Imaging prices at Richland Hospital
Richland Center, WI · every code in this section with a posted price and a Medicare benchmark.
245 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) | $288.80 | $361 | 3.4× |
| Abdomen 2 views (74019) | $348 | $435 | 3.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $3,332.80 | $4,166 | 8.6× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$192.80–$195.20 | $241–$244 | varies |
| Bone age studies (77072) | $76 | $95 | 0.7× |
| Bone Imaging 3 Phase (78315) | $3,311.20 | $4,139 | 8.5× |
| Bone Imaging Limited Area (78300) | $1,720 | $2,150 | 4.4× |
| Bone Imaging Multiple Areas (78305) | $2,198.40 | $2,748 | 5.7× |
| Bone Imaging Whole Body (78306) | $3,277.60 | $4,097 | 8.4× |
| Bone survey infant (77076) | $572 | $715 | 5.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $3,272 | $4,090 | 6.2× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,894.40 | $2,368 | 3.6× |
| Chest 1 view (71045) | $332.80 | $416 | 3.9× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$360.80–$488 | $451–$610 | varies |
| Chest 3 views (71047) | $396 | $495 | 4.7× |
| Chest 4 or more views (71048) | $765.60 | $957 | 7.5× |
| Clavicle complete (73000) | $325.60 | $407 | 3.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $2,552.80 | $3,191 | 25.1× |
| Contrast X-Ray Bladder (74430) | $465.60 | $582 | 1.4× |
| CT abdomen and pelvis without and with contrast (74178) | $4,664.80 | $5,831 | 13.8× |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$2,445.60–$2,652 | $3,057–$3,315 | varies |
| CT abdomen w contrast (74160) | $3,048.80 | $3,811 | 17.9× |
| CT abdomen w wo contrast (74170) | $3,468 | $4,335 | 20.4× |
| CT abdomen w/o contrast (74150) | $1,984 | $2,480 | 19.5× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$3,503.20–$3,795.20 | $4,379–$4,744 | varies |
| CT Angio Chest (71275) | $3,967.20 | $4,959 | 23.3× |
| CT Angio Head (70496) | $3,909.60 | $4,887 | 22.9× |
| CT Angio Neck (70498) | $3,900.80 | $4,876 | 22.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,090.40 | $2,613 | 12.3× |
| CT cervical spine w/ contrast (72126) | $3,029.60 | $3,787 | 8.9× |
| CT cervical spine w/o contrast (72125) | $2,436.80 | $3,046 | 24.0× |
| CT cervical spine w/wo cont (72127) | $3,571.20 | $4,464 | 21.0× |
| CT chest w contrast (71260) | $3,029.60 | $3,787 | 17.8× |
| CT chest w/wo contrast (71270) | $3,634.40 | $4,543 | 21.3× |
| CT head/brain with contrast (70460) | $2,142.40 | $2,678 | 12.6× |
| CT head/brain without and with contrast (70470) | $2,532.80 | $3,166 | 14.9× |
| CT iac w contrast (70481) | $3,641.60 | $4,552 | 21.4× |
| CT l-spine w&w/o contrast (72133) | $3,576.80 | $4,471 | 21.0× |
| CT lower ext w/o (73700) | $2,365.60 | $2,957 | 23.3× |
| CT lower extremity w/contrast material (73701) | $2,982.40 | $3,728 | 17.5× |
| CT lumbar spine w contrast (72132) | $3,020.80 | $3,776 | 8.9× |
| CT lumbar spine w/o contrast (72131) | $2,365.60 | $2,957 | 23.3× |
| CT maxillofacial w contrast (70487) | $2,061.60 | $2,577 | 12.1× |
| CT maxillofacial wo contrast (70486) | $1,851.20 | $2,314 | 18.2× |
| CT neck tissue combo (70492) | $3,670.40 | $4,588 | 21.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,988.80 | $4,986 | 23.4× |
| CT orbits w/o contrast (70480) | $3,080.80 | $3,851 | 30.3× |
| CT pelvis w&w/o contrast (72194) | $3,439.20 | $4,299 | 20.2× |
| CT pelvis w/o contrast (72192) | $1,936.80 | $2,421 | 19.1× |
| CT scan of leg combo (73702) | $3,608.80 | $4,511 | 21.2× |
| CT scans face/jaw combo (70488) | $2,709.60 | $3,387 | 15.9× |
| CT soft tissue neck w contrast (70491) | $3,113.60 | $3,892 | 18.3× |
| CT soft tissue neck w/o contrast (70490) | $2,549.60 | $3,187 | 25.1× |
| CT thoracic spine w contrast (72129) | $3,029.60 | $3,787 | 17.8× |
| CT thoracic spine w/o contrast (72128) | $2,379.20 | $2,974 | 23.4× |
| CT thoracic spine w/wo cont (72130) | $3,576.80 | $4,471 | 21.0× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$2,194.40–$2,379.20 | $2,743–$2,974 | varies |
| CT upper ext wo (73200) | $2,365.60 | $2,957 | 23.3× |
| CT upper extremity w/o & w/contrast material (73202) | $3,670.40 | $4,588 | 21.5× |
| CT upper extremity with contrast (73201) | $2,940.80 | $3,676 | 8.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $5,869.60 | $7,337 | 34.5× |
| Cta Abdomen (74175) | $4,291.20 | $5,364 | 25.2× |
| Dxa Bone Density Axial (77080) | $371.20 | $464 | 3.7× |
| Dxa bone density study (77085) | $490.40 | $613 | 4.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $284 | $355 | 3.4× |
| Echo exam uterus (76831) | $604 | $755 | 2.6× |
| Esophagram (74220) | $982.40 | $1,228 | 5.8× |
| Fetal Biophys Profile W/Nst (76818) | $619.20 | $774 | 6.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $636.80 | $796 | 6.3× |
| Fluoroscopy up to 1 hr (76000) | $376 | $470 | 1.6× |
| Foot 2 views (73620) | $280 | $350 | 3.3× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$280.80–$288.80 | $351–$361 | varies |
| Gastric emptying imaging study (78264) | $3,754.40 | $4,693 | 9.7× |
| Gated Heart Planar Single (78472) | $2,192 | $2,740 | 5.6× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$244.80–$312 | $306–$390 | varies |
| Hepatobil Syst Image W/Drug (78227) | $5,062.40 | $6,328 | 9.6× |
| Hepatobiliary System Imaging (78226) | $3,718.40 | $4,648 | 9.6× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$876.80–$3,512 | $1,096–$4,390 | varies |
| Hysterosalpingogram (74740) | $430.40 | $538 | 1.9× |
| Joint Survey Single View (77077) | $412.80 | $516 | 4.1× |
| K Flow/Funct Image W/Drug (78708) | $1,654.40 | $2,068 | 3.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,654.40 | $2,068 | 3.1× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$312.80–$430.40 | $391–$538 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,480.80 | $1,851 | 3.8× |
| Liver imaging static only (78201) | $1,436.80 | $1,796 | 2.7× |
| Lung Ventilat&Perfus Imaging (78582) | $3,608.80 | $4,511 | 6.8× |
| Lung Ventilation Imaging (78579) | $3,193.60 | $3,992 | 8.2× |
| Lymph System Imaging (78195) | $3,394.40 | $4,243 | 6.4× |
| Magnetic Image Jaw Joint (70336) | $4,092.80 | $5,116 | 17.7× |
| Meckels Divert Exam (78290) | $3,175.20 | $3,969 | 8.2× |
| Mr safety determination physician/other qhp (76016) | $32 | $40 | 0.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $8.80 | $11 | 0.3× |
| MRA head w/o contrast (70544) | $2,873.60 | $3,592 | 12.4× |
| MRA head with contrast (70545) | $2,357.60 | $2,947 | 7.0× |
| MRA neck w contrast (70548) | $3,424.80 | $4,281 | 10.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,713.60 | $5,892 | 13.9× |
| MRA neck w/o contrast (70547) | $2,804 | $3,505 | 12.1× |
| MRI abdomen w contrast (74182) | $3,352.80 | $4,191 | 9.9× |
| MRI abdomen w/o contrast (74181) | $1,280.80 | $1,601 | 5.5× |
| MRI any jt lower extrem w/contrast material (73722) | $3,279.20 | $4,099 | 4.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $5,278.40 | $6,598 | 15.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $4,362.40 | $5,453 | 5.7× |
| MRI cervical spine w contrast (72142) | $3,332.80 | $4,166 | 9.8× |
| MRI cervical spine w/o cont (72141) | $2,680.80 | $3,351 | 11.6× |
| MRI chest w/o contrast (71550) | $2,343.20 | $2,929 | 10.1× |
| MRI chest with contrast (71551) | $3,332.80 | $4,166 | 4.4× |
| MRI chest wo w contrast (71552) | $6,762.40 | $8,453 | 20.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,279.20 | $4,099 | 9.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $4,354.40 | $5,443 | 12.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,929.60 | $3,662 | 12.6× |
| MRI lumbar spine w contrast (72149) | $3,320.80 | $4,151 | 9.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,928 | $4,910 | 11.6× |
| MRI orbit face &/neck w/o contrast (70540) | $3,388.80 | $4,236 | 14.6× |
| MRI orbit face neck w contrast (70542) | $4,005.60 | $5,007 | 11.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,408 | $5,510 | 13.0× |
| MRI pelvis w contrast (72196) | $3,279.20 | $4,099 | 9.7× |
| MRI pelvis w/o & w contrast (72197) | $4,315.20 | $5,394 | 12.7× |
| MRI pelvis w/o contrast (72195) | $2,952.80 | $3,691 | 12.7× |
| MRI thoracic spine w/o contrast (72146) | $2,343.20 | $2,929 | 10.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,234.40 | $4,043 | 9.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $4,402.40 | $5,503 | 19.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $5,705.60 | $7,132 | 16.8× |
| MRI, abdomen, combo (74183) | $4,330.40 | $5,413 | 12.8× |
| MRI, dorsal spine combo (72157) | $3,932.80 | $4,916 | 11.6× |
| MRI, dorsal spine contrast (72147) | $3,332.80 | $4,166 | 9.8× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,507.20–$2,601.60 | $3,134–$3,252 | varies |
| MRI, joint upper extrem combo (73223) | $3,623.20 | $4,529 | 10.7× |
| MRI, lumbar spine combo (72158) | $3,932.80 | $4,916 | 11.6× |
| Myocardial Spect Multiple Studies (78452) | $2,664.80 | $3,331 | 2.1× |
| Neck soft tissue (70360) | $344.80 | $431 | 4.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) range across 2 matching MRF lines |
$560–$667.20 | $700–$834 | varies |
| Nonvascular Shunt X-Ray (75809) | $141.60 | $177 | 1.4× |
| Parathyroid Planar Imaging (78070) | $2,865.60 | $3,582 | 7.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $3,415.20 | $4,269 | 8.8× |
| Pelvis 1 or 2 views (72170) | $261.60 | $327 | 2.6× |
| Pet Image W/Ct Lmtd (78814) | $7,297.60 | $9,122 | 5.3× |
| PET image w/CT, full body (78816) | $7,297.60 | $9,122 | 5.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $7,297.60 | $9,122 | 5.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,575.20 | $3,219 | 6.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $720.80 | $901 | 7.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $628.80 | $786 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$283.20–$385.60 | $354–$482 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$210.40–$284 | $263–$355 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$250.40–$325.60 | $313–$407 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $384.80 | $481 | 3.8× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$243.20–$417.60 | $304–$522 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$223.20–$225.60 | $279–$282 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$251.20–$381.60 | $314–$477 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $415.20 | $519 | 4.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $275.20 | $344 | 2.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $403.20 | $504 | 4.8× |
| Radex Ribs Unilateral 2 Views (71100) | $353.60 | $442 | 4.2× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$210.40–$344 | $263–$430 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $164.80 | $206 | 1.9× |
| Radex Spine 1 View Specify Level (72020) | $225.60 | $282 | 2.7× |
| Radex Sternum Minimum 2 Views (71120) | $331.20 | $414 | 3.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $326.40 | $408 | 3.9× |
| Radex Toe Minimum 2 Views (73660) | $308 | $385 | 3.6× |
| Radex upper extremity infant minimum 2 views (73092) | $271.20 | $339 | 2.7× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$249.60–$440 | $312–$550 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $296 | $370 | 2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $412.80 | $516 | 4.1× |
| Radiologic exam colon double contrast study (74280) | $1,175.20 | $1,469 | 6.9× |
| Radiologic exam colon single contrast study (74270) | $808.80 | $1,011 | 4.7× |
| Radiologic exam knee complete 4/more views (73564) | $480 | $600 | 4.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $371.20 | $464 | 3.7× |
| Radiologic exam swallow function contrast study (74230) | $1,430.40 | $1,788 | 8.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $845.60 | $1,057 | 5.0× |
| Radiologic examination femur 1 view (73551) | $284 | $355 | 3.4× |
| Radiologic examination femur minimum 2 views (73552) | $282.40 | $353 | 3.3× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$300.80–$353.60 | $376–$442 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $3,824.80 | $4,781 | 37.7× |
| Radiologic examination tibia & fibula 2 views (73590) | $320.80 | $401 | 3.8× |
| Ribs bilateral 3 views (71110) | $380.80 | $476 | 3.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,764.80–$2,102.40 | $2,206–$2,628 | varies |
| Scapula (73010) | $232 | $290 | 2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $174.40 | $218 | 7.5× |
| Sella turcica (70240) | $161.60 | $202 | 1.9× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$180–$189.60 | $225–$237 | varies |
| Shoulder Arthrography (73040) | $648.80 | $811 | 1.9× |
| Skull less than 4 views (70250) | $317.60 | $397 | 3.1× |
| Testicular Imaging W/Flow (78761) | $2,009.60 | $2,512 | 5.2× |
| Thoracic spine 2 views (72070) | $312 | $390 | 3.1× |
| Thoracic spine 3 views (72072) | $385.60 | $482 | 3.8× |
| Thoracolumbar 2 views (72080) | $290.40 | $363 | 3.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,296 | $2,870 | 5.9× |
| Ultrasound Breast Limited (76642) | $895.20 | $1,119 | 10.6× |
| Ultrasound Exam Aaa Screen (76706) | $704.80 | $881 | 6.9× |
| Ultrasound, abdomen limited (76705) | $818.40 | $1,023 | 8.1× |
| Upper gi w/o kub (74240) | $763.20 | $954 | 4.5× |
| Urethrocystogram voiding (74455) | $530.40 | $663 | 2.3× |
| Urethrocystography retrograde (74450) | $835.20 | $1,044 | 3.6× |
| Us chest (76604) | $632 | $790 | 6.2× |
| Us complete joint (76881) | $1,081.60 | $1,352 | 10.7× |
| Us exam, pelvic, limited (76857) | $459.20 | $574 | 4.5× |
| Us kidney transplant (76776) | $969.60 | $1,212 | 9.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $831.20 | $1,039 | 8.2× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$728.80–$786.40 | $911–$983 | varies |
| Us ob transvaginal (76817) | $906.40 | $1,133 | 8.9× |
| Us pelvic non ob complete (76856) | $741.60 | $927 | 7.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,154.40 | $1,443 | 11.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,068.80 | $1,336 | 10.5× |
| Us retroperitoneal limited (76775) | $529.60 | $662 | 5.2× |
| Us scrotum and contents (76870) | $618.40 | $773 | 6.1× |
| Us thyroid (76536) | $1,078.40 | $1,348 | 10.6× |
| Vertebral fracture assessment via dxa (77086) | $331.20 | $414 | 3.9× |
| Wrist 2 views (73100) | $206.40 | $258 | 2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $288 | $360 | 3.4× |
| X-Ray Bend Only L-S Spine (72120) | $1,012 | $1,265 | 10.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $284 | $355 | 3.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $408.80 | $511 | 4.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $452 | $565 | 4.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $269.60 | $337 | 3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $300.80 | $376 | 3.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $380.80 | $476 | 3.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $368.80 | $461 | 3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $415.20 | $519 | 4.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $432.80 | $541 | 4.3× |
| X-Ray Exam L-S Spine Bending (72114) | $645.60 | $807 | 6.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $389.60 | $487 | 4.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $300.80 | $376 | 3.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $398.40 | $498 | 3.9× |
| X-ray eye for foreign body (70030) | $320.80 | $401 | 3.8× |
| X-ray humerus (73060) | $325.60 | $407 | 3.9× |
| X-ray IV pyelogram (ivp) (74400) | $972.80 | $1,216 | 5.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $227.20 | $284 | 2.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $173.60 | $217 | 2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $393.60 | $492 | 3.9× |
| X-ray nose-rectum child f.b. (76010) | $152 | $190 | 1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $508.80 | $636 | 5.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $444.80 | $556 | 4.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $657.60 | $822 | 6.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $325.60 | $407 | 3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $371.20 | $464 | 4.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $418.40 | $523 | 4.1× |
| X-Ray Stress View (77071) | $258.40 | $323 | 3.1× |
| X-ray thoracic spine 4 vw (72074) | $436.80 | $546 | 4.3× |
| X-Ray Tmj Unilat (70328) | $384 | $480 | 4.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $765.60 | $957 | 2.3× |
| X-Rays Bone Length Studies (77073) | $118.40 | $148 | 1.2× |
| X-Rays Bone Survey Complete (77075) | $4,963.20 | $6,204 | 48.9× |
| Xr c-spine 4 or 5 views (72050) | $544 | $680 | 5.4× |
| Xr facial bones less than 3 views (70140) | $273.60 | $342 | 3.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $227.20 | $284 | 2.2× |
| Xr orbits complete 4 views (70200) | $346.40 | $433 | 3.4× |
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.