Imaging prices at Prairie Ridge Health
Columbus, WI · every code in this section with a posted price and a Medicare benchmark.
256 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) | $270.05 | $491 | 3.2× |
| Abdomen 2 views (74019) | $322.30 | $586 | 3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,507 | $2,740 | 3.9× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$260.70–$326.70 | $474–$594 | varies |
| Arthrogram ankle (73615) | $440 | $800 | 1.3× |
| Arthrogram hip (73525) | $778.25 | $1,415 | 2.3× |
| Bone age studies (77072) | $384.45 | $699 | 3.8× |
| Bone Imaging 3 Phase (78315) | $1,867.80 | $3,396 | 4.8× |
| Bone Imaging Limited Area (78300) | $1,342.55 | $2,441 | 3.5× |
| Bone Imaging Multiple Areas (78305) | $1,065.90 | $1,938 | 2.7× |
| Bone Imaging Whole Body (78306) | $1,591.70 | $2,894 | 4.1× |
| Bone survey infant (77076) | $700.70 | $1,274 | 6.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,275.70 | $7,774 | 3.1× |
| Chest 1 view (71045) | $292.60 | $532 | 3.5× |
| Chest 2 views (71046) | $304.15 | $553 | 3.6× |
| Chest 3 views (71047) | $448.80 | $816 | 5.3× |
| Cholecystography Oral Contrast (74290) | $457.60 | $832 | 2.7× |
| Clavicle complete (73000) | $333.30 | $606 | 3.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $728.20 | $1,324 | 7.2× |
| Contrast X-Ray Bladder (74430) | $717.75 | $1,305 | 2.1× |
| Contrast X-Ray Of Knee Joint (73580) | $715 | $1,300 | 2.1× |
| CT abdomen and pelvis without and with contrast (74178) | $4,414.30 | $8,026 | 13.0× |
| CT abdomen and pelvis without contrast (74176) | $2,879.80 | $5,236 | 12.4× |
| CT abdomen w contrast (74160) | $2,227.50 | $4,050 | 13.1× |
| CT abdomen w wo contrast (74170) | $2,501.40 | $4,548 | 14.7× |
| CT abdomen w/o contrast (74150) | $1,802.35 | $3,277 | 17.7× |
| CT Angio Abdomen and Pelvis (74174) | $4,718.45 | $8,579 | 13.9× |
| CT Angio Chest (71275) | $3,071.75 | $5,585 | 18.0× |
| CT Angio Head (70496) | $2,869.35 | $5,217 | 16.8× |
| CT Angio Neck (70498) | $2,586.65 | $4,703 | 15.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,586.65 | $4,703 | 15.2× |
| CT cervical spine w/ contrast (72126) | $2,191.20 | $3,984 | 6.5× |
| CT cervical spine w/o contrast (72125) | $2,046.55 | $3,721 | 20.2× |
| CT cervical spine w/wo cont (72127) | $2,443.10 | $4,442 | 14.3× |
| CT chest w contrast (71260) | $2,095.50 | $3,810 | 12.3× |
| CT chest w/wo contrast (71270) | $2,501.40 | $4,548 | 14.7× |
| CT head/brain with contrast (70460) | $2,279.75 | $4,145 | 13.4× |
| CT head/brain without and with contrast (70470) | $2,202.20 | $4,004 | 12.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $104.50 | $190 | 1.2× |
| CT iac w contrast (70481) | $1,790.25 | $3,255 | 10.5× |
| CT l-spine w&w/o contrast (72133) | $2,443.10 | $4,442 | 14.3× |
| CT lower ext w/o (73700) | $1,679.70 | $3,054 | 16.5× |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,653.30–$1,692.35 | $3,006–$3,077 | varies |
| CT lumbar spine w contrast (72132) | $2,100.45 | $3,819 | 6.2× |
| CT lumbar spine w/o contrast (72131) | $1,953.60 | $3,552 | 19.2× |
| CT maxillofacial w contrast (70487) | $2,058.65 | $3,743 | 12.1× |
| CT maxillofacial wo contrast (70486) | $1,527.35 | $2,777 | 15.0× |
| CT neck tissue combo (70492) | $2,409.55 | $4,381 | 14.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,002.55 | $3,641 | 11.8× |
| CT orbits w/o contrast (70480) | $1,711.60 | $3,112 | 16.9× |
| CT pelvis w&w/o contrast (72194) | $2,280.30 | $4,146 | 13.4× |
| CT pelvis w/o contrast (72192) | $1,872.75 | $3,405 | 18.4× |
| CT scan of leg combo (73702) | $1,689.05 | $3,071 | 9.9× |
| CT scans face/jaw combo (70488) | $2,086.15 | $3,793 | 12.2× |
| CT soft tissue neck w contrast (70491) | $1,885.40 | $3,428 | 11.1× |
| CT soft tissue neck w/o contrast (70490) | $1,609.30 | $2,926 | 15.8× |
| CT thoracic spine w contrast (72129) | $1,987.70 | $3,614 | 11.7× |
| CT thoracic spine w/o contrast (72128) | $1,895.30 | $3,446 | 18.7× |
| CT thoracic spine w/wo cont (72130) | $2,443.10 | $4,442 | 14.3× |
| CT thorax w/o contrast (71250) | $1,707.75 | $3,105 | 16.8× |
| CT upper ext wo (73200) | $1,646.15 | $2,993 | 16.2× |
| CT upper extremity w/o & w/contrast material (73202) | $1,716.55 | $3,121 | 10.1× |
| CT upper extremity with contrast (73201) | $1,692.35 | $3,077 | 5.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,193.85 | $5,807 | 18.7× |
| Cta Abdomen (74175) | $2,749.45 | $4,999 | 16.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $4,718.45 | $8,579 | 13.9× |
| CTA pelvis (72191) | $2,526.15 | $4,593 | 14.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $15.40 | $28 | 0.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $21.45 | $39 | 0.2× |
| Dxa Bone Density Axial (77080) | $454.85 | $827 | 4.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $264 | $480 | 3.1× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$35.75–$678.15 | $65–$1,233 | varies |
| Esophagram (74220) | $565.40 | $1,028 | 3.3× |
| Fetal Biophys Profile W/Nst (76818) | $32.45 | $59 | 0.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$475.75–$833.80 | $865–$1,516 | varies |
| Fluoroscopy up to 1 hr (76000) | $571.45 | $1,039 | 2.5× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$256.85–$550 | $467–$1,000 | varies |
| Forearm 2 views (73090) | $301.95 | $549 | 3.6× |
| Gastric emptying imaging study (78264) | $1,173.70 | $2,134 | 3.0× |
| Gated Heart Planar Single (78472) | $1,997.60 | $3,632 | 5.1× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$320.10–$359.70 | $582–$654 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,376.10 | $2,502 | 2.6× |
| Hepatobiliary System Imaging (78226) | $1,320.55 | $2,401 | 3.4× |
| Ht Muscle Image Spect Sing (78451) | $3,599.75 | $6,545 | 2.9× |
| Hysterosalpingogram (74740) | $691.35 | $1,257 | 3.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $479.60 | $872 | 5.7× |
| Joint Survey Single View (77077) | $472.45 | $859 | 4.7× |
| K Flow/Funct Image W/Drug (78708) | $1,427.25 | $2,595 | 2.7× |
| K Flow/Funct Image W/O Drug (78707) | $1,164.35 | $2,117 | 2.2× |
| Knee 3 Views (73562) | $370.15 | $673 | 4.4× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $1,032.90 | $1,878 | 2.7× |
| Liver & Spleen Imaging Static Only (78215) | $1,452.55 | $2,641 | 3.7× |
| Lung Ventilat&Perfus Imaging (78582) | $970.20 | $1,764 | 1.8× |
| Lung Ventilation Imaging (78579) | $1,537.25 | $2,795 | 4.0× |
| Lymph System Imaging (78195) | $1,742.40 | $3,168 | 3.3× |
| Magnetic Image Jaw Joint (70336) | $2,163.70 | $3,934 | 9.3× |
| Mammary ductogram or galactogram multiple (77054) | $627.55 | $1,141 | 2.7× |
| Mammary ductogram or galactogram single (77053) | $586.30 | $1,066 | 2.5× |
| Meckels Divert Exam (78290) | $1,328.25 | $2,415 | 3.4× |
| Mra Head W/O & W/Contrast Material (70546) | $3,630.55 | $6,601 | 10.7× |
| MRA head w/o contrast (70544) | $2,505.80 | $4,556 | 10.8× |
| MRA head with contrast (70545) | $2,615.25 | $4,755 | 7.7× |
| MRA neck w contrast (70548) | $2,598.75 | $4,725 | 7.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,595.90 | $6,538 | 10.6× |
| MRA neck w/o contrast (70547) | $2,495.90 | $4,538 | 10.8× |
| MRI abdomen w contrast (74182) | $3,587.10 | $6,522 | 10.6× |
| MRI abdomen w/o contrast (74181) | $2,519.55 | $4,581 | 10.9× |
| MRI any jt lower extrem w/contrast material (73722) | $3,703.15 | $6,733 | 4.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,890.70 | $7,074 | 11.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,665.75 | $6,665 | 4.8× |
| MRI cervical spine w contrast (72142) | $3,655.30 | $6,646 | 10.8× |
| MRI cervical spine w/o cont (72141) | $2,878.70 | $5,234 | 12.4× |
| MRI chest w/o contrast (71550) | $2,495.90 | $4,538 | 10.8× |
| MRI chest with contrast (71551) | $3,596.45 | $6,539 | 4.7× |
| MRI chest wo w contrast (71552) | $3,792.25 | $6,895 | 11.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,623.40 | $6,588 | 10.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,853.85 | $7,007 | 11.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,567.95 | $4,669 | 11.1× |
| MRI lumbar spine w contrast (72149) | $4,268.55 | $7,761 | 12.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,158 | $7,560 | 12.3× |
| MRI orbit face &/neck w/o contrast (70540) | $2,577.30 | $4,686 | 11.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,904.45 | $7,099 | 11.5× |
| MRI pelvis w/o & w contrast (72197) | $3,786.75 | $6,885 | 11.2× |
| MRI pelvis w/o contrast (72195) | $2,593.25 | $4,715 | 11.2× |
| MRI thoracic spine w/o contrast (72146) | $2,889.15 | $5,253 | 12.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,495.90 | $4,538 | 10.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,418.80 | $6,216 | 10.1× |
| MRI, abdomen, combo (74183) | $3,639.90 | $6,618 | 10.7× |
| MRI, dorsal spine combo (72157) | $4,128.30 | $7,506 | 12.2× |
| MRI, dorsal spine contrast (72147) | $3,560.70 | $6,474 | 10.5× |
| MRI, joint upper extrem (73221) | $2,495.90 | $4,538 | 10.8× |
| MRI, joint upper extrem combo (73223) | $3,557.95 | $6,469 | 10.5× |
| MRI, lumbar spine combo (72158) | $3,828.55 | $6,961 | 11.3× |
| Myelogram Lumbar (72265) | $1,747.90 | $3,178 | 2.3× |
| Myocardial Spect Multiple Studies (78452) | $4,425.85 | $8,047 | 3.5× |
| Neck soft tissue (70360) | $273.90 | $498 | 3.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $689.70 | $1,254 | 1.8× |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$35.20–$684.20 | $64–$1,244 | varies |
| Parathyroid Planar Imaging (78070) | $1,103.30 | $2,006 | 2.8× |
| Pelvis 1 or 2 views (72170) | $335.50 | $610 | 3.3× |
| Pet Image Skull-Thigh (78812) | $4,275.70 | $7,774 | 3.1× |
| Pet Image W/Ct Lmtd (78814) | $4,275.70 | $7,774 | 3.1× |
| PET image w/CT, full body (78816) | $4,904.35 | $8,917 | 3.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,249.20 | $9,544 | 3.8× |
| PET whole body (78813) | $4,275.70 | $7,774 | 3.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,773.20 | $3,224 | 4.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $641.85 | $1,167 | 6.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $904.20 | $1,644 | 1.7× |
| Radex Ankle Complete Minimum 3 Views (73610) | $332.20 | $604 | 3.9× |
| Radex Calcaneus Minimum 2 Views (73650) | $268.40 | $488 | 3.2× |
| Radex elbow complete minimum 3 views (73080) | $339.35 | $617 | 4.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $638.55 | $1,161 | 6.3× |
| Radex fingr minimum 2 views (73140) | $274.45 | $499 | 3.2× |
| Radex foot complete minimum 3 views (73630) | $348.70 | $634 | 4.1× |
| Radex Hand Minimum 3 Views (73130) | $383.90 | $698 | 4.5× |
| Radex lower extremity infant minimum 2 views (73592) | $384.45 | $699 | 4.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $657.25 | $1,195 | 6.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $371.80 | $676 | 4.4× |
| Radex Ribs Unilateral 2 Views (71100) | $347.05 | $631 | 4.1× |
| Radex shoulder complete minimum 2 views (73030) | $341.55 | $621 | 4.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $324.50 | $590 | 3.8× |
| Radex Spine 1 View Specify Level (72020) | $360.80 | $656 | 4.3× |
| Radex Sternum Minimum 2 Views (71120) | $359.15 | $653 | 4.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $691.90 | $1,258 | 8.2× |
| Radex Toe Minimum 2 Views (73660) | $235.95 | $429 | 2.8× |
| Radex upper extremity infant minimum 2 views (73092) | $400.40 | $728 | 3.9× |
| Radex Wrist Complete Minimum 3 Views (73110) | $334.40 | $608 | 4.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $612.15 | $1,113 | 6.0× |
| Radiologic exam colon double contrast study (74280) | $1,095.60 | $1,992 | 6.4× |
| Radiologic exam colon single contrast study (74270) | $744.70 | $1,354 | 4.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $887.15 | $1,613 | 5.2× |
| Radiologic exam knee complete 4/more views (73564) | $444.40 | $808 | 4.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $456.50 | $830 | 4.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $757.35 | $1,377 | 4.4× |
| Radiologic exam swallow function contrast study (74230) | $608.30 | $1,106 | 3.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $966.90 | $1,758 | 5.7× |
| Radiologic examination femur 1 view (73551) | $242.55 | $441 | 2.9× |
| Radiologic examination femur minimum 2 views (73552) | $356.95 | $649 | 4.2× |
| Radiologic examination knee 1/2 views (73560) | $332.20 | $604 | 3.9× |
| Radiologic Examination Osseous Survey Limited (77074) | $730.95 | $1,329 | 7.2× |
| Radiologic Examination Salivary Gland Calculus (70380) | $197.45 | $359 | 2.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $332.20 | $604 | 3.9× |
| Ribs bilateral 3 views (71110) | $596.75 | $1,085 | 5.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,153.80 | $3,916 | 4.1× |
| Scapula (73010) | $381.15 | $693 | 3.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$42.90–$50.05 | $78–$91 | varies |
| Shoulder 1 view (73020) | $255.75 | $465 | 3.0× |
| Shoulder Arthrography (73040) | $708.95 | $1,289 | 2.1× |
| Skull less than 4 views (70250) | $350.90 | $638 | 3.5× |
| Sternoclavicular joints (71130) | $337.70 | $614 | 4.0× |
| Tbs technical calculation only (77091) | $297 | $540 | 3.5× |
| Testicular Imaging W/Flow (78761) | $1,079.10 | $1,962 | 2.8× |
| Thoracic spine 2 views (72070) | $383.90 | $698 | 3.8× |
| Thoracolumbar 2 views (72080) | $314.05 | $571 | 3.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,241.35 | $2,257 | 3.2× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$599.50–$705.10 | $1,090–$1,282 | varies |
| Ultrasound Exam Aaa Screen (76706) | $442.75 | $805 | 4.4× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$15.40–$722.15 | $28–$1,313 | varies |
| Umbilical-artery Doppler (OB) (76820) | $846.45 | $1,539 | 8.3× |
| Upper gi w/o kub (74240) | $729.85 | $1,327 | 4.3× |
| Urethrocystogram voiding (74455) | $1,148.40 | $2,088 | 5.0× |
| Us breast unilateral complete (76641) | $479.60 | $872 | 4.7× |
| Us chest (76604) | $451 | $820 | 4.4× |
| Us complete joint (76881) range across 2 matching MRF lines |
$36.30–$982.30 | $66–$1,786 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$15.40–$565.40 | $28–$1,028 | varies |
| Us head (76506) | $460.90 | $838 | 4.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$15.40–$598.40 | $28–$1,088 | varies |
| Us ob detailed single fetus (76811) | $697.95 | $1,269 | 3.0× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$26.40–$479.60 | $48–$872 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$32.45–$527.45 | $59–$959 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$35.75–$802.45 | $65–$1,459 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$36.30–$689.70 | $66–$1,254 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$33.55–$587.95 | $61–$1,069 | varies |
| Us retroperitoneal complete (76770) | $812.35 | $1,477 | 8.0× |
| Us retroperitoneal limited (76775) | $607.75 | $1,105 | 6.0× |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$36.30–$860.20 | $66–$1,564 | varies |
| Us spinal canal and contents (76800) | $460.90 | $838 | 4.5× |
| Us thyroid (76536) range across 2 matching MRF lines |
$41.25–$735.90 | $75–$1,338 | varies |
| Us transrectal (76872) | $777.15 | $1,413 | 7.7× |
| Venography extremity bilateral rs&i (75822) | $1,349.70 | $2,454 | 0.9× |
| Wrist 2 views (73100) | $298.65 | $543 | 3.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $458.15 | $833 | 5.4× |
| X-Ray Bend Only L-S Spine (72120) | $252.45 | $459 | 2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $262.90 | $478 | 3.1× |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$287.65–$660.55 | $523–$1,201 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $323.40 | $588 | 3.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $448.80 | $816 | 4.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $297.55 | $541 | 3.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $370.15 | $673 | 4.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $455.40 | $828 | 4.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $481.80 | $876 | 4.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $748.55 | $1,361 | 7.4× |
| X-Ray Exam L-S Spine Bending (72114) | $840.95 | $1,529 | 8.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $337.15 | $613 | 4.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $865.70 | $1,574 | 8.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $441.65 | $803 | 4.3× |
| X-ray eye for foreign body (70030) | $265.10 | $482 | 3.1× |
| X-ray humerus (73060) | $297.55 | $541 | 3.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $451 | $820 | 5.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $322.30 | $586 | 3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $385.55 | $701 | 3.8× |
| X-ray nose-rectum child f.b. (76010) | $253 | $460 | 3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $821.15 | $1,493 | 8.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $289.85 | $527 | 2.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $345.95 | $629 | 4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $557.70 | $1,014 | 6.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $594.55 | $1,081 | 5.9× |
| X-Ray Stress View (77071) | $235.40 | $428 | 2.8× |
| X-Ray Tmj Unilat (70328) | $187 | $340 | 2.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $851.40 | $1,548 | 2.5× |
| X-Rays Bone Length Studies (77073) | $328.90 | $598 | 3.2× |
| X-Rays Bone Survey Complete (77075) | $967.45 | $1,759 | 9.5× |
| Xr c-spine 4 or 5 views (72050) | $498.30 | $906 | 4.9× |
| Xr facial bones less than 3 views (70140) | $589.05 | $1,071 | 7.0× |
| Xr orbits complete 4 views (70200) | $354.75 | $645 | 3.5× |
| Xr Tomogram Single Plane (76100) | $708.40 | $1,288 | 7.0× |
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.