Ascension All Saints Hospital - Spring Street Campus (Ascension All Saints Hospital, Inc.)
3803 Spring St Racine WI 53405|1320 Wisconsin Ave, Racine, WI · Ascension · · NPI 1639123284
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
What this hospital publishes
Ascension All Saints Hospital - Spring Street Campus (Ascension All Saints Hospital, Inc.) publishes its rates as percent of total billed charges, not as a price per service. A per diem covers a day of care and a case rate covers a whole episode, so these numbers cannot be set against another hospital’s price for the same procedure — and they are left out of every comparison on this site.
They are what the hospital disclosed, shown here in full rather than hidden.
| Procedure | Payer | Plan | Negotiated rate |
|---|---|---|---|
| Abdominal and Pelvic Blood Vessel Ultrasound (complete) CPT 93975 | CIGNA | 1273_CIGNA 20250701 | $1,416.48 |
| Abdominal and Pelvic Blood Vessel Ultrasound (limited) CPT 93976 | CIGNA | 1273_CIGNA 20250701 | $1,196.52 |
| Abdominal Ultrasound (complete) CPT 76700 | CIGNA | 1273_CIGNA 20250701 | $611.52 |
| Abdominal Ultrasound (limited) CPT 76705 | CIGNA | 1273_CIGNA 20250701 | $551.46 |
| Abdominal X-ray Series (acute, with chest view) CPT 74022 | CIGNA | 1273_CIGNA 20250701 | $269.10 |
| Abdominal X-ray (single view) CPT 74018 | CIGNA | 1273_CIGNA 20250701 | $251.16 |
| Amniocentesisdiagnostic 59000 CPT 59000 | CIGNA | 1273_CIGNA 20250701 | $706.68 |
| An fluoro guide for cvp CPT 77001 | CIGNA | 1273_CIGNA 20250701 | $204.36 |
| Ankle X-ray CPT 73610 | CIGNA | 1273_CIGNA 20250701 | $233.22 |
| Ankle X-ray (2 views, both ankles) CPT 73600 | CIGNA | 1273_CIGNA 20250701 | $198.90 |
| Aortic Aneurysm Screening Ultrasound CPT 76706 | CIGNA | 1273_CIGNA 20250701 | $517.92 |
| Arm or Leg Ultrasound (limited, left side) CPT 76882 | CIGNA | 1273_CIGNA 20250701 | $421.98 |
| Barium Swallow (Esophagus X-ray) CPT 74220 | CIGNA | 1273_CIGNA 20250701 | $230.88 |
| Bone Age X-ray (hand and wrist) CPT 77072 | CIGNA | 1273_CIGNA 20250701 | $215.28 |
| Bone Density Scan (DEXA) CPT 77080 | CIGNA | 1273_CIGNA 20250701 | $255.84 |
| Bone survey-lead poisoning CPT 77074 | CIGNA | 1273_CIGNA 20250701 | $237.12 |
| Breastbone (Sternum) X-ray CPT 71120 | CIGNA | 1273_CIGNA 20250701 | $217.62 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | CIGNA | 1273_CIGNA 20250701 | $1,561.56 |
| Chest Ultrasound CPT 76604 | CIGNA | 1273_CIGNA 20250701 | $510.90 |
| Chest X-ray CPT 71046 | CIGNA | 1273_CIGNA 20250701 | $251.94 |
| Chest X-ray (single view) CPT 71045 | CIGNA | 1273_CIGNA 20250701 | $170.04 |
| Collarbone (Clavicle) X-ray (both sides) CPT 73000 | CIGNA | 1273_CIGNA 20250701 | $212.94 |
| CT 3d report other modality w/workstation CPT 76377 | CIGNA | 1273_CIGNA 20250701 | $670.80 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | CIGNA | 1273_CIGNA 20250701 | $957.84 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | CIGNA | 1273_CIGNA 20250701 | $38.22 |
| CT limited or localized follow-up study CPT 76380 | CIGNA | 1273_CIGNA 20250701 | $759.72 |
| CT scan for therapy guide CPT 77014 | CIGNA | 1273_CIGNA 20250701 | $804.18 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | CIGNA | 1273_CIGNA 20250701 | $198.12 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | ALLIANCE | 1166_ALLIANCE 20241001 | $27.14 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | CENTIVO NW1 | 1253_CENTIVO NW1 20250101 | $32.66 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | CENTIVO NW2 | 1254_CENTIVO NW2 20250101 | $30.82 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | CENTIVO NW3 | 1255_CENTIVO NW3 20250101 | $29.44 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | CIGNA | 1273_CIGNA 20250701 | $35.88 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | ALLIANCE | 1166_ALLIANCE 20241001 | $23.60 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | CENTIVO NW1 | 1253_CENTIVO NW1 20250101 | $28.40 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | CENTIVO NW2 | 1254_CENTIVO NW2 20250101 | $26.80 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | CENTIVO NW3 | 1255_CENTIVO NW3 20250101 | $25.60 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | CIGNA | 1273_CIGNA 20250701 | $31.20 |
| Diagnostic Mammogram (both breasts) CPT 77066 | CIGNA | 1273_CIGNA 20250701 | $561.60 |
| Diagnostic Mammogram (one breast) CPT 77065 | CIGNA | 1273_CIGNA 20250701 | $400.14 |
| Diagnostic radio unlisted proc CPT 76499 | CIGNA | 1273_CIGNA 20250701 | $181.74 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | CIGNA | 1273_CIGNA 20250701 | $1,272.96 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | CIGNA | 1273_CIGNA 20250701 | $1,004.64 |
| Ductogram sgl duct CPT 77053 | CIGNA | 1273_CIGNA 20250701 | $256.62 |
| Duplex scan bilateral study 93985 CPT 93985 | CIGNA | 1273_CIGNA 20250701 | $1,952.34 |
| Dup scan/hemodialysis access 93990 CPT 93990 | CIGNA | 1273_CIGNA 20250701 | $925.08 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | CIGNA | 1273_CIGNA 20250701 | $1,426.62 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | CIGNA | 1273_CIGNA 20250701 | $1,347.06 |
| Echo exam of fetal heart CPT 76828 | CIGNA | 1273_CIGNA 20250701 | $370.50 |
| Echo exam of fetal heart CPT 76827 | CIGNA | 1273_CIGNA 20250701 | $475.02 |
| Echo exam of fetal heart CPT 76826 | CIGNA | 1273_CIGNA 20250701 | $459.42 |
| Echo exam of fetal heart CPT 76825 | CIGNA | 1273_CIGNA 20250701 | $573.30 |
| Echograp trans r pros study CPT 76873 | CIGNA | 1273_CIGNA 20250701 | $512.46 |
| Echo guide for amniocentesis CPT 76946 | CIGNA | 1273_CIGNA 20250701 | $471.90 |
| Echo guide for artery repair CPT 76936 | CIGNA | 1273_CIGNA 20250701 | $874.38 |
| Elbow X-ray (2 views, both sides) CPT 73070 | CIGNA | 1273_CIGNA 20250701 | $204.36 |
| Elbow X-ray (3 or more views, both sides) CPT 73080 | CIGNA | 1273_CIGNA 20250701 | $233.22 |
| Eye Socket (Orbit) X-ray CPT 70200 | CIGNA | 1273_CIGNA 20250701 | $233.22 |
| Facial Bones X-ray (1 to 2 views) CPT 70140 | CIGNA | 1273_CIGNA 20250701 | $217.62 |
| Facial Bones X-ray (complete) CPT 70150 | CIGNA | 1273_CIGNA 20250701 | $233.22 |
| Fetal biophys profile w/nst 76818 CPT 76818 | CIGNA | 1273_CIGNA 20250701 | $540.54 |
| Fetal non stress test CPT 59025 | CIGNA | 1273_CIGNA 20250701 | $772.20 |
| Finger X-ray (both hands) CPT 73140 | CIGNA | 1273_CIGNA 20250701 | $229.32 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | CIGNA | 1273_CIGNA 20250701 | $240.24 |
| Fluoroguide needle placement CPT 77002 | CIGNA | 1273_CIGNA 20250701 | $233.22 |
| Fluoroscopy (Live X-ray Guidance, up to 1 hour) CPT 76000 | CIGNA | 1273_CIGNA 20250701 | $237.12 |
| Foot X-ray CPT 73630 | CIGNA | 1273_CIGNA 20250701 | $251.16 |
| Foot X-ray (2 views, both feet) CPT 73620 | CIGNA | 1273_CIGNA 20250701 | $219.18 |
| Forearm X-ray (both sides) CPT 73090 | CIGNA | 1273_CIGNA 20250701 | $212.94 |
| Fracture assessment via dxa CPT 77086 | CIGNA | 1273_CIGNA 20250701 | $202.80 |
| Hand X-ray CPT 73130 | CIGNA | 1273_CIGNA 20250701 | $251.94 |
| Hand X-ray (2 views, both hands) CPT 73120 | CIGNA | 1273_CIGNA 20250701 | $205.92 |
| Heel (Calcaneus) X-ray (both feet) CPT 73650 | CIGNA | 1273_CIGNA 20250701 | $198.90 |
| Hip and Pelvis X-ray (2 views, both hips) CPT 73521 | CIGNA | 1273_CIGNA 20250701 | $258.96 |
| Hip and Pelvis X-ray (single view, left side) CPT 73501 | CIGNA | 1273_CIGNA 20250701 | $193.44 |
| Hip X-ray CPT 73502 | CIGNA | 1273_CIGNA 20250701 | $268.32 |
| Intracranial complete study CPT 93886 | CIGNA | 1273_CIGNA 20250701 | $1,965.60 |
| Intracranial limited study CPT 93888 | CIGNA | 1273_CIGNA 20250701 | $1,170.78 |
| Intro long gi tube w/mult fluo CPT 74340 | CIGNA | 1273_CIGNA 20250701 | $249.60 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | CIGNA | 1273_CIGNA 20250701 | $230.88 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | CIGNA | 1273_CIGNA 20250701 | $237.12 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | CIGNA | 1273_CIGNA 20250701 | $751.14 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | CIGNA | 1273_CIGNA 20250701 | $691.08 |
| Knee X-ray CPT 73564 | CIGNA | 1273_CIGNA 20250701 | $230.88 |
| Knee X-ray (1 to 2 views, both knees) CPT 73560 | CIGNA | 1273_CIGNA 20250701 | $217.62 |
| Knee X-ray (3 views, both knees) CPT 73562 | CIGNA | 1273_CIGNA 20250701 | $224.64 |
| Knee X-ray (standing, both knees) CPT 73565 | CIGNA | 1273_CIGNA 20250701 | $204.36 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | CIGNA | 1273_CIGNA 20250701 | $1,408.68 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | CIGNA | 1273_CIGNA 20250701 | $1,581.06 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | CIGNA | 1273_CIGNA 20250701 | $876.72 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | CIGNA | 1273_CIGNA 20250701 | $228.54 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | CIGNA | 1273_CIGNA 20250701 | $240.24 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | CIGNA | 1273_CIGNA 20250701 | $251.94 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | CIGNA | 1273_CIGNA 20250701 | $233.22 |
| Mid and Lower Back (Thoracolumbar Spine) X-ray CPT 72080 | CIGNA | 1273_CIGNA 20250701 | $204.36 |
| Middle cerebral artery echo CPT 76821 | CIGNA | 1273_CIGNA 20250701 | $489.06 |
| MRA spinal canal CPT 72159 | CIGNA | 1273_CIGNA 20250701 | $567.84 |
| MRI breast c- unilateral CPT 77046 | CIGNA | 1273_CIGNA 20250701 | $932.88 |
| MRI breast without cont bi CPT 77047 | CIGNA | 1273_CIGNA 20250701 | $956.28 |
| MRI breast w IV cont bi CPT 77049 | CIGNA | 1273_CIGNA 20250701 | $390.00 |
| Mr safety determination physician/other qhp CPT 76016 | CIGNA | 1273_CIGNA 20250701 | $240.24 |
| Mr safety implant elec prepj CPT 76018 | CIGNA | 1273_CIGNA 20250701 | $250.38 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | CIGNA | 1273_CIGNA 20250701 | $33.54 |
| Mr safety implt pos&/immoblj CPT 76019 | CIGNA | 1273_CIGNA 20250701 | $162.24 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | CIGNA | 1273_CIGNA 20250701 | $67.08 |
| Mr sfty med physics xm cstmz CPT 76017 | CIGNA | 1273_CIGNA 20250701 | $659.88 |
| Neck Airway (Soft Tissue) X-ray CPT 70360 | CIGNA | 1273_CIGNA 20250701 | $204.36 |
| Neck (Cervical Spine) X-ray (2 to 3 views) CPT 72040 | CIGNA | 1273_CIGNA 20250701 | $230.88 |
| Neck (Cervical Spine) X-ray (4 to 5 views) CPT 72050 | CIGNA | 1273_CIGNA 20250701 | $238.68 |
| Neck (Cervical Spine) X-ray (6 or more views) CPT 72052 | CIGNA | 1273_CIGNA 20250701 | $244.92 |
| Nose (Nasal Bone) X-ray (complete) CPT 70160 | CIGNA | 1273_CIGNA 20250701 | $233.22 |
| Ob Ultrasound nuchal meas 1 gest CPT 76813 | CIGNA | 1273_CIGNA 20250701 | $475.02 |
| Ob Ultrasound nuchal meas add-on CPT 76814 | CIGNA | 1273_CIGNA 20250701 | $237.90 |
| Orthopantogram CPT 70355 | CIGNA | 1273_CIGNA 20250701 | $181.74 |
| Pelvic Ultrasound (complete) CPT 76856 | CIGNA | 1273_CIGNA 20250701 | $546.00 |
| Pelvic Ultrasound (limited) CPT 76857 | CIGNA | 1273_CIGNA 20250701 | $492.18 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | CIGNA | 1273_CIGNA 20250701 | $192.66 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | CIGNA | 1273_CIGNA 20250701 | $233.22 |
| Penile vascular study CPT 93980 | CIGNA | 1273_CIGNA 20250701 | $1,416.48 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | CIGNA | 1273_CIGNA 20250701 | $540.54 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | CIGNA | 1273_CIGNA 20250701 | $540.54 |
| Pregnancy Ultrasound (limited) CPT 76815 | CIGNA | 1273_CIGNA 20250701 | $540.54 |
| Remove cva lumen obstruct CPT 75902 | CIGNA | 1273_CIGNA 20250701 | $265.98 |
| Rib and Chest X-ray (3 views, left side) CPT 71101 | CIGNA | 1273_CIGNA 20250701 | $233.22 |
| Rib and Chest X-ray (4 or more views, both sides) CPT 71111 | CIGNA | 1273_CIGNA 20250701 | $261.30 |
| Rib X-ray (3 views, both sides) CPT 71110 | CIGNA | 1273_CIGNA 20250701 | $261.30 |
| Sacroiliac Joint X-ray (3 or more views) CPT 72202 | CIGNA | 1273_CIGNA 20250701 | $230.88 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | CIGNA | 1273_CIGNA 20250701 | $1,315.08 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | CIGNA | 1273_CIGNA 20250701 | $1,002.30 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | CIGNA | 1273_CIGNA 20250701 | $1,151.28 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | CIGNA | 1273_CIGNA 20250701 | $1,465.62 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | CIGNA | 1273_CIGNA 20250701 | $1,212.90 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | CIGNA | 1273_CIGNA 20250701 | $1,024.14 |
| Screening Mammogram CPT 77067 | CIGNA | 1273_CIGNA 20250701 | $381.42 |
| Scrotal (Testicle) Ultrasound CPT 76870 | CIGNA | 1273_CIGNA 20250701 | $567.84 |
| Shoulder AC Joint X-ray (both sides) CPT 73050 | CIGNA | 1273_CIGNA 20250701 | $217.62 |
| Shoulder Blade (Scapula) X-ray (both sides) CPT 73010 | CIGNA | 1273_CIGNA 20250701 | $216.06 |
| Shoulder X-ray CPT 73030 | CIGNA | 1273_CIGNA 20250701 | $233.22 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | CIGNA | 1273_CIGNA 20250701 | $216.06 |
| Sinus X-ray (complete) CPT 70220 | CIGNA | 1273_CIGNA 20250701 | $230.88 |
| Sinus X-ray (limited) CPT 70210 | CIGNA | 1273_CIGNA 20250701 | $217.62 |
| Skull X-ray (1 to 3 views) CPT 70250 | CIGNA | 1273_CIGNA 20250701 | $217.62 |
| Skull X-ray (complete) CPT 70260 | CIGNA | 1273_CIGNA 20250701 | $230.88 |
| Spine X-ray (single view, one level) CPT 72020 | CIGNA | 1273_CIGNA 20250701 | $184.86 |
| Tailbone (Sacrum and Coccyx) X-ray CPT 72220 | CIGNA | 1273_CIGNA 20250701 | $230.88 |
| Tbs techl calculation only CPT 77091 | CIGNA | 1273_CIGNA 20250701 | $165.36 |
| Tbs techl prep&transmis data CPT 77090 | CIGNA | 1273_CIGNA 20250701 | $165.36 |
| Thigh Bone (Femur) X-ray (both sides) CPT 73552 | CIGNA | 1273_CIGNA 20250701 | $269.10 |
| Thyroid Ultrasound CPT 76536 | CIGNA | 1273_CIGNA 20250701 | $751.14 |
| Toe X-ray (both feet) CPT 73660 | CIGNA | 1273_CIGNA 20250701 | $204.36 |
| Tomosynthesis breast screen bilateral CPT 77063 | ALLIANCE | 1166_ALLIANCE 20241001 | $24.19 |
| Tomosynthesis breast screen bilateral CPT 77063 | CENTIVO NW1 | 1253_CENTIVO NW1 20250101 | $29.11 |
| Tomosynthesis breast screen bilateral CPT 77063 | CENTIVO NW2 | 1254_CENTIVO NW2 20250101 | $27.47 |
| Tomosynthesis breast screen bilateral CPT 77063 | CENTIVO NW3 | 1255_CENTIVO NW3 20250101 | $26.24 |
| Tomosynthesis breast screen bilateral CPT 77063 | CIGNA | 1273_CIGNA 20250701 | $31.98 |
| Transvaginal Pelvic Ultrasound (not pregnancy) CPT 76830 | CIGNA | 1273_CIGNA 20250701 | $691.08 |
| Transvaginal Pregnancy Ultrasound CPT 76817 | CIGNA | 1273_CIGNA 20250701 | $546.00 |
| Ultrasound breast complete CPT 76641 | CIGNA | 1273_CIGNA 20250701 | $786.24 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | CIGNA | 1273_CIGNA 20250701 | $751.14 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | CIGNA | 1273_CIGNA 20250701 | $487.50 |
| Ultrasound dx ophth b-scan CPT 76512 | CIGNA | 1273_CIGNA 20250701 | $333.06 |
| Ultrasound encephalogram CPT 76506 | CIGNA | 1273_CIGNA 20250701 | $415.74 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | CIGNA | 1273_CIGNA 20250701 | $540.54 |
| Ultrasound Guidance for a Needle Procedure CPT 76942 | CIGNA | 1273_CIGNA 20250701 | $550.68 |
| Ultrasound guidance for vascular access CPT 76937 | CIGNA | 1273_CIGNA 20250701 | $404.82 |
| Ultrasound guide intraoperative CPT 76998 | CIGNA | 1273_CIGNA 20250701 | $567.84 |
| Ultrasound guide tissue ablation CPT 76940 | CIGNA | 1273_CIGNA 20250701 | $446.16 |
| Ultrasound hips infant dynamic CPT 76885 | CIGNA | 1273_CIGNA 20250701 | $366.60 |
| Ultrasound infant hips ltd without stress CPT 76886 | CIGNA | 1273_CIGNA 20250701 | $540.54 |
| Ultrasound joint complete left CPT 76881 | CIGNA | 1273_CIGNA 20250701 | $540.54 |
| Ultrasound nrv&acc strux 1xtr compre CPT 76883 | CIGNA | 1273_CIGNA 20250701 | $291.72 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | CIGNA | 1273_CIGNA 20250701 | $270.66 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | CIGNA | 1273_CIGNA 20250701 | $270.66 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | CIGNA | 1273_CIGNA 20250701 | $595.92 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | CIGNA | 1273_CIGNA 20250701 | $691.08 |
| Ultrasound prostate/transrectal CPT 76872 | CIGNA | 1273_CIGNA 20250701 | $516.36 |
| Ultrasound spinal canal and contents CPT 76800 | CIGNA | 1273_CIGNA 20250701 | $540.54 |
| Ultrasound transabd ea addl gest CPT 76812 | CIGNA | 1273_CIGNA 20250701 | $297.96 |
| Upper Arm (Humerus) X-ray (left side) CPT 73060 | CIGNA | 1273_CIGNA 20250701 | $217.62 |
| Upper Back (Thoracic Spine) X-ray (2 views) CPT 72070 | CIGNA | 1273_CIGNA 20250701 | $198.90 |
| Upper Back (Thoracic Spine) X-ray (3 views) CPT 72072 | CIGNA | 1273_CIGNA 20250701 | $237.12 |
| Video Swallow Study (Modified Barium Swallow) CPT 74230 | CIGNA | 1273_CIGNA 20250701 | $244.92 |
| Wrist X-ray CPT 73110 | CIGNA | 1273_CIGNA 20250701 | $233.22 |
| Wrist X-ray (2 views, both wrists) CPT 73100 | CIGNA | 1273_CIGNA 20250701 | $198.90 |
| X-ray bone length studies CPT 77073 | CIGNA | 1273_CIGNA 20250701 | $123.24 |
| X-ray bone survey infant CPT 77076 | CIGNA | 1273_CIGNA 20250701 | $238.68 |
| X-ray exam of arm infant CPT 73092 | CIGNA | 1273_CIGNA 20250701 | $224.64 |
| X-ray exam of femur 1 CPT 73551 | CIGNA | 1273_CIGNA 20250701 | $229.32 |
| X-ray exam of mastoids CPT 70120 | CIGNA | 1273_CIGNA 20250701 | $110.76 |
| X-ray exam si joints CPT 72200 | CIGNA | 1273_CIGNA 20250701 | $166.14 |
| X-ray exam thorac spine4/>vw CPT 72074 | CIGNA | 1273_CIGNA 20250701 | $240.24 |
| X-ray eye detection foreign body (both sides) CPT 70030 | CIGNA | 1273_CIGNA 20250701 | $207.48 |
| X-ray joint survey 1 view CPT 77077 | CIGNA | 1273_CIGNA 20250701 | $230.88 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | CIGNA | 1273_CIGNA 20250701 | $230.88 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | CIGNA | 1273_CIGNA 20250701 | $230.88 |
| X-ray mandible ltd <4 views CPT 70100 | CIGNA | 1273_CIGNA 20250701 | $175.50 |
| X-ray nose to rectum for foreign body child CPT 76010 | CIGNA | 1273_CIGNA 20250701 | $230.88 |
| X-ray ribs 2 views left CPT 71100 | CIGNA | 1273_CIGNA 20250701 | $233.22 |
| X-ray small intestine follow-through study CPT 74248 | CIGNA | 1273_CIGNA 20250701 | $156.00 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | CIGNA | 1273_CIGNA 20250701 | $230.88 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.