Imaging prices at SSM Health St. Anthony Hospital - Midwest
Midwest City, OK · every code in this section with a posted price and a Medicare benchmark.
267 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) | $484.33 | $880.60 | 5.8× |
| Abdomen 2 views (74019) | $490.88 | $892.50 | 4.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,918.81 | $3,488.75 | 5.0× |
| Angio internal mammary (75756) | $3,701.20 | $6,729.45 | 1.2× |
| Angio pulmonary bilat (75743) | $5,817.34 | $10,576.98 | 1.9× |
| Angiography extremity bilateral rs&i (75716) | $6,124.25 | $11,135 | 2.0× |
| Angiography extremity unilateral rs&i (75710) | $3,062.12 | $5,567.50 | 1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,908.78 | $5,288.70 | 1.0× |
| Ankle 2 views (73600) | $578.60 | $1,052 | 6.9× |
| Aortography thoracic serialography rs&i (75605) | $12,441.34 | $22,620.62 | 2.3× |
| Artery X-Rays Abdomen (75726) | $6,169.60 | $11,217.45 | 1.2× |
| Artery X-Rays Pelvis (75736) | $12,441.34 | $22,620.62 | 2.3× |
| Arthrogram ankle (73615) | $1,127.50 | $2,050 | 3.4× |
| Arthrogram hip (73525) | $3,727.61 | $6,777.48 | 11.1× |
| Arthrogram Wrist (73115) | $1,127.50 | $2,050 | 3.4× |
| Bone age studies (77072) | $275.55 | $501 | 2.7× |
| Bone Imaging 3 Phase (78315) | $1,918.81 | $3,488.75 | 5.0× |
| Bone Imaging Limited Area (78300) | $1,918.81 | $3,488.75 | 5.0× |
| Bone Imaging Whole Body (78306) | $1,918.81 | $3,488.75 | 5.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,487.92 | $4,523.50 | 4.8× |
| Cerebrospinal Fluid Scan (78630) | $1,218.25 | $2,215 | 2.3× |
| Chest 1 view (71045) | $501.07 | $911.04 | 6.0× |
| Chest 2 views (71046) | $505.43 | $918.97 | 6.0× |
| Chest 3 views (71047) | $508.82 | $925.13 | 6.1× |
| Chest 4 or more views (71048) | $520.94 | $947.16 | 5.2× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $321.64 | $584.80 | 3.2× |
| Clavicle complete (73000) | $578.57 | $1,051.94 | 6.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,421.20 | $2,584 | 14.1× |
| Contrast Exam Abdominl Aorta (75625) | $3,506.25 | $6,375 | 1.2× |
| Contrast X-Ray Bladder (74430) | $2,064.36 | $3,753.39 | 6.2× |
| Contrast X-Ray Of Elbow (73085) | $3,727.61 | $6,777.48 | 11.1× |
| Contrast X-Ray Of Knee Joint (73580) | $1,127.50 | $2,050 | 3.4× |
| CT abdomen and pelvis without and with contrast (74178) | $9,006.80 | $16,376 | 26.8× |
| CT abdomen and pelvis without contrast (74176) | $6,299.70 | $11,454 | 27.5× |
| CT abdomen w contrast (74160) | $3,934.15 | $7,153 | 23.3× |
| CT abdomen w wo contrast (74170) | $4,496.25 | $8,175 | 26.7× |
| CT abdomen w/o contrast (74150) | $3,716.90 | $6,758 | 37.0× |
| CT Angio Abdomen and Pelvis (74174) | $5,462.60 | $9,932 | 16.3× |
| CT Angio Chest (71275) | $3,469.54 | $6,308.25 | 20.6× |
| CT Angio Head (70496) | $2,949.11 | $5,362.01 | 17.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $3,469.54 | $6,308.25 | 20.6× |
| CT Angio Neck (70498) | $2,949.11 | $5,362.01 | 17.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,814.35 | $5,117 | 16.7× |
| CT cervical spine w/ contrast (72126) | $3,506.25 | $6,375 | 10.4× |
| CT cervical spine w/o contrast (72125) | $3,477.73 | $6,323.15 | 34.6× |
| CT cervical spine w/wo cont (72127) | $3,737.66 | $6,795.75 | 22.2× |
| CT chest w contrast (71260) | $4,242.70 | $7,714 | 25.1× |
| CT chest w/wo contrast (71270) | $4,397.25 | $7,995 | 26.1× |
| CT head/brain with contrast (70460) | $2,949.11 | $5,362.01 | 17.5× |
| CT head/brain without and with contrast (70470) | $2,949.11 | $5,362.01 | 17.5× |
| CT iac w contrast (70481) | $2,949.11 | $5,362.01 | 17.5× |
| CT l-spine w&w/o contrast (72133) | $4,397.25 | $7,995 | 26.1× |
| CT lower ext w/o (73700) | $4,117.85 | $7,487 | 41.0× |
| CT lower extremity w/contrast material (73701) | $4,143.15 | $7,533 | 24.6× |
| CT lumbar spine w contrast (72132) | $4,180.55 | $7,601 | 12.5× |
| CT lumbar spine w/o contrast (72131) | $4,180.55 | $7,601 | 41.6× |
| CT maxillofacial w contrast (70487) | $2,949.11 | $5,362.01 | 17.5× |
| CT maxillofacial wo contrast (70486) | $2,424.81 | $4,408.74 | 24.1× |
| CT neck tissue combo (70492) | $2,949.11 | $5,362.01 | 17.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,949.11 | $5,362.01 | 17.5× |
| CT orbits w/o contrast (70480) | $2,424.81 | $4,408.74 | 24.1× |
| CT pelvis w&w/o contrast (72194) | $3,715.25 | $6,755 | 22.0× |
| CT pelvis w/o contrast (72192) | $3,535.95 | $6,429 | 35.2× |
| CT scan of leg combo (73702) | $4,459.95 | $8,109 | 26.4× |
| CT scans face/jaw combo (70488) | $2,949.11 | $5,362.01 | 17.5× |
| CT soft tissue neck w contrast (70491) | $2,949.11 | $5,362.01 | 17.5× |
| CT soft tissue neck w/o contrast (70490) | $2,949.11 | $5,362.01 | 29.3× |
| CT thoracic spine w contrast (72129) | $3,816.45 | $6,939 | 22.6× |
| CT thoracic spine w/o contrast (72128) | $3,768.05 | $6,851 | 37.5× |
| CT thoracic spine w/wo cont (72130) | $4,461.05 | $8,111 | 26.4× |
| CT thorax w/o contrast (71250) | $4,138.20 | $7,524 | 41.2× |
| CT unlisted procedure (76497) | $632.50 | $1,150 | 7.6× |
| CT upper ext wo (73200) | $4,054.05 | $7,371 | 40.3× |
| CT upper extremity w/o & w/contrast material (73202) | $4,855.40 | $8,828 | 28.8× |
| CT upper extremity with contrast (73201) | $4,263.05 | $7,751 | 12.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,221.80 | $7,676 | 25.0× |
| Cta Abdomen (74175) | $3,915.45 | $7,119 | 23.2× |
| CTA pelvis (72191) | $1,323.30 | $2,406 | 7.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $554.40 | $1,008 | 5.5× |
| Dxa Bone Density Axial (77080) | $652.02 | $1,185.50 | 6.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $519.75 | $945 | 6.2× |
| Esophagram (74220) | $2,064.36 | $3,753.39 | 12.2× |
| Fetal Biophys Profile W/Nst (76818) | $467.50 | $850 | 4.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $412.50 | $750 | 4.1× |
| Fluoroscopy up to 1 hr (76000) | $898.07 | $1,632.85 | 3.9× |
| Follow-Up Angiography (75898) | $3,701.20 | $6,729.45 | 1.2× |
| Foot 2 views (73620) | $579.70 | $1,054 | 6.9× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$386.10–$582.64 | $702–$1,059.35 | varies |
| Gastric emptying imaging study (78264) | $1,918.81 | $3,488.75 | 5.0× |
| Gated Heart Planar Single (78472) | $1,918.81 | $3,488.75 | 5.0× |
| Hand 2 views (73120) | $467.50 | $850 | 4.6× |
| Hepatobil Syst Image W/Drug (78227) | $3,088.94 | $5,616.25 | 5.9× |
| Hepatobiliary System Imaging (78226) | $1,918.81 | $3,488.75 | 5.0× |
| Ht Muscle Image Spect Sing (78451) | $6,603.99 | $12,007.25 | 5.3× |
| Hysterosalpingogram (74740) | $1,854.69 | $3,372.16 | 8.1× |
| Joint Survey Single View (77077) | $169.95 | $309 | 1.7× |
| K Flow/Funct Image Multiple (78709) | $2,842.68 | $5,168.50 | 5.4× |
| K Flow/Funct Image W/Drug (78708) | $2,487.92 | $4,523.50 | 4.8× |
| K Flow/Funct Image W/O Drug (78707) | $1,386.55 | $2,521 | 2.7× |
| Knee 3 Views (73562) | $586.30 | $1,066 | 7.0× |
| Liver & Spleen Imaging Static Only (78215) | $1,543.58 | $2,806.50 | 4.0× |
| Liver imaging static only (78201) | $1,021.08 | $1,856.50 | 2.0× |
| Liver imaging w/vascular flow (78202) | $1,592.25 | $2,895 | 3.0× |
| Lung Ventilat&Perfus Imaging (78582) | $2,487.92 | $4,523.50 | 4.8× |
| Lymph System Imaging (78195) | $2,487.92 | $4,523.50 | 4.8× |
| Magnetic Image Jaw Joint (70336) | $2,060.27 | $3,745.95 | 9.0× |
| Mra Head W/O & W/Contrast Material (70546) | $3,833.97 | $6,970.85 | 11.4× |
| MRA head w/o contrast (70544) | $2,060.27 | $3,745.95 | 9.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,833.97 | $6,970.85 | 11.4× |
| MRA neck w/o contrast (70547) | $2,060.27 | $3,745.95 | 9.0× |
| MRI abdomen w contrast (74182) | $2,103.75 | $3,825 | 6.3× |
| MRI abdomen w/o contrast (74181) | $2,060.27 | $3,745.95 | 9.0× |
| MRI any jt lower extrem w/contrast material (73722) | $3,062.12 | $5,567.50 | 4.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,833.97 | $6,970.85 | 11.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,062.12 | $5,567.50 | 4.1× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,060.27 | $3,745.95 | 9.0× |
| MRI cervical spine w contrast (72142) | $1,728.82 | $3,143.30 | 5.2× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,425.88–$1,502.08 | $2,592.50–$2,731.05 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$1,077.12–$1,310.87 | $1,958.40–$2,383.40 | varies |
| MRI chest wo w contrast (71552) | $3,833.97 | $6,970.85 | 11.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,185.08 | $5,791.05 | 9.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,833.97 | $6,970.85 | 11.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,079.91 | $3,781.65 | 9.1× |
| MRI lumbar spine w contrast (72149) | $3,833.97 | $6,970.85 | 11.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,737.66 | $6,795.75 | 11.1× |
| MRI orbit face &/neck w/o contrast (70540) | $2,060.27 | $3,745.95 | 9.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,833.97 | $6,970.85 | 11.4× |
| MRI pelvis w/o & w contrast (72197) | $3,833.97 | $6,970.85 | 11.4× |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,461.87–$2,060.27 | $2,657.95–$3,745.95 | varies |
| MRI thoracic spine w/o contrast (72146) | $2,060.27 | $3,745.95 | 9.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,060.27 | $3,745.95 | 9.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,833.97 | $6,970.85 | 11.4× |
| MRI, abdomen, combo (74183) | $3,833.97 | $6,970.85 | 11.4× |
| MRI, dorsal spine combo (72157) | $3,833.97 | $6,970.85 | 11.4× |
| MRI, dorsal spine contrast (72147) | $2,060.27 | $3,745.95 | 6.1× |
| MRI, joint upper extrem (73221) | $2,127.12 | $3,867.50 | 9.3× |
| MRI, joint upper extrem combo (73223) | $3,833.97 | $6,970.85 | 11.4× |
| MRI, lumbar spine combo (72158) | $3,833.97 | $6,970.85 | 11.4× |
| Myocardial Spect Multiple Studies (78452) | $6,603.99 | $12,007.25 | 5.3× |
| Neck soft tissue (70360) | $490.95 | $892.64 | 5.9× |
| Nonvascular Shunt X-Ray (75809) | $308.43 | $560.79 | 3.1× |
| Nuclear Rx Oral Admin (79005) | $1,069.06 | $1,943.75 | 4.8× |
| Parathyroid Planar Imaging (78070) | $1,918.81 | $3,488.75 | 5.0× |
| Pelvis 1 or 2 views (72170) | $412.50 | $750 | 4.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,918.81 | $3,488.75 | 5.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $614.76 | $1,117.75 | 6.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $601.15 | $1,093 | 7.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $577.21 | $1,049.47 | 6.9× |
| Radex elbow complete minimum 3 views (73080) | $302.50 | $550 | 3.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,084.74 | $1,972.25 | 10.8× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$580.96–$1,230.35 | $1,056.29–$2,237 | varies |
| Radex foot complete minimum 3 views (73630) | $1,137.95 | $2,069 | 13.6× |
| Radex Hand Minimum 3 Views (73130) | $581.35 | $1,057 | 6.9× |
| Radex lower extremity infant minimum 2 views (73592) | $552.61 | $1,004.75 | 6.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $740.53 | $1,346.42 | 8.8× |
| Radex Ribs Unilateral 2 Views (71100) | $570.32 | $1,036.95 | 6.8× |
| Radex shoulder complete minimum 2 views (73030) | $579.48 | $1,053.60 | 6.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $567.37 | $1,031.58 | 6.8× |
| Radex Spine 1 View Specify Level (72020) | $588.84 | $1,070.61 | 7.0× |
| Radex Sternum Minimum 2 Views (71120) | $580.28 | $1,055.06 | 6.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $596.89 | $1,085.25 | 7.1× |
| Radex Toe Minimum 2 Views (73660) | $585.25 | $1,064.09 | 7.0× |
| Radex upper extremity infant minimum 2 views (73092) | $1,141.11 | $2,074.75 | 11.3× |
| Radex Wrist Complete Minimum 3 Views (73110) | $583 | $1,060 | 7.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,141.25 | $2,075 | 11.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,098.83 | $1,997.88 | 10.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $537.62 | $977.50 | 5.3× |
| Radiologic exam colon double contrast study (74280) | $2,064.36 | $3,753.39 | 12.2× |
| Radiologic exam colon single contrast study (74270) | $2,064.36 | $3,753.39 | 12.2× |
| Radiologic exam knee complete 4/more views (73564) | $1,072.78 | $1,950.50 | 10.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $577.50 | $1,050 | 5.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $969.95 | $1,763.54 | 5.7× |
| Radiologic exam swallow function contrast study (74230) | $605.65 | $1,101.18 | 3.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,885.54 | $3,428.26 | 11.2× |
| Radiologic examination femur 1 view (73551) | $286.55 | $521 | 3.4× |
| Radiologic examination femur minimum 2 views (73552) | $583.09 | $1,060.16 | 7.0× |
| Radiologic examination knee 1/2 views (73560) | $584.10 | $1,062 | 7.0× |
| Radiologic examination tibia & fibula 2 views (73590) | $581.49 | $1,057.26 | 6.9× |
| Ribs bilateral 3 views (71110) | $1,098.83 | $1,997.88 | 10.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,304.74 | $2,372.25 | 3.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,797.68 | $3,268.50 | 4.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,348.05 | $4,269.19 | 4.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,914.62 | $3,481.12 | 3.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,740.79 | $4,983.25 | 5.2× |
| Scapula (73010) | $1,123.66 | $2,043.02 | 11.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$33.92–$67.84 | $61.68–$123.35 | varies |
| Shoulder 1 view (73020) | $575.46 | $1,046.30 | 6.9× |
| Shoulder Arthrography (73040) | $3,727.61 | $6,777.48 | 11.1× |
| Skull less than 4 views (70250) | $1,084.74 | $1,972.25 | 10.8× |
| Tbs technical calculation only (77091) | $100.98 | $183.60 | 1.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $477.32 | $867.85 | 2.8× |
| Thoracic spine 2 views (72070) | $265.65 | $483 | 2.6× |
| Thoracic spine 3 views (72072) | $1,109.51 | $2,017.29 | 11.0× |
| Thoracolumbar 2 views (72080) | $424.60 | $772 | 5.1× |
| Thyroid Met Imaging Body (78018) | $2,269.71 | $4,126.75 | 4.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $3,178.86 | $5,779.75 | 8.3× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$1,475.79–$2,213.75 | $2,683.25–$4,025 | varies |
| Ultrasound Exam Aaa Screen (76706) | $1,002.51 | $1,822.75 | 10.0× |
| Ultrasound, abdomen limited (76705) | $1,141.11 | $2,074.75 | 11.3× |
| Unlisted Dx Radiographic Procedure (76499) | $211.31 | $384.20 | 2.5× |
| Unlisted fluoroscopic procedure (76496) | $181.16 | $329.38 | 2.2× |
| Unlisted us procedure (76999) | $596.89 | $1,085.25 | 7.1× |
| Upper gi w/o kub (74240) | $1,851.88 | $3,367.06 | 11.0× |
| Urethrocystogram voiding (74455) | $624.11 | $1,134.75 | 2.7× |
| Urethrocystography retrograde (74450) | $2,003.12 | $3,642.04 | 8.7× |
| Us breast unilateral complete (76641) | $1,716 | $3,120 | 17.1× |
| Us chest (76604) | $1,141.11 | $2,074.75 | 11.3× |
| Us complete joint (76881) | $2,102.24 | $3,822.25 | 20.9× |
| Us exam, pelvic, limited (76857) | $962.50 | $1,750 | 9.6× |
| Us head (76506) | $1,141.11 | $2,074.75 | 11.3× |
| Us kidney transplant (76776) | $1,141.11 | $2,074.75 | 11.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,141.11 | $2,074.75 | 11.3× |
| Us ob limited 1 or more fetuses (76815) | $1,141.11 | $2,074.75 | 11.3× |
| Us ob transvaginal (76817) | $637.45 | $1,159 | 6.3× |
| Us pelvic non ob complete (76856) | $1,140.70 | $2,074 | 11.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,141.11 | $2,074.75 | 11.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,141.11 | $2,074.75 | 11.3× |
| Us retroperitoneal complete (76770) | $1,141.11 | $2,074.75 | 11.3× |
| Us retroperitoneal limited (76775) | $1,141.11 | $2,074.75 | 11.3× |
| Us scrotum and contents (76870) | $1,141.11 | $2,074.75 | 11.3× |
| Us spinal canal and contents (76800) | $347.60 | $632 | 3.5× |
| Us thyroid (76536) | $1,141.11 | $2,074.75 | 11.3× |
| Us transrectal (76872) | $1,141.11 | $2,074.75 | 11.3× |
| Vein X-Ray Chest (75827) | $2,015.86 | $3,665.20 | 1.3× |
| Venogram Sinus/Jugular (75860) | $2,219.69 | $4,035.80 | 0.7× |
| Venography caval inferior serialography rs&i (75825) | $3,701.20 | $6,729.45 | 1.2× |
| Venography extremity bilateral rs&i (75822) | $2,908.78 | $5,288.70 | 1.9× |
| Venography extremity unilateral rs&i (75820) | $1,454.39 | $2,644.35 | 1.0× |
| Venography Renal Bilateral (75833) | $7,271.61 | $13,221.11 | 2.4× |
| Vertebral fracture assessment via dxa (77086) | $289.97 | $527.21 | 3.5× |
| Wrist 2 views (73100) | $580.25 | $1,055 | 6.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $596.89 | $1,085.25 | 7.1× |
| X-Ray Aorta Leg Arteries (75630) | $3,623.12 | $6,587.50 | 1.2× |
| X-Ray Bend Only L-S Spine (72120) | $378.95 | $689 | 3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $275 | $500 | 3.3× |
| X-Ray Exam Breast Specimen (76098) | $661.47 | $1,202.67 | 1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $596.89 | $1,085.25 | 7.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $1,081.92 | $1,967.13 | 10.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,127.50 | $2,050 | 11.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $580.25 | $1,055 | 6.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $583 | $1,060 | 7.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $687.50 | $1,250 | 6.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $1,095.05 | $1,991 | 10.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,077.45 | $1,959 | 10.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,097.25 | $1,995 | 10.9× |
| X-Ray Exam L-S Spine Bending (72114) | $1,058.75 | $1,925 | 10.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $582.07 | $1,058.31 | 7.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,141.11 | $2,074.75 | 11.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,119.66 | $2,035.75 | 11.1× |
| X-ray eye for foreign body (70030) | $193.08 | $351.05 | 2.3× |
| X-ray humerus (73060) | $578.92 | $1,052.59 | 6.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $275 | $500 | 3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $213.12 | $387.50 | 2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,045 | $1,900 | 10.4× |
| X-ray nose-rectum child f.b. (76010) | $484.78 | $881.41 | 5.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,121.60 | $2,039.27 | 11.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,098.83 | $1,997.88 | 10.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $173.25 | $315 | 1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $588.59 | $1,070.16 | 7.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $596.89 | $1,085.25 | 7.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,098.83 | $1,997.88 | 10.9× |
| X-ray thoracic spine 4 vw (72074) | $1,141.11 | $2,074.75 | 11.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $3,727.61 | $6,777.48 | 11.1× |
| X-Rays Bone Survey Complete (77075) | $1,132.66 | $2,059.38 | 11.3× |
| Xr c-spine 4 or 5 views (72050) | $1,068.63 | $1,942.96 | 10.6× |
| Xr facial bones less than 3 views (70140) | $596.89 | $1,085.25 | 7.1× |
| Xr orbits complete 4 views (70200) | $1,098.83 | $1,997.88 | 10.9× |
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.