Imaging prices at Saint Alphonsus Medical Center Ontario
Ontario, OR · every code in this section with a posted price and a Medicare benchmark.
257 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) | $200.20 | $308 | 2.1× |
| Abdomen 2 views (74019) | $268.45 | $413 | 2.3× |
| Ankle 2 views (73600) range across 9 matching MRF lines |
$206.05–$309.40 | $317–$476 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$538.85–$808.60 | $829–$1,244 | varies |
| Bone age studies (77072) | $217.10 | $334 | 1.9× |
| Bone Imaging 3 Phase (78315) | $1,369.55 | $2,107 | 3.1× |
| Bone Imaging Limited Area (78300) | $930.15 | $1,431 | 2.1× |
| Bone Imaging Whole Body (78306) | $1,249.30 | $1,922 | 2.8× |
| Bone survey infant (77076) | $237.90 | $366 | 2.0× |
| Chest 1 view (71045) | $168.35 | $259 | 1.7× |
| 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 | 1.0× |
| Clavicle complete (73000) range across 9 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 | 11.2× |
| 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 | 7.9× |
| CT abdomen and pelvis without contrast (74176) | $2,087.80 | $3,212 | 7.9× |
| CT abdomen w contrast (74160) | $1,409.20 | $2,168 | 7.2× |
| CT abdomen w wo contrast (74170) | $1,571.70 | $2,418 | 8.1× |
| CT abdomen w/o contrast (74150) | $998.40 | $1,536 | 8.6× |
| CT Angio Abdomen and Pelvis (74174) | $2,910.05 | $4,477 | 7.5× |
| CT Angio Chest (71275) | $1,617.85 | $2,489 | 8.3× |
| CT Angio Head (70496) | $1,784.90 | $2,746 | 9.2× |
| 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 | 9.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,318.85 | $2,029 | 6.8× |
| CT cervical spine w/ contrast (72126) | $1,684.80 | $2,592 | 4.3× |
| CT cervical spine w/o contrast (72125) | $1,299.35 | $1,999 | 11.2× |
| CT cervical spine w/wo cont (72127) | $2,147.60 | $3,304 | 11.0× |
| CT chest w contrast (71260) | $1,413.10 | $2,174 | 7.2× |
| CT chest w/wo contrast (71270) | $1,552.85 | $2,389 | 8.0× |
| CT head/brain with contrast (70460) | $1,375.40 | $2,116 | 7.1× |
| CT head/brain without and with contrast (70470) | $1,571.70 | $2,418 | 8.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $518.05 | $797 | 1.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $51.35 | $79 | 0.5× |
| CT iac w contrast (70481) | $1,333.15 | $2,051 | 6.8× |
| CT l-spine w&w/o contrast (72133) | $1,742 | $2,680 | 8.9× |
| CT lower ext w/o (73700) range across 6 matching MRF lines |
$1,001–$1,501.50 | $1,540–$2,310 | 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 | 3.8× |
| CT lumbar spine w/o contrast (72131) | $1,298.70 | $1,998 | 11.2× |
| CT maxillofacial w contrast (70487) | $1,227.85 | $1,889 | 6.3× |
| CT maxillofacial wo contrast (70486) | $893.10 | $1,374 | 7.7× |
| CT neck tissue combo (70492) | $1,488.50 | $2,290 | 7.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,539.20 | $2,368 | 7.9× |
| CT orbits w/o contrast (70480) | $1,068.60 | $1,644 | 9.2× |
| CT pelvis w&w/o contrast (72194) | $1,483.95 | $2,283 | 7.6× |
| CT pelvis w/o contrast (72192) | $993.20 | $1,528 | 8.5× |
| CT scan of leg combo (73702) range across 6 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 | 7.3× |
| CT soft tissue neck w contrast (70491) | $1,414.40 | $2,176 | 7.3× |
| CT soft tissue neck w/o contrast (70490) | $856.05 | $1,317 | 7.4× |
| CT thoracic spine w contrast (72129) | $1,422.20 | $2,188 | 7.3× |
| CT thoracic spine w/o contrast (72128) | $1,173.90 | $1,806 | 10.1× |
| CT thoracic spine w/wo cont (72130) | $3,021.85 | $4,649 | 15.5× |
| CT thorax w/o contrast (71250) | $1,134.25 | $1,745 | 9.8× |
| 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 | 9.2× |
| Cta Abdomen (74175) | $1,718.60 | $2,644 | 8.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,571.70 | $2,418 | 4.1× |
| CTA pelvis (72191) | $1,430 | $2,200 | 7.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $284.70 | $438 | 2.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $485.55 | $747 | 4.2× |
| Dxa Bone Density Axial (77080) | $277.55 | $427 | 2.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $117 | $180 | 1.2× |
| 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 Biophysical Profile W/O Non-Stress Testing (76819) | $213.20 | $328 | 1.8× |
| Fluoroscopy up to 1 hr (76000) | $518.70 | $798 | 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) range across 9 matching MRF lines |
$211.25–$317.20 | $325–$488 | varies |
| Gastric emptying imaging study (78264) | $1,079.65 | $1,661 | 2.4× |
| Gated Heart Planar Single (78472) | $1,256.45 | $1,933 | 2.8× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$197.60–$296.40 | $304–$456 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,235 | $1,900 | 2.0× |
| Hepatobiliary System Imaging (78226) | $1,235 | $1,900 | 2.8× |
| Ht Muscle Image Spect Sing (78451) | $3,018.60 | $4,644 | 2.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $367.25 | $565 | 3.8× |
| Infant hip ultrasound, limited static exam (76886) | $367.25 | $565 | 3.8× |
| Joint Survey Single View (77077) | $91.65 | $141 | 0.8× |
| K Flow/Funct Image W/Drug (78708) | $1,371.50 | $2,110 | 2.3× |
| 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 | 5.0× |
| Meckels Divert Exam (78290) | $846.30 | $1,302 | 1.9× |
| Mr safety determination physician/other qhp (76016) | $118.30 | $182 | 1.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $33.15 | $51 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $2,520.70 | $3,878 | 6.5× |
| MRA head w/o contrast (70544) | $1,573.65 | $2,421 | 5.9× |
| MRA head with contrast (70545) | $1,817.40 | $2,796 | 4.7× |
| MRA neck w contrast (70548) | $1,663.35 | $2,559 | 4.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,564.90 | $3,946 | 6.6× |
| MRA neck w/o contrast (70547) | $1,433.90 | $2,206 | 5.4× |
| MRI abdomen w contrast (74182) | $1,767.35 | $2,719 | 4.6× |
| MRI abdomen w/o contrast (74181) | $1,600.95 | $2,463 | 6.0× |
| 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 3 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 | 6.1× |
| MRI cervical spine w contrast (72142) | $1,875.90 | $2,886 | 4.8× |
| MRI cervical spine w/o cont (72141) | $1,593.15 | $2,451 | 6.0× |
| MRI chest w/o contrast (71550) | $1,233.70 | $1,898 | 4.7× |
| MRI chest wo w contrast (71552) | $2,050.75 | $3,155 | 5.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$1,403.35–$2,105.35 | $2,159–$3,239 | varies |
| 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 3 matching MRF lines |
$1,422.20–$2,133.30 | $2,188–$3,282 | varies |
| MRI lumbar spine w contrast (72149) | $1,716 | $2,640 | 4.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,661.75 | $4,095 | 6.9× |
| MRI orbit face &/neck w/o contrast (70540) | $1,446.90 | $2,226 | 5.5× |
| MRI orbit face neck w contrast (70542) | $1,522.95 | $2,343 | 3.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,468.05 | $3,797 | 6.4× |
| MRI pelvis w contrast (72196) | $2,137.85 | $3,289 | 5.5× |
| MRI pelvis w/o & w contrast (72197) | $2,471.30 | $3,802 | 6.4× |
| MRI pelvis w/o contrast (72195) | $1,509.30 | $2,322 | 5.7× |
| MRI thoracic spine w/o contrast (72146) | $1,534.65 | $2,361 | 5.8× |
| 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 | 6.2× |
| MRI, dorsal spine combo (72157) | $2,531.75 | $3,895 | 6.5× |
| MRI, dorsal spine contrast (72147) | $1,716 | $2,640 | 4.4× |
| MRI, joint upper extrem (73221) range across 6 matching MRF lines |
$1,498.25–$2,247.70 | $2,305–$3,458 | 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 | 6.8× |
| Myelography thoracic (72255) | $1,364.35 | $2,099 | 1.6× |
| Myocardial Spect Multiple Studies (78452) | $3,613.35 | $5,559 | 2.5× |
| Neck soft tissue (70360) | $204.75 | $315 | 2.1× |
| Nonvascular Shunt X-Ray (75809) | $256.75 | $395 | 2.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 3 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 | 4.5× |
| Pelvis 1 or 2 views (72170) | $224.25 | $345 | 1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $676 | $1,040 | 1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $373.10 | $574 | 3.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $884 | $1,360 | 1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 9 matching MRF lines |
$228.80–$343.20 | $352–$528 | 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 | 1.3× |
| Radex fingr minimum 2 views (73140) range across 6 matching MRF lines |
$165.75–$248.95 | $255–$383 | varies |
| Radex foot complete minimum 3 views (73630) range across 12 matching MRF lines |
$237.90–$356.85 | $366–$549 | varies |
| Radex Hand Minimum 3 Views (73130) range across 12 matching MRF lines |
$206.05–$309.40 | $317–$476 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 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 12 matching MRF lines |
$228.80–$343.20 | $352–$528 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $130.65 | $201 | 1.4× |
| Radex Spine 1 View Specify Level (72020) | $225.55 | $347 | 2.3× |
| Radex Sternum Minimum 2 Views (71120) | $233.35 | $359 | 2.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $139.10 | $214 | 1.4× |
| 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 9 matching MRF lines |
$228.80–$343.20 | $352–$528 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $310.70 | $478 | 2.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $176.15 | $271 | 1.5× |
| 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 | 2.6× |
| Radiologic exam colon single contrast study (74270) | $549.25 | $845 | 2.8× |
| 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 | 1.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $488.80 | $752 | 2.5× |
| 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 6 matching MRF lines |
$200.20–$300.30 | $308–$462 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $217.10 | $334 | 1.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 12 matching MRF lines |
$243.10–$364.65 | $374–$561 | varies |
| Ribs bilateral 3 views (71110) | $373.75 | $575 | 3.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $722.80 | $1,112 | 1.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,710.80 | $2,632 | 2.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,590.55 | $2,447 | 1.1× |
| 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 3 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 | 2.2× |
| Sternoclavicular joints (71130) | $76.70 | $118 | 0.8× |
| Thoracic spine 2 views (72070) | $284.70 | $438 | 2.4× |
| Thoracic spine 3 views (72072) | $340.60 | $524 | 2.9× |
| Thoracolumbar 2 views (72080) | $308.75 | $475 | 3.2× |
| Thyroid Uptake Measurement (78012) | $676 | $1,040 | 1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $942.50 | $1,450 | 2.1× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$204.10–$306.15 | $314–$471 | varies |
| 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 | $566 | 3.2× |
| Umbilical-artery Doppler (OB) (76820) | $193.05 | $297 | 1.7× |
| Upper gi w/o kub (74240) | $410.80 | $632 | 2.1× |
| Urethrocystogram voiding (74455) | $457.60 | $704 | 1.7× |
| Us breast unilateral complete (76641) range across 3 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 | 1.5× |
| Us exam, pelvic, limited (76857) | $270.40 | $416 | 2.3× |
| Us head (76506) | $287.30 | $442 | 2.5× |
| Us kidney transplant (76776) | $361.40 | $556 | 3.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $217.10 | $334 | 1.9× |
| Us ob detailed single fetus (76811) | $590.85 | $909 | 2.2× |
| Us ob limited 1 or more fetuses (76815) | $286.65 | $441 | 2.5× |
| Us ob transvaginal (76817) | $254.80 | $392 | 2.2× |
| Us pelvic non ob complete (76856) | $458.90 | $706 | 3.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $299.65 | $461 | 2.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $283.40 | $436 | 2.4× |
| Us retroperitoneal complete (76770) | $439.40 | $676 | 3.8× |
| Us retroperitoneal limited (76775) | $292.50 | $450 | 2.5× |
| Us scrotum and contents (76870) | $428.35 | $659 | 3.7× |
| Us spinal canal and contents (76800) | $385.45 | $593 | 3.3× |
| Us thyroid (76536) | $345.80 | $532 | 3.0× |
| Venography extremity bilateral rs&i (75822) | $1,846 | $2,840 | 1.1× |
| Wrist 2 views (73100) range across 9 matching MRF lines |
$225.55–$338.65 | $347–$521 | 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 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $261.30 | $402 | 2.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$206.05–$309.40 | $317–$476 | varies |
| 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 | 2.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $174.20 | $268 | 1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $193.05 | $297 | 2.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $202.15 | $311 | 1.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $325.65 | $501 | 2.8× |
| 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 | 3.0× |
| X-Ray Exam L-S Spine Bending (72114) | $401.70 | $618 | 3.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $261.30 | $402 | 2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $319.15 | $491 | 2.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $257.40 | $396 | 2.2× |
| 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 | $352 | 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 | 4.7× |
| 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 | 2.9× |
| 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 | 2.6× |
| 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 | 2.9× |
| X-Ray Tmj Unilat (70328) | $92.95 | $143 | 1.0× |
| 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 | $508 | 2.8× |
| Xr facial bones less than 3 views (70140) | $146.25 | $225 | 1.5× |
| 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.