Imaging prices at Texas County Memorial Hospital
Houston, MO · every code in this section with a posted price and a Medicare benchmark.
262 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) range across 2 matching MRF lines |
$90–$220.50 | $90–$315 | varies |
| Abdomen 2 views (74019) | $317.10 | $453 | 3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $676.90 | $967 | 1.7× |
| Angiography extremity bilateral rs&i (75716) | $145 | $145 | 0.0× |
| Angiography extremity unilateral rs&i (75710) | $130 | $130 | 0.0× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$80–$207.90 | $80–$297 | varies |
| Bone age studies (77072) | $158.90 | $227 | 1.5× |
| Bone Imaging 3 Phase (78315) | $1,796.90 | $2,567 | 4.5× |
| Bone Imaging Limited Area (78300) | $1,365 | $1,950 | 3.4× |
| Bone Imaging Multiple Areas (78305) | $1,575.70 | $2,251 | 3.9× |
| Bone Imaging Whole Body (78306) | $1,041.60 | $1,488 | 2.6× |
| Bone survey infant (77076) | $158.90 | $227 | 1.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $963.90 | $1,377 | 1.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $641.20 | $916 | 1.6× |
| Cat Scan Follow-Up Study (76380) | $1,129.10 | $1,613 | 13.0× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$90–$122.50 | $90–$175 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$100–$147 | $100–$210 | varies |
| Chest 3 views (71047) | $245 | $350 | 2.8× |
| Chest 4 or more views (71048) | $292.60 | $418 | 2.8× |
| Cholecystography Oral Contrast (74290) | $263.20 | $376 | 1.5× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$105–$220.50 | $105–$315 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,961.40 | $2,802 | 18.7× |
| Contrast X-Ray Bladder (74430) | $203.70 | $291 | 0.6× |
| Contrast Xray Throat/Cerv Esopha (74210) | $490 | $700 | 2.8× |
| CT abdomen and pelvis without and with contrast (74178) | $3,392.20 | $4,846 | 9.7× |
| CT abdomen and pelvis without contrast (74176) | $2,482.20 | $3,546 | 10.4× |
| CT abdomen w contrast (74160) | $1,961.40 | $2,802 | 11.2× |
| CT abdomen w wo contrast (74170) | $2,262.40 | $3,232 | 12.9× |
| CT abdomen w/o contrast (74150) | $1,654.80 | $2,364 | 15.8× |
| CT Angio Abdomen and Pelvis (74174) | $2,286.90 | $3,267 | 6.5× |
| CT Angio Chest (71275) | $2,746.10 | $3,923 | 15.6× |
| CT Angio Head (70496) | $2,403.80 | $3,434 | 13.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,572.50 | $3,675 | 14.6× |
| CT Angio Neck (70498) | $2,403.80 | $3,434 | 13.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,403.80 | $3,434 | 13.7× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $115.50 | $165 | 0.7× |
| CT cervical spine w/ contrast (72126) | $2,262.40 | $3,232 | 6.5× |
| CT cervical spine w/o contrast (72125) | $1,961.40 | $2,802 | 18.7× |
| CT cervical spine w/wo cont (72127) | $2,565.50 | $3,665 | 14.6× |
| CT chest w contrast (71260) | $2,262.40 | $3,232 | 12.9× |
| CT chest w/wo contrast (71270) | $2,565.50 | $3,665 | 14.6× |
| CT head/brain with contrast (70460) | $1,961.40 | $2,802 | 11.2× |
| CT head/brain without and with contrast (70470) | $2,262.40 | $3,232 | 12.9× |
| CT iac w contrast (70481) | $2,109.80 | $3,014 | 12.0× |
| CT l-spine w&w/o contrast (72133) | $2,565.50 | $3,665 | 14.6× |
| CT lower ext w/o (73700) | $1,809.50 | $2,585 | 17.3× |
| CT lower extremity w/contrast material (73701) | $2,109.80 | $3,014 | 12.0× |
| CT lumbar spine w contrast (72132) | $2,262.40 | $3,232 | 6.5× |
| CT lumbar spine w/o contrast (72131) | $1,961.40 | $2,802 | 18.7× |
| CT maxillofacial w contrast (70487) | $2,109.80 | $3,014 | 12.0× |
| CT maxillofacial wo contrast (70486) | $1,809.50 | $2,585 | 17.3× |
| CT neck tissue combo (70492) | $2,262.40 | $3,232 | 12.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,413.60 | $3,448 | 13.7× |
| CT orbits w/o contrast (70480) | $1,809.50 | $2,585 | 17.3× |
| CT pelvis w&w/o contrast (72194) | $2,262.40 | $3,232 | 12.9× |
| CT pelvis w/o contrast (72192) | $1,654.80 | $2,364 | 15.8× |
| CT scan of leg combo (73702) | $2,413.60 | $3,448 | 13.7× |
| CT scans face/jaw combo (70488) | $2,413.60 | $3,448 | 13.7× |
| CT soft tissue neck w contrast (70491) | $1,961.40 | $2,802 | 11.2× |
| CT soft tissue neck w/o contrast (70490) | $1,654.80 | $2,364 | 15.8× |
| CT thoracic spine w contrast (72129) | $2,262.40 | $3,232 | 12.9× |
| CT thoracic spine w/o contrast (72128) | $1,961.40 | $2,802 | 18.7× |
| CT thoracic spine w/wo cont (72130) | $2,565.50 | $3,665 | 14.6× |
| CT thorax w/o contrast (71250) | $1,961.40 | $2,802 | 18.7× |
| CT upper ext wo (73200) | $1,654.80 | $2,364 | 15.8× |
| CT upper extremity w/o & w/contrast material (73202) | $2,262.40 | $3,232 | 12.9× |
| CT upper extremity with contrast (73201) | $1,961.40 | $2,802 | 5.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,403.80 | $3,434 | 13.7× |
| Cta Abdomen (74175) | $2,403.80 | $3,434 | 13.7× |
| CTA pelvis (72191) | $2,403.80 | $3,434 | 13.7× |
| Dxa Bone Density Axial (77080) | $296.10 | $423 | 2.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $158.90 | $227 | 1.8× |
| Esophagram (74220) | $214.90 | $307 | 1.2× |
| Fetal Biophys Profile W/Nst (76818) | $662.20 | $946 | 6.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $405.30 | $579 | 3.9× |
| Fluoroscopy up to 1 hr (76000) | $65 | $65 | 0.3× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$90–$220.50 | $90–$315 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$90–$220.50 | $90–$315 | varies |
| Gastric emptying imaging study (78264) | $892.50 | $1,275 | 2.2× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$80–$220.50 | $80–$315 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,541.40 | $2,202 | 2.8× |
| Hepatobiliary System Imaging (78226) | $1,379 | $1,970 | 3.4× |
| Ht Muscle Image Spect Sing (78451) | $2,030 | $2,900 | 1.6× |
| Hysterosalpingogram (74740) | $467.60 | $668 | 2.0× |
| Joint Survey Single View (77077) | $130.20 | $186 | 1.2× |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$1,227.80–$1,413.30 | $1,754–$2,019 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,106–$1,162 | $1,580–$1,660 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$696.50–$1,008 | $995–$1,440 | varies |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$100–$341.60 | $100–$488 | varies |
| Liver & Spleen Imaging Static Only (78215) | $865.90 | $1,237 | 2.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $962.50 | $1,375 | 2.4× |
| Lung Ventilat&Perfus Imaging (78582) | $1,030.40 | $1,472 | 1.9× |
| Lung Ventilation Imaging (78579) | $411.60 | $588 | 1.0× |
| Magnetic Image Jaw Joint (70336) | $1,774.50 | $2,535 | 7.4× |
| Meckels Divert Exam (78290) | $815.50 | $1,165 | 2.0× |
| Mra Head W/O & W/Contrast Material (70546) | $2,117.50 | $3,025 | 6.1× |
| MRA head w/o contrast (70544) | $1,463 | $2,090 | 6.1× |
| MRA head with contrast (70545) | $1,568 | $2,240 | 4.5× |
| MRA neck w contrast (70548) | $1,568 | $2,240 | 4.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,117.50 | $3,025 | 6.1× |
| MRA neck w/o contrast (70547) | $1,463 | $2,090 | 6.1× |
| MRI abdomen w contrast (74182) | $3,157 | $4,510 | 9.0× |
| MRI abdomen w/o contrast (74181) | $2,884 | $4,120 | 12.1× |
| MRI any jt lower extrem w/contrast material (73722) | $3,157 | $4,510 | 4.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,591 | $5,130 | 10.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,157 | $4,510 | 4.0× |
| MRI cervical spine w contrast (72142) | $3,157 | $4,510 | 9.0× |
| MRI cervical spine w/o cont (72141) | $2,884 | $4,120 | 12.1× |
| MRI chest w/o contrast (71550) | $2,884 | $4,120 | 12.1× |
| MRI chest with contrast (71551) | $3,157 | $4,510 | 4.0× |
| MRI chest wo w contrast (71552) | $3,591 | $5,130 | 10.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,157 | $4,510 | 9.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,591 | $5,130 | 10.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,884 | $4,120 | 12.1× |
| MRI lumbar spine w contrast (72149) | $3,157 | $4,510 | 9.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,591 | $5,130 | 10.3× |
| MRI orbit face &/neck w/o contrast (70540) | $2,884 | $4,120 | 12.1× |
| MRI orbit face neck w contrast (70542) | $3,157 | $4,510 | 9.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,591 | $5,130 | 10.3× |
| MRI pelvis w contrast (72196) | $3,157 | $4,510 | 9.0× |
| MRI pelvis w/o & w contrast (72197) | $3,591 | $5,130 | 10.3× |
| MRI pelvis w/o contrast (72195) | $2,884 | $4,120 | 12.1× |
| MRI thoracic spine w/o contrast (72146) | $2,884 | $4,120 | 12.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,157 | $4,510 | 9.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,884 | $4,120 | 12.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,591 | $5,130 | 10.3× |
| MRI, abdomen, combo (74183) | $3,591 | $5,130 | 10.3× |
| MRI, dorsal spine combo (72157) | $3,591 | $5,130 | 10.3× |
| MRI, dorsal spine contrast (72147) | $3,157 | $4,510 | 9.0× |
| MRI, joint upper extrem (73221) | $2,884 | $4,120 | 12.1× |
| MRI, joint upper extrem combo (73223) | $3,591 | $5,130 | 10.3× |
| MRI, lumbar spine combo (72158) | $3,591 | $5,130 | 10.3× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $856.80 | $1,224 | 2.1× |
| Myocardial Spect Multiple Studies (78452) | $2,792.30 | $3,989 | 2.2× |
| Neck soft tissue (70360) | $45 | $45 | 0.5× |
| Ob us nuchal meas 1 gest (76813) | $364.70 | $521 | 3.5× |
| Optic foramina (70190) | $106.40 | $152 | 1.2× |
| Parathyroid Planar Imaging (78070) | $653.80 | $934 | 1.6× |
| Pelvis 1 or 2 views (72170) | $115 | $115 | 1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $647.50 | $925 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $438.90 | $627 | 4.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $333.20 | $476 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$90–$220.50 | $90–$315 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $80 | $80 | 0.9× |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$100–$317.10 | $100–$453 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $389.90 | $557 | 3.7× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$70–$220.50 | $70–$315 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$100–$229.60 | $100–$328 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$85–$229.60 | $85–$328 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $135.10 | $193 | 1.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $305.90 | $437 | 2.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$85–$233.80 | $85–$334 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$110–$169.40 | $110–$242 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$125–$220.50 | $125–$315 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $145.60 | $208 | 1.7× |
| Radex Spine 1 View Specify Level (72020) | $172.20 | $246 | 2.0× |
| Radex Sternum Minimum 2 Views (71120) | $269.50 | $385 | 3.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $490 | $700 | 5.6× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$90–$220.50 | $90–$315 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $135.10 | $193 | 1.3× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$90–$220.50 | $90–$315 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $388.50 | $555 | 3.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $415.10 | $593 | 4.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $464.10 | $663 | 4.4× |
| Radiologic exam colon double contrast study (74280) | $855.40 | $1,222 | 4.9× |
| Radiologic exam colon single contrast study (74270) | $292.60 | $418 | 1.7× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$120–$366.80 | $120–$524 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $227.50 | $325 | 2.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $559.30 | $799 | 3.2× |
| Radiologic exam swallow function contrast study (74230) | $355.60 | $508 | 2.0× |
| Radiologic examination femur 1 view (73551) | $156.80 | $224 | 1.8× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$100–$220.50 | $100–$315 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$90–$220.50 | $90–$315 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $281.40 | $402 | 2.7× |
| Radiologic Examination Salivary Gland Calculus (70380) | $102.90 | $147 | 1.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$100–$220.50 | $100–$315 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $161.70 | $231 | 0.3× |
| Ribs bilateral 3 views (71110) | $227.50 | $325 | 2.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $993.30 | $1,419 | 1.8× |
| Scapula (73010) | $120 | $120 | 1.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 4 matching MRF lines |
$32.20–$43.40 | $46–$62 | varies |
| Sella turcica (70240) | $102.90 | $147 | 1.2× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$95–$183.40 | $95–$262 | varies |
| Shoulder Arthrography (73040) | $623 | $890 | 1.8× |
| Sialogram (70390) | $391.30 | $559 | 1.6× |
| Skull less than 4 views (70250) | $371 | $530 | 3.5× |
| Sternoclavicular joints (71130) | $114.10 | $163 | 1.3× |
| Tbs technical calculation only (77091) | $108.50 | $155 | 1.2× |
| Testicular Imaging W/Flow (78761) | $815.50 | $1,165 | 2.0× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$120–$291.90 | $120–$417 | varies |
| Thoracic spine 3 views (72072) | $317.10 | $453 | 3.0× |
| Thoracolumbar 2 views (72080) | $173.60 | $248 | 2.0× |
| Thyroid Imaging With Vascular Flow (78013) | $401.80 | $574 | 1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,321.60 | $1,888 | 3.3× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$56.44–$366.10 | $80.63–$523 | varies |
| Ultrasound Exam Aaa Screen (76706) | $305.20 | $436 | 2.9× |
| Ultrasound, abdomen limited (76705) | $688.80 | $984 | 6.6× |
| Umbilical-artery Doppler (OB) (76820) | $557.20 | $796 | 5.3× |
| Unlisted us procedure (76999) | $454.30 | $649 | 5.2× |
| Urethrocystogram voiding (74455) | $803.60 | $1,148 | 3.4× |
| Urethrocystography retrograde (74450) | $349.30 | $499 | 1.5× |
| Us breast unilateral complete (76641) | $155 | $155 | 1.5× |
| Us chest (76604) | $653.80 | $934 | 6.2× |
| Us complete joint (76881) | $292.60 | $418 | 2.8× |
| Us exam, pelvic, limited (76857) | $347.20 | $496 | 3.3× |
| Us head (76506) | $343 | $490 | 3.3× |
| Us kidney transplant (76776) | $403.90 | $577 | 3.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$195.30–$208.60 | $279–$298 | varies |
| Us ob limited 1 or more fetuses (76815) | $205 | $205 | 2.0× |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$483.70–$644 | $691–$920 | varies |
| Us pelvic non ob complete (76856) | $688.80 | $984 | 6.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $574 | $820 | 5.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $662.90 | $947 | 6.3× |
| Us retroperitoneal complete (76770) | $155 | $155 | 1.5× |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$305.20–$688.80 | $436–$984 | varies |
| Us scrotum and contents (76870) | $651.70 | $931 | 6.2× |
| Us thyroid (76536) range across 2 matching MRF lines |
$620.90–$653.80 | $887–$934 | varies |
| Venography extremity bilateral rs&i (75822) | $857.50 | $1,225 | 0.5× |
| Venography extremity unilateral rs&i (75820) | $437.50 | $625 | 0.3× |
| Venous thrombosis imaging (78457) | $816.90 | $1,167 | 1.5× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$80–$207.90 | $80–$297 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $259 | $370 | 3.0× |
| X-ray antegrade pyelogram tube (74425) | $375.20 | $536 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) | $313.60 | $448 | 3.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$90–$220.50 | $90–$315 | varies |
| X-Ray Exam Breast Specimen (76098) | $152.60 | $218 | 0.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $108.50 | $155 | 1.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $233.10 | $333 | 2.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $347.90 | $497 | 3.3× |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$139.30–$206.50 | $199–$295 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$100–$242.90 | $100–$347 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 4 matching MRF lines |
$347.90–$450.10 | $497–$643 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$347.90–$450.10 | $497–$643 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$450.10–$554.40 | $643–$792 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$554.40–$658 | $792–$940 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $303.10 | $433 | 2.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$120–$306.60 | $120–$438 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $385 | $550 | 3.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $307.30 | $439 | 2.9× |
| X-ray eye for foreign body (70030) | $163.80 | $234 | 1.9× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$100–$220.50 | $100–$315 | varies |
| X-ray IV pyelogram (ivp) (74400) | $655.20 | $936 | 3.7× |
| X-ray IV pyelogram+tomography (74415) | $924.70 | $1,321 | 5.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $341.60 | $488 | 3.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $207.20 | $296 | 2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$155–$329.70 | $155–$471 | varies |
| X-ray nose-rectum child f.b. (76010) | $72.80 | $104 | 0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $401.10 | $573 | 3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $389.90 | $557 | 3.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $120 | $120 | 1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $329.70 | $471 | 3.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$255.50–$415.10 | $365–$593 | varies |
| X-Ray Stress View (77071) | $130.20 | $186 | 1.5× |
| X-ray thoracic spine 4 vw (72074) | $393.40 | $562 | 3.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $281.40 | $402 | 0.8× |
| X-Rays Bone Length Studies (77073) | $158.90 | $227 | 1.5× |
| X-Rays Bone Survey Complete (77075) | $281.40 | $402 | 2.7× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$175–$354.20 | $175–$506 | varies |
| Xr facial bones less than 3 views (70140) | $317.10 | $453 | 3.6× |
| XR Mastoids < 3 Views Bilateral (70120) | $72.80 | $104 | 0.7× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$60–$173.60 | $60–$248 | varies |
| Xr Tomogram Single Plane (76100) | $424.20 | $606 | 4.1× |
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.