Imaging prices at St. Rose Hospital
Hayward, CA · every code in this section with a posted price and a Medicare benchmark.
261 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) | $116.24 | $387.45 | 0.9× |
| Abdomen 2 views (74019) | $187.01 | $623.38 | 1.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $963.27 | $3,210.90 | 1.7× |
| Angiography extremity bilateral rs&i (75716) | $3,373.68 | $11,245.59 | 0.8× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$3,373.68–$4,031.09 | $11,245.59–$13,436.96 | varies |
| Ankle 2 views (73600) | $247.91 | $826.35 | 2.0× |
| Artery X-Rays Pelvis (75736) | $5,816.35 | $19,387.83 | 0.7× |
| Arthrogram hip (73525) | $421.41 | $1,404.69 | 0.8× |
| Bone age studies (77072) | $186.48 | $621.60 | 1.3× |
| Bone Imaging 3 Phase (78315) | $1,285.83 | $4,286.10 | 2.3× |
| Bone Imaging Limited Area (78300) | $699.62 | $2,332.05 | 1.2× |
| Bone Imaging Multiple Areas (78305) | $436.53 | $1,455.11 | 0.8× |
| Bone Imaging Whole Body (78306) | $1,441.13 | $4,803.75 | 2.5× |
| Bone survey infant (77076) | $329.18 | $1,097.25 | 2.2× |
| Brain Image W/Flow < 4 Views (78601) | $436.53 | $1,455.10 | 0.8× |
| Brain imaging < 4 static views (78600) | $436.53 | $1,455.10 | 0.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $572.08 | $1,906.93 | 0.7× |
| Brain Imaging Minimum 4 Static Views (78605) | $572.08 | $1,906.93 | 0.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $436.53 | $1,455.11 | 0.8× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $572.08 | $1,906.93 | 0.7× |
| Cat Scan Follow-Up Study (76380) | $458.64 | $1,528.80 | 3.7× |
| Chest 1 view (71045) | $97.82 | $326.08 | 0.8× |
| Chest 2 views (71046) | $97.82 | $326.08 | 0.8× |
| Chest 3 views (71047) | $232.79 | $775.95 | 1.9× |
| Chest 4 or more views (71048) | $457.70 | $1,525.65 | 3.1× |
| Cisternography Positive Contrast Rs&I (70015) | $847.45 | $2,824.83 | 0.8× |
| Clavicle complete (73000) | $230.27 | $767.55 | 1.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$116.36–$128.32 | $387.87–$427.72 | varies |
| Contrast Exam Abdominl Aorta (75625) | $3,373.68 | $11,245.59 | 0.8× |
| Contrast X-Ray Bladder (74430) | $421.41 | $1,404.69 | 0.8× |
| Contrast X-Ray Of Elbow (73085) | $421.41 | $1,404.69 | 0.8× |
| Contrast X-Ray Of Knee Joint (73580) | $421.41 | $1,404.69 | 0.8× |
| CT abdomen and pelvis without and with contrast (74178) | $3,207.02 | $10,690.05 | 6.5× |
| CT abdomen and pelvis without contrast (74176) | $1,671.39 | $5,571.30 | 4.9× |
| CT abdomen w contrast (74160) | $1,201.41 | $4,004.70 | 4.8× |
| CT abdomen w wo contrast (74170) | $2,204.69 | $7,348.95 | 8.8× |
| CT abdomen w/o contrast (74150) | $1,161.72 | $3,872.40 | 7.8× |
| CT Angio Abdomen and Pelvis (74174) | $1,806.53 | $6,021.75 | 3.6× |
| CT Angio Chest (71275) | $2,360.93 | $7,869.75 | 9.5× |
| CT Angio Head (70496) | $1,594.53 | $5,315.10 | 6.4× |
| CT angio hrt w/3d image (75574) | $3,564.23 | $11,880.75 | 7.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,262.52 | $4,208.40 | 5.1× |
| CT Angio Neck (70498) | $1,594.53 | $5,315.10 | 6.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$528.32–$1,262.52 | $1,761.08–$4,208.40 | varies |
| CT cervical spine w/ contrast (72126) | $2,274.62 | $7,582.05 | 4.6× |
| CT cervical spine w/o contrast (72125) | $1,374.98 | $4,583.25 | 9.2× |
| CT chest w contrast (71260) | $1,660.05 | $5,533.50 | 6.7× |
| CT chest w/wo contrast (71270) | $1,746.05 | $5,820.15 | 7.0× |
| CT head/brain with contrast (70460) | $1,269.77 | $4,232.55 | 5.1× |
| CT head/brain without and with contrast (70470) | $1,557.05 | $5,190.15 | 6.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $194.47 | $648.22 | 0.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $96.18 | $320.59 | 0.8× |
| CT hrt w/3d image congen (75573) | $194.47 | $648.22 | 0.4× |
| CT iac w contrast (70481) | $1,410.57 | $4,701.90 | 5.7× |
| CT l-spine w&w/o contrast (72133) | $481.82 | $1,606.08 | 1.9× |
| CT lower ext w/o (73700) | $1,125.18 | $3,750.60 | 7.6× |
| CT lower extremity w/contrast material (73701) | $1,180.31 | $3,934.35 | 4.7× |
| CT lumbar spine w contrast (72132) | $2,274.62 | $7,582.05 | 4.6× |
| CT lumbar spine w/o contrast (72131) | $1,299.69 | $4,332.30 | 8.7× |
| CT maxillofacial w contrast (70487) | $1,381.91 | $4,606.35 | 5.5× |
| CT maxillofacial wo contrast (70486) | $1,185.98 | $3,953.25 | 8.0× |
| CT neck tissue combo (70492) | $1,707.60 | $5,692 | 6.8× |
| CT orbits w/o contrast (70480) | $975.87 | $3,252.90 | 6.6× |
| CT pelvis w/o contrast (72192) | $1,087.07 | $3,623.55 | 7.3× |
| CT soft tissue neck w contrast (70491) | $1,413.09 | $4,710.30 | 5.7× |
| CT soft tissue neck w/o contrast (70490) | $1,344.74 | $4,482.45 | 9.0× |
| CT thoracic spine w contrast (72129) | $2,182.95 | $7,276.50 | 8.8× |
| CT thoracic spine w/o contrast (72128) | $1,247.40 | $4,158 | 8.4× |
| CT thorax w/o contrast (71250) | $1,548.54 | $5,161.80 | 10.4× |
| CT upper ext wo (73200) | $1,146.92 | $3,823.05 | 7.7× |
| CT upper extremity with contrast (73201) range across 16 matching MRF lines |
$1,180.31–$1,203.30 | $3,934.35–$4,011 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,323.44 | $7,744.80 | 9.3× |
| Cta Abdomen (74175) | $2,803.82 | $9,346.05 | 11.2× |
| Dilation ureters/urethra rs&i (74485) | $2,155.79 | $7,185.97 | 0.7× |
| Echo exam uterus (76831) | $372.02 | $1,240.05 | 1.1× |
| Echo Guide For Artery Repair (76936) | $332.21 | $1,107.37 | 1.1× |
| Esophagram (74220) | $397.85 | $1,326.15 | 1.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $124.74 | $415.80 | 0.8× |
| Fluoroscopy up to 1 hr (76000) | $263.45 | $878.15 | 0.8× |
| Foot 2 views (73620) | $179.87 | $599.55 | 1.5× |
| Forearm 2 views (73090) | $253.26 | $844.20 | 2.0× |
| Gastric emptying imaging study (78264) | $930.51 | $3,101.70 | 1.6× |
| Gated Heart Planar Single (78472) | $1,125.77 | $3,752.57 | 2.0× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$142.38–$285.08 | $474.60–$950.25 | varies |
| Heart first pass single,planar (78481) | $725.76 | $2,419.20 | 0.9× |
| Hepatobil Syst Image W/Drug (78227) | $1,033.52 | $3,445.05 | 1.3× |
| Hepatobiliary System Imaging (78226) | $843.89 | $2,812.95 | 1.5× |
| Hysterosalpingogram (74740) | $397.85 | $1,326.15 | 1.2× |
| K Flow/Funct Image Multiple (78709) | $695.14 | $2,317.14 | 0.9× |
| K Flow/Funct Image W/Drug (78708) | $613.31 | $2,044.35 | 0.8× |
| K Flow/Funct Image W/O Drug (78707) | $688.80 | $2,296 | 0.9× |
| Kidney Imaging Morphol (78700) | $436.53 | $1,455.11 | 0.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $719.15 | $2,397.15 | 1.3× |
| Knee 3 Views (73562) | $266.18 | $887.25 | 2.2× |
| Liver & Spleen Imaging Static Only (78215) | $891.77 | $2,972.55 | 1.6× |
| Liver imaging static only (78201) | $968.14 | $3,227.12 | 1.3× |
| Lung Perf&Ventilat Diferentl (78598) | $572.08 | $1,906.93 | 0.7× |
| Lung perfusion differential (78597) | $436.53 | $1,455.11 | 0.8× |
| Lung Ventilat&Perfus Imaging (78582) | $1,539.41 | $5,131.35 | 2.0× |
| Lung Ventilation Imaging (78579) | $436.53 | $1,455.11 | 0.8× |
| Mammary ductogram or galactogram multiple (77054) | $530.62 | $1,768.72 | 1.6× |
| Mammary ductogram or galactogram single (77053) | $530.62 | $1,768.72 | 1.6× |
| MRA head w/o contrast (70544) | $899.96 | $2,999.85 | 2.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,285.83 | $4,286.10 | 2.6× |
| MRA neck w/o contrast (70547) | $899.96 | $2,999.85 | 2.7× |
| MRI abdomen w contrast (74182) | $971.46 | $3,238.20 | 2.0× |
| MRI abdomen w/o contrast (74181) | $1,052.42 | $3,508.05 | 3.1× |
| MRI any jt lower extrem w/contrast material (73722) | $970.20 | $3,234 | 0.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,284.26 | $4,280.85 | 2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $847.45 | $2,824.83 | 0.8× |
| MRI cervical spine w/o cont (72141) | $971.46 | $3,238.20 | 2.9× |
| MRI chest w/o contrast (71550) | $899.96 | $2,999.85 | 2.7× |
| MRI chest with contrast (71551) | $971.46 | $3,238.20 | 0.9× |
| MRI chest wo w contrast (71552) | $1,224.60 | $4,082 | 2.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $898.38 | $2,994.60 | 1.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,284.26 | $4,280.85 | 2.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $899.01 | $2,996.70 | 2.6× |
| MRI lumbar spine w contrast (72149) | $971.46 | $3,238.20 | 2.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,285.83 | $4,286.10 | 2.6× |
| MRI orbit face &/neck w/o contrast (70540) | $899.96 | $2,999.85 | 2.7× |
| MRI orbit face neck w contrast (70542) | $555.03 | $1,850.10 | 1.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,285.83 | $4,286.10 | 2.6× |
| MRI pelvis w contrast (72196) | $971.15 | $3,237.15 | 2.0× |
| MRI pelvis w/o & w contrast (72197) | $1,285.83 | $4,286.10 | 2.6× |
| MRI pelvis w/o contrast (72195) | $899.96 | $2,999.85 | 2.7× |
| MRI thoracic spine w/o contrast (72146) | $899.96 | $2,999.85 | 2.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $970.20 | $3,234 | 2.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $899.01 | $2,996.70 | 2.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,285.83 | $4,286.10 | 2.6× |
| MRI, abdomen, combo (74183) | $1,134.95 | $3,783.15 | 2.3× |
| MRI, dorsal spine combo (72157) | $1,285.83 | $4,286.10 | 2.6× |
| MRI, dorsal spine contrast (72147) | $925.20 | $3,084 | 1.9× |
| MRI, joint upper extrem (73221) | $899.96 | $2,999.85 | 2.7× |
| MRI, joint upper extrem combo (73223) | $1,285.83 | $4,286.10 | 2.6× |
| MRI, lumbar spine combo (72158) | $1,220.94 | $4,069.80 | 2.5× |
| Myelogram cervical (72240) | $967.11 | $3,223.71 | 0.9× |
| Myelogram Lumbar (72265) | $967.11 | $3,223.71 | 0.9× |
| Myelography thoracic (72255) | $967.11 | $3,223.71 | 0.9× |
| Myelograpy 2/more regions rs&i (72270) | $847.45 | $2,824.83 | 0.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,502.91 | $5,009.70 | 0.8× |
| Myocardial Spect Multiple Studies (78452) | $1,502.91 | $5,009.70 | 0.8× |
| Neck soft tissue (70360) | $182.39 | $607.95 | 1.5× |
| Nm csf leak detection (78650) | $1,540.18 | $5,133.92 | 0.8× |
| Nonvascular Shunt X-Ray (75809) | $173.25 | $577.50 | 1.2× |
| Ob us nuchal meas 1 gest (76813) | $124.74 | $415.80 | 0.8× |
| Parathyroid Planar Imaging (78070) | $679.46 | $2,264.85 | 1.2× |
| Parathyroid planar imaging w/wo subtraction (78071) | $523.92 | $1,746.41 | 0.9× |
| Pelvis 1 or 2 views (72170) | $181.76 | $605.85 | 1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $676.94 | $2,256.45 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $443.21 | $1,477.35 | 3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $583.90 | $1,946.33 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) | $96.18 | $320.59 | 0.8× |
| Radex Calcaneus Minimum 2 Views (73650) | $198.77 | $662.55 | 1.6× |
| Radex elbow complete minimum 3 views (73080) | $280.98 | $936.60 | 2.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $412.97 | $1,376.55 | 2.8× |
| Radex fingr minimum 2 views (73140) | $193.10 | $643.65 | 1.6× |
| Radex foot complete minimum 3 views (73630) | $272.16 | $907.20 | 2.2× |
| Radex Hand Minimum 3 Views (73130) | $285.08 | $950.25 | 2.3× |
| Radex lower extremity infant minimum 2 views (73592) | $182.07 | $606.90 | 1.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $271.22 | $904.05 | 2.2× |
| Radex Ribs Unilateral 2 Views (71100) | $270.90 | $903 | 2.2× |
| Radex shoulder complete minimum 2 views (73030) | $275.94 | $919.80 | 2.2× |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$95.33–$421.41 | $317.78–$1,404.69 | varies |
| Radex Spine 1 View Specify Level (72020) | $137.03 | $456.75 | 1.1× |
| Radex Sternum Minimum 2 Views (71120) | $262.71 | $875.70 | 2.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $388.08 | $1,293.60 | 3.1× |
| Radex Toe Minimum 2 Views (73660) | $186.48 | $621.60 | 1.5× |
| Radex upper extremity infant minimum 2 views (73092) | $191.84 | $639.45 | 1.3× |
| Radex Wrist Complete Minimum 3 Views (73110) | $300.83 | $1,002.75 | 2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $359.10 | $1,197 | 2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $187.01 | $623.38 | 1.3× |
| Radiologic exam colon double contrast study (74280) | $1,027.85 | $3,426.15 | 4.1× |
| Radiologic exam colon single contrast study (74270) | $322.25 | $1,074.15 | 1.3× |
| Radiologic exam knee complete 4/more views (73564) | $315 | $1,050 | 2.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $124.75 | $415.83 | 0.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $490.46 | $1,634.85 | 2.0× |
| Radiologic exam swallow function contrast study (74230) | $417.06 | $1,390.20 | 1.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $482.90 | $1,609.65 | 1.9× |
| Radiologic examination femur minimum 2 views (73552) | $95.76 | $319.20 | 0.8× |
| Radiologic examination knee 1/2 views (73560) | $137.97 | $459.90 | 1.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $258.62 | $862.05 | 2.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $436.53 | $1,455.11 | 0.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,502.91 | $5,009.70 | 1.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,502.91 | $5,009.70 | 1.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,511.52 | $5,038.40 | 2.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,502.91 | $5,009.70 | 0.8× |
| Scapula (73010) | $216.41 | $721.35 | 1.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $73.83 | $246.10 | 3.2× |
| Shoulder 1 view (73020) | $169.79 | $565.95 | 1.4× |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$407.04–$421.41 | $1,356.80–$1,404.69 | varies |
| Sialogram (70390) | $263.45 | $878.15 | 0.8× |
| Skull less than 4 views (70250) | $257.36 | $857.85 | 1.7× |
| Sternoclavicular joints (71130) | $188.37 | $627.90 | 1.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $204.40 | $681.32 | 0.8× |
| Thoracic spine 2 views (72070) | $325.40 | $1,084.65 | 2.2× |
| Thoracic spine 3 views (72072) | $318.78 | $1,062.60 | 2.1× |
| Thoracolumbar 2 views (72080) | $325.40 | $1,084.65 | 2.6× |
| Thyroid Met Imaging Body (78018) | $572.08 | $1,906.93 | 0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $607.01 | $2,023.35 | 1.1× |
| Ultrasound Breast Limited (76642) | $204.74 | $682.45 | 1.7× |
| Ultrasound, abdomen limited (76705) | $261.45 | $871.50 | 1.8× |
| Umbilical-artery Doppler (OB) (76820) | $124.74 | $415.80 | 0.8× |
| Unlisted Dx Radiographic Procedure (76499) | $96.18 | $320.59 | 0.8× |
| Unlisted fluoroscopic procedure (76496) | $96.18 | $320.59 | 0.8× |
| Unlisted us procedure (76999) | $96.42 | $321.40 | 0.8× |
| Upper gi w/o kub (74240) | $491.72 | $1,639.05 | 2.0× |
| Urethrocystogram voiding (74455) | $417.61 | $1,392.04 | 1.2× |
| Urethrocystography retrograde (74450) | $417.61 | $1,392.04 | 1.2× |
| Us breast unilateral complete (76641) | $204.74 | $682.45 | 1.4× |
| Us chest (76604) | $362.88 | $1,209.60 | 2.4× |
| Us complete joint (76881) | $444.47 | $1,481.55 | 3.0× |
| Us exam, pelvic, limited (76857) | $283.82 | $946.05 | 1.9× |
| Us kidney transplant (76776) | $341.52 | $1,138.41 | 2.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$116.36–$241.61 | $387.87–$805.35 | varies |
| Us ob limited 1 or more fetuses (76815) | $124.74 | $415.80 | 0.8× |
| Us ob transvaginal (76817) | $124.74 | $415.80 | 0.8× |
| Us pelvic non ob complete (76856) | $614.25 | $2,047.50 | 4.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $124.74 | $415.80 | 0.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $124.74 | $415.80 | 0.8× |
| Us retroperitoneal complete (76770) | $482.58 | $1,608.60 | 3.2× |
| Us retroperitoneal limited (76775) | $128.44 | $428.12 | 0.9× |
| Us scrotum and contents (76870) | $459.27 | $1,530.90 | 3.1× |
| Us thyroid (76536) | $124.74 | $415.80 | 0.8× |
| Venography caval inferior serialography rs&i (75825) | $3,373.68 | $11,245.59 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $1,695.09 | $5,650.29 | 0.8× |
| Wrist 2 views (73100) | $157.82 | $526.05 | 1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $235.31 | $784.35 | 1.9× |
| X-ray antegrade pyelogram tube (74425) | $421.41 | $1,404.69 | 0.8× |
| X-Ray Aorta Leg Arteries (75630) | $3,390.03 | $11,300.10 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $173.88 | $579.60 | 1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $159.08 | $530.25 | 1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $95.76 | $319.20 | 0.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $158.59 | $528.62 | 1.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $302.35 | $1,007.84 | 2.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $176.72 | $589.05 | 1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $95.76 | $319.20 | 0.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $158.59 | $528.62 | 1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $158.59 | $528.62 | 1.1× |
| X-Ray Exam L-S Spine Bending (72114) | $562.59 | $1,875.30 | 3.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $246.33 | $821.10 | 2.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $292.01 | $973.35 | 2.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $324.77 | $1,082.55 | 2.2× |
| X-ray eye for foreign body (70030) | $248.85 | $829.50 | 2.0× |
| X-ray humerus (73060) | $254.21 | $847.35 | 2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $96.18 | $320.59 | 0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $381.78 | $1,272.60 | 3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $262.71 | $875.70 | 1.8× |
| X-ray nose-rectum child f.b. (76010) | $194.99 | $649.95 | 1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $413.28 | $1,377.60 | 2.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $311.54 | $1,038.45 | 2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $124.75 | $415.83 | 0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $291.06 | $970.20 | 2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $311.22 | $1,037.40 | 2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $392.49 | $1,308.30 | 2.6× |
| X-Ray Stress View (77071) | $96.18 | $320.59 | 0.8× |
| X-Ray Tmj Unilat (70328) | $96.18 | $320.59 | 0.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $421.41 | $1,404.69 | 0.8× |
| X-Rays Bone Survey Complete (77075) | $593.46 | $1,978.20 | 4.0× |
| Xr c-spine 4 or 5 views (72050) | $246.33 | $821.10 | 1.7× |
| Xr facial bones less than 3 views (70140) | $223.97 | $746.55 | 1.8× |
| Xr orbits complete 4 views (70200) | $344.93 | $1,149.75 | 2.3× |
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.