Imaging prices at Allen Hospital
Waterloo, IA · every code in this section with a posted price and a Medicare benchmark.
359 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) | $145.10 | $181.37 | 1.7× |
| Abdomen 2 views (74019) | $277.37 | $346.71 | 2.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $682.10 | $852.62 | 1.8× |
| Angio pulmonary bilat (75743) | $2,827.16 | $3,533.95 | 0.9× |
| Angiography extremity bilateral rs&i (75716) | $4,029.72 | $5,037.15 | 1.3× |
| Angiography extremity unilateral rs&i (75710) | $3,458.54 | $4,323.17 | 1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,827.16 | $3,533.95 | 0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $6,408.81 | $8,011.01 | 2.1× |
| Ankle 2 views (73600) | $114.93 | $143.66 | 1.4× |
| Aortography thoracic serialography rs&i (75605) | $2,766.73 | $3,458.41 | 0.5× |
| Artery X-Rays Abdomen (75726) | $2,766.73 | $3,458.41 | 0.5× |
| Artery X-Rays Pelvis (75736) | $2,766.73 | $3,458.41 | 0.5× |
| Artery X-Rays Spine (75705) | $10,258.65 | $12,823.31 | 1.9× |
| Arthrogram hip (73525) | $770.88 | $963.59 | 2.3× |
| Arthrogram Wrist (73115) | $602.68 | $753.35 | 1.8× |
| Bone age studies (77072) | $156.05 | $195.06 | 1.6× |
| Bone Imaging 3 Phase (78315) | $1,823.94 | $2,279.92 | 4.7× |
| Bone Imaging Limited Area (78300) | $825.08 | $1,031.34 | 2.1× |
| Bone Imaging Whole Body (78306) | $1,697.80 | $2,122.24 | 4.4× |
| Bone marrow imaging limited area (78102) | $905.42 | $1,131.77 | 2.4× |
| Bone marrow imaging; multiple areas (78103) | $765.70 | $957.12 | 2.0× |
| Bone survey infant (77076) | $355.08 | $443.84 | 3.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $947.48 | $1,184.35 | 1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,781.68 | $3,477.10 | 2.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,203.49 | $1,504.36 | 3.6× |
| Cardiovasc nucl exam unlisted (78499) | $1,020.36 | $1,275.45 | 2.7× |
| Cat Scan Follow-Up Study (76380) | $558.76 | $698.45 | 6.7× |
| Cerebrospinal Fluid Scan (78630) | $1,140.89 | $1,426.11 | 2.2× |
| Chest 1 view (71045) | $145.10 | $181.37 | 1.7× |
| Chest 2 views (71046) | $145.10 | $181.37 | 1.7× |
| Chest 3 views (71047) | $145.10 | $181.37 | 1.7× |
| Chest 4 or more views (71048) | $277.37 | $346.71 | 2.8× |
| Cholecystography Oral Contrast (74290) | $297.14 | $371.42 | 1.8× |
| Clavicle complete (73000) | $253.24 | $316.54 | 3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $285.12 | $356.39 | 2.8× |
| Contrast Exam Abdominl Aorta (75625) | $3,458.54 | $4,323.17 | 1.1× |
| Contrast X-Ray Bladder (74430) | $351.33 | $439.16 | 1.0× |
| Contrast X-Ray Of Elbow (73085) | $387.78 | $484.72 | 1.2× |
| Contrast X-Ray Of Knee Joint (73580) | $387.78 | $484.72 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) | $3,127.72 | $3,909.65 | 9.3× |
| CT abdomen and pelvis without contrast (74176) | $2,086.05 | $2,607.56 | 9.1× |
| CT abdomen w contrast (74160) | $1,199.76 | $1,499.69 | 7.1× |
| CT abdomen w wo contrast (74170) | $1,396.92 | $1,746.14 | 8.3× |
| CT abdomen w/o contrast (74150) | $962.42 | $1,203.02 | 9.6× |
| CT Angio Abdomen and Pelvis (74174) | $2,618.16 | $3,272.69 | 7.8× |
| CT Angio Chest (71275) | $2,255.31 | $2,819.13 | 13.4× |
| CT Angio Head (70496) | $1,341.79 | $1,677.23 | 8.0× |
| CT angio hrt w/3d image (75574) | $1,632.38 | $2,040.47 | 4.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,341.79 | $1,677.23 | 8.0× |
| CT Angio Neck (70498) | $1,348.32 | $1,685.40 | 8.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,274.51 | $1,593.13 | 7.6× |
| CT bone density (77078) | $547.54 | $684.42 | 6.5× |
| CT cervical spine w/ contrast (72126) | $1,463.25 | $1,829.06 | 4.4× |
| CT cervical spine w/o contrast (72125) | $1,084.84 | $1,356.04 | 10.8× |
| CT cervical spine w/wo cont (72127) | $1,214.71 | $1,518.38 | 7.2× |
| CT chest w contrast (71260) | $1,210.97 | $1,513.71 | 7.2× |
| CT chest w/wo contrast (71270) | $1,367.94 | $1,709.92 | 8.1× |
| CT head/brain with contrast (70460) | $918.51 | $1,148.13 | 5.4× |
| CT head/brain without and with contrast (70470) | $1,798.98 | $2,248.72 | 10.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,399.72 | $1,749.64 | 4.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $88 | $110 | 1.1× |
| CT hrt w/3d image congen (75573) | $1,749.18 | $2,186.47 | 5.2× |
| CT iac w contrast (70481) | $1,144.64 | $1,430.79 | 6.8× |
| CT l-spine w&w/o contrast (72133) | $1,106.33 | $1,382.91 | 6.6× |
| CT lower ext w/o (73700) | $777.55 | $971.93 | 7.7× |
| CT lower extremity w/contrast material (73701) | $1,299.47 | $1,624.33 | 7.7× |
| CT lumbar spine w contrast (72132) | $1,214.71 | $1,518.38 | 3.6× |
| CT lumbar spine w/o contrast (72131) | $841.89 | $1,052.36 | 8.4× |
| CT maxillofacial w contrast (70487) | $1,111 | $1,388.74 | 6.6× |
| CT maxillofacial wo contrast (70486) | $719.47 | $899.33 | 7.2× |
| CT neck tissue combo (70492) | $976.44 | $1,220.55 | 5.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,337.11 | $1,671.38 | 7.9× |
| CT orbits w/o contrast (70480) | $981.11 | $1,226.38 | 9.8× |
| CT pelvis w&w/o contrast (72194) | $1,324.96 | $1,656.19 | 7.9× |
| CT pelvis w/o contrast (72192) | $946.54 | $1,183.17 | 9.4× |
| CT scan of leg combo (73702) | $1,299.47 | $1,624.33 | 7.7× |
| CT scans face/jaw combo (70488) | $1,246.48 | $1,558.10 | 7.4× |
| CT soft tissue neck w contrast (70491) | $1,082.97 | $1,353.71 | 6.4× |
| CT soft tissue neck w/o contrast (70490) | $832.55 | $1,040.68 | 8.3× |
| CT thoracic spine w contrast (72129) | $1,768.84 | $2,211.05 | 10.5× |
| CT thoracic spine w/o contrast (72128) | $1,058.40 | $1,323 | 10.5× |
| CT thoracic spine w/wo cont (72130) | $1,768.84 | $2,211.05 | 10.5× |
| CT thorax w/o contrast (71250) | $869.92 | $1,087.39 | 8.7× |
| CT upper ext wo (73200) | $656.21 | $820.26 | 6.5× |
| CT upper extremity w/o & w/contrast material (73202) | $1,096.67 | $1,370.83 | 6.5× |
| CT upper extremity with contrast (73201) | $2,295.55 | $2,869.43 | 6.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,491.28 | $1,864.10 | 8.8× |
| Cta Abdomen (74175) | $1,457.65 | $1,822.06 | 8.6× |
| CTA pelvis (72191) | $1,561.37 | $1,951.71 | 9.3× |
| Dilation ureters/urethra rs&i (74485) | $1,555.76 | $1,944.69 | 0.8× |
| Diskography lumbar (72295) | $2,212.64 | $2,765.79 | 1.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $246.35 | $307.93 | 2.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $246.35 | $307.93 | 2.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $287.23 | $359.03 | 2.9× |
| Dxa Bone Density Axial (77080) | $452.25 | $565.31 | 4.5× |
| Dxa bone density study (77085) | $216.78 | $270.97 | 2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $370.84 | $463.55 | 4.4× |
| Echo exam of fetal heart (76825) | $1,159.68 | $1,449.59 | 2.2× |
| Echo exam uterus (76831) | $638.20 | $797.75 | 2.8× |
| Echo Guide For Artery Repair (76936) | $575.60 | $719.49 | 2.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $538.27 | $672.83 | 2.3× |
| Esophagram (74220) | $176.60 | $220.75 | 1.0× |
| Fetal Biophys Profile W/Nst (76818) | $455.05 | $568.81 | 4.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $207.44 | $259.29 | 2.1× |
| Fluoroscopy up to 1 hr (76000) | $509.25 | $636.56 | 2.2× |
| Follow-Up Angiography (75898) | $1,024.09 | $1,280.11 | 0.3× |
| Foot 2 views (73620) | $87.20 | $109 | 1.0× |
| Forearm 2 views (73090) | $243.88 | $304.85 | 2.9× |
| Gastric emptying imaging study (78264) | $1,761.34 | $2,201.67 | 4.6× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $797.24 | $996.54 | 2.1× |
| Gated Heart Planar Single (78472) | $389.65 | $487.06 | 1.0× |
| Gated Heart, Multiple (78473) | $1,190.41 | $1,488.01 | 3.1× |
| Hand 2 views (73120) | $97.19 | $121.48 | 1.0× |
| Hepatobil Syst Image W/Drug (78227) | $1,922.97 | $2,403.71 | 3.7× |
| Hepatobiliary System Imaging (78226) | $1,884.68 | $2,355.84 | 4.9× |
| Ht Musc Image Planar Mult (78454) | $1,464.20 | $1,830.25 | 1.2× |
| Ht Muscle Image Spect Sing (78451) | $1,464.20 | $1,830.25 | 1.2× |
| Hysterosalpingogram (74740) | $835.36 | $1,044.19 | 3.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $463.46 | $579.32 | 5.5× |
| Infant hip ultrasound, limited static exam (76886) | $463.46 | $579.32 | 5.5× |
| Infusion Ivp (74410) | $629.78 | $787.22 | 3.7× |
| Joint Survey Single View (77077) | $244.73 | $305.91 | 2.4× |
| K Flow/Funct Image Multiple (78709) | $1,751.99 | $2,189.98 | 3.4× |
| K Flow/Funct Image W/Drug (78708) | $1,166.12 | $1,457.64 | 2.2× |
| K Flow/Funct Image W/O Drug (78707) | $1,132.48 | $1,415.60 | 2.2× |
| Knee 3 Views (73562) | $288.73 | $360.91 | 3.5× |
| Liver & Spleen Imaging Static Only (78215) | $729.77 | $912.21 | 1.9× |
| Liver imaging w/vascular flow (78202) | $865.24 | $1,081.55 | 1.7× |
| Lung Perf&Ventilat Diferentl (78598) | $487.76 | $609.69 | 0.9× |
| Lung perfusion differential (78597) | $857.99 | $1,072.48 | 2.2× |
| Lung Ventilat&Perfus Imaging (78582) | $384.04 | $480.04 | 0.7× |
| Lung Ventilation Imaging (78579) | $263.49 | $329.36 | 0.7× |
| Lymph System Imaging (78195) | $1,703.40 | $2,129.24 | 3.3× |
| Magnetic Image Jaw Joint (70336) | $967.10 | $1,208.87 | 4.2× |
| Mammary ductogram or galactogram multiple (77054) | $398.99 | $498.73 | 1.7× |
| Mammary ductogram or galactogram single (77053) | $376.56 | $470.70 | 1.6× |
| Meckels Divert Exam (78290) | $455.98 | $569.97 | 1.2× |
| Mr safety determination physician/other qhp (76016) | $178.60 | $223.25 | 2.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $49.68 | $62.09 | 1.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $186.19 | $232.73 | 2.0× |
| Mr safety implt pos&/immoblj (76019) | $120.49 | $150.61 | 2.1× |
| Mr safety med physics xm customization plng&mntr (76017) | $490.31 | $612.88 | 2.1× |
| Mra Head W/O & W/Contrast Material (70546) | $2,174.32 | $2,717.90 | 6.5× |
| MRA head w/o contrast (70544) | $1,377.28 | $1,721.60 | 6.0× |
| MRA head with contrast (70545) | $1,505.31 | $1,881.63 | 4.5× |
| MRA neck w contrast (70548) | $1,374.48 | $1,718.10 | 4.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,389.24 | $2,986.55 | 7.1× |
| MRA neck w/o contrast (70547) | $1,537.08 | $1,921.35 | 6.7× |
| MRI abdomen w contrast (74182) | $1,483.81 | $1,854.76 | 4.4× |
| MRI abdomen w/o contrast (74181) | $1,310.02 | $1,637.52 | 5.7× |
| MRI any jt lower extrem w/contrast material (73722) | $3,518.47 | $4,398.08 | 4.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,784.96 | $4,731.19 | 11.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,635.18 | $2,043.97 | 2.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,683.76 | $2,104.70 | 7.3× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,683.76 | $2,104.70 | 7.3× |
| MRI cardiac w/o contrast (75557) | $977.37 | $1,221.71 | 4.3× |
| MRI cervical spine w contrast (72142) | $1,579.12 | $1,973.90 | 4.7× |
| MRI cervical spine w/o cont (72141) | $1,183.88 | $1,479.85 | 5.2× |
| MRI chest w/o contrast (71550) | $1,395.97 | $1,744.96 | 6.1× |
| MRI chest with contrast (71551) | $1,483.81 | $1,854.76 | 2.0× |
| MRI chest wo w contrast (71552) | $2,346.26 | $2,932.82 | 7.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,483.81 | $1,854.76 | 4.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,614.43 | $3,268.03 | 7.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,063.34 | $1,329.17 | 4.6× |
| MRI lumbar spine w contrast (72149) | $1,693.12 | $2,116.39 | 5.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,667.68 | $3,334.60 | 8.0× |
| MRI orbit face &/neck w/o contrast (70540) | $1,657.60 | $2,072 | 7.2× |
| MRI orbit face neck w contrast (70542) | $2,016.40 | $2,520.50 | 6.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,473.33 | $3,091.66 | 7.4× |
| MRI pelvis w contrast (72196) | $1,564.17 | $1,955.21 | 4.7× |
| MRI pelvis w/o & w contrast (72197) | $2,525.67 | $3,157.08 | 7.5× |
| MRI pelvis w/o contrast (72195) | $1,295.07 | $1,618.83 | 5.6× |
| MRI spectroscopy (76390) | $1,002.60 | $1,253.24 | 12.0× |
| MRI thoracic spine w/o contrast (72146) | $1,480.08 | $1,850.09 | 6.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,563.04 | $3,203.79 | 7.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,364.20 | $1,705.25 | 5.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,563.04 | $3,203.79 | 7.6× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$2,487.34–$3,870.12 | $3,109.17–$4,837.64 | varies |
| MRI, dorsal spine combo (72157) | $2,532.20 | $3,165.24 | 7.6× |
| MRI, dorsal spine contrast (72147) | $1,665.09 | $2,081.36 | 5.0× |
| MRI, joint upper extrem (73221) | $1,299.74 | $1,624.67 | 5.7× |
| MRI, joint upper extrem combo (73223) | $2,425.67 | $3,032.08 | 7.2× |
| MRI, lumbar spine combo (72158) | $2,525.67 | $3,157.08 | 7.5× |
| Musculoskeletal Nuclear Exam (78399) | $1,020.36 | $1,275.45 | 2.7× |
| Myelogram cervical (72240) | $1,739.83 | $2,174.78 | 2.3× |
| Myelogram Lumbar (72265) | $1,583.79 | $1,979.73 | 2.1× |
| Myelography thoracic (72255) | $549.43 | $686.78 | 0.7× |
| Myelograpy 2/more regions rs&i (72270) | $1,721.15 | $2,151.43 | 2.3× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $780.23 | $975.28 | 2.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,256.36 | $4,070.44 | 2.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,615.57 | $2,019.46 | 1.3× |
| Myocardial Spect Multiple Studies (78452) | $2,801.31 | $3,501.63 | 2.3× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $2,958.61 | $3,698.26 | 2.2× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $4,564.92 | $5,706.14 | 2.2× |
| N-invas est c ffr sw aly CTA (75580) | $2,246.83 | $2,808.53 | 2.7× |
| Neck soft tissue (70360) | $260.69 | $325.86 | 3.1× |
| Nervous system nuclear exam (78699) | $891.41 | $1,114.26 | 2.3× |
| Nm myocard infarct spect (78469) | $828.82 | $1,036.02 | 1.6× |
| Nm unlisted gi procedure (78299) | $1,020.36 | $1,275.45 | 2.7× |
| Nonvascular Shunt X-Ray (75809) | $287.79 | $359.73 | 2.9× |
| Nuclear medicine study of endocrine organs (78099) | $1,020.36 | $1,275.45 | 2.7× |
| Nuclear Rx Oral Admin (79005) | $1,088.57 | $1,360.71 | 4.9× |
| Optic foramina (70190) | $185.95 | $232.43 | 2.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,409.06 | $1,761.32 | 2.7× |
| Parathyroid Planar Imaging (78070) | $620.44 | $775.54 | 1.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,214.71 | $1,518.38 | 3.2× |
| Pelvis 1 or 2 views (72170) | $97.19 | $121.48 | 1.0× |
| Pet Image W/Ct Lmtd (78814) | $3,643.19 | $4,553.98 | 2.7× |
| PET image w/CT, full body (78816) | $4,045.91 | $5,057.38 | 2.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,019.75 | $5,024.68 | 2.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $263.49 | $329.36 | 0.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $359.75 | $449.68 | 3.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $962.42 | $1,203.02 | 1.8× |
| Radex Ankle Complete Minimum 3 Views (73610) | $261.64 | $327.04 | 3.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $100.92 | $126.14 | 1.2× |
| Radex elbow complete minimum 3 views (73080) | $282.19 | $352.73 | 3.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $360.68 | $450.84 | 3.6× |
| Radex fingr minimum 2 views (73140) | $221.46 | $276.82 | 2.6× |
| Radex foot complete minimum 3 views (73630) | $258.84 | $323.54 | 3.1× |
| Radex Hand Minimum 3 Views (73130) | $109.32 | $136.65 | 1.3× |
| Radex lower extremity infant minimum 2 views (73592) | $189.70 | $237.12 | 2.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $364.42 | $455.52 | 3.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $193.44 | $241.79 | 2.3× |
| Radex Ribs Unilateral 2 Views (71100) | $184.08 | $230.10 | 2.2× |
| Radex shoulder complete minimum 2 views (73030) | $236.41 | $295.51 | 2.8× |
| Radex Sinuses Paransl < 3 Views (70210) | $113.07 | $141.33 | 1.4× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $533.55 | $666.93 | 3.2× |
| Radex Spine 1 View Specify Level (72020) | $156.99 | $196.23 | 1.9× |
| Radex Sternum Minimum 2 Views (71120) | $156.05 | $195.06 | 1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $288.73 | $360.91 | 3.5× |
| Radex Toe Minimum 2 Views (73660) | $194.36 | $242.95 | 2.3× |
| Radex upper extremity infant minimum 2 views (73092) | $276.58 | $345.72 | 2.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $258.84 | $323.54 | 3.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $427.96 | $534.94 | 4.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $327.04 | $408.79 | 3.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $277.37 | $346.71 | 2.8× |
| Radiologic exam colon double contrast study (74280) | $792.37 | $990.46 | 4.7× |
| Radiologic exam colon single contrast study (74270) | $206.52 | $258.14 | 1.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $379.01 | $473.76 | 2.2× |
| Radiologic exam knee complete 4/more views (73564) | $344.80 | $431 | 3.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $240.14 | $300.17 | 2.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $745.64 | $932.05 | 4.4× |
| Radiologic exam swallow function contrast study (74230) | $206.52 | $258.14 | 1.2× |
| Radiologic exam teeth complete full mouth (70320) | $193.44 | $241.79 | 0.8× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $484.72 | $605.90 | 2.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $671.84 | $839.79 | 4.0× |
| Radiologic examination femur 1 view (73551) | $128.01 | $160.01 | 1.5× |
| Radiologic examination femur minimum 2 views (73552) | $224.25 | $280.31 | 2.7× |
| Radiologic examination knee 1/2 views (73560) | $189.70 | $237.12 | 2.3× |
| Radiologic Examination Osseous Survey Limited (77074) | $380.30 | $475.37 | 3.8× |
| Radiologic examination tibia & fibula 2 views (73590) | $88.70 | $110.87 | 1.1× |
| Ribs bilateral 3 views (71110) | $341.08 | $426.34 | 3.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $792.50 | $990.62 | 2.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $792.50 | $990.62 | 2.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,728.42 | $3,410.52 | 5.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,728.42 | $3,410.52 | 5.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,728.42 | $3,410.52 | 5.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,645.76 | $3,307.19 | 2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,001.09 | $3,751.36 | 2.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,645.76 | $3,307.19 | 2.1× |
| Scapula (73010) | $307.42 | $384.27 | 3.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $33.64 | $42.04 | 1.4× |
| Sella turcica (70240) | $150.45 | $188.06 | 1.8× |
| Shoulder 1 view (73020) | $98.12 | $122.65 | 1.2× |
| Shoulder Arthrography (73040) | $475.61 | $594.51 | 1.4× |
| Sialogram (70390) | $192.48 | $240.60 | 0.8× |
| Skull less than 4 views (70250) | $123.34 | $154.17 | 1.2× |
| Sternoclavicular joints (71130) | $263.49 | $329.36 | 3.1× |
| Thoracic spine 2 views (72070) | $97.19 | $121.48 | 1.0× |
| Thoracic spine 3 views (72072) | $130.82 | $163.52 | 1.3× |
| Thoracolumbar 2 views (72080) | $164.57 | $205.71 | 2.0× |
| Thyroid Imaging With Vascular Flow (78013) | $376.56 | $470.70 | 1.0× |
| Thyroid Met Imaging Body (78018) | $1,894.01 | $2,367.51 | 3.6× |
| Thyroid Uptake Measurement (78012) | $285.93 | $357.41 | 0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $822.27 | $1,027.83 | 2.1× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$378.44–$756.88 | $473.05–$946.10 | varies |
| Ultrasound Exam Aaa Screen (76706) | $477.48 | $596.85 | 4.8× |
| Ultrasound, abdomen limited (76705) | $448.50 | $560.62 | 4.5× |
| Umbilical-artery Doppler (OB) (76820) | $223.71 | $279.63 | 2.2× |
| Unlisted genitourinary px dx nuclear medicine (78799) | $1,020.36 | $1,275.45 | 2.7× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) | $1,020.36 | $1,275.45 | 2.7× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $1,020.36 | $1,275.45 | 2.7× |
| Unlisted us procedure (76999) | $503.64 | $629.55 | 6.0× |
| Upper gi w/o kub (74240) | $225.19 | $281.48 | 1.3× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $90.55 | $113.18 | 8.2× |
| Urea breath test c-14 isotopic analysis (78268) | $135.34 | $169.17 | 1.4× |
| Ureteral Reflux Study (78740) | $962.42 | $1,203.02 | 2.5× |
| Urethrocystogram voiding (74455) | $738.16 | $922.70 | 3.2× |
| Urethrocystography retrograde (74450) | $537.28 | $671.60 | 2.3× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$378.44–$756.88 | $473.05–$946.10 | varies |
| Us chest (76604) | $122.42 | $153.02 | 1.2× |
| Us complete joint (76881) range across 2 matching MRF lines |
$136.28–$398.99 | $170.34–$498.73 | varies |
| Us exam, pelvic, limited (76857) | $138.29 | $172.86 | 1.4× |
| Us head (76506) | $344.80 | $431 | 3.4× |
| Us kidney transplant (76776) | $724.17 | $905.21 | 7.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$54.51–$340.12 | $68.13–$425.14 | varies |
| Us ob limited 1 or more fetuses (76815) | $309.29 | $386.61 | 3.1× |
| Us ob transvaginal (76817) | $361.62 | $452.02 | 3.6× |
| Us pelvic non ob complete (76856) | $746.58 | $933.22 | 7.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $441.04 | $551.30 | 4.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $367.23 | $459.03 | 3.7× |
| Us retroperitoneal complete (76770) | $719.47 | $899.33 | 7.2× |
| Us retroperitoneal limited (76775) | $612.04 | $765.04 | 6.1× |
| Us scrotum and contents (76870) | $599.88 | $749.84 | 6.0× |
| Us spinal canal and contents (76800) | $565.32 | $706.64 | 5.6× |
| Us thyroid (76536) | $546.62 | $683.27 | 5.4× |
| Us transrectal (76872) | $1,823.94 | $2,279.92 | 18.1× |
| Vein X-Ray Chest (75827) | $856.84 | $1,071.05 | 0.6× |
| Venography caval inferior serialography rs&i (75825) | $2,766.73 | $3,458.41 | 0.9× |
| Venography extremity bilateral rs&i (75822) | $897.96 | $1,122.44 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $2,145.36 | $2,681.69 | 1.4× |
| Venography Renal Bilateral (75833) | $2,766.73 | $3,458.41 | 0.9× |
| Venography Renal Unilateral (75831) | $2,766.73 | $3,458.41 | 0.9× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,284.79 | $1,605.98 | 0.2× |
| Vertebral fracture assessment via dxa (77086) | $108.40 | $135.49 | 1.3× |
| Wrist 2 views (73100) | $197.16 | $246.45 | 2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $309.29 | $386.61 | 3.7× |
| X-ray antegrade pyelogram tube (74425) | $917.57 | $1,146.96 | 2.7× |
| X-Ray Aorta Leg Arteries (75630) | $3,458.54 | $4,323.17 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) | $223.71 | $279.63 | 2.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $105.60 | $131.99 | 1.3× |
| X-Ray Exam Breast Specimen (76098) | $480.28 | $600.35 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $128.01 | $160.01 | 1.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $224.25 | $280.31 | 2.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $427.96 | $534.94 | 4.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $128.01 | $160.01 | 1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $128.01 | $160.01 | 1.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $224.25 | $280.31 | 2.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $224.25 | $280.31 | 2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $224.25 | $280.31 | 2.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $427.96 | $534.94 | 4.3× |
| X-Ray Exam L-S Spine Bending (72114) | $427.03 | $533.78 | 4.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $94.40 | $117.99 | 1.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $544.76 | $680.94 | 5.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $239.36 | $299.19 | 2.4× |
| X-ray eye for foreign body (70030) | $91.31 | $114.13 | 1.1× |
| X-ray humerus (73060) | $98.12 | $122.65 | 1.2× |
| X-ray IV pyelogram (ivp) (74400) | $634.28 | $792.84 | 3.8× |
| X-ray IV pyelogram+tomography (74415) | $848.44 | $1,060.54 | 5.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $146.72 | $183.39 | 1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $268.17 | $335.21 | 3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $111.20 | $139 | 1.1× |
| X-ray nose-rectum child f.b. (76010) | $164.57 | $205.71 | 2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $357.19 | $446.48 | 3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $288.73 | $360.91 | 2.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $221.65 | $277.06 | 2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $142.97 | $178.71 | 1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $266.32 | $332.89 | 3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $394.32 | $492.90 | 3.9× |
| X-Ray Stress View (77071) | $167.27 | $209.08 | 2.0× |
| X-ray thoracic spine 4 vw (72074) | $422.35 | $527.93 | 4.2× |
| X-Ray Tmj Unilat (70328) | $194.36 | $242.95 | 2.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $821.33 | $1,026.66 | 2.4× |
| X-Rays Bone Length Studies (77073) | $242.02 | $302.52 | 2.4× |
| X-Rays Bone Survey Complete (77075) | $541.96 | $677.44 | 5.4× |
| Xr c-spine 4 or 5 views (72050) | $149.49 | $186.86 | 1.5× |
| Xr facial bones less than 3 views (70140) | $181.20 | $226.49 | 2.2× |
| Xr orbits complete 4 views (70200) | $376.56 | $470.70 | 3.7× |
| Xr Tomogram Single Plane (76100) | $290.60 | $363.25 | 2.9× |
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.