Imaging prices at St. Elizabeth Hospital
Fort Morgan, CO · every code in this section with a posted price and a Medicare benchmark.
254 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) | $283.86 | $709.64 | 3.1× |
| Abdomen 2 views (74019) | $413.14 | $1,032.84 | 3.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,306.26 | $3,265.64 | 3.1× |
| Adrenal Cortex & Medulla Img (78075) | $1,950.59 | $4,876.47 | 1.4× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$296.33–$444.49 | $740.81–$1,111.21 | varies |
| Arthrogram ankle (73615) | $389.18 | $972.94 | 1.1× |
| Arthrogram hip (73525) | $485.47 | $1,213.67 | 1.3× |
| Arthrogram Wrist (73115) | $714.94 | $1,787.33 | 1.9× |
| Bone age studies (77072) | $261.53 | $653.82 | 2.4× |
| Bone Imaging 3 Phase (78315) | $2,056.37 | $5,140.91 | 4.9× |
| Bone Imaging Limited Area (78300) | $1,516.24 | $3,790.59 | 3.6× |
| Bone Imaging Multiple Areas (78305) | $1,819.49 | $4,548.72 | 4.3× |
| Bone Imaging Whole Body (78306) | $2,438.52 | $6,096.30 | 5.8× |
| Bone marrow imaging; whole body (78104) | $1,675.27 | $4,188.16 | 4.0× |
| Bone survey infant (77076) | $403.40 | $1,008.48 | 3.7× |
| Cat Scan Follow-Up Study (76380) | $1,197.82 | $2,994.54 | 13.0× |
| Cerebrospinal Fluid Scan (78630) | $2,425.79 | $6,064.46 | 4.2× |
| Chest 1 view (71045) | $350.49 | $876.21 | 3.8× |
| Chest 2 views (71046) | $391.61 | $979.02 | 4.3× |
| Clavicle complete (73000) | $392.86 | $982.13 | 4.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $378.75 | $946.87 | 3.4× |
| Contrast X-Ray Bladder (74430) | $745.79 | $1,864.47 | 2.0× |
| Contrast X-Ray Of Elbow (73085) | $679.97 | $1,699.92 | 1.8× |
| Contrast X-Ray Of Knee Joint (73580) | $618.52 | $1,546.29 | 1.7× |
| CT abdomen and pelvis without and with contrast (74178) | $6,173.94 | $15,434.85 | 16.8× |
| CT abdomen and pelvis without contrast (74176) | $4,112.56 | $10,281.38 | 16.3× |
| CT abdomen w contrast (74160) | $2,823.41 | $7,058.51 | 15.3× |
| CT abdomen w wo contrast (74170) | $3,233.96 | $8,084.90 | 17.5× |
| CT abdomen w/o contrast (74150) | $2,162.89 | $5,407.21 | 19.6× |
| CT Angio Abdomen and Pelvis (74174) | $6,443.52 | $16,108.80 | 17.5× |
| CT Angio Chest (71275) | $3,300.19 | $8,250.47 | 17.8× |
| CT Angio Head (70496) | $3,276.90 | $8,192.25 | 17.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $4,694.56 | $11,736.39 | 25.4× |
| CT Angio Neck (70498) | $3,472.98 | $8,682.44 | 18.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,153.80 | $5,384.48 | 11.6× |
| CT cervical spine w/ contrast (72126) | $2,575.72 | $6,439.29 | 7.0× |
| CT cervical spine w/o contrast (72125) | $2,302.40 | $5,756 | 20.9× |
| CT cervical spine w/wo cont (72127) | $2,667.05 | $6,667.62 | 14.4× |
| CT chest w contrast (71260) | $2,951.48 | $7,378.69 | 16.0× |
| CT chest w/wo contrast (71270) | $3,006.70 | $7,516.74 | 16.2× |
| CT head/brain with contrast (70460) | $2,599.28 | $6,498.20 | 14.0× |
| CT head/brain without and with contrast (70470) | $3,099.12 | $7,747.79 | 16.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $2,039.17 | $5,097.91 | 22.2× |
| CT iac w contrast (70481) | $2,506.38 | $6,265.95 | 13.5× |
| CT l-spine w&w/o contrast (72133) | $2,541.47 | $6,353.67 | 13.7× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,951.01–$2,926.51 | $4,877.52–$7,316.27 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$3,043.59–$4,565.38 | $7,608.96–$11,413.44 | varies |
| CT lumbar spine w contrast (72132) | $2,514.54 | $6,286.35 | 6.8× |
| CT lumbar spine w/o contrast (72131) | $2,297.77 | $5,744.42 | 20.8× |
| CT maxillofacial w contrast (70487) | $2,682.22 | $6,705.53 | 14.5× |
| CT maxillofacial wo contrast (70486) | $2,051.57 | $5,128.92 | 18.6× |
| CT neck tissue combo (70492) | $3,335.39 | $8,338.46 | 18.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$2,967.65–$2,970.04 | $7,419.12–$7,425.09 | varies |
| CT orbits w/o contrast (70480) | $2,369.10 | $5,922.74 | 21.5× |
| CT pelvis w&w/o contrast (72194) | $2,939.99 | $7,349.97 | 15.9× |
| CT pelvis w/o contrast (72192) | $1,949.69 | $4,874.21 | 17.7× |
| CT scan of leg combo (73702) | $3,652.30 | $9,130.74 | 19.7× |
| CT scans face/jaw combo (70488) | $3,218.65 | $8,046.62 | 17.4× |
| CT soft tissue neck w contrast (70491) | $2,972.56 | $7,431.39 | 16.1× |
| CT soft tissue neck w/o contrast (70490) | $2,220.11 | $5,550.26 | 20.1× |
| CT thoracic spine w contrast (72129) | $2,446.41 | $6,116.02 | 13.2× |
| CT thoracic spine w/o contrast (72128) | $2,349.89 | $5,874.72 | 21.3× |
| CT thoracic spine w/wo cont (72130) | $2,935.70 | $7,339.23 | 15.9× |
| CT thorax w/o contrast (71250) | $2,094.93 | $5,237.31 | 19.0× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$2,107.74–$3,161.60 | $5,269.34–$7,903.99 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $3,049.48 | $7,623.70 | 16.5× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$2,506.57–$3,759.85 | $6,266.41–$9,399.62 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,372.01 | $8,430.01 | 18.2× |
| Cta Abdomen (74175) | $3,154.76 | $7,886.88 | 17.0× |
| CTA pelvis (72191) | $3,288.78 | $8,221.93 | 17.8× |
| Doppler Fetal Mid Cerebral Artery (76821) | $449.14 | $1,122.85 | 4.1× |
| Dxa Bone Density Axial (77080) | $390.32 | $975.78 | 3.5× |
| Dxa bone density study (77085) | $549.47 | $1,373.67 | 5.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $461.51 | $1,153.77 | 5.0× |
| Esophagram (74220) | $108.13 | $270.32 | 0.6× |
| Fetal Biophys Profile W/Nst (76818) | $816.42 | $2,041.04 | 7.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $680.35 | $1,700.86 | 6.2× |
| Fluoroscopy up to 1 hr (76000) | $613.11 | $1,532.76 | 2.4× |
| Foot 2 views (73620) | $338.24 | $845.59 | 3.7× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$347.88–$521.82 | $869.70–$1,304.55 | varies |
| Gastric emptying imaging study (78264) | $1,665.11 | $4,162.77 | 3.9× |
| Gated Heart Planar Single (78472) | $1,966.28 | $4,915.68 | 4.7× |
| Hand 2 views (73120) | $347.30 | $868.23 | 3.1× |
| Hepatobil Syst Image W/Drug (78227) | $2,137.75 | $5,344.37 | 3.7× |
| Hepatobiliary System Imaging (78226) | $1,983.36 | $4,958.38 | 4.7× |
| Ht Muscle Image Spect Sing (78451) | $4,375.49 | $10,938.72 | 3.2× |
| Hysterosalpingogram (74740) | $749.36 | $1,873.38 | 3.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $345.61 | $864.01 | 3.8× |
| K Flow/Funct Image Multiple (78709) | $1,463.66 | $3,659.15 | 2.6× |
| K Flow/Funct Image W/Drug (78708) | $2,834.15 | $7,085.36 | 4.9× |
| K Flow/Funct Image W/O Drug (78707) | $1,903.17 | $4,757.91 | 3.3× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$414.06–$621.09 | $1,035.14–$1,552.72 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,157 | $2,892.49 | 2.7× |
| Lung perfusion differential (78597) | $1,731.93 | $4,329.82 | 4.1× |
| Lung Ventilat&Perfus Imaging (78582) | $2,477.65 | $6,194.11 | 4.3× |
| Lung Ventilation Imaging (78579) | $1,634.26 | $4,085.65 | 3.9× |
| Lymph System Imaging (78195) | $1,711.56 | $4,278.90 | 3.0× |
| Magnetic Image Jaw Joint (70336) | $2,397.09 | $5,992.71 | 9.5× |
| Meckels Divert Exam (78290) | $1,194.83 | $2,987.06 | 2.8× |
| Mr safety determination physician/other qhp (76016) | $551.20 | $1,378 | 6.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $551.20 | $1,378 | 18.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $551.20 | $1,378 | 5.5× |
| Mr safety implt pos&/immoblj (76019) | $551.20 | $1,378 | 8.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $551.20 | $1,378 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) | $3,623.74 | $9,059.33 | 9.8× |
| MRA head w/o contrast (70544) | $2,367.94 | $5,919.83 | 9.4× |
| MRA neck w contrast (70548) | $2,826.97 | $7,067.42 | 7.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,200.04 | $8,000.09 | 8.7× |
| MRA neck w/o contrast (70547) | $2,453.92 | $6,134.79 | 9.7× |
| MRI abdomen w/o contrast (74181) | $2,516 | $6,290 | 10.0× |
| MRI any jt lower extrem w/contrast material (73722) | $2,612.74 | $6,531.85 | 3.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,135.29 | $7,838.22 | 8.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,815.10 | $7,037.75 | 3.4× |
| MRI cervical spine w contrast (72142) | $2,797.52 | $6,993.80 | 7.6× |
| MRI cervical spine w/o cont (72141) | $2,557.34 | $6,393.35 | 10.2× |
| MRI chest w/o contrast (71550) | $2,126.88 | $5,317.18 | 8.5× |
| MRI chest wo w contrast (71552) | $3,323.23 | $8,308.06 | 9.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,863.36 | $7,158.40 | 7.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,360.29 | $8,400.71 | 9.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,366.44 | $5,916.10 | 9.4× |
| MRI lumbar spine w contrast (72149) | $3,072.90 | $7,682.24 | 8.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,090.77 | $7,726.92 | 8.4× |
| MRI orbit face &/neck w/o contrast (70540) | $2,726.83 | $6,817.07 | 10.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,512.73 | $8,781.82 | 9.5× |
| MRI pelvis w contrast (72196) | $2,287.50 | $5,718.73 | 6.2× |
| MRI pelvis w/o & w contrast (72197) | $3,126.39 | $7,815.97 | 8.5× |
| MRI pelvis w/o contrast (72195) | $1,448.58 | $3,621.45 | 5.8× |
| MRI thoracic spine w/o contrast (72146) | $2,441.29 | $6,103.21 | 9.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,693.42 | $6,733.55 | 7.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,338.28 | $5,845.70 | 9.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,232.10 | $8,080.23 | 8.8× |
| MRI, abdomen, combo (74183) | $3,151.77 | $7,879.41 | 8.6× |
| MRI, dorsal spine combo (72157) | $3,261.52 | $8,153.80 | 8.9× |
| MRI, dorsal spine contrast (72147) | $2,730.36 | $6,825.88 | 7.4× |
| MRI, joint upper extrem (73221) | $2,359.65 | $5,899.12 | 9.4× |
| MRI, joint upper extrem combo (73223) | $3,103.16 | $7,757.90 | 8.4× |
| MRI, lumbar spine combo (72158) | $3,468.35 | $8,670.87 | 9.4× |
| Myelogram cervical (72240) | $1,149.18 | $2,872.95 | 1.4× |
| Myelogram Lumbar (72265) | $1,127.59 | $2,818.97 | 1.4× |
| Myelography thoracic (72255) | $884.24 | $2,210.59 | 1.1× |
| Myelograpy 2/more regions rs&i (72270) | $1,306.79 | $3,266.96 | 1.6× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,184.10 | $2,960.24 | 2.8× |
| Myocardial Spect Multiple Studies (78452) | $5,311 | $13,277.50 | 3.9× |
| N-invas est c ffr sw aly CTA (75580) | $6,745.74 | $16,864.34 | 7.4× |
| Neck soft tissue (70360) | $360.77 | $901.91 | 3.9× |
| Nuclear Rx Oral Admin (79005) | $2,052.27 | $5,130.66 | 8.3× |
| Parathyroid Planar Imaging (78070) | $1,838.38 | $4,595.94 | 4.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,803.81 | $7,009.51 | 6.6× |
| Pelvis 1 or 2 views (72170) | $339.82 | $849.55 | 3.1× |
| Pet Image W/Ct Lmtd (78814) | $4,869.65 | $12,174.12 | 3.2× |
| PET image w/CT, full body (78816) | $5,345.28 | $13,363.20 | 3.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,101.24 | $12,753.09 | 3.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,360.58 | $3,401.44 | 3.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $506.65 | $1,266.61 | 4.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$443.55–$665.32 | $1,108.87–$1,663.30 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $349.50 | $873.74 | 3.8× |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$377.40–$566.10 | $943.50–$1,415.25 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $577.78 | $1,444.44 | 5.2× |
| Radex fingr minimum 2 views (73140) | $343.13 | $857.82 | 3.7× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$402.26–$603.39 | $1,005.65–$1,508.47 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$371.30–$556.94 | $928.23–$1,392.34 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$316.88–$492.30 | $792.18–$1,230.75 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $445.50 | $1,113.73 | 4.9× |
| Radex Ribs Unilateral 2 Views (71100) | $563.47 | $1,408.66 | 6.1× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$455.79–$683.68 | $1,139.47–$1,709.20 | varies |
| Radex Sternum Minimum 2 Views (71120) | $446.83 | $1,117.07 | 4.9× |
| Radex Toe Minimum 2 Views (73660) | $318.46 | $796.15 | 3.5× |
| Radex upper extremity infant minimum 2 views (73092) | $540.24 | $1,350.60 | 4.9× |
| Radex Wrist Complete Minimum 3 Views (73110) | $391.17 | $977.91 | 4.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $602.90 | $1,507.23 | 5.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $420.17 | $1,050.41 | 3.8× |
| Radiologic exam colon double contrast study (74280) | $1,098.10 | $2,745.23 | 5.9× |
| Radiologic exam colon single contrast study (74270) | $996.51 | $2,491.27 | 5.4× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$581.26–$871.89 | $1,453.15–$2,179.72 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $394.39 | $985.97 | 3.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $682.35 | $1,705.87 | 3.7× |
| Radiologic exam swallow function contrast study (74230) | $724.21 | $1,810.52 | 3.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $333.24 | $833.10 | 1.8× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$68.68–$89.27 | $171.68–$223.17 | varies |
| Radiologic examination femur minimum 2 views (73552) | $111.85 | $279.61 | 1.2× |
| Radiologic examination knee 1/2 views (73560) | $394.08 | $985.20 | 4.3× |
| Radiologic Examination Osseous Survey Limited (77074) | $303.14 | $757.83 | 2.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$381.49–$572.24 | $953.72–$1,430.59 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,944.09 | $7,360.21 | 5.1× |
| Scapula (73010) | $401.08 | $1,002.69 | 3.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $16 | $40 | 0.7× |
| Shoulder 1 view (73020) | $306.02 | $765.04 | 3.3× |
| Shoulder Arthrography (73040) | $621.84 | $1,554.60 | 1.7× |
| Skull less than 4 views (70250) | $428.50 | $1,071.25 | 3.9× |
| Sternoclavicular joints (71130) | $448.14 | $1,120.35 | 4.9× |
| Testicular Imaging W/Flow (78761) | $847.39 | $2,118.47 | 2.0× |
| Thoracic spine 2 views (72070) | $470.16 | $1,175.39 | 4.3× |
| Thoracic spine 3 views (72072) | $564.18 | $1,410.45 | 5.1× |
| Thoracolumbar 2 views (72080) | $518.07 | $1,295.17 | 5.6× |
| Thyroid Met Imaging Body (78018) | $2,527.89 | $6,319.72 | 4.4× |
| Thyroid Uptake Measurement (78012) | $480.33 | $1,200.81 | 1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,655.31 | $4,138.27 | 3.9× |
| Ultrasound Breast Limited (76642) | $345.61 | $864.01 | 3.8× |
| Ultrasound Exam Aaa Screen (76706) | $576.02 | $1,440.03 | 5.2× |
| Ultrasound, abdomen limited (76705) | $616.34 | $1,540.84 | 5.6× |
| Umbilical-artery Doppler (OB) (76820) | $559.84 | $1,399.60 | 5.1× |
| Unlisted Dx Radiographic Procedure (76499) | $461.51 | $1,153.77 | 5.0× |
| Upper gi w/o kub (74240) | $699.78 | $1,749.45 | 3.8× |
| Urethrocystogram voiding (74455) | $899.40 | $2,248.50 | 3.6× |
| Us breast unilateral complete (76641) | $576.02 | $1,440.03 | 5.2× |
| Us chest (76604) | $662.42 | $1,656.03 | 6.0× |
| Us complete joint (76881) | $662.42 | $1,656.03 | 6.0× |
| Us exam, pelvic, limited (76857) | $616.34 | $1,540.84 | 5.6× |
| Us head (76506) | $576.02 | $1,440.03 | 5.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $345.61 | $864.01 | 3.1× |
| Us ob limited 1 or more fetuses (76815) | $576.02 | $1,440.03 | 5.2× |
| Us ob transvaginal (76817) | $576.02 | $1,440.03 | 5.2× |
| Us pelvic non ob complete (76856) | $691.22 | $1,728.05 | 6.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $576.02 | $1,440.03 | 5.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $576.02 | $1,440.03 | 5.2× |
| Us retroperitoneal complete (76770) | $852.08 | $2,130.20 | 7.7× |
| Us retroperitoneal limited (76775) | $681.67 | $1,704.16 | 6.2× |
| Us scrotum and contents (76870) | $662.42 | $1,656.03 | 6.0× |
| Us spinal canal and contents (76800) | $345.61 | $864.01 | 3.1× |
| Us thyroid (76536) | $576.02 | $1,440.03 | 5.2× |
| Us transrectal (76872) | $576.02 | $1,440.03 | 5.2× |
| Vertebral fracture assessment via dxa (77086) | $63.95 | $159.87 | 0.7× |
| Wrist 2 views (73100) | $334.39 | $835.97 | 3.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $756.89 | $1,892.22 | 8.2× |
| X-ray antegrade pyelogram tube (74425) | $1,013.03 | $2,532.57 | 2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $335.29 | $838.21 | 3.7× |
| X-Ray Exam Breast Specimen (76098) | $347.95 | $869.86 | 0.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $514.68 | $1,286.68 | 4.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $530.51 | $1,326.27 | 5.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $636.61 | $1,591.51 | 6.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $827.60 | $2,068.98 | 7.5× |
| X-Ray Exam L-S Spine Bending (72114) | $1,127.18 | $2,817.94 | 10.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $455.20 | $1,138 | 5.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $848.68 | $2,121.68 | 7.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $811.84 | $2,029.58 | 7.4× |
| X-ray eye for foreign body (70030) | $540.18 | $1,350.44 | 5.9× |
| X-ray humerus (73060) | $394.27 | $985.67 | 4.3× |
| X-ray IV pyelogram (ivp) (74400) | $216.95 | $542.37 | 1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $538.75 | $1,346.86 | 5.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $482.56 | $1,206.38 | 5.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $599.99 | $1,499.97 | 5.4× |
| X-ray nose-rectum child f.b. (76010) | $337.70 | $844.25 | 3.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $942.57 | $2,356.42 | 8.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $514.81 | $1,287.01 | 4.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $445.61 | $1,114.01 | 4.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $442.45 | $1,106.12 | 4.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $592.47 | $1,481.16 | 6.5× |
| X-ray thoracic spine 4 vw (72074) | $470.15 | $1,175.36 | 4.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $605.38 | $1,513.44 | 1.6× |
| X-Rays Bone Length Studies (77073) | $104.96 | $262.40 | 1.0× |
| X-Rays Bone Survey Complete (77075) | $816.28 | $2,040.69 | 7.4× |
| Xr c-spine 4 or 5 views (72050) | $692.87 | $1,732.16 | 6.3× |
| Xr facial bones less than 3 views (70140) | $380.56 | $951.39 | 4.1× |
| Xr orbits complete 4 views (70200) | $668.52 | $1,671.30 | 6.1× |
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.