Imaging prices at Southwest Memorial Hospital
Cortez, CO · every code in this section with a posted price and a Medicare benchmark.
259 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) | $90 | $180 | 1.0× |
| Abdomen 2 views (74019) | $120 | $240 | 1.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $950 | $1,899 | 2.3× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $822 | $1,644 | 0.6× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$66–$70 | $131–$140 | varies |
| Arthrogram ankle (73615) | $299 | $597 | 0.8× |
| Arthrogram hip (73525) | $334 | $668 | 0.9× |
| Arthrogram Wrist (73115) | $328 | $655 | 0.9× |
| Bone Imaging Limited Area (78300) | $520 | $1,040 | 1.2× |
| Bone Imaging Whole Body (78306) | $788 | $1,576 | 1.9× |
| Cerebrospinal Fluid Scan (78630) | $850 | $1,700 | 1.5× |
| Chest 1 view (71045) | $84 | $168 | 0.9× |
| Chest 2 views (71046) | $118 | $236 | 1.3× |
| Chest 3 views (71047) | $195 | $389 | 2.1× |
| Chest 4 or more views (71048) | $230 | $459 | 2.1× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$78–$108 | $155–$216 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $827 | $1,653 | 7.5× |
| Contrast X-Ray Bladder (74430) | $329 | $657 | 0.9× |
| Contrast X-Ray Of Elbow (73085) | $290 | $579 | 0.8× |
| Contrast X-Ray Of Knee Joint (73580) | $360 | $719 | 1.0× |
| Contrast Xray Throat/Cerv Esopha (74210) | $209 | $418 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) | $2,117 | $4,234 | 5.8× |
| CT abdomen and pelvis without contrast (74176) | $1,407 | $2,814 | 5.6× |
| CT abdomen w contrast (74160) | $1,191 | $2,381 | 6.4× |
| CT abdomen w wo contrast (74170) | $1,448 | $2,896 | 7.8× |
| CT abdomen w/o contrast (74150) | $928 | $1,855 | 8.4× |
| CT Angio Abdomen and Pelvis (74174) | $476 | $951 | 1.3× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,149–$1,207 | $2,298–$2,413 | varies |
| CT Angio Head (70496) | $1,762 | $3,524 | 9.5× |
| CT angio hrt w/3d image (75574) | $1,400 | $2,799 | 3.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,732 | $3,464 | 9.4× |
| CT Angio Neck (70498) | $1,632 | $3,263 | 8.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,735 | $3,470 | 9.4× |
| CT cervical spine w/ contrast (72126) | $1,143 | $2,286 | 3.1× |
| CT cervical spine w/o contrast (72125) | $1,012 | $2,023 | 9.2× |
| CT cervical spine w/wo cont (72127) | $1,220 | $2,440 | 6.6× |
| CT chest w contrast (71260) | $1,207 | $2,413 | 6.5× |
| CT chest w/wo contrast (71270) | $1,232 | $2,464 | 6.7× |
| CT head/brain with contrast (70460) | $1,083 | $2,165 | 5.9× |
| CT head/brain without and with contrast (70470) | $1,261 | $2,521 | 6.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $234 | $467 | 2.5× |
| CT iac w contrast (70481) | $1,200 | $2,399 | 6.5× |
| CT l-spine w&w/o contrast (72133) | $1,219 | $2,437 | 6.6× |
| CT lower ext w/o (73700) | $714 | $1,428 | 6.5× |
| CT lower extremity w/contrast material (73701) | $875 | $1,750 | 4.7× |
| CT lumbar spine w contrast (72132) | $962 | $1,923 | 2.6× |
| CT lumbar spine w/o contrast (72131) | $945 | $1,889 | 8.6× |
| CT maxillofacial w contrast (70487) | $918 | $1,835 | 5.0× |
| CT maxillofacial wo contrast (70486) | $935 | $1,870 | 8.5× |
| CT neck tissue combo (70492) | $1,136 | $2,272 | 6.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,407 | $2,814 | 7.6× |
| CT orbits w/o contrast (70480) | $1,027 | $2,053 | 9.3× |
| CT pelvis w&w/o contrast (72194) | $1,136 | $2,272 | 6.1× |
| CT pelvis w/o contrast (72192) | $928 | $1,855 | 8.4× |
| CT scan of leg combo (73702) | $1,167 | $2,334 | 6.3× |
| CT scans face/jaw combo (70488) | $1,152 | $2,304 | 6.2× |
| CT soft tissue neck w contrast (70491) | $1,088 | $2,175 | 5.9× |
| CT soft tissue neck w/o contrast (70490) | $745 | $1,489 | 6.8× |
| CT thoracic spine w contrast (72129) | $998 | $1,995 | 5.4× |
| CT thoracic spine w/o contrast (72128) | $795 | $1,589 | 7.2× |
| CT thoracic spine w/wo cont (72130) | $1,218 | $2,435 | 6.6× |
| CT thorax w/o contrast (71250) | $827 | $1,653 | 7.5× |
| CT upper ext wo (73200) | $872 | $1,743 | 7.9× |
| CT upper extremity w/o & w/contrast material (73202) | $1,158 | $2,315 | 6.3× |
| CT upper extremity with contrast (73201) | $886 | $1,771 | 2.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,796 | $3,591 | 9.7× |
| Cta Abdomen (74175) | $1,677 | $3,354 | 9.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $472 | $943 | 1.3× |
| CTA pelvis (72191) | $1,195 | $2,390 | 6.5× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $310 | $620 | 1.2× |
| Dxa Bone Density Axial (77080) | $382 | $764 | 3.5× |
| Dxa bone density study (77085) | $364 | $728 | 3.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $327 | $653 | 3.6× |
| Echograp Trans R Pros Study (76873) | $471 | $942 | 4.3× |
| Esophagram (74220) | $346 | $692 | 1.9× |
| Fetal Biophys Profile W/Nst (76818) | $351 | $701 | 3.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$89–$326 | $177–$652 | varies |
| Fluoroscopy up to 1 hr (76000) | $314 | $628 | 1.2× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$58–$73 | $115–$145 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$78–$108 | $156–$216 | varies |
| Gastric emptying imaging study (78264) | $691 | $1,381 | 1.6× |
| Gated Heart Planar Single (78472) | $886 | $1,772 | 2.1× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$69–$89 | $137–$177 | varies |
| Hepatobiliary System Imaging (78226) | $898 | $1,796 | 2.1× |
| Ht Muscle Image Spect Sing (78451) | $1,350 | $2,700 | 1.0× |
| Hysterosalpingogram (74740) | $289 | $578 | 1.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $354 | $708 | 3.9× |
| Infusion Ivp (74410) | $158 | $316 | 0.9× |
| K Flow/Funct Image W/Drug (78708) | $686 | $1,371 | 1.2× |
| K Flow/Funct Image W/O Drug (78707) | $676 | $1,351 | 1.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $647 | $1,294 | 1.5× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$81–$133 | $161–$265 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $426 | $852 | 1.0× |
| Lung Ventilation Imaging (78579) | $494 | $988 | 1.2× |
| Lymph System Imaging (78195) | $986 | $1,971 | 1.7× |
| Magnetic Image Jaw Joint (70336) | $1,726 | $3,452 | 6.9× |
| Mammary ductogram or galactogram multiple (77054) | $294 | $587 | 1.2× |
| Mammary ductogram or galactogram single (77053) | $241 | $482 | 1.0× |
| Meckels Divert Exam (78290) | $728 | $1,456 | 1.7× |
| Mra Head W/O & W/Contrast Material (70546) | $2,325 | $4,650 | 6.3× |
| MRA head w/o contrast (70544) | $1,770 | $3,540 | 7.0× |
| MRA neck w contrast (70548) | $1,540 | $3,080 | 4.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,455 | $4,909 | 6.7× |
| MRA neck w/o contrast (70547) | $878 | $1,756 | 3.5× |
| MRI abdomen w contrast (74182) | $1,934 | $3,868 | 5.3× |
| MRI abdomen w/o contrast (74181) | $1,427 | $2,853 | 5.7× |
| MRI any jt lower extrem w/contrast material (73722) | $1,638 | $3,276 | 2.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,821 | $3,641 | 4.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,009 | $4,018 | 2.4× |
| MRI cervical spine w contrast (72142) | $1,600 | $3,200 | 4.3× |
| MRI cervical spine w/o cont (72141) | $1,518 | $3,036 | 6.0× |
| MRI chest w/o contrast (71550) | $1,066 | $2,132 | 4.2× |
| MRI chest with contrast (71551) | $1,317 | $2,633 | 1.6× |
| MRI chest wo w contrast (71552) | $1,317 | $2,633 | 3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,890 | $3,779 | 5.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,509 | $5,017 | 6.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,718 | $3,435 | 6.8× |
| MRI lumbar spine w contrast (72149) | $1,583 | $3,165 | 4.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,161 | $4,322 | 5.9× |
| MRI orbit face &/neck w/o contrast (70540) | $1,579 | $3,158 | 6.3× |
| MRI orbit face neck w contrast (70542) | $1,803 | $3,605 | 4.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,707 | $5,414 | 7.4× |
| MRI pelvis w/o & w contrast (72197) | $2,397 | $4,794 | 6.5× |
| MRI pelvis w/o contrast (72195) | $1,851 | $3,702 | 7.4× |
| MRI thoracic spine w/o contrast (72146) | $1,583 | $3,166 | 6.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,845 | $3,689 | 5.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,808 | $3,615 | 7.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,723 | $5,446 | 7.4× |
| MRI, abdomen, combo (74183) | $2,625 | $5,250 | 7.1× |
| MRI, dorsal spine combo (72157) | $2,268 | $4,535 | 6.2× |
| MRI, dorsal spine contrast (72147) | $1,657 | $3,313 | 4.5× |
| MRI, joint upper extrem (73221) | $1,467 | $2,934 | 5.8× |
| MRI, joint upper extrem combo (73223) | $2,642 | $5,284 | 7.2× |
| MRI, lumbar spine combo (72158) | $2,138 | $4,275 | 5.8× |
| Myelogram cervical (72240) | $1,263 | $2,526 | 1.5× |
| Myelogram Lumbar (72265) | $1,263 | $2,526 | 1.5× |
| Myelography thoracic (72255) | $1,263 | $2,526 | 1.5× |
| Myocardial Spect Multiple Studies (78452) | $1,735 | $3,469 | 1.3× |
| Neck soft tissue (70360) | $88 | $175 | 1.0× |
| Nonvascular Shunt X-Ray (75809) | $372 | $743 | 3.4× |
| Ob us nuchal meas 1 gest (76813) | $116 | $231 | 1.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $161 | $321 | 1.5× |
| Optic foramina (70190) | $103 | $205 | 1.1× |
| Parathyroid Planar Imaging (78070) | $505 | $1,009 | 1.2× |
| Pelvis 1 or 2 views (72170) | $108 | $216 | 1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $541 | $1,082 | 1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $154 | $308 | 1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $615 | $1,230 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$69–$90 | $137–$180 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$65–$73 | $130–$146 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$105–$112 | $210–$224 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $142 | $283 | 1.3× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$81–$106 | $161–$211 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$65–$85 | $130–$169 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$80–$124 | $159–$248 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $79 | $158 | 0.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $151 | $301 | 1.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $103 | $206 | 1.1× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $205 | $409 | 2.2× |
| Radex Ribs Unilateral 2 Views (71100) | $108 | $216 | 1.2× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$82–$124 | $163–$248 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $103 | $205 | 1.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $765 | $1,529 | 4.1× |
| Radex Spine 1 View Specify Level (72020) | $117 | $234 | 1.3× |
| Radex Sternum Minimum 2 Views (71120) | $108 | $216 | 1.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $133 | $265 | 1.4× |
| Radex Toe Minimum 2 Views (73660) | $81 | $161 | 0.9× |
| Radex upper extremity infant minimum 2 views (73092) | $75 | $150 | 0.7× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 5 matching MRF lines |
$80–$116 | $160–$232 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $110 | $219 | 1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $128 | $255 | 1.2× |
| Radiologic exam colon double contrast study (74280) | $663 | $1,325 | 3.6× |
| Radiologic exam colon single contrast study (74270) | $413 | $826 | 2.2× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$51–$156 | $102–$311 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $112 | $223 | 1.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $374 | $748 | 2.0× |
| Radiologic exam swallow function contrast study (74230) | $288 | $575 | 1.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $417 | $834 | 2.3× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$43–$81 | $85–$161 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$75–$95 | $150–$189 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $193 | $386 | 1.8× |
| Radiologic Examination Salivary Gland Calculus (70380) | $107 | $214 | 1.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$84–$112 | $167–$224 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $948 | $1,896 | 1.6× |
| Ribs bilateral 3 views (71110) | $139 | $277 | 1.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $874 | $1,747 | 1.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,180 | $2,359 | 2.1× |
| Scapula (73010) | $95 | $189 | 0.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$106–$110 | $212–$220 | varies |
| Sella turcica (70240) | $81 | $161 | 0.9× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$54–$80 | $107–$159 | varies |
| Shoulder Arthrography (73040) | $359 | $718 | 1.0× |
| Sialogram (70390) | $279 | $557 | 1.1× |
| Skull less than 4 views (70250) | $124 | $248 | 1.1× |
| Speech evaluation, complex (70371) | $307 | $613 | 1.2× |
| Sternoclavicular joints (71130) | $114 | $227 | 1.2× |
| Temporomandble Jt Arthrography Rs&I (70332) | $271 | $541 | 1.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $636 | $1,271 | 3.4× |
| Thoracic spine 2 views (72070) | $129 | $257 | 1.2× |
| Thoracic spine 3 views (72072) | $142 | $283 | 1.3× |
| Thoracolumbar 2 views (72080) | $101 | $201 | 1.1× |
| Thyroid Imaging With Vascular Flow (78013) | $446 | $891 | 1.1× |
| Thyroid Met Imaging Body (78018) | $856 | $1,712 | 1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $515 | $1,029 | 1.2× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$314–$327 | $628–$653 | varies |
| Upper gi w/o kub (74240) | $284 | $568 | 1.5× |
| Urethrocystogram voiding (74455) | $253 | $506 | 1.0× |
| Urethrocystography retrograde (74450) | $148 | $296 | 0.6× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$283–$286 | $565–$571 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$203–$262 | $406–$524 | varies |
| Us complete joint (76881) | $378 | $756 | 3.4× |
| Us exam, pelvic, limited (76857) | $161 | $321 | 1.5× |
| Us head (76506) | $313 | $626 | 2.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $161 | $321 | 1.5× |
| Us ob detailed single fetus (76811) | $589 | $1,178 | 2.3× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$82–$161 | $164–$321 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$180–$329 | $360–$657 | varies |
| Us pelvic non ob complete (76856) | $339 | $677 | 3.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $430 | $860 | 3.9× |
| Us retroperitoneal complete (76770) | $356 | $712 | 3.2× |
| Us retroperitoneal limited (76775) | $311 | $622 | 2.8× |
| Us scrotum and contents (76870) | $370 | $739 | 3.4× |
| Us thyroid (76536) range across 3 matching MRF lines |
$166–$348 | $331–$695 | varies |
| Venography extremity bilateral rs&i (75822) | $1,964 | $3,927 | 1.2× |
| Venography extremity unilateral rs&i (75820) | $1,785 | $3,570 | 1.1× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$69–$114 | $138–$227 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $117 | $234 | 1.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$66–$106 | $131–$212 | varies |
| X-Ray Exam Breast Specimen (76098) | $547 | $1,093 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $81 | $162 | 0.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $91 | $181 | 0.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $99 | $197 | 0.9× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$37–$130 | $74–$260 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$56–$130 | $111–$260 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$61–$143 | $122–$286 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$82 | $163–$164 | 0.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$57–$155 | $114–$310 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $171 | $341 | 1.6× |
| X-Ray Exam L-S Spine Bending (72114) | $227 | $453 | 2.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $120 | $239 | 1.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $216 | $431 | 2.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $131 | $261 | 1.2× |
| X-ray eye for foreign body (70030) | $75 | $149 | 0.8× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$80–$119 | $159–$237 | varies |
| X-ray IV pyelogram (ivp) (74400) | $463 | $926 | 2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $100 | $200 | 1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$100–$103 | $199–$205 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $130 | $259 | 1.2× |
| X-ray nose-rectum child f.b. (76010) | $83 | $165 | 0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $171 | $342 | 1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $115 | $230 | 1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $102 | $203 | 1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $133 | $265 | 1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $134 | $268 | 1.2× |
| X-ray thoracic spine 4 vw (72074) | $156 | $311 | 1.4× |
| X-Rays Bone Survey Complete (77075) | $315 | $629 | 2.9× |
| Xr c-spine 4 or 5 views (72050) | $211 | $422 | 1.9× |
| Xr facial bones less than 3 views (70140) | $104 | $208 | 1.1× |
| Xr orbits complete 4 views (70200) | $121 | $241 | 1.1× |
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.