Imaging prices at Tmc- Bonham Hospital
Bonham, TX · every code in this section with a posted price and a Medicare benchmark.
274 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) | $198 | $661.10 | 2.3× |
| Abdomen 2 views (74019) | $248.60 | $829.40 | 2.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,056 | $3,522.20 | 2.6× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $271.70 | $906.40 | 0.2× |
| Adrenal Cortex & Medulla Img (78075) | $1,459.70 | $4,864.20 | 1.1× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$85.80–$103.40 | $288.20–$345.40 | varies |
| Bone age studies (77072) | $83.60 | $278.30 | 0.8× |
| Bone Imaging 3 Phase (78315) | $1,738 | $5,793.70 | 4.3× |
| Bone Imaging Limited Area (78300) | $1,038.40 | $3,459.50 | 2.6× |
| Bone Imaging Multiple Areas (78305) | $700.70 | $2,336.40 | 1.7× |
| Bone Imaging Whole Body (78306) | $1,007.60 | $3,358.30 | 2.5× |
| Bone marrow imaging limited area (78102) | $381.70 | $1,272.70 | 1.0× |
| Bone marrow imaging; multiple areas (78103) | $381.70 | $1,272.70 | 1.0× |
| Bone marrow imaging; whole body (78104) | $381.70 | $1,272.70 | 1.0× |
| Bone survey infant (77076) | $138.60 | $463.10 | 1.3× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $454.30 | $1,513.60 | 0.8× |
| Cardiac Shunt Detection (78428) | $454.30 | $1,513.60 | 1.1× |
| Cat Scan Follow-Up Study (76380) range across 6 matching MRF lines |
$152.90–$690.80 | $509.30–$2,301.20 | varies |
| Chest 1 view (71045) | $170.50 | $569.80 | 2.0× |
| Chest 2 views (71046) | $193.60 | $644.60 | 2.2× |
| Chest 3 views (71047) | $200.20 | $666.60 | 2.3× |
| Clavicle complete (73000) | $504.90 | $1,683 | 5.8× |
| Contrast Xray Throat/Cerv Esopha (74210) | $127.60 | $425.70 | 0.7× |
| CT abdomen and pelvis without and with contrast (74178) | $2,052.60 | $6,844.20 | 5.9× |
| CT abdomen and pelvis without contrast (74176) | $1,268.30 | $4,228.40 | 5.3× |
| CT abdomen w contrast (74160) | $1,406.90 | $4,690.40 | 8.0× |
| CT abdomen w wo contrast (74170) | $1,801.80 | $6,008.20 | 10.2× |
| CT abdomen w/o contrast (74150) | $884.40 | $2,948 | 8.4× |
| CT Angio Chest (71275) | $1,134.10 | $3,780.70 | 6.4× |
| CT Angio Head (70496) | $1,134.10 | $3,780.70 | 6.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,045 | $3,484.80 | 5.9× |
| CT Angio Neck (70498) | $1,045 | $3,484.80 | 5.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,045 | $3,484.80 | 5.9× |
| CT cervical spine w/ contrast (72126) | $1,948.10 | $6,493.30 | 5.6× |
| CT cervical spine w/o contrast (72125) | $2,206.60 | $7,354.60 | 21.0× |
| CT cervical spine w/wo cont (72127) | $2,120.80 | $7,068.60 | 12.0× |
| CT chest w contrast (71260) | $1,709.40 | $5,698 | 9.7× |
| CT chest w/wo contrast (71270) | $1,709.40 | $5,698 | 9.7× |
| CT head/brain with contrast (70460) | $2,315.50 | $7,719.80 | 13.1× |
| CT head/brain without and with contrast (70470) | $2,175.80 | $7,251.20 | 12.3× |
| CT iac w contrast (70481) range across 4 matching MRF lines |
$447.70–$3,181.20 | $1,491.60–$10,605.10 | varies |
| CT l-spine w&w/o contrast (72133) | $3,098.70 | $10,327.90 | 17.6× |
| CT lower ext w/o (73700) | $1,243 | $4,143.70 | 11.8× |
| CT lower extremity w/contrast material (73701) range across 8 matching MRF lines |
$1,243–$1,491.60 | $4,143.70–$4,972 | varies |
| CT lumbar spine w contrast (72132) | $2,707.10 | $9,022.20 | 7.7× |
| CT lumbar spine w/o contrast (72131) | $2,175.80 | $7,251.20 | 20.7× |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$447.70–$574.20 | $1,491.60–$1,914 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$282.70–$363 | $942.70–$1,208.90 | varies |
| CT neck tissue combo (70492) | $1,771 | $5,904.80 | 10.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 4 matching MRF lines |
$496.10–$635.80 | $1,652.20–$2,118.60 | varies |
| CT orbits w/o contrast (70480) range across 6 matching MRF lines |
$282.70–$3,234 | $942.70–$10,781.10 | varies |
| CT pelvis w&w/o contrast (72194) | $2,019.60 | $6,734.20 | 11.5× |
| CT pelvis w/o contrast (72192) | $1,243 | $4,143.70 | 11.8× |
| CT scan of leg combo (73702) | $635.80 | $2,118.60 | 3.6× |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$496.10–$635.80 | $1,652.20–$2,118.60 | varies |
| CT soft tissue neck w contrast (70491) | $1,709.40 | $5,698 | 9.7× |
| CT soft tissue neck w/o contrast (70490) | $1,522.40 | $5,076.50 | 14.5× |
| CT thoracic spine w contrast (72129) | $2,471.70 | $8,239 | 14.0× |
| CT thoracic spine w/o contrast (72128) | $1,716 | $5,718.90 | 16.3× |
| CT thoracic spine w/wo cont (72130) | $2,087.80 | $6,960.80 | 11.8× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$363–$1,532.30 | $1,208.90–$5,108.40 | varies |
| CT upper ext wo (73200) | $1,087.90 | $3,625.60 | 10.4× |
| CT upper extremity w/o & w/contrast material (73202) | $635.80 | $2,118.60 | 3.6× |
| CT upper extremity with contrast (73201) | $574.20 | $1,914 | 1.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,357.40 | $4,525.40 | 7.7× |
| Cta Abdomen (74175) | $1,134.10 | $3,780.70 | 6.4× |
| CTA pelvis (72191) | $1,134.10 | $3,780.70 | 6.4× |
| Dxa Bone Density Axial (77080) | $233.20 | $778.80 | 2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $176 | $586.30 | 2.0× |
| Echograp Trans R Pros Study (76873) | $223.30 | $742.50 | 2.1× |
| Esophagram (74220) | $233.20 | $776.60 | 1.3× |
| Fluoroscopy up to 1 hr (76000) | $613.80 | $2,047.10 | 2.6× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$83.60–$100.10 | $278.30–$333.30 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$363–$436.70 | $1,212.20–$1,454.20 | varies |
| Gastric emptying imaging study (78264) | $959.20 | $3,195.50 | 2.4× |
| Gastric Mucosa Imaging (78261) | $353.10 | $1,178.10 | 0.9× |
| Gastroesophageal Reflux Exam (78262) | $353.10 | $1,178.10 | 0.9× |
| Gastrointestinal Protein Loss (78282) | $27.50 | $92.40 | 0.1× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$287.10–$454.30 | $957–$1,513.60 | varies |
| Gated Heart, Multiple (78473) | $583 | $1,941.50 | 1.5× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$83.60–$100.10 | $278.30–$333.30 | varies |
| Heart first pass single,planar (78481) | $454.30 | $1,513.60 | 0.8× |
| Hepatobil Syst Image W/Drug (78227) | $838.20 | $2,794 | 1.5× |
| Hepatobiliary System Imaging (78226) | $520.30 | $1,735.80 | 1.3× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$441.10–$1,652.20 | $1,470.70–$5,505.50 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $91.30 | $303.60 | 1.0× |
| Infant hip ultrasound, limited static exam (76886) | $91.30 | $303.60 | 1.0× |
| Infusion Ivp (74410) | $253 | $843.70 | 1.4× |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$364.10–$478.50 | $1,214.40–$1,595 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$138.60–$613.80 | $460.90–$2,044.90 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$499.40–$1,274.90 | $1,664.30–$4,249.30 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $239.80 | $798.60 | 0.6× |
| Kidney Imaging Morphol (78700) | $478.50 | $1,595 | 1.2× |
| Knee 3 Views (73562) | $202.40 | $673.20 | 2.3× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $581.90 | $1,939.30 | 1.4× |
| Liver & Spleen Imaging Static Only (78215) | $685.30 | $2,282.50 | 1.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $726 | $2,420 | 1.8× |
| Liver imaging static only (78201) | $512.60 | $1,708.30 | 0.9× |
| Liver imaging w/vascular flow (78202) | $668.80 | $2,228.60 | 1.2× |
| Lung Perf&Ventilat Diferentl (78598) | $606.10 | $2,018.50 | 1.1× |
| Lung Ventilat&Perfus Imaging (78582) | $502.70 | $1,677.50 | 0.9× |
| Lung Ventilation Imaging (78579) | $606.10 | $2,018.50 | 1.5× |
| Lymph System Imaging (78195) | $489.50 | $1,632.40 | 0.9× |
| Magnetic Image Jaw Joint (70336) | $649 | $2,163.70 | 2.7× |
| Mammary ductogram or galactogram multiple (77054) | $290.40 | $966.90 | 1.2× |
| Mammary ductogram or galactogram single (77053) | $290.40 | $966.90 | 1.2× |
| Meckels Divert Exam (78290) | $649 | $2,164.80 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $982.30 | $3,273.60 | 2.8× |
| MRA head w/o contrast (70544) | $1,740.20 | $5,801.40 | 7.3× |
| MRA head with contrast (70545) | $621.50 | $2,071.30 | 1.8× |
| MRA neck w contrast (70548) | $864.60 | $2,883.10 | 2.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,262.80 | $4,208.60 | 3.6× |
| MRA neck w/o contrast (70547) | $1,118.70 | $3,729 | 4.7× |
| MRI abdomen w contrast (74182) | $928.40 | $3,096.50 | 2.6× |
| MRI abdomen w/o contrast (74181) | $683.10 | $2,275.90 | 2.8× |
| MRI any jt lower extrem w/contrast material (73722) range across 6 matching MRF lines |
$796.40–$2,330.90 | $2,656.50–$7,768.20 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,004.30 | $3,349.50 | 2.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,287 | $4,292.20 | 1.6× |
| MRI cervical spine w contrast (72142) | $1,696.20 | $5,655.10 | 4.8× |
| MRI cervical spine w/o cont (72141) | $2,205.50 | $7,352.40 | 9.2× |
| MRI chest w/o contrast (71550) | $848.10 | $2,825.90 | 3.5× |
| MRI chest with contrast (71551) | $949.30 | $3,162.50 | 1.2× |
| MRI chest wo w contrast (71552) | $1,305.70 | $4,350.50 | 3.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $796.40 | $2,656.50 | 2.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,553.20 | $5,178.80 | 4.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,718.20 | $5,728.80 | 7.2× |
| MRI lumbar spine w contrast (72149) | $2,786.30 | $9,289.50 | 8.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,268.20 | $7,561.40 | 6.5× |
| MRI orbit face &/neck w/o contrast (70540) range across 5 matching MRF lines |
$652.30–$776.60 | $2,175.80–$2,589.40 | varies |
| MRI orbit face neck w contrast (70542) range across 5 matching MRF lines |
$863.50–$4,752 | $2,877.60–$15,841.10 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,004.30 | $3,349.50 | 2.9× |
| MRI pelvis w contrast (72196) | $851.40 | $2,838 | 2.4× |
| MRI pelvis w/o & w contrast (72197) | $1,073.60 | $3,577.20 | 3.1× |
| MRI pelvis w/o contrast (72195) | $765.60 | $2,553.10 | 3.2× |
| MRI thoracic spine w/o contrast (72146) | $2,052.60 | $6,840.90 | 8.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $796.40 | $2,656.50 | 2.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $838.20 | $2,794 | 3.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,067 | $3,555.20 | 3.0× |
| MRI, abdomen, combo (74183) | $1,075.80 | $3,586 | 3.1× |
| MRI, dorsal spine combo (72157) | $982.30 | $3,273.60 | 2.8× |
| MRI, dorsal spine contrast (72147) | $782.10 | $2,608.10 | 2.2× |
| MRI, joint upper extrem (73221) | $2,198.90 | $7,328.20 | 9.2× |
| MRI, joint upper extrem combo (73223) range across 6 matching MRF lines |
$1,287–$1,435.50 | $4,292.20–$4,785 | varies |
| MRI, lumbar spine combo (72158) | $2,409 | $8,030 | 6.9× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $454.30 | $1,513.60 | 1.1× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $454.30 | $1,513.60 | 0.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,288.10 | $4,293.30 | 1.0× |
| Myocardial Spect Multiple Studies (78452) | $2,747.80 | $9,157.50 | 2.1× |
| Neck soft tissue (70360) | $496.10 | $1,654.40 | 5.7× |
| Nm myocard infarct spect (78469) | $454.30 | $1,513.60 | 0.8× |
| Nm red cell survival study (78130) | $581.90 | $1,939.30 | 1.4× |
| Nm whole blood volume (78122) | $581.90 | $1,939.30 | 1.1× |
| Nuclear Rx Oral Admin (79005) | $401.50 | $1,337.60 | 1.7× |
| Parathyroid Planar Imaging (78070) | $471.90 | $1,573 | 1.2× |
| Parathyroid planar imaging w/wo subtraction (78071) | $456.50 | $1,521.30 | 1.1× |
| Pelvis 1 or 2 views (72170) | $83.60 | $278.30 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $425.70 | $1,420.10 | 1.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $326.70 | $1,089 | 3.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $214.50 | $716.10 | 2.5× |
| Radex Calcaneus Minimum 2 Views (73650) | $381.70 | $1,273.80 | 4.4× |
| Radex elbow complete minimum 3 views (73080) | $83.60 | $278.30 | 1.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$64.90–$826.10 | $216.70–$2,755.50 | varies |
| Radex fingr minimum 2 views (73140) | $326.70 | $1,089 | 3.7× |
| Radex foot complete minimum 3 views (73630) | $224.40 | $750.20 | 2.6× |
| Radex Hand Minimum 3 Views (73130) | $262.90 | $875.60 | 3.0× |
| Radex lower extremity infant minimum 2 views (73592) | $83.60 | $278.30 | 1.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $366.30 | $1,223.20 | 3.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $432.30 | $1,439.90 | 4.9× |
| Radex Ribs Unilateral 2 Views (71100) | $342.10 | $1,139.60 | 3.9× |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$236.50–$283.80 | $787.60–$944.90 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $111.10 | $368.50 | 1.3× |
| Radex Spine 1 View Specify Level (72020) | $83.60 | $278.30 | 1.0× |
| Radex Sternum Minimum 2 Views (71120) | $374 | $1,247.40 | 4.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $257.40 | $860.20 | 2.9× |
| Radex Toe Minimum 2 Views (73660) | $282.70 | $943.80 | 3.2× |
| Radex upper extremity infant minimum 2 views (73092) | $83.60 | $278.30 | 0.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $254.10 | $845.90 | 2.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $818.40 | $2,726.90 | 7.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $484 | $1,611.50 | 4.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $248.60 | $829.40 | 2.4× |
| Radiologic exam colon double contrast study (74280) | $1,133 | $3,777.40 | 6.4× |
| Radiologic exam colon single contrast study (74270) | $962.50 | $3,208.70 | 5.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $800.80 | $2,669.70 | 4.5× |
| Radiologic exam swallow function contrast study (74230) | $233.20 | $776.60 | 1.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,086.80 | $3,622.30 | 6.2× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$372.90–$497.20 | $1,244.10–$1,657.70 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$447.70–$497.20 | $1,491.60–$1,657.70 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$83.60–$221.10 | $278.30–$739.20 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $138.60 | $463.10 | 1.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$413.60–$496.10 | $1,378.30–$1,653.30 | varies |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $581.90 | $1,939.30 | 1.4× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $581.90 | $1,939.30 | 1.1× |
| Ribs bilateral 3 views (71110) | $497.20 | $1,657.70 | 4.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $506 | $1,688.50 | 1.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $819.50 | $2,733.50 | 2.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $341 | $1,137.40 | 0.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$341–$624.80 | $1,137.40–$2,083.40 | varies |
| Rp Therapy Intravenous Administration (79101) | $312.40 | $1,042.80 | 1.3× |
| Scapula (73010) | $183.70 | $611.60 | 1.7× |
| Sella turcica (70240) | $64.90 | $216.70 | 0.7× |
| Shoulder 1 view (73020) | $83.60 | $278.30 | 1.0× |
| Shoulder Arthrography (73040) | $622.60 | $2,074.60 | 1.8× |
| Skull less than 4 views (70250) | $467.50 | $1,559.80 | 4.5× |
| Spleen Imaging (78185) | $381.70 | $1,272.70 | 1.0× |
| Sternoclavicular joints (71130) | $300.30 | $1,002.10 | 3.4× |
| Thoracic spine 2 views (72070) | $599.50 | $1,998.70 | 5.7× |
| Thoracic spine 3 views (72072) | $226.60 | $756.80 | 2.2× |
| Thoracolumbar 2 views (72080) | $64.90 | $216.70 | 0.7× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $434.50 | $1,449.80 | 1.1× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $434.50 | $1,449.80 | 1.1× |
| Thyroid Imaging With Vascular Flow (78013) | $572 | $1,906.30 | 1.4× |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$239.80–$1,039.50 | $798.60–$3,466.10 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $572 | $1,906.30 | 1.4× |
| Ultrasound Breast Limited (76642) | $34.10 | $113.30 | 0.4× |
| Ultrasound Exam Aaa Screen (76706) | $732.60 | $2,442 | 7.0× |
| Ultrasound, abdomen limited (76705) range across 11 matching MRF lines |
$141.90–$709.50 | $474.10–$2,363.90 | varies |
| Umbilical-artery Doppler (OB) (76820) | $137.50 | $458.70 | 1.3× |
| Upper gi w/o kub (74240) | $1,109.90 | $3,699.30 | 6.3× |
| Ureteral Reflux Study (78740) | $478.50 | $1,595 | 1.2× |
| Us breast unilateral complete (76641) | $451 | $1,504.80 | 4.3× |
| Us chest (76604) | $515.90 | $1,719.30 | 4.9× |
| Us complete joint (76881) | $579.70 | $1,933.80 | 5.5× |
| Us exam, pelvic, limited (76857) | $387.20 | $1,289.20 | 3.7× |
| Us kidney transplant (76776) | $182.60 | $607.20 | 1.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $89.10 | $297 | 0.8× |
| Us ob detailed single fetus (76811) | $223.30 | $742.50 | 0.9× |
| Us ob limited 1 or more fetuses (76815) | $91.30 | $303.60 | 0.9× |
| Us ob transvaginal (76817) | $169.40 | $564.30 | 1.6× |
| Us pelvic non ob complete (76856) | $644.60 | $2,149.40 | 6.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $212.30 | $707.30 | 2.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $91.30 | $303.60 | 0.9× |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$553.30–$862.40 | $1,843.60–$2,873.20 | varies |
| Us retroperitoneal limited (76775) range across 5 matching MRF lines |
$553.30–$709.50 | $1,843.60–$2,363.90 | varies |
| Us scrotum and contents (76870) | $579.70 | $1,933.80 | 5.5× |
| Us spinal canal and contents (76800) | $141.90 | $474.10 | 1.4× |
| Us thyroid (76536) range across 3 matching MRF lines |
$182.60–$515.90 | $607.20–$1,719.30 | varies |
| Us transrectal (76872) | $704 | $2,345.20 | 6.7× |
| Vascular Flow Imaging (78445) | $271.70 | $906.40 | 0.7× |
| Venous thrombosis imaging (78457) | $335.50 | $1,116.50 | 0.6× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $465.30 | $1,553.20 | 1.2× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$85.80–$103.40 | $288.20–$345.40 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $308 | $1,027.40 | 3.5× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$107.80–$138.60 | $360.80–$463.10 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$100.10–$488.40 | $333.30–$1,626.90 | varies |
| X-Ray Exam Breast Specimen (76098) | $490.60 | $1,634.60 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $83.60 | $278.30 | 1.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $138.60 | $463.10 | 1.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $83.60 | $278.30 | 1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$64.90–$236.50 | $216.70–$787.60 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $652.30 | $2,175.80 | 6.2× |
| X-Ray Exam L-S Spine Bending (72114) | $138.60 | $463.10 | 1.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $236.50 | $787.60 | 2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $814 | $2,714.80 | 7.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $83.60 | $278.30 | 0.8× |
| X-ray eye for foreign body (70030) | $83.60 | $278.30 | 1.0× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$217.80–$260.70 | $724.90–$870.10 | varies |
| X-ray IV pyelogram (ivp) (74400) | $763.40 | $2,544.30 | 4.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $83.60 | $278.30 | 1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $83.60 | $278.30 | 1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $213.40 | $711.70 | 2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $537.90 | $1,791.90 | 5.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $83.60 | $278.30 | 0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $458.70 | $1,531.20 | 5.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $880 | $2,932.60 | 10.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $885.50 | $2,950.20 | 8.4× |
| X-Ray Stress View (77071) | $64.90 | $216.70 | 0.7× |
| X-ray thoracic spine 4 vw (72074) | $83.60 | $278.30 | 0.8× |
| X-Ray Tmj Unilat (70328) | $78.10 | $258.50 | 0.9× |
| X-Rays Bone Length Studies (77073) | $64.90 | $216.70 | 0.6× |
| X-Rays Bone Survey Complete (77075) | $815.10 | $2,715.90 | 7.8× |
| Xr c-spine 4 or 5 views (72050) | $189.20 | $630.30 | 1.8× |
| Xr facial bones less than 3 views (70140) | $352 | $1,172.60 | 4.0× |
| XR Mastoids < 3 Views Bilateral (70120) | $83.60 | $278.30 | 0.8× |
| Xr orbits complete 4 views (70200) | $709.50 | $2,363.90 | 6.8× |
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.