Imaging prices at Regional Medical Center
Manchester, IA · every code in this section with a posted price and a Medicare benchmark.
215 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) range across 2 matching MRF lines |
$190.40–$198.40 | $238–$248 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$257.60–$268 | $322–$335 | varies |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$240–$259.20 | $300–$324 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$449.60–$468 | $562–$585 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$204–$221.60 | $255–$277 | varies |
| Bone survey infant (77076) | $580 | $725 | 5.8× |
| Cat Scan Follow-Up Study (76380) | $765.60 | $957 | 9.2× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$204–$212.80 | $255–$266 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$215.20–$224 | $269–$280 | varies |
| Chest 3 views (71047) | $233.60 | $292 | 2.8× |
| Chest 4 or more views (71048) | $273.60 | $342 | 2.7× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$204–$212.80 | $255–$266 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$477.60–$496.80 | $597–$621 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$355.20–$369.60 | $444–$462 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $449.60 | $562 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$3,453.60–$3,733.60 | $4,317–$4,667 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$2,387.20–$2,582.40 | $2,984–$3,228 | varies |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$1,558.40–$1,762.40 | $1,948–$2,203 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$2,035.20–$2,116.80 | $2,544–$2,646 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,412.80–$1,469.60 | $1,766–$1,837 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$3,727.20–$3,876.80 | $4,659–$4,846 | varies |
| CT Angio Chest (71275) range across 4 matching MRF lines |
$2,104–$2,421.60 | $2,630–$3,027 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,841.60–$1,916 | $2,302–$2,395 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,876.80 | $2,346 | 11.1× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$2,230.40–$2,320 | $2,788–$2,900 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,793.60–$1,939.20 | $2,242–$2,424 | varies |
| CT cervical spine w/ contrast (72126) | $2,064.80 | $2,581 | 6.2× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$1,705.60–$1,774.40 | $2,132–$2,218 | varies |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$1,360–$1,933.60 | $1,700–$2,417 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$1,802.40–$2,096.80 | $2,253–$2,621 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,548.80–$1,676 | $1,936–$2,095 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,708.80–$1,777.60 | $2,136–$2,222 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,646.40–$1,712.80 | $2,058–$2,141 | varies |
| CT l-spine w&w/o contrast (72133) | $1,987.20 | $2,484 | 11.8× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,219.20–$1,268 | $1,524–$1,585 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,744–$1,814.40 | $2,180–$2,268 | varies |
| CT lumbar spine w contrast (72132) | $1,841.60 | $2,302 | 5.5× |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,412.80–$1,469.60 | $1,766–$1,837 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,452–$1,510.40 | $1,815–$1,888 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,059.20–$1,101.60 | $1,324–$1,377 | varies |
| CT neck tissue combo (70492) | $1,792.80 | $2,241 | 10.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,705.60 | $2,132 | 10.1× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,219.20–$1,268 | $1,524–$1,585 | varies |
| CT pelvis w&w/o contrast (72194) | $1,987.20 | $2,484 | 11.8× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,224–$1,273.60 | $1,530–$1,592 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,841.60–$1,916 | $2,302–$2,395 | varies |
| CT scans face/jaw combo (70488) | $1,406.40 | $1,758 | 8.3× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,646.40–$1,712.80 | $2,058–$2,141 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,121.60–$1,167.20 | $1,402–$1,459 | varies |
| CT thoracic spine w contrast (72129) | $1,841.60 | $2,302 | 10.9× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,412.80–$1,469.60 | $1,766–$1,837 | varies |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$926.40–$1,224 | $1,158–$1,530 | varies |
| CT unlisted procedure (76497) | $871.20 | $1,089 | 10.4× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,219.20–$1,268 | $1,524–$1,585 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $2,001.60 | $2,502 | 11.9× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,841.60–$1,916 | $2,302–$2,395 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$2,560–$2,662.40 | $3,200–$3,328 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$2,094.40–$2,178.40 | $2,618–$2,723 | varies |
| CTA pelvis (72191) | $1,739.20 | $2,174 | 10.3× |
| Doppler Fetal Mid Cerebral Artery (76821) | $304.80 | $381 | 3.0× |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$399.20–$432 | $499–$540 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$346.40–$360.80 | $433–$451 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 3 matching MRF lines |
$813.60–$880 | $1,017–$1,100 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$625.60–$651.20 | $782–$814 | varies |
| Fluoroscopy up to 1 hr (76000) | $433.60 | $542 | 1.9× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$240–$249.60 | $300–$312 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$257.60–$268 | $322–$335 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$257.60–$268 | $322–$335 | varies |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$273.60–$284.80 | $342–$356 | varies |
| Magnetic Image Jaw Joint (70336) | $2,785.60 | $3,482 | 12.1× |
| Mammary ductogram or galactogram multiple (77054) | $494.40 | $618 | 2.2× |
| Mammary ductogram or galactogram single (77053) | $355.20 | $444 | 1.5× |
| Mra Head W/O & W/Contrast Material (70546) range across 3 matching MRF lines |
$4,112.80–$4,448.80 | $5,141–$5,561 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$2,785.60–$2,897.60 | $3,482–$3,622 | varies |
| MRA head with contrast (70545) | $3,489.60 | $4,362 | 10.4× |
| MRA neck w contrast (70548) | $3,489.60 | $4,362 | 10.4× |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$4,112.80–$4,448.80 | $5,141–$5,561 | varies |
| MRA neck w/o contrast (70547) | $2,785.60 | $3,482 | 12.1× |
| MRI abdomen w contrast (74182) | $3,489.60 | $4,362 | 10.4× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$2,785.60–$2,897.60 | $3,482–$3,622 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$3,409.60–$3,774.40 | $4,262–$4,718 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$4,112.80–$4,277.60 | $5,141–$5,347 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$3,489.60–$3,629.60 | $4,362–$4,537 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$3,489.60–$3,629.60 | $4,362–$4,537 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$2,785.60–$2,897.60 | $3,482–$3,622 | varies |
| MRI chest w/o contrast (71550) | $2,785.60 | $3,482 | 12.1× |
| MRI chest with contrast (71551) | $3,489.60 | $4,362 | 4.6× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$4,112.80–$4,277.60 | $5,141–$5,347 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$3,489.60–$4,112.80 | $4,362–$5,141 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$4,112.80–$4,277.60 | $5,141–$5,347 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$2,785.60–$2,897.60 | $3,482–$3,622 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$3,489.60–$3,629.60 | $4,362–$4,537 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$4,112.80–$4,277.60 | $5,141–$5,347 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $2,785.60 | $3,482 | 12.1× |
| MRI orbit face neck w contrast (70542) | $3,489.60 | $4,362 | 10.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$4,112.80–$4,277.60 | $5,141–$5,347 | varies |
| MRI pelvis w contrast (72196) | $3,489.60 | $4,362 | 10.4× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$4,112.80–$4,277.60 | $5,141–$5,347 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$2,785.60–$2,897.60 | $3,482–$3,622 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$2,785.60–$2,897.60 | $3,482–$3,622 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,489.60 | $4,362 | 10.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$2,785.60–$2,897.60 | $3,482–$3,622 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$4,032.80–$4,277.60 | $5,041–$5,347 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$4,112.80–$4,277.60 | $5,141–$5,347 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$4,112.80–$4,277.60 | $5,141–$5,347 | varies |
| MRI, dorsal spine contrast (72147) | $3,489.60 | $4,362 | 10.4× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,785.60–$2,897.60 | $3,482–$3,622 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$4,112.80–$4,277.60 | $5,141–$5,347 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$4,112.80–$4,277.60 | $5,141–$5,347 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$204–$212.80 | $255–$266 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$181.60–$189.60 | $227–$237 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$303.20–$316 | $379–$395 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $336.80 | $421 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$257.60–$268 | $322–$335 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$204–$212.80 | $255–$266 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$267.20–$289.60 | $334–$362 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$240–$249.60 | $300–$312 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$215.20–$224 | $269–$280 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$257.60–$278.40 | $322–$348 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$267.20–$278.40 | $334–$348 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $165.60 | $207 | 2.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$240–$249.60 | $300–$312 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$190.40–$198.40 | $238–$248 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$346.40–$360.80 | $433–$451 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $220 | $275 | 2.6× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$204–$221.60 | $255–$277 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$204–$212.80 | $255–$266 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$257.60–$268 | $322–$335 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$204–$212.80 | $255–$266 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $204 | $255 | 2.0× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$267.20–$289.60 | $334–$362 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$244.80–$265.60 | $306–$332 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $283.20 | $354 | 2.8× |
| Radiologic exam colon double contrast study (74280) | $623.20 | $779 | 3.7× |
| Radiologic exam colon single contrast study (74270) | $496.80 | $621 | 2.9× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$312–$324.80 | $390–$406 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $204 | $255 | 2.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $478.40 | $598 | 2.8× |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$380.80–$396.80 | $476–$496 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$433.60–$451.20 | $542–$564 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$204–$212.80 | $255–$266 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$263.20–$274.40 | $329–$343 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$257.60–$268 | $322–$335 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$257.60–$556.80 | $322–$696 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$287.20–$299.20 | $359–$374 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$204–$212.80 | $255–$266 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$53.60–$56 | $67–$70 | varies |
| Sella turcica (70240) | $204 | $255 | 2.4× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$204–$212.80 | $255–$266 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$449.60–$468 | $562–$585 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$249.60–$260 | $312–$325 | varies |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$220–$228.80 | $275–$286 | varies |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$267.20–$289.60 | $334–$362 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$303.20–$316 | $379–$395 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$267.20–$278.40 | $334–$348 | varies |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$313.60–$652.80 | $392–$816 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$390.40–$406.40 | $488–$508 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$265.60–$459.20 | $332–$574 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$304.80–$330.40 | $381–$413 | varies |
| Unlisted us procedure (76999) | $371.20 | $464 | 4.4× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$380.80–$396.80 | $476–$496 | varies |
| Urethrocystogram voiding (74455) | $300.80 | $376 | 1.3× |
| Urethrocystography retrograde (74450) | $175.20 | $219 | 0.8× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$412–$892.80 | $515–$1,116 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$440.80–$459.20 | $551–$574 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$513.60–$534.40 | $642–$668 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$336.80–$350.40 | $421–$438 | varies |
| Us head (76506) range across 2 matching MRF lines |
$346.40–$360.80 | $433–$451 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$399.20–$415.20 | $499–$519 | varies |
| Us ob detailed single fetus (76811) | $588 | $735 | 2.6× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$308–$320.80 | $385–$401 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$590.40–$614.40 | $738–$768 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$492.80–$512.80 | $616–$641 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$590.40–$614.40 | $738–$768 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$625.60–$677.60 | $782–$847 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$590.40–$614.40 | $738–$768 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$340–$353.60 | $425–$442 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$521.60–$543.20 | $652–$679 | varies |
| Us spinal canal and contents (76800) | $315.20 | $394 | 3.1× |
| Us thyroid (76536) range across 2 matching MRF lines |
$440.80–$459.20 | $551–$574 | varies |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$257.60–$278.40 | $322–$348 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$253.60–$264 | $317–$330 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$303.20–$316 | $379–$395 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$257.60–$268 | $322–$335 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$108.80–$113.60 | $136–$142 | varies |
| X-Ray Exam Hip Uni 1 View (73501) | $204 | $255 | 2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$263.20–$285.60 | $329–$357 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $312 | $390 | 3.1× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$312–$324.80 | $390–$406 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$312–$324.80 | $390–$406 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $341.60 | $427 | 3.4× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$409.60–$426.40 | $512–$533 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$303.20–$316 | $379–$395 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$409.60–$426.40 | $512–$533 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$249.60–$260 | $312–$325 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$204–$212.80 | $255–$266 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$244.80–$255.20 | $306–$319 | varies |
| X-ray IV pyelogram (ivp) (74400) | $345.60 | $432 | 2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$204–$221.60 | $255–$277 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $204 | $255 | 2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$303.20–$328.80 | $379–$411 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$204–$212.80 | $255–$266 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$366.40–$381.60 | $458–$477 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$267.20–$278.40 | $334–$348 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$204–$212.80 | $255–$266 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $267.20 | $334 | 3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $287.20 | $359 | 2.9× |
| X-Ray Stress View (77071) | $96.80 | $121 | 1.2× |
| X-Ray Tmj Unilat (70328) | $204 | $255 | 2.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$593.60–$617.60 | $742–$772 | varies |
| X-Rays Bone Length Studies (77073) | $255.20 | $319 | 2.5× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$580–$603.20 | $725–$754 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$380–$395.20 | $475–$494 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$204–$212.80 | $255–$266 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$240–$259.20 | $300–$324 | 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.