Imaging prices at Dignity Health - St. Rose Dominican, Siena Campus
Henderson, NV · every code in this section with a posted price and a Medicare benchmark.
268 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) | $356.62 | $1,571 | 3.7× |
| Abdomen 2 views (74019) | $559.79 | $2,466 | 4.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $855.79 | $3,770 | 2.0× |
| Adrenal Cortex & Medulla Img (78075) | $1,332.04 | $5,868 | 0.9× |
| Angio internal mammary (75756) | $683.96 | $3,013 | 0.2× |
| Angio pulmonary bilat (75743) | $1,871.17 | $8,243 | 0.5× |
| Angiography extremity bilateral rs&i (75716) | $3,284.69 | $14,470 | 1.0× |
| Angiography extremity unilateral rs&i (75710) | $2,824.79 | $12,444 | 0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,609.21 | $7,089 | 0.5× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$344.82–$513.25 | $1,519–$2,261 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$1,396.96 | $6,154 | 0.2× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$1,964.92 | $8,656 | 0.3× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,095.44 | $9,231 | 0.3× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$2,473.62 | $10,897 | 0.4× |
| Arthrogram hip (73525) | $542.53 | $2,390 | 1.4× |
| Bone age studies (77072) | $158.90 | $700 | 1.4× |
| Bone Imaging 3 Phase (78315) | $1,550.64 | $6,831 | 3.5× |
| Bone Imaging Limited Area (78300) | $803.58 | $3,540 | 1.8× |
| Bone Imaging Whole Body (78306) | $1,131.83 | $4,986 | 2.6× |
| Bone survey infant (77076) | $582.26 | $2,565 | 5.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $462.86 | $2,039 | 0.8× |
| Cardiovasc nucl exam unlisted (78499) | $288.52 | $1,271 | 0.7× |
| Cat Scan Follow-Up Study (76380) | $89.22 | $393 | 0.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $416.10 | $1,833 | 0.7× |
| Cerebrospinal Fluid Scan (78630) | $727.99 | $3,207 | 1.2× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$109.87–$354.35 | $484–$1,561 | varies |
| Chest 2 views (71046) | $439.48 | $1,936 | 4.6× |
| Chest 3 views (71047) | $535.04 | $2,357 | 5.6× |
| Chest 4 or more views (71048) | $552.75 | $2,435 | 4.8× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$286.25–$429.49 | $1,261–$1,892 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $76.96 | $339 | 0.7× |
| Contrast Exam Abdominl Aorta (75625) | $3,075.17 | $13,547 | 0.9× |
| Contrast X-Ray Bladder (74430) | $576.36 | $2,539 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) | $4,795.61 | $21,126 | 12.6× |
| CT abdomen and pelvis without contrast (74176) | $2,716.06 | $11,965 | 10.4× |
| CT abdomen w contrast (74160) | $2,024.62 | $8,919 | 10.6× |
| CT abdomen w wo contrast (74170) | $2,739.21 | $12,067 | 14.3× |
| CT abdomen w/o contrast (74150) | $1,095.73 | $4,827 | 9.6× |
| CT Angio Abdomen and Pelvis (74174) | $1,509.55 | $6,650 | 4.0× |
| CT Angio Chest (71275) | $2,747.39 | $12,103 | 14.3× |
| CT Angio Head (70496) | $2,598.93 | $11,449 | 13.6× |
| CT angio hrt w/3d image (75574) | $3,435.65 | $15,135 | 9.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,544.74–$2,376.24 | $6,805–$10,468 | varies |
| CT Angio Neck (70498) | $2,492.01 | $10,978 | 13.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $909.14 | $4,005 | 4.7× |
| CT cervical spine w/ contrast (72126) | $3,057.01 | $13,467 | 8.0× |
| CT cervical spine w/o contrast (72125) | $1,749.04 | $7,705 | 15.3× |
| CT chest w contrast (71260) | $2,210.30 | $9,737 | 11.5× |
| CT chest w/wo contrast (71270) | $2,475.44 | $10,905 | 12.9× |
| CT head/brain with contrast (70460) | $2,116.10 | $9,322 | 11.0× |
| CT head/brain without and with contrast (70470) | $2,494.05 | $10,987 | 13.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $2,920.36 | $12,865 | 30.7× |
| CT iac w contrast (70481) | $1,435.10 | $6,322 | 7.5× |
| CT l-spine w&w/o contrast (72133) | $3,445.64 | $15,179 | 18.0× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,557.91–$2,336.74 | $6,863–$10,294 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,962.87–$2,897.66 | $8,647–$12,765 | varies |
| CT lumbar spine w contrast (72132) | $3,078.12 | $13,560 | 8.1× |
| CT lumbar spine w/o contrast (72131) | $1,531.35 | $6,746 | 13.4× |
| CT maxillofacial w contrast (70487) | $2,123.36 | $9,354 | 11.1× |
| CT maxillofacial wo contrast (70486) | $1,754.71 | $7,730 | 15.4× |
| CT neck tissue combo (70492) | $2,593.71 | $11,426 | 13.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,564.26 | $6,891 | 8.2× |
| CT orbits w/o contrast (70480) | $1,219.68 | $5,373 | 10.7× |
| CT pelvis w&w/o contrast (72194) | $2,271.14 | $10,005 | 11.8× |
| CT pelvis w/o contrast (72192) | $1,059.87 | $4,669 | 9.3× |
| CT scan of leg combo (73702) | $2,383.50 | $10,500 | 12.4× |
| CT scans face/jaw combo (70488) | $2,338.10 | $10,300 | 12.2× |
| CT soft tissue neck w contrast (70491) | $2,198.05 | $9,683 | 11.5× |
| CT soft tissue neck w/o contrast (70490) | $1,802.38 | $7,940 | 15.8× |
| CT thoracic spine w contrast (72129) | $3,211.60 | $14,148 | 16.8× |
| CT thoracic spine w/o contrast (72128) | $1,597.86 | $7,039 | 14.0× |
| CT thorax w/o contrast (71250) | $1,105.04 | $4,868 | 9.7× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,678.44–$2,517.66 | $7,394–$11,091 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $2,601.65 | $11,461 | 13.6× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$2,081.37–$3,071.54 | $9,169–$13,531 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $743.20 | $3,274 | 3.9× |
| Cta Abdomen (74175) | $1,192.44 | $5,253 | 6.2× |
| CTA pelvis (72191) | $1,056.24 | $4,653 | 5.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $62.66 | $276 | 0.5× |
| Echo exam of fetal heart (76825) | $409.06 | $1,802 | 0.7× |
| Esophagram (74220) | $576.58 | $2,540 | 3.0× |
| Fetal Biophys Profile W/Nst (76818) | $138.47 | $610 | 1.2× |
| Fluoroscopy up to 1 hr (76000) | $144.83 | $638 | 0.6× |
| Follow-Up Angiography (75898) | $703.48 | $3,099 | 0.2× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$337.33–$496.45 | $1,486–$2,187 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$333.92–$500.77 | $1,471–$2,206 | varies |
| Gastric emptying imaging study (78264) | $893.02 | $3,934 | 2.0× |
| Gated Heart Planar Single (78472) | $942.05 | $4,150 | 2.2× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$287.16–$420.64 | $1,265–$1,853 | varies |
| Heart Image (Pet) Multiple (78492) | $1,097.78 | $4,836 | 0.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,321.53 | $10,227 | 0.7× |
| Hepatobil Syst Image W/Drug (78227) | $2,272.50 | $10,011 | 3.8× |
| Hepatobiliary System Imaging (78226) | $1,658.69 | $7,307 | 3.8× |
| Ht Muscle Image Spect Sing (78451) | $4,010.64 | $17,668 | 2.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $290.11 | $1,278 | 3.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $365.93 | $1,612 | 0.8× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$366.16–$572.27 | $1,613–$2,521 | varies |
| Liver & Spleen Imaging Static Only (78215) | $517.34 | $2,279 | 1.2× |
| Lung perfusion differential (78597) | $302.37 | $1,332 | 0.7× |
| Lung Ventilat&Perfus Imaging (78582) | $1,285.96 | $5,665 | 2.2× |
| Lung Ventilation Imaging (78579) | $707.34 | $3,116 | 1.6× |
| Lymph System Imaging (78195) | $3,292.64 | $14,505 | 5.5× |
| Meckels Divert Exam (78290) | $620.17 | $2,732 | 1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $23.84 | $105 | 0.8× |
| Mra Head W/O & W/Contrast Material (70546) | $2,507.67 | $11,047 | 6.6× |
| MRA head w/o contrast (70544) | $1,483.90 | $6,537 | 5.7× |
| MRA head with contrast (70545) | $2,210.98 | $9,740 | 5.8× |
| MRA neck w contrast (70548) | $2,204.63 | $9,712 | 5.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,500.41 | $11,015 | 6.6× |
| MRA neck w/o contrast (70547) | $1,479.59 | $6,518 | 5.7× |
| MRI abdomen w contrast (74182) | $2,435.26 | $10,728 | 6.4× |
| MRI abdomen w/o contrast (74181) | $1,634.40 | $7,200 | 6.3× |
| MRI any jt lower extrem w/contrast material (73722) | $2,278.18 | $10,036 | 2.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,583.95 | $11,383 | 6.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,964.85 | $13,061 | 3.5× |
| MRI cervical spine w contrast (72142) | $3,003.21 | $13,230 | 7.9× |
| MRI cervical spine w/o cont (72141) | $2,275.23 | $10,023 | 8.7× |
| MRI chest w/o contrast (71550) | $972.93 | $4,286 | 3.7× |
| MRI chest with contrast (71551) | $1,451.22 | $6,393 | 1.7× |
| MRI chest wo w contrast (71552) | $1,649.16 | $7,265 | 4.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,669.52 | $11,760 | 7.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,579.70–$2,369.43 | $6,959–$10,438 | varies |
| MRI lumbar spine w contrast (72149) | $3,234.30 | $14,248 | 8.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,867.86 | $17,039 | 10.1× |
| MRI orbit face &/neck w/o contrast (70540) | $1,023.09 | $4,507 | 3.9× |
| MRI orbit face neck w contrast (70542) | $1,526.13 | $6,723 | 4.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,734.28 | $7,640 | 4.5× |
| MRI pelvis w contrast (72196) | $2,118.14 | $9,331 | 5.6× |
| MRI pelvis w/o & w contrast (72197) | $2,406.89 | $10,603 | 6.3× |
| MRI pelvis w/o contrast (72195) | $1,420.12 | $6,256 | 5.4× |
| MRI thoracic spine w/o contrast (72146) | $1,439.87 | $6,343 | 5.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $325.75 | $1,435 | 0.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,017.65 | $4,483 | 3.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,719.76 | $7,576 | 4.5× |
| MRI, abdomen, combo (74183) | $2,762.14 | $12,168 | 7.2× |
| MRI, dorsal spine combo (72157) | $2,440.48 | $10,751 | 6.4× |
| MRI, dorsal spine contrast (72147) | $2,147.65 | $9,461 | 5.6× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,989.89–$2,984.83 | $8,766–$13,149 | varies |
| MRI, joint upper extrem combo (73223) | $3,362.78 | $14,814 | 8.8× |
| MRI, lumbar spine combo (72158) | $3,668.55 | $16,161 | 9.6× |
| Myelogram cervical (72240) | $351.40 | $1,548 | 0.4× |
| Myelogram Lumbar (72265) | $456.73 | $2,012 | 0.5× |
| Myelograpy 2/more regions rs&i (72270) | $351.40 | $1,548 | 0.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,104.13 | $4,864 | 0.8× |
| Myocardial Spect Multiple Studies (78452) | $4,832.15 | $21,287 | 3.4× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $1,031.72 | $4,545 | 0.7× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $1,609.43 | $7,090 | 0.7× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $1,609.43 | $7,090 | 1.0× |
| N-invas est c ffr sw aly CTA (75580) | $555.93 | $2,449 | 0.6× |
| Neck soft tissue (70360) | $371.15 | $1,635 | 3.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $288.52 | $1,271 | 0.7× |
| Nuclear Rx Intra-Arterial (79445) | $224.96 | $991 | 0.9× |
| Nuclear Rx Oral Admin (79005) | $1,323.19 | $5,829 | 5.2× |
| Parathyroid Planar Imaging (78070) | $956.58 | $4,214 | 2.2× |
| Pelvis 1 or 2 views (72170) | $312.58 | $1,377 | 2.7× |
| Pet Image Skull-Thigh (78812) | $1,042.62 | $4,593 | 0.7× |
| Pet Image W/Ct Lmtd (78814) | $805.63 | $3,549 | 0.5× |
| PET image w/CT, full body (78816) | $805.63 | $3,549 | 0.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$805.63–$1,554.95 | $3,549–$6,850 | varies |
| Pet Myocardial Sngl Study (78491) | $911.18 | $4,014 | 0.6× |
| PET whole body (78813) | $1,042.62 | $4,593 | 0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $913 | $4,022 | 2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $673.97 | $2,969 | 5.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $451.05 | $1,987 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$400.89–$601.33 | $1,766–$2,649 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$273.09–$409.51 | $1,203–$1,804 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$386.36–$691.67 | $1,702–$3,047 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $321.89 | $1,418 | 2.8× |
| Radex fingr minimum 2 views (73140) | $285.34 | $1,257 | 3.0× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$378.87–$568.41 | $1,669–$2,504 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$333.92–$500.77 | $1,471–$2,206 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $272.40 | $1,200 | 2.9× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$375.92–$563.87 | $1,656–$2,484 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $201.13 | $886 | 2.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,757.67 | $7,743 | 9.2× |
| Radex Spine 1 View Specify Level (72020) | $297.15 | $1,309 | 3.1× |
| Radex Sternum Minimum 2 Views (71120) | $371.15 | $1,635 | 3.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $337.55 | $1,487 | 3.5× |
| Radex Toe Minimum 2 Views (73660) | $307.82 | $1,356 | 3.2× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$388.86–$583.17 | $1,713–$2,569 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $442.43 | $1,949 | 3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $520.52 | $2,293 | 4.6× |
| Radiologic exam colon double contrast study (74280) | $976.33 | $4,301 | 5.1× |
| Radiologic exam colon single contrast study (74270) | $697.35 | $3,072 | 3.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $599.97 | $2,643 | 3.1× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$420.86–$660.57 | $1,854–$2,910 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $434.03 | $1,912 | 2.3× |
| Radiologic exam swallow function contrast study (74230) | $553.20 | $2,437 | 2.9× |
| Radiologic examination femur 1 view (73551) | $578.63 | $2,549 | 6.1× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$131.21–$1,091.65 | $578–$4,809 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$311.45–$466.94 | $1,372–$2,057 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $389.99 | $1,718 | 3.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$280.12–$636.74 | $1,234–$2,805 | varies |
| Ribs bilateral 3 views (71110) | $412.92 | $1,819 | 3.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,213.55 | $5,346 | 2.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,026.66 | $8,928 | 3.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,213.55 | $5,346 | 2.0× |
| Rp Therapy Intravenous Administration (79101) | $326.66 | $1,439 | 1.3× |
| Scapula (73010) range across 2 matching MRF lines |
$371.15–$556.61 | $1,635–$2,452 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$300.78–$428.58 | $1,325–$1,888 | varies |
| Skull less than 4 views (70250) | $357.53 | $1,575 | 3.1× |
| Special treatment procedure (77470) | $297.15 | $1,309 | 0.5× |
| Sternoclavicular joints (71130) | $456.50 | $2,011 | 4.8× |
| Superior sagittal sinus venogram (75870) | $450.60 | $1,985 | 0.1× |
| Thoracic spine 3 views (72072) | $485.56 | $2,139 | 4.2× |
| Thoracolumbar 2 views (72080) | $310.77 | $1,369 | 3.3× |
| Thyroid Met Imaging Body (78018) | $972.93 | $4,286 | 1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $819.93 | $3,612 | 1.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$140.06–$215.65 | $617–$950 | varies |
| Ultrasound Exam Aaa Screen (76706) | $112.37 | $495 | 1.0× |
| Ultrasound, abdomen limited (76705) | $790.42 | $3,482 | 6.9× |
| Upper gi w/o kub (74240) | $528.23 | $2,327 | 2.8× |
| Urethrocystogram voiding (74455) | $460.13 | $2,027 | 1.8× |
| Urethrocystography retrograde (74450) | $460.13 | $2,027 | 1.8× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$140.06–$215.65 | $617–$950 | varies |
| Us chest (76604) | $236.77 | $1,043 | 2.1× |
| Us complete joint (76881) | $538.68 | $2,373 | 4.7× |
| Us head (76506) | $241.31 | $1,063 | 2.1× |
| Us kidney transplant (76776) | $311.68 | $1,373 | 2.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $167.08 | $736 | 1.5× |
| Us ob detailed single fetus (76811) | $219.51 | $967 | 0.8× |
| Us ob limited 1 or more fetuses (76815) | $749.56 | $3,302 | 6.6× |
| Us ob transvaginal (76817) | $861.47 | $3,795 | 7.5× |
| Us pelvic non ob complete (76856) | $884.85 | $3,898 | 7.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $457.41 | $2,015 | 4.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,016.51 | $4,478 | 8.9× |
| Us retroperitoneal complete (76770) | $814.25 | $3,587 | 7.1× |
| Us retroperitoneal limited (76775) | $415.41 | $1,830 | 3.6× |
| Us scrotum and contents (76870) | $806.76 | $3,554 | 7.1× |
| Us spinal canal and contents (76800) | $160.49 | $707 | 1.4× |
| Us thyroid (76536) | $752.06 | $3,313 | 6.6× |
| Vein X-Ray Chest (75827) | $636.74 | $2,805 | 0.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,470.28 | $6,477 | 0.4× |
| Venogram Sinus/Jugular (75860) | $648.32 | $2,856 | 0.2× |
| Venography caval inferior serialography rs&i (75825) | $1,989.89 | $8,766 | 0.6× |
| Venography extremity bilateral rs&i (75822) | $1,076.44 | $4,742 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $915.04 | $4,031 | 0.5× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$322.80–$486.01 | $1,422–$2,141 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $205.44 | $905 | 2.2× |
| X-ray antegrade pyelogram tube (74425) | $583.62 | $2,571 | 1.5× |
| X-Ray Aorta Leg Arteries (75630) | $3,782.51 | $16,663 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) | $471.71 | $2,078 | 4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$340.05–$579.76 | $1,498–$2,554 | varies |
| X-Ray Exam Breast Specimen (76098) | $422.22 | $1,860 | 0.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $76.28 | $336 | 0.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $297.15 | $1,309 | 3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $353.90 | $1,559 | 3.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $109.65 | $483 | 1.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $559.11 | $2,463 | 4.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $559.11 | $2,463 | 4.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $644 | $2,837 | 5.6× |
| X-Ray Exam L-S Spine Bending (72114) | $730.04 | $3,216 | 6.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $415.19 | $1,829 | 4.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $701.66 | $3,091 | 6.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $400.89 | $1,766 | 3.5× |
| X-ray humerus (73060) | $318.26 | $1,402 | 3.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $410.19 | $1,807 | 3.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $521.20 | $2,296 | 4.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $465.13 | $2,049 | 4.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $400.89 | $1,766 | 4.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $251.29 | $1,107 | 2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $450.60 | $1,985 | 3.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $583.62 | $2,571 | 1.5× |
| X-Rays Bone Survey Complete (77075) | $535.72 | $2,360 | 4.7× |
| Xr c-spine 4 or 5 views (72050) | $560.47 | $2,469 | 4.9× |
| Xr facial bones less than 3 views (70140) | $231.54 | $1,020 | 2.4× |
| XR Mastoids < 3 Views Bilateral (70120) | $152.32 | $671 | 1.3× |
| Xr orbits complete 4 views (70200) | $313.95 | $1,383 | 2.7× |
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.