24 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|
| Abdomen 2 views (74019) |
$222.60 |
$318 |
2.1× |
| Chest 1 view (71045) |
$157.50 |
$225 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,925 |
$2,750 |
5.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,102.50 |
$1,575 |
4.6× |
| CT c-spine w/o contrast (72125) |
$528.50 |
$755 |
5.0× |
| CT chest with contrast (71260) |
$1,295 |
$1,850 |
7.3× |
| CT maxillofacial w/o contrast (70486) |
$1,050 |
$1,500 |
10.0× |
| CT thorax w/o contrast (71250) |
$822.50 |
$1,175 |
7.8× |
| CTA abdomen pelvis (74174) |
$2,310 |
$3,300 |
6.6× |
| CTA chest (71275) |
$857.50 |
$1,225 |
4.9× |
| Hand 3 views (73130) |
$210 |
$300 |
2.4× |
| Knee 3 views (73562) |
$227.50 |
$325 |
2.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$210 |
$300 |
2.4× |
| Us soft tissue head/neck (76536) |
$490 |
$700 |
4.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$227.50 |
$325 |
2.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$178.50 |
$255 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$192.50 |
$275 |
2.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$210 |
$300 |
2.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$292.60 |
$418 |
2.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$330.40 |
$472 |
3.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$210 |
$300 |
2.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$210 |
$300 |
2.4× |
| Xr finger(s) 2+ views (73140) |
$158.90 |
$227 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$238 |
$340 |
2.3× |