Imaging prices at AnMed Medical Center
Anderson, SC · every code in this section with a posted price and a Medicare benchmark.
342 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $4,250 | $8,500 | 3.3× |
| Abdomen 1 View (74018) | $250 | $500 | 3.1× |
| Abdomen 2 views (74019) | $315 | $630 | 3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,500 | $3,000 | 4.0× |
| Angio internal mammary (75756) | $2,150 | $4,300 | 0.7× |
| Angio pulmonary bilat (75743) | $2,400 | $4,800 | 0.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,400 | $4,800 | 0.8× |
| Angiography extremity bilateral rs&i (75716) | $2,450 | $4,900 | 0.8× |
| Angiography extremity unilateral rs&i (75710) | $2,500 | $5,000 | 0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,900 | $3,800 | 0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,150 | $4,300 | 0.7× |
| Ankle 2 views (73600) | $225 | $450 | 2.8× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,250 | $4,500 | 0.4× |
| Artery X-Rays Abdomen (75726) | $2,750 | $5,500 | 0.5× |
| Artery X-Rays Adrenal Gland (75731) | $2,400 | $4,800 | 0.8× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,350 | $4,700 | 0.5× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$2,500 | $5,000 | 0.5× |
| Arthrogram ankle (73615) | $750 | $1,500 | 2.3× |
| Arthrogram hip (73525) | $850 | $1,700 | 2.6× |
| Arthrogram Wrist (73115) | $850 | $1,700 | 2.6× |
| Basic radiation dosimetry calculation (77300) | $300 | $600 | 2.4× |
| Bone age studies (77072) | $200 | $400 | 2.1× |
| Bone Imaging 3 Phase (78315) | $1,500 | $3,000 | 4.0× |
| Bone Imaging Limited Area (78300) | $1,000 | $2,000 | 2.7× |
| Bone Imaging Whole Body (78306) | $1,250 | $2,500 | 3.4× |
| Bone marrow imaging limited area (78102) | $1,100 | $2,200 | 3.0× |
| Bone marrow imaging; multiple areas (78103) | $1,250 | $2,500 | 3.4× |
| Bone marrow imaging; whole body (78104) | $1,400 | $2,800 | 3.8× |
| Bone survey infant (77076) | $250 | $500 | 2.6× |
| Brachytx isodose complex (77318) | $1,000 | $2,000 | 2.9× |
| Brachytx isodose intermed (77317) | $1,000 | $2,000 | 2.9× |
| Brachytx Isodose Plan Simple (77316) | $600 | $1,200 | 1.7× |
| Brain Flow Imaging Only (78610) | $600 | $1,200 | 1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,900 | $5,800 | 2.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,050 | $4,100 | 6.3× |
| Cardiac Shunt Detection (78428) | $900 | $1,800 | 2.4× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$250–$600 | $500–$1,200 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $650 | $1,300 | 1.3× |
| Cerebrospinal Fluid Scan (78630) | $1,500 | $3,000 | 3.0× |
| Chest 1 view (71045) | $212.50 | $425 | 2.6× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$107.50–$262.50 | $215–$525 | varies |
| Chest 3 views (71047) | $287.50 | $575 | 3.6× |
| Chest 4 or more views (71048) | $300 | $600 | 3.1× |
| Cholecystography Oral Contrast (74290) | $250 | $500 | 1.5× |
| Clavicle complete (73000) | $225 | $450 | 2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $237.50 | $475 | 2.4× |
| Continuing medical physics consltj pr wk (77336) | $325 | $650 | 2.6× |
| Contrast Exam Abdominl Aorta (75625) | $3,000 | $6,000 | 1.0× |
| Contrast X-Ray Bladder (74430) | $800 | $1,600 | 2.5× |
| Contrast X-Ray Of Elbow (73085) | $750 | $1,500 | 2.3× |
| Contrast X-Ray Of Knee Joint (73580) | $800 | $1,600 | 2.5× |
| CT abdomen and pelvis without and with contrast (74178) | $3,500 | $7,000 | 10.8× |
| CT abdomen and pelvis without contrast (74176) | $2,450 | $4,900 | 11.0× |
| CT abdomen w contrast (74160) | $1,450 | $2,900 | 8.9× |
| CT abdomen w wo contrast (74170) | $1,750 | $3,500 | 10.7× |
| CT abdomen w/o contrast (74150) | $1,100 | $2,200 | 11.3× |
| CT Angio Abdomen and Pelvis (74174) | $2,650 | $5,300 | 8.2× |
| CT Angio Chest (71275) | $1,650 | $3,300 | 10.1× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,575–$1,700 | $3,150–$3,400 | varies |
| CT angio hrt w/3d image (75574) | $1,750 | $3,500 | 5.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,600 | $3,200 | 9.8× |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$1,600–$1,750 | $3,200–$3,500 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,650 | $3,300 | 10.1× |
| CT cervical spine w/ contrast (72126) | $1,600 | $3,200 | 4.9× |
| CT cervical spine w/o contrast (72125) | $1,400 | $2,800 | 14.4× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$75–$1,500 | $150–$3,000 | varies |
| CT chest w/wo contrast (71270) | $1,575 | $3,150 | 9.7× |
| CT head/brain with contrast (70460) | $1,300 | $2,600 | 8.0× |
| CT head/brain without and with contrast (70470) | $1,625 | $3,250 | 10.0× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,500 | $3,000 | 4.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $100 | $100 | 1.2× |
| CT hrt w/3d image congen (75573) | $1,350 | $2,700 | 4.2× |
| CT iac w contrast (70481) | $1,500 | $3,000 | 9.2× |
| CT lower ext w/o (73700) | $1,375 | $2,750 | 14.1× |
| CT lower extremity w/contrast material (73701) | $1,500 | $3,000 | 9.2× |
| CT lumbar spine w contrast (72132) | $1,550 | $3,100 | 4.8× |
| CT lumbar spine w/o contrast (72131) | $1,250 | $2,500 | 12.9× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,250–$1,400 | $2,500–$2,800 | varies |
| CT maxillofacial wo contrast (70486) | $1,150 | $2,300 | 11.8× |
| CT neck tissue combo (70492) | $1,800 | $3,600 | 11.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,150–$1,575 | $2,300–$3,150 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,150–$1,200 | $2,300–$2,400 | varies |
| CT pelvis w&w/o contrast (72194) | $1,500 | $3,000 | 9.2× |
| CT pelvis w/o contrast (72192) | $1,125 | $2,250 | 11.6× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,500–$1,600 | $3,000–$3,200 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,550–$1,700 | $3,100–$3,400 | varies |
| CT soft tissue neck w contrast (70491) | $1,425 | $2,850 | 8.7× |
| CT soft tissue neck w/o contrast (70490) | $1,100 | $2,200 | 11.3× |
| CT thoracic spine w contrast (72129) | $1,350 | $2,700 | 8.3× |
| CT thoracic spine w/o contrast (72128) | $1,100 | $2,200 | 11.3× |
| CT thoracic spine w/wo cont (72130) | $1,425 | $2,850 | 8.7× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$69.50–$1,150 | $139–$2,300 | varies |
| CT upper ext wo (73200) | $1,350 | $2,700 | 13.9× |
| CT upper extremity w/o & w/contrast material (73202) | $1,650 | $3,300 | 10.1× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,350–$1,450 | $2,700–$2,900 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,100 | $4,200 | 12.9× |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$2,950–$3,200 | $5,900–$6,400 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$2,200–$2,350 | $4,400–$4,700 | varies |
| Discography Cerv/Thor Spine (72285) | $3,800 | $7,600 | 2.1× |
| Diskography lumbar (72295) | $3,800 | $7,600 | 2.1× |
| Dxa Bone Density Axial (77080) | $425 | $850 | 4.4× |
| Echo Guide For Artery Repair (76936) | $250 | $500 | 1.2× |
| Echograp Trans R Pros Study (76873) | $700 | $1,400 | 7.2× |
| Esophagram (74220) | $340 | $680 | 2.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $237.50 | $475 | 2.4× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$475–$1,400 | $950–$2,800 | varies |
| Follow-Up Angiography (75898) | $225 | $450 | 0.1× |
| Foot 2 views (73620) | $200 | $400 | 2.5× |
| Forearm 2 views (73090) | $250 | $500 | 3.1× |
| Gastric emptying imaging study (78264) | $1,500 | $3,000 | 4.0× |
| Gated Heart Planar Single (78472) | $1,250 | $2,500 | 3.4× |
| Hand 2 views (73120) | $190 | $380 | 2.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,500 | $5,000 | 3.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,500 | $5,000 | 3.9× |
| Hepatobil Syst Image W/Drug (78227) | $1,900 | $3,800 | 3.8× |
| Hepatobiliary System Imaging (78226) | $1,900 | $3,800 | 5.1× |
| Ht Muscle Image Spect Sing (78451) | $1,750 | $3,500 | 1.5× |
| Hysterosalpingogram (74740) | $465 | $930 | 2.1× |
| Interstitial radiation source applic complex (77778) | $2,750 | $5,500 | 4.2× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,000 | $2,000 | 1.5× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,000 | $2,000 | 1.9× |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$1,750–$2,000 | $3,500–$4,000 | varies |
| K Flow/Funct Image W/O Drug (78707) | $1,400 | $2,800 | 2.8× |
| Kidney Imaging Morphol (78700) | $750 | $1,500 | 2.0× |
| Knee 3 Views (73562) | $300 | $600 | 3.7× |
| Liver & Spleen Imaging Static Only (78215) | $1,050 | $2,100 | 2.8× |
| Lung Perf&Ventilat Diferentl (78598) | $2,000 | $4,000 | 4.0× |
| Lung perfusion differential (78597) | $1,100 | $2,200 | 3.0× |
| Lung Ventilat&Perfus Imaging (78582) | $1,750 | $3,500 | 3.5× |
| Lung Ventilation Imaging (78579) | $950 | $1,900 | 2.6× |
| Lymph System Imaging (78195) | $1,000 | $2,000 | 2.0× |
| Magnetic Image Jaw Joint (70336) | $1,800 | $3,600 | 8.1× |
| Mammary ductogram or galactogram multiple (77054) | $550 | $1,100 | 2.5× |
| Mammary ductogram or galactogram single (77053) | $550 | $1,100 | 2.5× |
| Meckels Divert Exam (78290) | $1,250 | $2,500 | 3.4× |
| Mlc imrt design & construction per imrt plan (77338) | $2,000 | $4,000 | 5.7× |
| Mra Head W/O & W/Contrast Material (70546) | $2,000 | $4,000 | 6.2× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,425–$1,500 | $2,850–$3,000 | varies |
| MRA head with contrast (70545) | $1,650 | $3,300 | 5.1× |
| MRA neck w contrast (70548) | $2,087.50 | $4,175 | 6.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,350 | $4,700 | 7.2× |
| MRA neck w/o contrast (70547) | $1,750 | $3,500 | 7.9× |
| MRI abdomen w/o contrast (74181) | $1,600 | $3,200 | 7.2× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,800–$2,125 | $3,600–$4,250 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,400 | $4,800 | 7.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,750 | $3,500 | 2.4× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,050 | $4,100 | 9.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,900 | $3,800 | 8.6× |
| MRI cardiac w/o contrast (75557) | $1,500 | $3,000 | 6.8× |
| MRI cervical spine w contrast (72142) | $2,000 | $4,000 | 6.2× |
| MRI cervical spine w/o cont (72141) | $1,500 | $3,000 | 6.8× |
| MRI chest w/o contrast (71550) | $1,900 | $3,800 | 8.6× |
| MRI chest wo w contrast (71552) | $2,250 | $4,500 | 6.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,950 | $3,900 | 6.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,200 | $4,400 | 6.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,700 | $3,400 | 7.7× |
| MRI lumbar spine w contrast (72149) | $1,900 | $3,800 | 5.9× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$2,300–$2,400 | $4,600–$4,800 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 3 matching MRF lines |
$1,200–$1,750 | $2,400–$3,500 | varies |
| MRI orbit face neck w contrast (70542) range across 3 matching MRF lines |
$2,200–$2,300 | $4,400–$4,600 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,350 | $4,700 | 7.2× |
| MRI pelvis w/o & w contrast (72197) | $2,075 | $4,150 | 6.4× |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,500–$1,800 | $3,000–$3,600 | varies |
| MRI spectroscopy (76390) | $1,500 | $3,000 | 18.5× |
| MRI thoracic spine w/o contrast (72146) | $1,500 | $3,000 | 6.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,800 | $3,600 | 8.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,250 | $4,500 | 6.9× |
| MRI, abdomen, combo (74183) | $2,100 | $4,200 | 6.5× |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$2,200–$2,400 | $4,400–$4,800 | varies |
| MRI, dorsal spine contrast (72147) | $2,100 | $4,200 | 6.5× |
| MRI, joint upper extrem (73221) | $1,750 | $3,500 | 7.9× |
| MRI, joint upper extrem combo (73223) | $2,400 | $4,800 | 7.4× |
| MRI, lumbar spine combo (72158) | $2,200 | $4,400 | 6.8× |
| Myelogram cervical (72240) | $1,050 | $2,100 | 1.4× |
| Myelogram Lumbar (72265) | $1,050 | $2,100 | 1.4× |
| Myelography thoracic (72255) | $1,050 | $2,100 | 1.4× |
| Myelograpy 2/more regions rs&i (72270) | $1,125 | $2,250 | 1.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $2,500 | $5,000 | 2.1× |
| Myocardial Spect Multiple Studies (78452) | $3,100 | $6,200 | 2.6× |
| N-invas est c ffr sw aly CTA (75580) | $1,200 | $2,400 | 1.5× |
| Neck soft tissue (70360) | $240 | $480 | 3.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $250 | $500 | 0.7× |
| Nm csf leak detection (78650) | $1,500 | $3,000 | 1.2× |
| Nonvascular Shunt X-Ray (75809) | $700 | $1,400 | 7.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,500 | $9,000 | 3.5× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$1,100–$1,350 | $2,200–$2,700 | varies |
| Panoramic X-ray of jaws (70355) | $750 | $1,500 | 9.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,500 | $3,000 | 3.0× |
| Pelvis 1 or 2 views (72170) | $200 | $400 | 2.1× |
| Peritoneogram Rs&I (74190) | $550 | $1,100 | 1.1× |
| PET image w/CT, full body (78816) | $3,500 | $7,000 | 2.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,300 | $6,600 | 2.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,400 | $4,800 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $800 | $1,600 | 2.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $437.50 | $875 | 4.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $550 | $1,100 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $300 | $600 | 3.7× |
| Radex Calcaneus Minimum 2 Views (73650) | $212.50 | $425 | 2.6× |
| Radex elbow complete minimum 3 views (73080) | $275 | $550 | 3.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $300 | $600 | 3.1× |
| Radex fingr minimum 2 views (73140) | $200 | $400 | 2.5× |
| Radex foot complete minimum 3 views (73630) | $287.50 | $575 | 3.6× |
| Radex Hand Minimum 3 Views (73130) | $290 | $580 | 3.6× |
| Radex lower extremity infant minimum 2 views (73592) | $215 | $430 | 2.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $425 | $850 | 4.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $262.50 | $525 | 3.2× |
| Radex Ribs Unilateral 2 Views (71100) | $300 | $600 | 3.7× |
| Radex shoulder complete minimum 2 views (73030) | $312.50 | $625 | 3.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $162.50 | $325 | 2.0× |
| Radex Spine 1 View Specify Level (72020) | $400 | $800 | 4.9× |
| Radex Sternum Minimum 2 Views (71120) | $282.50 | $565 | 3.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $262.50 | $525 | 3.2× |
| Radex Toe Minimum 2 Views (73660) | $200 | $400 | 2.5× |
| Radex upper extremity infant minimum 2 views (73092) | $225 | $450 | 2.3× |
| Radex Wrist Complete Minimum 3 Views (73110) | $265 | $530 | 3.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $9,500 | $19,000 | 1.4× |
| Radiation treatment delivery level 1 (77402) | $300 | $600 | 3.2× |
| Radiation treatment delivery level 2 (77407) | $400 | $800 | 1.1× |
| Radiation treatment delivery level 3 (77412) | $750 | $1,500 | 1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $300 | $600 | 3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $437.50 | $875 | 4.5× |
| Radiologic exam colon double contrast study (74280) | $750 | $1,500 | 4.6× |
| Radiologic exam colon single contrast study (74270) | $550 | $1,100 | 3.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $400 | $800 | 2.5× |
| Radiologic exam knee complete 4/more views (73564) | $237.50 | $475 | 2.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $300 | $600 | 3.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $475 | $950 | 2.9× |
| Radiologic exam swallow function contrast study (74230) | $362.50 | $725 | 2.2× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $120 | $240 | 0.5× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$550–$600 | $1,100–$1,200 | varies |
| Radiologic examination femur minimum 2 views (73552) | $232.50 | $465 | 2.9× |
| Radiologic examination knee 1/2 views (73560) | $237.50 | $475 | 2.9× |
| Radiologic Examination Salivary Gland Calculus (70380) | $300 | $600 | 3.7× |
| Radiologic examination tibia & fibula 2 views (73590) | $225 | $450 | 2.8× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $1,250 | $2,500 | 3.4× |
| Renal Cyst Study (74470) | $550 | $1,100 | 1.1× |
| Ribs bilateral 3 views (71110) | $350 | $700 | 3.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $700 | $1,400 | 1.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,725 | $3,450 | 4.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,400 | $4,800 | 4.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,162.50 | $4,325 | 4.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,800 | $3,600 | 3.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,950 | $3,900 | 1.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,750 | $3,500 | 1.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,750 | $3,500 | 8.1× |
| Rp Therapy Intravenous Administration (79101) | $1,250 | $2,500 | 5.8× |
| Scapula (73010) | $250 | $500 | 2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $45 | $90 | 1.9× |
| Shoulder 1 view (73020) | $170 | $340 | 2.1× |
| Shoulder Arthrography (73040) | $712.50 | $1,425 | 2.2× |
| Skull less than 4 views (70250) | $237.50 | $475 | 2.4× |
| Special dosimetry (77331) | $250 | $500 | 2.0× |
| Special Physics Consult (77370) | $750 | $1,500 | 6.0× |
| Special teletherapy port plan (77321) | $1,500 | $3,000 | 4.3× |
| Special treatment procedure (77470) | $1,650 | $3,300 | 3.2× |
| Stereotactic Body Radiation Delivery (77373) | $6,500 | $13,000 | 3.9× |
| Sternoclavicular joints (71130) | $300 | $600 | 3.7× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $250 | $500 | 2.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,150 | $2,300 | 3.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $550 | $1,100 | 1.6× |
| Testicular Imaging W/Flow (78761) | $750 | $1,500 | 2.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,250 | $2,500 | 3.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $650 | $1,300 | 1.9× |
| Ther rad simulaj-aided field setting simple (77280) | $600 | $1,200 | 4.8× |
| Thoracic spine 2 views (72070) | $275 | $550 | 2.8× |
| Thoracic spine 3 views (72072) | $357.50 | $715 | 3.7× |
| Thyroid Imaging With Vascular Flow (78013) | $800 | $1,600 | 2.2× |
| Thyroid Met Imaging Body (78018) | $1,250 | $2,500 | 2.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,400 | $2,800 | 3.8× |
| Tx Devices Design & Construction Complex (77334) | $1,000 | $2,000 | 2.9× |
| Tx devices design & construction intermediate (77333) | $400 | $800 | 3.2× |
| Tx devices design & construction simple (77332) | $300 | $600 | 2.4× |
| Ultrasound Breast Limited (76642) | $250 | $500 | 3.1× |
| Ultrasound Exam Aaa Screen (76706) | $237.50 | $475 | 2.4× |
| Ultrasound, abdomen limited (76705) | $500 | $1,000 | 5.1× |
| Unlisted magnetic resonance procedure (76498) | $1,650 | $3,300 | 20.4× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$475–$612.50 | $950–$1,225 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $159 | $318 | 14.4× |
| Urea breath test c-14 isotopic analysis (78268) | $393 | $786 | 4.2× |
| Ureteral Reflux Study (78740) | $1,200 | $2,400 | 3.2× |
| Urethrocystogram voiding (74455) | $475 | $950 | 2.1× |
| Urethrocystography retrograde (74450) | $475 | $950 | 2.1× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$315–$575 | $630–$1,150 | varies |
| Us chest (76604) | $337.50 | $675 | 3.5× |
| Us exam, pelvic, limited (76857) | $387.50 | $775 | 4.0× |
| Us head (76506) | $537.50 | $1,075 | 5.5× |
| Us kidney transplant (76776) | $550 | $1,100 | 5.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $387.50 | $775 | 4.0× |
| Us ob limited 1 or more fetuses (76815) | $325 | $650 | 3.3× |
| Us ob transvaginal (76817) | $475 | $950 | 4.9× |
| Us pelvic non ob complete (76856) | $550 | $1,100 | 5.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $462.50 | $925 | 4.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $325 | $650 | 3.3× |
| Us retroperitoneal complete (76770) | $600 | $1,200 | 6.2× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$425–$462.50 | $850–$925 | varies |
| Us scrotum and contents (76870) | $600 | $1,200 | 6.2× |
| Us spinal canal and contents (76800) | $237.50 | $475 | 2.4× |
| Us thyroid (76536) | $500 | $1,000 | 5.1× |
| Us transrectal (76872) | $800 | $1,600 | 8.2× |
| Vascular Flow Imaging (78445) | $375 | $750 | 1.0× |
| Vein X-Ray Chest (75827) | $2,150 | $4,300 | 1.5× |
| Vein X-Ray Spleen/Liver (75810) | $2,600 | $5,200 | 0.9× |
| Venography Adrenal Unilateral (75840) | $2,000 | $4,000 | 0.7× |
| Venography caval inferior serialography rs&i (75825) | $2,350 | $4,700 | 0.8× |
| Venography extremity bilateral rs&i (75822) | $1,600 | $3,200 | 1.1× |
| Venography extremity unilateral rs&i (75820) | $1,600 | $3,200 | 1.1× |
| Venography Renal Bilateral (75833) | $2,100 | $4,200 | 0.7× |
| Venography Renal Unilateral (75831) | $1,950 | $3,900 | 0.7× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$2,400 | $4,800 | 0.5× |
| Wrist 2 views (73100) | $180 | $360 | 2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $212.50 | $425 | 2.6× |
| X-ray antegrade pyelogram tube (74425) | $375 | $750 | 1.2× |
| X-Ray Aorta Leg Arteries (75630) | $2,800 | $5,600 | 1.0× |
| X-Ray Bend Only L-S Spine (72120) | $325 | $650 | 3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $200 | $400 | 2.5× |
| X-Ray Exam Breast Specimen (76098) | $187.50 | $375 | 0.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$300–$725 | $600–$1,450 | varies |
| X-Ray Exam Hip Uni 1 View (73501) | $200 | $400 | 2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $250 | $500 | 3.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $500 | $1,000 | 5.1× |
| X-Ray Exam L-S Spine Bending (72114) | $600 | $1,200 | 6.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $287.50 | $575 | 3.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $600 | $1,200 | 6.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $350 | $700 | 3.6× |
| X-ray eye for foreign body (70030) | $237.50 | $475 | 2.9× |
| X-ray humerus (73060) | $225 | $450 | 2.8× |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$750–$850 | $1,500–$1,700 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $232.50 | $465 | 2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $300 | $600 | 3.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $350 | $700 | 3.6× |
| X-ray nose-rectum child f.b. (76010) | $212.50 | $425 | 2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $375 | $750 | 3.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $287.50 | $575 | 3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $312.50 | $625 | 3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $300 | $600 | 3.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $310 | $620 | 3.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $850 | $1,700 | 2.6× |
| X-Rays Bone Length Studies (77073) | $337.50 | $675 | 3.5× |
| X-Rays Bone Survey Complete (77075) | $450 | $900 | 4.6× |
| Xr c-spine 4 or 5 views (72050) | $375 | $750 | 3.9× |
| Xr facial bones less than 3 views (70140) | $300 | $600 | 3.7× |
| Xr orbits complete 4 views (70200) | $325 | $650 | 3.3× |
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.