Imaging prices at Star Valley Medical Center
Afton, WY · every code in this section with a posted price and a Medicare benchmark.
245 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) | $207.20 | $296 | 2.3× |
| Abdomen 2 views (74019) | $250.60 | $358 | 2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $684.60 | $978 | 1.7× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$247.10–$250.60 | $353–$358 | varies |
| Bone age studies (77072) | $431.90 | $617 | 4.0× |
| Bone Imaging 3 Phase (78315) | $1,831.90 | $2,617 | 4.5× |
| Bone Imaging Limited Area (78300) | $760.20 | $1,086 | 1.9× |
| Bone Imaging Whole Body (78306) | $1,746.50 | $2,495 | 4.3× |
| Bone survey infant (77076) | $444.50 | $635 | 4.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,534.40 | $2,192 | 4.3× |
| Cat Scan Follow-Up Study (76380) | $573.30 | $819 | 6.4× |
| Chest 1 view (71045) | $189 | $270 | 2.1× |
| Chest 2 views (71046) | $241.50 | $345 | 2.7× |
| Chest 4 or more views (71048) | $705.60 | $1,008 | 6.6× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$268.80–$294 | $384–$420 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $573.30 | $819 | 5.4× |
| Contrast X-Ray Bladder (74430) | $1,218 | $1,740 | 3.4× |
| CT abdomen and pelvis without and with contrast (74178) | $3,887.10 | $5,553 | 10.9× |
| CT abdomen and pelvis without contrast (74176) | $2,805.60 | $4,008 | 11.5× |
| CT abdomen w contrast (74160) | $1,265.60 | $1,808 | 7.1× |
| CT abdomen w wo contrast (74170) | $1,483.30 | $2,119 | 8.3× |
| CT abdomen w/o contrast (74150) | $1,226.40 | $1,752 | 11.5× |
| CT Angio Abdomen and Pelvis (74174) | $3,031.70 | $4,331 | 8.5× |
| CT Angio Chest (71275) | $1,722 | $2,460 | 9.6× |
| CT Angio Head (70496) | $1,492.40 | $2,132 | 8.3× |
| CT angio hrt w/3d image (75574) | $1,265.60 | $1,808 | 3.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $885.50 | $1,265 | 4.9× |
| CT Angio Neck (70498) | $1,738.80 | $2,484 | 9.7× |
| CT cervical spine w/ contrast (72126) | $1,218 | $1,740 | 3.4× |
| CT cervical spine w/o contrast (72125) | $1,661.80 | $2,374 | 15.6× |
| CT cervical spine w/wo cont (72127) | $1,265.60 | $1,808 | 7.1× |
| CT chest w contrast (71260) | $2,086.70 | $2,981 | 11.6× |
| CT chest w/wo contrast (71270) | $1,392.30 | $1,989 | 7.8× |
| CT head/brain with contrast (70460) | $1,139.60 | $1,628 | 6.4× |
| CT head/brain without and with contrast (70470) | $1,521.10 | $2,173 | 8.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $236.60 | $338 | 2.7× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,392.30–$1,958.60 | $1,989–$2,798 | varies |
| CT l-spine w&w/o contrast (72133) | $1,265.60 | $1,808 | 7.1× |
| CT lower ext w/o (73700) | $1,370.60 | $1,958 | 12.8× |
| CT lower extremity w/contrast material (73701) | $1,139.60 | $1,628 | 6.4× |
| CT lumbar spine w contrast (72132) | $1,824.90 | $2,607 | 5.1× |
| CT lumbar spine w/o contrast (72131) | $1,393.70 | $1,991 | 13.0× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$889.70–$1,092.70 | $1,271–$1,561 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$849.80–$1,549.10 | $1,214–$2,213 | varies |
| CT neck tissue combo (70492) | $1,265.60 | $1,808 | 7.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,392.30 | $1,989 | 7.8× |
| CT orbits w/o contrast (70480) | $793.80 | $1,134 | 7.4× |
| CT pelvis w&w/o contrast (72194) | $1,265.60 | $1,808 | 7.1× |
| CT pelvis w/o contrast (72192) | $1,602.30 | $2,289 | 15.0× |
| CT scan of leg combo (73702) | $1,265.60 | $1,808 | 7.1× |
| CT scans face/jaw combo (70488) | $1,265.60 | $1,808 | 7.1× |
| CT soft tissue neck w contrast (70491) | $1,822.10 | $2,603 | 10.2× |
| CT soft tissue neck w/o contrast (70490) | $791.70 | $1,131 | 7.4× |
| CT thoracic spine w contrast (72129) | $1,265.60 | $1,808 | 7.1× |
| CT thoracic spine w/o contrast (72128) | $1,332.10 | $1,903 | 12.5× |
| CT thoracic spine w/wo cont (72130) | $1,265.60 | $1,808 | 7.1× |
| CT thorax w/o contrast (71250) | $1,449.70 | $2,071 | 13.6× |
| CT upper ext wo (73200) range across 14 matching MRF lines |
$849.80–$1,271.90 | $1,214–$1,817 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,265.60 | $1,808 | 7.1× |
| CT upper extremity with contrast (73201) range across 14 matching MRF lines |
$651.70–$1,339.10 | $931–$1,913 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,397.50 | $3,425 | 13.4× |
| Cta Abdomen (74175) | $1,265.60 | $1,808 | 7.1× |
| Dxa Bone Density Axial (77080) | $415.10 | $593 | 3.9× |
| Dxa bone density study (77085) | $251.30 | $359 | 2.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $267.40 | $382 | 3.0× |
| Echo exam uterus (76831) | $532.70 | $761 | 2.2× |
| Esophagram (74220) | $436.80 | $624 | 2.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $494.20 | $706 | 4.6× |
| Fluoroscopy up to 1 hr (76000) | $774.20 | $1,106 | 3.2× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$212.10–$294 | $303–$420 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$352.10–$704.20 | $503–$1,006 | varies |
| Gastric emptying imaging study (78264) | $1,575.70 | $2,251 | 3.9× |
| Gated Heart Planar Single (78472) | $760.20 | $1,086 | 1.9× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$161–$232.40 | $230–$332 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,360.40 | $3,372 | 4.3× |
| Hepatobiliary System Imaging (78226) | $1,187.90 | $1,697 | 2.9× |
| Ht Muscle Image Spect Sing (78451) | $2,632.70 | $3,761 | 2.0× |
| Hysterosalpingogram (74740) | $761.60 | $1,088 | 3.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $366.80 | $524 | 4.1× |
| Infant hip ultrasound, limited static exam (76886) | $366.80 | $524 | 4.1× |
| K Flow/Funct Image Multiple (78709) | $987 | $1,410 | 1.8× |
| K Flow/Funct Image W/Drug (78708) | $1,542.80 | $2,204 | 2.8× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$300.30–$360.50 | $429–$515 | varies |
| Lung Ventilat&Perfus Imaging (78582) | $2,584.40 | $3,692 | 4.7× |
| Lung Ventilation Imaging (78579) | $760.20 | $1,086 | 1.9× |
| Lymph System Imaging (78195) | $1,336.30 | $1,909 | 2.4× |
| Magnetic Image Jaw Joint (70336) | $1,054.90 | $1,507 | 4.3× |
| Meckels Divert Exam (78290) | $760.20 | $1,086 | 1.9× |
| Mra Head W/O & W/Contrast Material (70546) | $1,534.40 | $2,192 | 4.3× |
| MRA head w/o contrast (70544) | $1,537.90 | $2,197 | 6.3× |
| MRA head with contrast (70545) | $1,534.40 | $2,192 | 4.3× |
| MRA neck w contrast (70548) | $1,380.40 | $1,972 | 3.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,573.50 | $5,105 | 10.0× |
| MRA neck w/o contrast (70547) | $959 | $1,370 | 3.9× |
| MRI abdomen w contrast (74182) | $1,534.40 | $2,192 | 4.3× |
| MRI abdomen w/o contrast (74181) | $959 | $1,370 | 3.9× |
| MRI any jt lower extrem w/contrast material (73722) range across 6 matching MRF lines |
$1,337.70–$2,601.90 | $1,911–$3,717 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 9 matching MRF lines |
$393.40–$1,850.10 | $562–$2,643 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 12 matching MRF lines |
$968.10–$1,678.60 | $1,383–$2,398 | varies |
| MRI cardiac w/o contrast (75557) | $959 | $1,370 | 3.9× |
| MRI cervical spine w contrast (72142) | $1,534.40 | $2,192 | 4.3× |
| MRI cervical spine w/o cont (72141) | $1,634.50 | $2,335 | 6.7× |
| MRI chest w/o contrast (71550) | $1,054.90 | $1,507 | 4.3× |
| MRI chest with contrast (71551) | $2,979.20 | $4,256 | 3.7× |
| MRI chest wo w contrast (71552) | $1,534.40 | $2,192 | 4.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,534.40 | $2,192 | 4.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 6 matching MRF lines |
$1,686.30–$1,787.10 | $2,409–$2,553 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,537.90 | $2,197 | 6.3× |
| MRI lumbar spine w contrast (72149) | $1,534.40 | $2,192 | 4.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,090.90 | $2,987 | 5.9× |
| MRI orbit face &/neck w/o contrast (70540) | $863.10 | $1,233 | 3.5× |
| MRI orbit face neck w contrast (70542) | $1,534.40 | $2,192 | 4.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,787.10 | $2,553 | 5.0× |
| MRI pelvis w contrast (72196) | $1,534.40 | $2,192 | 4.3× |
| MRI pelvis w/o & w contrast (72197) | $2,111.20 | $3,016 | 5.9× |
| MRI pelvis w/o contrast (72195) | $1,641.50 | $2,345 | 6.7× |
| MRI thoracic spine w/o contrast (72146) | $1,634.50 | $2,335 | 6.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,534.40 | $2,192 | 4.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 6 matching MRF lines |
$959–$1,537.90 | $1,370–$2,197 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 6 matching MRF lines |
$1,534.40–$1,787.10 | $2,192–$2,553 | varies |
| MRI, abdomen, combo (74183) range across 3 matching MRF lines |
$1,843.80–$2,019.50 | $2,634–$2,885 | varies |
| MRI, dorsal spine combo (72157) | $2,046.80 | $2,924 | 5.7× |
| MRI, dorsal spine contrast (72147) | $1,534.40 | $2,192 | 4.3× |
| MRI, joint upper extrem (73221) | $1,099.70 | $1,571 | 4.5× |
| MRI, joint upper extrem combo (73223) range across 6 matching MRF lines |
$1,686.30–$1,701.70 | $2,409–$2,431 | varies |
| MRI, lumbar spine combo (72158) | $2,012.50 | $2,875 | 5.6× |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$931–$4,113.90 | $1,330–$5,877 | varies |
| Neck soft tissue (70360) | $194.60 | $278 | 2.2× |
| Nonvascular Shunt X-Ray (75809) | $360.50 | $515 | 3.4× |
| Ob us nuchal meas 1 gest (76813) | $494.20 | $706 | 4.6× |
| Parathyroid Planar Imaging (78070) | $1,288 | $1,840 | 3.2× |
| Pelvis 1 or 2 views (72170) | $315 | $450 | 2.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,187.90 | $1,697 | 2.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $319.90 | $457 | 3.0× |
| Radex Ankle Complete Minimum 3 Views (73610) | $267.40 | $382 | 3.0× |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$196.70–$294 | $281–$420 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$294–$381.50 | $420–$545 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $396.20 | $566 | 3.7× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$180.60–$196.70 | $258–$281 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$244.30–$267.40 | $349–$382 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$229.60–$259 | $328–$370 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$336–$806.40 | $480–$1,152 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $152.60 | $218 | 1.7× |
| Radex Ribs Unilateral 2 Views (71100) | $291.20 | $416 | 3.3× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$298.90–$344.40 | $427–$492 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $267.40 | $382 | 3.0× |
| Radex Spine 1 View Specify Level (72020) | $236.60 | $338 | 2.7× |
| Radex Sternum Minimum 2 Views (71120) | $352.80 | $504 | 4.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $366.80 | $524 | 4.1× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$158.90–$220.50 | $227–$315 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$494.20–$987.70 | $706–$1,411 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) | $281.40 | $402 | 3.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $175.70 | $251 | 1.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $319.90 | $457 | 3.0× |
| Radiologic exam colon double contrast study (74280) | $891.10 | $1,273 | 5.0× |
| Radiologic exam colon single contrast study (74270) | $590.10 | $843 | 3.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $649.60 | $928 | 3.6× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$371–$500.50 | $530–$715 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $366.10 | $523 | 3.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $191.10 | $273 | 1.1× |
| Radiologic exam swallow function contrast study (74230) | $702.80 | $1,004 | 3.9× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$366.80–$734.30 | $524–$1,049 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$198.10–$280.70 | $283–$401 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$259–$333.20 | $370–$476 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$262.50–$294 | $375–$420 | varies |
| Ribs bilateral 3 views (71110) | $263.90 | $377 | 2.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,632.70 | $3,761 | 2.0× |
| Scapula (73010) range across 3 matching MRF lines |
$324.10–$360.50 | $463–$515 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 4 matching MRF lines |
$36.40–$89.60 | $52–$128 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$184.80–$240.80 | $264–$344 | varies |
| Shoulder Arthrography (73040) | $846.30 | $1,209 | 2.4× |
| Skull less than 4 views (70250) | $342.30 | $489 | 3.2× |
| Sternoclavicular joints (71130) | $366.80 | $524 | 4.1× |
| Thoracic spine 2 views (72070) | $378 | $540 | 3.5× |
| Thoracic spine 3 views (72072) | $431.90 | $617 | 4.0× |
| Thoracolumbar 2 views (72080) | $308.70 | $441 | 3.5× |
| Thyroid Imaging With Vascular Flow (78013) | $799.40 | $1,142 | 2.0× |
| Thyroid Uptake Measurement (78012) | $499.10 | $713 | 1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,191 | $3,130 | 5.4× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$405.30–$810.60 | $579–$1,158 | varies |
| Ultrasound Exam Aaa Screen (76706) | $527.80 | $754 | 4.9× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$354.20–$510.30 | $506–$729 | varies |
| Umbilical-artery Doppler (OB) (76820) | $44.10 | $63 | 0.4× |
| Unlisted Dx Radiographic Procedure (76499) | $366.80 | $524 | 4.1× |
| Upper gi w/o kub (74240) | $649.60 | $928 | 3.6× |
| Urethrocystogram voiding (74455) | $761.60 | $1,088 | 3.1× |
| Us breast unilateral complete (76641) | $514.50 | $735 | 4.8× |
| Us chest (76604) range across 2 matching MRF lines |
$352.80–$354.20 | $504–$506 | varies |
| Us complete joint (76881) | $488.60 | $698 | 4.6× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$317.80–$360.50 | $454–$515 | varies |
| Us head (76506) | $494.20 | $706 | 4.6× |
| Us kidney transplant (76776) | $413.70 | $591 | 3.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $350 | $500 | 3.3× |
| Us ob detailed single fetus (76811) | $761.60 | $1,088 | 3.1× |
| Us ob limited 1 or more fetuses (76815) | $396.20 | $566 | 3.7× |
| Us ob transvaginal (76817) | $360.50 | $515 | 3.4× |
| Us pelvic non ob complete (76856) | $613.90 | $877 | 5.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $336.70 | $481 | 3.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $319.90 | $457 | 3.0× |
| Us retroperitoneal complete (76770) | $749.70 | $1,071 | 7.0× |
| Us retroperitoneal limited (76775) | $375.20 | $536 | 3.5× |
| Us scrotum and contents (76870) | $497.70 | $711 | 4.7× |
| Us thyroid (76536) range across 2 matching MRF lines |
$451.50–$550.90 | $645–$787 | varies |
| Us transrectal (76872) | $350 | $500 | 3.3× |
| Venography extremity unilateral rs&i (75820) | $4,650.80 | $6,644 | 2.9× |
| Vertebral fracture assessment via dxa (77086) | $366.80 | $524 | 4.1× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$294–$317.10 | $420–$453 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $294 | $420 | 3.3× |
| X-Ray Bend Only L-S Spine (72120) | $290.50 | $415 | 2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$259–$326.90 | $370–$467 | varies |
| X-Ray Exam Breast Specimen (76098) | $410.90 | $587 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $228.90 | $327 | 2.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $381.50 | $545 | 3.6× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$212.80–$240.80 | $304–$344 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $265.30 | $379 | 3.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $372.40 | $532 | 3.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $396.90 | $567 | 3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $399 | $570 | 3.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $505.40 | $722 | 4.7× |
| X-Ray Exam L-S Spine Bending (72114) | $387.10 | $553 | 3.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $270.20 | $386 | 3.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $403.20 | $576 | 3.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$281.40–$341.60 | $402–$488 | varies |
| X-ray eye for foreign body (70030) | $85.40 | $122 | 1.0× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$240.10–$294 | $343–$420 | varies |
| X-ray IV pyelogram (ivp) (74400) | $809.90 | $1,157 | 4.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $366.80 | $524 | 4.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $176.40 | $252 | 2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $282.10 | $403 | 2.6× |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$352.80–$403.20 | $504–$576 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $360.50 | $515 | 3.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $296.80 | $424 | 2.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $270.90 | $387 | 2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $291.90 | $417 | 3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $366.80 | $524 | 4.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $360.50 | $515 | 3.4× |
| X-Ray Stress View (77071) | $431.90 | $617 | 4.9× |
| X-ray thoracic spine 4 vw (72074) | $482.30 | $689 | 4.5× |
| X-Ray Tmj Unilat (70328) | $242.90 | $347 | 2.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,218 | $1,740 | 3.4× |
| X-Rays Bone Length Studies (77073) | $444.50 | $635 | 4.2× |
| X-Rays Bone Survey Complete (77075) | $678.30 | $969 | 6.4× |
| Xr c-spine 4 or 5 views (72050) | $340.90 | $487 | 3.2× |
| Xr facial bones less than 3 views (70140) | $366.80 | $524 | 4.1× |
| Xr orbits complete 4 views (70200) | $396.20 | $566 | 3.7× |
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.