Imaging prices at UMass Memorial Health–Harrington Hospital
Southbridge, MA · 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 |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $9,836 | $9,836 | 5.9× |
| Abdomen 1 View (74018) | $273 | $273 | 2.6× |
| Abdomen 2 views (74019) | $322 | $322 | 2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,338 | $1,338 | 2.8× |
| Ankle 2 views (73600) | $415 | $415 | 4.0× |
| Arthrogram ankle (73615) | $2,092 | $2,092 | 5.0× |
| Arthrogram hip (73525) | $1,303 | $1,303 | 3.1× |
| Arthrogram Wrist (73115) | $515 | $515 | 1.2× |
| Basic radiation dosimetry calculation (77300) | $621 | $621 | 3.9× |
| Bone age studies (77072) | $407 | $407 | 3.2× |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,560–$1,622 | $1,560–$1,622 | varies |
| Bone Imaging Limited Area (78300) | $961 | $961 | 2.0× |
| Bone Imaging Whole Body (78306) | $1,468 | $1,468 | 3.1× |
| Brain Flow Imaging Only (78610) | $1,582.40 | $1,582.40 | 2.4× |
| Brain Image W/Flow < 4 Views (78601) | $1,269 | $1,269 | 2.6× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$13,270.91–$13,895.43 | $13,270.91–$13,895.43 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$357–$20,165.66 | $357–$20,165.66 | varies |
| Chest 3 views (71047) | $407 | $407 | 3.9× |
| Chest 4 or more views (71048) | $506 | $506 | 4.0× |
| Clavicle complete (73000) | $444 | $444 | 4.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,687 | $1,687 | 13.5× |
| Continuing medical physics consltj pr wk (77336) | $1,041 | $1,041 | 6.5× |
| Contrast X-Ray Bladder (74430) | $1,061 | $1,061 | 2.5× |
| Contrast X-Ray Of Elbow (73085) | $1,191 | $1,191 | 2.8× |
| Contrast X-Ray Of Knee Joint (73580) | $540 | $540 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) | $4,717 | $4,717 | 11.3× |
| CT abdomen and pelvis without contrast (74176) | $3,478 | $3,478 | 12.2× |
| CT abdomen w contrast (74160) | $3,332 | $3,332 | 15.9× |
| CT abdomen w wo contrast (74170) | $4,717 | $4,717 | 22.4× |
| CT abdomen w/o contrast (74150) | $2,781 | $2,781 | 22.2× |
| CT Angio Abdomen and Pelvis (74174) | $4,876.35 | $4,876.35 | 11.7× |
| CT Angio Chest (71275) | $3,359.28 | $3,359.28 | 16.0× |
| CT Angio Head (70496) | $2,830 | $2,830 | 13.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,783 | $1,783 | 8.5× |
| CT Angio Neck (70498) | $2,830 | $2,830 | 13.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,565 | $1,565 | 7.4× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $2,830 | $2,830 | 13.5× |
| CT cervical spine w/ contrast (72126) | $2,341 | $2,341 | 5.6× |
| CT cervical spine w/o contrast (72125) | $2,030 | $2,030 | 16.2× |
| CT cervical spine w/wo cont (72127) | $2,964 | $2,964 | 14.1× |
| CT chest w contrast (71260) | $6,489.35 | $6,489.35 | 30.9× |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$2,859–$3,435 | $2,859–$3,435 | varies |
| CT colonography screening (74263) | $1,468 | $1,468 | 5.1× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $2,143 | $2,143 | 10.2× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,514 | $1,514 | 12.1× |
| CT head/brain with contrast (70460) | $2,408 | $2,408 | 11.5× |
| CT head/brain without and with contrast (70470) | $2,735 | $2,735 | 13.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $61 | $61 | 0.6× |
| CT iac w contrast (70481) | $2,884 | $2,884 | 13.7× |
| CT lower ext w/o (73700) | $1,883 | $1,883 | 15.0× |
| CT lower extremity w/contrast material (73701) | $2,186 | $2,186 | 10.4× |
| CT lumbar spine w contrast (72132) | $2,079 | $2,079 | 5.0× |
| CT lumbar spine w/o contrast (72131) | $1,740 | $1,740 | 13.9× |
| CT maxillofacial w contrast (70487) | $3,089 | $3,089 | 14.7× |
| CT maxillofacial wo contrast (70486) | $2,610 | $2,610 | 20.8× |
| CT neck tissue combo (70492) | $2,764 | $2,764 | 13.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,022 | $3,022 | 14.4× |
| CT orbits w/o contrast (70480) | $2,517 | $2,517 | 20.1× |
| CT pelvis w&w/o contrast (72194) | $4,111 | $4,111 | 19.6× |
| CT pelvis w/o contrast (72192) | $2,466 | $2,466 | 19.7× |
| CT scan of leg combo (73702) | $2,673 | $2,673 | 12.7× |
| CT scans face/jaw combo (70488) | $4,063 | $4,063 | 19.3× |
| CT soft tissue neck w contrast (70491) | $2,113 | $2,113 | 10.1× |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,574–$1,637 | $1,574–$1,637 | varies |
| CT thoracic spine w contrast (72129) | $2,094 | $2,094 | 10.0× |
| CT thoracic spine w/o contrast (72128) | $1,752 | $1,752 | 14.0× |
| CT thorax w/o contrast (71250) | $1,687 | $1,687 | 13.5× |
| CT upper ext wo (73200) | $2,006 | $2,006 | 16.0× |
| CT upper extremity with contrast (73201) | $2,451 | $2,451 | 5.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,848 | $2,848 | 13.5× |
| Cta Abdomen (74175) | $4,717 | $4,717 | 22.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,830 | $2,830 | 6.8× |
| CTA pelvis (72191) | $2,848 | $2,848 | 13.5× |
| Dxa Bone Density Axial (77080) | $1,036 | $1,036 | 8.3× |
| Dxa bone density study (77085) | $1,334 | $1,334 | 10.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $1,036 | $1,036 | 9.9× |
| Esophagram (74220) | $717 | $717 | 3.4× |
| Fluoroscopy up to 1 hr (76000) | $750 | $750 | 2.6× |
| Foot 2 views (73620) | $490 | $490 | 4.7× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$1,019–$1,455 | $1,019–$1,455 | varies |
| Gastric emptying imaging study (78264) | $1,545 | $1,545 | 3.2× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,220 | $1,220 | 2.5× |
| Gated Heart, Multiple (78473) | $1,281 | $1,281 | 2.7× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,578 | $1,578 | 2.4× |
| Hand 2 views (73120) | $417 | $417 | 3.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,779 | $1,779 | 2.7× |
| Hepatobiliary System Imaging (78226) | $1,841 | $1,841 | 3.8× |
| Ht Muscle Image Spect Sing (78451) | $4,560 | $4,560 | 2.9× |
| K Flow/Funct Image W/Drug (78708) | $1,596 | $1,596 | 2.5× |
| K Flow/Funct Image W/O Drug (78707) | $1,596 | $1,596 | 2.5× |
| Kidney Imaging Morphol (78700) | $1,777 | $1,777 | 3.7× |
| Knee 3 Views (73562) range across 7 matching MRF lines |
$578–$2,980 | $578–$2,980 | varies |
| Lung Perf&Ventilat Diferentl (78598) | $1,802 | $1,802 | 2.8× |
| Lung perfusion differential (78597) | $1,152 | $1,152 | 2.4× |
| Lung Ventilat&Perfus Imaging (78582) | $1,802 | $1,802 | 2.8× |
| Lymph System Imaging (78195) | $29,178.88 | $29,178.88 | 44.8× |
| Magnetic Image Jaw Joint (70336) | $3,568 | $3,568 | 12.5× |
| Mlc imrt design & construction per imrt plan (77338) | $4,946 | $4,946 | 11.0× |
| Mr safety determination physician/other qhp (76016) | $663 | $663 | 6.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $143 | $143 | 4.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) range across 2 matching MRF lines |
$551–$1,605 | $551–$1,605 | varies |
| Mr safety implt pos&/immoblj (76019) | $222 | $222 | 3.1× |
| Mra Head W/O & W/Contrast Material (70546) | $5,257 | $5,257 | 12.6× |
| MRA head w/o contrast (70544) | $3,818 | $3,818 | 13.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,257 | $5,257 | 12.6× |
| MRA neck w/o contrast (70547) | $3,675 | $3,675 | 12.9× |
| MRI abdomen w contrast (74182) | $3,321 | $3,321 | 7.9× |
| MRI abdomen w/o contrast (74181) | $3,100 | $3,100 | 10.8× |
| MRI any jt lower extrem w/contrast material (73722) | $4,231 | $4,231 | 4.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,405 | $4,405 | 10.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,539 | $2,539 | 2.7× |
| MRI Breast W/O Contrast Bilateral (77047) | $6,255 | $6,255 | 21.9× |
| MRI cervical spine w contrast (72142) | $4,526 | $4,526 | 10.8× |
| MRI cervical spine w/o cont (72141) | $3,889 | $3,889 | 13.6× |
| MRI chest w/o contrast (71550) | $2,360 | $2,360 | 8.3× |
| MRI chest with contrast (71551) | $2,327 | $2,327 | 2.5× |
| MRI chest wo w contrast (71552) | $3,211 | $3,211 | 7.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,877 | $3,877 | 9.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $5,352 | $5,352 | 12.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,889 | $3,889 | 13.6× |
| MRI lumbar spine w contrast (72149) | $4,064 | $4,064 | 9.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,352 | $5,352 | 12.8× |
| MRI orbit face &/neck w/o contrast (70540) | $3,675 | $3,675 | 12.9× |
| MRI orbit face neck w contrast (70542) | $3,877 | $3,877 | 9.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,257 | $5,257 | 12.6× |
| MRI pelvis w/o & w contrast (72197) | $5,352 | $5,352 | 12.8× |
| MRI pelvis w/o contrast (72195) | $3,744 | $3,744 | 13.1× |
| MRI thoracic spine w/o contrast (72146) | $2,335 | $2,335 | 8.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,442 | $2,442 | 5.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,247 | $2,247 | 7.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,373 | $3,373 | 8.1× |
| MRI, abdomen, combo (74183) | $4,006 | $4,006 | 9.6× |
| MRI, dorsal spine combo (72157) | $3,211 | $3,211 | 7.7× |
| MRI, dorsal spine contrast (72147) | $2,535 | $2,535 | 6.1× |
| MRI, joint upper extrem (73221) | $3,100 | $3,100 | 10.8× |
| MRI, joint upper extrem combo (73223) | $3,211 | $3,211 | 7.7× |
| MRI, lumbar spine combo (72158) | $5,352 | $5,352 | 12.8× |
| Myocardial Spect Multiple Studies (78452) | $5,371 | $5,371 | 3.5× |
| Neck soft tissue (70360) | $400 | $400 | 3.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,847 | $5,847 | 3.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $1,114 | $1,114 | 8.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,293 | $3,293 | 5.1× |
| Parathyroid Planar Imaging (78070) | $1,695 | $1,695 | 3.5× |
| Pelvis 1 or 2 views (72170) | $453 | $453 | 3.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,420 | $1,420 | 3.0× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,561 | $1,561 | 1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$447–$465 | $447–$465 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $550 | $550 | 5.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $406 | $406 | 3.9× |
| Radex elbow complete minimum 3 views (73080) | $644 | $644 | 6.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $578 | $578 | 4.6× |
| Radex fingr minimum 2 views (73140) | $407 | $407 | 3.9× |
| Radex foot complete minimum 3 views (73630) | $532 | $532 | 5.1× |
| Radex Hand Minimum 3 Views (73130) | $520 | $520 | 5.0× |
| Radex lower extremity infant minimum 2 views (73592) | $318 | $318 | 3.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $452 | $452 | 4.3× |
| Radex Ribs Unilateral 2 Views (71100) | $583 | $583 | 5.6× |
| Radex shoulder complete minimum 2 views (73030) | $910 | $910 | 8.7× |
| Radex Sinuses Paransl < 3 Views (70210) | $513 | $513 | 4.9× |
| Radex Spine 1 View Specify Level (72020) | $396 | $396 | 3.8× |
| Radex Sternum Minimum 2 Views (71120) | $463 | $463 | 4.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $583 | $583 | 5.6× |
| Radex Toe Minimum 2 Views (73660) | $306 | $306 | 2.9× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$960–$1,064 | $960–$1,064 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,142 | $1,142 | 9.1× |
| Radiation treatment delivery level 1 (77402) | $5,470 | $5,470 | 44.7× |
| Radiation treatment delivery level 2 (77407) | $6,860 | $6,860 | 14.8× |
| Radiation treatment delivery level 3 (77412) | $6,927 | $6,927 | 10.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $528 | $528 | 4.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $506 | $506 | 4.0× |
| Radiologic exam colon single contrast study (74270) | $822 | $822 | 3.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $657 | $657 | 3.1× |
| Radiologic exam knee complete 4/more views (73564) | $644 | $644 | 5.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $343 | $343 | 2.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$810–$842 | $810–$842 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$519–$539 | $519–$539 | varies |
| Radiologic exam upr gi trc double contrast study (74246) | $1,605 | $1,605 | 7.6× |
| Radiologic examination femur 1 view (73551) | $400 | $400 | 3.8× |
| Radiologic examination femur minimum 2 views (73552) | $555 | $555 | 5.3× |
| Radiologic examination knee 1/2 views (73560) range across 5 matching MRF lines |
$988–$108,527.99 | $988–$108,527.99 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $750 | $750 | 6.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$948–$986 | $948–$986 | varies |
| Ribs bilateral 3 views (71110) | $690 | $690 | 5.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,471 | $2,471 | 3.8× |
| Scapula (73010) | $657 | $657 | 5.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $182 | $182 | 7.8× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$65,851.22–$72,298.71 | $65,851.22–$72,298.71 | varies |
| Shoulder Arthrography (73040) | $1,265 | $1,265 | 3.0× |
| Skull less than 4 views (70250) | $544 | $544 | 4.3× |
| Special treatment procedure (77470) | $2,533 | $2,533 | 3.8× |
| Sternoclavicular joints (71130) | $886 | $886 | 8.5× |
| Tbs technical calculation only (77091) | $289 | $289 | 2.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $6,939 | $6,939 | 15.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,350 | $2,350 | 5.2× |
| Ther rad simulaj-aided field setting simple (77280) | $674 | $674 | 4.2× |
| Thoracic spine 2 views (72070) | $520 | $520 | 4.2× |
| Thoracic spine 3 views (72072) | $981 | $981 | 7.8× |
| Thoracolumbar 2 views (72080) | $432.88 | $432.88 | 4.2× |
| Thyroid Imaging With Vascular Flow (78013) | $837 | $837 | 1.7× |
| Thyroid Uptake Measurement (78012) | $1,141 | $1,141 | 2.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,299 | $1,299 | 2.7× |
| Tx Devices Design & Construction Complex (77334) | $1,466 | $1,466 | 3.3× |
| Tx devices design & construction simple (77332) | $754 | $754 | 4.7× |
| Ultrasound Breast Limited (76642) | $510 | $510 | 4.9× |
| Ultrasound Elastography Parenchyma (76981) | $351 | $351 | 2.8× |
| Ultrasound Exam Aaa Screen (76706) | $1,379 | $1,379 | 11.0× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$1,327–$1,678 | $1,327–$1,678 | varies |
| Upper gi w/o kub (74240) | $815 | $815 | 3.9× |
| Urethrocystogram voiding (74455) | $742 | $742 | 2.6× |
| Us breast unilateral complete (76641) | $1,084 | $1,084 | 8.7× |
| Us chest (76604) | $857 | $857 | 6.8× |
| Us complete joint (76881) | $719 | $719 | 5.7× |
| Us exam, pelvic, limited (76857) | $694 | $694 | 5.5× |
| Us head (76506) | $1,587 | $1,587 | 12.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$467–$2,081 | $467–$2,081 | varies |
| Us ob limited 1 or more fetuses (76815) | $780 | $780 | 6.2× |
| Us ob transvaginal (76817) | $636 | $636 | 5.1× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$2,530–$2,662 | $2,530–$2,662 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $507 | $507 | 4.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,058 | $1,058 | 8.4× |
| Us retroperitoneal complete (76770) | $1,379 | $1,379 | 11.0× |
| Us retroperitoneal limited (76775) | $1,327 | $1,327 | 10.6× |
| Us scrotum and contents (76870) | $1,045 | $1,045 | 8.3× |
| Us thyroid (76536) | $1,233 | $1,233 | 9.8× |
| Wrist 2 views (73100) | $485 | $485 | 4.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $443 | $443 | 4.2× |
| X-Ray Bend Only L-S Spine (72120) | $730 | $730 | 5.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $509 | $509 | 4.9× |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$16,165.68–$29,806.16 | $16,165.68–$29,806.16 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $495 | $495 | 4.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $746 | $746 | 6.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $998 | $998 | 8.0× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$54,775.39–$57,659.59 | $54,775.39–$57,659.59 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$689–$1,572 | $689–$1,572 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $727 | $727 | 5.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $602 | $602 | 4.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $811 | $811 | 6.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $998 | $998 | 8.0× |
| X-Ray Exam L-S Spine Bending (72114) | $916 | $916 | 7.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $493 | $493 | 4.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $651 | $651 | 5.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $667 | $667 | 5.3× |
| X-ray eye for foreign body (70030) | $407 | $407 | 3.9× |
| X-ray humerus (73060) | $325 | $325 | 3.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $345 | $345 | 3.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $314 | $314 | 3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $628 | $628 | 5.0× |
| X-ray nose-rectum child f.b. (76010) | $355 | $355 | 3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $947 | $947 | 7.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $607 | $607 | 4.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $363 | $363 | 2.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $426 | $426 | 4.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $594 | $594 | 5.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $803 | $803 | 6.4× |
| X-ray thoracic spine 4 vw (72074) | $1,018 | $1,018 | 8.1× |
| X-Ray Tmj Unilat (70328) | $504 | $504 | 4.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $941 | $941 | 2.3× |
| X-Rays Bone Length Studies (77073) | $649 | $649 | 5.2× |
| X-Rays Bone Survey Complete (77075) | $1,355 | $1,355 | 10.8× |
| Xr c-spine 4 or 5 views (72050) | $616 | $616 | 4.9× |
| Xr facial bones less than 3 views (70140) | $548 | $548 | 5.3× |
| Xr orbits complete 4 views (70200) | $672 | $672 | 5.4× |
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.