Imaging prices at Wayne Hospital
Greenville, OH · every code in this section with a posted price and a Medicare benchmark.
265 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) | $331.50 | $442 | 4.0× |
| Abdomen 2 views (74019) | $473.25 | $631 | 4.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,173.75 | $1,565 | 3.1× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$384–$439.50 | $512–$586 | varies |
| Arthrogram ankle (73615) | $1,244.25 | $1,659 | 3.8× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$1,368.75–$1,410 | $1,825–$1,880 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$1,368.75–$1,410 | $1,825–$1,880 | varies |
| Bone age studies (77072) | $333 | $444 | 3.4× |
| Bone Imaging 3 Phase (78315) | $1,477.50 | $1,970 | 3.9× |
| Bone Imaging Limited Area (78300) | $1,086 | $1,448 | 2.9× |
| Bone Imaging Whole Body (78306) | $1,410.75 | $1,881 | 3.7× |
| Bone marrow imaging; whole body (78104) | $1,113 | $1,484 | 2.9× |
| Bone survey infant (77076) | $352.50 | $470 | 3.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,654.75 | $4,873 | 2.7× |
| Chest 1 view (71045) | $303.75 | $405 | 3.7× |
| Chest 2 views (71046) | $306 | $408 | 3.7× |
| Chest 3 views (71047) | $384 | $512 | 4.7× |
| Chest 4 or more views (71048) | $381 | $508 | 3.9× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$376.50–$395.25 | $502–$527 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $329.25 | $439 | 3.3× |
| Contrast X-Ray Bladder (74430) | $1,467 | $1,956 | 4.4× |
| Contrast X-Ray Of Elbow (73085) | $1,244.25 | $1,659 | 3.8× |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$1,331.25–$1,371 | $1,775–$1,828 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $4,143.75 | $5,525 | 12.6× |
| CT abdomen and pelvis without contrast (74176) | $2,419.50 | $3,226 | 10.7× |
| CT abdomen w contrast (74160) | $1,705.50 | $2,274 | 10.3× |
| CT abdomen w wo contrast (74170) | $1,705.50 | $2,274 | 10.3× |
| CT abdomen w/o contrast (74150) | $1,049.25 | $1,399 | 10.6× |
| CT Angio Abdomen and Pelvis (74174) | $3,215.25 | $4,287 | 9.7× |
| CT Angio Chest (71275) | $1,977.75 | $2,637 | 11.9× |
| CT Angio Head (70496) | $1,977.75 | $2,637 | 11.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,920 | $2,560 | 11.6× |
| CT Angio Neck (70498) | $1,977.75 | $2,637 | 11.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,977.75 | $2,637 | 11.9× |
| CT cervical spine w/ contrast (72126) | $3,251.25 | $4,335 | 9.9× |
| CT cervical spine w/o contrast (72125) | $1,049.25 | $1,399 | 10.6× |
| CT cervical spine w/wo cont (72127) | $2,461.50 | $3,282 | 14.8× |
| CT chest w contrast (71260) | $1,705.50 | $2,274 | 10.3× |
| CT chest w/wo contrast (71270) | $1,671 | $2,228 | 10.1× |
| CT head/brain with contrast (70460) | $1,977.75 | $2,637 | 11.9× |
| CT head/brain without and with contrast (70470) | $1,977.75 | $2,637 | 11.9× |
| CT iac w contrast (70481) | $1,656 | $2,208 | 10.0× |
| CT l-spine w&w/o contrast (72133) | $1,552.50 | $2,070 | 9.4× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$1,216.50–$2,362.50 | $1,622–$3,150 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$1,656–$1,705.50 | $2,208–$2,274 | varies |
| CT lumbar spine w contrast (72132) | $3,571.50 | $4,762 | 10.8× |
| CT lumbar spine w/o contrast (72131) | $1,049.25 | $1,399 | 10.6× |
| CT maxillofacial w contrast (70487) | $1,977.75 | $2,637 | 11.9× |
| CT maxillofacial wo contrast (70486) | $1,049.25 | $1,399 | 10.6× |
| CT neck tissue combo (70492) | $1,977.75 | $2,637 | 11.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,977.75 | $2,637 | 11.9× |
| CT orbits w/o contrast (70480) | $1,216.50 | $1,622 | 12.3× |
| CT pelvis w&w/o contrast (72194) | $1,977.75 | $2,637 | 11.9× |
| CT pelvis w/o contrast (72192) | $1,049.25 | $1,399 | 10.6× |
| CT scan of leg combo (73702) range across 4 matching MRF lines |
$1,920–$1,977.75 | $2,560–$2,637 | varies |
| CT scans face/jaw combo (70488) | $1,977.75 | $2,637 | 11.9× |
| CT soft tissue neck w contrast (70491) | $1,705.50 | $2,274 | 10.3× |
| CT soft tissue neck w/o contrast (70490) | $1,049.25 | $1,399 | 10.6× |
| CT thoracic spine w contrast (72129) | $1,552.50 | $2,070 | 9.4× |
| CT thoracic spine w/o contrast (72128) | $1,049.25 | $1,399 | 10.6× |
| CT thoracic spine w/wo cont (72130) | $1,552.50 | $2,070 | 9.4× |
| CT thorax w/o contrast (71250) | $1,049.25 | $1,399 | 10.6× |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$1,018.50–$1,049.25 | $1,358–$1,399 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 4 matching MRF lines |
$2,363.25–$2,434.50 | $3,151–$3,246 | varies |
| CT upper extremity with contrast (73201) range across 4 matching MRF lines |
$4,023–$4,143.75 | $5,364–$5,525 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,977.75 | $2,637 | 11.9× |
| Cta Abdomen (74175) | $1,705.50 | $2,274 | 10.3× |
| CTA pelvis (72191) | $1,725 | $2,300 | 10.4× |
| Dxa Bone Density Axial (77080) | $420.75 | $561 | 4.3× |
| Dxa bone density study (77085) | $489 | $652 | 4.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $298.50 | $398 | 3.6× |
| Echo exam uterus (76831) | $1,160.25 | $1,547 | 5.1× |
| Esophagram (74220) | $762 | $1,016 | 4.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $913.50 | $1,218 | 9.2× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$387.75–$395.25 | $517–$527 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$264.75–$340.50 | $353–$454 | varies |
| Gastric emptying imaging study (78264) | $1,698.75 | $2,265 | 4.5× |
| Gated Heart Planar Single (78472) | $1,714.50 | $2,286 | 4.5× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$465–$473.25 | $620–$631 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,196.75 | $2,929 | 4.3× |
| Hepatobiliary System Imaging (78226) | $1,477.50 | $1,970 | 3.9× |
| Ht Musc Image Planar Mult (78454) | $5,224.50 | $6,966 | 4.3× |
| Ht Muscle Image Spect Sing (78451) | $5,919.75 | $7,893 | 4.8× |
| Hysterosalpingogram (74740) | $1,301.25 | $1,735 | 5.8× |
| Joint Survey Single View (77077) | $250.50 | $334 | 2.5× |
| K Flow/Funct Image Multiple (78709) | $2,074.50 | $2,766 | 4.0× |
| K Flow/Funct Image W/Drug (78708) | $1,461 | $1,948 | 2.8× |
| K Flow/Funct Image W/O Drug (78707) | $1,587 | $2,116 | 3.1× |
| Knee 3 Views (73562) | $331.50 | $442 | 4.0× |
| Liver & Spleen Imaging Static Only (78215) | $1,281 | $1,708 | 3.4× |
| Lung Perf&Ventilat Diferentl (78598) | $1,504.50 | $2,006 | 2.9× |
| Lung Ventilat&Perfus Imaging (78582) | $1,807.50 | $2,410 | 3.5× |
| Lung Ventilation Imaging (78579) | $1,642.50 | $2,190 | 4.3× |
| Lymph System Imaging (78195) | $1,504.50 | $2,006 | 2.9× |
| Magnetic Image Jaw Joint (70336) | $1,627.50 | $2,170 | 7.2× |
| Mammary ductogram or galactogram single (77053) | $756.75 | $1,009 | 3.4× |
| Meckels Divert Exam (78290) | $1,512.75 | $2,017 | 4.0× |
| Mra Head W/O & W/Contrast Material (70546) | $3,294 | $4,392 | 10.0× |
| MRA head w/o contrast (70544) | $1,546.50 | $2,062 | 6.9× |
| MRA head with contrast (70545) | $3,121.50 | $4,162 | 9.5× |
| MRA neck w contrast (70548) | $3,121.50 | $4,162 | 9.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,940 | $3,920 | 8.9× |
| MRA neck w/o contrast (70547) | $1,419 | $1,892 | 6.3× |
| MRI abdomen w contrast (74182) | $3,861.75 | $5,149 | 11.7× |
| MRI abdomen w/o contrast (74181) | $1,827 | $2,436 | 8.1× |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$5,229.75–$5,386.50 | $6,973–$7,182 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$2,994.75–$5,181.75 | $3,993–$6,909 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$5,229.75–$5,386.50 | $6,973–$7,182 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,627.50 | $2,170 | 7.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $4,377 | $5,836 | 19.4× |
| MRI cervical spine w contrast (72142) | $4,248 | $5,664 | 12.9× |
| MRI cervical spine w/o cont (72141) | $1,844.25 | $2,459 | 8.2× |
| MRI chest w/o contrast (71550) | $2,914.50 | $3,886 | 12.9× |
| MRI chest with contrast (71551) | $3,861.75 | $5,149 | 5.2× |
| MRI chest wo w contrast (71552) | $4,672.50 | $6,230 | 14.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 4 matching MRF lines |
$3,861.75–$4,194 | $5,149–$5,592 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 4 matching MRF lines |
$3,022.50–$4,615.50 | $4,030–$6,154 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$1,790.25–$1,844.25 | $2,387–$2,459 | varies |
| MRI lumbar spine w contrast (72149) | $3,861.75 | $5,149 | 11.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,605.50 | $3,474 | 7.9× |
| MRI orbit face &/neck w/o contrast (70540) | $3,177 | $4,236 | 14.1× |
| MRI orbit face neck w contrast (70542) | $3,861.75 | $5,149 | 11.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,022.50 | $4,030 | 9.2× |
| MRI pelvis w contrast (72196) | $3,861.75 | $5,149 | 11.7× |
| MRI pelvis w/o & w contrast (72197) | $2,605.50 | $3,474 | 7.9× |
| MRI pelvis w/o contrast (72195) | $1,590 | $2,120 | 7.0× |
| MRI thoracic spine w/o contrast (72146) | $1,709.25 | $2,279 | 7.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 4 matching MRF lines |
$3,861.75–$4,194 | $5,149–$5,592 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$1,773.75–$3,997.50 | $2,365–$5,330 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$2,605.50–$4,615.50 | $3,474–$6,154 | varies |
| MRI, abdomen, combo (74183) | $2,487 | $3,316 | 7.5× |
| MRI, dorsal spine combo (72157) | $3,022.50 | $4,030 | 9.2× |
| MRI, dorsal spine contrast (72147) | $4,375.50 | $5,834 | 13.3× |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$1,709.25–$1,760.25 | $2,279–$2,347 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$4,536.75–$4,672.50 | $6,049–$6,230 | varies |
| MRI, lumbar spine combo (72158) | $3,022.50 | $4,030 | 9.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,654.75 | $4,873 | 3.0× |
| Myocardial Spect Multiple Studies (78452) | $4,547.25 | $6,063 | 3.7× |
| Neck soft tissue (70360) | $337.50 | $450 | 4.1× |
| Nuclear Rx Oral Admin (79005) | $1,251.75 | $1,669 | 5.7× |
| Optic foramina (70190) | $674.25 | $899 | 8.2× |
| Parathyroid Planar Imaging (78070) | $1,173.75 | $1,565 | 3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,096.50 | $1,462 | 2.9× |
| Pelvis 1 or 2 views (72170) | $477.75 | $637 | 4.8× |
| Pet Image W/Ct Lmtd (78814) | $4,068.75 | $5,425 | 3.0× |
| PET image w/CT, full body (78816) | $4,734.75 | $6,313 | 3.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,698 | $6,264 | 3.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,232.25 | $1,643 | 3.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $463.50 | $618 | 4.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,632 | $2,176 | 3.2× |
| Radex Ankle Complete Minimum 3 Views (73610) | $395.25 | $527 | 4.8× |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$384–$395.25 | $512–$527 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$330.75–$340.50 | $441–$454 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $477.75 | $637 | 4.8× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$324–$333.75 | $432–$445 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$330.75–$340.50 | $441–$454 | varies |
| Radex Hand Minimum 3 Views (73130) | $340.50 | $454 | 4.1× |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$264.75–$546 | $353–$728 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $510 | $680 | 5.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $384 | $512 | 4.7× |
| Radex Ribs Unilateral 2 Views (71100) | $331.50 | $442 | 4.0× |
| Radex shoulder complete minimum 2 views (73030) | $331.50 | $442 | 4.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $291 | $388 | 3.5× |
| Radex Spine 1 View Specify Level (72020) | $288.75 | $385 | 3.5× |
| Radex Sternum Minimum 2 Views (71120) | $395.25 | $527 | 4.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $577.50 | $770 | 7.0× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$333.75–$497.25 | $445–$663 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 4 matching MRF lines |
$294.75–$410.25 | $393–$547 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$321.75–$331.50 | $429–$442 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $747 | $996 | 7.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $463.50 | $618 | 4.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $475.50 | $634 | 4.8× |
| Radiologic exam colon double contrast study (74280) | $1,012.50 | $1,350 | 6.1× |
| Radiologic exam colon single contrast study (74270) | $776.25 | $1,035 | 4.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $685.50 | $914 | 4.1× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$538.50–$555 | $718–$740 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $419.25 | $559 | 4.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,400.25 | $1,867 | 8.4× |
| Radiologic exam swallow function contrast study (74230) | $741.75 | $989 | 4.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $685.50 | $914 | 4.1× |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$298.50–$307.50 | $398–$410 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$324–$333.75 | $432–$445 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$387.75–$395.25 | $517–$527 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $693.75 | $925 | 7.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$325.50–$331.50 | $434–$442 | varies |
| Ribs bilateral 3 views (71110) | $473.25 | $631 | 4.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,304.25 | $1,739 | 3.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $4,856.25 | $6,475 | 9.5× |
| Scapula (73010) range across 4 matching MRF lines |
$463.50–$477.75 | $618–$637 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $162 | $216 | 6.9× |
| Sella turcica (70240) | $387 | $516 | 4.7× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$321–$330.75 | $428–$441 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$1,368.75–$1,410 | $1,825–$1,880 | varies |
| Sialogram (70390) | $1,017.75 | $1,357 | 4.5× |
| Skull less than 4 views (70250) | $473.25 | $631 | 4.8× |
| Sternoclavicular joints (71130) | $396.75 | $529 | 4.8× |
| Tbs technical calculation only (77091) | $234 | $312 | 2.8× |
| Thoracic spine 2 views (72070) | $337.50 | $450 | 3.4× |
| Thoracic spine 3 views (72072) | $463.50 | $618 | 4.7× |
| Thoracolumbar 2 views (72080) | $340.50 | $454 | 4.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,714.50 | $2,286 | 4.5× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$632.25–$651 | $843–$868 | varies |
| Ultrasound Exam Aaa Screen (76706) | $689.25 | $919 | 7.0× |
| Ultrasound, abdomen limited (76705) | $895.50 | $1,194 | 9.1× |
| Unlisted Dx Radiographic Procedure (76499) | $83.25 | $111 | 1.0× |
| Upper gi w/o kub (74240) | $876 | $1,168 | 5.3× |
| Urethrocystogram voiding (74455) | $894.75 | $1,193 | 4.0× |
| Urethrocystography retrograde (74450) | $844.50 | $1,126 | 3.7× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$846.75–$872.25 | $1,129–$1,163 | varies |
| Us chest (76604) | $789 | $1,052 | 8.0× |
| Us exam, pelvic, limited (76857) | $855 | $1,140 | 8.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$765.75–$789 | $1,021–$1,052 | varies |
| Us ob limited 1 or more fetuses (76815) | $895.50 | $1,194 | 9.1× |
| Us ob transvaginal (76817) | $905.25 | $1,207 | 9.2× |
| Us pelvic non ob complete (76856) | $913.50 | $1,218 | 9.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $905.25 | $1,207 | 9.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $879 | $1,172 | 8.9× |
| Us retroperitoneal complete (76770) | $730.50 | $974 | 7.4× |
| Us retroperitoneal limited (76775) | $752.25 | $1,003 | 7.6× |
| Us scrotum and contents (76870) | $913.50 | $1,218 | 9.2× |
| Us thyroid (76536) | $913.50 | $1,218 | 9.2× |
| Us transrectal (76872) | $690 | $920 | 7.0× |
| Vein X-Ray Chest (75827) | $2,910 | $3,880 | 2.0× |
| Venography extremity bilateral rs&i (75822) | $1,214.25 | $1,619 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $1,085.25 | $1,447 | 0.7× |
| Vertebral fracture assessment via dxa (77086) | $234 | $312 | 2.8× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$321–$330.75 | $428–$441 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $370.50 | $494 | 4.5× |
| X-ray antegrade pyelogram tube (74425) | $894 | $1,192 | 2.7× |
| X-Ray Bend Only L-S Spine (72120) | $555 | $740 | 5.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$376.50–$387.75 | $502–$517 | varies |
| X-Ray Exam Breast Specimen (76098) | $2,311.50 | $3,082 | 4.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $258 | $344 | 3.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $555 | $740 | 5.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $846.75 | $1,129 | 8.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $384.75 | $513 | 4.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$333.75–$340.50 | $445–$454 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$529.50–$545.25 | $706–$727 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $540 | $720 | 5.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $524.25 | $699 | 5.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $468.75 | $625 | 4.7× |
| X-Ray Exam L-S Spine Bending (72114) | $477.75 | $637 | 4.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $377.25 | $503 | 4.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $555 | $740 | 5.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 4 matching MRF lines |
$450.75–$464.25 | $601–$619 | varies |
| X-ray eye for foreign body (70030) | $414 | $552 | 5.0× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$315.75–$325.50 | $421–$434 | varies |
| X-ray IV pyelogram (ivp) (74400) | $795 | $1,060 | 4.8× |
| X-ray IV pyelogram+tomography (74415) | $1,067.25 | $1,423 | 6.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $307.50 | $410 | 3.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $456.75 | $609 | 4.6× |
| X-ray nose-rectum child f.b. (76010) | $391.50 | $522 | 4.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $555 | $740 | 5.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $540 | $720 | 5.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $331.50 | $442 | 4.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $395.25 | $527 | 4.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $534 | $712 | 5.4× |
| X-ray thoracic spine 4 vw (72074) | $381 | $508 | 3.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,888.50 | $2,518 | 5.7× |
| X-Rays Bone Length Studies (77073) | $555 | $740 | 5.6× |
| X-Rays Bone Survey Complete (77075) | $447.75 | $597 | 4.5× |
| Xr c-spine 4 or 5 views (72050) | $555 | $740 | 5.6× |
| Xr facial bones less than 3 views (70140) | $391.50 | $522 | 4.8× |
| Xr orbits complete 4 views (70200) | $428.25 | $571 | 4.3× |
| Xr Tomogram Single Plane (76100) | $760.50 | $1,014 | 7.7× |
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.