Imaging prices at Westover Hills Baptist Hospital
San Antonio, TX · every code in this section with a posted price and a Medicare benchmark.
311 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) | $996 | $1,328 | 11.4× |
| Abdomen 2 views (74019) | $1,034.25 | $1,379 | 9.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $4,802.25 | $6,403 | 12.0× |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$2,644.50–$10,098.75 | $3,526–$13,465 | varies |
| Angio pulmonary bilat (75743) | $6,114 | $8,152 | 1.9× |
| Angiography extremity bilateral rs&i (75716) | $7,396.50 | $9,862 | 2.3× |
| Angiography extremity unilateral rs&i (75710) | $6,719.25 | $8,959 | 2.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $6,938.25 | $9,251 | 2.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,952 | $3,936 | 0.9× |
| Ankle 2 views (73600) | $1,526.25 | $2,035 | 17.5× |
| Aortography thoracic serialography rs&i (75605) | $5,682 | $7,576 | 1.0× |
| Artery X-Rays Abdomen (75726) | $10,320.75 | $13,761 | 1.8× |
| Artery X-Rays Pelvis (75736) | $8,010.75 | $10,681 | 1.4× |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$7,573.50–$11,366.25 | $10,098–$15,155 | varies |
| Arthrogram hip (73525) | $3,024.75 | $4,033 | 8.6× |
| Arthrogram Wrist (73115) | $1,341.75 | $1,789 | 3.8× |
| Bone age studies (77072) | $737.25 | $983 | 7.0× |
| Bone Imaging 3 Phase (78315) | $5,031 | $6,708 | 12.5× |
| Bone Imaging Limited Area (78300) | $2,686.50 | $3,582 | 6.7× |
| Bone Imaging Multiple Areas (78305) | $3,711.75 | $4,949 | 9.2× |
| Bone Imaging Whole Body (78306) | $4,117.50 | $5,490 | 10.3× |
| Bone survey infant (77076) | $2,083.50 | $2,778 | 19.8× |
| Brain Flow Imaging Only (78610) | $2,296.50 | $3,062 | 4.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $5,778 | $7,704 | 16.5× |
| Cat Scan Follow-Up Study (76380) | $1,857 | $2,476 | 21.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,060.25 | $2,747 | 3.8× |
| Cerebrospinal Fluid Scan (78630) | $3,518.25 | $4,691 | 6.5× |
| Chest 1 view (71045) | $1,155 | $1,540 | 13.2× |
| Chest 2 views (71046) | $1,487.25 | $1,983 | 17.0× |
| Chest 3 views (71047) | $1,487.25 | $1,983 | 17.0× |
| Chest 4 or more views (71048) | $1,912.50 | $2,550 | 18.2× |
| Clavicle complete (73000) | $1,842.75 | $2,457 | 21.1× |
| Contrast Exam Abdominl Aorta (75625) | $9,234.75 | $12,313 | 2.9× |
| Contrast X-Ray Bladder (74430) | $2,403 | $3,204 | 6.9× |
| Contrast X-Ray Of Elbow (73085) | $1,531.50 | $2,042 | 4.4× |
| Contrast X-Ray Of Knee Joint (73580) | $1,509 | $2,012 | 4.3× |
| CT abdomen and pelvis without and with contrast (74178) | $23,517.75 | $31,357 | 67.1× |
| CT abdomen and pelvis without contrast (74176) | $19,806.75 | $26,409 | 82.6× |
| CT abdomen w contrast (74160) | $10,384.50 | $13,846 | 58.9× |
| CT abdomen w wo contrast (74170) | $10,583.25 | $14,111 | 60.1× |
| CT abdomen w/o contrast (74150) | $9,668.25 | $12,891 | 92.1× |
| CT Angio Abdomen and Pelvis (74174) | $23,259 | $31,012 | 66.4× |
| CT Angio Chest (71275) | $11,974.50 | $15,966 | 68.0× |
| CT Angio Head (70496) | $10,668.75 | $14,225 | 60.5× |
| CT angio hrt w/3d image (75574) | $19,534.50 | $26,046 | 55.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $6,828 | $9,104 | 38.8× |
| CT Angio Neck (70498) | $10,668.75 | $14,225 | 60.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $7,924.50 | $10,566 | 45.0× |
| CT cervical spine w/ contrast (72126) | $7,742.25 | $10,323 | 22.1× |
| CT cervical spine w/o contrast (72125) | $6,368.25 | $8,491 | 60.6× |
| CT cervical spine w/wo cont (72127) | $8,680.50 | $11,574 | 49.3× |
| CT chest w contrast (71260) | $8,592 | $11,456 | 48.8× |
| CT chest w/wo contrast (71270) | $8,783.25 | $11,711 | 49.8× |
| CT colonography screening (74263) | $2,754.75 | $3,673 | 11.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $3,742.50 | $4,990 | 35.6× |
| CT head/brain with contrast (70460) | $6,649.50 | $8,866 | 37.7× |
| CT head/brain without and with contrast (70470) | $7,005 | $9,340 | 39.8× |
| CT heart contrast eval cardiac structure&morph (75572) | $9,939 | $13,252 | 28.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $3,654 | $4,872 | 41.8× |
| CT hrt w/3d image congen (75573) | $12,858.75 | $17,145 | 36.7× |
| CT iac w contrast (70481) | $7,749 | $10,332 | 44.0× |
| CT l-spine w&w/o contrast (72133) | $8,593.50 | $11,458 | 48.8× |
| CT lower ext w/o (73700) | $4,758 | $6,344 | 45.3× |
| CT lower extremity w/contrast material (73701) | $5,595.75 | $7,461 | 31.8× |
| CT lumbar spine w contrast (72132) | $6,557.25 | $8,743 | 18.7× |
| CT lumbar spine w/o contrast (72131) | $6,265.50 | $8,354 | 59.7× |
| CT maxillofacial w contrast (70487) | $7,519.50 | $10,026 | 42.7× |
| CT maxillofacial wo contrast (70486) | $7,374.75 | $9,833 | 70.2× |
| CT neck tissue combo (70492) | $9,726.75 | $12,969 | 55.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $8,306.25 | $11,075 | 47.1× |
| CT orbits w/o contrast (70480) | $6,463.50 | $8,618 | 61.5× |
| CT pelvis w&w/o contrast (72194) | $10,161.75 | $13,549 | 57.7× |
| CT pelvis w/o contrast (72192) | $7,278 | $9,704 | 69.3× |
| CT scan of leg combo (73702) | $6,055.50 | $8,074 | 34.4× |
| CT scans face/jaw combo (70488) | $9,435.75 | $12,581 | 53.6× |
| CT soft tissue neck w contrast (70491) | $8,346.75 | $11,129 | 47.4× |
| CT soft tissue neck w/o contrast (70490) | $7,849.50 | $10,466 | 74.7× |
| CT thoracic spine w contrast (72129) | $7,236 | $9,648 | 41.1× |
| CT thoracic spine w/o contrast (72128) | $7,224.75 | $9,633 | 68.8× |
| CT thoracic spine w/wo cont (72130) | $9,011.25 | $12,015 | 51.1× |
| CT thorax w/o contrast (71250) | $7,046.25 | $9,395 | 67.1× |
| CT upper ext wo (73200) | $7,515 | $10,020 | 71.6× |
| CT upper extremity w/o & w/contrast material (73202) | $11,118.75 | $14,825 | 63.1× |
| CT upper extremity with contrast (73201) | $10,672.50 | $14,230 | 30.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $14,879.25 | $19,839 | 84.4× |
| Cta Abdomen (74175) | $12,535.50 | $16,714 | 71.1× |
| CTA pelvis (72191) | $8,237.25 | $10,983 | 46.7× |
| Dilation ureters/urethra rs&i (74485) | $3,410.25 | $4,547 | 1.6× |
| Diskography lumbar (72295) | $2,114.25 | $2,819 | 1.1× |
| Echo Guide For Artery Repair (76936) | $1,783.50 | $2,378 | 8.2× |
| Esophagram (74220) | $1,749.75 | $2,333 | 9.9× |
| Fetal Biophys Profile W/Nst (76818) | $4,431 | $5,908 | 42.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $2,259.75 | $3,013 | 21.5× |
| Fluoroscopy up to 1 hr (76000) | $2,070 | $2,760 | 8.6× |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$3,468–$4,006.50 | $4,624–$5,342 | varies |
| Foot 2 views (73620) | $1,689 | $2,252 | 19.3× |
| Forearm 2 views (73090) | $1,549.50 | $2,066 | 17.7× |
| Gastric emptying imaging study (78264) | $4,802.25 | $6,403 | 12.0× |
| Gastroesophageal Reflux Exam (78262) | $3,686.25 | $4,915 | 9.2× |
| Gated Heart Planar Single (78472) | $5,860.50 | $7,814 | 14.6× |
| Hand 2 views (73120) | $1,204.50 | $1,606 | 11.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,480 | $4,640 | 1.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $6,060.75 | $8,081 | 1.9× |
| Hepatobil Syst Image W/Drug (78227) | $5,076 | $6,768 | 9.3× |
| Hepatobiliary System Imaging (78226) | $5,076 | $6,768 | 12.6× |
| Ht Musc Image Planar Mult (78454) | $5,706.75 | $7,609 | 4.4× |
| Ht Muscle Image Spect Sing (78451) | $12,340.50 | $16,454 | 9.5× |
| Hysterosalpingogram (74740) | $3,480 | $4,640 | 14.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $2,226.75 | $2,969 | 25.5× |
| Infant hip ultrasound, limited static exam (76886) | $1,711.50 | $2,282 | 19.6× |
| Infusion Ivp (74410) | $1,410.75 | $1,881 | 8.0× |
| K Flow/Funct Image Multiple (78709) | $5,883 | $7,844 | 10.8× |
| K Flow/Funct Image W/Drug (78708) | $5,683.50 | $7,578 | 10.4× |
| K Flow/Funct Image W/O Drug (78707) | $4,560.75 | $6,081 | 8.4× |
| Knee 3 Views (73562) | $1,398.75 | $1,865 | 16.0× |
| Leveen/Shunt Patency Exam (78291) | $1,444.50 | $1,926 | 3.6× |
| Liver & Spleen Imaging Static Only (78215) | $4,059 | $5,412 | 10.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $2,553 | $3,404 | 6.4× |
| Liver imaging static only (78201) | $3,687 | $4,916 | 6.8× |
| Lung Perf&Ventilat Diferentl (78598) | $2,756.25 | $3,675 | 5.1× |
| Lung perfusion differential (78597) | $2,261.25 | $3,015 | 5.6× |
| Lung Ventilat&Perfus Imaging (78582) | $3,867.75 | $5,157 | 7.1× |
| Lung Ventilation Imaging (78579) | $2,756.25 | $3,675 | 6.9× |
| Lymph System Imaging (78195) | $5,076 | $6,768 | 9.3× |
| Magnetic Image Jaw Joint (70336) | $3,580.50 | $4,774 | 14.9× |
| Meckels Divert Exam (78290) | $3,260.25 | $4,347 | 8.1× |
| Mr safety determination physician/other qhp (76016) | $540.75 | $721 | 6.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $150.75 | $201 | 5.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $564 | $752 | 5.9× |
| Mr safety implt pos&/immoblj (76019) | $364.50 | $486 | 6.2× |
| Mr safety med physics xm customization plng&mntr (76017) | $1,484.25 | $1,979 | 6.2× |
| Mra Head W/O & W/Contrast Material (70546) | $11,869.50 | $15,826 | 33.9× |
| MRA head w/o contrast (70544) | $9,384.75 | $12,513 | 39.2× |
| MRA head with contrast (70545) | $10,354.50 | $13,806 | 29.5× |
| MRA neck w contrast (70548) | $10,354.50 | $13,806 | 29.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $11,869.50 | $15,826 | 33.9× |
| MRA neck w/o contrast (70547) | $8,962.50 | $11,950 | 37.4× |
| MRI abdomen w contrast (74182) | $8,687.25 | $11,583 | 24.8× |
| MRI abdomen w/o contrast (74181) | $8,493 | $11,324 | 35.4× |
| MRI any jt lower extrem w/contrast material (73722) | $10,685.25 | $14,247 | 13.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $11,181.75 | $14,909 | 31.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $11,751.75 | $15,669 | 14.9× |
| MRI cardiac w/o contrast (75557) | $4,626.75 | $6,169 | 19.3× |
| MRI cervical spine w contrast (72142) | $15,708 | $20,944 | 44.8× |
| MRI cervical spine w/o cont (72141) | $15,000 | $20,000 | 62.6× |
| MRI chest w/o contrast (71550) | $6,841.50 | $9,122 | 28.5× |
| MRI chest with contrast (71551) | $3,811.50 | $5,082 | 4.8× |
| MRI chest wo w contrast (71552) | $8,375.25 | $11,167 | 23.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $11,775.75 | $15,701 | 33.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $12,314.25 | $16,419 | 35.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $9,715.50 | $12,954 | 40.5× |
| MRI lumbar spine w contrast (72149) | $10,583.25 | $14,111 | 30.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $20,487 | $27,316 | 58.5× |
| MRI orbit face &/neck w/o contrast (70540) | $13,201.50 | $17,602 | 55.1× |
| MRI orbit face neck w contrast (70542) | $14,517 | $19,356 | 41.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $17,024.25 | $22,699 | 48.6× |
| MRI pelvis w contrast (72196) | $9,854.25 | $13,139 | 28.1× |
| MRI pelvis w/o & w contrast (72197) | $11,273.25 | $15,031 | 32.2× |
| MRI pelvis w/o contrast (72195) | $10,135.50 | $13,514 | 42.3× |
| MRI thoracic spine w/o contrast (72146) | $9,501 | $12,668 | 39.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $9,909 | $13,212 | 28.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $7,622.25 | $10,163 | 31.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $11,578.50 | $15,438 | 33.0× |
| MRI, abdomen, combo (74183) | $10,304.25 | $13,739 | 29.4× |
| MRI, dorsal spine combo (72157) | $14,992.50 | $19,990 | 42.8× |
| MRI, dorsal spine contrast (72147) | $10,451.25 | $13,935 | 29.8× |
| MRI, joint upper extrem (73221) | $10,587.75 | $14,117 | 44.2× |
| MRI, joint upper extrem combo (73223) | $11,578.50 | $15,438 | 33.0× |
| MRI, lumbar spine combo (72158) | $14,287.50 | $19,050 | 40.8× |
| Myelograpy 2/more regions rs&i (72270) | $6,932.25 | $9,243 | 8.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $4,731.75 | $6,309 | 3.6× |
| Myocardial Spect Multiple Studies (78452) | $16,440 | $21,920 | 12.6× |
| Neck soft tissue (70360) | $1,719 | $2,292 | 19.7× |
| Nm csf leak detection (78650) | $2,988.75 | $3,985 | 2.3× |
| Nuclear Rx Intra-Arterial (79445) | $9,011.25 | $12,015 | 38.4× |
| Nuclear Rx Oral Admin (79005) | $5,556 | $7,408 | 23.7× |
| Parathyroid Planar Imaging (78070) | $2,292 | $3,056 | 5.7× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$503.25–$975.75 | $671–$1,301 | varies |
| Peritoneogram Rs&I (74190) | $1,749.75 | $2,333 | 3.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,480 | $4,640 | 1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,088 | $2,784 | 5.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $2,108.25 | $2,811 | 20.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,890.75 | $2,521 | 3.4× |
| Radex Ankle Complete Minimum 3 Views (73610) | $1,968 | $2,624 | 22.5× |
| Radex Calcaneus Minimum 2 Views (73650) | $1,623 | $2,164 | 18.6× |
| Radex elbow complete minimum 3 views (73080) | $1,827 | $2,436 | 20.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $2,658 | $3,544 | 25.3× |
| Radex fingr minimum 2 views (73140) | $1,634.25 | $2,179 | 18.7× |
| Radex foot complete minimum 3 views (73630) | $1,894.50 | $2,526 | 21.7× |
| Radex Hand Minimum 3 Views (73130) | $1,689 | $2,252 | 19.3× |
| Radex lower extremity infant minimum 2 views (73592) | $1,845 | $2,460 | 21.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $1,813.50 | $2,418 | 20.7× |
| Radex Ribs Unilateral 2 Views (71100) | $1,473.75 | $1,965 | 16.9× |
| Radex shoulder complete minimum 2 views (73030) | $1,778.25 | $2,371 | 20.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $1,124.25 | $1,499 | 12.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,598.25 | $2,131 | 9.1× |
| Radex Spine 1 View Specify Level (72020) | $1,310.25 | $1,747 | 15.0× |
| Radex Sternum Minimum 2 Views (71120) | $1,662 | $2,216 | 19.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $1,373.25 | $1,831 | 15.7× |
| Radex Toe Minimum 2 Views (73660) | $1,447.50 | $1,930 | 16.6× |
| Radex upper extremity infant minimum 2 views (73092) | $1,065 | $1,420 | 10.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $1,152 | $1,536 | 13.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $4,064.25 | $5,419 | 38.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,209 | $1,612 | 11.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,623.75 | $2,165 | 15.5× |
| Radiologic exam colon double contrast study (74280) | $3,103.50 | $4,138 | 17.6× |
| Radiologic exam colon single contrast study (74270) | $2,855.25 | $3,807 | 16.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,749.75 | $2,333 | 9.9× |
| Radiologic exam knee complete 4/more views (73564) | $1,551 | $2,068 | 14.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $1,000.50 | $1,334 | 9.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,627.50 | $2,170 | 9.2× |
| Radiologic exam swallow function contrast study (74230) | $1,968 | $2,624 | 11.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $3,035.25 | $4,047 | 17.2× |
| Radiologic examination femur 1 view (73551) | $812.25 | $1,083 | 9.3× |
| Radiologic examination femur minimum 2 views (73552) | $1,052.25 | $1,403 | 12.0× |
| Radiologic examination knee 1/2 views (73560) | $1,236.75 | $1,649 | 14.1× |
| Radiologic Examination Osseous Survey Limited (77074) | $1,750.50 | $2,334 | 16.7× |
| Radiologic examination tibia & fibula 2 views (73590) | $1,554.75 | $2,073 | 17.8× |
| Ribs bilateral 3 views (71110) | $2,177.25 | $2,903 | 20.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $3,435.75 | $4,581 | 8.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $3,944.25 | $5,259 | 9.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $6,165.75 | $8,221 | 11.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $4,808.25 | $6,411 | 8.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $6,340.50 | $8,454 | 11.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $4,173 | $5,564 | 3.2× |
| Scapula (73010) | $1,858.50 | $2,478 | 17.7× |
| Shoulder 1 view (73020) | $1,413.75 | $1,885 | 16.2× |
| Shoulder Arthrography (73040) | $2,083.50 | $2,778 | 5.9× |
| Sialogram (70390) | $1,566 | $2,088 | 6.5× |
| Skull less than 4 views (70250) | $1,874.25 | $2,499 | 17.8× |
| Thoracic spine 2 views (72070) | $2,403 | $3,204 | 22.9× |
| Thoracic spine 3 views (72072) | $2,739 | $3,652 | 26.1× |
| Thoracolumbar 2 views (72080) | $1,829.25 | $2,439 | 20.9× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,554 | $2,072 | 3.9× |
| Thyroid Imaging With Vascular Flow (78013) | $1,338 | $1,784 | 3.3× |
| Thyroid Met Imaging Body (78018) | $3,432.75 | $4,577 | 6.3× |
| Thyroid Uptake Measurement (78012) | $1,559.25 | $2,079 | 3.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $4,145.25 | $5,527 | 10.3× |
| Ultrasound Breast Limited (76642) | $1,318.50 | $1,758 | 15.1× |
| Ultrasound Exam Aaa Screen (76706) | $1,228.50 | $1,638 | 11.7× |
| Ultrasound, abdomen limited (76705) | $2,985 | $3,980 | 28.4× |
| Umbilical-artery Doppler (OB) (76820) | $2,144.25 | $2,859 | 20.4× |
| Upper gi w/o kub (74240) | $3,054 | $4,072 | 17.3× |
| Urethrocystogram voiding (74455) | $2,525.25 | $3,367 | 10.5× |
| Urethrocystography retrograde (74450) | $2,685 | $3,580 | 11.2× |
| Us breast unilateral complete (76641) | $1,688.25 | $2,251 | 16.1× |
| Us chest (76604) | $1,350.75 | $1,801 | 12.9× |
| Us complete joint (76881) | $1,820.25 | $2,427 | 17.3× |
| Us exam, pelvic, limited (76857) | $2,328.75 | $3,105 | 22.2× |
| Us head (76506) | $2,808 | $3,744 | 26.7× |
| Us kidney transplant (76776) | $1,650.75 | $2,201 | 15.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$1,803.75–$1,820.25 | $2,405–$2,427 | varies |
| Us ob limited 1 or more fetuses (76815) | $2,355.75 | $3,141 | 22.4× |
| Us ob transvaginal (76817) | $2,886 | $3,848 | 27.5× |
| Us pelvic non ob complete (76856) | $2,853.75 | $3,805 | 27.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $3,657.75 | $4,877 | 34.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,928.25 | $2,571 | 18.4× |
| Us retroperitoneal complete (76770) | $3,445.50 | $4,594 | 32.8× |
| Us retroperitoneal limited (76775) | $2,317.50 | $3,090 | 22.1× |
| Us scrotum and contents (76870) | $2,392.50 | $3,190 | 22.8× |
| Us spinal canal and contents (76800) | $2,401.50 | $3,202 | 22.9× |
| Us thyroid (76536) | $2,477.25 | $3,303 | 23.6× |
| Us transrectal (76872) | $2,613.75 | $3,485 | 24.9× |
| Vein X-Ray Chest (75827) | $9,944.25 | $13,259 | 6.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,765.75 | $5,021 | 1.2× |
| Venogram Sinus/Jugular (75860) | $3,480 | $4,640 | 1.1× |
| Venography Adrenal Unilateral (75840) | $4,270.50 | $5,694 | 1.3× |
| Venography caval inferior serialography rs&i (75825) | $9,944.25 | $13,259 | 3.1× |
| Venography extremity bilateral rs&i (75822) | $4,847.25 | $6,463 | 3.1× |
| Venography extremity unilateral rs&i (75820) | $4,269.75 | $5,693 | 2.7× |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$8,680.50–$10,074 | $11,574–$13,432 | varies |
| Venography Renal Unilateral (75831) | $7,908.75 | $10,545 | 2.5× |
| Venous sampling by catheter (75893) | $7,339.50 | $9,786 | 1.3× |
| Wrist 2 views (73100) | $1,126.50 | $1,502 | 12.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,224.75 | $1,633 | 14.0× |
| X-ray antegrade pyelogram tube (74425) | $2,408.25 | $3,211 | 6.9× |
| X-Ray Aorta Leg Arteries (75630) | $11,956.50 | $15,942 | 3.8× |
| X-Ray Bend Only L-S Spine (72120) | $2,416.50 | $3,222 | 23.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $1,433.25 | $1,911 | 16.4× |
| X-Ray Exam Breast Specimen (76098) | $1,353.75 | $1,805 | 2.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $1,634.25 | $2,179 | 18.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $2,101.50 | $2,802 | 20.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $3,219 | $4,292 | 30.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $710.25 | $947 | 8.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $899.25 | $1,199 | 10.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,052.25 | $1,403 | 10.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $1,236 | $1,648 | 11.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,350.75 | $1,801 | 12.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,602.75 | $2,137 | 15.3× |
| X-Ray Exam L-S Spine Bending (72114) | $3,550.50 | $4,734 | 33.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $1,962 | $2,616 | 22.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $2,123.25 | $2,831 | 20.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,902 | $2,536 | 18.1× |
| X-ray eye for foreign body (70030) | $357.75 | $477 | 4.1× |
| X-ray humerus (73060) | $933 | $1,244 | 10.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $1,096.50 | $1,462 | 12.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $2,308.50 | $3,078 | 22.0× |
| X-ray nose-rectum child f.b. (76010) | $1,737.75 | $2,317 | 19.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $2,176.50 | $2,902 | 20.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $911.25 | $1,215 | 8.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $662.25 | $883 | 6.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,791 | $2,388 | 20.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,228.50 | $1,638 | 14.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $2,118.75 | $2,825 | 20.2× |
| X-Ray Tmj Unilat (70328) | $669 | $892 | 7.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $3,048 | $4,064 | 8.7× |
| X-Rays Bone Length Studies (77073) | $2,076.75 | $2,769 | 19.8× |
| X-Rays Bone Survey Complete (77075) | $2,889 | $3,852 | 27.5× |
| Xr c-spine 4 or 5 views (72050) | $2,123.25 | $2,831 | 20.2× |
| Xr facial bones less than 3 views (70140) | $1,949.25 | $2,599 | 22.3× |
| Xr orbits complete 4 views (70200) | $2,138.25 | $2,851 | 20.4× |
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.