Imaging prices at Three Rivers Medical Center
Louisa, KY · every code in this section with a posted price and a Medicare benchmark.
233 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) | $615.23 | $1,025.38 | 7.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,141.54 | $3,569.24 | 5.7× |
| Ankle 2 views (73600) | $455.54 | $759.24 | 5.6× |
| Bone age studies (77072) | $144.59 | $240.99 | 1.5× |
| Bone Imaging 3 Phase (78315) | $2,067.49 | $3,445.81 | 5.5× |
| Bone Imaging Limited Area (78300) | $1,800.76 | $3,001.26 | 4.8× |
| Bone Imaging Whole Body (78306) | $2,417.74 | $4,029.57 | 6.4× |
| Bone survey infant (77076) | $2,829.07 | $4,715.12 | 28.8× |
| Brain Flow Imaging Only (78610) | $2,258.76 | $3,764.60 | 4.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,846.97 | $4,744.95 | 5.6× |
| Cat Scan Follow-Up Study (76380) | $1,436.38 | $2,393.96 | 17.6× |
| Chest 1 view (71045) | $822.29 | $1,370.48 | 10.1× |
| Chest 2 views (71046) | $373.42 | $622.37 | 4.6× |
| Chest 4 or more views (71048) | $488.53 | $814.22 | 5.0× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$759.47–$1,139.56 | $1,265.78–$1,899.27 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $214.16 | $356.93 | 2.2× |
| Contrast X-Ray Bladder (74430) | $1,550.53 | $2,584.21 | 4.7× |
| CT abdomen and pelvis without and with contrast (74178) | $4,579.71 | $7,632.85 | 14.0× |
| CT abdomen and pelvis without contrast (74176) | $3,201.20 | $5,335.34 | 14.3× |
| CT abdomen w contrast (74160) | $3,605.42 | $6,009.04 | 21.9× |
| CT abdomen w wo contrast (74170) | $4,510.80 | $7,518 | 27.4× |
| CT abdomen w/o contrast (74150) | $3,605.42 | $6,009.04 | 36.8× |
| CT Angio Abdomen and Pelvis (74174) | $5,420.06 | $9,033.44 | 16.6× |
| CT Angio Chest (71275) | $3,733.69 | $6,222.82 | 22.7× |
| CT Angio Head (70496) | $5,124.14 | $8,540.23 | 31.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$3,949.38–$5,001.83 | $6,582.30–$8,336.38 | varies |
| CT Angio Neck (70498) | $5,124.14 | $8,540.23 | 31.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$3,949.38–$5,001.83 | $6,582.30–$8,336.38 | varies |
| CT cervical spine w/o contrast (72125) | $3,599.75 | $5,999.58 | 36.7× |
| CT chest w contrast (71260) | $3,733.69 | $6,222.82 | 22.7× |
| CT chest w/wo contrast (71270) | $3,815.13 | $6,358.55 | 23.2× |
| CT head/brain with contrast (70460) | $1,729.63 | $2,882.71 | 10.5× |
| CT head/brain without and with contrast (70470) | $2,301.79 | $3,836.32 | 14.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $92.48 | $154.13 | 1.1× |
| CT hrt w/3d image congen (75573) | $1,200 | $2,000 | 3.7× |
| CT iac w contrast (70481) | $3,639.43 | $6,065.72 | 22.1× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$2,271.65–$2,498.08 | $3,786.09–$4,163.46 | varies |
| CT lower extremity w/contrast material (73701) | $2,271.65 | $3,786.09 | 13.8× |
| CT lumbar spine w contrast (72132) | $3,894.79 | $6,491.31 | 11.9× |
| CT lumbar spine w/o contrast (72131) | $1,524.38 | $2,540.64 | 15.5× |
| CT maxillofacial w contrast (70487) | $2,336.09 | $3,893.49 | 14.2× |
| CT maxillofacial wo contrast (70486) | $2,570.27 | $4,283.78 | 26.2× |
| CT neck tissue combo (70492) | $2,791.92 | $4,653.20 | 17.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,958.33 | $6,597.21 | 24.1× |
| CT orbits w/o contrast (70480) | $2,673.19 | $4,455.32 | 27.3× |
| CT pelvis w&w/o contrast (72194) | $3,816.92 | $6,361.53 | 23.2× |
| CT pelvis w/o contrast (72192) | $3,733.69 | $6,222.82 | 38.1× |
| CT scan of leg combo (73702) | $2,586.97 | $4,311.62 | 15.7× |
| CT scans face/jaw combo (70488) | $2,876.64 | $4,794.40 | 17.5× |
| CT soft tissue neck w contrast (70491) | $2,570.27 | $4,283.78 | 15.6× |
| CT soft tissue neck w/o contrast (70490) | $1,398.50 | $2,330.83 | 14.3× |
| CT thoracic spine w contrast (72129) | $3,894.79 | $6,491.31 | 23.7× |
| CT thoracic spine w/o contrast (72128) | $2,946.74 | $4,911.24 | 30.0× |
| CT thorax w/o contrast (71250) | $3,050.26 | $5,083.76 | 31.1× |
| CT upper ext wo (73200) | $2,498.08 | $4,163.46 | 25.5× |
| CT upper extremity w/o & w/contrast material (73202) | $2,586.97 | $4,311.62 | 15.7× |
| CT upper extremity with contrast (73201) | $2,271.65 | $3,786.09 | 6.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $5,001.83 | $8,336.38 | 30.4× |
| Cta Abdomen (74175) | $5,124.14 | $8,540.23 | 31.1× |
| CTA pelvis (72191) | $5,124.14 | $8,540.23 | 31.1× |
| Dxa Bone Density Axial (77080) | $854.93 | $1,424.89 | 8.7× |
| Esophagram (74220) | $1,078.85 | $1,798.08 | 6.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $531.35 | $885.58 | 5.4× |
| Fluoroscopy up to 1 hr (76000) | $555.56 | $925.94 | 2.5× |
| Foot 2 views (73620) | $473.79 | $789.65 | 5.8× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$531.35–$796.33 | $885.58–$1,327.21 | varies |
| Gastric emptying imaging study (78264) | $1,301.70 | $2,169.50 | 3.5× |
| Gastroesophageal Reflux Exam (78262) | $1,435.41 | $2,392.35 | 3.8× |
| Gated Heart Planar Single (78472) | $4,932 | $8,220 | 13.1× |
| Hand 2 views (73120) | $435.89 | $726.48 | 4.4× |
| Heart first pass single,planar (78481) | $3,254.08 | $5,423.46 | 6.4× |
| Hepatobil Syst Image W/Drug (78227) | $2,685.88 | $4,476.46 | 5.3× |
| Hepatobiliary System Imaging (78226) | $2,685.88 | $4,476.46 | 7.2× |
| Ht Musc Image Planar Mult (78454) | $4,038.47 | $6,730.79 | 3.3× |
| Ht Muscle Image Spect Sing (78451) | $1,619.66 | $2,699.44 | 1.3× |
| Hysterosalpingogram (74740) | $822.29 | $1,370.48 | 3.7× |
| Infusion Ivp (74410) | $1,874.81 | $3,124.69 | 11.4× |
| Joint Survey Single View (77077) | $157.93 | $263.21 | 1.6× |
| K Flow/Funct Image W/Drug (78708) | $3,429.56 | $5,715.93 | 6.7× |
| Kidney Imaging Morphol (78700) | $2,550.76 | $4,251.26 | 6.8× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$697.70–$1,139.56 | $1,162.83–$1,899.27 | varies |
| Leveen/Shunt Patency Exam (78291) | $2,806.26 | $4,677.10 | 7.5× |
| Liver & Spleen Imaging Static Only (78215) | $2,417.74 | $4,029.57 | 6.4× |
| Liver imaging static only (78201) | $3,808.24 | $6,347.07 | 7.5× |
| Liver imaging w/vascular flow (78202) | $4,352.57 | $7,254.29 | 8.5× |
| Lung Ventilation Imaging (78579) | $2,262.97 | $3,771.62 | 6.0× |
| Lymph System Imaging (78195) | $2,942.08 | $4,903.46 | 5.8× |
| Magnetic Image Jaw Joint (70336) | $3,832.46 | $6,387.43 | 17.1× |
| Meckels Divert Exam (78290) | $2,364.40 | $3,940.66 | 6.3× |
| MRA head w/o contrast (70544) | $4,239.56 | $7,065.94 | 18.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $6,661.52 | $11,102.54 | 20.3× |
| MRA neck w/o contrast (70547) | $4,239.56 | $7,065.94 | 18.9× |
| MRI abdomen w contrast (74182) | $5,017.99 | $8,363.32 | 15.3× |
| MRI abdomen w/o contrast (74181) | $4,106.56 | $6,844.26 | 18.3× |
| MRI any jt lower extrem w/contrast material (73722) | $4,607.72 | $7,679.54 | 6.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$5,356.67–$5,970.14 | $8,927.78–$9,950.23 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$3,686.80–$4,607.72 | $6,144.67–$7,679.54 | varies |
| MRI cervical spine w contrast (72142) | $2,993.66 | $4,989.44 | 9.1× |
| MRI cervical spine w/o cont (72141) | $2,464.43 | $4,107.38 | 11.0× |
| MRI chest w/o contrast (71550) | $4,106.56 | $6,844.26 | 18.3× |
| MRI chest with contrast (71551) | $5,017.99 | $8,363.32 | 6.8× |
| MRI chest wo w contrast (71552) | $6,928.25 | $11,547.09 | 21.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $4,843.91 | $8,073.19 | 14.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$5,970.14–$6,976.68 | $9,950.23–$11,627.80 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $4,239.56 | $7,065.94 | 18.9× |
| MRI lumbar spine w contrast (72149) | $2,993.66 | $4,989.44 | 9.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,522.91 | $5,871.52 | 10.8× |
| MRI orbit face &/neck w/o contrast (70540) | $2,724.49 | $4,540.81 | 12.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $6,473.41 | $10,789.02 | 19.8× |
| MRI pelvis w contrast (72196) | $5,017.99 | $8,363.32 | 15.3× |
| MRI pelvis w/o & w contrast (72197) | $6,313.03 | $10,521.71 | 19.3× |
| MRI pelvis w/o contrast (72195) | $4,106.56 | $6,844.26 | 18.3× |
| MRI thoracic spine w/o contrast (72146) | $2,464.43 | $4,107.38 | 11.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $4,660.01 | $7,766.69 | 20.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $5,970.14 | $9,950.23 | 18.2× |
| MRI, abdomen, combo (74183) | $6,928.25 | $11,547.09 | 21.2× |
| MRI, dorsal spine combo (72157) | $3,522.91 | $5,871.52 | 10.8× |
| MRI, dorsal spine contrast (72147) | $2,993.66 | $4,989.44 | 9.1× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,896.92–$3,157.22 | $3,161.54–$5,262.03 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$3,694.88–$5,970.14 | $6,158.13–$9,950.23 | varies |
| MRI, lumbar spine combo (72158) | $3,874.92 | $6,458.20 | 11.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $2,712.90 | $4,521.50 | 7.2× |
| Myocardial Spect Multiple Studies (78452) | $4,199.56 | $6,999.26 | 3.5× |
| Neck soft tissue (70360) | $718.76 | $1,197.93 | 8.8× |
| Nm myocard infarct spect (78469) | $3,095.80 | $5,159.67 | 6.1× |
| Nm red cell survival study (78130) | $2,445.12 | $4,075.20 | 6.5× |
| Pelvis 1 or 2 views (72170) | $718.76 | $1,197.93 | 7.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,262.97 | $3,771.62 | 6.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $783.69 | $1,306.15 | 1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$524.33–$786.85 | $873.89–$1,311.41 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$470.98–$705.08 | $784.97–$1,175.13 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$500.12–$1,000.23 | $833.53–$1,667.05 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $567.15 | $945.25 | 5.8× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$391.31–$591.02 | $652.19–$985.03 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$518.02–$774.21 | $863.36–$1,290.35 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$518.02–$774.21 | $863.36–$1,290.35 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $247.07 | $411.79 | 3.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $821.24 | $1,368.73 | 8.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $288.84 | $481.40 | 3.5× |
| Radex Ribs Unilateral 2 Views (71100) | $904.06 | $1,506.77 | 11.1× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$757.37–$1,135.35 | $1,262.28–$1,892.25 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $157.93 | $263.21 | 1.9× |
| Radex Spine 1 View Specify Level (72020) | $516.96 | $861.60 | 6.3× |
| Radex Sternum Minimum 2 Views (71120) | $673.84 | $1,123.06 | 8.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $796.33 | $1,327.21 | 9.8× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$327.44–$491.69 | $545.74–$819.49 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $247.07 | $411.79 | 2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$543.98–$730.34 | $906.64–$1,217.24 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,206.59 | $2,010.99 | 12.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $647.52 | $1,079.20 | 6.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $964.79 | $1,607.98 | 9.8× |
| Radiologic exam colon double contrast study (74280) | $1,281.70 | $2,136.16 | 7.8× |
| Radiologic exam colon single contrast study (74270) | $1,138.51 | $1,897.51 | 6.9× |
| Radiologic exam knee complete 4/more views (73564) | $649.62 | $1,082.70 | 6.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $970.04 | $1,616.74 | 9.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $649.62 | $1,082.70 | 3.9× |
| Radiologic exam swallow function contrast study (74230) | $1,787.08 | $2,978.46 | 10.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,592.29 | $2,653.82 | 9.7× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$582.94–$873.53 | $971.57–$1,455.89 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$459.41–$689.63 | $765.68–$1,149.39 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $915.65 | $1,526.09 | 9.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$545.03–$818.08 | $908.39–$1,363.46 | varies |
| Ribs bilateral 3 views (71110) | $1,824.98 | $3,041.64 | 18.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,186.58 | $1,977.64 | 3.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,712.90 | $4,521.50 | 5.3× |
| Scapula (73010) range across 2 matching MRF lines |
$662.26–$991.81 | $1,103.76–$1,653.01 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $187.20 | $312 | 8.0× |
| Sella turcica (70240) | $362.89 | $604.82 | 4.4× |
| Shoulder 1 view (73020) | $219 | $365 | 2.7× |
| Speech evaluation, complex (70371) | $1,787.08 | $2,978.46 | 8.0× |
| Spleen Imaging (78185) | $915.65 | $1,526.09 | 2.4× |
| Sternoclavicular joints (71130) | $652.79 | $1,087.98 | 8.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $930.04 | $1,550.06 | 5.7× |
| Thoracic spine 3 views (72072) | $840.20 | $1,400.33 | 8.6× |
| Thyroid Imaging With Vascular Flow (78013) | $1,348.73 | $2,247.88 | 3.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,234.89 | $3,724.82 | 6.0× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$336.22–$672.79 | $560.36–$1,121.31 | varies |
| Ultrasound, abdomen limited (76705) | $1,253.27 | $2,088.79 | 12.8× |
| Unlisted Dx Radiographic Procedure (76499) | $85.64 | $142.73 | 1.0× |
| Upper gi w/o kub (74240) | $1,412.60 | $2,354.34 | 8.6× |
| Ureteral Reflux Study (78740) | $1,533.68 | $2,556.14 | 4.1× |
| Urethrocystogram voiding (74455) | $1,550.53 | $2,584.21 | 6.9× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$336.22–$672.79 | $560.36–$1,121.31 | varies |
| Us chest (76604) | $1,155 | $1,925 | 11.8× |
| Us complete joint (76881) | $784.74 | $1,307.90 | 8.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $390.26 | $650.44 | 4.0× |
| Us ob detailed single fetus (76811) | $412.37 | $687.29 | 1.8× |
| Us ob limited 1 or more fetuses (76815) | $1,344.52 | $2,240.86 | 13.7× |
| Us ob transvaginal (76817) | $294.10 | $490.17 | 3.0× |
| Us pelvic non ob complete (76856) | $1,186.58 | $1,977.64 | 12.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,366.27 | $2,277.12 | 13.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $591.02 | $985.03 | 6.0× |
| Us retroperitoneal complete (76770) | $1,285.91 | $2,143.18 | 13.1× |
| Us retroperitoneal limited (76775) | $1,056.73 | $1,761.22 | 10.8× |
| Us scrotum and contents (76870) | $644.36 | $1,073.94 | 6.6× |
| Us spinal canal and contents (76800) | $713.50 | $1,189.17 | 7.3× |
| Us thyroid (76536) | $888.27 | $1,480.45 | 9.1× |
| Venography extremity unilateral rs&i (75820) | $1,420.68 | $2,367.80 | 1.0× |
| Venous thrombosis imaging (78457) | $1,629.14 | $2,715.24 | 3.2× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$524.33–$786.85 | $873.89–$1,311.41 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $481.16 | $801.94 | 5.9× |
| X-ray antegrade pyelogram tube (74425) | $1,694.07 | $2,823.45 | 5.2× |
| X-Ray Bend Only L-S Spine (72120) | $529.25 | $882.08 | 5.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$524.33–$786.85 | $873.89–$1,311.41 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$595.61–$619.44 | $992.69–$1,032.40 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $603.30 | $1,005.50 | 7.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $603.30 | $1,005.50 | 6.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,206.59 | $2,010.99 | 12.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $524.33 | $873.89 | 6.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $637.33 | $1,062.22 | 7.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $956.01 | $1,593.35 | 9.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $919.16 | $1,531.93 | 9.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $919.16 | $1,531.93 | 9.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,837.97 | $3,063.28 | 18.7× |
| X-Ray Exam L-S Spine Bending (72114) | $1,065.86 | $1,776.43 | 10.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $545.03 | $908.39 | 6.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $529.25 | $882.08 | 5.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,186.58 | $1,977.64 | 12.1× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$518.02–$774.21 | $863.36–$1,290.35 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,054.62 | $1,757.70 | 6.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $642.25 | $1,070.42 | 6.5× |
| X-ray nose-rectum child f.b. (76010) | $321.23 | $535.39 | 3.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,617.56 | $2,695.94 | 16.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $724.03 | $1,206.71 | 7.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $662.26 | $1,103.76 | 8.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $970.04 | $1,616.74 | 11.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,302.76 | $2,171.26 | 13.3× |
| X-Ray Stress View (77071) | $145.30 | $242.16 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,362.06 | $2,270.10 | 4.2× |
| X-Rays Bone Survey Complete (77075) | $1,449.10 | $2,415.17 | 14.8× |
| Xr c-spine 4 or 5 views (72050) | $840.20 | $1,400.33 | 8.6× |
| Xr facial bones less than 3 views (70140) | $288.84 | $481.40 | 3.5× |
| Xr orbits complete 4 views (70200) | $1,196.06 | $1,993.44 | 12.2× |
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.