Imaging prices at Sublette County Health
Pinedale, WY · 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) | $268.20 | $298 | 3.0× |
| Abdomen 2 views (74019) | $334.80 | $372 | 3.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,561.50 | $1,735 | 3.8× |
| Ankle 2 views (73600) | $284.40 | $316 | 3.2× |
| Arthrogram hip (73525) | $972 | $1,080 | 2.7× |
| Arthrogram Wrist (73115) | $765 | $850 | 2.1× |
| Bone age studies (77072) | $477 | $530 | 4.5× |
| Bone Imaging 3 Phase (78315) | $1,929.60 | $2,144 | 4.7× |
| Bone Imaging Limited Area (78300) | $1,300.50 | $1,445 | 3.2× |
| Bone Imaging Whole Body (78306) | $1,765.80 | $1,962 | 4.3× |
| Bone survey infant (77076) | $239.40 | $266 | 2.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,006.10 | $2,229 | 3.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $6,864.30 | $7,627 | 4.7× |
| Cat Scan Follow-Up Study (76380) | $505.80 | $562 | 5.7× |
| Chest 1 view (71045) | $274.50 | $305 | 3.1× |
| Chest 2 views (71046) | $336.60 | $374 | 3.8× |
| Chest 3 views (71047) | $368.10 | $409 | 4.1× |
| Chest 4 or more views (71048) | $378 | $420 | 3.5× |
| Clavicle complete (73000) | $278.10 | $309 | 3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $774 | $860 | 7.2× |
| Contrast X-Ray Of Knee Joint (73580) | $1,143 | $1,270 | 3.2× |
| CT abdomen and pelvis without and with contrast (74178) | $4,393.80 | $4,882 | 12.3× |
| CT abdomen and pelvis without contrast (74176) | $3,123.90 | $3,471 | 12.8× |
| CT abdomen w contrast (74160) | $1,951.20 | $2,168 | 10.9× |
| CT abdomen w wo contrast (74170) | $2,529 | $2,810 | 14.1× |
| CT abdomen w/o contrast (74150) | $1,494 | $1,660 | 14.0× |
| CT Angio Abdomen and Pelvis (74174) | $3,951 | $4,390 | 11.1× |
| CT Angio Chest (71275) | $2,819.70 | $3,133 | 15.7× |
| CT Angio Head (70496) | $2,461.50 | $2,735 | 13.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$2,101.50–$3,151.80 | $2,335–$3,502 | varies |
| CT Angio Neck (70498) | $2,682.90 | $2,981 | 15.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,233.80 | $2,482 | 12.5× |
| CT cervical spine w/ contrast (72126) | $2,265.30 | $2,517 | 6.4× |
| CT cervical spine w/o contrast (72125) | $2,070.90 | $2,301 | 19.4× |
| CT cervical spine w/wo cont (72127) | $2,790 | $3,100 | 15.6× |
| CT chest w contrast (71260) | $2,452.50 | $2,725 | 13.7× |
| CT chest w/wo contrast (71270) | $2,700 | $3,000 | 15.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $2,302.20 | $2,558 | 21.6× |
| CT head/brain with contrast (70460) | $1,909.80 | $2,122 | 10.7× |
| CT head/brain without and with contrast (70470) | $2,174.40 | $2,416 | 12.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $1,151.10 | $1,279 | 12.9× |
| CT iac w contrast (70481) | $3,084.30 | $3,427 | 17.2× |
| CT l-spine w&w/o contrast (72133) | $2,520 | $2,800 | 14.1× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,350–$2,025 | $1,500–$2,250 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,506.60–$2,259.90 | $1,674–$2,511 | varies |
| CT lumbar spine w contrast (72132) | $2,236.50 | $2,485 | 6.3× |
| CT lumbar spine w/o contrast (72131) | $2,025 | $2,250 | 19.0× |
| CT maxillofacial w contrast (70487) | $2,906.10 | $3,229 | 16.2× |
| CT maxillofacial wo contrast (70486) | $1,717.20 | $1,908 | 16.1× |
| CT neck tissue combo (70492) | $2,160 | $2,400 | 12.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,632.60 | $1,814 | 9.1× |
| CT orbits w/o contrast (70480) | $1,728 | $1,920 | 16.2× |
| CT pelvis w&w/o contrast (72194) | $2,340 | $2,600 | 13.1× |
| CT pelvis w/o contrast (72192) | $1,652.40 | $1,836 | 15.5× |
| CT scan of leg combo (73702) | $2,348.10 | $2,609 | 13.1× |
| CT scans face/jaw combo (70488) | $3,410.10 | $3,789 | 19.0× |
| CT soft tissue neck w contrast (70491) | $1,927.80 | $2,142 | 10.8× |
| CT soft tissue neck w/o contrast (70490) | $1,629.90 | $1,811 | 15.3× |
| CT thoracic spine w contrast (72129) | $2,313.90 | $2,571 | 12.9× |
| CT thoracic spine w/o contrast (72128) | $2,122.20 | $2,358 | 19.9× |
| CT thoracic spine w/wo cont (72130) | $3,060 | $3,400 | 17.1× |
| CT thorax w/o contrast (71250) | $1,661.40 | $1,846 | 15.6× |
| CT unlisted procedure (76497) | $1,545.30 | $1,717 | 17.4× |
| CT upper ext wo (73200) | $1,368 | $1,520 | 12.8× |
| CT upper extremity w/o & w/contrast material (73202) | $1,957.50 | $2,175 | 10.9× |
| CT upper extremity with contrast (73201) | $1,665 | $1,850 | 4.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,844.90 | $3,161 | 15.9× |
| Cta Abdomen (74175) | $2,073.60 | $2,304 | 11.6× |
| CTA pelvis (72191) | $1,980 | $2,200 | 11.0× |
| Dxa Bone Density Axial (77080) | $503.10 | $559 | 4.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $275.40 | $306 | 3.1× |
| Echo exam uterus (76831) | $1,015.20 | $1,128 | 4.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $665.10 | $739 | 6.2× |
| Fluoroscopy up to 1 hr (76000) | $673.20 | $748 | 2.8× |
| Foot 2 views (73620) | $260.10 | $289 | 2.9× |
| Forearm 2 views (73090) | $325.80 | $362 | 3.7× |
| Gastric emptying imaging study (78264) | $1,548 | $1,720 | 3.8× |
| Gated Heart Planar Single (78472) | $3,410.10 | $3,789 | 8.3× |
| Hand 2 views (73120) | $268.20 | $298 | 2.5× |
| Hepatobil Syst Image W/Drug (78227) | $2,137.50 | $2,375 | 3.9× |
| Hepatobiliary System Imaging (78226) | $1,607.40 | $1,786 | 3.9× |
| Ht Muscle Image Spect Sing (78451) | $4,108.50 | $4,565 | 3.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $198 | $220 | 2.2× |
| K Flow/Funct Image W/Drug (78708) | $1,745.10 | $1,939 | 3.1× |
| Kidney Imaging Morphol (78700) | $1,849.50 | $2,055 | 4.5× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$364.50–$547.20 | $405–$608 | varies |
| Liver & Spleen Imaging Static Only (78215) | $2,150.10 | $2,389 | 5.3× |
| Lung Ventilat&Perfus Imaging (78582) | $1,817.10 | $2,019 | 3.3× |
| Lung Ventilation Imaging (78579) | $847.80 | $942 | 2.1× |
| Lymph System Imaging (78195) | $1,491.30 | $1,657 | 2.7× |
| Magnetic Image Jaw Joint (70336) | $1,618.20 | $1,798 | 6.6× |
| Meckels Divert Exam (78290) | $1,665.90 | $1,851 | 4.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $45 | $50 | 1.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $206.10 | $229 | 2.1× |
| Mr safety implt pos&/immoblj (76019) | $134.10 | $149 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) | $3,150 | $3,500 | 8.8× |
| MRA head w/o contrast (70544) | $2,126.70 | $2,363 | 8.7× |
| MRA head with contrast (70545) | $2,430 | $2,700 | 6.8× |
| MRA neck w contrast (70548) | $2,700 | $3,000 | 7.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,285.90 | $3,651 | 9.2× |
| MRA neck w/o contrast (70547) | $2,457.90 | $2,731 | 10.1× |
| MRI abdomen w contrast (74182) | $4,096.80 | $4,552 | 11.5× |
| MRI abdomen w/o contrast (74181) | $3,510 | $3,900 | 14.4× |
| MRI any jt lower extrem w/contrast material (73722) | $4,080.60 | $4,534 | 5.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$3,411–$4,577.40 | $3,790–$5,086 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,510 | $3,900 | 4.4× |
| MRI cervical spine w contrast (72142) | $3,225.60 | $3,584 | 9.0× |
| MRI cervical spine w/o cont (72141) | $2,574.90 | $2,861 | 10.6× |
| MRI chest w/o contrast (71550) | $2,025 | $2,250 | 8.3× |
| MRI chest with contrast (71551) | $2,835 | $3,150 | 3.5× |
| MRI chest wo w contrast (71552) | $3,537 | $3,930 | 9.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,510 | $3,900 | 9.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$3,130.20–$4,694.40 | $3,478–$5,216 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,980–$2,970 | $2,200–$3,300 | varies |
| MRI lumbar spine w contrast (72149) | $3,499.20 | $3,888 | 9.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,818.70 | $4,243 | 10.7× |
| MRI orbit face &/neck w/o contrast (70540) | $1,854 | $2,060 | 7.6× |
| MRI orbit face neck w contrast (70542) | $2,342.70 | $2,603 | 6.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,969.10 | $3,299 | 8.3× |
| MRI pelvis w contrast (72196) | $2,880 | $3,200 | 8.1× |
| MRI pelvis w/o & w contrast (72197) | $3,537 | $3,930 | 9.9× |
| MRI pelvis w/o contrast (72195) | $2,528.10 | $2,809 | 10.4× |
| MRI thoracic spine w/o contrast (72146) | $2,436.30 | $2,707 | 10.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,780 | $4,200 | 10.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$2,073.60–$3,109.50 | $2,304–$3,455 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $4,530.60 | $5,034 | 12.7× |
| MRI, abdomen, combo (74183) | $5,294.70 | $5,883 | 14.9× |
| MRI, dorsal spine combo (72157) | $3,644.10 | $4,049 | 10.2× |
| MRI, dorsal spine contrast (72147) | $3,486.60 | $3,874 | 9.8× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,220.30–$3,330 | $2,467–$3,700 | varies |
| MRI, joint upper extrem combo (73223) | $4,091.40 | $4,546 | 11.5× |
| MRI, lumbar spine combo (72158) | $3,654.90 | $4,061 | 10.3× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $2,011.50 | $2,235 | 4.9× |
| Myocardial Spect Multiple Studies (78452) | $4,194.90 | $4,661 | 3.2× |
| Neck soft tissue (70360) | $322.20 | $358 | 3.6× |
| Nuclear Rx Oral Admin (79005) | $1,827.90 | $2,031 | 7.7× |
| Parathyroid Planar Imaging (78070) | $1,472.40 | $1,636 | 3.6× |
| Pelvis 1 or 2 views (72170) | $313.20 | $348 | 2.9× |
| PET image w/CT, full body (78816) | $6,124.50 | $6,805 | 4.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,131.70 | $6,813 | 4.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,204.20 | $1,338 | 2.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $473.40 | $526 | 4.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$344.70–$517.50 | $383–$575 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $278.10 | $309 | 3.1× |
| Radex elbow complete minimum 3 views (73080) | $378.90 | $421 | 4.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $351 | $390 | 3.3× |
| Radex fingr minimum 2 views (73140) | $264.60 | $294 | 3.0× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$335.70–$503.10 | $373–$559 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$341.10–$512.10 | $379–$569 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$198–$297 | $220–$330 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $740.70 | $823 | 6.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $387.90 | $431 | 4.4× |
| Radex Ribs Unilateral 2 Views (71100) | $281.70 | $313 | 3.2× |
| Radex shoulder complete minimum 2 views (73030) | $405.90 | $451 | 4.6× |
| Radex Sinuses Paransl < 3 Views (70210) | $168.30 | $187 | 1.9× |
| Radex Spine 1 View Specify Level (72020) | $241.20 | $268 | 2.7× |
| Radex Sternum Minimum 2 Views (71120) | $372.60 | $414 | 4.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $407.70 | $453 | 4.6× |
| Radex Toe Minimum 2 Views (73660) | $230.40 | $256 | 2.6× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$382.50–$574.20 | $425–$638 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$352.80–$530.10 | $392–$589 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $787.50 | $875 | 7.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $329.40 | $366 | 3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $382.50 | $425 | 3.6× |
| Radiologic exam knee complete 4/more views (73564) | $400.50 | $445 | 3.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $375.30 | $417 | 3.5× |
| Radiologic examination femur 1 view (73551) | $265.50 | $295 | 3.0× |
| Radiologic examination femur minimum 2 views (73552) | $283.50 | $315 | 3.2× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$305.10–$457.20 | $339–$508 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $565.20 | $628 | 5.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $342 | $380 | 3.8× |
| Renal Cyst Study (74470) | $2,079 | $2,310 | 3.7× |
| Ribs bilateral 3 views (71110) | $561.60 | $624 | 5.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,479.50 | $2,755 | 6.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,281.50 | $2,535 | 4.1× |
| Scapula (73010) | $336.60 | $374 | 3.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$61.20–$81.90 | $68–$91 | varies |
| Sella turcica (70240) | $199.80 | $222 | 2.2× |
| Shoulder 1 view (73020) | $231.30 | $257 | 2.6× |
| Shoulder Arthrography (73040) | $883.80 | $982 | 2.5× |
| Skull less than 4 views (70250) | $359.10 | $399 | 3.4× |
| Spleen Imaging (78185) | $904.50 | $1,005 | 2.2× |
| Sternoclavicular joints (71130) | $271.80 | $302 | 3.1× |
| Thoracic spine 2 views (72070) | $392.40 | $436 | 3.7× |
| Thoracic spine 3 views (72072) | $432 | $480 | 4.0× |
| Thoracolumbar 2 views (72080) | $414 | $460 | 4.7× |
| Thyroid Imaging With Vascular Flow (78013) | $559.80 | $622 | 1.4× |
| Thyroid Met Imaging Body (78018) | $1,676.70 | $1,863 | 3.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,628.10 | $1,809 | 4.0× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$428.40–$642.60 | $476–$714 | varies |
| Ultrasound Exam Aaa Screen (76706) | $524.70 | $583 | 4.9× |
| Ultrasound, abdomen limited (76705) | $668.70 | $743 | 6.3× |
| Umbilical-artery Doppler (OB) (76820) | $345.60 | $384 | 3.2× |
| Upper gi w/o kub (74240) | $873.90 | $971 | 4.9× |
| Urethrocystogram voiding (74455) | $772.20 | $858 | 3.2× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$497.70–$746.10 | $553–$829 | varies |
| Us chest (76604) | $472.50 | $525 | 4.4× |
| Us complete joint (76881) | $457.20 | $508 | 4.3× |
| Us exam, pelvic, limited (76857) | $725.40 | $806 | 6.8× |
| Us kidney transplant (76776) | $630 | $700 | 5.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $581.40 | $646 | 5.4× |
| Us ob detailed single fetus (76811) | $994.50 | $1,105 | 4.1× |
| Us ob limited 1 or more fetuses (76815) | $441.90 | $491 | 4.1× |
| Us ob transvaginal (76817) | $554.40 | $616 | 5.2× |
| Us pelvic non ob complete (76856) | $756 | $840 | 7.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $492.30 | $547 | 4.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $316.80 | $352 | 3.0× |
| Us retroperitoneal complete (76770) | $810 | $900 | 7.6× |
| Us retroperitoneal limited (76775) | $706.50 | $785 | 6.6× |
| Us scrotum and contents (76870) | $589.50 | $655 | 5.5× |
| Us thyroid (76536) | $660.60 | $734 | 6.2× |
| Us transrectal (76872) | $350.10 | $389 | 3.3× |
| Wrist 2 views (73100) | $294.30 | $327 | 3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $623.70 | $693 | 7.0× |
| X-Ray Bend Only L-S Spine (72120) | $377.10 | $419 | 3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $282.60 | $314 | 3.2× |
| X-Ray Exam Breast Specimen (76098) | $710.10 | $789 | 1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $281.70 | $313 | 3.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $441.90 | $491 | 4.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $540 | $600 | 5.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $288 | $320 | 3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $347.40 | $386 | 3.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $432.90 | $481 | 4.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $500.40 | $556 | 4.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $524.70 | $583 | 4.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $540 | $600 | 5.1× |
| X-Ray Exam L-S Spine Bending (72114) | $665.10 | $739 | 6.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $333.90 | $371 | 3.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $684.90 | $761 | 6.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $423.90 | $471 | 4.0× |
| X-ray eye for foreign body (70030) | $168.30 | $187 | 1.9× |
| X-ray humerus (73060) | $320.40 | $356 | 3.6× |
| X-ray IV pyelogram (ivp) (74400) | $838.80 | $932 | 4.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$304.20–$456.30 | $338–$507 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $176.40 | $196 | 2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $401.40 | $446 | 3.8× |
| X-ray nose-rectum child f.b. (76010) | $279 | $310 | 3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $612 | $680 | 5.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $344.70 | $383 | 3.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $315 | $350 | 2.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $387 | $430 | 4.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $477.90 | $531 | 5.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $447.30 | $497 | 4.2× |
| X-ray thoracic spine 4 vw (72074) | $641.70 | $713 | 6.0× |
| X-Ray Tmj Unilat (70328) | $315.90 | $351 | 3.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,195.20 | $1,328 | 3.4× |
| X-Rays Bone Length Studies (77073) | $479.70 | $533 | 4.5× |
| X-Rays Bone Survey Complete (77075) | $990 | $1,100 | 9.3× |
| Xr c-spine 4 or 5 views (72050) | $497.70 | $553 | 4.7× |
| Xr facial bones less than 3 views (70140) | $195.30 | $217 | 2.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $565.20 | $628 | 5.3× |
| Xr orbits complete 4 views (70200) | $427.50 | $475 | 4.0× |
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.