Imaging prices at Whitfield Regional Hospital
Demopolis, AL · every code in this section with a posted price and a Medicare benchmark.
274 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $1,267.20 | $2,112 | 1.1× |
| Abdomen 1 View (74018) | $90 | $150 | 1.2× |
| Abdomen 2 views (74019) | $168 | $280 | 1.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $414 | $690 | 1.2× |
| Adrenal Cortex & Medulla Img (78075) | $2,028 | $3,380 | 1.8× |
| Ankle 2 views (73600) | $60 | $100 | 0.8× |
| Arthrogram ankle (73615) | $489 | $815 | 1.6× |
| Arthrogram hip (73525) | $405 | $675 | 1.3× |
| Arthrogram Wrist (73115) | $489 | $815 | 1.6× |
| Bone age studies (77072) | $168 | $280 | 1.9× |
| Bone Imaging 3 Phase (78315) | $643.50 | $1,072.50 | 1.9× |
| Bone Imaging Limited Area (78300) | $372.30 | $620.50 | 1.1× |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$372.30–$396 | $620.50–$660 | varies |
| Bone Imaging Whole Body (78306) | $618 | $1,030 | 1.8× |
| Bone marrow imaging; whole body (78104) | $371.70 | $619.50 | 1.1× |
| Bone survey infant (77076) | $84 | $140 | 0.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $456.60 | $761 | 1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,220 | $3,700 | 1.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $600 | $1,000 | 1.7× |
| Cerebrospinal Fluid Scan (78630) | $780 | $1,300 | 1.7× |
| Chest 1 view (71045) | $72 | $120 | 1.0× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$123–$399 | $205–$665 | varies |
| Chest 3 views (71047) | $90 | $150 | 1.2× |
| Chest 4 or more views (71048) | $174 | $290 | 1.9× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$49.50–$54 | $82.50–$90 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $168 | $280 | 1.9× |
| Contrast X-Ray Bladder (74430) | $162 | $270 | 0.5× |
| Contrast X-Ray Of Elbow (73085) | $489 | $815 | 1.6× |
| Contrast X-Ray Of Knee Joint (73580) | $489 | $815 | 1.6× |
| CT abdomen and pelvis without and with contrast (74178) | $1,644 | $2,740 | 5.5× |
| CT abdomen and pelvis without contrast (74176) | $924 | $1,540 | 4.5× |
| CT abdomen w contrast (74160) | $552.60 | $921 | 3.7× |
| CT abdomen w wo contrast (74170) | $668.40 | $1,114 | 4.4× |
| CT abdomen w/o contrast (74150) | $459 | $765 | 5.1× |
| CT Angio Abdomen and Pelvis (74174) | $576 | $960 | 1.9× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$576–$720 | $960–$1,200 | varies |
| CT Angio Head (70496) | $834 | $1,390 | 5.5× |
| CT angio hrt w/3d image (75574) | $540 | $900 | 1.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $720 | $1,200 | 4.8× |
| CT Angio Neck (70498) | $840 | $1,400 | 5.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $720 | $1,200 | 4.8× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$551.40–$576 | $919–$960 | varies |
| CT cervical spine w/o contrast (72125) | $483 | $805 | 5.4× |
| CT cervical spine w/wo cont (72127) | $622.20 | $1,037 | 4.1× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$552.60–$576 | $921–$960 | varies |
| CT chest w/wo contrast (71270) | $668.40 | $1,114 | 4.4× |
| CT head/brain with contrast (70460) | $639 | $1,065 | 4.2× |
| CT head/brain without and with contrast (70470) | $693.60 | $1,156 | 4.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $540 | $900 | 1.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $120 | $200 | 1.6× |
| CT hrt w/3d image congen (75573) | $540 | $900 | 1.8× |
| CT iac w contrast (70481) range across 4 matching MRF lines |
$532.20–$576 | $887–$960 | varies |
| CT l-spine w&w/o contrast (72133) | $668.40 | $1,114 | 4.4× |
| CT lower ext w/o (73700) range across 11 matching MRF lines |
$297–$465 | $495–$775 | varies |
| CT lower extremity w/contrast material (73701) | $576 | $960 | 3.8× |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$575.40–$576 | $959–$960 | varies |
| CT lumbar spine w/o contrast (72131) | $483 | $805 | 5.4× |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$574.80–$576 | $958–$960 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$297–$520.80 | $495–$868 | varies |
| CT neck tissue combo (70492) range across 4 matching MRF lines |
$575.40–$576 | $959–$960 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 4 matching MRF lines |
$576–$585 | $960–$975 | varies |
| CT orbits w/o contrast (70480) range across 4 matching MRF lines |
$297–$465.60 | $495–$776 | varies |
| CT pelvis w&w/o contrast (72194) | $978 | $1,630 | 6.5× |
| CT pelvis w/o contrast (72192) | $465.60 | $776 | 5.2× |
| CT scan of leg combo (73702) | $576 | $960 | 3.8× |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$576–$639 | $960–$1,065 | varies |
| CT soft tissue neck w contrast (70491) range across 3 matching MRF lines |
$513–$576 | $855–$960 | varies |
| CT soft tissue neck w/o contrast (70490) | $465 | $775 | 5.2× |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$551.40–$576 | $919–$960 | varies |
| CT thoracic spine w/o contrast (72128) | $483 | $805 | 5.4× |
| CT thoracic spine w/wo cont (72130) | $622.20 | $1,037 | 4.1× |
| CT thorax w/o contrast (71250) | $465.60 | $776 | 5.2× |
| CT upper ext wo (73200) | $297 | $495 | 3.3× |
| CT upper extremity w/o & w/contrast material (73202) | $576 | $960 | 3.8× |
| CT upper extremity with contrast (73201) | $576 | $960 | 1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $720 | $1,200 | 4.8× |
| Cta Abdomen (74175) | $720 | $1,200 | 4.8× |
| CTA pelvis (72191) | $720 | $1,200 | 4.8× |
| Dxa Bone Density Axial (77080) | $162 | $270 | 1.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $108 | $180 | 1.4× |
| Esophagram (74220) | $240 | $400 | 1.6× |
| Fetal Biophys Profile W/Nst (76818) | $108 | $180 | 1.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $162 | $270 | 1.8× |
| Fluoroscopy up to 1 hr (76000) | $300 | $500 | 1.5× |
| Foot 2 views (73620) | $45 | $75 | 0.6× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$61.13–$61.20 | $101.88–$102 | varies |
| Gastric emptying imaging study (78264) | $457.20 | $762 | 1.3× |
| Gated Heart Planar Single (78472) | $540 | $900 | 1.6× |
| Gated Heart, Multiple (78473) | $375 | $625 | 1.1× |
| Hand 2 views (73120) | $144 | $240 | 1.6× |
| Heart first pass single,planar (78481) | $471.30 | $785.50 | 1.0× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$540–$780 | $900–$1,300 | varies |
| Hepatobiliary System Imaging (78226) | $480 | $800 | 1.4× |
| Ht Muscle Image Spect Sing (78451) | $695.40 | $1,159 | 0.6× |
| Hysterosalpingogram (74740) | $181.50 | $302.50 | 0.9× |
| Joint Survey Single View (77077) | $73.20 | $122 | 0.8× |
| K Flow/Funct Image W/Drug (78708) | $425.10 | $708.50 | 0.9× |
| K Flow/Funct Image W/O Drug (78707) | $516 | $860 | 1.1× |
| Knee 3 Views (73562) | $69 | $115 | 0.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $438 | $730 | 1.3× |
| Liver imaging w/vascular flow (78202) | $780 | $1,300 | 1.7× |
| Lung Ventilat&Perfus Imaging (78582) | $600 | $1,000 | 1.3× |
| Lung Ventilation Imaging (78579) | $397.80 | $663 | 1.2× |
| Lymph System Imaging (78195) | $762 | $1,270 | 1.6× |
| Magnetic Image Jaw Joint (70336) | $660 | $1,100 | 3.2× |
| Meckels Divert Exam (78290) | $384 | $640 | 1.1× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$1,272–$1,320 | $2,120–$2,200 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$798–$840 | $1,330–$1,400 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$840–$1,272 | $1,400–$2,120 | varies |
| MRA neck w contrast (70548) | $840 | $1,400 | 2.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,320 | $2,200 | 4.4× |
| MRA neck w/o contrast (70547) | $864 | $1,440 | 4.2× |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$900–$1,116 | $1,500–$1,860 | varies |
| MRI abdomen w/o contrast (74181) range across 8 matching MRF lines |
$660–$693 | $1,100–$1,155 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 12 matching MRF lines |
$780–$1,116 | $1,300–$1,860 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,080 | $1,800 | 3.6× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 12 matching MRF lines |
$780–$1,116 | $1,300–$1,860 | varies |
| MRI cervical spine w contrast (72142) | $840 | $1,400 | 2.8× |
| MRI cervical spine w/o cont (72141) | $720 | $1,200 | 3.5× |
| MRI chest w/o contrast (71550) | $840 | $1,400 | 4.1× |
| MRI chest with contrast (71551) | $960 | $1,600 | 1.4× |
| MRI chest wo w contrast (71552) | $1,260 | $2,100 | 4.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $840 | $1,400 | 2.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,140 | $1,900 | 3.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $780 | $1,300 | 3.8× |
| MRI lumbar spine w contrast (72149) | $840 | $1,400 | 2.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,140 | $1,900 | 3.8× |
| MRI orbit face &/neck w/o contrast (70540) | $693 | $1,155 | 3.4× |
| MRI orbit face neck w contrast (70542) | $864 | $1,440 | 2.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,116 | $1,860 | 3.7× |
| MRI pelvis w contrast (72196) | $840 | $1,400 | 2.8× |
| MRI pelvis w/o & w contrast (72197) | $1,140 | $1,900 | 3.8× |
| MRI pelvis w/o contrast (72195) | $780 | $1,300 | 3.8× |
| MRI thoracic spine w/o contrast (72146) | $720 | $1,200 | 3.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,116 | $1,860 | 3.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $693 | $1,155 | 3.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,116 | $1,860 | 3.7× |
| MRI, abdomen, combo (74183) range across 7 matching MRF lines |
$1,116–$1,140 | $1,860–$1,900 | varies |
| MRI, dorsal spine combo (72157) | $1,080 | $1,800 | 3.6× |
| MRI, dorsal spine contrast (72147) | $780 | $1,300 | 2.6× |
| MRI, joint upper extrem (73221) | $720 | $1,200 | 3.5× |
| MRI, joint upper extrem combo (73223) | $1,080 | $1,800 | 3.6× |
| MRI, lumbar spine combo (72158) | $1,140 | $1,900 | 3.8× |
| Myelogram cervical (72240) | $1,116 | $1,860 | 1.7× |
| Myelogram Lumbar (72265) | $330 | $550 | 0.5× |
| Myelography thoracic (72255) | $1,116 | $1,860 | 1.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $479.70 | $799.50 | 1.4× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $322.80 | $538 | 0.7× |
| Myocardial Spect Multiple Studies (78452) | $2,040 | $3,400 | 1.8× |
| Neck soft tissue (70360) | $51 | $85 | 0.7× |
| Nm csf leak detection (78650) | $2,040 | $3,400 | 1.8× |
| Nuclear Rx Oral Admin (79005) | $365.40 | $609 | 1.8× |
| Ob us nuchal meas 1 gest (76813) | $162 | $270 | 1.8× |
| Parathyroid Planar Imaging (78070) | $261 | $435 | 0.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $600 | $1,000 | 1.7× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$66–$72 | $110–$120 | varies |
| Pet Image W/Ct Lmtd (78814) | $1,819.44 | $3,032.40 | 1.5× |
| PET image w/CT, full body (78816) | $1,959 | $3,265 | 1.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,959 | $3,265 | 1.6× |
| PET whole body (78813) | $1,819.44 | $3,032.40 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $251.40 | $419 | 0.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $87 | $145 | 1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) | $63.60 | $106 | 0.8× |
| Radex Calcaneus Minimum 2 Views (73650) | $60 | $100 | 0.8× |
| Radex elbow complete minimum 3 views (73080) | $63.60 | $106 | 0.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $82.50 | $137.50 | 0.9× |
| Radex fingr minimum 2 views (73140) | $49.50 | $82.50 | 0.7× |
| Radex foot complete minimum 3 views (73630) | $63.60 | $106 | 0.8× |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$63.38–$63.60 | $105.63–$106 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$48–$108 | $80–$180 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $72 | $120 | 0.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $55.20 | $92 | 0.7× |
| Radex Ribs Unilateral 2 Views (71100) | $64.50 | $107.50 | 0.9× |
| Radex shoulder complete minimum 2 views (73030) | $72 | $120 | 1.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $58.20 | $97 | 0.8× |
| Radex Spine 1 View Specify Level (72020) | $108 | $180 | 1.4× |
| Radex Sternum Minimum 2 Views (71120) | $60 | $100 | 0.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $90.30 | $150.50 | 1.2× |
| Radex Toe Minimum 2 Views (73660) | $45 | $75 | 0.6× |
| Radex upper extremity infant minimum 2 views (73092) | $144 | $240 | 1.6× |
| Radex Wrist Complete Minimum 3 Views (73110) | $60.60 | $101 | 0.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $180 | $300 | 2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $75 | $125 | 0.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $87 | $145 | 1.0× |
| Radiologic exam colon double contrast study (74280) | $192 | $320 | 1.3× |
| Radiologic exam colon single contrast study (74270) | $126 | $210 | 0.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $282 | $470 | 1.9× |
| Radiologic exam knee complete 4/more views (73564) | $78 | $130 | 0.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $115.50 | $192.50 | 0.8× |
| Radiologic exam swallow function contrast study (74230) | $282 | $470 | 1.9× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$195–$237 | $325–$395 | varies |
| Radiologic examination femur 1 view (73551) | $84 | $140 | 1.1× |
| Radiologic examination femur minimum 2 views (73552) | $90 | $150 | 1.2× |
| Radiologic examination knee 1/2 views (73560) | $60 | $100 | 0.8× |
| Radiologic examination tibia & fibula 2 views (73590) | $63.60 | $106 | 0.8× |
| Ribs bilateral 3 views (71110) | $115.50 | $192.50 | 1.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$454.80–$600 | $758–$1,000 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,028 | $3,380 | 4.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,028 | $3,380 | 4.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 5 matching MRF lines |
$420–$2,028 | $700–$3,380 | varies |
| Scapula (73010) | $61.20 | $102 | 0.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $78 | $130 | 3.3× |
| Sella turcica (70240) | $40.20 | $67 | 0.5× |
| Shoulder 1 view (73020) | $49.50 | $82.50 | 0.7× |
| Shoulder Arthrography (73040) range across 4 matching MRF lines |
$489–$513 | $815–$855 | varies |
| Skull less than 4 views (70250) | $60 | $100 | 0.7× |
| Testicular Imaging W/Flow (78761) | $410.40 | $684 | 1.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $624 | $1,040 | 1.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $360 | $600 | 1.1× |
| Ther rad simulaj-aided field setting simple (77280) | $144 | $240 | 1.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $126 | $210 | 0.8× |
| Thoracic spine 2 views (72070) | $72 | $120 | 0.8× |
| Thoracic spine 3 views (72072) | $78 | $130 | 0.9× |
| Thoracolumbar 2 views (72080) | $108 | $180 | 1.4× |
| Thyroid Imaging With Vascular Flow (78013) | $270 | $450 | 0.8× |
| Thyroid Met Imaging Body (78018) | $618 | $1,030 | 1.3× |
| Thyroid Uptake Measurement (78012) | $205.20 | $342 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $457.20 | $762 | 1.3× |
| Ultrasound Breast Limited (76642) | $108 | $180 | 1.4× |
| Ultrasound Exam Aaa Screen (76706) | $165 | $275 | 1.8× |
| Ultrasound, abdomen limited (76705) | $396 | $660 | 4.4× |
| Upper gi w/o kub (74240) | $165 | $275 | 1.1× |
| Ureteral Reflux Study (78740) | $306.90 | $511.50 | 0.9× |
| Urethrocystogram voiding (74455) | $513 | $855 | 2.5× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$144–$288 | $240–$480 | varies |
| Us chest (76604) | $144 | $240 | 1.6× |
| Us exam, pelvic, limited (76857) | $96 | $160 | 1.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $168 | $280 | 1.9× |
| Us ob limited 1 or more fetuses (76815) | $96 | $160 | 1.1× |
| Us ob transvaginal (76817) | $145.20 | $242 | 1.6× |
| Us pelvic non ob complete (76856) | $145.20 | $242 | 1.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $135 | $225 | 1.5× |
| Us retroperitoneal complete (76770) | $394.80 | $658 | 4.4× |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$99–$195 | $165–$325 | varies |
| Us scrotum and contents (76870) | $201 | $335 | 2.2× |
| Us spinal canal and contents (76800) | $144 | $240 | 1.6× |
| Us thyroid (76536) | $144 | $240 | 1.6× |
| Us transrectal (76872) | $162 | $270 | 1.8× |
| Venography extremity bilateral rs&i (75822) | $720 | $1,200 | 0.5× |
| Venography extremity unilateral rs&i (75820) | $660 | $1,100 | 0.5× |
| Venous thrombosis imaging (78457) | $315 | $525 | 0.7× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $372 | $620 | 1.1× |
| Wrist 2 views (73100) | $49.50 | $82.50 | 0.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $48.90 | $81.50 | 0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$61.13–$61.20 | $101.88–$102 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $88.20 | $147 | 1.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$120–$180 | $200–$300 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $180 | $300 | 2.0× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$60–$186 | $100–$310 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $72 | $120 | 1.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $98.40 | $164 | 1.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $144 | $240 | 1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $150 | $250 | 1.7× |
| X-Ray Exam L-S Spine Bending (72114) | $146.40 | $244 | 1.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$60–$144 | $100–$240 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $162 | $270 | 1.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $144 | $240 | 1.6× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$63.38–$63.60 | $105.63–$106 | varies |
| X-ray IV pyelogram (ivp) (74400) | $162 | $270 | 1.1× |
| X-ray IV pyelogram+tomography (74415) | $181.50 | $302.50 | 1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $57.30 | $95.50 | 0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $108 | $180 | 1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $78 | $130 | 0.9× |
| X-ray nose-rectum child f.b. (76010) | $180 | $300 | 2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $144 | $240 | 1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $61.20 | $102 | 0.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $57.60 | $96 | 0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$45–$61.20 | $75–$102 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $73.20 | $122 | 1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $90 | $150 | 1.0× |
| X-Rays Bone Length Studies (77073) | $126 | $210 | 1.4× |
| X-Rays Bone Survey Complete (77075) | $145.20 | $242 | 1.6× |
| Xr c-spine 4 or 5 views (72050) | $102 | $170 | 1.1× |
| Xr facial bones less than 3 views (70140) | $51 | $85 | 0.7× |
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.