Imaging prices at St. Josephs Hospital
Breese, IL · every code in this section with a posted price and a Medicare benchmark.
250 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) | $373.68 | $519 | 4.0× |
| Abdomen 2 views (74019) | $543.60 | $755 | 4.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,512.72 | $2,101 | 3.5× |
| Ankle 2 views (73600) | $440.64 | $612 | 4.7× |
| Arthrogram ankle (73615) | $1,267.20 | $1,760 | 3.4× |
| Arthrogram hip (73525) | $1,149.84 | $1,597 | 3.1× |
| Arthrogram Wrist (73115) | $1,334.88 | $1,854 | 3.6× |
| Bone age studies (77072) | $462.96 | $643 | 4.1× |
| Bone Imaging 3 Phase (78315) | $2,648.88 | $3,679 | 6.2× |
| Bone Imaging Limited Area (78300) | $1,207.44 | $1,677 | 2.8× |
| Bone Imaging Multiple Areas (78305) | $1,305.36 | $1,813 | 3.0× |
| Bone Imaging Whole Body (78306) | $2,521.44 | $3,502 | 5.9× |
| Bone survey infant (77076) | $784.08 | $1,089 | 7.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,965.60 | $2,730 | 4.6× |
| Cat Scan Follow-Up Study (76380) | $1,955.52 | $2,716 | 21.0× |
| Chest 1 view (71045) | $348.48 | $484 | 3.7× |
| Chest 2 views (71046) | $472.32 | $656 | 5.1× |
| Chest 3 views (71047) | $519.12 | $721 | 5.6× |
| Chest 4 or more views (71048) | $519.12 | $721 | 4.6× |
| Clavicle complete (73000) | $375.12 | $521 | 4.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $197.28 | $274 | 1.8× |
| Contrast X-Ray Bladder (74430) | $732.24 | $1,017 | 2.0× |
| Contrast X-Ray Of Elbow (73085) | $1,095.12 | $1,521 | 2.9× |
| Contrast X-Ray Of Knee Joint (73580) | $1,334.88 | $1,854 | 3.6× |
| CT abdomen and pelvis without and with contrast (74178) | $5,340.96 | $7,418 | 14.3× |
| CT abdomen and pelvis without contrast (74176) | $3,755.52 | $5,216 | 14.7× |
| CT abdomen w contrast (74160) | $2,733.84 | $3,797 | 14.5× |
| CT abdomen w wo contrast (74170) | $3,343.68 | $4,644 | 17.8× |
| CT abdomen w/o contrast (74150) | $2,418.48 | $3,359 | 21.6× |
| CT Angio Abdomen and Pelvis (74174) | $4,681.44 | $6,502 | 12.5× |
| CT Angio Chest (71275) | $2,839.68 | $3,944 | 15.1× |
| CT Angio Head (70496) | $2,175.12 | $3,021 | 11.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,280.24 | $3,167 | 12.1× |
| CT Angio Neck (70498) | $2,259.36 | $3,138 | 12.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,306.88 | $3,204 | 12.3× |
| CT cervical spine w/ contrast (72126) | $1,886.40 | $2,620 | 5.0× |
| CT cervical spine w/o contrast (72125) | $2,640.24 | $3,667 | 23.6× |
| CT chest w contrast (71260) | $2,862 | $3,975 | 15.2× |
| CT chest w/wo contrast (71270) | $3,054.24 | $4,242 | 16.2× |
| CT head/brain with contrast (70460) | $1,891.44 | $2,627 | 10.1× |
| CT head/brain without and with contrast (70470) | $2,286.72 | $3,176 | 12.2× |
| CT iac w contrast (70481) | $1,625.76 | $2,258 | 8.6× |
| CT l-spine w&w/o contrast (72133) | $3,150.72 | $4,376 | 16.8× |
| CT lower ext w/o (73700) | $1,815.12 | $2,521 | 16.2× |
| CT lower extremity w/contrast material (73701) | $1,908 | $2,650 | 10.2× |
| CT lumbar spine w contrast (72132) | $3,029.76 | $4,208 | 8.1× |
| CT lumbar spine w/o contrast (72131) | $2,685.60 | $3,730 | 24.0× |
| CT maxillofacial w contrast (70487) | $1,941.12 | $2,696 | 10.3× |
| CT maxillofacial wo contrast (70486) | $1,744.56 | $2,423 | 15.6× |
| CT neck tissue combo (70492) | $2,095.92 | $2,911 | 11.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,804.32 | $2,506 | 9.6× |
| CT orbits w/o contrast (70480) | $1,447.20 | $2,010 | 12.9× |
| CT pelvis w&w/o contrast (72194) | $2,558.88 | $3,554 | 13.6× |
| CT pelvis w/o contrast (72192) | $2,144.88 | $2,979 | 19.1× |
| CT scan of leg combo (73702) | $2,230.56 | $3,098 | 11.9× |
| CT scans face/jaw combo (70488) | $2,136.96 | $2,968 | 11.4× |
| CT soft tissue neck w contrast (70491) | $2,136.96 | $2,968 | 11.4× |
| CT soft tissue neck w/o contrast (70490) | $1,504.08 | $2,089 | 13.4× |
| CT thoracic spine w contrast (72129) | $3,029.76 | $4,208 | 16.1× |
| CT thoracic spine w/o contrast (72128) | $2,637.36 | $3,663 | 23.5× |
| CT thoracic spine w/wo cont (72130) | $3,294.72 | $4,576 | 17.5× |
| CT thorax w/o contrast (71250) | $2,305.44 | $3,202 | 20.6× |
| CT upper ext wo (73200) | $1,815.12 | $2,521 | 16.2× |
| CT upper extremity w/o & w/contrast material (73202) | $2,306.88 | $3,204 | 12.3× |
| CT upper extremity with contrast (73201) | $1,908 | $2,650 | 5.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,203.20 | $3,060 | 11.7× |
| Cta Abdomen (74175) | $2,413.44 | $3,352 | 12.8× |
| CTA pelvis (72191) | $2,558.88 | $3,554 | 13.6× |
| Doppler Fetal Mid Cerebral Artery (76821) | $236.88 | $329 | 2.1× |
| Dxa Bone Density Axial (77080) | $463.68 | $644 | 4.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $387.36 | $538 | 4.2× |
| Echo exam uterus (76831) | $995.76 | $1,383 | 3.9× |
| Esophagram (74220) | $553.68 | $769 | 2.9× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$277.20–$1,613.52 | $385–$2,241 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$262.80–$1,236.24 | $365–$1,717 | varies |
| Fluoroscopy up to 1 hr (76000) | $514.80 | $715 | 2.0× |
| Foot 2 views (73620) | $385.92 | $536 | 4.1× |
| Forearm 2 views (73090) | $423.36 | $588 | 4.5× |
| Gastric emptying imaging study (78264) | $2,157.12 | $2,996 | 5.0× |
| Gated Heart Planar Single (78472) | $2,093.76 | $2,908 | 4.9× |
| Hand 2 views (73120) | $432.72 | $601 | 3.9× |
| Hepatobil Syst Image W/Drug (78227) | $3,003.12 | $4,171 | 5.2× |
| Hepatobiliary System Imaging (78226) | $2,456.64 | $3,412 | 5.7× |
| Ht Muscle Image Spect Sing (78451) | $1,409.76 | $1,958 | 1.0× |
| Hysterosalpingogram (74740) | $694.08 | $964 | 2.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $480.96 | $668 | 5.2× |
| Infant hip ultrasound, limited static exam (76886) | $427.68 | $594 | 4.6× |
| K Flow/Funct Image Multiple (78709) | $1,290.24 | $1,792 | 2.2× |
| K Flow/Funct Image W/Drug (78708) | $1,150.56 | $1,598 | 2.0× |
| K Flow/Funct Image W/O Drug (78707) | $1,015.92 | $1,411 | 1.7× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $599.04 | $832 | 1.4× |
| Knee 3 Views (73562) | $547.92 | $761 | 5.9× |
| Liver & Spleen Imaging Static Only (78215) | $1,427.04 | $1,982 | 3.3× |
| Lung perfusion differential (78597) | $1,645.92 | $2,286 | 3.8× |
| Lymph System Imaging (78195) | $3,181.68 | $4,419 | 5.5× |
| Magnetic Image Jaw Joint (70336) | $2,614.32 | $3,631 | 10.2× |
| Mammary ductogram or galactogram single (77053) | $534.96 | $743 | 2.1× |
| Meckels Divert Exam (78290) | $1,539.36 | $2,138 | 3.6× |
| Mra Head W/O & W/Contrast Material (70546) | $3,175.20 | $4,410 | 8.5× |
| MRA head w/o contrast (70544) | $2,981.52 | $4,141 | 11.7× |
| MRA head with contrast (70545) | $3,132 | $4,350 | 8.4× |
| MRA neck w contrast (70548) | $3,340.80 | $4,640 | 8.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,551.76 | $4,933 | 9.5× |
| MRA neck w/o contrast (70547) | $3,129.84 | $4,347 | 12.2× |
| MRI abdomen w contrast (74182) | $3,523.68 | $4,894 | 9.4× |
| MRI abdomen w/o contrast (74181) | $3,130.56 | $4,348 | 12.2× |
| MRI any jt lower extrem w/contrast material (73722) | $3,488.40 | $4,845 | 4.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,085.28 | $5,674 | 10.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,587.04 | $4,982 | 4.3× |
| MRI cervical spine w contrast (72142) | $3,735.36 | $5,188 | 10.0× |
| MRI cervical spine w/o cont (72141) | $3,133.44 | $4,352 | 12.3× |
| MRI chest w/o contrast (71550) | $2,928.96 | $4,068 | 11.5× |
| MRI chest with contrast (71551) | $3,368.16 | $4,678 | 4.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,488.40 | $4,845 | 9.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $4,085.28 | $5,674 | 10.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,192.48 | $4,434 | 12.5× |
| MRI lumbar spine w contrast (72149) | $3,517.92 | $4,886 | 9.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,293.36 | $5,963 | 11.5× |
| MRI orbit face &/neck w/o contrast (70540) | $2,906.64 | $4,037 | 11.4× |
| MRI orbit face neck w contrast (70542) | $3,412.80 | $4,740 | 9.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,367.52 | $6,066 | 11.7× |
| MRI pelvis w contrast (72196) | $3,435.12 | $4,771 | 9.2× |
| MRI pelvis w/o & w contrast (72197) | $4,230 | $5,875 | 11.3× |
| MRI pelvis w/o contrast (72195) | $2,942.64 | $4,087 | 11.5× |
| MRI thoracic spine w/o contrast (72146) | $3,099.60 | $4,305 | 12.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,497.76 | $4,858 | 9.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,192.48 | $4,434 | 12.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $4,085.28 | $5,674 | 10.9× |
| MRI, abdomen, combo (74183) | $4,053.60 | $5,630 | 10.8× |
| MRI, dorsal spine combo (72157) | $4,278.96 | $5,943 | 11.4× |
| MRI, dorsal spine contrast (72147) | $3,492.72 | $4,851 | 9.3× |
| MRI, joint upper extrem (73221) | $3,338.64 | $4,637 | 13.1× |
| MRI, joint upper extrem combo (73223) | $4,085.28 | $5,674 | 10.9× |
| MRI, lumbar spine combo (72158) | $4,242.24 | $5,892 | 11.3× |
| Myocardial Spect Multiple Studies (78452) | $4,363.20 | $6,060 | 3.1× |
| Neck soft tissue (70360) | $348.48 | $484 | 3.7× |
| Ob us nuchal meas 1 gest (76813) | $629.28 | $874 | 5.6× |
| Parathyroid Planar Imaging (78070) | $1,782 | $2,475 | 4.2× |
| Pelvis 1 or 2 views (72170) | $319.68 | $444 | 2.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,243.52 | $3,116 | 5.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $892.08 | $1,239 | 8.0× |
| Radex Ankle Complete Minimum 3 Views (73610) | $515.52 | $716 | 5.5× |
| Radex Calcaneus Minimum 2 Views (73650) | $375.12 | $521 | 4.0× |
| Radex elbow complete minimum 3 views (73080) | $506.16 | $703 | 5.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $637.92 | $886 | 5.7× |
| Radex fingr minimum 2 views (73140) | $580.32 | $806 | 6.2× |
| Radex foot complete minimum 3 views (73630) | $489.60 | $680 | 5.2× |
| Radex Hand Minimum 3 Views (73130) | $509.04 | $707 | 5.5× |
| Radex lower extremity infant minimum 2 views (73592) | $367.92 | $511 | 3.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $606.24 | $842 | 5.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $465.84 | $647 | 5.0× |
| Radex Ribs Unilateral 2 Views (71100) | $355.68 | $494 | 3.8× |
| Radex shoulder complete minimum 2 views (73030) | $515.52 | $716 | 5.5× |
| Radex Spine 1 View Specify Level (72020) | $463.68 | $644 | 5.0× |
| Radex Sternum Minimum 2 Views (71120) | $494.64 | $687 | 5.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $355.68 | $494 | 3.8× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$321.84–$447 | $447 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $399.60 | $555 | 3.6× |
| Radex Wrist Complete Minimum 3 Views (73110) | $462.96 | $643 | 5.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $563.76 | $783 | 5.0× |
| Radiologic exam colon double contrast study (74280) | $1,267.20 | $1,760 | 6.7× |
| Radiologic exam colon single contrast study (74270) | $1,121.76 | $1,558 | 6.0× |
| Radiologic exam knee complete 4/more views (73564) | $567.36 | $788 | 5.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $380.88 | $529 | 3.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $613.44 | $852 | 3.3× |
| Radiologic exam swallow function contrast study (74230) | $613.44 | $852 | 3.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,092.96 | $1,518 | 5.8× |
| Radiologic examination femur 1 view (73551) | $169.20 | $235 | 1.8× |
| Radiologic examination femur minimum 2 views (73552) | $271.44 | $377 | 2.9× |
| Radiologic examination knee 1/2 views (73560) | $453.60 | $630 | 4.9× |
| Radiologic examination tibia & fibula 2 views (73590) | $493.20 | $685 | 5.3× |
| Ribs bilateral 3 views (71110) | $445.68 | $619 | 4.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,052.64 | $1,462 | 2.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,733.76 | $2,408 | 4.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,660.48 | $5,084 | 6.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,491.20 | $3,460 | 4.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,660.48 | $5,084 | 2.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,660.48 | $5,084 | 2.6× |
| Scapula (73010) | $375.12 | $521 | 3.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $78.48 | $109 | 3.4× |
| Shoulder 1 view (73020) | $365.76 | $508 | 3.9× |
| Shoulder Arthrography (73040) | $1,306.80 | $1,815 | 3.5× |
| Skull less than 4 views (70250) | $519.84 | $722 | 4.6× |
| Sternoclavicular joints (71130) | $296.64 | $412 | 3.2× |
| Thoracic spine 2 views (72070) | $353.52 | $491 | 3.2× |
| Thoracic spine 3 views (72072) | $647.28 | $899 | 5.8× |
| Thoracolumbar 2 views (72080) | $198 | $275 | 2.1× |
| Thyroid Imaging With Vascular Flow (78013) | $645.12 | $896 | 1.5× |
| Thyroid Uptake Measurement (78012) | $820.08 | $1,139 | 1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,342.08 | $1,864 | 3.1× |
| Ultrasound Breast Limited (76642) | $501.84 | $697 | 5.4× |
| Ultrasound Exam Aaa Screen (76706) | $822.96 | $1,143 | 7.3× |
| Ultrasound, abdomen limited (76705) | $1,182.24 | $1,642 | 10.6× |
| Umbilical-artery Doppler (OB) (76820) | $453.60 | $630 | 4.0× |
| Upper gi w/o kub (74240) | $979.92 | $1,361 | 5.2× |
| Urethrocystogram voiding (74455) | $1,030.32 | $1,431 | 4.0× |
| Us breast unilateral complete (76641) | $871.92 | $1,211 | 7.8× |
| Us chest (76604) | $601.20 | $835 | 5.4× |
| Us complete joint (76881) | $730.80 | $1,015 | 6.5× |
| Us exam, pelvic, limited (76857) | $566.64 | $787 | 5.1× |
| Us head (76506) | $668.88 | $929 | 6.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $622.80 | $865 | 5.6× |
| Us ob detailed single fetus (76811) | $1,283.76 | $1,783 | 5.0× |
| Us ob limited 1 or more fetuses (76815) | $936.72 | $1,301 | 8.4× |
| Us ob transvaginal (76817) | $956.88 | $1,329 | 8.5× |
| Us pelvic non ob complete (76856) | $1,245.60 | $1,730 | 11.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,056.24 | $1,467 | 9.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$262.80–$995.04 | $365–$1,382 | varies |
| Us retroperitoneal complete (76770) | $978.48 | $1,359 | 8.7× |
| Us retroperitoneal limited (76775) | $886.32 | $1,231 | 7.9× |
| Us scrotum and contents (76870) | $1,144.08 | $1,589 | 10.2× |
| Us spinal canal and contents (76800) | $303.12 | $421 | 2.7× |
| Us thyroid (76536) | $1,069.92 | $1,486 | 9.6× |
| Us transrectal (76872) | $872.64 | $1,212 | 7.8× |
| Vertebral fracture assessment via dxa (77086) | $252.72 | $351 | 2.7× |
| Wrist 2 views (73100) | $406.08 | $564 | 4.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $326.16 | $453 | 3.5× |
| X-Ray Bend Only L-S Spine (72120) | $387.36 | $538 | 3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $385.92 | $536 | 4.1× |
| X-Ray Exam Breast Specimen (76098) | $591.84 | $822 | 1.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $236.16 | $328 | 2.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $236.16 | $328 | 2.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $236.16 | $328 | 2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $271.44 | $377 | 2.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $303.12 | $421 | 2.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $406.80 | $565 | 3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $457.20 | $635 | 4.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $568.08 | $789 | 5.1× |
| X-Ray Exam L-S Spine Bending (72114) | $1,158.48 | $1,609 | 10.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $642.96 | $893 | 6.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,059.84 | $1,472 | 9.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $411.84 | $572 | 3.7× |
| X-ray eye for foreign body (70030) | $344.16 | $478 | 3.7× |
| X-ray humerus (73060) | $453.60 | $630 | 4.9× |
| X-ray IV pyelogram (ivp) (74400) | $1,164.24 | $1,617 | 6.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $225.36 | $313 | 2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $776.16 | $1,078 | 8.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $688.32 | $956 | 6.1× |
| X-ray nose-rectum child f.b. (76010) | $360 | $500 | 3.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $528.48 | $734 | 4.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $501.12 | $696 | 4.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $264.96 | $368 | 2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $494.64 | $687 | 5.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $675.36 | $938 | 7.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $765.36 | $1,063 | 6.8× |
| X-ray thoracic spine 4 vw (72074) | $755.28 | $1,049 | 6.7× |
| X-Rays Bone Length Studies (77073) | $728.64 | $1,012 | 6.5× |
| X-Rays Bone Survey Complete (77075) | $982.80 | $1,365 | 8.8× |
| Xr c-spine 4 or 5 views (72050) | $811.44 | $1,127 | 7.2× |
| Xr orbits complete 4 views (70200) | $515.52 | $716 | 4.6× |
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.