Imaging prices at West Valley Medical Center
Caldwell, ID · every code in this section with a posted price and a Medicare benchmark.
250 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Abdomen 2 views (74019) | $485.29 | $485.29 | 4.6× |
| Acute gi blood loss imaging (78278) | $3,205.04 | $3,205.04 | 7.9× |
| Angiography extremity bilateral rs&i (75716) | $8,708.58 | $8,708.58 | 2.7× |
| Angiography extremity unilateral rs&i (75710) | $8,708.58 | $8,708.58 | 2.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) | $8,708.58 | $8,708.58 | 1.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) | $9,746.32 | $9,746.32 | 3.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $9,024.36 | $9,024.36 | 2.8× |
| Ankle 2 views (73600) | $1,014.02 | $1,014.02 | 11.5× |
| Aortogram thoracic (75605) | $8,708.58 | $8,708.58 | 1.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) | $8,708.58 | $8,708.58 | 2.7× |
| Aortography abdominal serialography rs&i (75625) | $8,708.58 | $8,708.58 | 2.7× |
| Arthrogram ankle (73615) | $692.74 | $692.74 | 2.0× |
| Arthrogram elbow (73085) | $939.30 | $939.30 | 2.7× |
| Arthrogram hip (73525) | $1,535.54 | $1,535.54 | 4.4× |
| Arthrogram knee (73580) | $1,615.95 | $1,615.95 | 4.6× |
| Arthrogram shoulder (73040) | $1,628.79 | $1,628.79 | 4.6× |
| Arthrogram wrist (73115) | $1,478.66 | $1,478.66 | 4.2× |
| Bone &/Joint Imaging Limited Area (78300) | $1,602.71 | $1,602.71 | 4.0× |
| Bone &/joint imaging whole body (78306) | $3,568.17 | $3,568.17 | 8.8× |
| Bone age studies (77072) | $688.21 | $688.21 | 6.5× |
| Bone Imaging 3 Phase (78315) | $3,748.63 | $3,748.63 | 9.3× |
| Bone survey complete (77075) | $2,040.23 | $2,040.23 | 19.3× |
| Bone survey infant (77076) | $1,405.33 | $1,405.33 | 13.3× |
| Bowel imaging (78290) | $2,555.45 | $2,555.45 | 6.3× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) | $3,211.80 | $3,211.80 | 8.0× |
| Cervical spine 2 or 3 views (72040) | $821.45 | $821.45 | 9.3× |
| Chest 1 view (71045) | $256.41 | $256.41 | 2.9× |
| Chest xray 3 views (71047) | $246.92 | $246.92 | 2.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) | $1,147.78 | $1,147.78 | 6.5× |
| Clavicle complete (73000) | $688.21 | $688.21 | 7.8× |
| CT abdomen and pelvis without and with contrast (74178) | $8,852.52 | $8,852.52 | 25.1× |
| CT abdomen and pelvis without contrast (74176) | $6,250.61 | $6,250.61 | 25.9× |
| CT abdomen w contrast (74160) | $3,788.32 | $3,788.32 | 21.4× |
| CT abdomen w wo contrast (74170) | $4,427.34 | $4,427.34 | 25.0× |
| CT abdomen w/o contrast (74150) | $2,765.03 | $2,765.03 | 26.2× |
| CT angio hrt w/3d image (75574) | $1,650.81 | $1,650.81 | 4.7× |
| CT angio lwr extr w/o&w/dye (73706) | $3,515.72 | $3,515.72 | 19.8× |
| CT angiography upper extremity lt (73206) | $3,515.72 | $3,515.72 | 19.8× |
| CT c-spine w/contrast (72126) | $5,016.23 | $5,016.23 | 14.2× |
| CT c-spine w/o contrast (72125) | $4,377.21 | $4,377.21 | 41.4× |
| CT cervical spine w&w/o contrast (72127) | $4,959.66 | $4,959.66 | 28.0× |
| CT chest w contrast (71260) | $5,166.68 | $5,166.68 | 29.2× |
| CT chest w/wo contrast (71270) | $5,753.37 | $5,753.37 | 32.5× |
| CT head/brain with contrast (70460) | $4,734.87 | $4,734.87 | 26.7× |
| CT head/brain without and with contrast (70470) | $5,677.04 | $5,677.04 | 32.0× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,070.29 | $1,070.29 | 3.0× |
| CT heart w/o contrast quant eval coronary calcium (75571) | $69 | $69 | 0.8× |
| CT hrt w/3d image congen (75573) | $1,650.81 | $1,650.81 | 4.7× |
| CT iac w contrast (70481) | $3,956.28 | $3,956.28 | 22.3× |
| CT lower ext w/o (73700) | $1,989.04 | $1,989.04 | 18.8× |
| CT lower extremity w wo contrast (73702) | $2,578.78 | $2,578.78 | 14.6× |
| CT lower extremity w/contrast material (73701) | $2,388.14 | $2,388.14 | 13.5× |
| CT lumbar spine w & w/o contrast (72133) | $5,157.58 | $5,157.58 | 29.1× |
| CT lumbar spine w/contrast (72132) | $5,016.23 | $5,016.23 | 14.2× |
| CT lumbar spine w/o contrast (72131) | $3,271.88 | $3,271.88 | 31.0× |
| CT maxillofacial w contrast (70487) | $4,377.21 | $4,377.21 | 24.7× |
| CT maxillofacial w/wo contrast (70488) | $3,711.67 | $3,711.67 | 20.9× |
| CT maxillofacial wo contrast (70486) | $2,843.97 | $2,843.97 | 26.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) | $4,023.87 | $4,023.87 | 22.7× |
| CT orbits w/o contrast (70480) | $4,115.47 | $4,115.47 | 39.0× |
| CT pelvis w/o contrast (72192) | $3,088.25 | $3,088.25 | 29.2× |
| CT pelvis w/wo contrast (72194) | $4,427.34 | $4,427.34 | 25.0× |
| CT scan of arm combo (73202) | $2,578.78 | $2,578.78 | 14.6× |
| CT soft tissue neck w contrast (70491) | $4,913.68 | $4,913.68 | 27.7× |
| CT soft tissue neck w/o & w/contrast material (70492) | $5,210.08 | $5,210.08 | 29.4× |
| CT soft tissue neck w/o contrast (70490) | $4,165.64 | $4,165.64 | 39.4× |
| CT thoracic spine w/contrast (72129) | $5,016.23 | $5,016.23 | 28.3× |
| CT thoracic spine w/o contrast (72128) | $2,774.56 | $2,774.56 | 26.3× |
| CT thoracic spine w/wo contrast (72130) | $5,157.58 | $5,157.58 | 29.1× |
| CT thorax w/o contrast (71250) | $2,774.56 | $2,774.56 | 26.3× |
| CT upper ext wo (73200) | $2,257.31 | $2,257.31 | 21.4× |
| CT upper extremity with contrast (73201) | $2,388.14 | $2,388.14 | 6.8× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) | $6,784.95 | $6,784.95 | 38.3× |
| Cta Abdomen (74175) | $6,555.99 | $6,555.99 | 37.0× |
| CTA abdomen pelvis (74174) | $12,782.58 | $12,782.58 | 36.3× |
| CTA chest (71275) | $6,344.42 | $6,344.42 | 35.8× |
| Cta Head (70496) | $6,252.82 | $6,252.82 | 35.3× |
| Cta Neck (70498) | $6,307.33 | $6,307.33 | 35.6× |
| Cta Pelvis (72191) | $5,765.40 | $5,765.40 | 32.5× |
| Cystography minimum 3 views rs&i (74430) | $1,158.90 | $1,158.90 | 3.3× |
| Dxa bone density study 1/> sites axial skel (77080) | $824.73 | $824.73 | 7.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $190.35 | $190.35 | 2.2× |
| Dxa bone density study axial skeleton (77085) | $430.27 | $430.27 | 4.1× |
| Esophagus (74220) | $1,229.43 | $1,229.43 | 6.9× |
| Facial bones min 3 views (70150) | $1,138.83 | $1,138.83 | 10.8× |
| Fetal biophysical profile non-stress testing (76818) | $1,254.47 | $1,254.47 | 11.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $996.66 | $996.66 | 9.4× |
| Fluoroscopy up to 1 hr (76000) | $1,355.47 | $1,355.47 | 5.6× |
| Foot 2 views (73620) | $688.21 | $688.21 | 7.8× |
| Forearm 2 views (73090) | $688.21 | $688.21 | 7.8× |
| Hand 2 views (73120) | $688.21 | $688.21 | 6.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) | $3,405.78 | $3,405.78 | 6.2× |
| Hepatobiliary syst imaging including gallbladder (78226) | $2,483.29 | $2,483.29 | 6.1× |
| Hysterosalpingogram (74740) | $1,411.96 | $1,411.96 | 5.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) | $3,342.61 | $3,342.61 | 6.1× |
| Knee 3 views (73562) | $751.33 | $751.33 | 8.5× |
| Lung perfusion differential (78597) | $4,422.99 | $4,422.99 | 11.0× |
| Lymphoscintigraphy (78195) | $1,930.69 | $1,930.69 | 3.5× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) | $2,808.87 | $2,808.87 | 3.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) | $4,260.91 | $4,260.91 | 12.1× |
| Mammary ductogram or galactogram multiple (77054) | $1,908.40 | $1,908.40 | 7.9× |
| Mammary ductogram or galactogram single (77053) | $996.62 | $996.62 | 4.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $67.35 | $67.35 | 2.3× |
| MRA head w & w/o contrast (70546) | $3,267.68 | $3,267.68 | 9.3× |
| MRA head w/o contrast (70544) | $2,286.61 | $2,286.61 | 9.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,960.74 | $3,960.74 | 11.2× |
| MRA neck w/o contrast (70547) | $3,170.08 | $3,170.08 | 13.1× |
| MRI abdomen w/o & w/contrast material (74183) | $3,541.03 | $3,541.03 | 10.0× |
| MRI abdomen w/o contrast (74181) | $2,286.61 | $2,286.61 | 9.5× |
| MRI any jt lower extrem w/contrast material (73722) | $2,957.76 | $2,957.76 | 3.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,159.79 | $3,159.79 | 9.0× |
| MRI breast w/o contrast bilateral (77047) | $897.74 | $897.74 | 3.7× |
| MRI c-spine with contrast (72142) | $3,541.03 | $3,541.03 | 10.0× |
| MRI cervical spine w/o contrast (72141) | $1,845.12 | $1,845.12 | 7.7× |
| MRI chest w/o & w/contrast material (71552) | $1,457.48 | $1,457.48 | 4.1× |
| MRI chest w/o contrast (71550) | $2,340.98 | $2,340.98 | 9.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,541.03 | $3,541.03 | 10.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,118.24 | $2,118.24 | 8.8× |
| MRI orbit face &/neck w/o contrast (70540) | $1,966.97 | $1,966.97 | 8.2× |
| MRI orbit/face/neck w&w/o cont (70543) | $3,638.62 | $3,638.62 | 10.3× |
| MRI pelvis w/o & w/contrast material (72197) | $3,289.66 | $3,289.66 | 9.3× |
| MRI pelvis w/o contrast (72195) | $2,354.97 | $2,354.97 | 9.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) | $2,453.96 | $2,453.96 | 7.0× |
| MRI spinal canal lumbar w/contrast material (72149) | $2,672.21 | $2,672.21 | 7.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) | $2,213 | $2,213 | 6.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) | $2,903.20 | $2,903.20 | 8.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) | $2,276.68 | $2,276.68 | 6.5× |
| MRI thoracic spine w/o contrast (72146) | $1,505.88 | $1,505.88 | 6.2× |
| MRI up ext w/o contrast (73218) | $2,130.47 | $2,130.47 | 8.8× |
| MRI upper ext joint w/o contrast (73221) | $2,286.61 | $2,286.61 | 9.5× |
| MRI, joint upper extrem combo (73223) | $3,233.51 | $3,233.51 | 9.2× |
| Myocardial Spect Multiple Studies (78452) | $4,777.10 | $4,777.10 | 3.7× |
| Myocardial spect single study at rest or stress (78451) | $4,163.61 | $4,163.61 | 3.2× |
| Neck soft tissue (70360) | $688.21 | $688.21 | 7.8× |
| Nm gastric emptying study (78264) | $2,722.36 | $2,722.36 | 6.7× |
| Nonvascular shunt X-ray (75809) | $639.53 | $639.53 | 6.1× |
| Ob us nuchal meas 1 gest (76813) | $482.10 | $482.10 | 4.6× |
| Osseous survey limited (77074) | $1,438.93 | $1,438.93 | 13.6× |
| Parathyrd planar w/spect&CT (78072) | $4,143.30 | $4,143.30 | 7.6× |
| Parathyroid Planar Imaging (78070) | $3,011.06 | $3,011.06 | 7.5× |
| Pelvis 1 or 2 views (72170) | $690.44 | $690.44 | 6.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) | $2,541.57 | $2,541.57 | 4.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,411.96 | $1,411.96 | 2.6× |
| Radex Ankle Compl Minimum 3 Views (73610) | $641.24 | $641.24 | 7.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $688.21 | $688.21 | 7.8× |
| Radex Elbw Compl Minimum 3 Views (73080) | $714.63 | $714.63 | 8.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) | $281.97 | $281.97 | 3.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) | $466.93 | $466.93 | 4.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) | $890.22 | $890.22 | 8.4× |
| Radex fingr minimum 2 views (73140) | $630.49 | $630.49 | 7.2× |
| Radex Foot Compl Minimum 3 Views (73630) | $677.94 | $677.94 | 7.7× |
| Radex Hand Minimum 3 Views (73130) | $714.63 | $714.63 | 8.1× |
| Radex Hip Unilateral With Pelvis 1 View (73501) | $281.97 | $281.97 | 3.2× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) | $432.33 | $432.33 | 4.1× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) | $466.93 | $466.93 | 4.4× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) | $890.22 | $890.22 | 8.4× |
| Radex Humerus Minimum 2 Views (73060) | $717.09 | $717.09 | 8.2× |
| Radex Kne 1/2 Views (73560) | $677.94 | $677.94 | 7.7× |
| Radex Kne Compl 4/More Views (73564) | $985.73 | $985.73 | 9.3× |
| Radex Mndbl Compl Minimum 4 Views (70110) | $1,116.69 | $1,116.69 | 10.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $708.18 | $708.18 | 8.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) | $931.20 | $931.20 | 8.8× |
| Radex Sho Compl Minimum 2 Views (73030) | $714.63 | $714.63 | 8.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $579.19 | $579.19 | 6.6× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) | $1,025.70 | $1,025.70 | 9.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $904.46 | $904.46 | 10.3× |
| Radex Toe Minimum 2 Views (73660) | $619.39 | $619.39 | 7.0× |
| Radex upper extremity infant minimum 2 views (73092) | $703.76 | $703.76 | 6.7× |
| Radex Wrst Compl Minimum 3 Views (73110) | $608.41 | $608.41 | 6.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $890.22 | $890.22 | 8.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) | $256.41 | $256.41 | 2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $490.24 | $490.24 | 4.6× |
| Radiologic exam chest 2 views (71046) | $256.41 | $256.41 | 2.9× |
| Radiologic exam colon single contrast study (74270) | $1,680.60 | $1,680.60 | 9.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,350.38 | $1,350.38 | 7.6× |
| Radiologic exam upr gi trc single contrast study (74240) | $1,489.67 | $1,489.67 | 8.4× |
| Radiologic examination femur 1 view (73551) | $281.97 | $281.97 | 3.2× |
| Radiologic examination tibia & fibula 2 views (73590) | $821.45 | $821.45 | 9.3× |
| Radiological examination surgical specimen (76098) | $1,789.30 | $1,789.30 | 3.2× |
| Ribs bilateral 3 views (71110) | $925.02 | $925.02 | 8.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,286.85 | $5,286.85 | 9.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) | $2,889.27 | $2,889.27 | 5.3× |
| Scapula (73010) | $688.21 | $688.21 | 6.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $591.51 | $591.51 | 25.3× |
| Shoulder 1 view (73020) | $785.89 | $785.89 | 8.9× |
| Sialogram (70390) | $1,313.72 | $1,313.72 | 5.4× |
| Small bowel series (74250) | $1,567.36 | $1,567.36 | 8.8× |
| Spine thoracic 3 views (72072) | $1,005.67 | $1,005.67 | 9.5× |
| Thoracolumbar 2 views (72080) | $821.45 | $821.45 | 9.3× |
| Thyroid uptake measurement (78012) | $1,330.73 | $1,330.73 | 3.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,483.29 | $2,483.29 | 6.1× |
| Ultrasound breast complete (76641) | $441.90 | $441.90 | 4.2× |
| Ultrasound Exam Aaa Screen (76706) | $935.37 | $935.37 | 8.9× |
| Ultrasound, abdomen limited (76705) | $1,215.31 | $1,215.31 | 11.5× |
| Urethrocystogram voiding (74455) | $1,076.75 | $1,076.75 | 4.5× |
| Urethrocystography retrograde rs&i (74450) | $1,158.90 | $1,158.90 | 4.8× |
| Us breast unilateral limited (76642) | $441.90 | $441.90 | 5.0× |
| Us chest (76604) | $782.13 | $782.13 | 7.4× |
| Us compl joint r-t w/image documentation (76881) | $816.83 | $816.83 | 7.7× |
| Us encephalogram (76506) | $1,172.15 | $1,172.15 | 11.1× |
| Us infant hips w manipulation (76885) | $740.97 | $740.97 | 8.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $537.33 | $537.33 | 5.1× |
| Us ob limited (76815) | $877.79 | $877.79 | 8.3× |
| Us ob transvaginal (76817) | $688.94 | $688.94 | 6.5× |
| Us pelvic non ob complete (76856) | $1,215.31 | $1,215.31 | 11.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) | $519.86 | $519.86 | 4.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $828.27 | $828.27 | 7.8× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) | $578.36 | $578.36 | 5.5× |
| Us retroperitoneal complete (76770) | $1,327.56 | $1,327.56 | 12.6× |
| Us retroperitoneal limited (76775) | $972.82 | $972.82 | 9.2× |
| Us scrotum and contents (76870) | $1,039.20 | $1,039.20 | 9.8× |
| Us soft tissue head/neck (76536) | $687.24 | $687.24 | 6.5× |
| Us spinal canal and contents (76800) | $818.97 | $818.97 | 7.8× |
| Venogram extremity bilateral (75822) | $2,837.64 | $2,837.64 | 1.8× |
| Venogram Extremity Unilateral (75820) | $3,925.08 | $3,925.08 | 2.5× |
| Venography caval inferior serialography rs&i (75825) | $8,708.58 | $8,708.58 | 2.7× |
| Venography caval superior serialography rs&i (75827) | $3,620.93 | $3,620.93 | 2.3× |
| Wrist 2 views (73100) | $688.21 | $688.21 | 7.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $888.03 | $888.03 | 10.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) | $1,860.35 | $1,860.35 | 10.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $832.53 | $832.53 | 9.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $281.97 | $281.97 | 3.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $466.93 | $466.93 | 4.4× |
| X-ray exam of femur 2/> (73552) | $281.97 | $281.97 | 3.2× |
| X-ray eye for foreign body (70030) | $492.85 | $492.85 | 5.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) | $828.08 | $828.08 | 9.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $710.42 | $710.42 | 8.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $577.21 | $577.21 | 6.6× |
| X-ray leg, infant (73592) | $708.18 | $708.18 | 8.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $821.45 | $821.45 | 7.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) | $1,411.96 | $1,411.96 | 13.4× |
| X-ray nose-rectum child f.b. (76010) | $597.21 | $597.21 | 6.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) | $734.69 | $734.69 | 7.0× |
| X-ray retrograde pyelogram (74420) | $1,749.41 | $1,749.41 | 5.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) | $861.39 | $861.39 | 8.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,081.19 | $1,081.19 | 10.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,038.99 | $1,038.99 | 9.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $852.52 | $852.52 | 9.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,030.13 | $1,030.13 | 11.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,307.61 | $1,307.61 | 12.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) | $653.46 | $653.46 | 6.2× |
| X-Ray Spine One View - Xr Spine (72020) | $532.49 | $532.49 | 6.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) | $871.58 | $871.58 | 9.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) | $1,116.69 | $1,116.69 | 12.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) | $821.45 | $821.45 | 7.8× |
| Xr bone length studies (77073) | $814.77 | $814.77 | 7.7× |
| Xr c-spine 4 or 5 views (72050) | $1,229.93 | $1,229.93 | 11.6× |
| Xr c-spine 6 or more views (72052) | $1,411.96 | $1,411.96 | 13.4× |
| Xr chest 4+ views (71048) | $721.54 | $721.54 | 6.8× |
| Xr urogram antegrade (74425) | $923.12 | $923.12 | 2.6× |