Imaging prices at Adventist Health Castle
Kailua, HI · every code in this section with a posted price and a Medicare benchmark.
353 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) range across 2 matching MRF lines |
$55.36–$100.48 | $173–$314 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$72–$121.28 | $225–$379 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $710.08 | $2,219 | 1.5× |
| Adrenal Cortex & Medulla Img (78075) | $729.28 | $2,279 | 0.5× |
| Angio internal mammary (75756) | $1,221.12 | $3,816 | 0.3× |
| Angio pulmonary bilat (75743) | $1,221.12 | $3,816 | 0.3× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$99.20–$1,669.12 | $310–$5,216 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$88–$1,395.20 | $275–$4,360 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$1,535.04–$2,984.96 | $4,797–$9,328 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,221.12 | $3,816 | 0.3× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$33.92–$147.52 | $106–$461 | varies |
| Aortography thoracic serialography rs&i (75605) | $5,126.40 | $16,020 | 0.8× |
| Aortography thoracic w/o serialography rs&i (75600) | $1,356.80 | $4,240 | 0.4× |
| Artery X-Rays Abdomen (75726) | $4,688 | $14,650 | 0.7× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,253.44 | $7,042 | 0.3× |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$2,117.12–$5,258.88 | $6,616–$16,434 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$176.64–$264.96 | $552–$828 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$424–$636.16 | $1,325–$1,988 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$212.16–$318.40 | $663–$995 | varies |
| Basic radiation dosimetry calculation (77300) | $197.12 | $616 | 1.2× |
| Bone age studies (77072) range across 2 matching MRF lines |
$98.24–$150.08 | $307–$469 | varies |
| Bone Imaging 3 Phase (78315) | $612.80 | $1,915 | 1.3× |
| Bone Imaging Limited Area (78300) | $515.20 | $1,610 | 1.1× |
| Bone Imaging Multiple Areas (78305) | $496.32 | $1,551 | 1.1× |
| Bone Imaging Whole Body (78306) | $587.20 | $1,835 | 1.2× |
| Brain Flow Imaging Only (78610) | $321.28 | $1,004 | 0.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $430.08 | $1,344 | 0.7× |
| Cat Scan Follow-Up Study (76380) | $303.68 | $949 | 3.0× |
| Cerebrospinal Fluid Scan (78630) | $648.64 | $2,027 | 1.0× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$63.04–$113.60 | $197–$355 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$86.40–$128 | $270–$400 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$94.72–$168 | $296–$525 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$107.52–$181.12 | $336–$566 | varies |
| Cholecystography Oral Contrast (74290) | $190.08 | $594 | 0.9× |
| Clavicle complete (73000) range across 6 matching MRF lines |
$45.76–$163.20 | $143–$510 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $456 | $1,425 | 3.7× |
| Continuing medical physics consltj pr wk (77336) | $431.36 | $1,348 | 2.7× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$1,227.84–$1,520.96 | $3,837–$4,753 | varies |
| Contrast X-Ray Bladder (74430) | $267.52 | $836 | 0.6× |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$248.96–$373.44 | $778–$1,167 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $233.92 | $731 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) | $1,458.24 | $4,557 | 3.5× |
| CT abdomen and pelvis without contrast (74176) | $1,109.12 | $3,466 | 3.9× |
| CT abdomen w contrast (74160) | $733.76 | $2,293 | 3.5× |
| CT abdomen w wo contrast (74170) | $838.72 | $2,621 | 4.0× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$522.88–$696.96 | $1,634–$2,178 | varies |
| CT Angio Abdomen and Pelvis (74174) | $937.92 | $2,931 | 2.3× |
| CT Angio Chest (71275) | $737.28 | $2,304 | 3.6× |
| CT Angio Head (70496) | $930.88 | $2,909 | 4.5× |
| CT angio hrt w/3d image (75574) | $343.68 | $1,074 | 0.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$798.72–$1,198.08 | $2,496–$3,744 | varies |
| CT Angio Neck (70498) | $780.80 | $2,440 | 3.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $786.88 | $2,459 | 3.8× |
| CT bone density (77078) | $94.72 | $296 | 0.9× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $408.96 | $1,278 | 2.0× |
| CT cervical spine w/ contrast (72126) | $725.76 | $2,268 | 1.8× |
| CT cervical spine w/o contrast (72125) | $621.76 | $1,943 | 5.0× |
| CT cervical spine w/wo cont (72127) | $901.76 | $2,818 | 4.4× |
| CT chest w contrast (71260) | $744 | $2,325 | 3.6× |
| CT chest w/wo contrast (71270) | $852.80 | $2,665 | 4.1× |
| CT head/brain with contrast (70460) | $600.96 | $1,878 | 2.9× |
| CT head/brain without and with contrast (70470) | $738.56 | $2,308 | 3.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $343.68 | $1,074 | 0.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $61.76 | $193 | 0.6× |
| CT iac w contrast (70481) | $738.56 | $2,308 | 3.6× |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$66.56–$831.04 | $208–$2,597 | varies |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$455.04–$910.08 | $1,422–$2,844 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$746.24–$1,119.36 | $2,332–$3,498 | varies |
| CT lumbar spine w contrast (72132) | $758.08 | $2,369 | 1.8× |
| CT lumbar spine w/o contrast (72131) | $718.08 | $2,244 | 5.8× |
| CT maxillofacial w contrast (70487) | $671.36 | $2,098 | 3.2× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$377.92–$503.68 | $1,181–$1,574 | varies |
| CT neck tissue combo (70492) | $823.36 | $2,573 | 4.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $884.16 | $2,763 | 4.3× |
| CT orbits w/o contrast (70480) | $629.12 | $1,966 | 5.1× |
| CT pelvis w&w/o contrast (72194) | $795.20 | $2,485 | 3.8× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$457.60–$609.92 | $1,430–$1,906 | varies |
| CT scan of leg combo (73702) | $835.20 | $2,610 | 4.0× |
| CT scans face/jaw combo (70488) | $991.68 | $3,099 | 4.8× |
| CT soft tissue neck w contrast (70491) | $731.84 | $2,287 | 3.5× |
| CT soft tissue neck w/o contrast (70490) | $688.32 | $2,151 | 5.6× |
| CT thoracic spine w contrast (72129) | $728.32 | $2,276 | 3.5× |
| CT thoracic spine w/o contrast (72128) | $669.12 | $2,091 | 5.4× |
| CT thoracic spine w/wo cont (72130) | $818.88 | $2,559 | 4.0× |
| CT thorax w/o contrast (71250) | $578.56 | $1,808 | 4.7× |
| CT upper ext wo (73200) range across 5 matching MRF lines |
$98.88–$882.24 | $309–$2,757 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $794.88 | $2,484 | 3.8× |
| CT upper extremity with contrast (73201) | $717.44 | $2,242 | 1.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $884.16 | $2,763 | 4.3× |
| Cta Abdomen (74175) | $829.44 | $2,592 | 4.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $930.88 | $2,909 | 2.3× |
| CTA pelvis (72191) | $885.12 | $2,766 | 4.3× |
| Dilation ureters/urethra rs&i (74485) | $784.64 | $2,452 | 0.3× |
| Discography Cerv/Thor Spine (72285) | $759.68 | $2,374 | 0.3× |
| Diskography lumbar (72295) | $1,168.32 | $3,651 | 0.5× |
| Dxa Bone Density Axial (77080) | $138.24 | $432 | 1.1× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$38.72–$343.36 | $121–$1,073 | varies |
| Echo Guide For Artery Repair (76936) | $375.68 | $1,174 | 1.5× |
| Esophagram (74220) | $182.08 | $569 | 0.9× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$56.32–$300.16 | $176–$938 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$40.96–$276.80 | $128–$865 | varies |
| Fluoroscopy up to 1 hr (76000) | $184 | $575 | 0.7× |
| Follow-Up Angiography (75898) | $1,791.04 | $5,597 | 0.5× |
| Foot 2 views (73620) range across 7 matching MRF lines |
$54.72–$152.32 | $171–$476 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$75.20–$160.32 | $235–$501 | varies |
| Gastric emptying imaging study (78264) | $576.64 | $1,802 | 1.2× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $176.32 | $551 | 0.4× |
| Gated Heart Planar Single (78472) | $701.76 | $2,193 | 1.5× |
| Gated Heart, Multiple (78473) | $725.76 | $2,268 | 1.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $306.24 | $957 | 0.5× |
| Hand 2 views (73120) range across 7 matching MRF lines |
$44.16–$165.12 | $138–$516 | varies |
| Heart first pass single,planar (78481) | $367.04 | $1,147 | 0.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,377.60 | $4,305 | 0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,227.84 | $3,837 | 0.3× |
| Hepatobil Syst Image W/Drug (78227) | $373.76 | $1,168 | 0.6× |
| Hepatobiliary System Imaging (78226) | $373.76 | $1,168 | 0.8× |
| Ht Musc Image Planar Mult (78454) | $1,697.60 | $5,305 | 1.1× |
| Ht Muscle Image Spect Sing (78451) | $1,731.20 | $5,410 | 1.1× |
| Hysterosalpingogram (74740) | $260.80 | $815 | 0.9× |
| K Flow/Funct Image Multiple (78709) | $836.80 | $2,615 | 1.3× |
| K Flow/Funct Image W/Drug (78708) | $791.36 | $2,473 | 1.2× |
| K Flow/Funct Image W/O Drug (78707) | $745.60 | $2,330 | 1.2× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $389.76 | $1,218 | 0.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $412.16 | $1,288 | 0.9× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$75.20–$192 | $235–$600 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $481.92 | $1,506 | 1.0× |
| Liver imaging static only (78201) | $814.40 | $2,545 | 1.3× |
| Liver imaging w/vascular flow (78202) | $729.28 | $2,279 | 1.1× |
| Lung Perf&Ventilat Diferentl (78598) | $321.92 | $1,006 | 0.5× |
| Lung perfusion differential (78597) | $218.56 | $683 | 0.5× |
| Lung Ventilat&Perfus Imaging (78582) | $401.92 | $1,256 | 0.6× |
| Lung Ventilation Imaging (78579) | $220.48 | $689 | 0.5× |
| Lymph System Imaging (78195) | $463.36 | $1,448 | 0.7× |
| Magnetic Image Jaw Joint (70336) | $700.80 | $2,190 | 2.5× |
| Mammary ductogram or galactogram multiple (77054) | $201.60 | $630 | 0.7× |
| Mammary ductogram or galactogram single (77053) | $134.72 | $421 | 0.5× |
| Meckels Divert Exam (78290) | $742.40 | $2,320 | 1.6× |
| Mlc imrt design & construction per imrt plan (77338) | $310.40 | $970 | 0.7× |
| Mra Head W/O & W/Contrast Material (70546) | $1,232.64 | $3,852 | 3.0× |
| MRA head w/o contrast (70544) | $809.28 | $2,529 | 2.9× |
| MRA head with contrast (70545) | $1,101.44 | $3,442 | 2.7× |
| MRA neck w contrast (70548) | $1,093.12 | $3,416 | 2.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,150.08 | $3,594 | 2.8× |
| MRA neck w/o contrast (70547) | $829.76 | $2,593 | 2.9× |
| MRI abdomen w contrast (74182) | $913.92 | $2,856 | 2.2× |
| MRI abdomen w/o contrast (74181) | $802.24 | $2,507 | 2.8× |
| MRI any jt lower extrem w/contrast material (73722) | $965.12 | $3,016 | 1.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,135.04 | $3,547 | 2.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,102.08 | $3,444 | 1.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,037.76 | $3,243 | 3.7× |
| MRI Breast Without Contrast Material Unilateral (77046) | $657.92 | $2,056 | 2.3× |
| MRI cervical spine w contrast (72142) | $814.08 | $2,544 | 2.0× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$565.76–$754.24 | $1,768–$2,357 | varies |
| MRI chest w/o contrast (71550) | $927.36 | $2,898 | 3.3× |
| MRI chest with contrast (71551) | $961.60 | $3,005 | 1.0× |
| MRI chest wo w contrast (71552) | $1,040 | $3,250 | 2.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $946.88 | $2,959 | 2.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,116.80–$1,675.20 | $3,490–$5,235 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$891.52–$1,337.28 | $2,786–$4,179 | varies |
| MRI lumbar spine w contrast (72149) | $846.08 | $2,644 | 2.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,135.36 | $3,548 | 2.8× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$588.48–$784.64 | $1,839–$2,452 | varies |
| MRI orbit face neck w contrast (70542) | $896 | $2,800 | 2.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,127.04 | $3,522 | 2.7× |
| MRI pelvis w contrast (72196) | $869.12 | $2,716 | 2.1× |
| MRI pelvis w/o & w contrast (72197) | $1,132.16 | $3,538 | 2.7× |
| MRI pelvis w/o contrast (72195) | $832.64 | $2,602 | 3.0× |
| MRI spectroscopy (76390) | $657.92 | $2,056 | 6.4× |
| MRI thoracic spine w/o contrast (72146) | $843.52 | $2,636 | 3.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $934.40 | $2,920 | 2.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$662.72–$883.52 | $2,071–$2,761 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,130.24–$1,695.36 | $3,532–$5,298 | varies |
| MRI, abdomen, combo (74183) | $1,145.60 | $3,580 | 2.8× |
| MRI, dorsal spine combo (72157) | $1,122.56 | $3,508 | 2.7× |
| MRI, dorsal spine contrast (72147) | $928 | $2,900 | 2.3× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$690.88–$1,382.08 | $2,159–$4,319 | varies |
| MRI, joint upper extrem combo (73223) | $1,148.48 | $3,589 | 2.8× |
| MRI, lumbar spine combo (72158) | $1,125.12 | $3,516 | 2.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $430.08 | $1,344 | 0.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,400.32 | $4,376 | 0.9× |
| Myocardial Spect Multiple Studies (78452) | $1,995.20 | $6,235 | 1.3× |
| N-invas est c ffr sw aly CTA (75580) | $811.52 | $2,536 | 0.8× |
| Neck soft tissue (70360) | $135.68 | $424 | 1.3× |
| Nm myocard infarct spect (78469) | $514.88 | $1,609 | 0.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,225.28 | $3,829 | 0.7× |
| Nuclear Rx Oral Admin (79005) | $573.12 | $1,791 | 2.1× |
| Ob us nuchal meas 1 gest (76813) | $38.72 | $121 | 0.3× |
| Optic foramina (70190) range across 2 matching MRF lines |
$135.68–$203.52 | $424–$636 | varies |
| Panoramic X-ray of jaws (70355) | $135.68 | $424 | 1.3× |
| Parathyroid Planar Imaging (78070) | $496.32 | $1,551 | 1.1× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$57.92–$111.36 | $181–$348 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,417.60 | $4,430 | 0.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,227.84 | $3,837 | 0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $450.56 | $1,408 | 1.0× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $879.36 | $2,748 | 0.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$115.20–$222.40 | $360–$695 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $315.52 | $986 | 0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 6 matching MRF lines |
$9.28–$188.80 | $29–$590 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 6 matching MRF lines |
$33.92–$147.52 | $106–$461 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$75.20–$188.80 | $235–$590 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $203.52 | $636 | 1.6× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$52.16–$143.04 | $163–$447 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$75.20–$188.80 | $235–$590 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$75.20–$195.84 | $235–$612 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$63.04–$139.52 | $197–$436 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$135.68–$203.52 | $424–$636 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$101.76–$135.68 | $318–$424 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $135.68 | $424 | 1.3× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$76.48–$125.76 | $239–$393 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$75.20–$188.80 | $235–$590 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $135.68 | $424 | 1.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $444.48 | $1,389 | 2.1× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$52.80–$116.80 | $165–$365 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$71.36–$133.12 | $223–$416 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $271.36 | $848 | 2.6× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$52.16–$142.08 | $163–$444 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 4 matching MRF lines |
$63.04–$139.52 | $197–$436 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$75.20–$196.80 | $235–$615 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $266.24 | $832 | 2.2× |
| Radiation treatment delivery level 3 (77412) | $431.36 | $1,348 | 0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$135.68–$203.52 | $424–$636 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$82.88–$125.76 | $259–$393 | varies |
| Radiologic exam colon double contrast study (74280) | $368 | $1,150 | 1.8× |
| Radiologic exam colon single contrast study (74270) | $393.60 | $1,230 | 1.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $229.44 | $717 | 1.1× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$100.48–$248.64 | $314–$777 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$118.72–$202.24 | $371–$632 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $264.32 | $826 | 1.3× |
| Radiologic exam swallow function contrast study (74230) | $333.76 | $1,043 | 1.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $227.20 | $710 | 1.1× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$104.64–$157.12 | $327–$491 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$75.20–$188.80 | $235–$590 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$60.48–$161.28 | $189–$504 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $310.72 | $971 | 2.5× |
| Radiologic Examination Salivary Gland Calculus (70380) | $135.68 | $424 | 1.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$75.20–$160.32 | $235–$501 | varies |
| Radiopharm Dacryocystography (78660) | $503.36 | $1,573 | 1.1× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $481.92 | $1,506 | 1.7× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$95.36–$189.12 | $298–$591 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $347.84 | $1,087 | 0.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $745.60 | $2,330 | 1.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $770.88 | $2,409 | 1.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $745.60 | $2,330 | 1.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,441.60 | $4,505 | 2.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,017.60 | $3,180 | 0.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,441.60 | $4,505 | 0.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,272 | $3,975 | 0.8× |
| Salivary Gland Imaging (78230) | $298.56 | $933 | 0.6× |
| Scapula (73010) range across 4 matching MRF lines |
$91.52–$218.56 | $286–$683 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$24.64–$32.96 | $77–$103 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$60.48–$154.24 | $189–$482 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$384.96–$577.60 | $1,203–$1,805 | varies |
| Sialogram (70390) | $203.52 | $636 | 0.7× |
| Skull less than 4 views (70250) | $203.52 | $636 | 1.6× |
| Special Physics Consult (77370) | $131.84 | $412 | 0.8× |
| Special teletherapy port plan (77321) | $464.96 | $1,453 | 1.1× |
| Special treatment procedure (77470) | $504.64 | $1,577 | 0.8× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$90.56–$187.52 | $283–$586 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $373.12 | $1,166 | 0.8× |
| Testicular Imaging W/Flow (78761) | $503.36 | $1,573 | 1.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $754.24 | $2,357 | 1.7× |
| Ther rad simulaj-aided field setting simple (77280) | $455.68 | $1,424 | 2.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $380.16 | $1,188 | 1.8× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$86.72–$145.60 | $271–$455 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$86.72–$159.68 | $271–$499 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$86.72–$145.60 | $271–$455 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $475.84 | $1,487 | 1.0× |
| Thyroid Imaging With Vascular Flow (78013) | $273.28 | $854 | 0.6× |
| Thyroid Met Imaging Body (78018) | $640.96 | $2,003 | 1.0× |
| Thyroid Uptake Measurement (78012) | $273.28 | $854 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $310.40 | $970 | 0.7× |
| Tx Devices Design & Construction Complex (77334) | $468.16 | $1,463 | 1.1× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$140.16–$210.24 | $438–$657 | varies |
| Ultrasound Elastography Parenchyma (76981) | $31.68 | $99 | 0.3× |
| Ultrasound, abdomen limited (76705) | $212.80 | $665 | 1.7× |
| Umbilical-artery Doppler (OB) (76820) | $55.68 | $174 | 0.5× |
| Unlisted Dx Radiographic Procedure (76499) | $34.88 | $109 | 0.3× |
| Upper gi w/o kub (74240) | $225.92 | $706 | 1.1× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $27.52 | $86 | 2.5× |
| Urea breath test c-14 isotopic analysis (78268) | $88.32 | $276 | 0.9× |
| Urethrocystogram voiding (74455) | $327.04 | $1,022 | 1.2× |
| Urethrocystography retrograde (74450) | $301.12 | $941 | 1.1× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$160–$240 | $500–$750 | varies |
| Us chest (76604) | $232 | $725 | 1.9× |
| Us complete joint (76881) | $203.52 | $636 | 1.6× |
| Us exam, pelvic, limited (76857) | $186.24 | $582 | 1.5× |
| Us head (76506) | $255.36 | $798 | 2.1× |
| Us kidney transplant (76776) | $189.12 | $591 | 1.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$140.16–$210.24 | $438–$657 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$101.12–$241.92 | $316–$756 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$34.24–$199.68 | $107–$624 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$40–$214.08 | $125–$669 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$36.16–$232.64 | $113–$727 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$50.88–$247.68 | $159–$774 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$45.44–$212.48 | $142–$664 | varies |
| Us retroperitoneal complete (76770) | $239.68 | $749 | 1.9× |
| Us retroperitoneal limited (76775) | $213.12 | $666 | 1.7× |
| Us scrotum and contents (76870) | $200 | $625 | 1.6× |
| Us thyroid (76536) range across 2 matching MRF lines |
$29.76–$216 | $93–$675 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$22.40–$36.16 | $70–$113 | varies |
| Vascular Flow Imaging (78445) | $247.68 | $774 | 0.5× |
| Vein X-Ray Chest (75827) | $616.96 | $1,928 | 0.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,791.04 | $5,597 | 0.5× |
| Vein X-Ray Spleen/Liver (75810) | $1,791.04 | $5,597 | 0.5× |
| Venography caval inferior serialography rs&i (75825) | $1,428.48 | $4,464 | 0.4× |
| Venography extremity bilateral rs&i (75822) | $593.60 | $1,855 | 0.3× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$714.24–$1,437.12 | $2,232–$4,491 | varies |
| Venography Renal Bilateral (75833) | $1,746.88 | $5,459 | 0.5× |
| Venography Renal Unilateral (75831) | $1,227.84 | $3,837 | 0.3× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$2,117.12 | $6,616 | 0.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $412.16 | $1,288 | 0.9× |
| Wrist 2 views (73100) range across 7 matching MRF lines |
$33.92–$166.72 | $106–$521 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$68.80–$168.64 | $215–$527 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$100.80–$1,557.12 | $315–$4,866 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$91.20–$157.44 | $285–$492 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$39.04–$147.52 | $122–$461 | varies |
| X-Ray Exam Breast Specimen (76098) | $273.28 | $854 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $67.84 | $212 | 0.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $139.52 | $436 | 1.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $214.72 | $671 | 1.7× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$60.48–$111.68 | $189–$349 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$85.76–$149.12 | $268–$466 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $169.60 | $530 | 1.4× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$72.64–$111.36 | $227–$348 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$72.64–$139.52 | $227–$436 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$83.20–$266.24 | $260–$832 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$157.44–$224 | $492–$700 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$75.20–$129.92 | $235–$406 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$139.20–$200.96 | $435–$628 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$76.48–$146.24 | $239–$457 | varies |
| X-ray eye for foreign body (70030) | $135.68 | $424 | 1.3× |
| X-ray humerus (73060) range across 6 matching MRF lines |
$75.20–$160.32 | $235–$501 | varies |
| X-ray IV pyelogram (ivp) (74400) | $326.72 | $1,021 | 1.6× |
| X-ray IV pyelogram+tomography (74415) | $431.36 | $1,348 | 2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$57.92–$118.08 | $181–$369 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$86.72–$145.60 | $271–$455 | varies |
| X-ray nose-rectum child f.b. (76010) | $101.76 | $318 | 1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$95.36–$217.28 | $298–$679 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$94.72–$159.04 | $296–$497 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $88.32 | $276 | 0.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$86.72–$145.60 | $271–$455 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$135.68–$155.84 | $424–$487 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$203.52–$223.04 | $636–$697 | varies |
| X-ray thoracic spine 4 vw (72074) | $79.04 | $247 | 0.6× |
| X-Ray Tmj Unilat (70328) | $135.68 | $424 | 1.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$27.20–$332.80 | $85–$1,040 | varies |
| X-Rays Bone Length Studies (77073) | $287.04 | $897 | 2.3× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$123.20–$354.56 | $385–$1,108 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$118.72–$171.84 | $371–$537 | varies |
| Xr facial bones less than 3 views (70140) | $135.68 | $424 | 1.3× |
| Xr myelogram posterior fossa (70010) | $407.04 | $1,272 | 1.0× |
| Xr orbits complete 4 views (70200) | $203.52 | $636 | 1.6× |
| Xr Tomogram Single Plane (76100) | $171.20 | $535 | 1.4× |
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.