Imaging prices at UT Health East Texas Athens Hospital
Athens, 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 |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $720.70 | $7,207 | 0.5× |
| Abdomen 1 View (74018) | $83.10 | $831 | 1.0× |
| Abdomen 2 views (74019) | $94.80 | $948 | 0.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $402.30 | $4,023 | 1.0× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$97.70–$146.55 | $977–$1,465.50 | varies |
| Basic radiation dosimetry calculation (77300) | $34.80 | $348 | 0.3× |
| Bone age studies (77072) | $97.70 | $977 | 0.9× |
| Bone Imaging 3 Phase (78315) | $579.60 | $5,796 | 1.4× |
| Bone Imaging Limited Area (78300) | $116.80 | $1,168 | 0.3× |
| Bone Imaging Whole Body (78306) | $440.70 | $4,407 | 1.1× |
| Bone survey infant (77076) | $38.40 | $384 | 0.4× |
| Brain Image W/Flow < 4 Views (78601) | $275.50 | $2,755 | 0.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,009.80 | $10,098 | 2.9× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $768.80 | $7,688 | 1.0× |
| Chest 1 view (71045) | $109 | $1,090 | 1.2× |
| Chest 2 views (71046) | $89.60 | $896 | 1.0× |
| Chest 3 views (71047) | $28.90 | $289 | 0.3× |
| Chest 4 or more views (71048) | $38.80 | $388 | 0.4× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$97.70–$146.55 | $977–$1,465.50 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $114 | $1,140 | 1.1× |
| Continuing medical physics consltj pr wk (77336) | $77 | $770 | 0.6× |
| Contrast X-Ray Bladder (74430) | $157.30 | $1,573 | 0.4× |
| CT abdomen and pelvis without and with contrast (74178) | $1,652.50 | $16,525 | 4.7× |
| CT abdomen and pelvis without contrast (74176) | $1,115.40 | $11,154 | 4.7× |
| CT abdomen w contrast (74160) | $728.80 | $7,288 | 4.1× |
| CT abdomen w wo contrast (74170) | $826.40 | $8,264 | 4.7× |
| CT abdomen w/o contrast (74150) | $557.80 | $5,578 | 5.3× |
| CT Angio Abdomen and Pelvis (74174) | $420.90 | $4,209 | 1.2× |
| CT Angio Chest (71275) | $924 | $9,240 | 5.2× |
| CT Angio Head (70496) | $907 | $9,070 | 5.1× |
| CT angio hrt w/3d image (75574) | $606.50 | $6,065 | 1.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,127.80–$1,691.70 | $11,278–$16,917 | varies |
| CT Angio Neck (70498) | $907 | $9,070 | 5.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $924 | $9,240 | 5.2× |
| CT bone density (77078) | $52.90 | $529 | 0.6× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $57 | $570 | 0.3× |
| CT cervical spine w/ contrast (72126) | $715.30 | $7,153 | 2.0× |
| CT cervical spine w/o contrast (72125) | $547.60 | $5,476 | 5.2× |
| CT cervical spine w/wo cont (72127) | $811.20 | $8,112 | 4.6× |
| CT chest w contrast (71260) | $728.80 | $7,288 | 4.1× |
| CT chest w/wo contrast (71270) | $826.40 | $8,264 | 4.7× |
| CT head/brain with contrast (70460) | $715.30 | $7,153 | 4.1× |
| CT head/brain without and with contrast (70470) | $811.20 | $8,112 | 4.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $71.90 | $719 | 0.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $606.50 | $6,065 | 6.9× |
| CT iac w contrast (70481) | $715.30 | $7,153 | 4.1× |
| CT l-spine w&w/o contrast (72133) | $826.40 | $8,264 | 4.7× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$557.80–$836.70 | $5,578–$8,367 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$728.80–$1,093.20 | $7,288–$10,932 | varies |
| CT lumbar spine w contrast (72132) | $728.80 | $7,288 | 2.1× |
| CT lumbar spine w/o contrast (72131) | $557.80 | $5,578 | 5.3× |
| CT maxillofacial w contrast (70487) | $715.30 | $7,153 | 4.1× |
| CT maxillofacial wo contrast (70486) | $547.60 | $5,476 | 5.2× |
| CT neck tissue combo (70492) | $811.20 | $8,112 | 4.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $811.20 | $8,112 | 4.6× |
| CT orbits w/o contrast (70480) | $547.60 | $5,476 | 5.2× |
| CT pelvis w&w/o contrast (72194) | $826.40 | $8,264 | 4.7× |
| CT pelvis w/o contrast (72192) | $557.80 | $5,578 | 5.3× |
| CT scan of leg combo (73702) | $826.40 | $8,264 | 4.7× |
| CT scans face/jaw combo (70488) | $811.20 | $8,112 | 4.6× |
| CT soft tissue neck w contrast (70491) | $715.30 | $7,153 | 4.1× |
| CT soft tissue neck w/o contrast (70490) | $547.60 | $5,476 | 5.2× |
| CT thoracic spine w contrast (72129) | $728.80 | $7,288 | 4.1× |
| CT thoracic spine w/o contrast (72128) | $557.80 | $5,578 | 5.3× |
| CT thoracic spine w/wo cont (72130) | $826.40 | $8,264 | 4.7× |
| CT thorax w/o contrast (71250) | $557.80 | $5,578 | 5.3× |
| CT upper ext wo (73200) | $557.80 | $5,578 | 5.3× |
| CT upper extremity w/o & w/contrast material (73202) | $826.40 | $8,264 | 4.7× |
| CT upper extremity with contrast (73201) | $728.80 | $7,288 | 2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,127.80 | $11,278 | 6.4× |
| Cta Abdomen (74175) | $924 | $9,240 | 5.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $907 | $9,070 | 2.6× |
| CTA pelvis (72191) | $924 | $9,240 | 5.2× |
| Dxa Bone Density Axial (77080) | $80.30 | $803 | 0.8× |
| Dxa bone density study (77085) | $116.40 | $1,164 | 1.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $80.30 | $803 | 0.9× |
| Esophagram (74220) | $107.60 | $1,076 | 0.6× |
| Fetal Biophys Profile W/Nst (76818) | $63.80 | $638 | 0.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $40.60 | $406 | 0.4× |
| Fluoroscopy up to 1 hr (76000) | $81.90 | $819 | 0.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$97.70–$146.55 | $977–$1,465.50 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$97.70–$146.55 | $977–$1,465.50 | varies |
| Gastric emptying imaging study (78264) | $324.50 | $3,245 | 0.8× |
| Gated Heart Planar Single (78472) | $350.30 | $3,503 | 0.9× |
| Hand 2 views (73120) | $97.70 | $977 | 0.9× |
| Hepatobil Syst Image W/Drug (78227) | $398.60 | $3,986 | 0.7× |
| Hepatobiliary System Imaging (78226) | $398.60 | $3,986 | 1.0× |
| Ht Muscle Image Spect Sing (78451) | $479.50 | $4,795 | 0.4× |
| Hysterosalpingogram (74740) | $135.30 | $1,353 | 0.6× |
| Image fusion (77399) | $93.20 | $932 | 0.7× |
| K Flow/Funct Image Multiple (78709) | $197.40 | $1,974 | 0.4× |
| K Flow/Funct Image W/Drug (78708) | $196.20 | $1,962 | 0.4× |
| K Flow/Funct Image W/O Drug (78707) | $360.20 | $3,602 | 0.7× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $151.30 | $1,513 | 0.4× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$108.20–$162.30 | $1,082–$1,623 | varies |
| Lung Perf&Ventilat Diferentl (78598) | $197.40 | $1,974 | 0.4× |
| Lung perfusion differential (78597) | $132.50 | $1,325 | 0.3× |
| Lymph System Imaging (78195) | $323.60 | $3,236 | 0.6× |
| Magnetic Image Jaw Joint (70336) | $746.50 | $7,465 | 3.1× |
| Meckels Divert Exam (78290) | $300.30 | $3,003 | 0.7× |
| Mlc imrt design & construction per imrt plan (77338) | $162 | $1,620 | 0.4× |
| Mra Head W/O & W/Contrast Material (70546) | $1,059.50 | $10,595 | 3.0× |
| MRA head w/o contrast (70544) | $960.70 | $9,607 | 4.0× |
| MRA head with contrast (70545) | $973.70 | $9,737 | 2.8× |
| MRA neck w contrast (70548) | $973.70 | $9,737 | 2.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,059.50 | $10,595 | 3.0× |
| MRA neck w/o contrast (70547) | $783.20 | $7,832 | 3.3× |
| MRI abdomen w contrast (74182) | $888.30 | $8,883 | 2.5× |
| MRI abdomen w/o contrast (74181) | $746.50 | $7,465 | 3.1× |
| MRI any jt lower extrem w/contrast material (73722) | $888.30 | $8,883 | 1.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,009.80 | $10,098 | 2.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $888.30 | $8,883 | 1.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $81.80 | $818 | 0.3× |
| MRI cardiac w/o cont stress (75559) | $743.10 | $7,431 | 1.4× |
| MRI cardiac w/o contrast (75557) | $746.50 | $7,465 | 3.1× |
| MRI cervical spine w contrast (72142) | $932 | $9,320 | 2.7× |
| MRI cervical spine w/o cont (72141) | $783.20 | $7,832 | 3.3× |
| MRI chest w/o contrast (71550) | $746.50 | $7,465 | 3.1× |
| MRI chest with contrast (71551) | $746.50 | $7,465 | 0.9× |
| MRI chest wo w contrast (71552) | $746.50 | $7,465 | 2.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $888.30 | $8,883 | 2.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,009.80 | $10,098 | 2.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $746.50 | $7,465 | 3.1× |
| MRI lumbar spine w contrast (72149) | $888.30 | $8,883 | 2.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,059.50 | $10,595 | 3.0× |
| MRI orbit face &/neck w/o contrast (70540) | $783.20 | $7,832 | 3.3× |
| MRI orbit face neck w contrast (70542) | $932 | $9,320 | 2.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,059.50 | $10,595 | 3.0× |
| MRI pelvis w contrast (72196) | $888.30 | $8,883 | 2.5× |
| MRI pelvis w/o & w contrast (72197) | $1,009.80 | $10,098 | 2.9× |
| MRI pelvis w/o contrast (72195) | $746.50 | $7,465 | 3.1× |
| MRI thoracic spine w/o contrast (72146) | $746.50 | $7,465 | 3.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $888.30 | $8,883 | 2.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $746.50 | $7,465 | 3.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,009.80 | $10,098 | 2.9× |
| MRI, abdomen, combo (74183) | $1,009.80 | $10,098 | 2.9× |
| MRI, dorsal spine combo (72157) | $1,009.80 | $10,098 | 2.9× |
| MRI, dorsal spine contrast (72147) | $888.30 | $8,883 | 2.5× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$746.50–$1,119.75 | $7,465–$11,197.50 | varies |
| MRI, joint upper extrem combo (73223) | $1,009.80 | $10,098 | 2.9× |
| MRI, lumbar spine combo (72158) | $1,009.80 | $10,098 | 2.9× |
| Myocardial Spect Multiple Studies (78452) | $799.30 | $7,993 | 0.6× |
| Neck soft tissue (70360) | $83.10 | $831 | 1.0× |
| Nonvascular Shunt X-Ray (75809) | $36.30 | $363 | 0.3× |
| Ntsty modul radthx pln dose-vol histos (77301) | $720.70 | $7,207 | 0.5× |
| Parathyroid Planar Imaging (78070) | $300.30 | $3,003 | 0.7× |
| Pelvis 1 or 2 views (72170) | $97.70 | $977 | 0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $473.70 | $4,737 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $114 | $1,140 | 1.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $147.20 | $1,472 | 0.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$108.20–$162.30 | $1,082–$1,623 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$97.70–$146.55 | $977–$1,465.50 | varies |
| Radex elbow complete minimum 3 views (73080) | $108.20 | $1,082 | 1.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $108.20 | $1,082 | 1.0× |
| Radex fingr minimum 2 views (73140) | $97.70 | $977 | 1.1× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$108.20–$162.30 | $1,082–$1,623 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$108.20–$162.30 | $1,082–$1,623 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$29.30–$43.95 | $293–$439.50 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $108.20 | $1,082 | 1.2× |
| Radex Ribs Unilateral 2 Views (71100) | $97.70 | $977 | 1.1× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$97.70–$146.55 | $977–$1,465.50 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $31.20 | $312 | 0.4× |
| Radex Spine 1 View Specify Level (72020) | $85.60 | $856 | 1.0× |
| Radex Sternum Minimum 2 Views (71120) | $97.70 | $977 | 1.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $28.90 | $289 | 0.3× |
| Radex Toe Minimum 2 Views (73660) | $97.70 | $977 | 1.1× |
| Radex upper extremity infant minimum 2 views (73092) | $38.40 | $384 | 0.4× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$108.20–$162.30 | $1,082–$1,623 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $128.40 | $1,284 | 1.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) unusually low: confirm this is the full procedure |
$2,601.60 | $26,016 | 0.4× |
| Radiation treatment delivery level 1 (77402) | $159 | $1,590 | 1.6× |
| Radiation treatment delivery level 2 (77407) | $356.20 | $3,562 | 0.9× |
| Radiation treatment delivery level 3 (77412) | $468.50 | $4,685 | 0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $108.20 | $1,082 | 1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $37.70 | $377 | 0.4× |
| Radiologic exam colon double contrast study (74280) | $212.70 | $2,127 | 1.2× |
| Radiologic exam colon single contrast study (74270) | $169.30 | $1,693 | 1.0× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$132.80–$199.20 | $1,328–$1,992 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $41.10 | $411 | 0.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $174.90 | $1,749 | 1.0× |
| Radiologic exam swallow function contrast study (74230) | $107.60 | $1,076 | 0.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $95.50 | $955 | 0.5× |
| Radiologic examination femur 1 view (73551) | $97.70 | $977 | 1.1× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$97.70–$146.55 | $977–$1,465.50 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$85.60–$128.40 | $856–$1,284 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $202.70 | $2,027 | 1.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$97.70–$146.55 | $977–$1,465.50 | varies |
| Ribs bilateral 3 views (71110) | $108.20 | $1,082 | 1.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $313.80 | $3,138 | 0.6× |
| Scapula (73010) | $97.70 | $977 | 0.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $18.60 | $186 | 0.8× |
| Shoulder 1 view (73020) | $85.60 | $856 | 1.0× |
| Skull less than 4 views (70250) | $41.10 | $411 | 0.4× |
| Special dosimetry (77331) | $48.30 | $483 | 0.4× |
| Special Physics Consult (77370) | $90.20 | $902 | 0.7× |
| Special teletherapy port plan (77321) | $104.20 | $1,042 | 0.3× |
| Special treatment procedure (77470) | $287.20 | $2,872 | 0.5× |
| Stereotactic Body Radiation Delivery (77373) | $1,391.80 | $13,918 | 0.8× |
| Sternoclavicular joints (71130) | $30.40 | $304 | 0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $68.80 | $688 | 0.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $172.20 | $1,722 | 0.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $281.60 | $2,816 | 0.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $220.10 | $2,201 | 0.6× |
| Ther rad simulaj-aided field setting simple (77280) | $150 | $1,500 | 1.1× |
| Thoracic spine 2 views (72070) | $97.70 | $977 | 0.9× |
| Thoracic spine 3 views (72072) | $108.20 | $1,082 | 1.0× |
| Thoracolumbar 2 views (72080) | $30.60 | $306 | 0.4× |
| Thyroid Uptake Measurement (78012) | $308.60 | $3,086 | 0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $155.80 | $1,558 | 0.4× |
| Tx Devices Design & Construction Complex (77334) | $83.80 | $838 | 0.2× |
| Tx devices design & construction intermediate (77333) | $42.30 | $423 | 0.3× |
| Ultrasound Breast Limited (76642) | $30.20 | $302 | 0.3× |
| Ultrasound Exam Aaa Screen (76706) | $201.80 | $2,018 | 1.9× |
| Ultrasound, abdomen limited (76705) | $198 | $1,980 | 1.9× |
| Umbilical-artery Doppler (OB) (76820) | $37.20 | $372 | 0.4× |
| Upper gi w/o kub (74240) | $237.70 | $2,377 | 1.3× |
| Urethrocystogram voiding (74455) | $149.20 | $1,492 | 0.6× |
| Urethrocystography retrograde (74450) | $98.10 | $981 | 0.4× |
| Us breast unilateral complete (76641) | $128.50 | $1,285 | 1.2× |
| Us chest (76604) | $57.80 | $578 | 0.6× |
| Us complete joint (76881) | $83.60 | $836 | 0.8× |
| Us exam, pelvic, limited (76857) | $97.20 | $972 | 0.9× |
| Us kidney transplant (76776) | $41.80 | $418 | 0.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $52.20 | $522 | 0.5× |
| Us ob detailed single fetus (76811) | $85.40 | $854 | 0.4× |
| Us ob limited 1 or more fetuses (76815) | $132.70 | $1,327 | 1.3× |
| Us ob transvaginal (76817) | $52.50 | $525 | 0.5× |
| Us pelvic non ob complete (76856) | $181.40 | $1,814 | 1.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $168.20 | $1,682 | 1.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $83.60 | $836 | 0.8× |
| Us retroperitoneal complete (76770) | $178.30 | $1,783 | 1.7× |
| Us retroperitoneal limited (76775) | $51.90 | $519 | 0.5× |
| Us scrotum and contents (76870) | $142.80 | $1,428 | 1.4× |
| Us spinal canal and contents (76800) | $41.80 | $418 | 0.4× |
| Us thyroid (76536) | $97.20 | $972 | 0.9× |
| Wrist 2 views (73100) | $97.70 | $977 | 1.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $108.20 | $1,082 | 1.2× |
| X-ray antegrade pyelogram tube (74425) | $133.90 | $1,339 | 0.4× |
| X-Ray Bend Only L-S Spine (72120) | $52.50 | $525 | 0.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$97.70–$146.55 | $977–$1,465.50 | varies |
| X-Ray Exam Breast Specimen (76098) | $167.50 | $1,675 | 0.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $97.70 | $977 | 1.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $97.20 | $972 | 0.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $38.80 | $388 | 0.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $85.60 | $856 | 1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $97.70 | $977 | 1.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $41.10 | $411 | 0.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $51.40 | $514 | 0.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $41.10 | $411 | 0.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $122.70 | $1,227 | 1.2× |
| X-Ray Exam L-S Spine Bending (72114) | $55.40 | $554 | 0.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $97.70 | $977 | 1.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $68.90 | $689 | 0.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $97.70 | $977 | 0.9× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$97.70–$146.55 | $977–$1,465.50 | varies |
| X-ray IV pyelogram (ivp) (74400) | $156.20 | $1,562 | 0.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $97.70 | $977 | 1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $30.70 | $307 | 0.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $97.70 | $977 | 0.9× |
| X-ray nose-rectum child f.b. (76010) | $31.20 | $312 | 0.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $60.50 | $605 | 0.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $41.30 | $413 | 0.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $97.70 | $977 | 0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $97.70 | $977 | 1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $108.20 | $1,082 | 1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $80.70 | $807 | 0.8× |
| X-ray thoracic spine 4 vw (72074) | $119.10 | $1,191 | 1.1× |
| X-Ray Tmj Unilat (70328) | $31.50 | $315 | 0.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $168.90 | $1,689 | 0.5× |
| X-Rays Bone Length Studies (77073) | $42.30 | $423 | 0.4× |
| X-Rays Bone Survey Complete (77075) | $202.70 | $2,027 | 1.9× |
| Xr c-spine 4 or 5 views (72050) | $76.60 | $766 | 0.7× |
| Xr facial bones less than 3 views (70140) | $97.70 | $977 | 1.1× |
| Xr orbits complete 4 views (70200) | $118.70 | $1,187 | 1.1× |
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.