Imaging prices at Sauk Prairie Hospital
Prairie Du Sac, WI · every code in this section with a posted price and a Medicare benchmark.
245 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) | $233.57 | $427 | 2.8× |
| Abdomen 2 views (74019) | $312.34 | $571 | 3.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,206.41 | $2,205.50 | 3.1× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$29.82–$239.04 | $54.50–$437 | varies |
| Arthrogram ankle (73615) | $513.64 | $939 | 1.5× |
| Arthrogram hip (73525) | $726.69 | $1,328.50 | 2.1× |
| Arthrogram Wrist (73115) | $605.53 | $1,107 | 1.8× |
| Bone age studies (77072) | $191.18 | $349.50 | 1.9× |
| Bone Imaging 3 Phase (78315) | $1,353.01 | $2,473.50 | 3.5× |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$921.15–$1,100.30 | $1,684–$2,011.50 | varies |
| Bone Imaging Whole Body (78306) | $1,291.20 | $2,360.50 | 3.3× |
| Bone survey infant (77076) | $661.60 | $1,209.50 | 6.5× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$230.02–$234.39 | $420.50–$428.50 | varies |
| Chest 2 views (71046) | $278.97 | $510 | 3.3× |
| Chest 3 views (71047) | $310.43 | $567.50 | 3.7× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$25.99–$265.30 | $47.50–$485 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $250.26 | $457.50 | 2.5× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$45.95–$509.26 | $84–$931 | varies |
| Contrast X-Ray Of Elbow (73085) | $616.47 | $1,127 | 1.8× |
| Contrast X-Ray Of Knee Joint (73580) | $513.64 | $939 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) | $4,559.25 | $8,335 | 13.5× |
| CT abdomen and pelvis without contrast (74176) | $3,766.65 | $6,886 | 16.3× |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$2,177.06–$3,766.65 | $3,980–$6,886 | varies |
| CT abdomen w wo contrast (74170) | $2,545.74 | $4,654 | 14.9× |
| CT abdomen w/o contrast (74150) | $1,896.45 | $3,467 | 18.7× |
| CT Angio Abdomen and Pelvis (74174) | $3,857.18 | $7,051.50 | 11.4× |
| CT Angio Chest (71275) | $3,857.18 | $7,051.50 | 22.6× |
| CT Angio Head (70496) | $3,857.18 | $7,051.50 | 22.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,772.20 | $5,068 | 16.3× |
| CT Angio Neck (70498) | $3,857.18 | $7,051.50 | 22.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,772.20 | $5,068 | 16.3× |
| CT cervical spine w/ contrast (72126) | $2,200.86 | $4,023.50 | 6.5× |
| CT cervical spine w/o contrast (72125) | $1,896.45 | $3,467 | 18.7× |
| CT cervical spine w/wo cont (72127) | $2,217.27 | $4,053.50 | 13.0× |
| CT chest w contrast (71260) | $2,054.81 | $3,756.50 | 12.1× |
| CT chest w/wo contrast (71270) | $2,215.35 | $4,050 | 13.0× |
| CT head/brain with contrast (70460) | $2,130.84 | $3,895.50 | 12.5× |
| CT head/brain without and with contrast (70470) | $2,128.11 | $3,890.50 | 12.5× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,765.99–$1,823.43 | $3,228.50–$3,333.50 | varies |
| CT l-spine w&w/o contrast (72133) | $2,217.27 | $4,053.50 | 13.0× |
| CT lower ext w/o (73700) | $1,704.46 | $3,116 | 16.8× |
| CT lower extremity w/contrast material (73701) | $1,970.30 | $3,602 | 11.6× |
| CT lumbar spine w contrast (72132) | $1,880.32 | $3,437.50 | 5.5× |
| CT lumbar spine w/o contrast (72131) | $1,896.45 | $3,467 | 18.7× |
| CT maxillofacial w contrast (70487) | $1,850.51 | $3,383 | 10.9× |
| CT maxillofacial wo contrast (70486) | $1,823.43 | $3,333.50 | 18.0× |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,999.02–$2,172.14 | $3,654.50–$3,971 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$2,128.11–$2,133.30 | $3,890.50–$3,900 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,704.46–$1,823.43 | $3,116–$3,333.50 | varies |
| CT pelvis w&w/o contrast (72194) | $2,215.35 | $4,050 | 13.0× |
| CT pelvis w/o contrast (72192) | $1,880.32 | $3,437.50 | 18.5× |
| CT scan of leg combo (73702) | $2,185 | $3,994.50 | 12.8× |
| CT scans face/jaw combo (70488) | $2,139.32 | $3,911 | 12.6× |
| CT soft tissue neck w contrast (70491) | $1,719.77 | $3,144 | 10.1× |
| CT soft tissue neck w/o contrast (70490) | $1,582.75 | $2,893.50 | 15.6× |
| CT thoracic spine w contrast (72129) | $1,880.32 | $3,437.50 | 11.0× |
| CT thoracic spine w/o contrast (72128) | $1,908.49 | $3,489 | 18.8× |
| CT thoracic spine w/wo cont (72130) | $2,217.27 | $4,053.50 | 13.0× |
| CT thorax w/o contrast (71250) | $1,880.32 | $3,437.50 | 18.5× |
| CT upper ext wo (73200) range across 6 matching MRF lines |
$1,448.73–$1,704.46 | $2,648.50–$3,116 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $2,258.29 | $4,128.50 | 13.3× |
| CT upper extremity with contrast (73201) | $1,704.46 | $3,116 | 5.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,857.18 | $7,051.50 | 22.6× |
| Cta Abdomen (74175) | $3,857.18 | $7,051.50 | 22.6× |
| CTA pelvis (72191) | $3,857.18 | $7,051.50 | 22.6× |
| Dxa Bone Density Axial (77080) | $368.14 | $673 | 3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $187.63 | $343 | 2.2× |
| Esophagram (74220) | $491.48 | $898.50 | 2.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,105.77 | $2,021.50 | 10.9× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$28.72–$420.10 | $52.50–$768 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$27.63–$212.79 | $50.50–$389 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$33.92–$285.54 | $62–$522 | varies |
| Gastric emptying imaging study (78264) | $1,142.14 | $2,088 | 2.9× |
| Gated Heart Planar Single (78472) | $1,191.92 | $2,179 | 3.1× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$25.71–$231.93 | $47–$424 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,307.33 | $2,390 | 2.5× |
| Hepatobiliary System Imaging (78226) | $1,046.42 | $1,913 | 2.7× |
| Ht Muscle Image Spect Sing (78451) | $1,997.38 | $3,651.50 | 1.6× |
| Hysterosalpingogram (74740) | $589.67 | $1,078 | 2.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $563.41 | $1,030 | 6.7× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$44.31–$231.93 | $81–$424 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,180.70–$1,235.13 | $2,158.50–$2,258 | varies |
| K Flow/Funct Image W/O Drug (78707) | $1,000.74 | $1,829.50 | 1.9× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$42.12–$271.86 | $77–$497 | varies |
| Liver & Spleen Imaging Static Only (78215) | $936.20 | $1,711.50 | 2.4× |
| Liver imaging static only (78201) | $936.20 | $1,711.50 | 1.8× |
| Lung Ventilat&Perfus Imaging (78582) | $2,190.47 | $4,004.50 | 4.2× |
| Lung Ventilation Imaging (78579) | $1,095.92 | $2,003.50 | 2.8× |
| Lymph System Imaging (78195) | $1,242.52 | $2,271.50 | 2.4× |
| Magnetic Image Jaw Joint (70336) | $2,173.78 | $3,974 | 9.4× |
| Mammary ductogram or galactogram multiple (77054) | $726.42 | $1,328 | 3.1× |
| Mammary ductogram or galactogram single (77053) | $552.47 | $1,010 | 2.4× |
| Meckels Divert Exam (78290) | $754.32 | $1,379 | 1.9× |
| Mra Head W/O & W/Contrast Material (70546) | $3,307.44 | $6,046.50 | 9.8× |
| MRA head w/o contrast (70544) | $2,377.27 | $4,346 | 10.3× |
| MRA head with contrast (70545) | $2,377.27 | $4,346 | 7.0× |
| MRA neck w contrast (70548) | $2,619.86 | $4,789.50 | 7.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,307.44 | $6,046.50 | 9.8× |
| MRA neck w/o contrast (70547) | $2,377.27 | $4,346 | 10.3× |
| MRI abdomen w contrast (74182) | $2,572 | $4,702 | 7.6× |
| MRI abdomen w/o contrast (74181) | $2,565.43 | $4,690 | 11.1× |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$1,716.22–$2,377.27 | $3,137.50–$4,346 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$2,099.66–$2,651.86 | $3,838.50–$4,848 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,377.27 | $4,346 | 3.1× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,377.27 | $4,346 | 10.3× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,188.91 | $2,173.50 | 5.1× |
| MRI cervical spine w contrast (72142) | $2,293.85 | $4,193.50 | 6.8× |
| MRI cervical spine w/o cont (72141) | $2,450.29 | $4,479.50 | 10.6× |
| MRI chest w/o contrast (71550) | $2,377.27 | $4,346 | 10.3× |
| MRI chest with contrast (71551) | $2,377.27 | $4,346 | 3.1× |
| MRI chest wo w contrast (71552) | $2,523.86 | $4,614 | 7.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,040.78 | $5,559 | 9.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,125.84 | $5,714.50 | 9.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,040.78 | $5,559 | 13.1× |
| MRI lumbar spine w contrast (72149) | $2,450.29 | $4,479.50 | 7.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,661.90 | $6,694.50 | 10.8× |
| MRI orbit face &/neck w/o contrast (70540) | $2,707.38 | $4,949.50 | 11.7× |
| MRI orbit face neck w contrast (70542) | $2,238.33 | $4,092 | 6.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,307.44 | $6,046.50 | 9.8× |
| MRI pelvis w contrast (72196) | $2,377.27 | $4,346 | 7.0× |
| MRI pelvis w/o & w contrast (72197) | $2,593.61 | $4,741.50 | 7.7× |
| MRI pelvis w/o contrast (72195) | $2,377.27 | $4,346 | 10.3× |
| MRI thoracic spine w/o contrast (72146) | $2,450.29 | $4,479.50 | 10.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,377.27 | $4,346 | 7.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,377.27 | $4,346 | 10.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,330.69 | $6,089 | 9.8× |
| MRI, abdomen, combo (74183) | $2,652.41 | $4,849 | 7.8× |
| MRI, dorsal spine combo (72157) | $3,330.69 | $6,089 | 9.8× |
| MRI, dorsal spine contrast (72147) | $2,450.29 | $4,479.50 | 7.2× |
| MRI, joint upper extrem (73221) | $2,377.27 | $4,346 | 10.3× |
| MRI, joint upper extrem combo (73223) | $2,705.19 | $4,945.50 | 8.0× |
| MRI, lumbar spine combo (72158) | $3,629.62 | $6,635.50 | 10.7× |
| Myelogram cervical (72240) | $771.27 | $1,410 | 1.0× |
| Myelography thoracic (72255) | $771.27 | $1,410 | 1.0× |
| Myocardial Spect Multiple Studies (78452) | $3,198.86 | $5,848 | 2.5× |
| Neck soft tissue (70360) | $239.59 | $438 | 2.8× |
| Parathyroid Planar Imaging (78070) | $970.93 | $1,775 | 2.5× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$39.94–$252.45 | $73–$461.50 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,095.92 | $2,003.50 | 2.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $563.41 | $1,030 | 5.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $675.82 | $1,235.50 | 1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$35.83–$288 | $65.50–$526.50 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$31.18–$240.96 | $57–$440.50 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$32.55–$284.99 | $59.50–$521 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $368.96 | $674.50 | 3.6× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$31.18–$223.73 | $57–$409 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$38.29–$284.99 | $70–$521 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$41.30–$285.54 | $75.50–$522 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $284.99 | $521 | 3.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $380.44 | $695.50 | 3.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $272.68 | $498.50 | 3.2× |
| Radex Ribs Unilateral 2 Views (71100) | $365.40 | $668 | 4.3× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$32.82–$288 | $60–$526.50 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $242.60 | $443.50 | 2.9× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$22.43–$242.60 | $41–$443.50 | varies |
| Radex Sternum Minimum 2 Views (71120) | $439.25 | $803 | 5.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $546.73 | $999.50 | 6.5× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$26.53–$223.73 | $48.50–$409 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $285.54 | $522 | 2.8× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$39.12–$378.26 | $71.50–$691.50 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $439.25 | $803 | 4.3× |
| Radiologic exam colon double contrast study (74280) | $813.39 | $1,487 | 4.8× |
| Radiologic exam colon single contrast study (74270) | $516.10 | $943.50 | 3.0× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$38.84–$324.92 | $71–$594 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$52.24–$275.97 | $95.50–$504.50 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$703.72–$1,229.66 | $1,286.50–$2,248 | varies |
| Radiologic exam swallow function contrast study (74230) | $515.55 | $942.50 | 3.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $830.62 | $1,518.50 | 4.9× |
| Radiologic examination femur 1 view (73551) | $236.86 | $433 | 2.8× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$25.17–$284.99 | $46–$521 | varies |
| Radiologic examination knee 1/2 views (73560) range across 9 matching MRF lines |
$41.58–$560.68 | $76–$1,025 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$21.34–$284.99 | $39–$521 | varies |
| Ribs bilateral 3 views (71110) | $645.74 | $1,180.50 | 6.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,537.07–$1,576.19 | $2,810–$2,881.50 | varies |
| Scapula (73010) range across 4 matching MRF lines |
$23.25–$324.92 | $42.50–$594 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $25.71 | $47 | 1.1× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$25.71–$231.11 | $47–$422.50 | varies |
| Shoulder Arthrography (73040) | $726.69 | $1,328.50 | 2.1× |
| Skull less than 4 views (70250) | $340.51 | $622.50 | 3.4× |
| Sternoclavicular joints (71130) | $334.50 | $611.50 | 4.0× |
| Testicular Imaging W/Flow (78761) | $718.22 | $1,313 | 1.8× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$46.23–$403.42 | $84.50–$737.50 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$29.54–$282.26 | $54–$516 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $1,001.01 | $1,830 | 2.6× |
| Thyroid Uptake Measurement (78012) | $335.86 | $614 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $934.28 | $1,708 | 2.4× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$495.04–$987.89 | $905–$1,806 | varies |
| Ultrasound Exam Aaa Screen (76706) | $695.24 | $1,271 | 6.8× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$709.46–$826.52 | $1,297–$1,511 | varies |
| Unlisted us procedure (76999) | $117.34 | $214.50 | 1.4× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$728.06–$911.03 | $1,331–$1,665.50 | varies |
| Urethrocystogram voiding (74455) | $545.91 | $998 | 2.4× |
| Urethrocystography retrograde (74450) | $509.26 | $931 | 2.2× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$688.13–$1,373.25 | $1,258–$2,510.50 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$461.13–$553.57 | $843–$1,012 | varies |
| Us complete joint (76881) range across 8 matching MRF lines |
$99.56–$691.96 | $182–$1,265 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$76.31–$502.70 | $139.50–$919 | varies |
| Us head (76506) range across 2 matching MRF lines |
$396.58–$439.52 | $725–$803.50 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 8 matching MRF lines |
$40.21–$491.21 | $73.50–$898 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$265.03–$508.44 | $484.50–$929.50 | varies |
| Us ob transvaginal (76817) | $366.22 | $669.50 | 3.6× |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$699.89–$839.92 | $1,279.50–$1,535.50 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $731.34 | $1,337 | 7.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $731.34 | $1,337 | 7.2× |
| Us retroperitoneal complete (76770) | $649.29 | $1,187 | 6.4× |
| Us retroperitoneal limited (76775) | $712.20 | $1,302 | 7.0× |
| Us scrotum and contents (76870) | $741.19 | $1,355 | 7.3× |
| Us spinal canal and contents (76800) | $489.30 | $894.50 | 4.8× |
| Us thyroid (76536) range across 2 matching MRF lines |
$705.36–$826.52 | $1,289.50–$1,511 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$105.85–$485.74 | $193.50–$888 | varies |
| Vascular Flow Imaging (78445) | $329.03 | $601.50 | 0.8× |
| Vertebral fracture assessment via dxa (77086) | $374.97 | $685.50 | 4.4× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$33.10–$240.68 | $60.50–$440 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$26.53–$346.80 | $48.50–$634 | varies |
| X-ray antegrade pyelogram tube (74425) | $886.69 | $1,621 | 2.6× |
| X-Ray Bend Only L-S Spine (72120) | $502.15 | $918 | 4.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$36.65–$239.04 | $67–$437 | varies |
| X-Ray Exam Breast Specimen (76098) | $191.73 | $350.50 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $275.42 | $503.50 | 3.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $360.48 | $659 | 3.5× |
| X-Ray Exam Hip Uni 1 View (73501) range across 6 matching MRF lines |
$24.89–$658.59 | $45.50–$1,204 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 8 matching MRF lines |
$29.54–$658.59 | $54–$1,204 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 6 matching MRF lines |
$24.89–$698.80 | $45.50–$1,277.50 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 4 matching MRF lines |
$39.12–$658.59 | $71.50–$1,204 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$40.76–$425.02 | $74.50–$777 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $697.43 | $1,275 | 6.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$42.67–$370.87 | $78–$678 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $446.08 | $815.50 | 4.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $416.55 | $761.50 | 4.1× |
| X-ray eye for foreign body (70030) | $259.01 | $473.50 | 3.1× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$35.56–$284.99 | $65–$521 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$23.25–$228.10 | $42.50–$417 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$45.41–$396.03 | $83–$724 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $470.15 | $859.50 | 4.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $520.20 | $951 | 5.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $288.27 | $527 | 2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$21.61–$282.26 | $39.50–$516 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $360.48 | $659 | 4.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $417.37 | $763 | 4.1× |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$119.25–$152.62 | $218–$279 | varies |
| X-Ray Tmj Unilat (70328) | $142.50 | $260.50 | 1.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$50.06–$477.54 | $91.50–$873 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$44.04–$360.48 | $80.50–$659 | varies |
| X-Rays Bone Survey Complete (77075) | $660.78 | $1,208 | 6.5× |
| Xr c-spine 4 or 5 views (72050) | $446.08 | $815.50 | 4.4× |
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.