Imaging prices at Wayne Medical Center
Waynesboro, TN · every code in this section with a posted price and a Medicare benchmark.
298 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) | $166.46 | $406 | 2.1× |
| Abdomen 2 views (74019) | $166.46 | $406 | 1.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $392.78 | $958 | 1.1× |
| Angio pulmonary bilat (75743) | $277.98 | $678 | 0.1× |
| Angiography extremity bilateral rs&i (75716) | $272.65 | $665 | 0.1× |
| Angiography extremity unilateral rs&i (75710) | $266.91 | $651 | 0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $305.86 | $746 | 0.1× |
| Ankle 2 views (73600) | $166.46 | $406 | 2.1× |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$258.71 | $631 | 0.1× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$296.43 | $723 | 0.1× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,039.34 | $4,974 | 0.4× |
| Arthrogram ankle (73615) | $168.51 | $411 | 0.5× |
| Arthrogram hip (73525) | $186.55 | $455 | 0.6× |
| Arthrogram Wrist (73115) | $289.05 | $705 | 0.9× |
| Bone age studies (77072) | $116.03 | $283 | 1.2× |
| Bone Imaging 3 Phase (78315) | $753.58 | $1,838 | 2.1× |
| Bone Imaging Limited Area (78300) | $449.77 | $1,097 | 1.2× |
| Bone Imaging Whole Body (78306) | $595.32 | $1,452 | 1.6× |
| Bone survey infant (77076) | $234.11 | $571 | 2.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $619.51 | $1,511 | 1.3× |
| Cerebrospinal Fluid Scan (78630) | $771.62 | $1,882 | 1.6× |
| Chest 1 view (71045) | $170.56 | $416 | 2.2× |
| Chest 2 views (71046) | $218.12 | $532 | 2.8× |
| Chest 3 views (71047) | $93.89 | $229 | 1.2× |
| Chest 4 or more views (71048) | $97.58 | $238 | 1.0× |
| Clavicle complete (73000) | $132.02 | $322 | 1.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $758.09 | $1,849 | 8.0× |
| Contrast Exam Abdominl Aorta (75625) | $236.57 | $577 | 0.1× |
| Contrast X-Ray Bladder (74430) | $232.06 | $566 | 0.7× |
| Contrast X-Ray Of Elbow (73085) | $226.73 | $553 | 0.7× |
| Contrast X-Ray Of Knee Joint (73580) | $184.09 | $449 | 0.6× |
| CT abdomen and pelvis without and with contrast (74178) | $1,751.11 | $4,271 | 5.5× |
| CT abdomen and pelvis without contrast (74176) | $1,564.97 | $3,817 | 7.2× |
| CT abdomen w contrast (74160) | $736.36 | $1,796 | 4.6× |
| CT abdomen w wo contrast (74170) | $906.10 | $2,210 | 5.7× |
| CT abdomen w/o contrast (74150) | $674.45 | $1,645 | 7.1× |
| CT Angio Abdomen and Pelvis (74174) | $1,848.28 | $4,508 | 5.8× |
| CT Angio Chest (71275) | $821.23 | $2,003 | 5.2× |
| CT Angio Head (70496) | $821.23 | $2,003 | 5.2× |
| CT angio hrt w/3d image (75574) | $1,002.45 | $2,445 | 3.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,039.76 | $2,536 | 6.5× |
| CT Angio Neck (70498) | $821.23 | $2,003 | 5.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $749.89 | $1,829 | 4.7× |
| CT cervical spine w/ contrast (72126) | $821.23 | $2,003 | 2.6× |
| CT cervical spine w/o contrast (72125) | $971.29 | $2,369 | 10.2× |
| CT cervical spine w/wo cont (72127) | $925.37 | $2,257 | 5.8× |
| CT chest w contrast (71260) | $1,026.23 | $2,503 | 6.4× |
| CT chest w/wo contrast (71270) | $905.28 | $2,208 | 5.7× |
| CT head/brain with contrast (70460) | $854.03 | $2,083 | 5.4× |
| CT head/brain without and with contrast (70470) | $1,002.45 | $2,445 | 6.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $840.50 | $2,050 | 2.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $379.25 | $925 | 4.8× |
| CT iac w contrast (70481) | $666.25 | $1,625 | 4.2× |
| CT l-spine w&w/o contrast (72133) | $1,034.02 | $2,522 | 6.5× |
| CT lower ext w/o (73700) | $639.19 | $1,559 | 6.7× |
| CT lower extremity w/contrast material (73701) | $710.53 | $1,733 | 4.5× |
| CT lumbar spine w contrast (72132) | $881.50 | $2,150 | 2.8× |
| CT lumbar spine w/o contrast (72131) | $772.85 | $1,885 | 8.1× |
| CT maxillofacial w contrast (70487) | $733.08 | $1,788 | 4.6× |
| CT maxillofacial wo contrast (70486) | $783.10 | $1,910 | 8.3× |
| CT neck tissue combo (70492) | $778.59 | $1,899 | 4.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $824.92 | $2,012 | 5.2× |
| CT orbits w/o contrast (70480) | $652.72 | $1,592 | 6.9× |
| CT pelvis w&w/o contrast (72194) | $845.01 | $2,061 | 5.3× |
| CT pelvis w/o contrast (72192) | $629.35 | $1,535 | 6.6× |
| CT scan of leg combo (73702) | $975.39 | $2,379 | 6.1× |
| CT scans face/jaw combo (70488) | $764.65 | $1,865 | 4.8× |
| CT soft tissue neck w contrast (70491) | $740.05 | $1,805 | 4.7× |
| CT soft tissue neck w/o contrast (70490) | $620.33 | $1,513 | 6.5× |
| CT thoracic spine w contrast (72129) | $737.18 | $1,798 | 4.6× |
| CT thoracic spine w/o contrast (72128) | $684.70 | $1,670 | 7.2× |
| CT thoracic spine w/wo cont (72130) | $833.53 | $2,033 | 5.2× |
| CT thorax w/o contrast (71250) | $715.04 | $1,744 | 7.5× |
| CT upper ext wo (73200) | $638.78 | $1,558 | 6.7× |
| CT upper extremity w/o & w/contrast material (73202) range across 10 matching MRF lines |
$887.24–$932.34 | $2,164–$2,274 | varies |
| CT upper extremity with contrast (73201) | $710.53 | $1,733 | 2.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $921.68 | $2,248 | 5.8× |
| Cta Abdomen (74175) | $889.70 | $2,170 | 5.6× |
| CTA pelvis (72191) | $848.29 | $2,069 | 5.3× |
| Dilation ureters/urethra rs&i (74485) | $251.33 | $613 | 0.1× |
| Diskography lumbar (72295) | $660.51 | $1,611 | 0.4× |
| Dxa Bone Density Axial (77080) | $116.03 | $283 | 1.2× |
| Dxa bone density study (77085) | $132.02 | $322 | 1.4× |
| Echo exam uterus (76831) | $269.78 | $658 | 1.2× |
| Esophagram (74220) | $134.48 | $328 | 0.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $166.46 | $406 | 1.8× |
| Fluoroscopy up to 1 hr (76000) | $90.20 | $220 | 0.4× |
| Follow-Up Angiography (75898) | $571.13 | $1,393 | 0.2× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$116.03–$166.46 | $283–$406 | varies |
| Forearm 2 views (73090) | $166.46 | $406 | 2.1× |
| Gastric emptying imaging study (78264) | $568.67 | $1,387 | 1.6× |
| Gated Heart Planar Single (78472) | $561.29 | $1,369 | 1.5× |
| Hand 2 views (73120) | $134.48 | $328 | 1.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $656.41 | $1,601 | 0.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $656.41 | $1,601 | 0.2× |
| Hepatobil Syst Image W/Drug (78227) | $861.82 | $2,102 | 1.7× |
| Hepatobiliary System Imaging (78226) | $694.95 | $1,695 | 1.9× |
| Ht Muscle Image Spect Sing (78451) | $874.53 | $2,133 | 0.7× |
| Hysterosalpingogram (74740) | $245.18 | $598 | 1.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $367.77 | $897 | 4.7× |
| Infant hip ultrasound, limited static exam (76886) | $256.25 | $625 | 3.2× |
| K Flow/Funct Image Multiple (78709) | $708.48 | $1,728 | 1.4× |
| K Flow/Funct Image W/Drug (78708) | $578.92 | $1,412 | 1.2× |
| K Flow/Funct Image W/O Drug (78707) | $482.57 | $1,177 | 1.0× |
| Knee 3 Views (73562) | $202.95 | $495 | 2.6× |
| Liver & Spleen Imaging Static Only (78215) | $536.28 | $1,308 | 1.5× |
| Lung perfusion differential (78597) | $439.93 | $1,073 | 1.2× |
| Lung Ventilat&Perfus Imaging (78582) | $577.69 | $1,409 | 1.2× |
| Lung Ventilation Imaging (78579) | $377.20 | $920 | 1.0× |
| Lymph System Imaging (78195) | $525.62 | $1,282 | 1.1× |
| Magnetic Image Jaw Joint (70336) | $1,020.08 | $2,488 | 4.7× |
| Mammary ductogram or galactogram multiple (77054) | $248.05 | $605 | 1.1× |
| Mammary ductogram or galactogram single (77053) | $201.31 | $491 | 0.9× |
| Meckels Divert Exam (78290) | $373.51 | $911 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $1,211.96 | $2,956 | 3.8× |
| MRA head w/o contrast (70544) | $839.68 | $2,048 | 3.9× |
| MRA head with contrast (70545) | $990.56 | $2,416 | 3.1× |
| MRA neck w contrast (70548) | $922.91 | $2,251 | 2.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,211.96 | $2,956 | 3.8× |
| MRA neck w/o contrast (70547) | $786.79 | $1,919 | 3.6× |
| MRI abdomen w contrast (74182) | $1,100.03 | $2,683 | 3.5× |
| MRI abdomen w/o contrast (74181) | $922.09 | $2,249 | 4.3× |
| MRI any jt lower extrem w/contrast material (73722) | $1,039.76 | $2,536 | 1.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,257.47 | $3,067 | 4.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,042.22 | $2,542 | 1.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,054.93 | $2,573 | 4.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $966.78 | $2,358 | 4.5× |
| MRI cervical spine w contrast (72142) | $1,223.03 | $2,983 | 3.9× |
| MRI cervical spine w/o cont (72141) | $1,002.45 | $2,445 | 4.6× |
| MRI chest w/o contrast (71550) | $872.89 | $2,129 | 4.0× |
| MRI chest with contrast (71551) | $1,033.61 | $2,521 | 1.5× |
| MRI chest wo w contrast (71552) | $1,121.76 | $2,736 | 3.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,204.17 | $2,937 | 3.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,320.20 | $3,220 | 4.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $910.20 | $2,220 | 4.2× |
| MRI lumbar spine w contrast (72149) | $1,115.61 | $2,721 | 3.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,429.26 | $3,486 | 4.5× |
| MRI orbit face &/neck w/o contrast (70540) | $973.75 | $2,375 | 4.5× |
| MRI orbit face neck w contrast (70542) | $1,271.82 | $3,102 | 4.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,228.77 | $2,997 | 3.9× |
| MRI pelvis w contrast (72196) | $969.65 | $2,365 | 3.1× |
| MRI pelvis w/o & w contrast (72197) | $1,367.35 | $3,335 | 4.3× |
| MRI pelvis w/o contrast (72195) | $819.18 | $1,998 | 3.8× |
| MRI thoracic spine w/o contrast (72146) | $969.65 | $2,365 | 4.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,086.50 | $2,650 | 3.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $932.34 | $2,274 | 4.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,120.94 | $2,734 | 3.5× |
| MRI, abdomen, combo (74183) | $1,284.12 | $3,132 | 4.1× |
| MRI, dorsal spine combo (72157) | $1,422.29 | $3,469 | 4.5× |
| MRI, dorsal spine contrast (72147) | $1,055.34 | $2,574 | 3.3× |
| MRI, joint upper extrem (73221) | $913.89 | $2,229 | 4.2× |
| MRI, joint upper extrem combo (73223) | $1,476.41 | $3,601 | 4.7× |
| MRI, lumbar spine combo (72158) | $1,380.47 | $3,367 | 4.4× |
| Myocardial Spect Multiple Studies (78452) | $1,023.36 | $2,496 | 0.9× |
| N-invas est c ffr sw aly CTA (75580) | $3,451.38 | $8,418 | 4.4× |
| Neck soft tissue (70360) | $144.73 | $353 | 1.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $186.55 | $455 | 0.5× |
| Nonvascular Shunt X-Ray (75809) | $332.92 | $812 | 3.5× |
| Nuclear Rx Oral Admin (79005) | $460.02 | $1,122 | 2.2× |
| Optic foramina (70190) | $63.14 | $154 | 0.8× |
| Parathyroid Planar Imaging (78070) | $491.18 | $1,198 | 1.4× |
| Pelvis 1 or 2 views (72170) | $116.03 | $283 | 1.2× |
| Peritoneogram Rs&I (74190) | $210.74 | $514 | 0.4× |
| Pet Image W/Ct Lmtd (78814) | $2,367.34 | $5,774 | 1.8× |
| PET image w/CT, full body (78816) | $2,503.05 | $6,105 | 1.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,503.05 | $6,105 | 1.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $279.21 | $681 | 0.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $377.20 | $920 | 1.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $291.92 | $712 | 3.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $113.57 | $277 | 0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) | $194.34 | $474 | 2.5× |
| Radex Calcaneus Minimum 2 Views (73650) | $166.46 | $406 | 2.1× |
| Radex elbow complete minimum 3 views (73080) | $166.46 | $406 | 2.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $184.50 | $450 | 1.9× |
| Radex fingr minimum 2 views (73140) | $139.40 | $340 | 1.8× |
| Radex foot complete minimum 3 views (73630) | $179.58 | $438 | 2.3× |
| Radex Hand Minimum 3 Views (73130) | $166.46 | $406 | 2.1× |
| Radex lower extremity infant minimum 2 views (73592) | $116.03 | $283 | 1.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $129.56 | $316 | 1.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $116.03 | $283 | 1.5× |
| Radex Ribs Unilateral 2 Views (71100) | $166.46 | $406 | 2.1× |
| Radex shoulder complete minimum 2 views (73030) | $166.46 | $406 | 2.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $116.03 | $283 | 1.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,184.08 | $2,888 | 7.4× |
| Radex Spine 1 View Specify Level (72020) | $116.03 | $283 | 1.5× |
| Radex Sternum Minimum 2 Views (71120) | $76.67 | $187 | 1.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $134.48 | $328 | 1.7× |
| Radex Toe Minimum 2 Views (73660) | $166.46 | $406 | 2.1× |
| Radex upper extremity infant minimum 2 views (73092) | $116.03 | $283 | 1.2× |
| Radex Wrist Complete Minimum 3 Views (73110) | $166.46 | $406 | 2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $184.50 | $450 | 1.9× |
| Radiologic exam colon double contrast study (74280) | $546.94 | $1,334 | 3.4× |
| Radiologic exam colon single contrast study (74270) | $351.78 | $858 | 2.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $253.79 | $619 | 1.6× |
| Radiologic exam knee complete 4/more views (73564) | $205 | $500 | 2.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $95.12 | $232 | 1.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $275.52 | $672 | 1.7× |
| Radiologic exam swallow function contrast study (74230) | $354.24 | $864 | 2.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $321.03 | $783 | 2.0× |
| Radiologic examination femur minimum 2 views (73552) | $161.54 | $394 | 2.0× |
| Radiologic examination knee 1/2 views (73560) | $166.46 | $406 | 2.1× |
| Radiologic Examination Osseous Survey Limited (77074) | $114.80 | $280 | 1.2× |
| Radiologic examination tibia & fibula 2 views (73590) | $166.46 | $406 | 2.1× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $210.74 | $514 | 0.4× |
| Renal Cyst Study (74470) | $199.26 | $486 | 0.4× |
| Ribs bilateral 3 views (71110) | $166.46 | $406 | 1.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 3 matching MRF lines |
$279.62–$622.79 | $682–$1,519 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,047.14 | $2,554 | 2.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $782.69 | $1,909 | 1.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $717.91 | $1,751 | 1.5× |
| Scapula (73010) | $159.08 | $388 | 1.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $45.92 | $112 | 2.0× |
| Sella turcica (70240) | $68.88 | $168 | 0.9× |
| Shoulder 1 view (73020) | $116.03 | $283 | 1.5× |
| Shoulder Arthrography (73040) | $319.80 | $780 | 1.0× |
| Sialogram (70390) | $321.03 | $783 | 1.5× |
| Skull less than 4 views (70250) | $116.03 | $283 | 1.2× |
| Sternoclavicular joints (71130) | $97.58 | $238 | 1.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $151.29 | $369 | 1.0× |
| Thoracic spine 2 views (72070) | $166.46 | $406 | 1.8× |
| Thoracic spine 3 views (72072) | $207.87 | $507 | 2.2× |
| Thyroid Imaging With Vascular Flow (78013) | $306.68 | $748 | 0.8× |
| Thyroid Met Imaging Body (78018) | $653.13 | $1,593 | 1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $467.40 | $1,140 | 1.3× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$184.91–$387.86 | $451–$946 | varies |
| Ultrasound Elastography Parenchyma (76981) | $241.08 | $588 | 2.5× |
| Ultrasound Exam Aaa Screen (76706) | $297.66 | $726 | 3.1× |
| Ultrasound, abdomen limited (76705) | $336.61 | $821 | 3.5× |
| Umbilical-artery Doppler (OB) (76820) | $74.21 | $181 | 0.8× |
| Unlisted Dx Radiographic Procedure (76499) | $225.91 | $551 | 2.9× |
| Unlisted fluoroscopic procedure (76496) | $134.48 | $328 | 1.7× |
| Upper gi w/o kub (74240) | $274.29 | $669 | 1.7× |
| Urethrocystogram voiding (74455) | $279.21 | $681 | 1.3× |
| Urethrocystography retrograde (74450) | $184.91 | $451 | 0.9× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$243.95–$581.79 | $595–$1,419 | varies |
| Us chest (76604) | $172.61 | $421 | 1.8× |
| Us complete joint (76881) | $191.06 | $466 | 2.0× |
| Us exam, pelvic, limited (76857) | $252.97 | $617 | 2.7× |
| Us head (76506) | $286.59 | $699 | 3.0× |
| Us kidney transplant (76776) | $406.72 | $992 | 4.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $191.06 | $466 | 2.0× |
| Us ob limited 1 or more fetuses (76815) | $213.20 | $520 | 2.2× |
| Us ob transvaginal (76817) | $287.41 | $701 | 3.0× |
| Us pelvic non ob complete (76856) | $317.75 | $775 | 3.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $704.79 | $1,719 | 7.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $139.40 | $340 | 1.5× |
| Us retroperitoneal complete (76770) | $226.32 | $552 | 2.4× |
| Us retroperitoneal limited (76775) | $139.40 | $340 | 1.5× |
| Us scrotum and contents (76870) | $252.15 | $615 | 2.7× |
| Us spinal canal and contents (76800) | $291.51 | $711 | 3.1× |
| Us thyroid (76536) | $302.58 | $738 | 3.2× |
| Us transrectal (76872) | $280.44 | $684 | 3.0× |
| Vein X-Ray Chest (75827) | $499.79 | $1,219 | 0.3× |
| Venography Adrenal Unilateral (75840) | $1,225.90 | $2,990 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $1,189 | $2,900 | 0.4× |
| Venography extremity bilateral rs&i (75822) | $720.37 | $1,757 | 0.5× |
| Venography extremity unilateral rs&i (75820) | $560.88 | $1,368 | 0.4× |
| Venography Renal Bilateral (75833) | $1,225.90 | $2,990 | 0.4× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$590.40 | $1,440 | 0.1× |
| Wrist 2 views (73100) | $82.82 | $202 | 1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $90.20 | $220 | 1.1× |
| X-ray antegrade pyelogram tube (74425) | $231.65 | $565 | 0.7× |
| X-Ray Aorta Leg Arteries (75630) | $250.10 | $610 | 0.1× |
| X-Ray Bend Only L-S Spine (72120) | $116.03 | $283 | 1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $166.46 | $406 | 2.1× |
| X-Ray Exam Breast Specimen (76098) | $92.66 | $226 | 0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $116.03 | $283 | 1.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $176.30 | $430 | 1.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $134.48 | $328 | 1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $166.46 | $406 | 2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $152.52 | $372 | 1.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $177.53 | $433 | 1.9× |
| X-Ray Exam L-S Spine Bending (72114) | $287 | $700 | 3.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $195.16 | $476 | 2.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $225.50 | $550 | 2.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$149.24–$166.46 | $364–$406 | varies |
| X-ray eye for foreign body (70030) | $72.98 | $178 | 0.9× |
| X-ray humerus (73060) | $166.46 | $406 | 2.1× |
| X-ray IV pyelogram (ivp) (74400) | $356.70 | $870 | 2.2× |
| X-ray IV pyelogram+tomography (74415) | $440.34 | $1,074 | 2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $93.89 | $229 | 1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $116.03 | $283 | 1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $234.11 | $571 | 2.5× |
| X-ray nose-rectum child f.b. (76010) | $116.03 | $283 | 1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $166.46 | $406 | 1.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $166.46 | $406 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $116.03 | $283 | 1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $86.51 | $211 | 1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $170.15 | $415 | 1.8× |
| X-Ray Stress View (77071) | $70.52 | $172 | 0.9× |
| X-Ray Tmj Unilat (70328) | $82.82 | $202 | 1.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $166.46 | $406 | 0.5× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$151.70–$379.25 | $370–$925 | varies |
| X-Rays Bone Survey Complete (77075) | $231.65 | $565 | 2.4× |
| Xr c-spine 4 or 5 views (72050) | $212.79 | $519 | 2.2× |
| Xr facial bones less than 3 views (70140) | $116.03 | $283 | 1.5× |
| Xr orbits complete 4 views (70200) | $135.71 | $331 | 1.4× |
| Xr Tomogram Single Plane (76100) | $229.19 | $559 | 2.4× |
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.