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.

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ProcedureCash priceGross charge× Medicare
Acute gi blood loss imaging (78278) $1,306.26 $3,265.64 3.1×
Ankle 2 views (73600) $370.41 $926.01 4.0×
Clavicle complete (73000) $392.86 $982.13 4.3×
Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) $6,443.52 $16,108.80 17.5×
Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) $3,154.76 $7,886.88 17.0×
Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) $3,372.01 $8,430.01 18.2×
Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) $3,300.19 $8,250.47 17.8×
Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) $4,694.56 $11,736.39 25.4×
Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) $3,472.98 $8,682.44 18.8×
Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) $3,288.78 $8,221.93 17.8×
Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) $2,153.80 $5,384.48 11.6×
Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) $2,667.05 $6,667.62 14.4×
Computed tomography, lower extremity; without contrast material Age Under 21 (73700) $2,438.76 $6,096.90 22.1×
Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) $3,652.30 $9,130.74 19.7×
Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) $2,541.47 $6,353.67 13.7×
Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) $2,682.22 $6,705.53 14.5×
Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) $2,051.57 $5,128.92 18.6×
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) $2,506.38 $6,265.95 13.5×
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) $2,369.10 $5,922.74 21.5×
Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) $2,968.84 $7,422.10 16.0×
Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) $3,335.39 $8,338.46 18.0×
Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) $2,935.70 $7,339.23 15.9×
Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) $3,006.70 $7,516.74 16.2×
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 & w/o contrast (74170) $3,233.96 $8,084.90 17.5×
CT abdomen w/contrast (74160) $2,823.41 $7,058.51 15.3×
CT abdomen w/o contrast (74150) $2,162.89 $5,407.21 19.6×
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 chest w/contrast (71260) $2,951.48 $7,378.69 16.0×
CT extremity upper w & w/o contrast (73202) $3,049.48 $7,623.70 16.5×
CT extremity upper w/o contrast (73200) $2,634.67 $6,586.66 23.9×
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 l-spine w/contrast (72132) $2,514.54 $6,286.35 6.8×
CT limited/localized follow up study (76380) $1,197.82 $2,994.54 13.0×
CT lower extremity w/dye (73701) $3,804.48 $9,511.20 20.6×
CT lumbar spine w/o contrast (72131) $2,297.77 $5,744.42 20.8×
CT maxillofacial w/wo contrast (70488) $3,218.65 $8,046.62 17.4×
CT neck w/contrast (70491) $2,972.56 $7,431.39 16.1×
CT neck w/o contrast (70490) $2,220.11 $5,550.26 20.1×
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 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 thorax lung cancer scr c- (71271) $378.75 $946.87 3.4×
CT thorax w/o contrast (71250) $2,094.93 $5,237.31 19.0×
CT upper extremity w/dye (73201) $3,133.21 $7,833.02 8.5×
CTA head w contrast (70496) $3,276.90 $8,192.25 17.7×
Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) $745.79 $1,864.47 2.0×
Doppler fetal mid cerebral artery (76821) $449.14 $1,122.85 4.1×
Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) $390.32 $975.78 3.5×
Dxa bone density study axial skeleton (77085) $549.47 $1,373.67 5.0×
Dxa bone density/peripheral (77081) $461.51 $1,153.77 5.0×
Fetal biophys profile w/o nst (76819) $680.35 $1,700.86 6.2×
Fetal biophysical profile non-stress testing (76818) $816.42 $2,041.04 7.4×
Fluoroscopy up to 1 hour physician/qhp time (76000) $613.11 $1,532.76 2.4×
Gated heart planar single (78472) $1,966.28 $4,915.68 4.7×
Heart infarct image (78466) $1,184.10 $2,960.24 2.8×
Hepatobil syst imag inc gb w/pharma intervenj (78227) $2,137.75 $5,344.37 3.7×
Hepatobiliary syst imaging including gallbladder (78226) $1,983.36 $4,958.38 4.7×
Ht muscle image spect sing (78451) $4,375.49 $10,938.72 3.2×
Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) $1,194.83 $2,987.06 2.8×
Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) $1,463.66 $3,659.15 2.6×
Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) $1,903.17 $4,757.91 3.3×
Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) $2,834.15 $7,085.36 4.9×
Liver and spleen imaging (78215) $1,157 $2,892.49 2.7×
Lung perfusion imaging (78580) $1,360.58 $3,401.44 3.2×
Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) $3,135.29 $7,838.22 8.5×
Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) $2,863.36 $7,158.40 7.8×
Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) $2,366.44 $5,916.10 9.4×
Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) $3,360.29 $8,400.71 9.1×
Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) $2,726.83 $6,817.07 10.8×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) $2,693.42 $6,733.55 7.3×
Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) $3,232.10 $8,080.23 8.8×
Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) $3,623.74 $9,059.33 9.8×
Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) $3,200.04 $8,000.09 8.7×
Mandible min 4v (70110) $602.90 $1,507.23 5.5×
Mr safety determination physician/other qhp (76016) $551.20 $1,378 6.0×
Mr safety implant pos&/immoblj supvj phys/qhp (76019) $551.20 $1,378 8.9×
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 med physics xm customization plng&mntr (76017) $551.20 $1,378 2.2×
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 contrast (70547) $2,453.92 $6,134.79 9.7×
MRI abdomen w/o contrast (74181) $2,516 $6,290 10.0×
MRI abdomen w/wo contrast (74183) $3,151.77 $7,879.41 8.6×
MRI any jt lower extrem w/contrast material (73722) $2,612.74 $6,531.85 3.2×
MRI c-spine w&w/o cont (72156) $3,090.77 $7,726.92 8.4×
MRI cervical spine w/contrast (72142) $2,797.52 $6,993.80 7.6×
MRI chest w/o contrast (71550) $2,126.88 $5,317.18 8.5×
MRI chest w/wo contrast (71552) $3,323.23 $8,308.06 9.0×
MRI joint upr extr w/o&w/dye (73223) $3,103.16 $7,757.90 8.4×
MRI joint upr extrem w/dye (73222) $2,815.10 $7,037.75 3.4×
MRI joint upr extrem w/o dye (73221) $2,359.65 $5,899.12 9.4×
MRI lumbar spine w/contrast (72149) $3,072.90 $7,682.24 8.3×
MRI lumbar spine w/wo contrast (72158) $3,468.35 $8,670.87 9.4×
MRI orbit/face/neck w&w/o cont (70543) $3,512.73 $8,781.82 9.5×
MRI pelvis w & w/o contrast (72197) $3,126.39 $7,815.97 8.5×
MRI pelvis w/contrast (72196) $2,287.50 $5,718.73 6.2×
MRI pelvis w/o contrast (72195) $1,448.58 $3,621.45 5.8×
MRI spine cervical w/o contrast (72141) $2,557.34 $6,393.35 10.2×
MRI t-spine w&w/o cont (72157) $3,261.52 $8,153.80 8.9×
MRI thoracic spine w/contrast (72147) $2,730.36 $6,825.88 7.4×
MRI thoracic spine w/o contrst (72146) $2,441.29 $6,103.21 9.7×
MRI tmj (70336) $2,397.09 $5,992.71 9.5×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,338.28 $5,845.70 9.3×
Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical),… (72270) $1,306.79 $3,266.96 1.6×
Myocardial spect multiple studies (78452) $5,311 $13,277.50 3.9×
N-invas est c ffr augmnt sw alys CTA i&r phy/qhp (75580) $6,745.74 $16,864.34 7.4×
Nm adrenal imaging (78075) $1,950.59 $4,876.47 1.4×
Nm bone 3 phase (78315) $2,056.37 $5,140.91 4.9×
Nm bone imaging whole body (78306) $2,438.52 $6,096.30 5.8×
Nm bone marrow wb (78104) $1,675.27 $4,188.16 4.0×
Nm csf cisternogram (78630) $2,425.79 $6,064.46 4.2×
Nm gastric emptying (78264) $1,665.11 $4,162.77 3.9×
Nm lung ventilation imaging (78579) $1,634.26 $4,085.65 3.9×
Nm lymph system (78195) $1,711.56 $4,278.90 3.0×
Nuclear medicine study of bone and/or joint limited area (78300) $1,516.24 $3,790.59 3.6×
Nuclear medicine study of bone and/or joint multiple areas (78305) $1,819.49 $4,548.72 4.3×
Ob us limited fetus(s) (76815) $576.02 $1,440.03 5.2×
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×
PET imaging CT attenuation skull base mid-thigh (78815) $5,101.24 $12,753.09 3.4×
PET imaging CT for attenuation limited area (78814) $4,869.65 $12,174.12 3.2×
PET imaging for CT attenuation whole body (78816) $5,345.28 $13,363.20 3.5×
Pulmonary ventilation & perfusion imaging (78582) $2,477.65 $6,194.11 4.3×
Quant differential pulm perfusion w/wo imaging (78597) $1,731.93 $4,329.82 4.1×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $514.68 $1,286.68 4.7×
Radex hip unilateral with pelvis 1 view (73501) $530.51 $1,326.27 5.8×
Radex hip unilateral with pelvis 2-3 views (73502) $636.61 $1,591.51 6.9×
Radex hips bilateral with pelvis 2 views (73521) $827.60 $2,068.98 7.5×
Radex spine cervical 2 or 3 views (72040) $455.20 $1,138 5.0×
Radex spine cervical 4 or 5 views (72050) $692.87 $1,732.16 6.3×
Radex spine cervical 6 or more views (72052) $848.68 $2,121.68 7.7×
Radex spine thoracolumbar junction min 2 views (72080) $518.07 $1,295.17 5.6×
Radiologic exam 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 esophagus single contrast study (74220) $108.13 $270.32 0.6×
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 exam upr gi trc single contrast study (74240) $699.78 $1,749.45 3.8×
Radiologic examination femur 1 view (73551) $78.98 $197.42 0.9×
Radiologic examination femur minimum 2 views (73552) $111.85 $279.61 1.2×
Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) $337.70 $844.25 3.7×
Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) $554.44 $1,386.08 6.0×
Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) $506.65 $1,266.61 4.6×
Radiologic examination, elbow; 2 views Age Under 21 (73070) $335.29 $838.21 3.7×
Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) $471.75 $1,179.38 5.1×
Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) $380.56 $951.39 4.1×
Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) $502.82 $1,257.06 5.5×
Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) $464.12 $1,160.28 5.1×
Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) $482.56 $1,206.38 5.3×
Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) $726.58 $1,816.44 6.6×
Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) $538.75 $1,346.86 5.9×
Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) $445.50 $1,113.73 4.9×
Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) $942.57 $2,356.42 8.5×
Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) $811.84 $2,029.58 7.4×
Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) $445.61 $1,114.01 4.0×
Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) $621.84 $1,554.60 1.7×
Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) $569.74 $1,424.34 6.2×
Radiologic examination, skull; less than 4 views Age Under 21 (70250) $428.50 $1,071.25 3.9×
Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) $599.99 $1,499.97 5.4×
Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) $1,127.18 $2,817.94 10.2×
Radiologic examination, spine; thoracic, minimum of 4 views Age Under 21 (72074) $470.15 $1,175.36 4.3×
Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) $391.17 $977.91 4.3×
Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) $756.89 $1,892.22 8.2×
Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) $394.27 $985.67 4.3×
Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) $404.59 $1,011.46 4.4×
Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) $668.52 $1,671.30 6.1×
Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) $448.14 $1,120.35 4.9×
Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) $318.46 $796.15 3.5×
Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) $540.24 $1,350.60 4.9×
Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s)… (78803) $2,944.09 $7,360.21 5.1×
Radiopharmaceutical therapy, by oral administration Age Under 21 (79005) $2,052.27 $5,130.66 8.3×
Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) $899.40 $2,248.50 3.6×
Scapula complete (73010) $401.08 $1,002.69 3.6×
Screening digital breast tomosynthesis bi (77063) $16 $40
Testicular imaging with vascular flow Age Under 21 (78761) $847.39 $2,118.47 2.0×
Thyroid met imaging body (78018) $2,527.89 $6,319.72 4.4×
Thyroid uptake single/multiple quant 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, abdomen limited (76705) $616.34 $1,540.84 5.6×
Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) $345.61 $864.01 3.1×
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) $691.22 $1,728.05 6.3×
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) $576.02 $1,440.03 5.2×
Umbilical-artery Doppler (OB) (76820) $559.84 $1,399.60 5.1×
Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) $216.95 $542.37 1.2×
Urography antegrade rs&i (74425) $1,013.03 $2,532.57 2.8×
Us abdominal aorta real time screen study aaa (76706) $576.02 $1,440.03 5.2×
Us breast uni real time with image complete (76641) $576.02 $1,440.03 5.2×
Us chest (76604) $662.42 $1,656.03 6.0×
Us compl joint r-t w/image documentation (76881) $662.42 $1,656.03 6.0×
Us encephalogram (76506) $576.02 $1,440.03 5.2×
Us exam, pelvic, limited (76857) $616.34 $1,540.84 5.6×
Us inft hips r-t img dynamic req phys/qhp manj (76885) $345.61 $864.01 3.8×
US OB Follow-Up/Repeat (76816) $576.02 $1,440.03 5.2×
Us ob transvaginal (76817) $576.02 $1,440.03 5.2×
Us retroperitoneal complete (76770) $852.08 $2,130.20 7.7×
Us retroperitoneal ltd (76775) $681.67 $1,704.16 6.2×
Us scrotum (76870) $662.42 $1,656.03 6.0×
Us soft tissue head/neck (76536) $576.02 $1,440.03 5.2×
Us spinal canal (76800) $345.61 $864.01 3.1×
Us transrectal (76872) $576.02 $1,440.03 5.2×
Venography deep dorsal vein penis radiolgicl supervision interpretation (76499) $461.51 $1,153.77 5.0×
Vertebral fracture assessment via dxa (77086) $63.95 $159.87 0.7×
X-ray exam of finger(s) (73140) $343.13 $857.82 3.7×
X-ray exam of knee 1 or 2 (73560) $394.08 $985.20 4.3×
X-ray exam ribs uni 2 views (71100) $563.47 $1,408.66 6.1×
X-ray heel (73650) $349.50 $873.74 3.8×
X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) $514.81 $1,287.01 4.7×
X-ray retrograde pyelogram (74420) $605.38 $1,513.44 1.6×
Xr abdomen 1 view (74018) $283.86 $709.64 3.1×
Xr abdomen 2 views (74019) $413.14 $1,032.84 3.7×
Xr arthrogram ankle (73615) $389.18 $972.94 1.1×
Xr arthrogram elbow (73085) $679.97 $1,699.92 1.8×
Xr arthrogram hip (73525) $485.47 $1,213.67 1.3×
Xr arthrogram knee (73580) $618.52 $1,546.29 1.7×
Xr arthrogram wrist (73115) $714.94 $1,787.33 1.9×
Xr bone age studies (77072) $261.53 $653.82 2.4×
Xr bone length study (77073) $104.96 $262.40 1.0×
Xr bone survey infant (77076) $403.40 $1,008.48 3.7×
Xr bone survey ltd (77074) $303.14 $757.83 2.7×
Xr chest 1 view (71045) $350.49 $876.21 3.8×
Xr chest 2 views (71046) $391.61 $979.02 4.3×
Xr eye foreign body (70030) $540.18 $1,350.44 5.9×
Xr facial bones 3+ views (70150) $577.78 $1,444.44 5.2×
Xr foot arthritis pa only bilateral - report(ortho pro) (73620) $338.24 $845.59 3.7×
Xr forearm 2 views (73090) $434.85 $1,087.12 4.7×
Xr hand 2v (73120) $347.30 $868.23 3.1×
Xr hysterosalpingogram (74740) $749.36 $1,873.38 3.0×
Xr myelogram c-spine (72240) $1,149.18 $2,872.95 1.4×
Xr myelogram l-spine (72265) $1,127.59 $2,818.97 1.4×
Xr myelogram t-spine (72255) $884.24 $2,210.59 1.1×
Xr neck soft tissue (70360) $360.77 $901.91 3.9×
Xr o knee w/ merchant view bilat - report(ortho pro) (73562) $517.58 $1,293.93 5.6×
Xr osseous survey complete (77075) $816.28 $2,040.69 7.4×
Xr pelvis 1-2 views (72170) $339.82 $849.55 3.1×
Xr pelvis min 3 view (72190) $394.39 $985.97 3.6×
Xr sacrum/coccyx 2+ views (72220) $442.45 $1,106.12 4.8×
Xr shoulder 1 view (73020) $306.02 $765.04 3.3×
Xr sinuses 3+ views (70220) $592.47 $1,481.16 6.5×
Xr spine thoracic 3v (72072) $564.18 $1,410.45 5.1×
Xr sternum 2+ views (71120) $446.83 $1,117.07 4.9×
Xr surgical specimen (76098) $347.95 $869.86 0.6×
Xr t-spine 2 views (72070) $470.16 $1,175.39 4.3×
Xr tibia/fibula 2 views (73590) $476.86 $1,192.16 5.2×
Xr wrist 2 views (73100) $334.39 $835.97 3.6×