Imaging prices at Savoy Medical Center
Mamou, LA · every code in this section with a posted price and a Medicare benchmark.
236 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $1,973.29 | $3,288.81 | 1.6× |
| Abdomen 1 View (74018) | $167.53 | $279.21 | 2.1× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$355.69–$381.53 | $592.81–$635.88 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,391.81 | $2,319.69 | 3.8× |
| Ankle 2 views (73600) | $245.15 | $408.59 | 3.1× |
| Basic radiation dosimetry calculation (77300) | $387.16 | $645.27 | 3.2× |
| Bone age studies (77072) | $605.62 | $1,009.37 | 6.4× |
| Bone Imaging 3 Phase (78315) | $1,196.35 | $1,993.92 | 3.3× |
| Bone Imaging Limited Area (78300) | $848.32 | $1,413.87 | 2.3× |
| Bone Imaging Whole Body (78306) | $1,132.16 | $1,886.94 | 3.1× |
| Bone survey infant (77076) | $637.49 | $1,062.48 | 6.7× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$217.15–$251.76 | $361.92–$419.60 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$294.03–$324.37 | $490.05–$540.62 | varies |
| Chest 3 views (71047) | $319.09 | $531.81 | 4.0× |
| Chest 4 or more views (71048) | $319.09 | $531.81 | 3.4× |
| Cholecystography Oral Contrast (74290) | $277.36 | $462.27 | 1.7× |
| Clavicle complete (73000) | $214.78 | $357.97 | 2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $630 | $1,050 | 6.7× |
| Continuing medical physics consltj pr wk (77336) | $302.50 | $504.17 | 2.5× |
| Contrast X-Ray Bladder (74430) | $280.83 | $468.05 | 0.9× |
| CT abdomen and pelvis without and with contrast (74178) | $3,521.69 | $5,869.48 | 11.1× |
| CT abdomen and pelvis without contrast (74176) | $3,080.05 | $5,133.42 | 14.3× |
| CT abdomen w contrast (74160) | $1,758.78 | $2,931.30 | 11.1× |
| CT abdomen w wo contrast (74170) | $1,878.74 | $3,131.24 | 11.8× |
| CT abdomen w/o contrast (74150) | $1,643.11 | $2,738.52 | 17.4× |
| CT Angio Abdomen and Pelvis (74174) | $2,602.01 | $4,336.69 | 8.2× |
| CT Angio Chest (71275) | $1,636.83 | $2,728.05 | 10.3× |
| CT Angio Head (70496) | $1,654.49 | $2,757.49 | 10.4× |
| CT Angio Neck (70498) | $1,567.54 | $2,612.56 | 9.9× |
| CT cervical spine w/ contrast (72126) | $1,813.43 | $3,022.38 | 5.7× |
| CT cervical spine w/o contrast (72125) | $1,766.44 | $2,944.06 | 18.7× |
| CT cervical spine w/wo cont (72127) | $1,813.43 | $3,022.38 | 11.4× |
| CT chest w contrast (71260) | $1,758.78 | $2,931.30 | 11.1× |
| CT chest w/wo contrast (71270) | $1,878.74 | $3,131.24 | 11.8× |
| CT head/brain with contrast (70460) | $1,839.02 | $3,065.04 | 11.6× |
| CT head/brain without and with contrast (70470) | $1,829.59 | $3,049.32 | 11.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $60 | $100 | 0.8× |
| CT iac w contrast (70481) | $2,161.24 | $3,602.07 | 13.6× |
| CT l-spine w&w/o contrast (72133) | $2,005 | $3,341.66 | 12.6× |
| CT lower ext w/o (73700) | $1,562.69 | $2,604.49 | 16.5× |
| CT lower extremity w/contrast material (73701) | $1,643.11 | $2,738.52 | 10.3× |
| CT lumbar spine w contrast (72132) | $2,158.05 | $3,596.75 | 6.8× |
| CT lumbar spine w/o contrast (72131) | $1,997.88 | $3,329.80 | 21.1× |
| CT maxillofacial w contrast (70487) | $1,776.02 | $2,960.03 | 11.2× |
| CT maxillofacial wo contrast (70486) | $1,730.22 | $2,883.70 | 18.3× |
| CT neck tissue combo (70492) | $1,730.22 | $2,883.70 | 10.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,314.04 | $3,856.73 | 14.6× |
| CT orbits w/o contrast (70480) | $1,625.01 | $2,708.35 | 17.2× |
| CT pelvis w&w/o contrast (72194) | $1,642.94 | $2,738.24 | 10.3× |
| CT pelvis w/o contrast (72192) | $1,436.77 | $2,394.62 | 15.2× |
| CT scan of leg combo (73702) | $1,758.78 | $2,931.30 | 11.1× |
| CT scans face/jaw combo (70488) | $1,685.62 | $2,809.37 | 10.6× |
| CT soft tissue neck w contrast (70491) | $1,813.43 | $3,022.38 | 11.4× |
| CT soft tissue neck w/o contrast (70490) | $1,605.70 | $2,676.17 | 17.0× |
| CT thoracic spine w contrast (72129) | $1,652.54 | $2,754.23 | 10.4× |
| CT thoracic spine w/o contrast (72128) | $1,362.92 | $2,271.53 | 14.4× |
| CT thoracic spine w/wo cont (72130) | $2,005 | $3,341.66 | 12.6× |
| CT thorax w/o contrast (71250) | $1,643.11 | $2,738.52 | 17.4× |
| CT upper ext wo (73200) | $1,562.69 | $2,604.49 | 16.5× |
| CT upper extremity w/o & w/contrast material (73202) | $1,758.78 | $2,931.30 | 11.1× |
| CT upper extremity with contrast (73201) | $1,643.11 | $2,738.52 | 5.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,733.13 | $2,888.55 | 10.9× |
| Cta Abdomen (74175) | $1,540.36 | $2,567.26 | 9.7× |
| CTA pelvis (72191) | $1,636.83 | $2,728.05 | 10.3× |
| Dxa Bone Density Axial (77080) | $379.80 | $633 | 4.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $379.80 | $633 | 4.8× |
| Esophagram (74220) | $280.83 | $468.05 | 1.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $841.93 | $1,403.22 | 8.9× |
| Fluoroscopy up to 1 hr (76000) | $341.37 | $568.95 | 1.6× |
| Forearm 2 views (73090) | $214.78 | $357.97 | 2.7× |
| Gastric emptying imaging study (78264) | $1,256.68 | $2,094.46 | 3.5× |
| Gated Heart Planar Single (78472) | $1,394.08 | $2,323.47 | 3.9× |
| Heart first pass single,planar (78481) | $817.84 | $1,363.07 | 1.7× |
| Hepatobil Syst Image W/Drug (78227) | $1,603.42 | $2,672.37 | 3.3× |
| Hepatobiliary System Imaging (78226) | $1,603.42 | $2,672.37 | 4.4× |
| Hysterosalpingogram (74740) | $655.11 | $1,091.85 | 3.0× |
| Infusion Ivp (74410) | $582.30 | $970.50 | 3.7× |
| K Flow/Funct Image W/Drug (78708) | $1,637.29 | $2,728.81 | 3.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,263.61 | $2,106.02 | 3.5× |
| Knee 3 Views (73562) | $242.25 | $403.75 | 3.1× |
| Liver & Spleen Imaging Static Only (78215) | $990.73 | $1,651.21 | 2.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,389.40 | $2,315.67 | 3.8× |
| Lung Ventilat&Perfus Imaging (78582) | $2,570.60 | $4,284.33 | 5.2× |
| Lung Ventilation Imaging (78579) | $1,183.45 | $1,972.41 | 3.3× |
| Lymph System Imaging (78195) | $2,647.36 | $4,412.27 | 5.4× |
| Magnetic Image Jaw Joint (70336) | $1,699.41 | $2,832.35 | 7.9× |
| Meckels Divert Exam (78290) | $788.48 | $1,314.14 | 2.2× |
| Mlc imrt design & construction per imrt plan (77338) | $1,369.67 | $2,282.78 | 4.0× |
| MRA head w/o contrast (70544) | $1,923.92 | $3,206.54 | 8.9× |
| MRA neck w/o contrast (70547) | $1,849.60 | $3,082.66 | 8.6× |
| MRI abdomen w contrast (74182) | $1,699.41 | $2,832.35 | 5.4× |
| MRI abdomen w/o contrast (74181) | $1,451.74 | $2,419.57 | 6.7× |
| MRI any jt lower extrem w/contrast material (73722) | $1,930.70 | $3,217.84 | 2.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,967.04 | $3,278.40 | 6.2× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 6 matching MRF lines |
$1,785.38–$2,240.13 | $2,975.64–$3,733.55 | varies |
| MRI cervical spine w contrast (72142) | $2,578.01 | $4,296.69 | 8.2× |
| MRI cervical spine w/o cont (72141) | $2,365.56 | $3,942.60 | 10.9× |
| MRI chest w/o contrast (71550) | $1,528.51 | $2,547.51 | 7.1× |
| MRI chest with contrast (71551) | $1,788.11 | $2,980.18 | 2.5× |
| MRI chest wo w contrast (71552) | $2,421.11 | $4,035.19 | 7.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,699.41 | $2,832.35 | 5.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,299.83 | $3,833.05 | 7.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,451.74 | $2,419.57 | 6.7× |
| MRI lumbar spine w contrast (72149) | $2,212.49 | $3,687.48 | 7.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,778.96 | $4,631.60 | 8.8× |
| MRI orbit face &/neck w/o contrast (70540) | $1,941.41 | $3,235.69 | 9.0× |
| MRI orbit face neck w contrast (70542) | $2,272.93 | $3,788.22 | 7.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,076.49 | $5,127.48 | 9.7× |
| MRI pelvis w contrast (72196) | $1,699.41 | $2,832.35 | 5.4× |
| MRI pelvis w/o & w contrast (72197) | $2,299.83 | $3,833.05 | 7.3× |
| MRI pelvis w/o contrast (72195) | $1,451.74 | $2,419.57 | 6.7× |
| MRI thoracic spine w/o contrast (72146) | $2,030.16 | $3,383.60 | 9.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,785.38 | $2,975.64 | 5.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,525.60 | $2,542.67 | 7.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,416.84 | $4,028.07 | 7.7× |
| MRI, abdomen, combo (74183) | $2,299.83 | $3,833.05 | 7.3× |
| MRI, dorsal spine combo (72157) | $2,384.95 | $3,974.92 | 7.5× |
| MRI, dorsal spine contrast (72147) | $2,212.49 | $3,687.48 | 7.0× |
| MRI, joint upper extrem (73221) range across 6 matching MRF lines |
$1,523.45–$2,055.74 | $2,539.08–$3,426.23 | varies |
| MRI, joint upper extrem combo (73223) | $2,416.84 | $4,028.07 | 7.7× |
| MRI, lumbar spine combo (72158) | $2,384.95 | $3,974.92 | 7.5× |
| Myelogram cervical (72240) | $1,211.14 | $2,018.57 | 1.7× |
| Myelogram Lumbar (72265) | $1,211.14 | $2,018.57 | 1.7× |
| Myelography thoracic (72255) | $1,211.14 | $2,018.57 | 1.7× |
| Myocardial Spect Multiple Studies (78452) | $3,355.37 | $5,592.28 | 2.9× |
| Neck soft tissue (70360) | $215.59 | $359.31 | 2.7× |
| Nonvascular Shunt X-Ray (75809) | $637.49 | $1,062.48 | 6.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,220.22 | $8,700.37 | 4.2× |
| Parathyroid Planar Imaging (78070) | $1,417.79 | $2,362.98 | 3.9× |
| Pelvis 1 or 2 views (72170) | $275.68 | $459.47 | 2.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,088.78 | $1,814.63 | 3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $396.19 | $660.31 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) | $245.15 | $408.59 | 3.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $214.78 | $357.97 | 2.7× |
| Radex elbow complete minimum 3 views (73080) | $245.15 | $408.59 | 3.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $275.68 | $459.47 | 2.9× |
| Radex fingr minimum 2 views (73140) | $181.34 | $302.23 | 2.3× |
| Radex foot complete minimum 3 views (73630) | $214.78 | $357.97 | 2.7× |
| Radex Hand Minimum 3 Views (73130) | $214.78 | $357.97 | 2.7× |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$214.78–$242.25 | $357.97–$403.75 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $334.19 | $556.99 | 3.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $181.34 | $302.23 | 2.3× |
| Radex shoulder complete minimum 2 views (73030) | $260.50 | $434.16 | 3.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $275.68 | $459.47 | 3.5× |
| Radex Spine 1 View Specify Level (72020) | $227.92 | $379.86 | 2.9× |
| Radex Sternum Minimum 2 Views (71120) | $214.78 | $357.97 | 2.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $334.19 | $556.99 | 4.2× |
| Radex Toe Minimum 2 Views (73660) | $181.34 | $302.23 | 2.3× |
| Radex upper extremity infant minimum 2 views (73092) | $214.78 | $357.97 | 2.3× |
| Radex Wrist Complete Minimum 3 Views (73110) | $214.78 | $357.97 | 2.7× |
| Radiation treatment delivery level 1 (77402) | $1,150.11 | $1,916.85 | 12.4× |
| Radiation treatment delivery level 2 (77407) | $1,283.46 | $2,139.10 | 3.7× |
| Radiation treatment delivery level 3 (77412) | $1,289.32 | $2,148.86 | 2.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $275.68 | $459.47 | 2.9× |
| Radiologic exam colon double contrast study (74280) | $641.41 | $1,069.01 | 4.0× |
| Radiologic exam colon single contrast study (74270) | $640.76 | $1,067.94 | 4.0× |
| Radiologic exam knee complete 4/more views (73564) | $242.25 | $403.75 | 2.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $275.68 | $459.47 | 2.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $277.36 | $462.27 | 1.7× |
| Radiologic exam swallow function contrast study (74230) | $926.33 | $1,543.88 | 5.8× |
| Radiologic examination femur minimum 2 views (73552) | $242.25 | $403.75 | 3.1× |
| Radiologic examination knee 1/2 views (73560) | $214.78 | $357.97 | 2.7× |
| Radiologic Examination Salivary Gland Calculus (70380) | $288.55 | $480.92 | 3.7× |
| Radiologic examination tibia & fibula 2 views (73590) | $214.78 | $357.97 | 2.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,503.43 | $2,505.71 | 4.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,503.43 | $2,505.71 | 3.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 5 matching MRF lines |
$947.35–$1,803.72 | $1,578.91–$3,006.20 | varies |
| Scapula (73010) | $214.78 | $357.97 | 2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $41.58 | $69.30 | 1.8× |
| Sella turcica (70240) | $169.06 | $281.77 | 2.1× |
| Shoulder 1 view (73020) | $214.78 | $357.97 | 2.7× |
| Skull less than 4 views (70250) | $514.86 | $858.10 | 5.4× |
| Special dosimetry (77331) | $99.80 | $166.33 | 0.8× |
| Special Physics Consult (77370) | $605.51 | $1,009.18 | 5.0× |
| Special treatment procedure (77470) | $1,130.84 | $1,884.73 | 2.3× |
| Sternoclavicular joints (71130) | $214.78 | $357.97 | 2.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $438.01 | $730.01 | 1.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $438.01 | $730.01 | 1.3× |
| Testicular Imaging W/Flow (78761) | $720.26 | $1,200.44 | 2.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,247.39 | $3,745.65 | 6.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,403.05 | $2,338.42 | 4.1× |
| Ther rad simulaj-aided field setting simple (77280) | $781.88 | $1,303.13 | 6.4× |
| Thoracic spine 2 views (72070) | $280.97 | $468.29 | 3.0× |
| Thoracic spine 3 views (72072) | $290.02 | $483.36 | 3.1× |
| Thoracolumbar 2 views (72080) | $290.02 | $483.36 | 3.7× |
| Thyroid Uptake Measurement (78012) | $976.37 | $1,627.28 | 2.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,261.03 | $2,101.71 | 3.5× |
| Tx Devices Design & Construction Complex (77334) | $482.14 | $803.57 | 1.4× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$419.90–$1,320.47 | $699.84–$2,200.78 | varies |
| Ultrasound Exam Aaa Screen (76706) | $857.88 | $1,429.80 | 9.1× |
| Ultrasound, abdomen limited (76705) range across 6 matching MRF lines |
$654.92–$1,347.97 | $1,091.53–$2,246.61 | varies |
| Upper gi w/o kub (74240) | $499.88 | $833.13 | 3.1× |
| Urethrocystogram voiding (74455) | $276.89 | $461.49 | 1.3× |
| Us breast unilateral complete (76641) | $419.90 | $699.84 | 4.4× |
| Us chest (76604) | $555.87 | $926.45 | 5.9× |
| Us complete joint (76881) | $307.64 | $512.73 | 3.2× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$511.96–$1,320.47 | $853.27–$2,200.78 | varies |
| Us kidney transplant (76776) | $722.98 | $1,204.96 | 7.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $307.64 | $512.73 | 3.2× |
| Us ob limited 1 or more fetuses (76815) | $516.68 | $861.13 | 5.5× |
| Us ob transvaginal (76817) | $496.78 | $827.96 | 5.2× |
| Us pelvic non ob complete (76856) | $569.54 | $949.23 | 6.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $442.09 | $736.81 | 4.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $131.41 | $219.02 | 1.4× |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$722.98–$857.88 | $1,204.96–$1,429.80 | varies |
| Us scrotum and contents (76870) | $614.66 | $1,024.44 | 6.5× |
| Us thyroid (76536) range across 2 matching MRF lines |
$307.64–$338.32 | $512.73–$563.86 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $214.78 | $357.97 | 2.7× |
| X-Ray Bend Only L-S Spine (72120) | $327.72 | $546.20 | 3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $245.15 | $408.59 | 3.1× |
| X-Ray Exam Breast Specimen (76098) | $205.40 | $342.33 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $242.25 | $403.75 | 3.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $212.90 | $354.84 | 2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $275.68 | $459.47 | 3.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $289.51 | $482.51 | 3.1× |
| X-Ray Exam L-S Spine Bending (72114) | $600.67 | $1,001.12 | 6.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $229.96 | $383.27 | 2.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $554.95 | $924.92 | 5.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $389.13 | $648.55 | 4.1× |
| X-ray humerus (73060) | $214.78 | $357.97 | 2.7× |
| X-ray IV pyelogram (ivp) (74400) | $582.30 | $970.50 | 3.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $275.68 | $459.47 | 3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $242.25 | $403.75 | 3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $233.38 | $388.96 | 2.5× |
| X-ray nose-rectum child f.b. (76010) | $182.81 | $304.68 | 2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $442.53 | $737.55 | 4.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $275.68 | $459.47 | 2.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $275.68 | $459.47 | 3.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $275.68 | $459.47 | 3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $514.86 | $858.10 | 5.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $392.24 | $653.74 | 1.2× |
| X-Rays Bone Length Studies (77073) | $637.49 | $1,062.48 | 6.7× |
| X-Rays Bone Survey Complete (77075) | $637.49 | $1,062.48 | 6.7× |
| Xr c-spine 4 or 5 views (72050) | $334.19 | $556.99 | 3.5× |
| Xr facial bones less than 3 views (70140) | $232.19 | $386.98 | 2.9× |
| Xr orbits complete 4 views (70200) | $334.19 | $556.99 | 3.5× |
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.