Imaging prices at Washington County Regional Medical Center
Sandersville, GA · 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) | $142.50 | $285 | 1.9× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$45.50–$86 | $91–$172 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $428.50 | $857 | 1.2× |
| Adrenal Cortex & Medulla Img (78075) | $1,191.50 | $2,383 | 1.1× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$125–$174 | $250–$348 | varies |
| Arthrogram hip (73525) | $349.50 | $699 | 1.1× |
| Arthrogram Wrist (73115) | $349.50 | $699 | 1.1× |
| Bone age studies (77072) | $30 | $60 | 0.3× |
| Bone Imaging 3 Phase (78315) | $910 | $1,820 | 2.6× |
| Bone Imaging Limited Area (78300) | $333.50 | $667 | 1.0× |
| Bone Imaging Multiple Areas (78305) | $333.50 | $667 | 1.0× |
| Bone Imaging Whole Body (78306) | $700.50 | $1,401 | 2.0× |
| Bone survey infant (77076) | $117 | $234 | 1.3× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $1,187 | $2,374 | 2.5× |
| Cat Scan Follow-Up Study (76380) | $205 | $410 | 2.7× |
| Chest 1 view (71045) | $43.25 | $86.50 | 0.6× |
| Chest 2 views (71046) | $225.25 | $450.50 | 3.0× |
| Chest 3 views (71047) | $59.50 | $119 | 0.8× |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$42–$59.50 | $84–$119 | varies |
| Clavicle complete (73000) | $174 | $348 | 2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $293 | $586 | 3.2× |
| Contrast X-Ray Of Knee Joint (73580) | $349.50 | $699 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) | $1,601.50 | $3,203 | 5.2× |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$1,176.50–$1,988.50 | $2,353–$3,977 | varies |
| CT abdomen w contrast (74160) | $1,883.50 | $3,767 | 12.3× |
| CT abdomen w wo contrast (74170) | $2,121 | $4,242 | 13.8× |
| CT abdomen w/o contrast (74150) | $182 | $364 | 2.0× |
| CT Angio Abdomen and Pelvis (74174) | $484 | $968 | 1.6× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$376–$1,797.50 | $752–$3,595 | varies |
| CT Angio Head (70496) | $2,129.75 | $4,259.50 | 13.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $426.50 | $853 | 2.8× |
| CT Angio Neck (70498) | $2,413.50 | $4,827 | 15.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $751.50 | $1,503 | 4.9× |
| CT cervical spine w/ contrast (72126) | $641 | $1,282 | 2.1× |
| CT cervical spine w/o contrast (72125) | $431 | $862 | 4.7× |
| CT cervical spine w/wo cont (72127) | $721.50 | $1,443 | 4.7× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,700–$2,636.90 | $3,400–$5,273.80 | varies |
| CT chest w/wo contrast (71270) | $2,969.40 | $5,938.80 | 19.3× |
| CT head/brain with contrast (70460) | $449 | $898 | 2.9× |
| CT head/brain without and with contrast (70470) | $469.50 | $939 | 3.1× |
| CT iac w contrast (70481) | $641 | $1,282 | 4.2× |
| CT l-spine w&w/o contrast (72133) | $361 | $722 | 2.3× |
| CT lower ext w/o (73700) | $216 | $432 | 2.4× |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$449–$897 | $898–$1,794 | varies |
| CT lumbar spine w contrast (72132) | $449 | $898 | 1.5× |
| CT lumbar spine w/o contrast (72131) | $431 | $862 | 4.7× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$449–$641 | $898–$1,282 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$167.50–$287 | $335–$574 | varies |
| CT neck tissue combo (70492) | $505.50 | $1,011 | 3.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,515 | $3,030 | 9.9× |
| CT orbits w/o contrast (70480) | $279.50 | $559 | 3.1× |
| CT pelvis w&w/o contrast (72194) | $361 | $722 | 2.3× |
| CT pelvis w/o contrast (72192) | $201.75 | $403.50 | 2.2× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$721.50–$1,010 | $1,443–$2,020 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$505.50–$721.50 | $1,011–$1,443 | varies |
| CT soft tissue neck w contrast (70491) | $1,883.50 | $3,767 | 12.3× |
| CT soft tissue neck w/o contrast (70490) | $233 | $466 | 2.5× |
| CT thoracic spine w contrast (72129) | $897 | $1,794 | 5.8× |
| CT thoracic spine w/o contrast (72128) | $1,339.10 | $2,678.20 | 14.6× |
| CT thoracic spine w/wo cont (72130) | $721.50 | $1,443 | 4.7× |
| CT thorax w/o contrast (71250) | $1,425 | $2,850 | 15.6× |
| CT upper ext wo (73200) | $228 | $456 | 2.5× |
| CT upper extremity w/o & w/contrast material (73202) | $721.50 | $1,443 | 4.7× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$641–$897 | $1,282–$1,794 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $459.50 | $919 | 3.0× |
| Cta Abdomen (74175) | $1,577.50 | $3,155 | 10.3× |
| CTA pelvis (72191) | $751.50 | $1,503 | 4.9× |
| Dxa Bone Density Axial (77080) | $266.50 | $533 | 2.9× |
| Echo exam uterus (76831) | $194 | $388 | 0.9× |
| Esophagram (74220) | $105.50 | $211 | 0.7× |
| Fetal Biophys Profile W/Nst (76818) | $152 | $304 | 1.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $138.50 | $277 | 1.5× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$161.50–$613.20 | $323–$1,226.40 | varies |
| Foot 2 views (73620) | $189.25 | $378.50 | 2.5× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$79.50–$243.60 | $159–$487.20 | varies |
| Gastric emptying imaging study (78264) | $980.50 | $1,961 | 2.8× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $489.50 | $979 | 1.4× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $579.50 | $1,159 | 1.2× |
| Hand 2 views (73120) | $230 | $460 | 2.5× |
| Heart first pass single,planar (78481) | $394.50 | $789 | 0.8× |
| Hepatobil Syst Image W/Drug (78227) | $1,127 | $2,254 | 2.4× |
| Hepatobiliary System Imaging (78226) | $1,127 | $2,254 | 3.2× |
| Ht Muscle Image Spect Sing (78451) | $1,187 | $2,374 | 1.0× |
| Hysterosalpingogram (74740) | $327.50 | $655 | 1.6× |
| Infusion Ivp (74410) | $133 | $266 | 0.9× |
| K Flow/Funct Image Multiple (78709) | $450 | $900 | 0.9× |
| K Flow/Funct Image W/Drug (78708) | $429.50 | $859 | 0.9× |
| K Flow/Funct Image W/O Drug (78707) | $429.50 | $859 | 0.9× |
| Knee 3 Views (73562) | $253.50 | $507 | 3.3× |
| Liver & Spleen Imaging Static Only (78215) | $383.50 | $767 | 1.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $383.50 | $767 | 1.1× |
| Liver imaging w/vascular flow (78202) | $383.50 | $767 | 0.8× |
| Lung Perf&Ventilat Diferentl (78598) | $931.50 | $1,863 | 2.0× |
| Lung perfusion differential (78597) | $249 | $498 | 0.7× |
| Lymph System Imaging (78195) | $438.50 | $877 | 0.9× |
| Magnetic Image Jaw Joint (70336) | $455 | $910 | 2.2× |
| Meckels Divert Exam (78290) | $333.50 | $667 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $761 | $1,522 | 2.5× |
| MRA head w/o contrast (70544) | $1,338 | $2,676 | 6.4× |
| MRA head with contrast (70545) | $658.50 | $1,317 | 2.2× |
| MRA neck w contrast (70548) | $658.50 | $1,317 | 2.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $761 | $1,522 | 2.5× |
| MRA neck w/o contrast (70547) | $468 | $936 | 2.2× |
| MRI abdomen w contrast (74182) | $658.50 | $1,317 | 2.2× |
| MRI abdomen w/o contrast (74181) | $455 | $910 | 2.2× |
| MRI any jt lower extrem w/contrast material (73722) | $658.50 | $1,317 | 1.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $562 | $1,124 | 1.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $658.50 | $1,317 | 1.0× |
| MRI cervical spine w contrast (72142) | $658.50 | $1,317 | 2.2× |
| MRI cervical spine w/o cont (72141) | $1,873.20 | $3,746.40 | 9.0× |
| MRI chest w/o contrast (71550) | $493.50 | $987 | 2.4× |
| MRI chest with contrast (71551) | $658.50 | $1,317 | 1.0× |
| MRI chest wo w contrast (71552) | $761 | $1,522 | 2.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$483–$658.50 | $966–$1,317 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $599 | $1,198 | 2.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,338 | $2,676 | 6.4× |
| MRI lumbar spine w contrast (72149) | $658.50 | $1,317 | 2.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,598.50 | $3,197 | 5.2× |
| MRI orbit face &/neck w/o contrast (70540) | $361 | $722 | 1.7× |
| MRI orbit face neck w contrast (70542) | $658.50 | $1,317 | 2.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,066 | $2,132 | 3.5× |
| MRI pelvis w contrast (72196) | $658.50 | $1,317 | 2.2× |
| MRI pelvis w/o & w contrast (72197) | $2,238 | $4,476 | 7.3× |
| MRI pelvis w/o contrast (72195) | $955 | $1,910 | 4.6× |
| MRI thoracic spine w/o contrast (72146) | $273.50 | $547 | 1.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $658.50 | $1,317 | 2.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $435 | $870 | 2.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $761 | $1,522 | 2.5× |
| MRI, abdomen, combo (74183) | $605 | $1,210 | 2.0× |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$761–$1,598.50 | $1,522–$3,197 | varies |
| MRI, dorsal spine contrast (72147) | $658.50 | $1,317 | 2.2× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,679.25–$1,873.20 | $3,358.50–$3,746.40 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$561.50–$761 | $1,123–$1,522 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$761–$2,238 | $1,522–$4,476 | varies |
| Myelogram cervical (72240) | $615 | $1,230 | 0.9× |
| Myelogram Lumbar (72265) | $615 | $1,230 | 0.9× |
| Myelography thoracic (72255) | $615 | $1,230 | 0.9× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $394.50 | $789 | 1.1× |
| Myocardial Spect Multiple Studies (78452) | $2,840.50 | $5,681 | 2.5× |
| Neck soft tissue (70360) | $149.50 | $299 | 2.0× |
| Nm myocard infarct spect (78469) | $394.50 | $789 | 0.8× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$368.50–$414 | $737–$828 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,043 | $2,086 | 3.0× |
| Pelvis 1 or 2 views (72170) | $72.75 | $145.50 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $249 | $498 | 0.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $212.25 | $424.50 | 2.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$164–$327.50 | $328–$655 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $243.60 | $487.20 | 3.2× |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$32.50–$174 | $65–$348 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$198.25–$243.60 | $396.50–$487.20 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $197 | $394 | 2.2× |
| Radex fingr minimum 2 views (73140) range across 10 matching MRF lines |
$42–$174 | $84–$348 | varies |
| Radex foot complete minimum 3 views (73630) | $243.60 | $487.20 | 3.2× |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$189–$243.60 | $378–$487.20 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $59.50 | $119 | 0.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $66 | $132 | 0.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $174 | $348 | 2.3× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $161.50 | $323 | 2.1× |
| Radex Ribs Unilateral 2 Views (71100) | $184 | $368 | 2.4× |
| Radex shoulder complete minimum 2 views (73030) | $243.60 | $487.20 | 3.2× |
| Radex Spine 1 View Specify Level (72020) | $59.50 | $119 | 0.8× |
| Radex Sternum Minimum 2 Views (71120) | $42 | $84 | 0.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $83 | $166 | 1.1× |
| Radex Toe Minimum 2 Views (73660) range across 10 matching MRF lines |
$42–$125 | $84–$250 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $131.50 | $263 | 1.4× |
| Radex Wrist Complete Minimum 3 Views (73110) | $243.60 | $487.20 | 3.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $382.90 | $765.80 | 4.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $197 | $394 | 2.2× |
| Radiologic exam colon double contrast study (74280) | $255 | $510 | 1.7× |
| Radiologic exam colon single contrast study (74270) | $457 | $914 | 3.0× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$48–$125 | $96–$250 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $300.50 | $601 | 2.0× |
| Radiologic exam swallow function contrast study (74230) | $152.50 | $305 | 1.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $457 | $914 | 3.0× |
| Radiologic examination femur minimum 2 views (73552) | $191 | $382 | 2.5× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$142.50–$168.75 | $285–$337.50 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$73.75–$79.50 | $147.50–$159 | varies |
| Ribs bilateral 3 views (71110) | $66 | $132 | 0.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $676.50 | $1,353 | 1.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $676.50 | $1,353 | 1.4× |
| Scapula (73010) | $42 | $84 | 0.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $71.75 | $143.50 | 3.1× |
| Shoulder Arthrography (73040) | $349.50 | $699 | 1.1× |
| Skull less than 4 views (70250) | $110 | $220 | 1.2× |
| Speech evaluation, complex (70371) | $161.50 | $323 | 0.8× |
| Sternoclavicular joints (71130) | $59.50 | $119 | 0.8× |
| Testicular Imaging W/Flow (78761) | $429.50 | $859 | 1.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $255 | $510 | 1.7× |
| Thoracic spine 3 views (72072) | $386.40 | $772.80 | 4.2× |
| Thyroid Imaging With Vascular Flow (78013) | $234.50 | $469 | 0.7× |
| Thyroid Uptake Measurement (78012) | $304 | $608 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $868.50 | $1,737 | 2.5× |
| Ultrasound Breast Limited (76642) | $108 | $216 | 1.4× |
| Ultrasound Exam Aaa Screen (76706) | $113.50 | $227 | 1.2× |
| Ultrasound, abdomen limited (76705) range across 8 matching MRF lines |
$138.50–$570.50 | $277–$1,141 | varies |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$93–$130 | $186–$260 | varies |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$190.25–$457 | $380.50–$914 | varies |
| Urethrocystogram voiding (74455) | $265 | $530 | 1.3× |
| Urethrocystography retrograde (74450) | $265 | $530 | 1.3× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$325–$523.50 | $650–$1,047 | varies |
| Us chest (76604) | $194 | $388 | 2.1× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$194–$194.50 | $388–$389 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$189–$194 | $378–$388 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 6 matching MRF lines |
$143–$272.50 | $286–$545 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$104–$138.50 | $208–$277 | varies |
| Us ob transvaginal (76817) | $407.50 | $815 | 4.4× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$194–$407.50 | $388–$815 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $407.50 | $815 | 4.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $141.50 | $283 | 1.5× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$138.50–$194 | $277–$388 | varies |
| Us retroperitoneal limited (76775) range across 6 matching MRF lines |
$72–$439 | $144–$878 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$194–$291 | $388–$582 | varies |
| Us thyroid (76536) range across 4 matching MRF lines |
$140–$407.50 | $280–$815 | varies |
| Us transrectal (76872) | $138.50 | $277 | 1.5× |
| Venography extremity bilateral rs&i (75822) | $760 | $1,520 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $851 | $1,702 | 0.6× |
| Vertebral fracture assessment via dxa (77086) | $59.50 | $119 | 0.8× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$35–$56.75 | $70–$113.50 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $83 | $166 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) | $52.50 | $105 | 0.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$33–$42 | $66–$84 | varies |
| X-Ray Exam Breast Specimen (76098) | $327.50 | $655 | 0.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $185.25 | $370.50 | 2.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $365.03 | $730.06 | 4.0× |
| X-Ray Exam L-S Spine Bending (72114) | $276 | $552 | 3.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $322 | $644 | 4.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $294.50 | $589 | 3.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $166.27 | $332.54 | 1.8× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$51.50–$66 | $103–$132 | varies |
| X-ray IV pyelogram (ivp) (74400) | $265 | $530 | 1.7× |
| X-ray IV pyelogram+tomography (74415) | $265 | $530 | 1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $40 | $80 | 0.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$52.50–$322 | $105–$644 | varies |
| X-ray nose-rectum child f.b. (76010) | $59.50 | $119 | 0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $58.50 | $117 | 0.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $55.50 | $111 | 0.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $59.50 | $119 | 0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $174 | $348 | 2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $174 | $348 | 2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $56.50 | $113 | 0.6× |
| X-Ray Tmj Unilat (70328) | $59.50 | $119 | 0.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $265 | $530 | 0.9× |
| X-Rays Bone Length Studies (77073) | $59.50 | $119 | 0.6× |
| X-Rays Bone Survey Complete (77075) | $105 | $210 | 1.1× |
| Xr c-spine 4 or 5 views (72050) | $386.40 | $772.80 | 4.2× |
| Xr orbits complete 4 views (70200) | $51 | $102 | 0.6× |
| Xr Tomogram Single Plane (76100) | $107.50 | $215 | 1.2× |
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.