Imaging prices at Saint Alphonsus Medical Center - Nampa

Nampa, ID · every code in this section with a posted price and a Medicare benchmark.

304 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $5,346.90 $8,226 3.6×
Abdomen 1 View (74018) $200.20 — 2.1×
Abdomen 2 views (74019) $268.45 $413 2.4×
Acute Gastrointestinal Blood Loss Imaging (78278) $976.95 $1,503 2.3×
Angiography extremity unilateral rs&i (75710) $5,697.25 $8,765 1.7×
Ankle 2 views (73600)
range across 2 matching MRF lines
$237.90–$305.50 — varies
Artery X-Rays Abdomen (75726) $9,982.70 $15,358 1.7×
Arthrogram hip (73525)
range across 3 matching MRF lines
$538.85–$808.60 $829–$1,244 varies
Basic radiation dosimetry calculation (77300) $524.55 $807 3.6×
Bone age studies (77072) $217.10 $334 1.9×
Bone Imaging 3 Phase (78315) $1,369.55 $2,107 3.2×
Bone Imaging Limited Area (78300) $930.15 $1,431 2.2×
Bone Imaging Multiple Areas (78305) $975 $1,500 2.3×
Bone Imaging Whole Body (78306) $1,249.30 $1,922 2.9×
Bone survey infant (77076) $237.90 $366 2.1×
Brachytx isodose complex (77318) $765.70 $1,178 1.9×
Cardiac MRI w/w/o contrast & further seq (75561) $2,481.05 $3,817 6.6×
Cat Scan Follow-Up Study (76380) $354.25 $545 3.8×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $1,054.95 $1,623 1.8×
Chest 1 view (71045)
range across 4 matching MRF lines
$1,703–$13,079.66 — varies
Chest 2 views (71046) $192.40 $296 2.0×
Chest 3 views (71047) $209.95 $323 2.2×
Chest 4 or more views (71048) $219.70 $338 1.9×
Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $120.90 $186 1.1×
Cineradiograpy/vidradiograpy xcpt where spec (76120) $501.15 $771 4.4×
Clavicle complete (73000)
range across 6 matching MRF lines
$206.70–$299.65 $318–$461 varies
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,298.05 $1,997 11.5×
Continuing medical physics consltj pr wk (77336) $556.40 $856 3.8×
Contrast Exam Abdominl Aorta (75625) $5,697.25 $8,765 1.7×
Contrast X-Ray Bladder (74430) $834.60 $1,284 2.2×
CT abdomen and pelvis without and with contrast (74178) $3,078.40 $4,736 8.2×
CT abdomen and pelvis without contrast (74176) $2,087.80 — 8.1×
CT abdomen w contrast (74160) $1,409.20 $2,168 7.4×
CT abdomen w wo contrast (74170) $1,571.70 $2,418 8.3×
CT abdomen w/o contrast (74150) $998.40 $1,536 8.8×
CT Angio Abdomen and Pelvis (74174) $2,910.05 $4,477 7.7×
CT Angio Chest (71275) $1,765.72 — 9.3×
CT Angio Head (70496) $1,932.77 — 10.2×
CT angio hrt w/3d image (75574) $852.80 $1,312 2.3×
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 6 matching MRF lines
$1,196–$1,794 $1,840–$2,760 varies
CT Angio Neck (70498) $1,820.65 $2,801 9.6×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,318.85 $2,029 7.0×
CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) $785.85 $1,209 4.1×
CT cervical spine w/ contrast (72126) $1,684.80 $2,592 4.5×
CT cervical spine w/o contrast (72125) $1,299.35 $1,999 11.5×
CT cervical spine w/wo cont (72127) $2,147.60 $3,304 11.3×
CT chest w contrast (71260) $4,374.17 — 23.1×
CT chest w/wo contrast (71270) $1,552.85 $2,389 8.2×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $1,083.55 $1,667 5.7×
CT head/brain with contrast (70460) $1,375.40 $2,116 7.3×
CT head/brain without and with contrast (70470) $1,571.70 $2,418 8.3×
CT heart contrast eval cardiac structure&morph (75572) $518.05 $797 1.4×
CT heart no contrast quant eval coronry calcium (75571) $51.35 $79 0.5×
CT iac w contrast (70481) $1,333.15 $2,051 7.0×
CT l-spine w&w/o contrast (72133) $1,742 $2,680 9.2×
CT lower ext w/o (73700)
range across 2 matching MRF lines
$1,001–$2,232.75 — varies
CT lower extremity w/contrast material (73701)
range across 6 matching MRF lines
$1,342.90–$2,014.35 $2,066–$3,099 varies
CT lumbar spine w contrast (72132) $1,482.65 $2,281 3.9×
CT lumbar spine w/o contrast (72131) $1,298.70 $1,998 11.5×
CT maxillofacial w contrast (70487) $1,227.85 $1,889 6.5×
CT maxillofacial wo contrast (70486) $893.10 $1,374 7.9×
CT neck tissue combo (70492) $1,488.50 $2,290 7.9×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,539.20 $2,368 8.1×
CT orbits w/o contrast (70480) $1,068.60 $1,644 9.5×
CT pelvis w&w/o contrast (72194) $1,483.95 $2,283 7.8×
CT pelvis w/o contrast (72192) $993.20 — 8.8×
CT scan of leg combo (73702)
range across 3 matching MRF lines
$1,875.90–$2,813.85 $2,886–$4,329 varies
CT scans face/jaw combo (70488) $1,420.90 $2,186 7.5×
CT soft tissue neck w contrast (70491) $1,562.27 — 8.2×
CT soft tissue neck w/o contrast (70490) $856.05 $1,317 7.6×
CT thoracic spine w contrast (72129) $1,422.20 $2,188 7.5×
CT thoracic spine w/o contrast (72128) $1,173.90 $1,806 10.4×
CT thoracic spine w/wo cont (72130) $3,021.85 $4,649 16.0×
CT thorax w/o contrast (71250) $1,134.25 — 10.0×
CT upper ext wo (73200)
range across 3 matching MRF lines
$1,017.25–$1,526.20 $1,565–$2,348 varies
CT upper extremity w/o & w/contrast material (73202)
range across 3 matching MRF lines
$1,483.30–$2,224.95 $2,282–$3,423 varies
CT upper extremity with contrast (73201)
range across 3 matching MRF lines
$1,288.30–$1,932.45 $1,982–$2,973 varies
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,787.50 $2,750 9.4×
Cta Abdomen (74175) $1,718.60 $2,644 9.1×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,571.70 $2,418 4.2×
CTA pelvis (72191) $1,430 $2,200 7.6×
Dilation ureters/urethra rs&i (74485) $1,493.05 $2,297 0.7×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $284.70 $438 2.5×
Doppler Echo Fetal Spectral Display Complete (76827) $485.55 $747 4.3×
Dxa Bone Density Axial (77080) $277.55 $427 2.5×
Dxa bone density study 1/>sites appendiclr skel (77081) $333.45 — 3.5×
Echo exam of fetal heart (76825) $971.10 $1,494 1.6×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $625.30 $962 2.4×
Esophagram (74220) $419.90 $646 2.2×
Fetal Biophys Profile W/Nst (76818) $225.55 $347 2.0×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $213.20 $328 1.9×
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $512.85 $789 2.0×
Fluoroscopy up to 1 hr (76000) $518.70 — 2.0×
Follow-Up Angiography (75898) $1,705.60 $2,624 0.5×
Foot 2 views (73620)
range across 6 matching MRF lines
$206.05–$309.40 $317–$476 varies
Forearm 2 views (73090) $379.60 — 4.0×
Gastric emptying imaging study (78264) $1,079.65 $1,661 2.5×
Gated Heart Planar Single (78472) $1,256.45 $1,933 2.9×
Hand 2 views (73120)
range across 2 matching MRF lines
$296.40–$395.20 — varies
Hepatobil Syst Image W/Drug (78227) $1,235 $1,900 2.1×
Hepatobiliary System Imaging (78226) $1,235 $1,900 2.9×
Ht Muscle Image Spect Sing (78451) $3,018.60 $4,644 2.2×
Hysterosalpingogram (74740) $495.95 $763 1.9×
Infant hip ultrasound with hip movement (dynamic) (76885) $367.25 $565 3.9×
Infant hip ultrasound, limited static exam (76886) $367.25 $565 3.9×
Joint Survey Single View (77077) $235.95 $363 2.1×
K Flow/Funct Image W/Drug (78708) $1,371.50 $2,110 2.3×
K Flow/Funct Image W/O Drug (78707) $1,091.35 $1,679 1.9×
Kidney Imaging Morphol (78700) $738.40 $1,136 1.7×
Knee 3 Views (73562)
range across 6 matching MRF lines
$247.65–$371.80 $381–$572 varies
Lung Perf&Ventilat Diferentl (78598) $1,418.30 $2,182 2.4×
Lung Ventilat&Perfus Imaging (78582) $1,493.05 $2,297 2.5×
Lymph System Imaging (78195) $1,249.30 $1,922 2.1×
Magnetic Image Jaw Joint (70336) $1,316.25 $2,025 5.1×
Meckels Divert Exam (78290) $846.30 $1,302 2.0×
Mlc imrt design & construction per imrt plan (77338) $3,674.45 $5,653 9.1×
Mr safety determination physician/other qhp (76016) $118.30 $182 1.3×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $33.15 $51 1.1×
Mra Head W/O & W/Contrast Material (70546) $2,569.45 — 6.8×
MRA head w/o contrast (70544)
range across 2 matching MRF lines
$1,573.65–$4,381 — varies
MRA head with contrast (70545) $1,817.40 $2,796 4.8×
MRA neck w contrast (70548) $1,663.35 $2,559 4.4×
Mra Neck W/O &W/Contrast Material (70549) $2,564.90 $3,946 6.8×
MRA neck w/o contrast (70547) $1,433.90 $2,206 5.6×
MRI abdomen w contrast (74182) $1,767.35 $2,719 4.7×
MRI abdomen w/o contrast (74181) $1,600.95 $2,463 6.2×
MRI any jt lower extrem w/contrast material (73722)
range across 3 matching MRF lines
$1,923.35–$2,885.35 $2,959–$4,439 varies
MRI any jt lower extrem w/o & w/contrast matrl (73723)
range across 6 matching MRF lines
$2,361.45–$3,542.50 $3,633–$5,450 varies
MRI any jt upper extremity w/contrast matrl (73222)
range across 3 matching MRF lines
$1,870.70–$2,806.05 $2,878–$4,317 varies
MRI cardiac w/o contrast (75557) $1,610.05 $2,477 6.2×
MRI cervical spine w contrast (72142) $1,875.90 $2,886 5.0×
MRI cervical spine w/o cont (72141) $1,593.15 $2,451 6.2×
MRI chest w/o contrast (71550) $1,233.70 $1,898 4.8×
MRI chest wo w contrast (71552) $2,122.25 $3,265 5.6×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 6 matching MRF lines
$2,469.35–$3,704.35 $3,799–$5,699 varies
MRI lower extrem oth/thn jt w/o contr matrl (73718)
range across 9 matching MRF lines
$1,422.20–$2,133.30 $2,188–$3,282 varies
MRI lumbar spine w contrast (72149) $1,716 $2,640 4.6×
Mri Neck Spine W/O & W/Dye (72156) $2,661.75 $4,095 7.1×
MRI orbit face &/neck w/o contrast (70540) $1,446.90 $2,226 5.6×
MRI orbit face neck w contrast (70542) $1,522.95 $2,343 4.0×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,468.05 $3,797 6.6×
MRI pelvis w contrast (72196) $2,137.85 $3,289 5.7×
MRI pelvis w/o & w contrast (72197) $2,471.30 $3,802 6.6×
MRI pelvis w/o contrast (72195) $1,509.30 $2,322 5.9×
MRI thoracic spine w/o contrast (72146) $1,534.65 $2,361 6.0×
MRI upper extremity oth than jt w/o contr matrl (73218)
range across 3 matching MRF lines
$1,474.85–$2,212.60 $2,269–$3,404 varies
Mri Uppr Extremity W/O&W/Dye (73220)
range across 3 matching MRF lines
$2,379.65–$3,569.80 $3,661–$5,492 varies
MRI, abdomen, combo (74183) $2,419.95 $3,723 6.4×
MRI, dorsal spine combo (72157) $2,531.75 $3,895 6.7×
MRI, dorsal spine contrast (72147) $1,716 $2,640 4.6×
MRI, joint upper extrem (73221)
range across 2 matching MRF lines
$1,498.25–$5,707 — varies
MRI, joint upper extrem combo (73223)
range across 3 matching MRF lines
$2,141.10–$3,211.65 $3,294–$4,941 varies
MRI, lumbar spine combo (72158) $2,648.10 $4,074 7.0×
Myelography thoracic (72255) $1,364.35 $2,099 1.6×
Myocardial Spect Multiple Studies (78452) $3,613.35 $5,559 2.6×
Neck soft tissue (70360) $204.75 $315 2.2×
Nonvascular Shunt X-Ray (75809) $256.75 $395 2.3×
Ntsty modul radthx pln dose-vol histos (77301) $4,854.20 $7,468 3.2×
Nuclear Rx Oral Admin (79005) $1,018.55 $1,567 4.0×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512)
range across 8 matching MRF lines
$212.55–$319.15 $327–$491 varies
Parathyroid Planar Imaging (78070) $780 $1,200 1.8×
Parathyroid planar imaging w/wo subtraction (78071) $2,004.60 $3,084 4.6×
Pelvis 1 or 2 views (72170) $520.65 — 4.6×
Pulmonary Perfusion Imaging Particulate (78580) $676 $1,040 1.6×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $373.10 $574 3.3×
Radex abscess/fistula/sinus tract rs&i (76080) $884 $1,360 1.5×
Radex Ankle Complete Minimum 3 Views (73610)
range across 3 matching MRF lines
$176.80–$51,224.76 — varies
Radex Calcaneus Minimum 2 Views (73650)
range across 6 matching MRF lines
$206.05–$309.40 $317–$476 varies
Radex elbow complete minimum 3 views (73080)
range across 6 matching MRF lines
$228.80–$343.20 $352–$528 varies
Radex Facial Bones Complete Minimum 3 Views (70150) $156 $240 1.4×
Radex fingr minimum 2 views (73140)
range across 2 matching MRF lines
$179.40–$449.80 — varies
Radex foot complete minimum 3 views (73630)
range across 2 matching MRF lines
$171.60–$206.70 — varies
Radex Hand Minimum 3 Views (73130)
range across 2 matching MRF lines
$176.80–$214.50 — varies
Radex lower extremity infant minimum 2 views (73592)
range across 6 matching MRF lines
$210.60–$315.90 $324–$486 varies
Radex Mastoids Compl Minimum 3 Views PR Side (70130)
range across 3 matching MRF lines
$248.95–$373.75 $383–$575 varies
Radex Nasal Bones Complete Minimum 3 Views (70160) $143 $220 1.5×
Radex Ribs Unilateral 2 Views (71100) $169.65 $261 1.8×
Radex shoulder complete minimum 2 views (73030)
range across 4 matching MRF lines
$104.65–$36,093.58 — varies
Radex Sinuses Paransl < 3 Views (70210) $130.65 $201 1.4×
Radex Spine 1 View Specify Level (72020) $225.55 $347 2.4×
Radex Sternum Minimum 2 Views (71120) $233.35 $359 2.5×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $139.10 $214 1.5×
Radex Toe Minimum 2 Views (73660)
range across 6 matching MRF lines
$182–$273 $280–$420 varies
Radex upper extremity infant minimum 2 views (73092)
range across 3 matching MRF lines
$556.40–$834.60 $856–$1,284 varies
Radex Wrist Complete Minimum 3 Views (73110)
range across 2 matching MRF lines
$185.25–$226.85 — varies
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $310.70 $478 2.8×
Radiation Delivery Stereotactic Cranial Linear (77372) $14,486.55 $22,287 1.8×
Radiation treatment delivery level 1 (77402) $2,009.15 $3,091 18.2×
Radiation treatment delivery level 2 (77407) $2,149.55 $3,307 5.2×
Radiation treatment delivery level 3 (77412) $2,289.95 $3,523 3.8×
Radiolog exam mandible compl minimum 4 views (70110) $176.15 $271 1.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $309.40 $476 2.7×
Radiologic exam colon double contrast study (74280) $511.55 $787 2.7×
Radiologic exam colon single contrast study (74270) $549.25 $845 2.9×
Radiologic exam knee complete 4/more views (73564)
range across 6 matching MRF lines
$299.65–$449.80 $461–$692 varies
Radiologic exam pelvis compl minimum 3 views (72190) $275.60 $424 2.4×
Radiologic Exam Small Int Single Contrast Study (74250) $400.40 $616 2.1×
Radiologic exam swallow function contrast study (74230) $359.45 $553 1.9×
Radiologic exam upr gi trc double contrast study (74246) $488.80 $752 2.6×
Radiologic examination femur 1 view (73551)
range across 3 matching MRF lines
$142.35–$213.85 $219–$329 varies
Radiologic examination femur minimum 2 views (73552)
range across 9 matching MRF lines
$250.90–$376.35 $386–$579 varies
Radiologic examination knee 1/2 views (73560)
range across 2 matching MRF lines
$170.95–$300.30 — varies
Radiologic Examination Osseous Survey Limited (77074) $217.10 $334 1.9×
Radiologic examination tibia & fibula 2 views (73590)
range across 2 matching MRF lines
$243.10–$364.65 — varies
Ribs bilateral 3 views (71110) $373.75 $575 3.3×
Rp loclzj tum plnr 1 area single day imaging (78800) $733.85 $1,129 1.7×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $722.80 $1,112 1.7×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $3,030.30 $4,662 5.2×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $1,710.80 $2,632 2.9×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $1,590.55 $2,447 1.1×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $2,847 $4,380 1.8×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $1,710.80 $2,632 1.2×
Scapula (73010)
range across 3 matching MRF lines
$252.85–$366.60 $389–$564 varies
Screening Digital Breast Tomosynthesis Bi (77063)
range across 3 matching MRF lines
$37.05–$39 $57–$60 varies
Shoulder 1 view (73020)
range across 9 matching MRF lines
$193.70–$280.80 $298–$432 varies
Shoulder Arthrography (73040)
range across 3 matching MRF lines
$734.50–$1,101.75 $1,130–$1,695 varies
Skull less than 4 views (70250) $258.05 $397 2.3×
Special dosimetry (77331) $524.55 $807 3.6×
Special Physics Consult (77370) $308.10 $474 2.1×
Special teletherapy port plan (77321) $871.65 $1,341 2.2×
Special treatment procedure (77470) $1,235.65 $1,901 2.1×
Stereotactic Body Radiation Delivery (77373) $4,306.25 $6,625 2.2×
Sternoclavicular joints (71130) $76.70 $118 0.8×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,647.10 $2,534 4.1×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $1,318.20 $2,028 3.3×
Ther rad simulaj-aided field setting simple (77280) $295.75 $455 2.0×
Thoracic spine 2 views (72070) $284.70 $438 2.5×
Thoracic spine 3 views (72072) $340.60 $524 3.0×
Thoracolumbar 2 views (72080) $308.75 $475 3.3×
Thyroid Met Imaging Body (78018) $1,254.50 $1,930 2.1×
Thyroid Uptake Measurement (78012) $676 $1,040 1.6×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $942.50 $1,450 2.2×
Tx Devices Design & Construction Complex (77334) $1,005.55 $1,547 2.5×
Tx devices design & construction intermediate (77333) $678.60 $1,044 4.7×
Tx devices design & construction simple (77332) $527.80 $812 3.6×
Ultrasound Breast Limited (76642)
range across 6 matching MRF lines
$204.10–$306.15 $314–$471 varies
Ultrasound elastography first target lesion (76982) $267.80 $412 2.4×
Ultrasound Elastography Parenchyma (76981) $274.95 $423 2.4×
Ultrasound Exam Aaa Screen (76706) $229.45 $353 2.0×
Ultrasound, abdomen limited (76705) $367.90 — 3.3×
Umbilical-artery Doppler (OB) (76820) $193.05 $297 1.7×
Upper gi w/o kub (74240) $410.80 $632 2.2×
Urethrocystogram voiding (74455) $457.60 $704 1.8×
Urethrocystography retrograde (74450) $618.80 $952 2.4×
Us breast unilateral complete (76641)
range across 6 matching MRF lines
$250.90–$376.35 $386–$579 varies
Us chest (76604) $287.30 $442 2.5×
Us complete joint (76881) $176.15 $271 1.6×
Us exam, pelvic, limited (76857) $270.40 $416 2.4×
Us head (76506) $287.30 $442 2.5×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $217.10 — 1.9×
Us ob detailed single fetus (76811) $590.85 $909 2.3×
Us ob limited 1 or more fetuses (76815) $286.65 $441 2.5×
Us ob transvaginal (76817) $254.80 $392 2.3×
Us pelvic non ob complete (76856) $458.90 $706 4.1×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $299.65 $461 2.7×
Us preg uterus real time f/u trnsabdl per fetus (76816) $283.40 $436 2.5×
Us retroperitoneal complete (76770) $439.40 — 3.9×
Us retroperitoneal limited (76775) $292.50 $450 2.6×
Us scrotum and contents (76870) $428.35 $659 3.8×
Us spinal canal and contents (76800) $385.45 $593 3.4×
Us thyroid (76536) $345.80 $532 3.1×
Vein X-Ray Chest (75827) $2,041.65 $3,141 1.2×
Venography caval inferior serialography rs&i (75825) $6,040.45 $9,293 1.8×
Venography extremity bilateral rs&i (75822) $1,846 $2,840 1.1×
Wrist 2 views (73100)
range across 2 matching MRF lines
$201.50–$225.55 — varies
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $181.35 $279 1.9×
X-ray antegrade pyelogram tube (74425) $834.60 $1,284 2.2×
X-Ray Aorta Leg Arteries (75630) $5,042.05 $7,757 1.5×
X-Ray Bend Only L-S Spine (72120) $261.30 $402 2.3×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $308.10 — 3.3×
X-Ray Exam Breast Specimen (76098) $404.30 $622 0.7×
X-Ray Exam Entire Spi 1 Vw (72081) $143 $220 1.5×
X-Ray Exam Entire Spi 2/3 Vw (72082) $215.80 $332 1.9×
X-Ray Exam Entire Spi 4/5 Vw (72083) $269.75 $415 2.4×
X-Ray Exam Hip Uni 1 View (73501) $174.20 $268 1.9×
X-Ray Exam Hip Uni 2-3 Views (73502)
range across 2 matching MRF lines
$197.60–$443.95 — varies
X-Ray Exam Hip Uni 4/> Views (73503) $202.15 $311 1.8×
X-Ray Exam Hips Bi 2 Views (73521) $325.65 $501 2.9×
X-Ray Exam Hips Bi 3-4 Views (73522) $354.90 $546 3.1×
X-Ray Exam Hips Bi 5/> Views (73523) $349.05 $537 3.1×
X-Ray Exam L-S Spine Bending (72114) $401.70 $618 3.6×
X-Ray Exam Neck Spine 2-3 Vw (72040) $261.30 $402 2.8×
X-Ray Exam Neck Spine 6/>Vws (72052) $319.15 $491 2.8×
X-Ray Exam Unilat Ribs/Chest (71101) $257.40 $396 2.3×
X-ray eye for foreign body (70030)
range across 6 matching MRF lines
$132.60–$198.90 $204–$306 varies
X-ray humerus (73060) $228.80 — 2.4×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $130.65 $201 1.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $449.80 $692 4.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $296.40 $456 2.6×
X-ray nose-rectum child f.b. (76010) $145.60 $224 1.5×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $340.60 $524 3.0×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $230.75 $355 2.0×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $89.05 $137 0.8×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $250.25 $385 2.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $144.95 $223 1.5×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $250.25 $385 2.2×
X-ray thoracic spine 4 vw (72074) $340.60 $524 3.0×
X-Ray Tmj Unilat (70328) $92.95 $143 1.0×
X-Ray Urinary Tract Exam With Contrast Material (74420) $834.60 $1,284 2.2×
X-Rays Bone Length Studies (77073) $217.10 $334 1.9×
X-Rays Bone Survey Complete (77075) $263.90 $406 2.3×
Xr c-spine 4 or 5 views (72050) $330.20 — 2.9×
Xr facial bones less than 3 views (70140) $146.25 $225 1.6×
Xr orbits complete 4 views (70200) $241.15 $371 2.1×

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.