Imaging prices at TriStar Horizon Medical Center
Dickson, TN · every code in this section with a posted price and a Medicare benchmark.
246 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $12,459.44 | $12,459.44 | 9.4× |
| Abdomen 1 View (74018) | $1,186.86 | $1,186.86 | 14.2× |
| Abdomen 2 views (74019) | $1,661.05 | $1,661.05 | 16.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,085.94 | $2,085.94 | 5.4× |
| Angiography extremity bilateral rs&i (75716) | $11,756.06 | $11,756.06 | 3.9× |
| Angiography extremity unilateral rs&i (75710) | $12,070.86 | $12,070.86 | 4.0× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$462.52–$733 | $462.52–$733 | varies |
| Aortography thoracic serialography rs&i (75605) | $16,224.17 | $16,224.17 | 3.0× |
| Artery X-Rays Abdomen (75726) | $15,776.39 | $15,776.39 | 3.0× |
| Basic radiation dosimetry calculation (77300) | $1,741.51 | $1,741.51 | 13.5× |
| Bone age studies (77072) | $1,077.59 | $1,077.59 | 10.7× |
| Bone Imaging 3 Phase (78315) | $6,756.79 | $6,756.79 | 17.6× |
| Bone Imaging Limited Area (78300) | $4,939.88 | $4,939.88 | 12.9× |
| Bone Imaging Multiple Areas (78305) | $7,121.70 | $7,121.70 | 18.6× |
| Bone Imaging Whole Body (78306) | $5,024.30 | $5,024.30 | 13.1× |
| Bone survey infant (77076) | $462.52 | $462.52 | 4.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,506.73 | $1,506.73 | 2.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,027.80 | $7,027.80 | 5.1× |
| Cat Scan Follow-Up Study (76380) | $3,935.66 | $3,935.66 | 47.1× |
| Cerebrospinal Fluid Scan (78630) | $1,512.89 | $1,512.89 | 2.9× |
| Chest 1 view (71045) | $623.81 | $623.81 | 7.5× |
| Chest 2 views (71046) | $1,364.22 | $1,364.22 | 16.3× |
| Chest 3 views (71047) | $1,815.56 | $1,815.56 | 21.7× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$1,006–$1,215.07 | $1,006–$1,215.07 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $272.85 | $272.85 | 2.7× |
| Continuing medical physics consltj pr wk (77336) | $2,320.32 | $2,320.32 | 18.0× |
| Contrast Exam Abdominl Aorta (75625) | $12,464.16 | $12,464.16 | 4.1× |
| Contrast X-Ray Bladder (74430) | $867.19 | $867.19 | 2.6× |
| CT abdomen and pelvis without and with contrast (74178) | $32,173.97 | $32,173.97 | 96.1× |
| CT abdomen and pelvis without contrast (74176) | $20,102.28 | $20,102.28 | 87.8× |
| CT abdomen w contrast (74160) | $11,011.47 | $11,011.47 | 65.4× |
| CT abdomen w wo contrast (74170) | $11,484.15 | $11,484.15 | 68.2× |
| CT abdomen w/o contrast (74150) | $11,011.47 | $11,011.47 | 109.8× |
| CT Angio Abdomen and Pelvis (74174) | $4,102.09 | $4,102.09 | 12.3× |
| CT Angio Chest (71275) | $10,913.26 | $10,913.26 | 64.9× |
| CT Angio Head (70496) | $12,673.63 | $12,673.63 | 75.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $11,757.66 | $11,757.66 | 69.9× |
| CT Angio Neck (70498) | $12,673.63 | $12,673.63 | 75.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $11,757.66 | $11,757.66 | 69.9× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $14,458.27 | $14,458.27 | 85.9× |
| CT cervical spine w/ contrast (72126) | $7,849.16 | $7,849.16 | 23.5× |
| CT cervical spine w/o contrast (72125) | $6,857.75 | $6,857.75 | 68.4× |
| CT cervical spine w/wo cont (72127) | $6,857.75 | $6,857.75 | 40.8× |
| CT chest w contrast (71260) | $8,326.30 | $8,326.30 | 49.5× |
| CT chest w/wo contrast (71270) | $9,309.38 | $9,309.38 | 55.3× |
| CT head/brain with contrast (70460) | $9,833.09 | $9,833.09 | 58.4× |
| CT head/brain without and with contrast (70470) | $11,067.49 | $11,067.49 | 65.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $56.63 | $56.63 | 0.7× |
| CT iac w contrast (70481) | $7,397.56 | $7,397.56 | 44.0× |
| CT l-spine w&w/o contrast (72133) | $10,770.15 | $10,770.15 | 64.0× |
| CT lower ext w/o (73700) | $4,110.39 | $4,110.39 | 41.0× |
| CT lower extremity w/contrast material (73701) | $4,110.39 | $4,110.39 | 24.4× |
| CT lumbar spine w contrast (72132) | $8,861.63 | $8,861.63 | 26.5× |
| CT lumbar spine w/o contrast (72131) | $8,861.63 | $8,861.63 | 88.4× |
| CT maxillofacial w contrast (70487) | $6,079.92 | $6,079.92 | 36.1× |
| CT maxillofacial wo contrast (70486) | $8,761.23 | $8,761.23 | 87.4× |
| CT neck tissue combo (70492) | $10,828.93 | $10,828.93 | 64.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $10,810.07 | $10,810.07 | 64.2× |
| CT orbits w/o contrast (70480) | $7,397.56 | $7,397.56 | 73.8× |
| CT pelvis w&w/o contrast (72194) | $9,207.82 | $9,207.82 | 54.7× |
| CT pelvis w/o contrast (72192) | $9,093.55 | $9,093.55 | 90.7× |
| CT scan of leg combo (73702) | $4,434.97 | $4,434.97 | 26.4× |
| CT soft tissue neck w contrast (70491) | $10,086.08 | $10,086.08 | 59.9× |
| CT soft tissue neck w/o contrast (70490) | $10,086.08 | $10,086.08 | 100.6× |
| CT thoracic spine w contrast (72129) | $9,890.22 | $9,890.22 | 58.8× |
| CT thoracic spine w/o contrast (72128) | $9,890.22 | $9,890.22 | 98.6× |
| CT thoracic spine w/wo cont (72130) | $8,496.91 | $8,496.91 | 50.5× |
| CT thorax w/o contrast (71250) | $8,326.30 | $8,326.30 | 83.0× |
| CT upper ext wo (73200) | $9,042 | $9,042 | 90.1× |
| CT upper extremity w/o & w/contrast material (73202) | $10,150.98 | $10,150.98 | 60.3× |
| CT upper extremity with contrast (73201) | $8,761.23 | $8,761.23 | 26.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $11,872.52 | $11,872.52 | 70.6× |
| Cta Abdomen (74175) | $13,091.93 | $13,091.93 | 77.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $25,347.26 | $25,347.26 | 75.7× |
| Dxa Bone Density Axial (77080) | $526.14 | $526.14 | 5.2× |
| Echo Guide For Artery Repair (76936) | $2,364.53 | $2,364.53 | 11.4× |
| Esophagram (74220) | $2,159.05 | $2,159.05 | 12.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $2,505.33 | $2,505.33 | 25.0× |
| Fluoroscopy up to 1 hr (76000) | $2,449 | $2,449 | 10.7× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$1,066–$1,090.68 | $1,066–$1,090.68 | varies |
| Forearm 2 views (73090) | $791 | $791 | 9.5× |
| Gastric emptying imaging study (78264) | $3,228.85 | $3,228.85 | 8.4× |
| Gated Heart Planar Single (78472) | $4,201.94 | $4,201.94 | 11.0× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$929.38–$929.88 | $929.38–$929.88 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,798.29 | $1,798.29 | 3.5× |
| Hepatobiliary System Imaging (78226) | $1,798.29 | $1,798.29 | 4.7× |
| Ht Muscle Image Spect Sing (78451) | $5,612.91 | $5,612.91 | 4.5× |
| Hysterosalpingogram (74740) | $2,468.52 | $2,468.52 | 10.8× |
| K Flow/Funct Image W/O Drug (78707) | $4,968.96 | $4,968.96 | 9.5× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$462.52–$1,349 | $462.52–$1,349 | varies |
| Lung Perf&Ventilat Diferentl (78598) | $1,937.11 | $1,937.11 | 3.7× |
| Lung Ventilat&Perfus Imaging (78582) | $1,937.11 | $1,937.11 | 3.7× |
| Lymph System Imaging (78195) | $4,983.27 | $4,983.27 | 9.6× |
| Magnetic Image Jaw Joint (70336) | $14,129.91 | $14,129.91 | 61.7× |
| Mlc imrt design & construction per imrt plan (77338) | $1,485.69 | $1,485.69 | 4.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $65.82 | $65.82 | 2.4× |
| MRA head w/o contrast (70544) | $10,094.98 | $10,094.98 | 44.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $18,610.14 | $18,610.14 | 55.6× |
| MRA neck w/o contrast (70547) | $10,094.98 | $10,094.98 | 44.1× |
| MRI abdomen w/o contrast (74181) | $10,094.98 | $10,094.98 | 44.1× |
| MRI any jt lower extrem w/contrast material (73722) | $12,479.09 | $12,479.09 | 16.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $12,479.09 | $12,479.09 | 37.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $12,479.09 | $12,479.09 | 16.6× |
| MRI cervical spine w contrast (72142) | $12,479.09 | $12,479.09 | 37.3× |
| MRI cervical spine w/o cont (72141) | $9,675.22 | $9,675.22 | 42.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $13,384.04 | $13,384.04 | 40.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $12,479.09 | $12,479.09 | 37.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $9,675.22 | $9,675.22 | 42.3× |
| MRI lumbar spine w contrast (72149) | $13,771.84 | $13,771.84 | 41.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $12,479.09 | $12,479.09 | 37.3× |
| MRI orbit face &/neck w/o contrast (70540) | $13,177.64 | $13,177.64 | 57.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $15,982.01 | $15,982.01 | 47.8× |
| MRI pelvis w/o & w contrast (72197) | $15,313.61 | $15,313.61 | 45.8× |
| MRI pelvis w/o contrast (72195) | $14,294.58 | $14,294.58 | 62.4× |
| MRI thoracic spine w/o contrast (72146) | $9,675.22 | $9,675.22 | 42.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$9,675.22–$12,479.09 | $9,675.22–$12,479.09 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $14,462.48 | $14,462.48 | 43.2× |
| MRI, abdomen, combo (74183) | $12,897.95 | $12,897.95 | 38.5× |
| MRI, dorsal spine combo (72157) | $12,479.09 | $12,479.09 | 37.3× |
| MRI, dorsal spine contrast (72147) | $13,724.98 | $13,724.98 | 41.0× |
| MRI, joint upper extrem (73221) | $9,675.22 | $9,675.22 | 42.3× |
| MRI, joint upper extrem combo (73223) | $14,462.48 | $14,462.48 | 43.2× |
| MRI, lumbar spine combo (72158) | $12,479.09 | $12,479.09 | 37.3× |
| Myocardial Spect Multiple Studies (78452) | $5,612.91 | $5,612.91 | 4.5× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$879–$967.78 | $879–$967.78 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $10,142.67 | $10,142.67 | 7.6× |
| Parathyroid Planar Imaging (78070) | $2,990.81 | $2,990.81 | 7.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,262.76 | $1,262.76 | 3.3× |
| Pelvis 1 or 2 views (72170) | $1,098 | $1,098 | 10.9× |
| PET image w/CT, full body (78816) | $5,052.48 | $5,052.48 | 3.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,052.48 | $5,052.48 | 3.7× |
| PET whole body (78813) | $5,052.48 | $5,052.48 | 3.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $4,151.37 | $4,151.37 | 10.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$1,015–$1,739.77 | $1,015–$1,739.77 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,800.35 | $1,800.35 | 3.4× |
| Radex Ankle Complete Minimum 3 Views (73610) | $945 | $945 | 11.3× |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$291.50–$1,145 | $291.50–$1,145 | varies |
| Radex elbow complete minimum 3 views (73080) range across 5 matching MRF lines |
$291.50–$1,394 | $291.50–$1,394 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $905 | $905 | 9.0× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$715–$959.04 | $715–$959.04 | varies |
| Radex foot complete minimum 3 views (73630) | $1,143 | $1,143 | 13.7× |
| Radex Hand Minimum 3 Views (73130) | $1,008 | $1,008 | 12.1× |
| Radex lower extremity infant minimum 2 views (73592) | $637 | $637 | 7.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $989 | $989 | 11.8× |
| Radex Ribs Unilateral 2 Views (71100) range across 5 matching MRF lines |
$759.83–$1,372.47 | $759.83–$1,372.47 | varies |
| Radex shoulder complete minimum 2 views (73030) | $1,155 | $1,155 | 13.8× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$753.98–$754.98 | $753.98–$754.98 | varies |
| Radex Sternum Minimum 2 Views (71120) | $1,104.28 | $1,104.28 | 13.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $1,613.42 | $1,613.42 | 19.3× |
| Radex Toe Minimum 2 Views (73660) | $856 | $856 | 10.3× |
| Radex upper extremity infant minimum 2 views (73092) | $992 | $992 | 9.9× |
| Radex Wrist Complete Minimum 3 Views (73110) | $1,060 | $1,060 | 12.7× |
| Radiation treatment delivery level 1 (77402) | $2,139.60 | $2,139.60 | 21.9× |
| Radiation treatment delivery level 2 (77407) | $4,523.29 | $4,523.29 | 12.2× |
| Radiation treatment delivery level 3 (77412) | $2,900.67 | $2,900.67 | 5.5× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$732–$1,458.46 | $732–$1,458.46 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$2,572.01–$2,572.48 | $2,572.01–$2,572.48 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $625.41 | $625.41 | 3.7× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$1,425.91–$1,533 | $1,425.91–$1,533 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $1,908.36 | $1,908.36 | 19.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$2,999.06–$2,999.56 | $2,999.06–$2,999.56 | varies |
| Radiologic exam swallow function contrast study (74230) | $522.22 | $522.22 | 3.1× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$3,854.64–$3,855.12 | $3,854.64–$3,855.12 | varies |
| Radiologic examination femur 1 view (73551) | $278.65 | $278.65 | 3.3× |
| Radiologic examination femur minimum 2 views (73552) | $278.65 | $278.65 | 3.3× |
| Radiologic examination knee 1/2 views (73560) | $694 | $694 | 8.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $1,053 | $1,053 | 12.6× |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$724.08–$1,937.48 | $724.08–$1,937.48 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $4,744.77 | $4,744.77 | 12.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $6,596.49 | $6,596.49 | 12.7× |
| Scapula (73010) range across 4 matching MRF lines |
$291.50–$547.51 | $291.50–$547.51 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $83.47 | $83.47 | 3.6× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$291.50–$918.21 | $291.50–$918.21 | varies |
| Shoulder Arthrography (73040) | $3,150.63 | $3,150.63 | 9.4× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$462.52–$1,227.19 | $462.52–$1,227.19 | varies |
| Special dosimetry (77331) | $2,174.21 | $2,174.21 | 16.9× |
| Special Physics Consult (77370) | $4,206.96 | $4,206.96 | 32.6× |
| Special teletherapy port plan (77321) | $5,364.57 | $5,364.57 | 14.9× |
| Special treatment procedure (77470) | $5,652.69 | $5,652.69 | 10.7× |
| Stereotactic Body Radiation Delivery (77373) | $6,095.65 | $6,095.65 | 3.6× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $95.40 | $95.40 | 2.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $12,183.11 | $12,183.11 | 33.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $6,522.19 | $6,522.19 | 18.2× |
| Ther rad simulaj-aided field setting simple (77280) | $3,332.84 | $3,332.84 | 25.8× |
| Thoracic spine 2 views (72070) | $1,677 | $1,677 | 16.7× |
| Thoracic spine 3 views (72072) | $1,730 | $1,730 | 17.2× |
| Thoracolumbar 2 views (72080) | $949.78 | $949.78 | 11.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,307.94 | $1,307.94 | 3.4× |
| Tx Devices Design & Construction Complex (77334) | $4,491.50 | $4,491.50 | 12.5× |
| Ultrasound Breast Limited (76642) | $183.04 | $183.04 | 2.2× |
| Ultrasound Exam Aaa Screen (76706) | $501.32 | $501.32 | 5.0× |
| Ultrasound, abdomen limited (76705) | $2,858.40 | $2,858.40 | 28.5× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$3,040.85–$3,041.33 | $3,040.85–$3,041.33 | varies |
| Us breast unilateral complete (76641) | $183.04 | $183.04 | 1.8× |
| Us chest (76604) | $899.85 | $899.85 | 9.0× |
| Us complete joint (76881) | $2,185.26 | $2,185.26 | 21.8× |
| Us exam, pelvic, limited (76857) | $1,243.42 | $1,243.42 | 12.4× |
| Us head (76506) | $2,278.63 | $2,278.63 | 22.7× |
| Us kidney transplant (76776) | $788.49 | $788.49 | 7.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,844.16 | $1,844.16 | 18.4× |
| Us ob limited 1 or more fetuses (76815) | $1,553.04 | $1,553.04 | 15.5× |
| Us ob transvaginal (76817) | $2,962.75 | $2,962.75 | 29.5× |
| Us pelvic non ob complete (76856) | $3,409.72 | $3,409.72 | 34.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $2,474.90 | $2,474.90 | 24.7× |
| Us retroperitoneal complete (76770) | $3,036.19 | $3,036.19 | 30.3× |
| Us retroperitoneal limited (76775) | $2,567.28 | $2,567.28 | 25.6× |
| Us scrotum and contents (76870) | $3,041.19 | $3,041.19 | 30.3× |
| Us spinal canal and contents (76800) | $788.49 | $788.49 | 7.9× |
| Us thyroid (76536) | $2,424.95 | $2,424.95 | 24.2× |
| Vein X-Ray Chest (75827) | $4,613.99 | $4,613.99 | 3.1× |
| Venography caval inferior serialography rs&i (75825) | $3,345.32 | $3,345.32 | 1.1× |
| Venography extremity unilateral rs&i (75820) | $4,149.16 | $4,149.16 | 2.7× |
| Wrist 2 views (73100) | $944 | $944 | 11.3× |
| X-Ray Aorta Leg Arteries (75630) | $12,464.16 | $12,464.16 | 4.1× |
| X-Ray Bend Only L-S Spine (72120) | $1,501.71 | $1,501.71 | 15.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $793 | $793 | 9.5× |
| X-Ray Exam Breast Specimen (76098) | $920.64 | $920.64 | 1.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $278.65 | $278.65 | 3.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $461.47 | $461.47 | 4.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $417.08 | $417.08 | 4.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $278.65 | $278.65 | 3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $278.65 | $278.65 | 3.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $461.47 | $461.47 | 4.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $461.47 | $461.47 | 4.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $879.83 | $879.83 | 8.8× |
| X-Ray Exam L-S Spine Bending (72114) | $2,389 | $2,389 | 23.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $1,157 | $1,157 | 13.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $2,625 | $2,625 | 26.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,379 | $1,379 | 13.7× |
| X-ray humerus (73060) | $1,060 | $1,060 | 12.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,308 | $1,308 | 13.0× |
| X-ray nose-rectum child f.b. (76010) | $620.39 | $620.39 | 7.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $2,485 | $2,485 | 24.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,113 | $1,113 | 11.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $1,151.40 | $1,151.40 | 11.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,093 | $1,093 | 13.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$1,747.06–$1,747.54 | $1,747.06–$1,747.54 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$462.52–$1,982.68 | $462.52–$1,982.68 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$1,608.58–$1,609.09 | $1,608.58–$1,609.09 | varies |
| X-Ray Tmj Unilat (70328) | $1,261.21 | $1,261.21 | 15.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,644.06 | $1,644.06 | 4.9× |
| X-Rays Bone Length Studies (77073) | $812.30 | $812.30 | 8.1× |
| X-Rays Bone Survey Complete (77075) | $1,166.47 | $1,166.47 | 11.6× |
| Xr c-spine 4 or 5 views (72050) | $1,253 | $1,253 | 12.5× |
| Xr facial bones less than 3 views (70140) | $988.16 | $988.16 | 11.8× |
| Xr orbits complete 4 views (70200) | $1,584.79 | $1,584.79 | 15.8× |
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.