Imaging prices at Adventist Health Clearlake
Clearlake, CA · every code in this section with a posted price and a Medicare benchmark.
253 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 |
$236.88–$246.96 | $658–$686 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$263.52–$302.04 | $732–$839 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,245.24 | $3,459 | 2.4× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$165.96–$380.88 | $461–$1,058 | varies |
| Arthrogram hip (73525) | $752.76 | $2,091 | 1.7× |
| Bone age studies (77072) | $152.28 | $423 | 1.1× |
| Bone Imaging 3 Phase (78315) | $1,730.52 | $4,807 | 3.4× |
| Bone Imaging Whole Body (78306) | $1,685.16 | $4,681 | 3.3× |
| Bone survey infant (77076) | $249.84 | $694 | 1.9× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$258.84–$290.52 | $719–$807 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$128.88–$293.13 | $358–$814.24 | varies |
| Chest 3 views (71047) | $261.72 | $727 | 2.3× |
| Chest 4 or more views (71048) | $274.32 | $762 | 2.0× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$112.68–$342.36 | $313–$951 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $298.80 | $830 | 2.2× |
| Contrast X-Ray Bladder (74430) | $518.76 | $1,441 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$3,006–$4,006.80 | $8,350–$11,130 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$2,346.48–$2,376 | $6,518–$6,600 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,565.28–$1,891.44 | $4,348–$5,254 | varies |
| CT abdomen w wo contrast (74170) | $1,742.04 | $4,839 | 7.7× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,313.64–$1,603.08 | $3,649–$4,453 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$1,000.80–$1,260 | $2,780–$3,500 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$2,418.84–$2,824.56 | $6,719–$7,846 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$2,466–$2,966.04 | $6,850–$8,239 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$2,479.32–$4,236.84 | $6,887–$11,769 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$2,400.12–$2,966.04 | $6,667–$8,239 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$220.68–$331.20 | $613–$920 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $213.12 | $592 | 0.9× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,755.36–$2,457.36 | $4,876–$6,826 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$1,620–$2,359.08 | $4,500–$6,553 | varies |
| CT cervical spine w/wo cont (72127) | $1,831.68 | $5,088 | 8.1× |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$1,570.68–$1,856.52 | $4,363–$5,157 | varies |
| CT chest w/wo contrast (71270) | $1,654.92 | $4,597 | 7.3× |
| CT head/brain with contrast (70460) | $1,548 | $4,300 | 6.9× |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,693.80–$1,946.16 | $4,705–$5,406 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,465.56–$1,573.56 | $4,071–$4,371 | varies |
| CT l-spine w&w/o contrast (72133) | $1,831.68 | $5,088 | 8.1× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$962.28–$1,924.56 | $2,673–$5,346 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$1,373.76–$2,885.04 | $3,816–$8,014 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,729.80–$1,859.40 | $4,805–$5,165 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,661.04–$1,796.04 | $4,614–$4,989 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,865.88–$2,013.12 | $5,183–$5,592 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,392.12–$1,763.28 | $3,867–$4,898 | varies |
| CT neck tissue combo (70492) | $1,599.84 | $4,444 | 7.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,551.60 | $4,310 | 6.9× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,191.24–$1,284.48 | $3,309–$3,568 | varies |
| CT pelvis w&w/o contrast (72194) | $1,800 | $5,000 | 8.0× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,616.76–$1,855.44 | $4,491–$5,154 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,450.08–$2,030.04 | $4,028–$5,639 | varies |
| CT scans face/jaw combo (70488) | $1,944 | $5,400 | 8.6× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,427.76–$1,621.80 | $3,966–$4,505 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,206.36–$1,582.92 | $3,351–$4,397 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,797.48–$2,516.40 | $4,993–$6,990 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,671.48–$2,179.80 | $4,643–$6,055 | varies |
| CT thoracic spine w/wo cont (72130) | $1,831.68 | $5,088 | 8.1× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,268.64–$1,637.28 | $3,524–$4,548 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,237.32–$1,856.16 | $3,437–$5,156 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,530 | $4,250 | 6.8× |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,433.88–$2,151 | $3,983–$5,975 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$2,015.64–$2,224.80 | $5,599–$6,180 | varies |
| Cta Abdomen (74175) | $1,604.88 | $4,458 | 7.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) range across 2 matching MRF lines |
$2,466–$2,966.04 | $6,850–$8,239 | varies |
| CTA pelvis (72191) | $1,321.56 | $3,671 | 5.9× |
| Dxa Bone Density Axial (77080) | $354.96 | $986 | 2.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $154.44 | $429 | 1.4× |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$123.84–$481.32 | $344–$1,337 | varies |
| Esophagram (74220) | $272.52 | $757 | 1.2× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$112.68–$265.32 | $313–$737 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$82.44–$612.72 | $229–$1,702 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$510.12–$575.28 | $1,417–$1,598 | varies |
| Foot 2 views (73620) range across 5 matching MRF lines |
$204.12–$337.68 | $567–$938 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$268.20–$402.48 | $745–$1,118 | varies |
| Gastric emptying imaging study (78264) | $1,229.76 | $3,416 | 2.4× |
| Gated Heart Planar Single (78472) | $1,271.16 | $3,531 | 2.5× |
| Hand 2 views (73120) range across 5 matching MRF lines |
$245.52–$422.28 | $682–$1,173 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,520.64 | $4,224 | 2.2× |
| Hepatobiliary System Imaging (78226) | $1,593 | $4,425 | 3.1× |
| Ht Musc Image Planar Mult (78454) | $1,991.16 | $5,531 | 1.2× |
| Ht Muscle Image Spect Sing (78451) | $2,308.68 | $6,413 | 1.4× |
| Hysterosalpingogram (74740) | $316.80 | $880 | 1.0× |
| Infant hip ultrasound, limited static exam (76886) | $338.76 | $941 | 3.0× |
| Joint Survey Single View (77077) | $290.88 | $808 | 2.2× |
| K Flow/Funct Image W/Drug (78708) | $1,585.44 | $4,404 | 2.3× |
| K Flow/Funct Image W/O Drug (78707) | $1,521.72 | $4,227 | 2.2× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$313.20–$489.24 | $870–$1,359 | varies |
| Liver & Spleen Imaging Static Only (78215) | $934.20 | $2,595 | 1.8× |
| Lung Ventilat&Perfus Imaging (78582) | $1,265.04 | $3,514 | 1.8× |
| Lymph System Imaging (78195) | $1,820.52 | $5,057 | 2.6× |
| Magnetic Image Jaw Joint (70336) | $1,324.80 | $3,680 | 4.3× |
| Meckels Divert Exam (78290) | $1,034.28 | $2,873 | 2.0× |
| Mra Head W/O & W/Contrast Material (70546) | $1,980 | $5,500 | 4.4× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,545.48–$1,608.84 | $4,293–$4,469 | varies |
| MRA neck w contrast (70548) | $1,741.32 | $4,837 | 3.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,428.56 | $6,746 | 5.4× |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$1,680.12–$1,752.84 | $4,667–$4,869 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,346.76–$1,545.48 | $3,741–$4,293 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,800–$2,700 | $5,000–$7,500 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,662.20–$3,993.48 | $7,395–$11,093 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,692 | $4,700 | 1.7× |
| MRI cervical spine w contrast (72142) | $2,088 | $5,800 | 4.7× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,545.48–$1,608.84 | $4,293–$4,469 | varies |
| MRI chest w/o contrast (71550) | $1,282.32 | $3,562 | 4.2× |
| MRI chest wo w contrast (71552) | $1,853.64 | $5,149 | 4.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,510.56 | $4,196 | 3.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,662.20–$2,736 | $7,395–$7,600 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,308.96–$1,963.44 | $3,636–$5,454 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$1,948.32–$2,160 | $5,412–$6,000 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$2,233.08–$3,575.16 | $6,203–$9,931 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,249.92–$1,337.76 | $3,472–$3,716 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$2,233.08–$3,528.72 | $6,203–$9,802 | varies |
| MRI pelvis w contrast (72196) | $1,656.36 | $4,601 | 3.7× |
| MRI pelvis w/o & w contrast (72197) | $3,536.64 | $9,824 | 7.9× |
| MRI pelvis w/o contrast (72195) | $1,594.80 | $4,430 | 5.2× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,346.76–$1,545.48 | $3,741–$4,293 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,800 | $5,000 | 4.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,341.36–$2,012.04 | $3,726–$5,589 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,528.72 | $9,802 | 7.9× |
| MRI, abdomen, combo (74183) | $1,947.60 | $5,410 | 4.3× |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,945.80–$2,233.08 | $5,405–$6,203 | varies |
| MRI, dorsal spine contrast (72147) | $1,512 | $4,200 | 3.4× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$1,405.08–$2,383.56 | $3,903–$6,621 | varies |
| MRI, joint upper extrem combo (73223) | $1,871.28 | $5,198 | 4.2× |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,945.80–$2,233.08 | $5,405–$6,203 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $871.20 | $2,420 | 1.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,659.24 | $4,609 | 1.0× |
| Myocardial Spect Multiple Studies (78452) | $2,720.16 | $7,556 | 1.6× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$230.04–$240.12 | $639–$667 | varies |
| Nuclear Rx Oral Admin (79005) | $911.52 | $2,532 | 3.0× |
| Ob us nuchal meas 1 gest (76813) | $388.08 | $1,078 | 2.9× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $55.80 | $155 | 0.4× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $10.44 | $29 | 0.3× |
| Optic foramina (70190) range across 2 matching MRF lines |
$99–$148.68 | $275–$413 | varies |
| Parathyroid Planar Imaging (78070) | $1,125 | $3,125 | 2.2× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$293.04–$335.52 | $814–$932 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,243.80 | $3,455 | 2.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$457.92–$604.08 | $1,272–$1,678 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $654.12 | $1,817 | 0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$300.24–$494.64 | $834–$1,374 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$224.64–$336.96 | $624–$936 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$322.92–$555.84 | $897–$1,544 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$367.56–$474.48 | $1,021–$1,318 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$196.92–$295.56 | $547–$821 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$294.48–$479.52 | $818–$1,332 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$295.20–$507.24 | $820–$1,409 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $187.92 | $522 | 1.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$241.56–$335.16 | $671–$931 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$272.88–$282.60 | $758–$785 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$286.20–$484.92 | $795–$1,347 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $210.96 | $586 | 1.9× |
| Radex Spine 1 View Specify Level (72020) | $198.36 | $551 | 1.8× |
| Radex Sternum Minimum 2 Views (71120) | $249.84 | $694 | 2.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $226.80 | $630 | 2.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$174.24–$261.36 | $484–$726 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $173.88 | $483 | 1.3× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$33.12–$493.20 | $92–$1,370 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $368.64 | $1,024 | 2.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $381.60 | $1,060 | 2.8× |
| Radiologic exam colon double contrast study (74280) | $508.32 | $1,412 | 2.3× |
| Radiologic exam colon single contrast study (74270) | $493.56 | $1,371 | 2.2× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$303.48–$455.40 | $843–$1,265 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$610.20–$776.88 | $1,695–$2,158 | varies |
| Radiologic exam upr gi trc double contrast study (74246) | $574.20 | $1,595 | 2.5× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$109.44–$164.16 | $304–$456 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$236.52–$354.96 | $657–$986 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$163.44–$344.16 | $454–$956 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $257.76 | $716 | 1.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$190.80–$381.24 | $530–$1,059 | varies |
| Ribs bilateral 3 views (71110) | $373.32 | $1,037 | 2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $515.52 | $1,432 | 1.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,991.16 | $5,531 | 2.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,659.24 | $4,609 | 2.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,659.24 | $4,609 | 2.4× |
| Salivary Gland Imaging (78230) | $1,007.28 | $2,798 | 2.0× |
| Scapula (73010) range across 2 matching MRF lines |
$303.48–$455.40 | $843–$1,265 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $125.64 | $349 | 5.4× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$185.04–$277.56 | $514–$771 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$61.07–$943.56 | $169.65–$2,621 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$313.20–$324 | $870–$900 | varies |
| Sternoclavicular joints (71130) | $171.72 | $477 | 1.5× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$326.88–$375.12 | $908–$1,042 | varies |
| Thoracolumbar 2 views (72080) | $304.56 | $846 | 2.7× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,467.36 | $4,076 | 2.9× |
| Thyroid Imaging With Vascular Flow (78013) | $480.24 | $1,334 | 0.9× |
| Thyroid Uptake Measurement (78012) | $480.24 | $1,334 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $703.80 | $1,955 | 1.4× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$198.72–$335.88 | $552–$933 | varies |
| Ultrasound Exam Aaa Screen (76706) | $369 | $1,025 | 2.7× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$174.96–$441.36 | $486–$1,226 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$75.96–$559.08 | $211–$1,553 | varies |
| Urethrocystogram voiding (74455) | $816.12 | $2,267 | 2.7× |
| Urethrocystography retrograde (74450) | $418.32 | $1,162 | 1.4× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$294.48–$441.72 | $818–$1,227 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$188.28–$424.08 | $523–$1,178 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$169.92–$399.24 | $472–$1,109 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$123.48–$340.20 | $343–$945 | varies |
| Us head (76506) | $142.92 | $397 | 1.1× |
| Us kidney transplant (76776) | $48.60 | $135 | 0.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$86.76–$331.56 | $241–$921 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$165.96–$358.92 | $461–$997 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$125.64–$333 | $349–$925 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$91.80–$211.68 | $255–$588 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$197.28–$515.88 | $548–$1,433 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$196.56–$601.92 | $546–$1,672 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$150.84–$262.08 | $419–$728 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$206.64–$445.32 | $574–$1,237 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$352.44–$479.88 | $979–$1,333 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$220.68–$522 | $613–$1,450 | varies |
| Us spinal canal and contents (76800) | $122.04 | $339 | 0.9× |
| Us thyroid (76536) range across 2 matching MRF lines |
$224.28–$460.08 | $623–$1,278 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$88.20–$404.64 | $245–$1,124 | varies |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,345.32 | $3,737 | 2.6× |
| Vertebral fracture assessment via dxa (77086) | $111.24 | $309 | 1.0× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$203.40–$305.28 | $565–$848 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $255.96 | $711 | 2.3× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$144.72–$272.16 | $402–$756 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$169.92–$339.84 | $472–$944 | varies |
| X-Ray Exam Breast Specimen (76098) | $612 | $1,700 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $207.72 | $577 | 1.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $273.24 | $759 | 2.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $295.20 | $820 | 2.2× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$233.64–$268.56 | $649–$746 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$305.28–$308.88 | $848–$858 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $326.16 | $906 | 2.4× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$316.08–$402.12 | $878–$1,117 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $376.20 | $1,045 | 2.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $413.28 | $1,148 | 3.1× |
| X-Ray Exam L-S Spine Bending (72114) | $399.24 | $1,109 | 3.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$309.60–$333 | $860–$925 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $545.40 | $1,515 | 4.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$390.96–$451.80 | $1,086–$1,255 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$212.40–$270 | $590–$750 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$239.76–$359.64 | $666–$999 | varies |
| X-ray IV pyelogram (ivp) (74400) | $769.68 | $2,138 | 3.4× |
| X-ray IV pyelogram+tomography (74415) | $1,345.68 | $3,738 | 6.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $345.60 | $960 | 3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $244.08 | $678 | 2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$311.40–$355.32 | $865–$987 | varies |
| X-ray nose-rectum child f.b. (76010) | $179.64 | $499 | 1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $480.60 | $1,335 | 3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $294.48 | $818 | 2.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $131.76 | $366 | 1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$294.48–$335.52 | $818–$932 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $338.04 | $939 | 3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $324 | $900 | 2.4× |
| X-ray thoracic spine 4 vw (72074) | $121.68 | $338 | 0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $628.92 | $1,747 | 1.4× |
| X-Rays Bone Length Studies (77073) | $202.68 | $563 | 1.5× |
| X-Rays Bone Survey Complete (77075) | $494.28 | $1,373 | 3.7× |
| Xr c-spine 4 or 5 views (72050) | $468 | $1,300 | 3.5× |
| Xr facial bones less than 3 views (70140) | $347.40 | $965 | 3.1× |
| XR Mastoids < 3 Views Bilateral (70120) | $152.28 | $423 | 1.1× |
| Xr orbits complete 4 views (70200) | $131.76 | $366 | 1.0× |
| Xr Tomogram Single Plane (76100) | $596.16 | $1,656 | 4.4× |
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.