Imaging prices at UT Health East Texas Jacksonville Hospital
Jacksonville, TX · every code in this section with a posted price and a Medicare benchmark.
247 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) | $72.20 | $722 | 0.8× |
| Abdomen 2 views (74019) | $82.40 | $824 | 0.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $318.60 | $3,186 | 0.8× |
| Ankle 2 views (73600) | $82.40 | $824 | 0.9× |
| Bone age studies (77072) | $82.40 | $824 | 0.8× |
| Bone Imaging 3 Phase (78315) | $383.70 | $3,837 | 1.0× |
| Bone Imaging Whole Body (78306) | $348.80 | $3,488 | 0.9× |
| Bone survey infant (77076) | $78.10 | $781 | 0.7× |
| Chest 1 view (71045) | $72.20 | $722 | 0.8× |
| Chest 2 views (71046) | $82.40 | $824 | 0.9× |
| Chest 3 views (71047) | $63.10 | $631 | 0.7× |
| Chest 4 or more views (71048) | $63.10 | $631 | 0.6× |
| Clavicle complete (73000) | $82.40 | $824 | 0.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $170.90 | $1,709 | 1.6× |
| Contrast X-Ray Bladder (74430) | $221.80 | $2,218 | 0.6× |
| CT abdomen and pelvis without and with contrast (74178) | $1,285.90 | $12,859 | 3.7× |
| CT abdomen and pelvis without contrast (74176) | $867.90 | $8,679 | 3.6× |
| CT abdomen w contrast (74160) | $755.90 | $7,559 | 4.3× |
| CT abdomen w wo contrast (74170) | $857.20 | $8,572 | 4.9× |
| CT abdomen w/o contrast (74150) | $578.70 | $5,787 | 5.5× |
| CT Angio Abdomen and Pelvis (74174) | $909.30 | $9,093 | 2.6× |
| CT Angio Chest (71275) | $585.20 | $5,852 | 3.3× |
| CT Angio Head (70496) | $525.90 | $5,259 | 3.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$547.30–$820.95 | $5,473–$8,209.50 | varies |
| CT Angio Neck (70498) | $511.50 | $5,115 | 2.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $512.80 | $5,128 | 2.9× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $57 | $570 | 0.3× |
| CT cervical spine w/ contrast (72126) | $618.30 | $6,183 | 1.8× |
| CT cervical spine w/o contrast (72125) | $562.10 | $5,621 | 5.4× |
| CT cervical spine w/wo cont (72127) | $691.40 | $6,914 | 3.9× |
| CT chest w contrast (71260) | $755.90 | $7,559 | 4.3× |
| CT chest w/wo contrast (71270) | $857.20 | $8,572 | 4.9× |
| CT head/brain with contrast (70460) | $734.10 | $7,341 | 4.2× |
| CT head/brain without and with contrast (70470) | $832.50 | $8,325 | 4.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $29.50 | $295 | 0.3× |
| CT iac w contrast (70481) | $618.30 | $6,183 | 3.5× |
| CT l-spine w&w/o contrast (72133) | $691.40 | $6,914 | 3.9× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$578.70–$868.05 | $5,787–$8,680.50 | varies |
| CT lower extremity w/contrast material (73701) | $755.90 | $7,559 | 4.3× |
| CT lumbar spine w contrast (72132) | $636.60 | $6,366 | 1.8× |
| CT lumbar spine w/o contrast (72131) | $578.70 | $5,787 | 5.5× |
| CT maxillofacial w contrast (70487) | $734.10 | $7,341 | 4.2× |
| CT maxillofacial wo contrast (70486) | $562.10 | $5,621 | 5.4× |
| CT neck tissue combo (70492) | $832.50 | $8,325 | 4.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $832.50 | $8,325 | 4.7× |
| CT orbits w/o contrast (70480) | $562.10 | $5,621 | 5.4× |
| CT pelvis w&w/o contrast (72194) | $857.20 | $8,572 | 4.9× |
| CT pelvis w/o contrast (72192) | $578.70 | $5,787 | 5.5× |
| CT scan of leg combo (73702) | $857.20 | $8,572 | 4.9× |
| CT scans face/jaw combo (70488) | $832.50 | $8,325 | 4.7× |
| CT soft tissue neck w contrast (70491) | $734.10 | $7,341 | 4.2× |
| CT soft tissue neck w/o contrast (70490) | $562.10 | $5,621 | 5.4× |
| CT thoracic spine w contrast (72129) | $66.60 | $666 | 0.4× |
| CT thoracic spine w/o contrast (72128) | $578.70 | $5,787 | 5.5× |
| CT thoracic spine w/wo cont (72130) | $857.20 | $8,572 | 4.9× |
| CT thorax w/o contrast (71250) | $578.70 | $5,787 | 5.5× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$578.70–$868.05 | $5,787–$8,680.50 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $857.20 | $8,572 | 4.9× |
| CT upper extremity with contrast (73201) | $755.90 | $7,559 | 2.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $654.70 | $6,547 | 3.7× |
| Cta Abdomen (74175) | $570.10 | $5,701 | 3.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $907 | $9,070 | 2.6× |
| CTA pelvis (72191) | $559.70 | $5,597 | 3.2× |
| Dxa Bone Density Axial (77080) | $72.50 | $725 | 0.7× |
| Dxa bone density study (77085) | $40.70 | $407 | 0.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $72.50 | $725 | 0.8× |
| Echo exam of fetal heart (76825) | $180 | $1,800 | 0.3× |
| Echo Guide For Artery Repair (76936) | $98.60 | $986 | 0.5× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $85.80 | $858 | 0.4× |
| Esophagram (74220) | $66.60 | $666 | 0.4× |
| Fetal Biophys Profile W/Nst (76818) | $167.60 | $1,676 | 1.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $126.10 | $1,261 | 1.2× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $85.80 | $858 | 0.4× |
| Fluoroscopy up to 1 hr (76000) | $121.20 | $1,212 | 0.5× |
| Foot 2 views (73620) | $82.40 | $824 | 0.9× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$82.40–$123.60 | $824–$1,236 | varies |
| Gastric emptying imaging study (78264) | $254.90 | $2,549 | 0.6× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$82.40–$123.60 | $824–$1,236 | varies |
| Hepatobil Syst Image W/Drug (78227) | $404.40 | $4,044 | 0.7× |
| Hepatobiliary System Imaging (78226) | $268 | $2,680 | 0.7× |
| Ht Muscle Image Spect Sing (78451) | $501.80 | $5,018 | 0.4× |
| Hysterosalpingogram (74740) | $348.50 | $3,485 | 1.5× |
| K Flow/Funct Image W/Drug (78708) | $170 | $1,700 | 0.3× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$91.20–$136.80 | $912–$1,368 | varies |
| Liver & Spleen Imaging Static Only (78215) | $139.20 | $1,392 | 0.3× |
| Lung Ventilat&Perfus Imaging (78582) | $455.40 | $4,554 | 0.8× |
| Magnetic Image Jaw Joint (70336) | $85.80 | $858 | 0.4× |
| Mra Head W/O & W/Contrast Material (70546) | $1,018.10 | $10,181 | 2.9× |
| MRA head w/o contrast (70544) | $752.60 | $7,526 | 3.1× |
| MRA head with contrast (70545) | $441.50 | $4,415 | 1.3× |
| MRA neck w contrast (70548) | $895.60 | $8,956 | 2.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $348.10 | $3,481 | 1.0× |
| MRA neck w/o contrast (70547) | $752.60 | $7,526 | 3.1× |
| MRI abdomen w contrast (74182) | $137.30 | $1,373 | 0.4× |
| MRI abdomen w/o contrast (74181) | $781.80 | $7,818 | 3.3× |
| MRI any jt lower extrem w/contrast material (73722) | $461.60 | $4,616 | 0.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,057.50 | $10,575 | 3.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $480.80 | $4,808 | 0.6× |
| MRI cervical spine w contrast (72142) | $137.30 | $1,373 | 0.4× |
| MRI cervical spine w/o cont (72141) | $752.60 | $7,526 | 3.1× |
| MRI chest w/o contrast (71550) | $781.80 | $7,818 | 3.3× |
| MRI chest with contrast (71551) | $266.40 | $2,664 | 0.3× |
| MRI chest wo w contrast (71552) | $1,018.10 | $10,181 | 2.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $501.60 | $5,016 | 1.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,057.50 | $10,575 | 3.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $781.80 | $7,818 | 3.3× |
| MRI lumbar spine w contrast (72149) | $930.20 | $9,302 | 2.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,018.10 | $10,181 | 2.9× |
| MRI orbit face &/neck w/o contrast (70540) | $752.60 | $7,526 | 3.1× |
| MRI orbit face neck w contrast (70542) | $480.20 | $4,802 | 1.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,018.10 | $10,181 | 2.9× |
| MRI pelvis w contrast (72196) | $859.90 | $8,599 | 2.5× |
| MRI pelvis w/o & w contrast (72197) | $1,057.50 | $10,575 | 3.0× |
| MRI pelvis w/o contrast (72195) | $781.80 | $7,818 | 3.3× |
| MRI thoracic spine w/o contrast (72146) | $781.80 | $7,818 | 3.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $859.90 | $8,599 | 2.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $781.80 | $7,818 | 3.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,018.10 | $10,181 | 2.9× |
| MRI, abdomen, combo (74183) | $1,057.50 | $10,575 | 3.0× |
| MRI, dorsal spine combo (72157) | $1,057.50 | $10,575 | 3.0× |
| MRI, dorsal spine contrast (72147) | $137.30 | $1,373 | 0.4× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$781.80–$1,172.70 | $7,818–$11,727 | varies |
| MRI, joint upper extrem combo (73223) | $1,057.50 | $10,575 | 3.0× |
| MRI, lumbar spine combo (72158) | $1,057.50 | $10,575 | 3.0× |
| Myocardial Spect Multiple Studies (78452) | $821 | $8,210 | 0.6× |
| Neck soft tissue (70360) | $73.70 | $737 | 0.8× |
| Nonvascular Shunt X-Ray (75809) | $38.40 | $384 | 0.4× |
| Nuclear Rx Oral Admin (79005) | $147.30 | $1,473 | 0.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $194.70 | $1,947 | 0.5× |
| Pelvis 1 or 2 views (72170) | $82.40 | $824 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $335.90 | $3,359 | 0.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $136.20 | $1,362 | 1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $167.60 | $1,676 | 0.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$91.20–$136.80 | $912–$1,368 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$82.40–$123.60 | $824–$1,236 | varies |
| Radex elbow complete minimum 3 views (73080) | $91.20 | $912 | 1.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $91.20 | $912 | 0.9× |
| Radex fingr minimum 2 views (73140) | $82.40 | $824 | 0.9× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$91.20–$136.80 | $912–$1,368 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$91.20–$136.80 | $912–$1,368 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$91.20–$136.80 | $912–$1,368 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $91.60 | $916 | 1.0× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $114.10 | $1,141 | 1.3× |
| Radex Ribs Unilateral 2 Views (71100) | $30.40 | $304 | 0.3× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$82.40–$123.60 | $824–$1,236 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $62.90 | $629 | 0.7× |
| Radex Spine 1 View Specify Level (72020) | $62.90 | $629 | 0.7× |
| Radex Sternum Minimum 2 Views (71120) | $82.40 | $824 | 0.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $98.80 | $988 | 1.1× |
| Radex Toe Minimum 2 Views (73660) | $82.40 | $824 | 0.9× |
| Radex upper extremity infant minimum 2 views (73092) | $91.20 | $912 | 0.9× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$91.20–$136.80 | $912–$1,368 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $91.60 | $916 | 0.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $40.70 | $407 | 0.4× |
| Radiologic exam colon double contrast study (74280) | $152.10 | $1,521 | 0.9× |
| Radiologic exam colon single contrast study (74270) | $129.90 | $1,299 | 0.7× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$100.20–$150.30 | $1,002–$1,503 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $68.30 | $683 | 0.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $175.20 | $1,752 | 1.0× |
| Radiologic exam swallow function contrast study (74230) | $135.60 | $1,356 | 0.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $78.50 | $785 | 0.4× |
| Radiologic examination femur 1 view (73551) | $82.40 | $824 | 0.9× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$90.70–$136.05 | $907–$1,360.50 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$72.20–$108.30 | $722–$1,083 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $127.70 | $1,277 | 1.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$82.40–$123.60 | $824–$1,236 | varies |
| Ribs bilateral 3 views (71110) | $40.70 | $407 | 0.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $487.10 | $4,871 | 0.9× |
| Scapula (73010) | $82.40 | $824 | 0.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $18.20 | $182 | 0.8× |
| Shoulder 1 view (73020) | $72.20 | $722 | 0.8× |
| Shoulder Arthrography (73040) | $145.90 | $1,459 | 0.4× |
| Skull less than 4 views (70250) | $91.60 | $916 | 0.9× |
| Speech evaluation, complex (70371) | $85.80 | $858 | 0.4× |
| Sternoclavicular joints (71130) | $91.20 | $912 | 1.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $234 | $2,340 | 1.3× |
| Thoracic spine 2 views (72070) | $46.60 | $466 | 0.4× |
| Thoracic spine 3 views (72072) | $89.90 | $899 | 0.9× |
| Thoracolumbar 2 views (72080) | $82.40 | $824 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $275.80 | $2,758 | 0.7× |
| Ultrasound Breast Limited (76642) | $93.10 | $931 | 1.1× |
| Ultrasound Elastography Parenchyma (76981) | $40.70 | $407 | 0.4× |
| Ultrasound Exam Aaa Screen (76706) | $97.80 | $978 | 0.9× |
| Ultrasound, abdomen limited (76705) | $146.10 | $1,461 | 1.4× |
| Umbilical-artery Doppler (OB) (76820) | $67.70 | $677 | 0.6× |
| Unlisted Dx Radiographic Procedure (76499) | $98.80 | $988 | 1.1× |
| Upper gi w/o kub (74240) | $237 | $2,370 | 1.3× |
| Urethrocystogram voiding (74455) | $221.50 | $2,215 | 0.9× |
| Urethrocystography retrograde (74450) | $90.40 | $904 | 0.4× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$102.50–$153.75 | $1,025–$1,537.50 | varies |
| Us chest (76604) | $95.50 | $955 | 0.9× |
| Us complete joint (76881) | $42.80 | $428 | 0.4× |
| Us exam, pelvic, limited (76857) | $100.80 | $1,008 | 1.0× |
| Us head (76506) | $120.50 | $1,205 | 1.1× |
| Us kidney transplant (76776) | $169.40 | $1,694 | 1.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $40.70 | $407 | 0.4× |
| Us ob detailed single fetus (76811) | $79.40 | $794 | 0.3× |
| Us ob limited 1 or more fetuses (76815) | $77.10 | $771 | 0.7× |
| Us ob transvaginal (76817) | $187.70 | $1,877 | 1.8× |
| Us pelvic non ob complete (76856) | $241.30 | $2,413 | 2.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $167.40 | $1,674 | 1.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $111.10 | $1,111 | 1.1× |
| Us retroperitoneal complete (76770) | $145.20 | $1,452 | 1.4× |
| Us retroperitoneal limited (76775) | $229.10 | $2,291 | 2.2× |
| Us scrotum and contents (76870) | $138 | $1,380 | 1.3× |
| Us spinal canal and contents (76800) | $85.60 | $856 | 0.8× |
| Us thyroid (76536) | $174.70 | $1,747 | 1.7× |
| Vascular Flow Imaging (78445) | $92.30 | $923 | 0.2× |
| Wrist 2 views (73100) | $82.40 | $824 | 0.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $91.20 | $912 | 1.0× |
| X-ray antegrade pyelogram tube (74425) | $127.70 | $1,277 | 0.4× |
| X-Ray Bend Only L-S Spine (72120) | $94.60 | $946 | 0.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$82.40–$123.60 | $824–$1,236 | varies |
| X-Ray Exam Breast Specimen (76098) | $165.30 | $1,653 | 0.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $66.50 | $665 | 0.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $223.40 | $2,234 | 2.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $193.10 | $1,931 | 1.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $72.20 | $722 | 0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $82.40 | $824 | 0.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $46.10 | $461 | 0.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $86 | $860 | 0.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $111.70 | $1,117 | 1.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $127.70 | $1,277 | 1.2× |
| X-Ray Exam L-S Spine Bending (72114) | $265.40 | $2,654 | 2.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $82.40 | $824 | 0.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $118.60 | $1,186 | 1.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $91.20 | $912 | 0.9× |
| X-ray eye for foreign body (70030) | $30.40 | $304 | 0.3× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$82.40–$123.60 | $824–$1,236 | varies |
| X-ray IV pyelogram (ivp) (74400) | $368.70 | $3,687 | 2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $29.30 | $293 | 0.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $91.30 | $913 | 1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $82.40 | $824 | 0.8× |
| X-ray nose-rectum child f.b. (76010) | $100.20 | $1,002 | 1.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $104.50 | $1,045 | 1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $40.70 | $407 | 0.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $82.40 | $824 | 0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $82.40 | $824 | 0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $91.60 | $916 | 1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $75.70 | $757 | 0.7× |
| X-ray thoracic spine 4 vw (72074) | $63.10 | $631 | 0.6× |
| X-Ray Tmj Unilat (70328) | $63.10 | $631 | 0.7× |
| X-Rays Bone Length Studies (77073) | $62.90 | $629 | 0.6× |
| X-Rays Bone Survey Complete (77075) | $175.50 | $1,755 | 1.7× |
| Xr c-spine 4 or 5 views (72050) | $118.60 | $1,186 | 1.1× |
| Xr facial bones less than 3 views (70140) | $82.40 | $824 | 0.9× |
| Xr orbits complete 4 views (70200) | $100.20 | $1,002 | 1.0× |
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.