Imaging prices at Saint Mary's Hospital
Waterbury, CT · every code in this section with a posted price and a Medicare benchmark.
264 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) | $198.55 | — | 1.9× |
| Abdomen 2 views (74019) | $306.35 | $557 | 2.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $630.30 | $1,146 | 1.3× |
| Angio pulmonary bilat (75743) | $5,429.60 | $9,872 | 1.4× |
| Angiography extremity bilateral rs&i (75716) | $3,989.70 | $7,254 | 1.1× |
| Angiography extremity unilateral rs&i (75710) | $2,263.80 | $4,116 | 0.6× |
| Ankle 2 views (73600) | $437.25 | — | 4.2× |
| Aortography thoracic serialography rs&i (75605) | $3,681.70 | $6,694 | 0.6× |
| Artery X-Rays Abdomen (75726) | $4,030.95 | $7,329 | 0.6× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$704.55–$1,057.10 | $1,281–$1,922 | varies |
| Bone age studies (77072) | $190.30 | $346 | 1.5× |
| Bone Imaging 3 Phase (78315) | $862.40 | $1,568 | 1.8× |
| Bone Imaging Multiple Areas (78305) | $545.05 | $991 | 1.1× |
| Bone Imaging Whole Body (78306) | $713.35 | $1,297 | 1.5× |
| Bone marrow imaging limited area (78102) | $502.70 | $914 | 1.0× |
| Bone survey infant (77076) | $215.05 | $391 | 1.7× |
| Brain Image W/Flow < 4 Views (78601) | $761.20 | $1,384 | 1.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,087.90 | $1,978 | 1.7× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$14,512.09–$21,499.75 | — | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$227.70–$5,942.03 | — | varies |
| Chest 3 views (71047) | $238.70 | $434 | 2.3× |
| Clavicle complete (73000) range across 6 matching MRF lines |
$190.85–$287.10 | $347–$522 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $572.55 | $1,041 | 4.6× |
| Contrast Exam Abdominl Aorta (75625) | $3,138.85 | $5,707 | 0.8× |
| Contrast X-Ray Bladder (74430) | $451.55 | $821 | 1.1× |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$922.90–$1,384.35 | $1,678–$2,517 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $1,696.20 | $3,084 | 4.1× |
| CT abdomen and pelvis without contrast (74176) | $843.70 | — | 2.9× |
| CT abdomen w contrast (74160) | $955.35 | $1,737 | 4.5× |
| CT abdomen w wo contrast (74170) | $1,030.70 | $1,874 | 4.9× |
| CT abdomen w/o contrast (74150) | $804.10 | $1,462 | 6.4× |
| CT Angio Abdomen and Pelvis (74174) | $1,387.10 | $2,522 | 3.3× |
| CT Angio Chest (71275) | $1,139.38 | — | 5.4× |
| CT Angio Head (70496) | $3,703.48 | — | 17.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 6 matching MRF lines |
$1,271.05–$1,907.40 | $2,311–$3,468 | varies |
| CT Angio Neck (70498) | $1,837 | $3,340 | 8.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,355.75 | $2,465 | 6.4× |
| CT cervical spine w/ contrast (72126) | $1,217.15 | $2,213 | 2.9× |
| CT cervical spine w/o contrast (72125) | $910.25 | $1,655 | 7.3× |
| CT cervical spine w/wo cont (72127) | $1,291.95 | $2,349 | 6.1× |
| CT chest w contrast (71260) | $2,525.82 | — | 12.0× |
| CT chest w/wo contrast (71270) | $1,249.05 | $2,271 | 5.9× |
| CT head/brain with contrast (70460) | $1,300.75 | $2,365 | 6.2× |
| CT head/brain without and with contrast (70470) | $1,415.70 | $2,574 | 6.7× |
| CT iac w contrast (70481) | $1,062.60 | $1,932 | 5.1× |
| CT l-spine w&w/o contrast (72133) | $1,085.15 | $1,973 | 5.2× |
| CT lower ext w/o (73700) | $1,535.60 | — | 12.3× |
| CT lower extremity w/contrast material (73701) range across 6 matching MRF lines |
$1,280.40–$1,920.60 | $2,328–$3,492 | varies |
| CT lumbar spine w contrast (72132) | $1,376.65 | $2,503 | 3.3× |
| CT lumbar spine w/o contrast (72131) | $1,302.40 | $2,368 | 10.4× |
| CT maxillofacial w contrast (70487) | $1,103.30 | $2,006 | 5.2× |
| CT maxillofacial wo contrast (70486) | $1,003.75 | $1,825 | 8.0× |
| CT neck tissue combo (70492) | $1,340.35 | $2,437 | 6.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,098.35 | $1,997 | 5.2× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$871.20–$1,025.20 | — | varies |
| CT pelvis w&w/o contrast (72194) | $2,002 | $3,640 | 9.5× |
| CT pelvis w/o contrast (72192) | $1,056.55 | $1,921 | 8.4× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,492.70–$2,239.60 | $2,714–$4,072 | varies |
| CT scans face/jaw combo (70488) | $1,262.80 | $2,296 | 6.0× |
| CT soft tissue neck w contrast (70491) | $1,108.25 | $2,015 | 5.3× |
| CT soft tissue neck w/o contrast (70490) | $927.30 | $1,686 | 7.4× |
| CT thoracic spine w contrast (72129) | $1,183.05 | $2,151 | 5.6× |
| CT thoracic spine w/o contrast (72128) | $994.95 | $1,809 | 7.9× |
| CT thorax w/o contrast (71250) | $982.30 | — | 7.8× |
| CT upper ext wo (73200) range across 6 matching MRF lines |
$871.20–$1,306.80 | $1,584–$2,376 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,439.35–$2,159.85 | $2,617–$3,927 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$957–$1,436.60 | $1,740–$2,612 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,061.50 | $1,930 | 5.0× |
| Cta Abdomen (74175) | $974.60 | $1,772 | 4.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,567.85 | $6,487 | 8.5× |
| CTA pelvis (72191) | $1,865.05 | $3,391 | 8.9× |
| Dxa Bone Density Axial (77080) | $215.60 | $392 | 1.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $82.50 | $150 | 0.8× |
| Esophagram (74220) | $404.25 | $735 | 1.9× |
| Fetal Biophys Profile W/Nst (76818) | $856.90 | $1,558 | 6.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $209.55 | $381 | 1.7× |
| Fluoroscopy up to 1 hr (76000) | $225.50 | $410 | 0.8× |
| Follow-Up Angiography (75898) | $851.95 | $1,549 | 0.2× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$344.85–$452.65 | — | varies |
| Forearm 2 views (73090) | $250.25 | — | 2.4× |
| Gastric emptying imaging study (78264) | $829.40 | $1,508 | 1.7× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$233.20–$350.35 | $424–$637 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,055.45 | $1,919 | 1.6× |
| Hepatobiliary System Imaging (78226) | $999.90 | $1,818 | 2.1× |
| Ht Muscle Image Spect Sing (78451) | $1,862.85 | $3,387 | 1.2× |
| Hysterosalpingogram (74740) | $768.35 | $1,397 | 2.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $559.35 | $1,017 | 5.4× |
| K Flow/Funct Image W/Drug (78708) | $604.45 | $1,099 | 0.9× |
| K Flow/Funct Image W/O Drug (78707) | $1,074.15 | $1,953 | 1.7× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$276.10–$414.15 | — | varies |
| Lung Perf&Ventilat Diferentl (78598) | $952.05 | $1,731 | 1.5× |
| Lung perfusion differential (78597) | $790.90 | $1,438 | 1.7× |
| Lung Ventilat&Perfus Imaging (78582) | $1,030.15 | $1,873 | 1.6× |
| Lymph System Imaging (78195) | $1,026.30 | $1,866 | 1.6× |
| Mammary ductogram or galactogram single (77053) | $471.35 | $857 | 1.6× |
| Meckels Divert Exam (78290) | $1,163.80 | $2,116 | 2.4× |
| Mra Head W/O & W/Contrast Material (70546) | $2,549.80 | $4,636 | 6.1× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$2,019.05–$4,667.82 | — | varies |
| MRA head with contrast (70545) | $2,265.45 | $4,119 | 5.4× |
| MRA neck w contrast (70548) | $2,090.55 | $3,801 | 5.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,376 | $4,320 | 5.7× |
| MRA neck w/o contrast (70547) | $1,601.05 | $2,911 | 5.6× |
| MRI abdomen w contrast (74182) | $2,543.75 | $4,625 | 6.1× |
| MRI abdomen w/o contrast (74181) | $2,031.15 | $3,693 | 7.1× |
| MRI any jt lower extrem w/contrast material (73722) range across 6 matching MRF lines |
$2,151.05–$3,227.40 | $3,911–$5,868 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$2,562.45–$3,843.95 | $4,659–$6,989 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$2,222–$3,332.45 | $4,040–$6,059 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,779.25 | $3,235 | 6.2× |
| MRI cervical spine w contrast (72142) | $2,257.75 | $4,105 | 5.4× |
| MRI cervical spine w/o cont (72141) | $1,962.40 | $3,568 | 6.9× |
| MRI chest w/o contrast (71550) | $1,092.30 | $1,986 | 3.8× |
| MRI chest wo w contrast (71552) | $2,231.35 | $4,057 | 5.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,126.85–$3,191.10 | $3,867–$5,802 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,862.30 | — | 6.5× |
| MRI lumbar spine w contrast (72149) | $2,264.90 | $4,118 | 5.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,506.90 | $4,558 | 6.0× |
| MRI orbit face &/neck w/o contrast (70540) | $1,434.95 | $2,609 | 5.0× |
| MRI orbit face neck w contrast (70542) | $1,845.25 | $3,355 | 4.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,390.85 | $4,347 | 5.7× |
| MRI pelvis w contrast (72196) | $2,057.55 | $3,741 | 4.9× |
| MRI pelvis w/o & w contrast (72197) | $2,553.65 | $4,643 | 6.1× |
| MRI pelvis w/o contrast (72195) | $2,052.60 | $3,732 | 7.2× |
| MRI thoracic spine w/o contrast (72146) | $1,886.50 | $3,430 | 6.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$759.55–$1,139.60 | $1,381–$2,072 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,975.60–$2,962.85 | $3,592–$5,387 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,503.38 | — | 6.0× |
| MRI, abdomen, combo (74183) | $2,678.50 | $4,870 | 6.4× |
| MRI, dorsal spine combo (72157) | $2,476.10 | $4,502 | 5.9× |
| MRI, dorsal spine contrast (72147) | $2,155.45 | $3,919 | 5.2× |
| MRI, joint upper extrem (73221) | $2,010.80 | — | 7.0× |
| MRI, joint upper extrem combo (73223) | $2,379.55 | — | 5.7× |
| MRI, lumbar spine combo (72158) | $2,526.15 | $4,593 | 6.0× |
| Myocardial Spect Multiple Studies (78452) | $2,567.40 | $4,668 | 1.7× |
| Neck soft tissue (70360) | $154 | $280 | 1.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $421.30 | $766 | 0.9× |
| Nonvascular Shunt X-Ray (75809) | $217.25 | $395 | 1.7× |
| Nuclear Rx Oral Admin (79005) | $1,010.90 | $1,838 | 3.6× |
| Parathyroid Planar Imaging (78070) | $735.35 | $1,337 | 1.5× |
| Pelvis 1 or 2 views (72170) | $596.20 | — | 4.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $575.85 | $1,047 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $272.25 | $495 | 2.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $392.70 | $714 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$283.25–$700.70 | — | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$294.80–$442.75 | $536–$805 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$290.40–$1,129.15 | — | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $342.10 | $622 | 2.7× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$187–$279.95 | — | varies |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$284.90–$426.80 | $518–$776 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$275.55–$867.35 | — | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 6 matching MRF lines |
$317.35–$476.85 | $577–$867 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $215.05 | $391 | 2.1× |
| Radex Ribs Unilateral 2 Views (71100) | $255.20 | $464 | 2.4× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$266.75–$587.40 | — | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $225.50 | $410 | 2.2× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$21,495.85–$29,472.18 | — | varies |
| Radex Sternum Minimum 2 Views (71120) | $275 | $500 | 2.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $239.80 | $436 | 2.3× |
| Radex Toe Minimum 2 Views (73660) | $547.25 | — | 5.2× |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$237.60–$356.40 | $432–$648 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$302.50–$1,225.95 | — | varies |
| Radiation treatment delivery level 2 (77407) | $234.30 | $426 | 0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $134.20 | $244 | 1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $217.25 | $395 | 1.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $444.95 | $809 | 2.1× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$318.45–$478.50 | $579–$870 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $328.35 | $597 | 2.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $612.70 | $1,114 | 2.9× |
| Radiologic exam swallow function contrast study (74230) | $450.45 | $819 | 2.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $378.95 | $689 | 1.8× |
| Radiologic examination femur 1 view (73551) range across 6 matching MRF lines |
$178.75–$268.40 | $325–$488 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$205.70–$308.55 | $374–$561 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$218.35–$327.80 | $397–$596 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $392.70 | $714 | 3.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$289.85–$710.60 | — | varies |
| Ribs bilateral 3 views (71110) | $405.35 | $737 | 3.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,063.70 | $1,934 | 2.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,799.60 | $3,272 | 3.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,527.35 | $2,777 | 2.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,942.05 | $3,531 | 3.0× |
| Scapula (73010) range across 3 matching MRF lines |
$307.45–$460.90 | $559–$838 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 6 matching MRF lines |
$36.30–$59.95 | $66–$109 | varies |
| Shoulder 1 view (73020) | $210.10 | — | 2.0× |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$425.15–$637.45 | $773–$1,159 | varies |
| Skull less than 4 views (70250) | $279.40 | $508 | 2.2× |
| Special Physics Consult (77370) | $864.60 | $1,572 | 5.4× |
| Sternoclavicular joints (71130) | $276.10 | $502 | 2.6× |
| Thoracic spine 2 views (72070) | $293.70 | $534 | 2.3× |
| Thoracic spine 3 views (72072) | $331.65 | $603 | 2.6× |
| Thoracolumbar 2 views (72080) | $248.60 | $452 | 2.4× |
| Thyroid Met Imaging Body (78018) | $1,555.95 | $2,829 | 2.4× |
| Thyroid Uptake Measurement (78012) | $360.80 | $656 | 0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $612.70 | $1,114 | 1.3× |
| Tx devices design & construction intermediate (77333) | $851.40 | $1,548 | 5.3× |
| Tx devices design & construction simple (77332) | $818.95 | $1,489 | 5.1× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$324.50–$487.30 | $590–$886 | varies |
| Ultrasound Elastography Parenchyma (76981) | $245.30 | $446 | 2.0× |
| Ultrasound Exam Aaa Screen (76706) | $573.65 | $1,043 | 4.6× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $414.15 | $753 | 1.0× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$524.15–$544.50 | — | varies |
| Unlisted fluoroscopic procedure (76496) | $173.80 | $316 | 1.7× |
| Upper gi w/o kub (74240) | $564.85 | $1,027 | 2.7× |
| Us breast unilateral complete (76641) range across 12 matching MRF lines |
$375.10–$562.65 | $682–$1,023 | varies |
| Us chest (76604) | $396 | $720 | 3.2× |
| Us complete joint (76881) | $255.20 | — | 2.0× |
| Us exam, pelvic, limited (76857) | $519.20 | $944 | 4.1× |
| Us head (76506) | $470.25 | $855 | 3.8× |
| Us kidney transplant (76776) | $616.55 | $1,121 | 4.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $216.70 | — | 1.7× |
| Us ob limited 1 or more fetuses (76815) | $405.35 | $737 | 3.2× |
| Us ob transvaginal (76817) | $612.15 | $1,113 | 4.9× |
| Us pelvic non ob complete (76856) | $805.20 | $1,464 | 6.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $533.50 | $970 | 4.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $396.55 | $721 | 3.2× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$712.80–$1,623.05 | — | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$1,030.15–$1,417.35 | — | varies |
| Us scrotum and contents (76870) | $646.80 | $1,176 | 5.2× |
| Us spinal canal and contents (76800) | $398.75 | $725 | 3.2× |
| Us thyroid (76536) | $834.90 | $1,518 | 6.7× |
| Us transrectal (76872) | $12,880.98 | — | 102.8× |
| Vein X-Ray Chest (75827) | $1,524.60 | $2,772 | 0.8× |
| Venography caval inferior serialography rs&i (75825) | $4,414.30 | $8,026 | 1.2× |
| Venography extremity bilateral rs&i (75822) | $3,113.55 | $5,661 | 1.6× |
| Venography extremity unilateral rs&i (75820) | $1,201.75 | $2,185 | 0.6× |
| Vertebral fracture assessment via dxa (77086) | $178.20 | $324 | 1.7× |
| Wrist 2 views (73100) range across 9 matching MRF lines |
$212.85–$320.10 | $387–$582 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $363.55 | $661 | 3.5× |
| X-Ray Aorta Leg Arteries (75630) | $5,387.80 | $9,796 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $304.70 | $554 | 2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$216.15–$1,864.50 | — | varies |
| X-Ray Exam Breast Specimen (76098) | $473 | $860 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $223.85 | $407 | 2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $339.90 | $618 | 2.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $407.55 | $741 | 3.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $37,123.94 | — | 355.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $362.45 | — | 3.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $393.80 | $716 | 3.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $486.75 | $885 | 3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $510.95 | $929 | 4.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $722.15 | $1,313 | 5.8× |
| X-Ray Exam L-S Spine Bending (72114) | $550.55 | $1,001 | 4.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $317.90 | $578 | 3.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $372.90 | $678 | 3.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $365.75 | $665 | 2.9× |
| X-ray eye for foreign body (70030) range across 6 matching MRF lines |
$253–$380.05 | $460–$691 | varies |
| X-ray humerus (73060) | $295.90 | — | 2.8× |
| X-ray IV pyelogram (ivp) (74400) | $601.70 | $1,094 | 2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $130.35 | $237 | 1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $290.40 | $528 | 2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $301.40 | $548 | 2.4× |
| X-ray nose-rectum child f.b. (76010) | $200.75 | $365 | 1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $477.40 | $868 | 3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $328.35 | $597 | 2.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $251.35 | $457 | 2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $321.20 | $584 | 3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $360.80 | $656 | 3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $402.60 | $732 | 3.2× |
| X-ray thoracic spine 4 vw (72074) | $328.35 | $597 | 2.6× |
| X-Ray Tmj Unilat (70328) | $145.20 | $264 | 1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $13,202.10 | — | 31.6× |
| X-Rays Bone Length Studies (77073) | $298.10 | $542 | 2.4× |
| X-Rays Bone Survey Complete (77075) | $594.55 | $1,081 | 4.7× |
| Xr c-spine 4 or 5 views (72050) | $348.15 | $633 | 2.8× |
| Xr facial bones less than 3 views (70140) | $180.95 | $329 | 1.7× |
| Xr orbits complete 4 views (70200) | $410.30 | $746 | 3.3× |
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.