w/o kub (74240) | $514.50 | $1,029 | 2.8× |
| Urethrocystogram voiding (74455) | $574 | $1,148 | 2.3× |
| Urethrocystography retrograde (74450) | $619 | $1,238 | 2.5× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$430.50–$604.50 | $861–$1,209 | varies |
| Us chest (76604) | $363 | $726 | 3.3× |
| Us exam, pelvic, limited (76857) | $405 | $810 | 3.7× |
| Us head (76506) | $559.50 | $1,119 | 5.1× |
| Us kidney transplant (76776) | $500 | $1,000 | 4.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$295.50–$443 | $591–$886 | varies |
| Us ob detailed single fetus (76811) | $805 | $1,610 | 3.2× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$491–$517 | $982–$1,034 | varies |
| Us ob transvaginal (76817) | $439 | $878 | 4.0× |
| Us pelvic non ob complete (76856) | $434 | $868 | 3.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $590 | $1,180 | 5.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $537.50 | $1,075 | 4.9× |
| Us retroperitoneal complete (76770) | $480 | $960 | 4.3× |
| Us retroperitoneal limited (76775) | $341 | $682 | 3.1× |
| Us scrotum and contents (76870) | $405 | $810 | 3.7× |
| Us spinal canal and contents (76800) | $405 | $810 | 3.7× |
| Us thyroid (76536) range across 2 matching MRF lines |
$345–$431 | $690–$862 | varies |
| Venography extremity bilateral rs&i (75822) | $1,224.50 | $2,449 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $965 | $1,930 | 0.6× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$151–$240 | $302–$480 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $204.50 | $409 | 2.2× |
| X-Ray Bend Only L-S Spine (72120) | $239.50 | $479 | 2.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$160.50–$241 | $321–$482 | varies |
| X-Ray Exam Breast Specimen (76098) | $426.50 | $853 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $323.50 | $647 | 3.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $374.50 | $749 | 3.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $154 | $308 | 1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $199 | $398 | 2.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $233 | $466 | 2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $284 | $568 | 2.6× |
| X-Ray Exam L-S Spine Bending (72114) | $361 | $722 | 3.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $208.50 | $417 | 2.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $306 | $612 | 2.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $235 | $470 | 2.1× |
| X-ray eye for foreign body (70030) | $211 | $422 | 2.3× |
| X-ray humerus (73060) range across 5 matching MRF lines |
$191–$263.50 | $382–$527 | varies |
| X-ray IV pyelogram (ivp) (74400) | $486.50 | $973 | 2.6× |
| X-ray IV pyelogram+tomography (74415) | $638 | $1,276 | 3.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $143 | $286 | 1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $235.50 | $471 | 2.1× |
| X-ray nose-rectum child f.b. (76010) | $177 | $354 | 1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $307.50 | $615 | 2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $193.50 | $387 | 1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $199.50 | $399 | 2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $263 | $526 | 2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $299 | $598 | 2.7× |
| X-ray thoracic spine 4 vw (72074) | $282.50 | $565 | 2.6× |
| X-Ray Tmj Unilat (70328) | $170.50 | $341 | 1.9× |
| X-Rays Bone Length Studies (77073) | $267 | $534 | 2.4× |
| X-Rays Bone Survey Complete (77075) | $425.50 | $851 | 3.8× |
| Xr c-spine 4 or 5 views (72050) | $289.50 | $579 | 2.6× |
| Xr facial bones less than 3 views (70140) | $201.50 | $403 | 2.2× |
| Xr orbits complete 4 views (70200) | $225.50 | $451 | 2.0× |
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.