Imaging prices at Susan B Allen Memorial Hospital
El Dorado, KS · every code in this section with a posted price and a Medicare benchmark.
272 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $3,371.55 | $5,187 | 2.6× |
| Abdomen 1 View (74018) range across 4 matching MRF lines |
$97.50–$137.15 | $150–$211 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$97.50–$166.40 | $150–$256 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $967.85 | $1,489 | 2.6× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$107.25–$133.25 | $165–$205 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$538.85–$1,077.70 | $829–$1,658 | varies |
| Bone age studies (77072) | $209.30 | $322 | 2.2× |
| Bone Imaging 3 Phase (78315) | $943.15 | $1,451 | 2.6× |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$574.60–$1,058.85 | $884–$1,629 | varies |
| Bone Imaging Multiple Areas (78305) | $896.35 | $1,379 | 2.4× |
| Bone Imaging Whole Body (78306) | $767.65 | $1,181 | 2.1× |
| Bone marrow imaging limited area (78102) | $337.35 | $519 | 0.9× |
| Bone survey infant (77076) | $303.55 | $467 | 3.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,046.55 | $4,687 | 2.3× |
| Cat Scan Follow-Up Study (76380) | $553.80 | $852 | 6.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $720.85 | $1,109 | 1.4× |
| Cerebrospinal Fluid Scan (78630) | $770.25 | $1,185 | 1.5× |
| Chest 1 view (71045) range across 5 matching MRF lines |
$98.15–$126.75 | $151–$195 | varies |
| Chest 2 views (71046) range across 5 matching MRF lines |
$108.55–$161.85 | $167–$249 | varies |
| Chest 3 views (71047) | $161.85 | $249 | 2.0× |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$129.35–$242.45 | $199–$373 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$107.25–$133.25 | $165–$205 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $364.65 | $561 | 3.8× |
| Continuing medical physics consltj pr wk (77336) | $576.55 | $887 | 4.7× |
| Contrast X-Ray Bladder (74430) | $354.90 | $546 | 1.1× |
| Contrast X-Ray Of Knee Joint (73580) | $374.40 | $576 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) | $1,253.85 | $1,929 | 3.9× |
| CT abdomen and pelvis without contrast (74176) | $741 | $1,140 | 3.4× |
| CT abdomen w contrast (74160) | $741 | $1,140 | 4.6× |
| CT abdomen w wo contrast (74170) | $1,253.85 | $1,929 | 7.8× |
| CT abdomen w/o contrast (74150) | $741 | $1,140 | 7.7× |
| CT Angio Abdomen and Pelvis (74174) | $741 | $1,140 | 2.3× |
| CT Angio Chest (71275) | $741 | $1,140 | 4.6× |
| CT Angio Head (70496) | $741 | $1,140 | 4.6× |
| CT angio hrt w/3d image (75574) | $741 | $1,140 | 2.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $741 | $1,140 | 4.6× |
| CT Angio Neck (70498) | $741 | $1,140 | 4.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $741 | $1,140 | 4.6× |
| CT cervical spine w/ contrast (72126) | $741 | $1,140 | 2.3× |
| CT cervical spine w/o contrast (72125) | $741 | $1,140 | 7.7× |
| CT cervical spine w/wo cont (72127) | $1,253.85 | $1,929 | 7.8× |
| CT chest w contrast (71260) | $741 | $1,140 | 4.6× |
| CT chest w/wo contrast (71270) | $1,253.85 | $1,929 | 7.8× |
| CT colonography screening (74263) | $741 | $1,140 | 3.4× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $741 | $1,140 | 7.7× |
| CT head/brain with contrast (70460) | $741 | $1,140 | 4.6× |
| CT head/brain without and with contrast (70470) | $1,253.85 | $1,929 | 7.8× |
| CT heart contrast eval cardiac structure&morph (75572) | $741 | $1,140 | 2.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $364.65 | $561 | 4.5× |
| CT hrt w/3d image congen (75573) | $741 | $1,140 | 2.3× |
| CT iac w contrast (70481) | $741 | $1,140 | 4.6× |
| CT l-spine w&w/o contrast (72133) | $1,253.85 | $1,929 | 7.8× |
| CT lower ext w/o (73700) | $741 | $1,140 | 7.7× |
| CT lower extremity w/contrast material (73701) | $741 | $1,140 | 4.6× |
| CT lumbar spine w contrast (72132) | $741 | $1,140 | 2.3× |
| CT lumbar spine w/o contrast (72131) | $741 | $1,140 | 7.7× |
| CT maxillofacial w contrast (70487) | $741 | $1,140 | 4.6× |
| CT maxillofacial wo contrast (70486) | $741 | $1,140 | 7.7× |
| CT neck tissue combo (70492) | $1,253.85 | $1,929 | 7.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,253.85 | $1,929 | 7.8× |
| CT orbits w/o contrast (70480) | $741 | $1,140 | 7.7× |
| CT pelvis w&w/o contrast (72194) | $1,253.85 | $1,929 | 7.8× |
| CT pelvis w/o contrast (72192) | $741 | $1,140 | 7.7× |
| CT scan of leg combo (73702) | $1,253.85 | $1,929 | 7.8× |
| CT scans face/jaw combo (70488) | $1,253.85 | $1,929 | 7.8× |
| CT soft tissue neck w contrast (70491) | $741 | $1,140 | 4.6× |
| CT soft tissue neck w/o contrast (70490) | $741 | $1,140 | 7.7× |
| CT thoracic spine w contrast (72129) | $741 | $1,140 | 4.6× |
| CT thoracic spine w/o contrast (72128) | $741 | $1,140 | 7.7× |
| CT thoracic spine w/wo cont (72130) | $1,253.85 | $1,929 | 7.8× |
| CT thorax w/o contrast (71250) | $741 | $1,140 | 7.7× |
| CT upper ext wo (73200) | $741 | $1,140 | 7.7× |
| CT upper extremity w/o & w/contrast material (73202) | $1,253.85 | $1,929 | 7.8× |
| CT upper extremity with contrast (73201) | $741 | $1,140 | 2.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $741 | $1,140 | 4.6× |
| Cta Abdomen (74175) | $741 | $1,140 | 4.6× |
| CTA pelvis (72191) | $741 | $1,140 | 4.6× |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$1,478.75–$2,243.15 | $2,275–$3,451 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$222.30–$230.75 | $342–$355 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $161.85 | $249 | 2.0× |
| Esophagram (74220) | $329.55 | $507 | 2.0× |
| Fetal Biophys Profile W/Nst (76818) | $242.45 | $373 | 2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $303.55 | $467 | 3.2× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$86.45–$278.20 | $133–$428 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$107.25–$133.25 | $165–$205 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$108.55–$295.10 | $167–$454 | varies |
| Gastric emptying imaging study (78264) | $752.70 | $1,158 | 2.0× |
| Gated Heart Planar Single (78472) | $1,283.75 | $1,975 | 3.5× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$154.05–$193.05 | $237–$297 | varies |
| Hepatobil Syst Image W/Drug (78227) | $856.05 | $1,317 | 1.7× |
| Ht Muscle Image Spect Sing (78451) | $1,211.60 | $1,864 | 1.0× |
| Hysterosalpingogram (74740) | $421.85 | $649 | 1.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $416 | $640 | 5.2× |
| Infant hip ultrasound, limited static exam (76886) | $129.35 | $199 | 1.6× |
| Joint Survey Single View (77077) | $303.55 | $467 | 3.2× |
| K Flow/Funct Image W/Drug (78708) | $1,036.75 | $1,595 | 2.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,036.75 | $1,595 | 2.1× |
| Knee 3 Views (73562) range across 5 matching MRF lines |
$108.55–$143.65 | $167–$221 | varies |
| Lung Ventilat&Perfus Imaging (78582) | $1,032.20 | $1,588 | 2.1× |
| Lymph System Imaging (78195) | $599.95 | $923 | 1.2× |
| Magnetic Image Jaw Joint (70336) | $1,253.85 | $1,929 | 5.7× |
| Mammary ductogram or galactogram single (77053) | $406.90 | $626 | 1.9× |
| Meckels Divert Exam (78290) | $499.85 | $769 | 1.4× |
| Mlc imrt design & construction per imrt plan (77338) | $1,793.35 | $2,759 | 5.2× |
| MRA head w/o contrast (70544) | $1,253.85 | $1,929 | 5.7× |
| MRA neck w contrast (70548) | $1,253.85 | $1,929 | 3.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,914.90 | $2,946 | 6.0× |
| MRA neck w/o contrast (70547) | $1,253.85 | $1,929 | 5.7× |
| MRI abdomen w contrast (74182) | $1,253.85 | $1,929 | 3.9× |
| MRI abdomen w/o contrast (74181) | $1,253.85 | $1,929 | 5.7× |
| MRI any jt lower extrem w/contrast material (73722) | $1,253.85 | $1,929 | 1.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,914.90 | $2,946 | 6.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,253.85 | $1,929 | 1.7× |
| MRI bone marrow blood supply (77084) | $1,253.85 | $1,929 | 5.7× |
| MRI cardiac w/o contrast (75557) | $1,253.85 | $1,929 | 5.7× |
| MRI cervical spine w contrast (72142) | $1,253.85 | $1,929 | 3.9× |
| MRI cervical spine w/o cont (72141) | $1,253.85 | $1,929 | 5.7× |
| MRI chest w/o contrast (71550) | $1,253.85 | $1,929 | 5.7× |
| MRI chest wo w contrast (71552) | $1,914.90 | $2,946 | 6.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,253.85 | $1,929 | 3.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,914.90–$3,829.80 | $2,946–$5,892 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,253.85 | $1,929 | 5.7× |
| MRI lumbar spine w contrast (72149) | $1,253.85 | $1,929 | 3.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,914.90 | $2,946 | 6.0× |
| MRI orbit face &/neck w/o contrast (70540) | $1,253.85 | $1,929 | 5.7× |
| MRI orbit face neck w contrast (70542) | $1,253.85 | $1,929 | 3.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,914.90 | $2,946 | 6.0× |
| MRI pelvis w contrast (72196) | $1,253.85 | $1,929 | 3.9× |
| MRI pelvis w/o & w contrast (72197) | $1,914.90 | $2,946 | 6.0× |
| MRI pelvis w/o contrast (72195) | $1,253.85 | $1,929 | 5.7× |
| MRI thoracic spine w/o contrast (72146) | $1,253.85 | $1,929 | 5.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$1,253.85–$1,392.95 | $1,929–$2,143 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,253.85 | $1,929 | 5.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,914.90 | $2,946 | 6.0× |
| MRI, abdomen, combo (74183) | $1,914.90 | $2,946 | 6.0× |
| MRI, dorsal spine combo (72157) | $1,914.90 | $2,946 | 6.0× |
| MRI, dorsal spine contrast (72147) | $1,253.85 | $1,929 | 3.9× |
| MRI, joint upper extrem (73221) | $1,253.85 | $1,929 | 5.7× |
| MRI, joint upper extrem combo (73223) | $1,914.90 | $2,946 | 6.0× |
| MRI, lumbar spine combo (72158) | $1,914.90 | $2,946 | 6.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,046.55 | $4,687 | 2.6× |
| Myocardial Spect Multiple Studies (78452) | $1,614.60 | $2,484 | 1.4× |
| Neck soft tissue (70360) | $133.25 | $205 | 1.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,357.60 | $6,704 | 3.4× |
| Parathyroid Planar Imaging (78070) | $376.35 | $579 | 1.0× |
| Pelvis 1 or 2 views (72170) | $303.55 | $467 | 3.2× |
| PET image w/CT, full body (78816) | $3,046.55 | $4,687 | 2.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,046.55 | $4,687 | 2.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,269.45 | $1,953 | 3.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $276.25 | $425 | 2.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $574.60 | $884 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$107.25–$133.25 | $165–$205 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $119.60 | $184 | 1.5× |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$135.85–$157.30 | $209–$242 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $206.70 | $318 | 2.1× |
| Radex fingr minimum 2 views (73140) range across 6 matching MRF lines |
$95.55–$124.80 | $147–$192 | varies |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$107.25–$133.25 | $165–$205 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$126.10–$157.30 | $194–$242 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$78–$108.55 | $120–$167 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $242.45 | $373 | 2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $149.50 | $230 | 1.9× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $162.50 | $250 | 2.0× |
| Radex Ribs Unilateral 2 Views (71100) | $161.85 | $249 | 2.0× |
| Radex shoulder complete minimum 2 views (73030) | $160.55 | $247 | 2.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $124.80 | $192 | 1.6× |
| Radex Spine 1 View Specify Level (72020) | $164.45 | $253 | 2.1× |
| Radex Sternum Minimum 2 Views (71120) | $194.35 | $299 | 2.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $161.85 | $249 | 2.0× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$96.20–$119.60 | $148–$184 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$147.55–$209.30 | $227–$322 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$135.85–$150.80 | $209–$232 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $14,590.55 | $22,447 | 2.1× |
| Radiation treatment delivery level 1 (77402) | $359.45 | $553 | 3.8× |
| Radiation treatment delivery level 3 (77412) | $718.25 | $1,105 | 1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $213.85 | $329 | 2.2× |
| Radiologic exam colon double contrast study (74280) | $1,076.40 | $1,656 | 6.7× |
| Radiologic exam colon single contrast study (74270) | $1,076.40 | $1,656 | 6.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $329.55 | $507 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) | $197.60 | $304 | 2.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $303.55 | $467 | 3.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $360.10 | $554 | 2.2× |
| Radiologic exam swallow function contrast study (74230) | $341.25 | $525 | 2.1× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$605.80–$746.20 | $932–$1,148 | varies |
| Radiologic examination femur 1 view (73551) | $108.55 | $167 | 1.4× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$108.55–$143.65 | $167–$221 | varies |
| Radiologic examination knee 1/2 views (73560) range across 5 matching MRF lines |
$108.55–$143.65 | $167–$221 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $303.55 | $467 | 3.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$108.55–$147.55 | $167–$227 | varies |
| Ribs bilateral 3 views (71110) | $260 | $400 | 2.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,690 | $2,600 | 3.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,103.40 | $3,236 | 4.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$924.30–$1,699.75 | $1,422–$2,615 | varies |
| Salivary Gland Imaging Serial Images (78231) | $717.60 | $1,104 | 1.9× |
| Scapula (73010) | $138.45 | $213 | 1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $62.40 | $96 | 2.7× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$61.75–$94.90 | $95–$146 | varies |
| Shoulder Arthrography (73040) | $387.40 | $596 | 1.2× |
| Skull less than 4 views (70250) | $250.25 | $385 | 2.6× |
| Special dosimetry (77331) | $287.30 | $442 | 2.3× |
| Special Physics Consult (77370) | $789.75 | $1,215 | 6.4× |
| Special teletherapy port plan (77321) | $897.65 | $1,381 | 2.6× |
| Special treatment procedure (77470) | $1,076.40 | $1,656 | 2.1× |
| Speech evaluation, complex (70371) | $325 | $500 | 1.5× |
| Stereotactic Body Radiation Delivery (77373) | $10,309.65 | $15,861 | 6.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,076.40 | $1,656 | 3.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,435.20 | $2,208 | 4.2× |
| Ther rad simulaj-aided field setting simple (77280) | $897.65 | $1,381 | 7.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $303.55 | $467 | 1.9× |
| Thoracic spine 2 views (72070) | $131.95 | $203 | 1.4× |
| Thoracic spine 3 views (72072) | $204.75 | $315 | 2.1× |
| Thyroid Imaging With Vascular Flow (78013) | $596.70 | $918 | 1.6× |
| Thyroid Uptake Measurement (78012) | $404.95 | $623 | 1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $480.35 | $739 | 1.3× |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$1,166.10–$2,332.20 | $1,794–$3,588 | varies |
| Tx devices design & construction intermediate (77333) | $789.75 | $1,215 | 6.4× |
| Tx devices design & construction simple (77332) | $718.25 | $1,105 | 5.8× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$206.70–$280.80 | $318–$432 | varies |
| Ultrasound, abdomen limited (76705) | $286.65 | $441 | 3.0× |
| Unlisted us procedure (76999) | $161.85 | $249 | 2.0× |
| Upper gi w/o kub (74240) | $399.10 | $614 | 2.5× |
| Urethrocystogram voiding (74455) | $364.65 | $561 | 1.7× |
| Urethrocystography retrograde (74450) | $230.10 | $354 | 1.0× |
| Us breast unilateral complete (76641) | $234.65 | $361 | 2.4× |
| Us chest (76604) | $210.60 | $324 | 2.2× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$156–$195.65 | $240–$301 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$95.55–$232.70 | $147–$358 | varies |
| Us ob limited 1 or more fetuses (76815) | $323.70 | $498 | 3.4× |
| Us ob transvaginal (76817) | $303.55 | $467 | 3.2× |
| Us pelvic non ob complete (76856) | $326.30 | $502 | 3.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $407.55 | $627 | 4.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $242.45 | $373 | 2.5× |
| Us retroperitoneal complete (76770) | $412.10 | $634 | 4.3× |
| Us retroperitoneal limited (76775) | $337.35 | $519 | 3.5× |
| Us scrotum and contents (76870) | $316.55 | $487 | 3.3× |
| Us spinal canal and contents (76800) | $108.55 | $167 | 1.1× |
| Us thyroid (76536) | $450.45 | $693 | 4.7× |
| Us transrectal (76872) | $97.50 | $150 | 1.0× |
| Venography extremity unilateral rs&i (75820) | $1,123.85 | $1,729 | 0.8× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$135.85–$150.80 | $209–$232 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $164.45 | $253 | 2.1× |
| X-ray antegrade pyelogram tube (74425) | $763.10 | $1,174 | 2.4× |
| X-Ray Bend Only L-S Spine (72120) | $251.55 | $387 | 2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$108.55–$130 | $167–$200 | varies |
| X-Ray Exam Breast Specimen (76098) | $417.95 | $643 | 0.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $303.55 | $467 | 3.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $230.10 | $354 | 2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $304.20 | $468 | 3.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $304.20 | $468 | 3.2× |
| X-Ray Exam L-S Spine Bending (72114) | $378.30 | $582 | 3.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $164.45 | $253 | 2.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $283.40 | $436 | 2.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $129.35 | $199 | 1.3× |
| X-ray eye for foreign body (70030) | $143.65 | $221 | 1.8× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$135.85–$152.10 | $209–$234 | varies |
| X-ray IV pyelogram (ivp) (74400) | $676.65 | $1,041 | 4.2× |
| X-ray IV pyelogram+tomography (74415) | $608.40 | $936 | 3.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $212.55 | $327 | 2.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $197.60 | $304 | 2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $182.65 | $281 | 1.9× |
| X-ray nose-rectum child f.b. (76010) | $129.35 | $199 | 1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $208 | $320 | 2.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $147.55 | $227 | 1.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $303.55 | $467 | 3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $159.90 | $246 | 2.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $208.65 | $321 | 2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $234 | $360 | 2.4× |
| X-Ray Stress View (77071) | $161.85 | $249 | 2.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $594.75 | $915 | 1.8× |
| X-Rays Bone Length Studies (77073) | $260.65 | $401 | 2.7× |
| X-Rays Bone Survey Complete (77075) | $547.30 | $842 | 5.7× |
| Xr c-spine 4 or 5 views (72050) | $258.70 | $398 | 2.7× |
| Xr orbits complete 4 views (70200) | $175.50 | $270 | 1.8× |
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.