Imaging prices at Sampson Regional Medical Center
Clinton, NC · every code in this section with a posted price and a Medicare benchmark.
258 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) | $214.90 | $307 | 2.6× |
| Abdomen 2 views (74019) | $275.80 | $394 | 2.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $942.90 | $1,347 | 2.5× |
| Ankle 2 views (73600) | $203 | $290 | 2.4× |
| Bone age studies (77072) | $173.60 | $248 | 1.7× |
| Bone Imaging 3 Phase (78315) | $2,060.10 | $2,943 | 5.4× |
| Bone Imaging Limited Area (78300) | $629.30 | $899 | 1.6× |
| Bone Imaging Multiple Areas (78305) | $1,332.80 | $1,904 | 3.5× |
| Bone Imaging Whole Body (78306) | $1,559.60 | $2,228 | 4.1× |
| Bone survey infant (77076) | $182.70 | $261 | 1.8× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$140–$1,444.80 | $200–$2,064 | varies |
| Chest 1 view (71045) | $212.80 | $304 | 2.6× |
| Chest 2 views (71046) | $244.30 | $349 | 2.9× |
| Chest 3 views (71047) | $263.20 | $376 | 3.2× |
| Chest 4 or more views (71048) | $267.40 | $382 | 2.7× |
| Cholecystography Oral Contrast (74290) | $287.70 | $411 | 1.7× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$116.20–$280 | $166–$400 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $180.60 | $258 | 1.8× |
| Contrast X-Ray Bladder (74430) | $455 | $650 | 1.4× |
| CT abdomen and pelvis without and with contrast (74178) | $5,294.80 | $7,564 | 15.9× |
| CT abdomen and pelvis without contrast (74176) | $4,195.80 | $5,994 | 18.4× |
| CT abdomen w contrast (74160) | $2,121.70 | $3,031 | 12.7× |
| CT abdomen w wo contrast (74170) | $2,650.20 | $3,786 | 15.8× |
| CT abdomen w/o contrast (74150) | $1,908.90 | $2,727 | 19.1× |
| CT Angio Abdomen and Pelvis (74174) | $2,968 | $4,240 | 8.9× |
| CT Angio Chest (71275) | $2,643.20 | $3,776 | 15.8× |
| CT Angio Head (70496) | $2,459.80 | $3,514 | 14.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,806.70 | $2,581 | 10.8× |
| CT Angio Neck (70498) | $2,366.70 | $3,381 | 14.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,806.70 | $2,581 | 10.8× |
| CT bone density (77078) | $449.40 | $642 | 5.4× |
| CT cervical spine w/ contrast (72126) | $2,404.50 | $3,435 | 7.2× |
| CT cervical spine w/o contrast (72125) | $3,180.10 | $4,543 | 31.8× |
| CT cervical spine w/wo cont (72127) | $3,593.10 | $5,133 | 21.4× |
| CT chest w contrast (71260) | $1,499.40 | $2,142 | 8.9× |
| CT chest w/wo contrast (71270) | $2,244.20 | $3,206 | 13.4× |
| CT head/brain with contrast (70460) | $1,555.40 | $2,222 | 9.3× |
| CT head/brain without and with contrast (70470) | $2,593.50 | $3,705 | 15.5× |
| CT iac w contrast (70481) | $1,653.40 | $2,362 | 9.9× |
| CT l-spine w&w/o contrast (72133) | $3,282.30 | $4,689 | 19.6× |
| CT lower ext w/o (73700) | $1,904 | $2,720 | 19.1× |
| CT lower extremity w/contrast material (73701) | $2,026.50 | $2,895 | 12.1× |
| CT lumbar spine w contrast (72132) | $2,404.50 | $3,435 | 7.2× |
| CT lumbar spine w/o contrast (72131) | $2,762.20 | $3,946 | 27.6× |
| CT maxillofacial w contrast (70487) | $1,465.80 | $2,094 | 8.7× |
| CT maxillofacial wo contrast (70486) | $2,121.70 | $3,031 | 21.2× |
| CT neck tissue combo (70492) | $2,554.30 | $3,649 | 15.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,412.20 | $3,446 | 14.4× |
| CT orbits w/o contrast (70480) | $1,653.40 | $2,362 | 16.5× |
| CT pelvis w&w/o contrast (72194) | $2,650.20 | $3,786 | 15.8× |
| CT pelvis w/o contrast (72192) | $1,908.90 | $2,727 | 19.1× |
| CT scan of leg combo (73702) | $2,645.30 | $3,779 | 15.8× |
| CT scans face/jaw combo (70488) | $2,779 | $3,970 | 16.6× |
| CT soft tissue neck w contrast (70491) | $2,124.50 | $3,035 | 12.7× |
| CT soft tissue neck w/o contrast (70490) | $2,261 | $3,230 | 22.6× |
| CT thoracic spine w contrast (72129) | $1,841 | $2,630 | 11.0× |
| CT thoracic spine w/o contrast (72128) | $2,112.60 | $3,018 | 21.1× |
| CT thoracic spine w/wo cont (72130) | $2,749.60 | $3,928 | 16.4× |
| CT thorax w/o contrast (71250) | $1,499.40 | $2,142 | 15.0× |
| CT upper ext wo (73200) | $1,324.40 | $1,892 | 13.3× |
| CT upper extremity w/o & w/contrast material (73202) | $1,743.70 | $2,491 | 10.4× |
| CT upper extremity with contrast (73201) | $1,169 | $1,670 | 3.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,636.20 | $3,766 | 15.7× |
| Cta Abdomen (74175) | $2,636.20 | $3,766 | 15.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,660 | $3,800 | 8.0× |
| CTA pelvis (72191) | $2,783.90 | $3,977 | 16.6× |
| Doppler Fetal Mid Cerebral Artery (76821) | $163.80 | $234 | 1.6× |
| Dxa Bone Density Axial (77080) | $213.50 | $305 | 2.1× |
| Dxa bone density study (77085) | $163.80 | $234 | 1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $105.70 | $151 | 1.3× |
| Esophagram (74220) | $366.10 | $523 | 2.2× |
| Fetal Biophys Profile W/Nst (76818) | $375.20 | $536 | 3.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$247.10–$375.20 | $353–$536 | varies |
| Fluoroscopy up to 1 hr (76000) | $343.70 | $491 | 1.5× |
| Foot 2 views (73620) | $241.50 | $345 | 2.9× |
| Forearm 2 views (73090) | $268.10 | $383 | 3.2× |
| Gastric emptying imaging study (78264) | $707.70 | $1,011 | 1.9× |
| Gated Heart Planar Single (78472) | $1,395.10 | $1,993 | 3.7× |
| GI Endoscopic US S&I (76975) | $688.10 | $983 | 3.0× |
| Hand 2 views (73120) | $180.60 | $258 | 1.8× |
| Hepatobil Syst Image W/Drug (78227) | $1,611.40 | $2,302 | 3.1× |
| Hepatobiliary System Imaging (78226) | $1,611.40 | $2,302 | 4.2× |
| Ht Muscle Image Spect Sing (78451) | $3,619 | $5,170 | 2.9× |
| Hysterosalpingogram (74740) | $566.30 | $809 | 2.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $441.70 | $631 | 5.3× |
| Infusion Ivp (74410) | $733.60 | $1,048 | 4.4× |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$796.60–$2,368.80 | $1,138–$3,384 | varies |
| K Flow/Funct Image W/Drug (78708) | $796.60 | $1,138 | 1.5× |
| K Flow/Funct Image W/O Drug (78707) | $1,874.60 | $2,678 | 3.6× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,687 | $2,410 | 4.4× |
| Knee 3 Views (73562) | $294 | $420 | 3.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $935.90 | $1,337 | 2.4× |
| Lung Perf&Ventilat Diferentl (78598) | $768.60 | $1,098 | 1.5× |
| Lung Ventilat&Perfus Imaging (78582) | $1,579.90 | $2,257 | 3.0× |
| Lung Ventilation Imaging (78579) | $598.50 | $855 | 1.6× |
| Lymph System Imaging (78195) | $746.20 | $1,066 | 1.4× |
| Magnetic Image Jaw Joint (70336) | $1,977.50 | $2,825 | 8.7× |
| Meckels Divert Exam (78290) | $616 | $880 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $2,912.70 | $4,161 | 8.7× |
| MRA head w/o contrast (70544) | $1,789.20 | $2,556 | 7.8× |
| MRA head with contrast (70545) | $1,854.30 | $2,649 | 5.6× |
| MRA neck w contrast (70548) | $1,854.30 | $2,649 | 5.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,669.80 | $3,814 | 8.0× |
| MRA neck w/o contrast (70547) | $1,789.90 | $2,557 | 7.8× |
| MRI abdomen w contrast (74182) | $2,236.50 | $3,195 | 6.7× |
| MRI abdomen w/o contrast (74181) | $2,482.90 | $3,547 | 10.9× |
| MRI any jt lower extrem w/contrast material (73722) | $2,328.90 | $3,327 | 3.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,028.20 | $4,326 | 9.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,158.80 | $3,084 | 2.9× |
| MRI cervical spine w contrast (72142) | $2,316.30 | $3,309 | 6.9× |
| MRI cervical spine w/o cont (72141) | $2,636.20 | $3,766 | 11.6× |
| MRI chest w/o contrast (71550) | $1,915.20 | $2,736 | 8.4× |
| MRI chest with contrast (71551) | $2,071.30 | $2,959 | 2.8× |
| MRI chest wo w contrast (71552) | $2,431.10 | $3,473 | 7.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,537.90 | $2,197 | 4.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,312.10 | $3,303 | 6.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,461.20 | $3,516 | 10.8× |
| MRI lumbar spine w contrast (72149) | $2,524.90 | $3,607 | 7.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,493 | $4,990 | 10.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,675.10 | $2,393 | 7.3× |
| MRI orbit face neck w contrast (70542) | $2,225.30 | $3,179 | 6.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,431.10 | $3,473 | 7.3× |
| MRI pelvis w contrast (72196) | $2,232.30 | $3,189 | 6.7× |
| MRI pelvis w/o & w contrast (72197) | $2,552.90 | $3,647 | 7.7× |
| MRI pelvis w/o contrast (72195) | $2,400.30 | $3,429 | 10.5× |
| MRI thoracic spine w/o contrast (72146) | $2,662.80 | $3,804 | 11.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,158.80 | $3,084 | 6.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,659.30 | $3,799 | 11.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,464.70 | $3,521 | 7.4× |
| MRI, abdomen, combo (74183) | $3,143 | $4,490 | 9.4× |
| MRI, dorsal spine combo (72157) | $3,493 | $4,990 | 10.5× |
| MRI, dorsal spine contrast (72147) | $2,054.50 | $2,935 | 6.2× |
| MRI, joint upper extrem (73221) | $2,645.30 | $3,779 | 11.6× |
| MRI, joint upper extrem combo (73223) | $2,524.90 | $3,607 | 7.6× |
| MRI, lumbar spine combo (72158) | $3,493 | $4,990 | 10.5× |
| Myocardial Spect Multiple Studies (78452) | $5,637.10 | $8,053 | 4.6× |
| Neck soft tissue (70360) | $236.60 | $338 | 2.8× |
| Nuclear Rx Oral Admin (79005) | $1,098.30 | $1,569 | 4.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $459.20 | $656 | 4.6× |
| Optic foramina (70190) | $177.80 | $254 | 2.1× |
| Parathyroid Planar Imaging (78070) | $1,331.40 | $1,902 | 3.5× |
| Pelvis 1 or 2 views (72170) | $266.70 | $381 | 2.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,579.20 | $2,256 | 4.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $413.70 | $591 | 4.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $566.30 | $809 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $339.50 | $485 | 4.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $233.10 | $333 | 2.8× |
| Radex elbow complete minimum 3 views (73080) | $279.30 | $399 | 3.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $339.50 | $485 | 3.4× |
| Radex fingr minimum 2 views (73140) | $166.60 | $238 | 2.0× |
| Radex foot complete minimum 3 views (73630) | $339.50 | $485 | 4.1× |
| Radex Hand Minimum 3 Views (73130) | $343.70 | $491 | 4.1× |
| Radex lower extremity infant minimum 2 views (73592) | $182.70 | $261 | 2.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $203 | $290 | 2.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $247.80 | $354 | 3.0× |
| Radex Ribs Unilateral 2 Views (71100) | $345.80 | $494 | 4.2× |
| Radex shoulder complete minimum 2 views (73030) | $320.60 | $458 | 3.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $256.90 | $367 | 3.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $334.60 | $478 | 2.0× |
| Radex Spine 1 View Specify Level (72020) | $180.60 | $258 | 2.2× |
| Radex Sternum Minimum 2 Views (71120) | $202.30 | $289 | 2.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $242.90 | $347 | 2.9× |
| Radex Toe Minimum 2 Views (73660) | $179.20 | $256 | 2.2× |
| Radex upper extremity infant minimum 2 views (73092) | $182.70 | $261 | 1.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $341.60 | $488 | 4.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $320.60 | $458 | 3.2× |
| Radiologic exam colon double contrast study (74280) | $706.30 | $1,009 | 4.2× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$186.20–$426.30 | $266–$609 | varies |
| Radiologic exam knee complete 4/more views (73564) | $342.30 | $489 | 3.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $314.30 | $449 | 3.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $241.50 | $345 | 1.4× |
| Radiologic exam swallow function contrast study (74230) | $228.20 | $326 | 1.4× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$558.60–$576.80 | $798–$824 | varies |
| Radiologic examination femur minimum 2 views (73552) | $149.10 | $213 | 1.8× |
| Radiologic examination knee 1/2 views (73560) | $236.60 | $338 | 2.8× |
| Radiologic Examination Osseous Survey Limited (77074) | $275.10 | $393 | 2.8× |
| Radiologic Examination Salivary Gland Calculus (70380) | $182.70 | $261 | 2.2× |
| Radiologic examination tibia & fibula 2 views (73590) | $271.60 | $388 | 3.3× |
| Ribs bilateral 3 views (71110) | $377.30 | $539 | 3.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$1,167.60–$1,234.80 | $1,668–$1,764 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,212.40 | $1,732 | 2.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,416.80 | $2,024 | 2.7× |
| Scapula (73010) | $244.30 | $349 | 2.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $67.20 | $96 | 2.9× |
| Shoulder 1 view (73020) | $177.80 | $254 | 2.1× |
| Skull less than 4 views (70250) | $385.70 | $551 | 3.9× |
| Sternoclavicular joints (71130) | $207.20 | $296 | 2.5× |
| Testicular Imaging W/Flow (78761) | $747.60 | $1,068 | 2.0× |
| Thoracic spine 2 views (72070) | $282.10 | $403 | 2.8× |
| Thoracic spine 3 views (72072) | $182.70 | $261 | 1.8× |
| Thoracolumbar 2 views (72080) | $247.80 | $354 | 3.0× |
| Thyroid Imaging With Vascular Flow (78013) | $791.70 | $1,131 | 2.1× |
| Thyroid Met Imaging Body (78018) | $674.80 | $964 | 1.3× |
| Thyroid Uptake Measurement (78012) | $567.70 | $811 | 1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $921.90 | $1,317 | 2.4× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$168–$252 | $240–$360 | varies |
| Ultrasound Exam Aaa Screen (76706) | $401.80 | $574 | 4.0× |
| Ultrasound, abdomen limited (76705) | $688.10 | $983 | 6.9× |
| Umbilical-artery Doppler (OB) (76820) | $163.80 | $234 | 1.6× |
| Unlisted magnetic resonance procedure (76498) | $2,431.10 | $3,473 | 29.2× |
| Upper gi w/o kub (74240) | $497.70 | $711 | 3.0× |
| Ureteral Reflux Study (78740) | $1,187.90 | $1,697 | 3.1× |
| Urethrocystogram voiding (74455) | $566.30 | $809 | 2.5× |
| Urethrocystography retrograde (74450) | $525 | $750 | 2.3× |
| Us breast unilateral complete (76641) | $241.50 | $345 | 2.4× |
| Us exam, pelvic, limited (76857) | $165.90 | $237 | 1.7× |
| Us head (76506) | $276.50 | $395 | 2.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $441.70 | $631 | 4.4× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$191.80–$384.30 | $274–$549 | varies |
| Us ob transvaginal (76817) | $431.90 | $617 | 4.3× |
| Us pelvic non ob complete (76856) | $668.50 | $955 | 6.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $451.50 | $645 | 4.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $436.80 | $624 | 4.4× |
| Us retroperitoneal complete (76770) | $475.30 | $679 | 4.8× |
| Us retroperitoneal limited (76775) | $488.60 | $698 | 4.9× |
| Us scrotum and contents (76870) | $515.20 | $736 | 5.2× |
| Us spinal canal and contents (76800) | $334.60 | $478 | 3.3× |
| Us thyroid (76536) | $555.80 | $794 | 5.6× |
| Us transrectal (76872) | $436.10 | $623 | 4.4× |
| Vascular Flow Imaging (78445) | $566.30 | $809 | 1.5× |
| Vasogram (74440) | $427.70 | $611 | 1.9× |
| Vertebral fracture assessment via dxa (77086) | $109.20 | $156 | 1.3× |
| Wrist 2 views (73100) | $233.80 | $334 | 2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $275.80 | $394 | 3.3× |
| X-ray antegrade pyelogram tube (74425) | $468.30 | $669 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $182.70 | $261 | 1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $202.30 | $289 | 2.4× |
| X-Ray Exam Breast Specimen (76098) | $756 | $1,080 | 1.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $111.30 | $159 | 1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$111.30–$169.40 | $159–$242 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $213.50 | $305 | 2.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $265.30 | $379 | 2.7× |
| X-Ray Exam L-S Spine Bending (72114) | $560 | $800 | 5.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $301.70 | $431 | 3.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $621.60 | $888 | 6.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $275.10 | $393 | 2.8× |
| X-ray eye for foreign body (70030) | $273.70 | $391 | 3.3× |
| X-ray humerus (73060) | $229.60 | $328 | 2.8× |
| X-ray IV pyelogram (ivp) (74400) | $733.60 | $1,048 | 4.4× |
| X-ray IV pyelogram+tomography (74415) | $1,041.60 | $1,488 | 6.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $237.30 | $339 | 2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $116.20 | $166 | 1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $282.80 | $404 | 2.8× |
| X-ray nose-rectum child f.b. (76010) | $201.60 | $288 | 2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $403.20 | $576 | 4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $343.70 | $491 | 3.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $184.80 | $264 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $228.20 | $326 | 2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $378 | $540 | 4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $468.30 | $669 | 4.7× |
| X-Ray Tmj Unilat (70328) | $104.30 | $149 | 1.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $515.20 | $736 | 1.5× |
| X-Rays Bone Length Studies (77073) | $305.90 | $437 | 3.1× |
| X-Rays Bone Survey Complete (77075) | $275.80 | $394 | 2.8× |
| Xr c-spine 4 or 5 views (72050) | $525.70 | $751 | 5.3× |
| Xr facial bones less than 3 views (70140) | $206.50 | $295 | 2.5× |
| Xr orbits complete 4 views (70200) | $385.70 | $551 | 3.9× |
| Xr Tomogram Single Plane (76100) | $707.70 | $1,011 | 7.1× |
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.