Imaging prices at St. Francis Hospital
Litchfield, IL · every code in this section with a posted price and a Medicare benchmark.
252 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) | $336.96 | $468 | 3.6× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$424.80–$447.12 | $590–$621 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,103.76 | $1,533 | 2.6× |
| Ankle 2 views (73600) | $290.16 | $403 | 3.1× |
| Arthrogram hip (73525) | $893.52 | $1,241 | 2.4× |
| Arthrogram Wrist (73115) | $937.44 | $1,302 | 2.5× |
| Bone age studies (77072) | $229.68 | $319 | 2.1× |
| Bone Imaging 3 Phase (78315) | $1,267.20 | $1,760 | 3.0× |
| Bone Imaging Limited Area (78300) | $1,267.20 | $1,760 | 3.0× |
| Bone Imaging Multiple Areas (78305) | $1,267.20 | $1,760 | 3.0× |
| Bone Imaging Whole Body (78306) | $1,339.20 | $1,860 | 3.1× |
| Bone survey infant (77076) | $373.68 | $519 | 3.3× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,088.64 | $1,512 | 2.5× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$282.96–$289.44 | $393–$402 | varies |
| Chest 2 views (71046) | $352.08 | $489 | 3.8× |
| Chest 3 views (71047) | $336.24 | $467 | 3.6× |
| Chest 4 or more views (71048) | $370.08 | $514 | 3.3× |
| Clavicle complete (73000) | $424.80 | $590 | 4.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $385.92 | $536 | 3.4× |
| Contrast X-Ray Bladder (74430) | $771.12 | $1,071 | 2.1× |
| Contrast X-Ray Of Knee Joint (73580) | $815.76 | $1,133 | 2.2× |
| CT abdomen and pelvis without and with contrast (74178) | $5,049.36 | $7,013 | 13.5× |
| CT abdomen and pelvis without contrast (74176) | $4,098.24 | $5,692 | 16.0× |
| CT abdomen w contrast (74160) | $2,635.92 | $3,661 | 14.0× |
| CT abdomen w wo contrast (74170) | $2,930.40 | $4,070 | 15.6× |
| CT abdomen w/o contrast (74150) | $2,062.80 | $2,865 | 18.4× |
| CT Angio Abdomen and Pelvis (74174) | $5,049.36 | $7,013 | 13.5× |
| CT Angio Chest (71275) | $3,060.72 | $4,251 | 16.3× |
| CT Angio Head (70496) | $2,608.56 | $3,623 | 13.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,792.08 | $2,489 | 9.5× |
| CT Angio Neck (70498) | $2,715.12 | $3,771 | 14.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,445.12 | $3,396 | 13.0× |
| CT cervical spine w/ contrast (72126) | $2,878.56 | $3,998 | 7.7× |
| CT cervical spine w/o contrast (72125) | $2,339.28 | $3,249 | 20.9× |
| CT cervical spine w/wo cont (72127) | $3,060.72 | $4,251 | 16.3× |
| CT chest w contrast (71260) | $2,463.12 | $3,421 | 13.1× |
| CT chest w/wo contrast (71270) | $2,917.44 | $4,052 | 15.5× |
| CT head/brain with contrast (70460) | $2,424.24 | $3,367 | 12.9× |
| CT head/brain without and with contrast (70470) | $2,790 | $3,875 | 14.8× |
| CT iac w contrast (70481) | $2,754.72 | $3,826 | 14.7× |
| CT l-spine w&w/o contrast (72133) | $2,204.64 | $3,062 | 11.7× |
| CT lower ext w/o (73700) | $1,893.60 | $2,630 | 16.9× |
| CT lower extremity w/contrast material (73701) | $2,170.80 | $3,015 | 11.5× |
| CT lumbar spine w contrast (72132) | $2,023.20 | $2,810 | 5.4× |
| CT lumbar spine w/o contrast (72131) | $1,918.80 | $2,665 | 17.1× |
| CT maxillofacial w contrast (70487) | $1,987.20 | $2,760 | 10.6× |
| CT maxillofacial wo contrast (70486) | $1,719.36 | $2,388 | 15.3× |
| CT neck tissue combo (70492) | $3,336.48 | $4,634 | 17.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,898 | $4,025 | 15.4× |
| CT orbits w/o contrast (70480) | $2,188.80 | $3,040 | 19.5× |
| CT pelvis w&w/o contrast (72194) | $2,567.52 | $3,566 | 13.7× |
| CT pelvis w/o contrast (72192) | $1,985.76 | $2,758 | 17.7× |
| CT scan of leg combo (73702) | $3,912.48 | $5,434 | 20.8× |
| CT scans face/jaw combo (70488) | $2,041.20 | $2,835 | 10.9× |
| CT soft tissue neck w contrast (70491) | $2,570.40 | $3,570 | 13.7× |
| CT soft tissue neck w/o contrast (70490) | $2,121.84 | $2,947 | 18.9× |
| CT thoracic spine w contrast (72129) | $2,316.24 | $3,217 | 12.3× |
| CT thoracic spine w/o contrast (72128) | $1,895.76 | $2,633 | 16.9× |
| CT thoracic spine w/wo cont (72130) | $2,654.64 | $3,687 | 14.1× |
| CT thorax w/o contrast (71250) | $2,013.12 | $2,796 | 18.0× |
| CT upper ext wo (73200) | $2,070.72 | $2,876 | 18.5× |
| CT upper extremity w/o & w/contrast material (73202) | $2,994.48 | $4,159 | 15.9× |
| CT upper extremity with contrast (73201) | $2,645.28 | $3,674 | 7.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,089.52 | $4,291 | 16.4× |
| Cta Abdomen (74175) | $2,802.96 | $3,893 | 14.9× |
| CTA pelvis (72191) | $2,643.12 | $3,671 | 14.1× |
| Dxa Bone Density Axial (77080) | $331.20 | $460 | 3.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $198 | $275 | 2.1× |
| Echo exam uterus (76831) | $758.16 | $1,053 | 3.0× |
| Esophagram (74220) | $669.60 | $930 | 3.6× |
| Fetal Biophys Profile W/Nst (76818) | $945.36 | $1,313 | 8.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $945.36 | $1,313 | 8.4× |
| Fluoroscopy up to 1 hr (76000) | $962.64 | $1,337 | 3.8× |
| Foot 2 views (73620) | $336.96 | $468 | 3.6× |
| Forearm 2 views (73090) | $319.68 | $444 | 3.4× |
| Gastric emptying imaging study (78264) | $900 | $1,250 | 2.1× |
| Gated Heart Planar Single (78472) | $1,103.76 | $1,533 | 2.6× |
| Hand 2 views (73120) | $318.96 | $443 | 2.8× |
| Hepatobil Syst Image W/Drug (78227) | $2,026.80 | $2,815 | 3.5× |
| Hepatobiliary System Imaging (78226) | $1,249.20 | $1,735 | 2.9× |
| Ht Muscle Image Spect Sing (78451) | $3,489.12 | $4,846 | 2.5× |
| Hysterosalpingogram (74740) | $833.04 | $1,157 | 3.3× |
| Joint Survey Single View (77077) | $272.88 | $379 | 2.4× |
| K Flow/Funct Image Multiple (78709) | $1,848.96 | $2,568 | 3.2× |
| K Flow/Funct Image W/Drug (78708) | $1,407.60 | $1,955 | 2.4× |
| K Flow/Funct Image W/O Drug (78707) | $1,329.12 | $1,846 | 2.3× |
| Kidney Imaging Morphol (78700) | $962.64 | $1,337 | 2.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,281.60 | $1,780 | 3.0× |
| Knee 3 Views (73562) | $443.52 | $616 | 4.8× |
| Liver & Spleen Imaging Static Only (78215) | $1,232.64 | $1,712 | 2.9× |
| Lung perfusion differential (78597) | $2,763.36 | $3,838 | 6.5× |
| Lymph System Imaging (78195) | $1,935.36 | $2,688 | 3.3× |
| Magnetic Image Jaw Joint (70336) | $3,006 | $4,175 | 11.8× |
| Mammary ductogram or galactogram multiple (77054) | $835.92 | $1,161 | 3.3× |
| Mammary ductogram or galactogram single (77053) | $835.92 | $1,161 | 3.3× |
| Meckels Divert Exam (78290) | $912.24 | $1,267 | 2.1× |
| Mr safety determination physician/other qhp (76016) | $190.08 | $264 | 2.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $52.56 | $73 | 1.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $198 | $275 | 1.9× |
| Mr safety implt pos&/immoblj (76019) | $128.16 | $178 | 2.0× |
| Mr safety med physics xm customization plng&mntr (76017) | $522 | $725 | 2.0× |
| Mra Head W/O & W/Contrast Material (70546) | $4,232.88 | $5,879 | 11.3× |
| MRA head w/o contrast (70544) | $2,926.08 | $4,064 | 11.4× |
| MRA head with contrast (70545) | $3,228.48 | $4,484 | 8.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,803.76 | $5,283 | 10.2× |
| MRA neck w/o contrast (70547) | $3,080.88 | $4,279 | 12.0× |
| MRI abdomen w contrast (74182) | $3,337.20 | $4,635 | 8.9× |
| MRI abdomen w/o contrast (74181) | $3,098.16 | $4,303 | 12.1× |
| MRI any jt lower extrem w/contrast material (73722) | $3,111.84 | $4,322 | 3.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,672 | $5,100 | 9.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,487.68 | $4,844 | 4.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,674.80 | $3,715 | 10.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $553.68 | $769 | 2.2× |
| MRI cervical spine w contrast (72142) | $3,561.12 | $4,946 | 9.5× |
| MRI cervical spine w/o cont (72141) | $2,922.48 | $4,059 | 11.4× |
| MRI chest w/o contrast (71550) | $3,006 | $4,175 | 11.8× |
| MRI chest with contrast (71551) | $3,203.28 | $4,449 | 3.8× |
| MRI chest wo w contrast (71552) | $3,417.12 | $4,746 | 9.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,472.56 | $4,823 | 9.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $4,008.24 | $5,567 | 10.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,992.32 | $4,156 | 11.7× |
| MRI lumbar spine w contrast (72149) | $3,332.16 | $4,628 | 8.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,074.48 | $5,659 | 10.9× |
| MRI orbit face &/neck w/o contrast (70540) | $3,113.28 | $4,324 | 12.2× |
| MRI orbit face neck w contrast (70542) | $3,626.64 | $5,037 | 9.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,803.76 | $5,283 | 10.2× |
| MRI pelvis w contrast (72196) | $3,337.20 | $4,635 | 8.9× |
| MRI pelvis w/o & w contrast (72197) | $3,841.92 | $5,336 | 10.3× |
| MRI pelvis w/o contrast (72195) | $2,986.56 | $4,148 | 11.7× |
| MRI thoracic spine w/o contrast (72146) | $3,098.16 | $4,303 | 12.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,180.24 | $4,417 | 8.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,006 | $4,175 | 11.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,672 | $5,100 | 9.8× |
| MRI, abdomen, combo (74183) | $3,759.84 | $5,222 | 10.1× |
| MRI, dorsal spine combo (72157) | $4,185.36 | $5,813 | 11.2× |
| MRI, dorsal spine contrast (72147) | $3,700.08 | $5,139 | 9.9× |
| MRI, joint upper extrem (73221) | $2,957.76 | $4,108 | 11.6× |
| MRI, joint upper extrem combo (73223) | $4,219.20 | $5,860 | 11.3× |
| MRI, lumbar spine combo (72158) | $3,983.04 | $5,532 | 10.7× |
| Myocardial Spect Multiple Studies (78452) | $4,436.64 | $6,162 | 3.2× |
| Neck soft tissue (70360) | $165.60 | $230 | 1.8× |
| Parathyroid Planar Imaging (78070) | $1,069.92 | $1,486 | 2.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,176.48 | $1,634 | 2.7× |
| Pelvis 1 or 2 views (72170) | $440.64 | $612 | 3.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,851.12 | $2,571 | 4.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $429.12 | $596 | 3.8× |
| Radex Ankle Complete Minimum 3 Views (73610) | $446.40 | $620 | 4.8× |
| Radex Calcaneus Minimum 2 Views (73650) | $293.04 | $407 | 3.1× |
| Radex elbow complete minimum 3 views (73080) | $446.40 | $620 | 4.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $719.28 | $999 | 6.4× |
| Radex fingr minimum 2 views (73140) | $290.16 | $403 | 3.1× |
| Radex foot complete minimum 3 views (73630) | $446.40 | $620 | 4.8× |
| Radex Hand Minimum 3 Views (73130) | $354.24 | $492 | 3.8× |
| Radex lower extremity infant minimum 2 views (73592) | $440.64 | $612 | 4.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $440.64 | $612 | 4.7× |
| Radex Ribs Unilateral 2 Views (71100) | $440.64 | $612 | 4.7× |
| Radex shoulder complete minimum 2 views (73030) | $496.08 | $689 | 5.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $257.76 | $358 | 2.8× |
| Radex Spine 1 View Specify Level (72020) | $190.08 | $264 | 2.0× |
| Radex Sternum Minimum 2 Views (71120) | $440.64 | $612 | 4.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $719.28 | $999 | 7.7× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$290.16–$403 | $403 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $419.04 | $582 | 3.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $437.04 | $607 | 4.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $953.28 | $1,324 | 8.5× |
| Radiologic exam colon single contrast study (74270) | $810 | $1,125 | 4.3× |
| Radiologic exam knee complete 4/more views (73564) | $601.20 | $835 | 5.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $788.40 | $1,095 | 7.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $660.24 | $917 | 3.5× |
| Radiologic exam swallow function contrast study (74230) | $660.24 | $917 | 3.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $745.92 | $1,036 | 4.0× |
| Radiologic examination femur 1 view (73551) | $215.28 | $299 | 2.3× |
| Radiologic examination femur minimum 2 views (73552) | $461.52 | $641 | 4.9× |
| Radiologic examination knee 1/2 views (73560) | $327.60 | $455 | 3.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $326.16 | $453 | 3.5× |
| Ribs bilateral 3 views (71110) | $719.28 | $999 | 6.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,234.88 | $3,104 | 5.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,502.72 | $3,476 | 5.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,164.40 | $4,395 | 5.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,164.40 | $4,395 | 5.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,164.40 | $4,395 | 5.4× |
| Scapula (73010) | $440.64 | $612 | 3.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$94.32–$105.12 | $131–$146 | varies |
| Shoulder 1 view (73020) | $290.16 | $403 | 3.1× |
| Shoulder Arthrography (73040) | $893.52 | $1,241 | 2.4× |
| Skull less than 4 views (70250) | $440.64 | $612 | 3.9× |
| Sternoclavicular joints (71130) | $583.92 | $811 | 6.3× |
| Thoracic spine 2 views (72070) | $386.64 | $537 | 3.5× |
| Thoracic spine 3 views (72072) | $432.72 | $601 | 3.9× |
| Thoracolumbar 2 views (72080) | $190.08 | $264 | 2.0× |
| Thyroid Imaging With Vascular Flow (78013) | $867.60 | $1,205 | 2.0× |
| Ultrasound Breast Limited (76642) | $836.64 | $1,162 | 9.0× |
| Ultrasound Exam Aaa Screen (76706) | $815.76 | $1,133 | 7.3× |
| Ultrasound, abdomen limited (76705) | $1,131.84 | $1,572 | 10.1× |
| Umbilical-artery Doppler (OB) (76820) | $398.16 | $553 | 3.6× |
| Upper gi w/o kub (74240) | $804.96 | $1,118 | 4.3× |
| Urethrocystogram voiding (74455) | $749.52 | $1,041 | 2.9× |
| Urethrocystography retrograde (74450) | $550.80 | $765 | 2.2× |
| Us breast unilateral complete (76641) | $910.80 | $1,265 | 8.1× |
| Us chest (76604) | $852.48 | $1,184 | 7.6× |
| Us complete joint (76881) | $647.28 | $899 | 5.8× |
| Us exam, pelvic, limited (76857) | $767.52 | $1,066 | 6.9× |
| Us kidney transplant (76776) | $1,135.44 | $1,577 | 10.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $465.84 | $647 | 4.2× |
| Us ob detailed single fetus (76811) | $1,018.08 | $1,414 | 4.0× |
| Us ob limited 1 or more fetuses (76815) | $544.32 | $756 | 4.9× |
| Us ob transvaginal (76817) | $398.16 | $553 | 3.6× |
| Us pelvic non ob complete (76856) | $945.36 | $1,313 | 8.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $920.16 | $1,278 | 8.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $601.20 | $835 | 5.4× |
| Us retroperitoneal complete (76770) | $1,145.52 | $1,591 | 10.2× |
| Us retroperitoneal limited (76775) | $902.16 | $1,253 | 8.1× |
| Us scrotum and contents (76870) | $945.36 | $1,313 | 8.4× |
| Us thyroid (76536) | $743.04 | $1,032 | 6.6× |
| Us transrectal (76872) | $945.36 | $1,313 | 8.4× |
| Wrist 2 views (73100) | $290.16 | $403 | 3.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $583.92 | $811 | 6.3× |
| X-Ray Bend Only L-S Spine (72120) | $229.68 | $319 | 2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $290.16 | $403 | 3.1× |
| X-Ray Exam Breast Specimen (76098) | $1,184.40 | $1,645 | 2.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $440.64 | $612 | 4.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $485.28 | $674 | 4.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $529.92 | $736 | 4.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $342.72 | $476 | 3.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $583.92 | $811 | 6.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $586.80 | $815 | 5.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $421.92 | $586 | 3.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $875.52 | $1,216 | 7.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,070.64 | $1,487 | 9.6× |
| X-Ray Exam L-S Spine Bending (72114) | $1,139.76 | $1,583 | 10.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $449.28 | $624 | 4.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,008 | $1,400 | 9.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $612.72 | $851 | 5.5× |
| X-ray eye for foreign body (70030) | $558.72 | $776 | 6.0× |
| X-ray humerus (73060) | $445.68 | $619 | 4.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$198–$687.60 | $275–$955 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $194.40 | $270 | 2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $449.28 | $624 | 4.0× |
| X-ray nose-rectum child f.b. (76010) | $321.84 | $447 | 3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $719.28 | $999 | 6.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $583.92 | $811 | 5.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $262.08 | $364 | 2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $483.84 | $672 | 5.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $719.28 | $999 | 7.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $733.68 | $1,019 | 6.5× |
| X-Ray Stress View (77071) | $383.04 | $532 | 4.1× |
| X-ray thoracic spine 4 vw (72074) | $787.68 | $1,094 | 7.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $771.12 | $1,071 | 2.1× |
| X-Rays Bone Length Studies (77073) | $416.16 | $578 | 3.7× |
| X-Rays Bone Survey Complete (77075) | $1,301.76 | $1,808 | 11.6× |
| Xr c-spine 4 or 5 views (72050) | $719.28 | $999 | 6.4× |
| Xr orbits complete 4 views (70200) | $719.28 | $999 | 6.4× |
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.