Imaging prices at Sutter Lakeside Hospital
Lakeport, CA · every code in this section with a posted price and a Medicare benchmark.
293 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) | $666 | $666 | 6.0× |
| Abdomen 2 views (74019) | $921 | $921 | 6.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $3,141 | $3,141 | 6.1× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$743–$1,115 | $743–$1,115 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$1,664–$2,496 | $1,664–$2,496 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$846–$1,269 | $846–$1,269 | varies |
| Basic radiation dosimetry calculation (77300) | $1,213 | $1,213 | 7.0× |
| Bone age studies (77072) | $365 | $365 | 2.7× |
| Bone Imaging 3 Phase (78315) | $3,880 | $3,880 | 7.5× |
| Bone Imaging Limited Area (78300) | $1,936 | $1,936 | 3.8× |
| Bone Imaging Multiple Areas (78305) | $2,663 | $2,663 | 5.2× |
| Bone Imaging Whole Body (78306) | $3,457 | $3,457 | 6.7× |
| Bone survey infant (77076) | $1,423 | $1,423 | 10.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,000 | $7,000 | 3.8× |
| Cat Scan Follow-Up Study (76380) | $1,439 | $1,439 | 12.9× |
| Chest 1 view (71045) | $738 | $738 | 6.6× |
| Chest 2 views (71046) | $804 | $804 | 7.2× |
| Chest 3 views (71047) | $723 | $723 | 6.5× |
| Chest 4 or more views (71048) | $832 | $832 | 6.2× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$612–$918 | $612–$918 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $242 | $242 | 1.8× |
| Contrast X-Ray Bladder (74430) | $1,009 | $1,009 | 2.2× |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$1,507–$2,260 | $1,507–$2,260 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $294 | $294 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) | $8,994 | $8,994 | 20.0× |
| CT abdomen and pelvis without contrast (74176) | $6,374 | $6,374 | 20.8× |
| CT abdomen w contrast (74160) | $4,755 | $4,755 | 21.1× |
| CT abdomen w wo contrast (74170) | $4,989 | $4,989 | 22.1× |
| CT abdomen w/o contrast (74150) | $4,058 | $4,058 | 30.2× |
| CT Angio Abdomen and Pelvis (74174) | $7,842 | $7,842 | 17.5× |
| CT Angio Chest (71275) | $6,885 | $6,885 | 30.5× |
| CT Angio Head (70496) | $6,173 | $6,173 | 27.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$5,446–$8,169 | $5,446–$8,169 | varies |
| CT Angio Neck (70498) | $4,673 | $4,673 | 20.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $4,720 | $4,720 | 20.9× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $5,275 | $5,275 | 23.4× |
| CT cervical spine w/ contrast (72126) | $5,617 | $5,617 | 12.5× |
| CT cervical spine w/o contrast (72125) | $5,058 | $5,058 | 37.6× |
| CT cervical spine w/wo cont (72127) | $4,537 | $4,537 | 20.1× |
| CT chest w contrast (71260) | $5,153 | $5,153 | 22.8× |
| CT chest w/wo contrast (71270) | $5,607 | $5,607 | 24.9× |
| CT head/brain with contrast (70460) | $4,869 | $4,869 | 21.6× |
| CT head/brain without and with contrast (70470) | $5,345 | $5,345 | 23.7× |
| CT iac w contrast (70481) | $4,454 | $4,454 | 19.7× |
| CT l-spine w&w/o contrast (72133) | $4,637 | $4,637 | 20.6× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$3,471–$5,206 | $3,471–$5,206 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$4,233–$6,350 | $4,233–$6,350 | varies |
| CT lumbar spine w contrast (72132) | $4,937 | $4,937 | 11.0× |
| CT lumbar spine w/o contrast (72131) | $4,803 | $4,803 | 35.7× |
| CT maxillofacial w contrast (70487) | $5,254 | $5,254 | 23.3× |
| CT maxillofacial wo contrast (70486) | $4,272 | $4,272 | 31.8× |
| CT neck tissue combo (70492) | $3,639 | $3,639 | 16.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $4,248 | $4,248 | 18.8× |
| CT orbits w/o contrast (70480) | $3,592 | $3,592 | 26.7× |
| CT pelvis w&w/o contrast (72194) | $4,196 | $4,196 | 18.6× |
| CT pelvis w/o contrast (72192) | $4,656 | $4,656 | 34.6× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$4,363–$6,544 | $4,363–$6,544 | varies |
| CT scans face/jaw combo (70488) | $4,353 | $4,353 | 19.3× |
| CT soft tissue neck w contrast (70491) | $3,976 | $3,976 | 17.6× |
| CT soft tissue neck w/o contrast (70490) | $3,325 | $3,325 | 24.7× |
| CT thoracic spine w contrast (72129) | $5,255 | $5,255 | 23.3× |
| CT thoracic spine w/o contrast (72128) | $4,811 | $4,811 | 35.8× |
| CT thoracic spine w/wo cont (72130) | $5,430 | $5,430 | 24.1× |
| CT thorax w/o contrast (71250) | $4,097 | $4,097 | 30.5× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$3,395–$5,092 | $3,395–$5,092 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$4,471–$6,706 | $4,471–$6,706 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$4,078–$6,117 | $4,078–$6,117 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $5,611 | $5,611 | 24.9× |
| Cta Abdomen (74175) | $5,172 | $5,172 | 22.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $9,892 | $9,892 | 22.0× |
| CTA pelvis (72191) | $4,299 | $4,299 | 19.1× |
| Dxa Bone Density Axial (77080) | $913 | $913 | 6.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $377 | $377 | 3.4× |
| Echo exam uterus (76831) | $1,165 | $1,165 | 3.8× |
| Echo Guide For Artery Repair (76936) | $1,829 | $1,829 | 6.6× |
| Esophagram (74220) | $1,132 | $1,132 | 5.0× |
| Fetal Biophys Profile W/Nst (76818) | $1,358 | $1,358 | 10.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,257 | $1,257 | 9.3× |
| Fluoroscopy up to 1 hr (76000) | $1,380 | $1,380 | 4.5× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$698–$1,046 | $698–$1,046 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$726–$1,089 | $726–$1,089 | varies |
| Gastric emptying imaging study (78264) | $3,403 | $3,403 | 6.6× |
| Gastroesophageal Reflux Exam (78262) | $3,059 | $3,059 | 5.9× |
| Gated Heart Planar Single (78472) | $2,515 | $2,515 | 4.9× |
| Gated Heart, Multiple (78473) | $2,838 | $2,838 | 5.5× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$801–$1,202 | $801–$1,202 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $15,197 | $15,197 | 17.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $8,110 | $8,110 | 9.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $6,797 | $6,797 | 7.6× |
| Hepatobil Syst Image W/Drug (78227) | $3,269 | $3,269 | 4.7× |
| Hepatobiliary System Imaging (78226) | $2,851 | $2,851 | 5.5× |
| Ht Musc Image Planar Mult (78454) | $7,173 | $7,173 | 4.3× |
| Ht Muscle Image Spect Sing (78451) | $7,176 | $7,176 | 4.3× |
| Hysterosalpingogram (74740) | $1,140 | $1,140 | 3.7× |
| Interstitial radiation source applic complex (77778) | $6,386 | $6,386 | 7.1× |
| Joint Survey Single View (77077) | $492 | $492 | 3.7× |
| K Flow/Funct Image Multiple (78709) | $5,205 | $5,205 | 7.5× |
| K Flow/Funct Image W/Drug (78708) | $3,556 | $3,556 | 5.1× |
| K Flow/Funct Image W/O Drug (78707) | $3,302 | $3,302 | 4.7× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,369 | $1,369 | 2.7× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $2,510 | $2,510 | 4.9× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$954–$1,431 | $954–$1,431 | varies |
| Liver imaging static only (78201) | $3,217 | $3,217 | 4.6× |
| Lung Perf&Ventilat Diferentl (78598) | $3,251 | $3,251 | 4.7× |
| Lung perfusion differential (78597) | $1,715 | $1,715 | 3.3× |
| Lung Ventilat&Perfus Imaging (78582) | $3,632 | $3,632 | 5.2× |
| Lung Ventilation Imaging (78579) | $1,838 | $1,838 | 3.6× |
| Lymph System Imaging (78195) | $3,525 | $3,525 | 5.0× |
| Meckels Divert Exam (78290) | $3,446 | $3,446 | 6.7× |
| MRA head w/o contrast (70544) | $5,677 | $5,677 | 18.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $7,025 | $7,025 | 15.7× |
| MRA neck w/o contrast (70547) | $4,350 | $4,350 | 14.2× |
| MRI abdomen w contrast (74182) | $4,287 | $4,287 | 9.6× |
| MRI abdomen w/o contrast (74181) | $4,410 | $4,410 | 14.4× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$5,118–$7,678 | $5,118–$7,678 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$7,534–$11,300 | $7,534–$11,300 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$5,051–$7,576 | $5,051–$7,576 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $4,205 | $4,205 | 13.7× |
| MRI cervical spine w contrast (72142) | $6,480 | $6,480 | 14.4× |
| MRI cervical spine w/o cont (72141) | $5,265 | $5,265 | 17.2× |
| MRI chest w/o contrast (71550) | $3,653 | $3,653 | 11.9× |
| MRI chest with contrast (71551) | $5,011 | $5,011 | 5.0× |
| MRI chest wo w contrast (71552) | $6,411 | $6,411 | 14.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$5,373–$8,060 | $5,373–$8,060 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$5,328–$7,992 | $5,328–$7,992 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$3,579–$5,368 | $3,579–$5,368 | varies |
| MRI lumbar spine w contrast (72149) | $8,076 | $8,076 | 18.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $8,560 | $8,560 | 19.1× |
| MRI orbit face &/neck w/o contrast (70540) | $3,465 | $3,465 | 11.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $6,362 | $6,362 | 14.2× |
| MRI pelvis w contrast (72196) | $5,220 | $5,220 | 11.6× |
| MRI pelvis w/o & w contrast (72197) | $8,535 | $8,535 | 19.0× |
| MRI pelvis w/o contrast (72195) | $5,735 | $5,735 | 18.7× |
| MRI thoracic spine w/o contrast (72146) | $5,458 | $5,458 | 17.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$3,121–$4,682 | $3,121–$4,682 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$3,548–$5,322 | $3,548–$5,322 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$5,466–$8,199 | $5,466–$8,199 | varies |
| MRI, abdomen, combo (74183) | $6,139 | $6,139 | 13.7× |
| MRI, dorsal spine combo (72157) | $8,406 | $8,406 | 18.7× |
| MRI, dorsal spine contrast (72147) | $6,508 | $6,508 | 14.5× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$4,860–$7,291 | $4,860–$7,291 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$7,159–$10,739 | $7,159–$10,739 | varies |
| MRI, lumbar spine combo (72158) | $8,441 | $8,441 | 18.8× |
| Myelogram cervical (72240) | $2,141 | $2,141 | 2.1× |
| Myelogram Lumbar (72265) | $3,273 | $3,273 | 3.2× |
| Myelography thoracic (72255) | $2,448 | $2,448 | 2.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $2,642 | $2,642 | 5.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $5,394 | $5,394 | 3.2× |
| Myocardial Spect Multiple Studies (78452) | $9,698 | $9,698 | 5.8× |
| Neck soft tissue (70360) | $593 | $593 | 5.3× |
| Nuclear Rx Oral Admin (79005) | $1,823 | $1,823 | 6.1× |
| Parathyroid Planar Imaging (78070) | $2,041 | $2,041 | 4.0× |
| Parathyroid planar imaging w/wo subtraction (78071) | $3,314 | $3,314 | 6.4× |
| Pelvis 1 or 2 views (72170) | $770 | $770 | 5.7× |
| Pet Image Skull-Thigh (78812) | $8,973 | $8,973 | 4.9× |
| Pet Image W/Ct Lmtd (78814) | $7,856 | $7,856 | 4.3× |
| PET image w/CT, full body (78816) | $8,550 | $8,550 | 4.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,591 | $8,591 | 4.7× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $6,505 | $6,505 | 3.9× |
| PET whole body (78813) | $10,294 | $10,294 | 5.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,559 | $2,559 | 5.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,179 | $1,179 | 8.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,539 | $1,539 | 2.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$866–$1,300 | $866–$1,300 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$642–$963 | $642–$963 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$844–$1,265 | $844–$1,265 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $728 | $728 | 5.4× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$681–$1,022 | $681–$1,022 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$918–$1,377 | $918–$1,377 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$886–$1,329 | $886–$1,329 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$515–$772 | $515–$772 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $692 | $692 | 6.2× |
| Radex Ribs Unilateral 2 Views (71100) | $640 | $640 | 5.7× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$890–$1,335 | $890–$1,335 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $483 | $483 | 4.3× |
| Radex Spine 1 View Specify Level (72020) | $729 | $729 | 6.5× |
| Radex Sternum Minimum 2 Views (71120) | $579 | $579 | 5.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $560 | $560 | 5.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$662–$994 | $662–$994 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$517–$776 | $517–$776 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$862–$1,294 | $862–$1,294 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $989 | $989 | 7.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $747 | $747 | 5.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $879 | $879 | 6.5× |
| Radiologic exam colon double contrast study (74280) | $1,596 | $1,596 | 7.1× |
| Radiologic exam colon single contrast study (74270) | $1,297 | $1,297 | 5.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $975 | $975 | 4.3× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$1,025–$1,537 | $1,025–$1,537 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $890 | $890 | 6.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,388 | $1,388 | 6.2× |
| Radiologic exam swallow function contrast study (74230) | $1,251 | $1,251 | 5.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,309 | $1,309 | 5.8× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$714–$1,071 | $714–$1,071 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$797–$1,195 | $797–$1,195 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$709–$1,064 | $709–$1,064 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $693 | $693 | 5.2× |
| Radiologic Examination Salivary Gland Calculus (70380) | $746 | $746 | 6.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$645–$968 | $645–$968 | varies |
| Ribs bilateral 3 views (71110) | $835 | $835 | 6.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,034 | $2,034 | 4.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,458 | $4,458 | 6.4× |
| Rp Therapy Intravenous Administration (79101) | $1,450 | $1,450 | 4.8× |
| Scapula (73010) range across 3 matching MRF lines |
$669–$1,004 | $669–$1,004 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $145 | $145 | 6.2× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$693–$1,040 | $693–$1,040 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$1,464–$2,196 | $1,464–$2,196 | varies |
| Skull less than 4 views (70250) | $770 | $770 | 5.7× |
| Special dosimetry (77331) | $1,128 | $1,128 | 6.5× |
| Special Physics Consult (77370) | $1,971 | $1,971 | 11.4× |
| Special treatment procedure (77470) | $4,018 | $4,018 | 5.7× |
| Speech evaluation, complex (70371) | $1,537 | $1,537 | 5.0× |
| Sternoclavicular joints (71130) | $468 | $468 | 4.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $4,447 | $4,447 | 9.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $2,954 | $2,954 | 13.1× |
| Thoracic spine 2 views (72070) | $932 | $932 | 6.9× |
| Thoracic spine 3 views (72072) | $980 | $980 | 7.3× |
| Thoracolumbar 2 views (72080) | $805 | $805 | 7.2× |
| Thyroid Imaging With Vascular Flow (78013) | $140 | $140 | 0.3× |
| Thyroid Met Imaging Body (78018) | $4,359 | $4,359 | 6.2× |
| Thyroid Uptake Measurement (78012) | $1,510 | $1,510 | 2.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,847 | $1,847 | 3.6× |
| Tx devices design & construction simple (77332) | $1,032 | $1,032 | 6.0× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$865–$1,298 | $865–$1,298 | varies |
| Ultrasound Exam Aaa Screen (76706) | $812 | $812 | 6.0× |
| Ultrasound, abdomen limited (76705) | $1,656 | $1,656 | 12.3× |
| Unlisted Dx Radiographic Procedure (76499) | $446 | $446 | 4.0× |
| Upper gi w/o kub (74240) | $1,319 | $1,319 | 5.8× |
| Urethrocystogram voiding (74455) | $1,299 | $1,299 | 4.2× |
| Urethrocystography retrograde (74450) | $1,522 | $1,522 | 5.0× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$1,092–$1,637 | $1,092–$1,637 | varies |
| Us chest (76604) | $1,095 | $1,095 | 8.1× |
| Us complete joint (76881) | $1,034 | $1,034 | 7.7× |
| Us exam, pelvic, limited (76857) | $944 | $944 | 7.0× |
| Us head (76506) | $1,424 | $1,424 | 10.6× |
| Us kidney transplant (76776) | $1,579 | $1,579 | 11.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $674 | $674 | 5.0× |
| Us ob detailed single fetus (76811) | $1,325 | $1,325 | 4.3× |
| Us ob limited 1 or more fetuses (76815) | $1,194 | $1,194 | 8.9× |
| Us ob transvaginal (76817) | $1,457 | $1,457 | 10.8× |
| Us pelvic non ob complete (76856) | $1,596 | $1,596 | 11.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,625 | $1,625 | 12.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $894 | $894 | 6.6× |
| Us retroperitoneal complete (76770) | $1,326 | $1,326 | 9.9× |
| Us retroperitoneal limited (76775) | $1,059 | $1,059 | 7.9× |
| Us scrotum and contents (76870) | $1,224 | $1,224 | 9.1× |
| Us spinal canal and contents (76800) | $1,307 | $1,307 | 9.7× |
| Us thyroid (76536) | $1,368 | $1,368 | 10.2× |
| Us transrectal (76872) | $866 | $866 | 6.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,969 | $3,969 | 1.0× |
| Venography extremity bilateral rs&i (75822) | $3,954 | $3,954 | 2.0× |
| Venography extremity unilateral rs&i (75820) | $3,110 | $3,110 | 1.5× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$675–$1,012 | $675–$1,012 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $584 | $584 | 5.2× |
| X-ray antegrade pyelogram tube (74425) | $1,677 | $1,677 | 3.7× |
| X-Ray Bend Only L-S Spine (72120) | $836 | $836 | 6.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$752–$1,128 | $752–$1,128 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,020 | $1,020 | 1.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $458 | $458 | 4.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $654 | $654 | 4.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $774 | $774 | 5.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $685 | $685 | 6.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $768 | $768 | 6.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,048 | $1,048 | 7.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $764 | $764 | 5.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $905 | $905 | 6.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,064 | $1,064 | 7.9× |
| X-Ray Exam L-S Spine Bending (72114) | $1,169 | $1,169 | 8.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $864 | $864 | 7.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,308 | $1,308 | 9.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $854 | $854 | 6.4× |
| X-ray eye for foreign body (70030) | $485 | $485 | 4.3× |
| X-ray humerus (73060) | $732 | $732 | 6.5× |
| X-ray IV pyelogram (ivp) (74400) | $984 | $984 | 4.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $466 | $466 | 4.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $622 | $622 | 5.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $966 | $966 | 7.2× |
| X-ray nose-rectum child f.b. (76010) | $401 | $401 | 3.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,016 | $1,016 | 7.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $650 | $650 | 4.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $455 | $455 | 3.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $738 | $738 | 6.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $589 | $589 | 5.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $852 | $852 | 6.3× |
| X-Ray Stress View (77071) | $585 | $585 | 5.2× |
| X-ray thoracic spine 4 vw (72074) | $725 | $725 | 5.4× |
| X-Ray Tmj Unilat (70328) | $338 | $338 | 3.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,165 | $2,165 | 4.8× |
| X-Rays Bone Length Studies (77073) | $670 | $670 | 5.0× |
| X-Rays Bone Survey Complete (77075) | $1,211 | $1,211 | 9.0× |
| Xr c-spine 4 or 5 views (72050) | $1,175 | $1,175 | 8.7× |
| Xr facial bones less than 3 views (70140) | $608 | $608 | 5.4× |
| Xr orbits complete 4 views (70200) | $603 | $603 | 4.5× |
| Xr Tomogram Single Plane (76100) | $1,875 | $1,875 | 13.9× |
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.