Imaging prices at Saint Francis Medical Center

Cape Girardeau, MO · every code in this section with a posted price and a Medicare benchmark.

334 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) $12,690 $12,690 9.2×
Abdomen 1 View (74018) $401 $401 4.6×
Abdomen 2 views (74019) $672 $672 6.4×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,632 $1,632 4.1×
Adrenal Cortex & Medulla Img (78075) $2,889 $2,889 2.2×
Angio internal mammary (75756) $5,802 $5,802 1.8×
Angio pulmonary bilat (75743)
range across 2 matching MRF lines		 $6,262–$7,302 $6,262–$7,302 varies
Angiography extremity bilateral rs&i (75716)
range across 2 matching MRF lines		 $6,262–$7,143 $6,262–$7,143 varies
Angiography extremity unilateral rs&i (75710) $6,262 $6,262 2.0×
Angiography pulmonary unilateral slctv rs&i (75741)
range across 2 matching MRF lines		 $5,802–$6,319 $5,802–$6,319 varies
Ankle 2 views (73600) $436 $436 5.0×
Aortography thoracic serialography rs&i (75605)
range across 2 matching MRF lines		 $9,927–$9,928 $9,927–$9,928 varies
Aortography thoracic w/o serialography rs&i (75600) $7,302 $7,302 2.3×
Artery X-Rays Abdomen (75726)
range across 2 matching MRF lines		 $6,262–$15,185 $6,262–$15,185 varies
Artery X-Rays Pelvis (75736) $9,927 $9,927 1.8×
Artery X-Rays Spine (75705) $9,928 $9,928 1.8×
Arthrogram Wrist (73115) $1,217 $1,217 3.5×
Basic radiation dosimetry calculation (77300) $1,175 $1,175 8.7×
Bone age studies (77072) $786 $786 7.5×
Bone Imaging 3 Phase (78315) $2,271 $2,271 5.7×
Bone Imaging Limited Area (78300) $1,220 $1,220 3.0×
Bone Imaging Whole Body (78306) $2,406 $2,406 6.0×
Bone survey infant (77076) $665 $665 6.4×
Brain Flow Imaging Only (78610) $1,440 $1,440 2.6×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $845 $845 2.1×
Cardiac MRI w/w/o contrast & further seq (75561) $1,056 $1,056 3.0×
Cardiac MRI w/w/o contrast w/stress (75563) $2,051 $2,051 2.6×
Cerebrospinal Fluid Scan (78630) $1,940 $1,940 3.6×
Chest 1 view (71045) $484 $484 5.6×
Chest 2 views (71046)
range across 2 matching MRF lines		 $196–$452 $196–$452 varies
Chest 3 views (71047) $759 $759 8.7×
Chest 4 or more views (71048) $779 $779 7.4×
Clavicle complete (73000) $419 $419 4.8×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $296 $296 2.8×
Continuing medical physics consltj pr wk (77336) $1,506 $1,506 11.2×
Contrast Exam Abdominl Aorta (75625)
range across 2 matching MRF lines		 $6,220–$6,262 $6,220–$6,262 varies
Contrast X-Ray Bladder (74430) $755 $755 2.2×
Contrast X-Ray Of Knee Joint (73580) $1,217 $1,217 3.5×
CT abdomen and pelvis without and with contrast (74178) $2,135 $2,135 6.1×
CT abdomen and pelvis without contrast (74176) $1,944 $1,944 8.1×
CT abdomen w contrast (74160) $1,750 $1,750 10.0×
CT abdomen w wo contrast (74170) $1,939 $1,939 11.0×
CT abdomen w/o contrast (74150) $1,762 $1,762 16.8×
CT Angio Abdomen and Pelvis (74174) $2,207 $2,207 6.3×
CT Angio Chest (71275) $5,217 $5,217 29.7×
CT Angio Head (70496) $2,525 $2,525 14.4×
CT angio hrt w/3d image (75574) $3,860 $3,860 11.0×
Ct Angio Lwr Extr W/O&W/Dye (73706) $4,556 $4,556 25.9×
CT Angio Neck (70498) $3,309 $3,309 18.8×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,104 $2,104 12.0×
CT cervical spine w/ contrast (72126) $2,315 $2,315 6.6×
CT cervical spine w/o contrast (72125) $2,364 $2,364 22.6×
CT cervical spine w/wo cont (72127) $2,638 $2,638 15.0×
CT chest w contrast (71260) $3,632 $3,632 20.7×
CT chest w/wo contrast (71270) $4,264 $4,264 24.3×
CT head/brain with contrast (70460) $2,069 $2,069 11.8×
CT head/brain without and with contrast (70470) $2,320 $2,320 13.2×
CT heart contrast eval cardiac structure&morph (75572) $3,293 $3,293 9.4×
CT heart no contrast quant eval coronry calcium (75571)
range across 2 matching MRF lines		 $244–$909 $244–$909 varies
CT hrt w/3d image congen (75573) $3,293 $3,293 9.4×
CT iac w contrast (70481) $1,537 $1,537 8.7×
CT l-spine w&w/o contrast (72133) $3,840 $3,840 21.9×
CT lower ext w/o (73700) $3,190 $3,190 30.5×
CT lower extremity w/contrast material (73701) $2,193 $2,193 12.5×
CT lumbar spine w contrast (72132) $3,546 $3,546 10.1×
CT lumbar spine w/o contrast (72131) $3,324 $3,324 31.7×
CT maxillofacial w contrast (70487) $2,279 $2,279 13.0×
CT maxillofacial wo contrast (70486) $1,597 $1,597 15.3×
CT neck tissue combo (70492) $2,021 $2,021 11.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,724 $1,724 9.8×
CT orbits w/o contrast (70480) $1,822 $1,822 17.4×
CT pelvis w&w/o contrast (72194) $1,944 $1,944 11.1×
CT pelvis w/o contrast (72192) $1,759 $1,759 16.8×
CT scan of leg combo (73702) $3,461 $3,461 19.7×
CT scans face/jaw combo (70488) $2,942 $2,942 16.7×
CT soft tissue neck w contrast (70491) $2,836 $2,836 16.1×
CT soft tissue neck w/o contrast (70490) $2,753 $2,753 26.3×
CT thoracic spine w contrast (72129) $3,304 $3,304 18.8×
CT thoracic spine w/o contrast (72128) $3,414 $3,414 32.6×
CT thoracic spine w/wo cont (72130) $3,778 $3,778 21.5×
CT thorax w/o contrast (71250) $3,634 $3,634 34.7×
CT upper ext wo (73200) $1,559 $1,559 14.9×
CT upper extremity w/o & w/contrast material (73202) $2,459 $2,459 14.0×
CT upper extremity with contrast (73201) $2,193 $2,193 6.3×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,197 $2,197 12.5×
Cta Abdomen (74175) $2,121 $2,121 12.1×
CTA pelvis (72191) $4,291 $4,291 24.4×
Dilation ureters/urethra rs&i (74485) $6,146 $6,146 2.9×
Diskography lumbar (72295) $2,488 $2,488 1.3×
Doppler Fetal Mid Cerebral Artery (76821) $282 $282 2.7×
Dxa Bone Density Axial (77080) $660 $660 6.3×
Dxa bone density study 1/>sites appendiclr skel (77081) $162 $162 1.9×
Echo exam uterus (76831) $809 $809 3.4×
Esophagram (74220) $682 $682 3.9×
Fetal Biophys Profile W/Nst (76818) $432 $432 4.1×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $315 $315 3.0×
Fluoroscopy up to 1 hr (76000) $818 $818 3.4×
Foot 2 views (73620) $161 $161 1.8×
Forearm 2 views (73090) $377 $377 4.3×
Gastric emptying imaging study (78264) $1,897 $1,897 4.7×
Gastroesophageal Reflux Exam (78262) $845 $845 2.1×
Gated Heart Planar Single (78472) $2,189 $2,189 5.5×
Hand 2 views (73120) $315 $315 3.0×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $6,953 $6,953 2.2×
Hepatobil Syst Image W/Drug (78227) $2,434 $2,434 4.5×
Hepatobiliary System Imaging (78226) $1,225 $1,225 3.1×
Ht Muscle Image Spect Sing (78451) $1,745 $1,745 1.3×
Hysterosalpingogram (74740) $875 $875 3.7×
Infant hip ultrasound with hip movement (dynamic) (76885) $654 $654 7.5×
Infant hip ultrasound, limited static exam (76886) $175 $175 2.0×
Infusion Ivp (74410) $952 $952 5.4×
K Flow/Funct Image W/Drug (78708) $3,636 $3,636 6.7×
K Flow/Funct Image W/O Drug (78707) $1,089 $1,089 2.0×
Knee 3 Views (73562) $491 $491 5.6×
Liver & Spleen Imaging W/Vascular Flow (78216) $1,414 $1,414 3.5×
Liver imaging static only (78201) $2,889 $2,889 5.3×
Liver imaging w/vascular flow (78202) $2,889 $2,889 5.3×
Lung Perf&Ventilat Diferentl (78598) $3,210 $3,210 5.9×
Lung perfusion differential (78597) $2,572 $2,572 6.4×
Lung Ventilat&Perfus Imaging (78582) $2,597 $2,597 4.8×
Lymph System Imaging (78195) $2,011 $2,011 3.7×
Lymphangiography, pelvic/abdominal, unilateral (75805) $9,443 $9,443 3.0×
Magnetic Image Jaw Joint (70336) $3,391 $3,391 14.2×
Meckels Divert Exam (78290) $1,287 $1,287 3.2×
Medical physics dose eval radiation expos w/rprt (76145) $548 $548 1.5×
Mlc imrt design & construction per imrt plan (77338) $7,885 $7,885 21.0×
Mra Head W/O & W/Contrast Material (70546) $3,989 $3,989 11.4×
MRA head w/o contrast (70544) $3,167 $3,167 13.3×
MRA neck w contrast (70548) $3,020 $3,020 8.6×
MRA neck w/o contrast (70547) $3,020 $3,020 12.6×
MRI abdomen w/o contrast (74181) $3,906 $3,906 16.3×
MRI any jt lower extrem w/contrast material (73722) $3,724 $3,724 4.7×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $4,380 $4,380 12.5×
MRI any jt upper extremity w/contrast matrl (73222) $3,799 $3,799 4.8×
MRI Breast W/O Contrast Bilateral (77047) $2,910 $2,910 12.2×
MRI Breast Without Contrast Material Unilateral (77046) $1,499 $1,499 6.3×
MRI cardiac w/o cont stress (75559) $1,387 $1,387 2.5×
MRI cardiac w/o contrast (75557) $3,391 $3,391 14.2×
MRI cervical spine w/o cont (72141) $3,493 $3,493 14.6×
MRI chest w/o contrast (71550) $2,553 $2,553 10.7×
MRI chest with contrast (71551) $4,434 $4,434 5.6×
MRI chest wo w contrast (71552) $4,827 $4,827 13.8×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $3,724 $3,724 10.7×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,380 $4,380 12.5×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $3,724 $3,724 15.6×
MRI lumbar spine w contrast (72149) $3,256 $3,256 9.3×
Mri Neck Spine W/O & W/Dye (72156) $4,637 $4,637 13.3×
MRI orbit face &/neck w/o contrast (70540) $3,980 $3,980 16.7×
MRI orbit face neck w contrast (70542) $4,905 $4,905 14.0×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $4,897 $4,897 14.0×
MRI pelvis w contrast (72196) $3,391 $3,391 9.7×
MRI pelvis w/o & w contrast (72197) $4,737 $4,737 13.6×
MRI pelvis w/o contrast (72195) $3,691 $3,691 15.4×
MRI spectroscopy (76390) $2,626 $2,626 30.1×
MRI thoracic spine w/o contrast (72146) $3,137 $3,137 13.1×
MRI upper extremity oth than jt w/contr matrl (73219) $3,724 $3,724 10.7×
MRI upper extremity oth than jt w/o contr matrl (73218) $3,804 $3,804 15.9×
Mri Uppr Extremity W/O&W/Dye (73220) $4,590 $4,590 13.1×
MRI, abdomen, combo (74183) $5,339 $5,339 15.3×
MRI, dorsal spine combo (72157) $4,509 $4,509 12.9×
MRI, joint upper extrem (73221) $3,758 $3,758 15.7×
MRI, joint upper extrem combo (73223) $4,625 $4,625 13.2×
MRI, lumbar spine combo (72158) $4,401 $4,401 12.6×
Myelogram cervical (72240) $2,152 $2,152 2.7×
Myelogram Lumbar (72265) $2,124 $2,124 2.7×
Myelography thoracic (72255) $2,079 $2,079 2.6×
Myelograpy 2/more regions rs&i (72270) $2,860 $2,860 3.6×
Myocardial Spect Multiple Studies (78452) $6,527 $6,527 5.0×
Neck soft tissue (70360) $375 $375 4.3×
Nm myocard infarct spect (78469) $1,322 $1,322 2.4×
Nm unlisted gi procedure (78299) $845 $845 2.1×
Nm whole blood volume (78122) $1,099 $1,099 2.0×
Nonvascular Shunt X-Ray (75809) $371 $371 3.5×
Ntsty modul radthx pln dose-vol histos (77301) $12,202 $12,202 8.8×
Nuclear Rx Intra-Arterial (79445) $719 $719 3.1×
Nuclear Rx Oral Admin (79005) $2,165 $2,165 9.3×
Ob us nuchal meas 1 gest (76813) $348 $348 3.3×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $356 $356 3.4×
Optic foramina (70190) $436 $436 5.0×
Parathyroid Planar Imaging (78070) $848 $848 2.1×
Parathyroid planar imaging w/wo subtraction (78071) $1,050 $1,050 2.6×
Pelvis 1 or 2 views (72170) $396 $396 3.8×
Peritoneogram Rs&I (74190) $1,260 $1,260 2.3×
PET image w/CT, full body (78816) $9,561 $9,561 6.7×
PET imaging CT attenuation skull base mid-thigh (78815) $9,542 $9,542 6.7×
Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) $2,889 $2,889 2.2×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $6,030 $6,030 1.9×
Pulmonary Perfusion Imaging Particulate (78580) $1,325 $1,325 3.3×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $738 $738 7.0×
Radex abscess/fistula/sinus tract rs&i (76080) $1,173 $1,173 2.1×
Radex Ankle Complete Minimum 3 Views (73610) $439 $439 5.0×
Radex Calcaneus Minimum 2 Views (73650) $351 $351 4.0×
Radex elbow complete minimum 3 views (73080) $387 $387 4.4×
Radex Facial Bones Complete Minimum 3 Views (70150) $611 $611 5.8×
Radex fingr minimum 2 views (73140) $371 $371 4.3×
Radex foot complete minimum 3 views (73630) $443 $443 5.1×
Radex Hand Minimum 3 Views (73130) $463 $463 5.3×
Radex lower extremity infant minimum 2 views (73592) $420 $420 4.8×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $814 $814 7.8×
Radex Nasal Bones Complete Minimum 3 Views (70160) $493 $493 5.7×
Radex Ribs Unilateral 2 Views (71100) $594 $594 6.8×
Radex shoulder complete minimum 2 views (73030) $523 $523 6.0×
Radex Sinuses Paransl < 3 Views (70210) $401 $401 4.6×
Radex Spine 1 View Specify Level (72020) $404 $404 4.6×
Radex Sternum Minimum 2 Views (71120) $454 $454 5.2×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $465 $465 5.3×
Radex Toe Minimum 2 Views (73660) $344 $344 3.9×
Radex upper extremity infant minimum 2 views (73092) $494 $494 4.7×
Radex Wrist Complete Minimum 3 Views (73110) $422 $422 4.8×
Radiation Delivery Stereotactic Cranial Linear (77372) $35,424 $35,424 4.8×
Radiation treatment delivery level 1 (77402) $754 $754 7.4×
Radiation treatment delivery level 2 (77407) $958 $958 2.5×
Radiation treatment delivery level 3 (77412) $2,085 $2,085 3.8×
Radiolog exam mandible compl minimum 4 views (70110) $755 $755 7.2×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021)
range across 2 matching MRF lines		 $289–$649 $289–$649 varies
Radiologic exam colon double contrast study (74280) $1,508 $1,508 8.6×
Radiologic exam colon single contrast study (74270) $1,035 $1,035 5.9×
Radiologic Exam Esophagus Double Contrast Study (74221) $852 $852 4.8×
Radiologic exam knee complete 4/more views (73564) $509 $509 4.9×
Radiologic exam pelvis compl minimum 3 views (72190) $450 $450 4.3×
Radiologic Exam Small Int Single Contrast Study (74250) $1,160 $1,160 6.6×
Radiologic exam swallow function contrast study (74230) $699 $699 4.0×
Radiologic exam upr gi trc double contrast study (74246) $1,572 $1,572 8.9×
Radiologic examination femur minimum 2 views (73552) $416 $416 4.8×
Radiologic examination knee 1/2 views (73560) $488 $488 5.6×
Radiologic examination tibia & fibula 2 views (73590) $439 $439 5.0×
Red Cell Volume Determination Spx 1 Sampling (78120) $845 $845 2.1×
Ribs bilateral 3 views (71110) $892 $892 8.5×
Rp loclzj tum plnr 1 area single day imaging (78800)
range across 2 matching MRF lines		 $845–$4,264 $845–$4,264 varies
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $1,526 $1,526 2.8×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $3,075 $3,075 5.7×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $3,075 $3,075 5.7×
Rp Therapy Intravenous Administration (79101) $784 $784 3.4×
Salivary Gland Imaging (78230) $845 $845 2.1×
Scapula (73010) $512 $512 4.9×
Screening Digital Breast Tomosynthesis Bi (77063) $77 $77 3.3×
Shoulder 1 view (73020) $345 $345 4.0×
Shoulder Arthrography (73040) $1,433 $1,433 4.1×
Sialogram (70390) $735 $735 3.1×
Skull less than 4 views (70250) $461 $461 4.4×
Special dosimetry (77331)
range across 2 matching MRF lines		 $486–$1,165 $486–$1,165 varies
Special Physics Consult (77370) $1,306 $1,306 9.7×
Special teletherapy port plan (77321) $1,384 $1,384 3.7×
Special treatment procedure (77470) $7,230 $7,230 13.1×
Stereotactic Body Radiation Delivery (77373) $28,541 $28,541 15.9×
Sternoclavicular joints (71130) $348 $348 4.0×
Tbs techl prep&transmis data alys pfrmd elsewhr (77090) $265 $265 3.0×
Tbs technical calculation only (77091) $265 $265 3.0×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,275 $1,275 3.4×
Telethx isodose pln smpl w/dosimetry calculation (77306) $1,262 $1,262 3.4×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $4,352 $4,352 11.6×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $1,870 $1,870 5.0×
Ther rad simulaj-aided field setting simple (77280) $2,269 $2,269 16.9×
Thoracic spine 2 views (72070) $545 $545 5.2×
Thoracolumbar 2 views (72080) $544 $544 6.2×
Thyroid Imaging With Vascular Flow (78013) $845 $845 2.1×
Thyroid Met Imaging Body (78018) $1,766 $1,766 3.2×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,542 $1,542 3.9×
Tx Devices Design & Construction Complex (77334) $2,862 $2,862 7.6×
Tx devices design & construction intermediate (77333) $2,150 $2,150 16.0×
Tx devices design & construction simple (77332) $1,441 $1,441 10.7×
Ultrasound Breast Limited (76642) $272 $272 3.1×
Ultrasound Elastography Parenchyma (76981) $355 $355 3.4×
Ultrasound Exam Aaa Screen (76706) $338 $338 3.2×
Ultrasound, abdomen limited (76705)
range across 3 matching MRF lines		 $372–$1,425 $372–$1,425 varies
Umbilical-artery Doppler (OB) (76820) $306 $306 2.9×
Unlisted Dx Radiographic Procedure (76499) $207 $207 2.4×
Unlisted magnetic resonance procedure (76498) $1,326 $1,326 15.2×
Unlisted us procedure (76999) $281 $281 3.2×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $506 $506 45.8×
Urethrocystogram voiding (74455) $708 $708 3.0×
Urethrocystography retrograde (74450) $758 $758 3.2×
Us breast unilateral complete (76641) $387 $387 3.7×
Us chest (76604)
range across 2 matching MRF lines		 $372–$681 $372–$681 varies
Us complete joint (76881) $730 $730 7.0×
Us exam, pelvic, limited (76857) $469 $469 4.5×
Us head (76506) $789 $789 7.5×
Us kidney transplant (76776) $1,023 $1,023 9.8×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $620 $620 5.9×
Us ob detailed single fetus (76811)
range across 2 matching MRF lines		 $828–$1,401 $828–$1,401 varies
Us ob limited 1 or more fetuses (76815) $846 $846 8.1×
Us ob transvaginal (76817) $463 $463 4.4×
Us pelvic non ob complete (76856) $1,114 $1,114 10.6×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $463 $463 4.4×
Us preg uterus real time f/u trnsabdl per fetus (76816) $401 $401 3.8×
Us retroperitoneal complete (76770) $1,404 $1,404 13.4×
Us retroperitoneal limited (76775)
range across 3 matching MRF lines		 $351–$1,179 $351–$1,179 varies
Us scrotum and contents (76870) $1,271 $1,271 12.1×
Us spinal canal and contents (76800) $597 $597 5.7×
Us thyroid (76536) $1,065 $1,065 10.2×
Vein X-Ray Chest (75827)
range across 2 matching MRF lines		 $1,837–$2,361 $1,837–$2,361 varies
Vein X-Ray Liver W/O Hemodyn (75887) $9,443 $9,443 3.0×
Venogram Sinus/Jugular (75860) $5,748 $5,748 1.8×
Venography caval inferior serialography rs&i (75825) $7,770 $7,770 2.5×
Venography extremity bilateral rs&i (75822) $2,319 $2,319 1.5×
Venography extremity unilateral rs&i (75820) $6,261 $6,261 4.0×
Venography Renal Bilateral (75833) $7,302 $7,302 2.3×
Venography Renal Unilateral (75831)
range across 2 matching MRF lines		 $5,802–$7,302 $5,802–$7,302 varies
Venous sampling by catheter (75893) $9,554 $9,554 1.7×
Vertebral fracture assessment via dxa (77086) $165 $165 1.9×
Wrist 2 views (73100) $258 $258 3.0×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $572 $572 6.6×
X-ray antegrade pyelogram tube (74425) $584 $584 1.7×
X-Ray Aorta Leg Arteries (75630)
range across 2 matching MRF lines		 $5,802–$6,262 $5,802–$6,262 varies
X-Ray Bend Only L-S Spine (72120) $321 $321 3.1×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $412 $412 4.7×
X-Ray Exam Breast Specimen (76098) $1,679 $1,679 3.1×
X-Ray Exam Entire Spi 1 Vw (72081) $157 $157 1.8×
X-Ray Exam Entire Spi 2/3 Vw (72082) $593 $593 5.7×
X-Ray Exam Hip Uni 1 View (73501) $344 $344 3.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $405 $405 4.6×
X-Ray Exam Hips Bi 2 Views (73521) $706 $706 6.7×
X-Ray Exam Hips Bi 3-4 Views (73522) $706 $706 6.7×
X-Ray Exam Hips Bi 5/> Views (73523) $812 $812 7.8×
X-Ray Exam L-S Spine Bending (72114) $938 $938 9.0×
X-Ray Exam Neck Spine 2-3 Vw (72040) $527 $527 6.0×
X-Ray Exam Unilat Ribs/Chest (71101) $315 $315 3.0×
X-ray eye for foreign body (70030) $348 $348 4.0×
X-ray humerus (73060) $387 $387 4.4×
X-ray IV pyelogram+tomography (74415) $1,407 $1,407 8.0×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $377 $377 4.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $457 $457 4.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $547 $547 5.2×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $496 $496 4.7×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $321 $321 3.1×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $444 $444 5.1×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $572 $572 6.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $590 $590 5.6×
X-Ray Urinary Tract Exam With Contrast Material (74420) $952 $952 2.7×
X-Rays Bone Length Studies (77073) $348 $348 3.3×
X-Rays Bone Survey Complete (77075) $1,377 $1,377 13.2×
Xr c-spine 4 or 5 views (72050) $627 $627 6.0×
Xr orbits complete 4 views (70200) $572 $572 5.5×
Xr Tomogram Single Plane (76100) $1,154 $1,154 11.0×

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.