Imaging prices at Saint Luke's South Hospital

Overland Park, KS · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $559.20 $932 6.8×
Abdomen 2 views (74019) $789 $1,315 8.0×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,362 $2,270 3.6×
Angio pulmonary bilat (75743) $6,973.80 $11,623 2.3×
Angiography extremity bilateral rs&i (75716) $5,643.60 $9,406 1.9×
Angiography extremity unilateral rs&i (75710) $4,379.40 $7,299 1.5×
Angiography pulmonary unilateral slctv rs&i (75741) $6,844.80 $11,408 2.3×
Ankle 2 views (73600)
range across 4 matching MRF lines
$594.60–$892.20 $991–$1,487 varies
Aortography thoracic serialography rs&i (75605) $4,461 $7,435 0.8×
Artery X-Rays Abdomen (75726) $3,319.80 $5,533 0.6×
Artery X-Rays Pelvis (75736) $3,319.80 $5,533 0.6×
Artery X-Rays Spine (75705) $3,306 $5,510 0.6×
Arthrogram ankle (73615) $880.80 $1,468 2.7×
Arthrogram hip (73525) $1,461 $2,435 4.4×
Arthrogram Wrist (73115) $1,023.60 $1,706 3.1×
Bone age studies (77072) $299.40 $499 3.0×
Bone Imaging 3 Phase (78315) $2,437.80 $4,063 6.4×
Bone Imaging Limited Area (78300) $1,125 $1,875 3.0×
Bone Imaging Whole Body (78306) $1,625.40 $2,709 4.3×
Bone marrow imaging limited area (78102) $1,232.40 $2,054 3.3×
Bone survey infant (77076) $2,528.40 $4,214 25.5×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $1,357.20 $2,262 2.6×
Brain Imaging Pet Metabolic Evaluation (78608) $3,400.80 $5,668 2.5×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $836.40 $1,394 2.2×
Cat Scan Follow-Up Study (76380) $937.20 $1,562 11.4×
Chest 1 view (71045) $418.80 $698 5.1×
Chest 2 views (71046) $564 $940 6.8×
Chest 3 views (71047) $709.20 $1,182 8.6×
Chest 4 or more views (71048) $757.80 $1,263 7.7×
Clavicle complete (73000)
range across 3 matching MRF lines
$600–$900 $1,000–$1,500 varies
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $144 $240 1.5×
Contrast Exam Abdominl Aorta (75625) $3,019.80 $5,033 1.0×
Contrast X-Ray Bladder (74430) $778.20 $1,297 2.4×
Contrast X-Ray Of Elbow (73085) $807 $1,345 2.4×
Contrast X-Ray Of Knee Joint (73580) $1,109.40 $1,849 3.4×
CT abdomen and pelvis without and with contrast (74178) $7,394.40 $12,324 22.4×
CT abdomen and pelvis without contrast (74176) $6,001.20 $10,002 26.6×
CT abdomen w contrast (74160) $3,255.60 $5,426 19.6×
CT abdomen w wo contrast (74170) $3,690.60 $6,151 22.2×
CT abdomen w/o contrast (74150) $2,454.60 $4,091 24.8×
CT Angio Abdomen and Pelvis (74174) $8,329.80 $13,883 25.2×
CT Angio Chest (71275) $4,706.40 $7,844 28.3×
CT Angio Head (70496) $4,870.80 $8,118 29.3×
CT angio hrt w/3d image (75574) $936 $1,560 2.8×
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 3 matching MRF lines
$2,486.40–$3,729.60 $4,144–$6,216 varies
CT Angio Neck (70498) $4,902.60 $8,171 29.5×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,668.80 $4,448 16.1×
CT cervical spine w/ contrast (72126) $3,630 $6,050 11.0×
CT cervical spine w/o contrast (72125) $3,592.80 $5,988 36.3×
CT cervical spine w/wo cont (72127) $4,485.60 $7,476 27.0×
CT chest w contrast (71260) $2,535.60 $4,226 15.3×
CT chest w/wo contrast (71270) $3,679.20 $6,132 22.2×
CT head/brain with contrast (70460) $3,903 $6,505 23.5×
CT head/brain without and with contrast (70470) $4,665 $7,775 28.1×
CT heart contrast eval cardiac structure&morph (75572) $966 $1,610 2.9×
CT hrt w/3d image congen (75573) $1,224 $2,040 3.7×
CT iac w contrast (70481) $4,909.20 $8,182 29.6×
CT l-spine w&w/o contrast (72133) $4,530 $7,550 27.3×
CT lower ext w/o (73700)
range across 4 matching MRF lines
$2,226–$3,339 $3,710–$5,565 varies
CT lower extremity w/contrast material (73701)
range across 3 matching MRF lines
$2,234.40–$3,351.60 $3,724–$5,586 varies
CT lumbar spine w contrast (72132) $4,314 $7,190 13.1×
CT lumbar spine w/o contrast (72131) $4,108.80 $6,848 41.5×
CT maxillofacial w contrast (70487) $2,873.40 $4,789 17.3×
CT maxillofacial wo contrast (70486) $2,701.20 $4,502 27.3×
CT neck tissue combo (70492) $4,600.20 $7,667 27.7×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $5,824.20 $9,707 35.1×
CT orbits w/o contrast (70480) $3,808.80 $6,348 38.5×
CT pelvis w&w/o contrast (72194) $3,504 $5,840 21.1×
CT pelvis w/o contrast (72192) $2,454.60 $4,091 24.8×
CT scan of leg combo (73702) $2,368.20 $3,947 14.3×
CT scans face/jaw combo (70488) $3,605.40 $6,009 21.7×
CT soft tissue neck w contrast (70491) $4,354.20 $7,257 26.2×
CT soft tissue neck w/o contrast (70490) $3,280.20 $5,467 33.1×
CT thoracic spine w contrast (72129) $5,244.60 $8,741 31.6×
CT thoracic spine w/o contrast (72128) $5,042.40 $8,404 50.9×
CT thoracic spine w/wo cont (72130) $5,506.80 $9,178 33.2×
CT thorax w/o contrast (71250) $1,971.60 $3,286 19.9×
CT upper ext wo (73200)
range across 3 matching MRF lines
$1,985.40–$2,978.40 $3,309–$4,964 varies
CT upper extremity w/o & w/contrast material (73202)
range across 3 matching MRF lines
$2,368.20–$3,552.60 $3,947–$5,921 varies
CT upper extremity with contrast (73201)
range across 3 matching MRF lines
$2,232–$3,348 $3,720–$5,580 varies
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $4,089 $6,815 24.6×
Cta Abdomen (74175) $3,992.40 $6,654 24.0×
CTA pelvis (72191) $3,680.40 $6,134 22.2×
Dxa Bone Density Axial (77080) $468.60 $781 4.7×
Dxa bone density study 1/>sites appendiclr skel (77081) $424.20 $707 5.1×
Echo exam uterus (76831) $830.40 $1,384 3.7×
Echo Guide For Artery Repair (76936) $766.20 $1,277 3.7×
Esophagram (74220) $627.60 $1,046 3.8×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $348 $580 3.5×
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $864 $1,440 3.8×
Fluoroscopy up to 1 hr (76000) $748.80 $1,248 3.3×
Follow-Up Angiography (75898) $2,037 $3,395 0.7×
Foot 2 views (73620)
range across 5 matching MRF lines
$312.60–$469.20 $521–$782 varies
Forearm 2 views (73090)
range across 4 matching MRF lines
$382.20–$573.60 $637–$956 varies
Gastric emptying imaging study (78264) $1,863 $3,105 4.9×
Hand 2 views (73120)
range across 4 matching MRF lines
$312.60–$469.20 $521–$782 varies
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $3,861.60 $6,436 1.3×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $2,981.40 $4,969 1.0×
Hepatobil Syst Image W/Drug (78227) $2,796 $4,660 5.4×
Hepatobiliary System Imaging (78226) $1,854.60 $3,091 4.9×
Ht Muscle Image Spect Sing (78451) $5,955 $9,925 4.9×
Hysterosalpingogram (74740) $913.20 $1,522 4.0×
Infant hip ultrasound with hip movement (dynamic) (76885) $831 $1,385 10.1×
Joint Survey Single View (77077) $301.80 $503 3.0×
K Flow/Funct Image Multiple (78709) $2,944.80 $4,908 5.7×
K Flow/Funct Image W/Drug (78708) $2,804.40 $4,674 5.5×
K Flow/Funct Image W/O Drug (78707) $1,698 $2,830 3.3×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $712.80 $1,188 1.9×
Knee 3 Views (73562)
range across 3 matching MRF lines
$595.20–$892.80 $992–$1,488 varies
Leveen/Shunt Patency Exam (78291) $970.80 $1,618 2.6×
Lung perfusion differential (78597) $1,214.40 $2,024 3.2×
Lung Ventilat&Perfus Imaging (78582) $1,671.60 $2,786 3.3×
Lung Ventilation Imaging (78579) $1,177.20 $1,962 3.1×
Lymph System Imaging (78195) $3,336.60 $5,561 6.5×
Mammary ductogram or galactogram multiple (77054) $432.60 $721 1.9×
Mammary ductogram or galactogram single (77053) $353.40 $589 1.6×
Meckels Divert Exam (78290) $844.80 $1,408 2.2×
Mr safety determination physician/other qhp (76016) $193.80 $323 2.4×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $64.20 $107 2.3×
Mr safety implt electronics prepj supvj phys/qhp (76018) $206.40 $344 2.3×
Mr safety implt pos&/immoblj (76019) $315.60 $526 5.7×
Mra Head W/O & W/Contrast Material (70546) $4,012.20 $6,687 12.1×
MRA head w/o contrast (70544) $2,461.80 $4,103 10.9×
MRA head with contrast (70545) $2,640 $4,400 8.0×
MRA neck w contrast (70548) $2,216.40 $3,694 6.7×
Mra Neck W/O &W/Contrast Material (70549) $2,686.80 $4,478 8.1×
MRA neck w/o contrast (70547) $2,014.20 $3,357 8.9×
MRI abdomen w contrast (74182) $3,310.20 $5,517 10.0×
MRI abdomen w/o contrast (74181) $3,152.40 $5,254 14.0×
MRI any jt lower extrem w/contrast material (73722)
range across 3 matching MRF lines
$4,123.20–$6,184.80 $6,872–$10,308 varies
MRI any jt lower extrem w/o & w/contrast matrl (73723)
range across 3 matching MRF lines
$4,947.60–$7,421.40 $8,246–$12,369 varies
MRI any jt upper extremity w/contrast matrl (73222)
range across 3 matching MRF lines
$3,748.20–$5,622.60 $6,247–$9,371 varies
MRI Breast W/O Contrast Bilateral (77047) $696.60 $1,161 3.1×
MRI Breast Without Contrast Material Unilateral (77046) $633 $1,055 2.8×
MRI cervical spine w contrast (72142) $4,045.80 $6,743 12.2×
MRI cervical spine w/o cont (72141) $3,853.20 $6,422 17.1×
MRI chest w/o contrast (71550) $3,027.60 $5,046 13.4×
MRI chest wo w contrast (71552) $4,599 $7,665 13.9×
MRI lower extrem oth/thn jt w/contrast matrl (73719)
range across 3 matching MRF lines
$3,091.20–$4,636.80 $5,152–$7,728 varies
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 3 matching MRF lines
$3,904.80–$5,857.20 $6,508–$9,762 varies
MRI lower extrem oth/thn jt w/o contr matrl (73718)
range across 3 matching MRF lines
$3,066.60–$4,600.20 $5,111–$7,667 varies
MRI lumbar spine w contrast (72149) $4,045.80 $6,743 12.2×
Mri Neck Spine W/O & W/Dye (72156) $4,248 $7,080 12.9×
MRI orbit face &/neck w/o contrast (70540) $3,027.60 $5,046 13.4×
MRI orbit face neck w contrast (70542) $3,574.80 $5,958 10.8×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $4,500.60 $7,501 13.6×
MRI pelvis w/o & w contrast (72197) $4,888.20 $8,147 14.8×
MRI pelvis w/o contrast (72195) $3,748.20 $6,247 16.6×
MRI thoracic spine w/o contrast (72146) $3,853.20 $6,422 17.1×
MRI upper extremity oth than jt w/o contr matrl (73218)
range across 6 matching MRF lines
$3,748.20–$5,622.60 $6,247–$9,371 varies
Mri Uppr Extremity W/O&W/Dye (73220)
range across 6 matching MRF lines
$4,502.40–$6,753.60 $7,504–$11,256 varies
MRI, abdomen, combo (74183) $4,683 $7,805 14.2×
MRI, dorsal spine combo (72157) $4,248 $7,080 12.9×
MRI, dorsal spine contrast (72147) $4,045.80 $6,743 12.2×
MRI, joint upper extrem (73221)
range across 3 matching MRF lines
$2,209.20–$3,313.80 $3,682–$5,523 varies
MRI, joint upper extrem combo (73223) $4,683 $7,805 14.2×
MRI, lumbar spine combo (72158) $4,248 $7,080 12.9×
Myocardial Spect Multiple Studies (78452) $7,850.40 $13,084 6.4×
Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) $3,451.20 $5,752 2.5×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $3,616.80 $6,028 2.7×
Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) $5,943.60 $9,906 2.8×
Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) $6,690 $11,150 3.2×
Neck soft tissue (70360) $358.80 $598 4.4×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $967.80 $1,613 2.6×
Nuclear Rx Oral Admin (79005) $1,989.60 $3,316 9.0×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $328.20 $547 3.3×
Panoramic X-ray of jaws (70355) $717 $1,195 8.7×
Parathyroid imaging w/tomographic spect & CT (78072) $1,482.60 $2,471 2.9×
Parathyroid Planar Imaging (78070) $1,368.60 $2,281 3.6×
Parathyroid planar imaging w/wo subtraction (78071) $1,471.80 $2,453 3.9×
Pelvis 1 or 2 views (72170) $492 $820 5.0×
Peritoneogram Rs&I (74190) $615.60 $1,026 1.2×
Pet Image W/Ct Lmtd (78814) $3,796.20 $6,327 2.8×
PET image w/CT, full body (78816) $5,571.60 $9,286 4.1×
PET imaging CT attenuation skull base mid-thigh (78815) $5,529.60 $9,216 4.1×
Pulmonary Perfusion Imaging Particulate (78580) $1,219.20 $2,032 3.2×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $949.20 $1,582 9.6×
Radex abscess/fistula/sinus tract rs&i (76080) $780.60 $1,301 1.5×
Radex Ankle Complete Minimum 3 Views (73610)
range across 3 matching MRF lines
$700.20–$1,050.60 $1,167–$1,751 varies
Radex Calcaneus Minimum 2 Views (73650)
range across 3 matching MRF lines
$357–$535.80 $595–$893 varies
Radex elbow complete minimum 3 views (73080)
range across 3 matching MRF lines
$649.20–$973.80 $1,082–$1,623 varies
Radex Facial Bones Complete Minimum 3 Views (70150) $640.80 $1,068 6.5×
Radex fingr minimum 2 views (73140)
range across 4 matching MRF lines
$483–$724.80 $805–$1,208 varies
Radex foot complete minimum 3 views (73630)
range across 3 matching MRF lines
$607.20–$910.80 $1,012–$1,518 varies
Radex Hand Minimum 3 Views (73130)
range across 3 matching MRF lines
$628.20–$942.60 $1,047–$1,571 varies
Radex lower extremity infant minimum 2 views (73592)
range across 2 matching MRF lines
$365.40–$548.40 $609–$914 varies
Radex Nasal Bones Complete Minimum 3 Views (70160) $622.20 $1,037 7.6×
Radex Ribs Unilateral 2 Views (71100) $383.40 $639 4.7×
Radex shoulder complete minimum 2 views (73030)
range across 3 matching MRF lines
$756.60–$1,135.20 $1,261–$1,892 varies
Radex Sinuses Paransl < 3 Views (70210) $401.40 $669 4.9×
Radex Spine 1 View Specify Level (72020) $438 $730 5.3×
Radex Sternum Minimum 2 Views (71120) $549 $915 6.7×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $689.40 $1,149 8.4×
Radex Toe Minimum 2 Views (73660)
range across 3 matching MRF lines
$355.20–$532.80 $592–$888 varies
Radex upper extremity infant minimum 2 views (73092)
range across 2 matching MRF lines
$365.40–$548.40 $609–$914 varies
Radex Wrist Complete Minimum 3 Views (73110)
range across 3 matching MRF lines
$673.20–$1,009.80 $1,122–$1,683 varies
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $845.40 $1,409 8.5×
Radiolog exam mandible compl minimum 4 views (70110) $630.60 $1,051 6.4×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $920.40 $1,534 9.3×
Radiologic exam colon double contrast study (74280) $1,702.20 $2,837 10.3×
Radiologic exam colon single contrast study (74270) $1,112.40 $1,854 6.7×
Radiologic Exam Esophagus Double Contrast Study (74221) $697.20 $1,162 4.2×
Radiologic exam knee complete 4/more views (73564)
range across 3 matching MRF lines
$675.60–$1,013.40 $1,126–$1,689 varies
Radiologic exam pelvis compl minimum 3 views (72190) $703.80 $1,173 7.1×
Radiologic Exam Small Int Single Contrast Study (74250) $638.40 $1,064 3.8×
Radiologic exam swallow function contrast study (74230) $1,031.40 $1,719 6.2×
Radiologic exam upr gi trc double contrast study (74246) $874.80 $1,458 5.3×
Radiologic examination femur 1 view (73551) $211.80 $353 2.6×
Radiologic examination femur minimum 2 views (73552)
range across 3 matching MRF lines
$268.20–$402.60 $447–$671 varies
Radiologic examination knee 1/2 views (73560)
range across 3 matching MRF lines
$434.40–$651.60 $724–$1,086 varies
Radiologic examination tibia & fibula 2 views (73590)
range across 4 matching MRF lines
$476.40–$714.60 $794–$1,191 varies
Renal Cyst Study (74470) $680.40 $1,134 1.3×
Ribs bilateral 3 views (71110) $682.20 $1,137 6.9×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,038 $1,730 2.7×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,108.20 $1,847 2.9×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $2,775 $4,625 5.4×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $1,258.80 $2,098 2.4×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $1,531.20 $2,552 3.0×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $2,915.40 $4,859 2.4×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $3,737.40 $6,229 2.8×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $1,896 $3,160 1.5×
Scapula (73010)
range across 3 matching MRF lines
$586.20–$879.60 $977–$1,466 varies
Screening Digital Breast Tomosynthesis Bi (77063) $18 $30 0.8×
Shoulder 1 view (73020)
range across 3 matching MRF lines
$463.20–$694.80 $772–$1,158 varies
Shoulder Arthrography (73040) $792.60 $1,321 2.4×
Skull less than 4 views (70250) $375.60 $626 3.8×
Sternoclavicular joints (71130) $576.60 $961 7.0×
Thoracic spine 2 views (72070) $591 $985 6.0×
Thoracic spine 3 views (72072) $730.20 $1,217 7.4×
Thoracolumbar 2 views (72080) $661.80 $1,103 8.0×
Thyroid Imaging With Vascular Flow (78013) $782.40 $1,304 2.1×
Thyroid Met Imaging Body (78018) $1,878 $3,130 3.7×
Thyroid Uptake Measurement (78012) $700.20 $1,167 1.9×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,321.80 $2,203 3.5×
Ultrasound Breast Limited (76642)
range across 6 matching MRF lines
$255.60–$383.40 $426–$639 varies
Ultrasound Exam Aaa Screen (76706) $373.80 $623 3.8×
Ultrasound, abdomen limited (76705) $670.20 $1,117 6.8×
Umbilical-artery Doppler (OB) (76820) $262.20 $437 2.6×
Unlisted fluoroscopic procedure (76496) $339.60 $566 4.1×
Upper gi w/o kub (74240) $533.40 $889 3.2×
Urethrocystogram voiding (74455) $1,019.40 $1,699 4.5×
Urethrocystography retrograde (74450) $1,079.40 $1,799 4.8×
Us breast unilateral complete (76641)
range across 6 matching MRF lines
$329.40–$494.40 $549–$824 varies
Us chest (76604) $816.60 $1,361 8.3×
Us complete joint (76881) $1,311.60 $2,186 13.3×
Us exam, pelvic, limited (76857) $630 $1,050 6.4×
Us head (76506) $926.40 $1,544 9.4×
Us kidney transplant (76776) $996.60 $1,661 10.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $1,212 $2,020 12.2×
Us ob limited 1 or more fetuses (76815) $583.80 $973 5.9×
Us ob transvaginal (76817) $708.60 $1,181 7.2×
Us pelvic non ob complete (76856) $987.60 $1,646 10.0×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $766.80 $1,278 7.7×
Us preg uterus real time f/u trnsabdl per fetus (76816) $484.80 $808 4.9×
Us retroperitoneal complete (76770) $938.40 $1,564 9.5×
Us retroperitoneal limited (76775) $868.20 $1,447 8.8×
Us scrotum and contents (76870) $1,065 $1,775 10.8×
Us spinal canal and contents (76800) $396.60 $661 4.0×
Us thyroid (76536) $1,095.60 $1,826 11.1×
Vein X-Ray Chest (75827) $4,205.40 $7,009 2.8×
Venography caval inferior serialography rs&i (75825) $3,929.40 $6,549 1.3×
Venography extremity bilateral rs&i (75822) $1,486.80 $2,478 1.0×
Venography extremity unilateral rs&i (75820) $1,398 $2,330 0.9×
Venography Renal Bilateral (75833) $3,849.60 $6,416 1.3×
Venography Renal Unilateral (75831) $3,279.60 $5,466 1.1×
Venous sampling by catheter (75893) $3,306 $5,510 0.6×
Wrist 2 views (73100)
range across 5 matching MRF lines
$530.40–$795.60 $884–$1,326 varies
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $574.80 $958 7.0×
X-ray antegrade pyelogram tube (74425) $579.60 $966 1.8×
X-Ray Aorta Leg Arteries (75630) $5,643.60 $9,406 1.9×
X-Ray Bend Only L-S Spine (72120) $211.80 $353 2.1×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 4 matching MRF lines
$561.60–$842.40 $936–$1,404 varies
X-Ray Exam Entire Spi 1 Vw (72081) $211.80 $353 2.6×
X-Ray Exam Entire Spi 2/3 Vw (72082) $349.20 $582 3.5×
X-Ray Exam Entire Spi 4/5 Vw (72083) $667.20 $1,112 6.7×
X-Ray Exam Hip Uni 1 View (73501) $211.80 $353 2.6×
X-Ray Exam Hip Uni 2-3 Views (73502) $326.40 $544 4.0×
X-Ray Exam Hip Uni 4/> Views (73503) $349.20 $582 3.5×
X-Ray Exam Hips Bi 2 Views (73521) $349.20 $582 3.5×
X-Ray Exam Hips Bi 3-4 Views (73522) $455.40 $759 4.6×
X-Ray Exam Hips Bi 5/> Views (73523) $666.60 $1,111 6.7×
X-Ray Exam L-S Spine Bending (72114) $1,102.80 $1,838 11.1×
X-Ray Exam Neck Spine 2-3 Vw (72040) $637.80 $1,063 7.7×
X-Ray Exam Neck Spine 6/>Vws (72052) $1,304.40 $2,174 13.2×
X-Ray Exam Unilat Ribs/Chest (71101) $948.60 $1,581 9.6×
X-ray eye for foreign body (70030) $310.20 $517 3.8×
X-ray humerus (73060)
range across 4 matching MRF lines
$490.20–$735.60 $817–$1,226 varies
X-ray IV pyelogram (ivp) (74400) $1,338.60 $2,231 8.1×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $597.60 $996 7.3×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $319.80 $533 3.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $637.20 $1,062 6.4×
X-ray nose-rectum child f.b. (76010) $318 $530 3.9×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $1,194 $1,990 12.1×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $577.80 $963 5.8×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $415.80 $693 4.2×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $586.20 $977 7.1×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $543 $905 6.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $651 $1,085 6.6×
X-ray thoracic spine 4 vw (72074) $775.80 $1,293 7.8×
X-Ray Tmj Unilat (70328) $217.20 $362 2.6×
X-Ray Urinary Tract Exam With Contrast Material (74420) $1,169.40 $1,949 3.5×
X-Rays Bone Length Studies (77073) $478.80 $798 4.8×
X-Rays Bone Survey Complete (77075) $2,505.60 $4,176 25.3×
Xr c-spine 4 or 5 views (72050) $1,128.60 $1,881 11.4×
Xr facial bones less than 3 views (70140) $535.80 $893 6.5×
Xr orbits complete 4 views (70200) $738 $1,230 7.5×

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.