Imaging prices at Texas Scottish Rite Hospital For Children
Dallas, TX · every code in this section with a posted price and a Medicare benchmark.
228 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 3 matching MRF lines |
$28–$112 | $28–$112 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$100–$243 | $100–$243 | varies |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$26–$322 | $26–$322 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$89–$389 | $89–$389 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$89–$941 | $89–$941 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$88–$389 | $88–$389 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$29–$374 | $29–$374 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$110–$262 | $110–$262 | varies |
| Cat Scan Follow-Up Study (76380) | $153 | $153 | 1.8× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$28–$108 | $28–$108 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$34–$124 | $34–$124 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$43–$150 | $43–$150 | varies |
| Chest 4 or more views (71048) range across 4 matching MRF lines |
$48–$245 | $48–$245 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$26–$394 | $26–$394 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$88–$950 | $88–$950 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$92–$389 | $92–$389 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$1,040–$1,321 | $1,040–$1,321 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$542–$748 | $542–$748 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$198–$4,003 | $198–$4,003 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$218–$4,802 | $218–$4,802 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$186–$3,003 | $186–$3,003 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$357–$3,735 | $357–$3,735 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$298–$4,230 | $298–$4,230 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$272–$4,274 | $272–$4,274 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$296–$3,961 | $296–$3,961 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$272–$4,157 | $272–$4,157 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$280–$3,837 | $280–$3,837 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$189–$3,947 | $189–$3,947 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$166–$3,509 | $166–$3,509 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$197–$4,203 | $197–$4,203 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$193–$3,442 | $193–$3,442 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$214–$4,075 | $214–$4,075 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$175–$3,242 | $175–$3,242 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$198–$4,040 | $198–$4,040 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$214–$3,268 | $214–$3,268 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$198–$4,544 | $198–$4,544 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$684–$2,693 | $684–$2,693 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$182–$2,831 | $182–$2,831 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$189–$4,337 | $189–$4,337 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$157–$3,827 | $157–$3,827 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$202–$3,230 | $202–$3,230 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$178–$2,510 | $178–$2,510 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$225–$3,658 | $225–$3,658 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$225–$3,249 | $225–$3,249 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$200–$2,783 | $200–$2,783 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$189–$4,319 | $189–$4,319 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$168–$2,780 | $168–$2,780 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$189–$3,181 | $189–$3,181 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$220–$3,456 | $220–$3,456 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$216–$3,214 | $216–$3,214 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$200–$2,869 | $200–$2,869 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$189–$3,470 | $189–$3,470 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$157–$3,313 | $157–$3,313 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$198–$4,128 | $198–$4,128 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$160–$2,888 | $160–$2,888 | varies |
| CT unlisted procedure (76497) | $981 | $981 | 11.2× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$159–$2,643 | $159–$2,643 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$189–$2,981 | $189–$2,981 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$182–$2,812 | $182–$2,812 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$357–$963 | $357–$963 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$296–$4,041 | $296–$4,041 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$285–$3,749 | $285–$3,749 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$72–$778 | $72–$778 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$172–$640 | $172–$640 | varies |
| Foot 2 views (73620) range across 2 matching MRF lines |
$24–$346 | $24–$346 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$25–$459 | $25–$459 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$26–$394 | $26–$394 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$115–$391 | $115–$391 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$94–$391 | $94–$391 | varies |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$53–$346 | $53–$346 | varies |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$30–$414 | $30–$414 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$226–$1,083 | $226–$1,083 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$280–$5,105 | $280–$5,105 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$187–$3,509 | $187–$3,509 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$186–$4,000 | $186–$4,000 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$187–$4,318 | $187–$4,318 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$279–$4,691 | $279–$4,691 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$187–$3,443 | $187–$3,443 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$269–$3,828 | $269–$3,828 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$227–$3,473 | $227–$3,473 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$255–$3,668 | $255–$3,668 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$334–$4,840 | $334–$4,840 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$253–$3,918 | $253–$3,918 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$300–$4,273 | $300–$4,273 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$250–$3,991 | $250–$3,991 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$226–$3,327 | $226–$3,327 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$269–$3,550 | $269–$3,550 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$350–$4,000 | $350–$4,000 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$253–$3,648 | $253–$3,648 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$334–$4,866 | $334–$4,866 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$210–$3,578 | $210–$3,578 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$279–$4,289 | $279–$4,289 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$401–$5,478 | $401–$5,478 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$210–$3,790 | $210–$3,790 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$252–$3,985 | $252–$3,985 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$333–$4,860 | $333–$4,860 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$270–$4,044 | $270–$4,044 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$349–$4,872 | $349–$4,872 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$229–$3,536 | $229–$3,536 | varies |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$1,448–$1,492 | $1,448–$1,492 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$250–$3,991 | $250–$3,991 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$253–$3,518 | $253–$3,518 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$210–$1,660 | $210–$1,660 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$335–$5,148 | $335–$5,148 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$349–$5,658 | $349–$5,658 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$401–$5,454 | $401–$5,454 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$300–$4,169 | $300–$4,169 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$213–$3,560 | $213–$3,560 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$335–$4,985 | $335–$4,985 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$370–$5,461 | $370–$5,461 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$141–$1,549 | $141–$1,549 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$130–$2,065 | $130–$2,065 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$141–$1,681 | $141–$1,681 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$208–$2,495 | $208–$2,495 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$26–$238 | $26–$238 | varies |
| Nm csf leak detection (78650) | $797 | $797 | 0.6× |
| Optic foramina (70190) range across 2 matching MRF lines |
$34–$157 | $34–$157 | varies |
| Panoramic X-ray of jaws (70355) | $34 | $34 | 0.4× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$29–$380 | $29–$380 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$84–$552 | $84–$552 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$27–$399 | $27–$399 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$25–$374 | $25–$374 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$27–$440 | $27–$440 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$40–$491 | $40–$491 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$22–$296 | $22–$296 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$26–$395 | $26–$395 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$27–$424 | $27–$424 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$26–$157 | $26–$157 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$53–$157 | $53–$157 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$27–$333 | $27–$333 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$35–$426 | $35–$426 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$30–$422 | $30–$422 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$27–$254 | $27–$254 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$24–$351 | $24–$351 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$31–$373 | $31–$373 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$40–$181 | $40–$181 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$21–$327 | $21–$327 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$25–$164 | $25–$164 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$27–$472 | $27–$472 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$64–$689 | $64–$689 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$40–$485 | $40–$485 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$117–$214 | $117–$214 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$108–$933 | $108–$933 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$37–$480 | $37–$480 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$35–$476 | $35–$476 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$74–$703 | $74–$703 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$83–$704 | $83–$704 | varies |
| Radiologic exam teeth complete full mouth (70320) range across 2 matching MRF lines |
$37–$299 | $37–$299 | varies |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) range across 2 matching MRF lines |
$26–$453 | $26–$453 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$108–$796 | $108–$796 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$89–$132 | $89–$132 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$104–$136 | $104–$136 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$29–$373 | $29–$373 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$27–$383 | $27–$383 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) range across 2 matching MRF lines |
$57–$558 | $57–$558 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) range across 2 matching MRF lines |
$19–$93 | $19–$93 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$43–$528 | $43–$528 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$29–$314 | $29–$314 | varies |
| Sella turcica (70240) range across 2 matching MRF lines |
$30–$157 | $30–$157 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$24–$284 | $24–$284 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$86–$589 | $86–$589 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$38–$339 | $38–$339 | varies |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$35–$405 | $35–$405 | varies |
| Temporomandble Jt Arthrography Rs&I (70332) range across 2 matching MRF lines |
$84–$950 | $84–$950 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$35–$593 | $35–$593 | varies |
| Thoracic spine 3 views (72072) | $34 | $34 | 0.3× |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$36–$423 | $36–$423 | varies |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$175–$205 | $175–$205 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$90–$949 | $90–$949 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$82–$424 | $82–$424 | varies |
| Unlisted fluoroscopic procedure (76496) range across 2 matching MRF lines |
$234–$537 | $234–$537 | varies |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$615–$1,980 | $615–$1,980 | varies |
| Unlisted us procedure (76999) | $211 | $211 | 2.4× |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$107–$1,024 | $107–$1,024 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$51–$1,092 | $51–$1,092 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$53–$503 | $53–$503 | varies |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$205–$229 | $205–$229 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$85–$617 | $85–$617 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$97–$848 | $97–$848 | varies |
| Us exam, pelvic, limited (76857) | $540 | $540 | 5.1× |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$116–$870 | $116–$870 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$76–$500 | $76–$500 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$107–$1,092 | $107–$1,092 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$114–$888 | $114–$888 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$89–$647 | $89–$647 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$100–$950 | $100–$950 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$174–$391 | $174–$391 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$87–$868 | $87–$868 | varies |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$29–$400 | $29–$400 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$35–$313 | $35–$313 | varies |
| X-ray antegrade pyelogram tube (74425) | $55 | $55 | 0.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$25–$418 | $25–$418 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$87–$320 | $87–$320 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$50–$423 | $50–$423 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$57–$610 | $57–$610 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$29–$136 | $29–$136 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$35–$384 | $35–$384 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$43–$496 | $43–$496 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$124–$216 | $124–$216 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$46–$548 | $46–$548 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$49–$613 | $49–$613 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $54 | $54 | 0.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$36–$449 | $36–$449 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $59 | $59 | 0.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$42–$408 | $42–$408 | varies |
| X-ray head for orthodontia (70350) | $30 | $30 | 0.3× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$27–$371 | $27–$371 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$76–$2,376 | $76–$2,376 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$28–$262 | $28–$262 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$30–$461 | $30–$461 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$36–$539 | $36–$539 | varies |
| X-ray nose-rectum child f.b. (76010) | $28 | $28 | 0.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $50 | $50 | 0.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$29–$402 | $29–$402 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$99–$157 | $99–$157 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$27–$411 | $27–$411 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$40–$572 | $40–$572 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$53–$544 | $53–$544 | varies |
| X-Ray Stress View (77071) | $162 | $162 | 1.9× |
| X-ray thoracic spine 4 vw (72074) | $34 | $34 | 0.3× |
| X-Ray Tmj Unilat (70328) | $28 | $28 | 0.3× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$47–$613 | $47–$613 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$85–$1,162 | $85–$1,162 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$50–$662 | $50–$662 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$31–$326 | $31–$326 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$29–$157 | $29–$157 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$44–$231 | $44–$231 | varies |
| Xr Tomogram Single Plane (76100) | $99 | $99 | 0.9× |
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.