Imaging prices at Ascension St. Vincent Evansville

Evansville, IN · every code in this section with a posted price and a Medicare benchmark.

357 codes. Prices are the hospital's own posted facility charges.

Compare against other hospitals interactively →

ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $5,404.20 $9,007 3.7×
Abdomen 1 View (74018) $251.40 $419 2.7×
Abdomen 2 views (74019) $281.40 $469 2.5×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,202.40 $2,004 2.8×
Angio internal mammary (75756) $1,562.40 $2,604 0.5×
Angio pulmonary bilat (75743) $3,858 $6,430 1.2×
Angiography extremity bilateral rs&i (75716) $4,902 $8,170 1.5×
Angiography extremity unilateral rs&i (75710) $2,450.40 $4,084 0.7×
Angiography pulmonary unilateral slctv rs&i (75741) $1,703.40 $2,839 0.5×
Ankle 2 views (73600) $281.40 $469 3.1×
Aortography thoracic serialography rs&i (75605) $3,084 $5,140 0.5×
Artery X-Rays Abdomen (75726) $3,865.20 $6,442 0.7×
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure		 $2,800.20 $4,667 0.5×
Artery X-Rays Spine (75705) $3,399 $5,665 0.6×
Arthrogram hip (73525) $511.20 $852 1.4×
Arthrogram Wrist (73115) $403.20 $672 1.1×
Basic radiation dosimetry calculation (77300) $510 $850 3.6×
Bone age studies (77072) $251.40 $419 2.3×
Bone Imaging 3 Phase (78315) $1,761.60 $2,936 4.2×
Bone Imaging Limited Area (78300) $1,247.40 $2,079 2.9×
Bone Imaging Whole Body (78306) $1,777.20 $2,962 4.2×
Bone marrow imaging limited area (78102) $769.80 $1,283 1.8×
Bone marrow imaging; multiple areas (78103) $1,230.60 $2,051 2.9×
Bone marrow imaging; whole body (78104) $1,261.80 $2,103 3.0×
Bone survey infant (77076) $281.40 $469 2.5×
Brachytx isodose complex (77318) $1,174.20 $1,957 3.0×
Brachytx isodose intermed (77317) $843.60 $1,406 2.1×
Brachytx Isodose Plan Simple (77316) $682.80 $1,138 1.7×
Brain Image W/Flow < 4 Views (78601) $792.60 $1,321 1.9×
Brain Imaging Pet Metabolic Evaluation (78608) $3,789 $6,315 2.5×
Cardiac MRI w/w/o contrast & further seq (75561) $2,176.20 $3,627 5.9×
Cardiac Shunt Detection (78428) $1,210.80 $2,018 2.9×
Cat Scan Follow-Up Study (76380) $481.20 $802 5.2×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $1,000.80 $1,668 1.7×
Cerebrospinal Fluid Scan (78630) $1,594.20 $2,657 2.8×
Chest 1 view (71045) $251.40 $419 2.7×
Chest 2 views (71046) $281.40 $469 3.1×
Chest 3 views (71047) $310.80 $518 3.4×
Chest 4 or more views (71048) $330 $550 3.0×
Clavicle complete (73000) $251.40 $419 2.7×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $885 $1,475 8.0×
Continuing medical physics consltj pr wk (77336) $627 $1,045 4.4×
Contrast Exam Abdominl Aorta (75625) $3,084 $5,140 0.9×
Contrast X-Ray Bladder (74430) $920.40 $1,534 2.5×
Contrast X-Ray Of Elbow (73085) $478.80 $798 1.3×
Contrast X-Ray Of Knee Joint (73580) $484.80 $808 1.3×
CT abdomen and pelvis without and with contrast (74178) $1,722.60 $2,871 4.7×
CT abdomen and pelvis without contrast (74176) $885 $1,475 3.5×
CT abdomen w contrast (74160) $1,680.60 $2,801 9.1×
CT abdomen w wo contrast (74170) $1,707.60 $2,846 9.2×
CT abdomen w/o contrast (74150) $885 $1,475 8.0×
CT Angio Abdomen and Pelvis (74174) $1,707.60 $2,846 4.6×
CT Angio Chest (71275) $1,707.60 $2,846 9.2×
CT Angio Head (70496) $1,972.80 $3,288 10.6×
CT angio hrt w/3d image (75574) $1,707.60 $2,846 4.6×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,707.60 $2,846 9.2×
CT Angio Neck (70498) $1,707.60 $2,846 9.2×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,707.60 $2,846 9.2×
CT cervical spine w/ contrast (72126) $1,680.60 $2,801 4.6×
CT cervical spine w/o contrast (72125) $885 $1,475 8.0×
CT cervical spine w/wo cont (72127) $1,707.60 $2,846 9.2×
CT chest w contrast (71260) $1,707.60 $2,846 9.2×
CT chest w/wo contrast (71270) $1,680.60 $2,801 9.1×
CT colonography screening (74263) $1,320 $2,200 5.2×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $1,281 $2,135 6.9×
CT colonogrphy dx image postprocess w/o contrast (74261) $961.20 $1,602 8.7×
CT head/brain with contrast (70460) $1,707.60 $2,846 9.2×
CT head/brain without and with contrast (70470) $1,722.60 $2,871 9.3×
CT heart contrast eval cardiac structure&morph (75572) $1,773.60 $2,956 4.8×
CT heart no contrast quant eval coronry calcium (75571) $225 $375 2.4×
CT iac w contrast (70481) $994.20 $1,657 5.4×
CT l-spine w&w/o contrast (72133) $1,707.60 $2,846 9.2×
CT lower ext w/o (73700)
range across 2 matching MRF lines		 $885–$968.40 $1,475–$1,614 varies
CT lower extremity w/contrast material (73701) $1,680.60 $2,801 9.1×
CT lumbar spine w contrast (72132) $1,680.60 $2,801 4.6×
CT lumbar spine w/o contrast (72131) $885 $1,475 8.0×
CT maxillofacial w contrast (70487) $1,680.60 $2,801 9.1×
CT maxillofacial wo contrast (70486) $885 $1,475 8.0×
CT neck tissue combo (70492) $1,707.60 $2,846 9.2×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,707.60 $2,846 9.2×
CT orbits w/o contrast (70480) $885 $1,475 8.0×
CT pelvis w&w/o contrast (72194) $1,707.60 $2,846 9.2×
CT pelvis w/o contrast (72192) $885 $1,475 8.0×
CT scan of leg combo (73702) $1,707.60 $2,846 9.2×
CT scans face/jaw combo (70488) $1,707.60 $2,846 9.2×
CT soft tissue neck w contrast (70491) $1,680.60 $2,801 9.1×
CT soft tissue neck w/o contrast (70490) $885 $1,475 8.0×
CT thoracic spine w contrast (72129) $1,680.60 $2,801 9.1×
CT thoracic spine w/o contrast (72128) $885 $1,475 8.0×
CT thoracic spine w/wo cont (72130) $1,707.60 $2,846 9.2×
CT thorax w/o contrast (71250) $885 $1,475 8.0×
CT upper ext wo (73200) $885 $1,475 8.0×
CT upper extremity w/o & w/contrast material (73202) $1,707.60 $2,846 9.2×
CT upper extremity with contrast (73201) $1,680.60 $2,801 4.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,745.40 $2,909 9.4×
Cta Abdomen (74175) $1,707.60 $2,846 9.2×
CTA pelvis (72191) $1,707.60 $2,846 9.2×
Discography Cerv/Thor Spine (72285) $1,227.60 $2,046 0.6×
Diskography lumbar (72295) $1,227.60 $2,046 0.6×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $540 $900 4.9×
Doppler Echo Fetal Spectral Display Complete (76827) $544.20 $907 4.9×
Doppler Fetal Mid Cerebral Artery (76821) $544.20 $907 4.9×
Echo exam of fetal heart (76825) $544.20 $907 0.9×
Echo exam uterus (76831) $345.60 $576 1.4×
Echo Guide For Artery Repair (76936) $523.80 $873 2.3×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $420 $700 1.7×
Esophagram (74220) $564.60 $941 3.0×
Fetal Biophys Profile W/Nst (76818) $544.20 $907 4.9×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $523.80 $873 4.7×
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $1,551 $2,585 6.1×
Fluoroscopy up to 1 hr (76000) $635.40 $1,059 2.5×
Follow-Up Angiography (75898) $1,578 $2,630 0.5×
Foot 2 views (73620) $281.40 $469 3.1×
Forearm 2 views (73090) $281.40 $469 3.1×
Gastric emptying imaging study (78264) $1,300.80 $2,168 3.1×
Gastroesophageal Reflux Exam (78262) $1,408.20 $2,347 3.3×
Gated Heart Planar Single (78472) $1,684.20 $2,807 4.0×
Hand 2 views (73120) $281.40 $469 2.5×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $4,662.60 $7,771 6.3×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $4,295.40 $7,159 5.8×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $4,171.80 $6,953 5.7×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $2,822.40 $4,704 0.8×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $2,822.40 $4,704 0.8×
Hepatobil Syst Image W/Drug (78227) $1,472.40 $2,454 2.6×
Hepatobiliary System Imaging (78226) $1,569.60 $2,616 3.7×
Ht Muscle Image Spect Sing (78451) $3,981 $6,635 2.9×
Hysterosalpingogram (74740) $557.40 $929 2.2×
Infant hip ultrasound with hip movement (dynamic) (76885) $523.80 $873 5.7×
Interstitial radiation source applic complex (77778) $3,262.80 $5,438 4.4×
K Flow/Funct Image W/Drug (78708) $1,600.20 $2,667 2.8×
K Flow/Funct Image W/O Drug (78707) $1,600.20 $2,667 2.8×
Knee 3 Views (73562) $281.40 $469 3.1×
Leveen/Shunt Patency Exam (78291) $1,183.80 $1,973 2.8×
Liver & Spleen Imaging Static Only (78215) $1,825.20 $3,042 4.3×
Lung Perf&Ventilat Diferentl (78598) $2,930.40 $4,884 5.1×
Lung perfusion differential (78597) $1,353.60 $2,256 3.2×
Lung Ventilat&Perfus Imaging (78582) $1,990.80 $3,318 3.5×
Lung Ventilation Imaging (78579) $1,140 $1,900 2.7×
Lymph System Imaging (78195) $1,207.80 $2,013 2.1×
Lymphangiography Extremity Only Bilateral Rs&I (75803) $2,746.80 $4,578 1.6×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $1,411.80 $2,353 0.4×
Lymphangiography, pelvic/abdominal, unilateral (75805) $706.20 $1,177 0.2×
Magnetic Image Jaw Joint (70336) $1,179 $1,965 4.7×
Meckels Divert Exam (78290) $1,192.80 $1,988 2.8×
Mlc imrt design & construction per imrt plan (77338) $852.60 $1,421 2.2×
Mra Head W/O & W/Contrast Material (70546) $1,270.20 $2,117 3.4×
MRA head w/o contrast (70544) $1,270.20 $2,117 5.0×
MRA head with contrast (70545) $2,474.40 $4,124 6.7×
MRA neck w contrast (70548) $2,176.20 $3,627 5.9×
Mra Neck W/O &W/Contrast Material (70549) $2,176.20 $3,627 5.9×
MRA neck w/o contrast (70547) $1,270.20 $2,117 5.0×
MRI abdomen w contrast (74182) $2,176.20 $3,627 5.9×
MRI abdomen w/o contrast (74181) $1,270.20 $2,117 5.0×
MRI any jt lower extrem w/contrast material (73722) $2,176.20 $3,627 2.6×
MRI any jt lower extrem w/o & w/contrast matrl (73723)
range across 2 matching MRF lines		 $2,176.20–$4,352.40 $3,627–$7,254 varies
MRI any jt upper extremity w/contrast matrl (73222) $2,176.20 $3,627 2.6×
MRI Breast W/O Contrast Bilateral (77047) $1,270.20 $2,117 5.0×
MRI Breast Without Contrast Material Unilateral (77046) $1,270.20 $2,117 5.0×
MRI cardiac w/o contrast (75557) $1,270.20 $2,117 5.0×
MRI cervical spine w contrast (72142) $2,176.20 $3,627 5.9×
MRI cervical spine w/o cont (72141) $1,270.20 $2,117 5.0×
MRI chest w/o contrast (71550) $1,270.20 $2,117 5.0×
MRI chest with contrast (71551) $2,730.60 $4,551 3.3×
MRI chest wo w contrast (71552) $2,176.20 $3,627 5.9×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,176.20 $3,627 5.9×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,176.20 $3,627 5.9×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,270.20 $2,117 5.0×
MRI lumbar spine w contrast (72149) $2,176.20 $3,627 5.9×
Mri Neck Spine W/O & W/Dye (72156) $2,176.20 $3,627 5.9×
MRI orbit face &/neck w/o contrast (70540) $1,270.20 $2,117 5.0×
MRI orbit face neck w contrast (70542) $2,176.20 $3,627 5.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,176.20 $3,627 5.9×
MRI pelvis w contrast (72196) $2,176.20 $3,627 5.9×
MRI pelvis w/o & w contrast (72197) $2,176.20 $3,627 5.9×
MRI pelvis w/o contrast (72195) $1,270.20 $2,117 5.0×
MRI thoracic spine w/o contrast (72146) $1,270.20 $2,117 5.0×
MRI upper extremity oth than jt w/contr matrl (73219) $2,176.20 $3,627 5.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,270.20 $2,117 5.0×
Mri Uppr Extremity W/O&W/Dye (73220) $2,176.20 $3,627 5.9×
MRI, abdomen, combo (74183) $2,176.20 $3,627 5.9×
MRI, dorsal spine combo (72157) $2,176.20 $3,627 5.9×
MRI, dorsal spine contrast (72147) $2,176.20 $3,627 5.9×
MRI, joint upper extrem (73221) $1,270.20 $2,117 5.0×
MRI, joint upper extrem combo (73223) $2,176.20 $3,627 5.9×
MRI, lumbar spine combo (72158) $2,176.20 $3,627 5.9×
Myelograpy 2/more regions rs&i (72270) $314.40 $524 0.4×
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $1,076.40 $1,794 2.5×
Myocardial Spect Multiple Studies (78452) $4,942.20 $8,237 3.6×
Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) $5,950.20 $9,917 3.9×
Neck soft tissue (70360) $251.40 $419 2.7×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $368.40 $614 0.9×
Nm csf leak detection (78650) $1,087.80 $1,813 0.8×
Nonvascular Shunt X-Ray (75809) $302.40 $504 2.7×
Ntsty modul radthx pln dose-vol histos (77301) $4,588.80 $7,648 3.1×
Nuclear Rx Intra-Arterial (79445) $855.60 $1,426 3.5×
Nuclear Rx Oral Admin (79005) $1,353.60 $2,256 5.5×
Ob us nuchal meas 1 gest (76813) $544.20 $907 4.9×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $343.80 $573 3.1×
Panoramic X-ray of jaws (70355) $281.40 $469 3.1×
Parathyroid imaging w/tomographic spect & CT (78072) $1,729.80 $2,883 3.0×
Parathyroid Planar Imaging (78070) $1,170.60 $1,951 2.8×
Parathyroid planar imaging w/wo subtraction (78071) $1,542 $2,570 3.6×
Pelvis 1 or 2 views (72170) $281.40 $469 2.5×
Pet Image W/Ct Lmtd (78814) $5,160.60 $8,601 3.4×
PET image w/CT, full body (78816) $5,860.20 $9,767 3.9×
PET imaging CT attenuation skull base mid-thigh (78815) $5,433 $9,055 3.6×
Pulmonary Perfusion Imaging Particulate (78580) $1,133.40 $1,889 2.7×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $281.40 $469 2.5×
Radex abscess/fistula/sinus tract rs&i (76080) $336 $560 0.6×
Radex Ankle Complete Minimum 3 Views (73610) $281.40 $469 3.1×
Radex Calcaneus Minimum 2 Views (73650) $310.80 $518 3.4×
Radex elbow complete minimum 3 views (73080) $281.40 $469 3.1×
Radex Facial Bones Complete Minimum 3 Views (70150) $310.80 $518 2.8×
Radex fingr minimum 2 views (73140) $281.40 $469 3.1×
Radex foot complete minimum 3 views (73630) $281.40 $469 3.1×
Radex Hand Minimum 3 Views (73130) $281.40 $469 3.1×
Radex lower extremity infant minimum 2 views (73592) $251.40 $419 2.7×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $330 $550 3.0×
Radex Nasal Bones Complete Minimum 3 Views (70160) $281.40 $469 3.1×
Radex Ribs Unilateral 2 Views (71100) $281.40 $469 3.1×
Radex shoulder complete minimum 2 views (73030) $281.40 $469 3.1×
Radex Sinuses Paransl < 3 Views (70210) $281.40 $469 3.1×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $273.60 $456 1.5×
Radex Spine 1 View Specify Level (72020) $251.40 $419 2.7×
Radex Sternum Minimum 2 Views (71120) $281.40 $469 3.1×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $281.40 $469 3.1×
Radex Toe Minimum 2 Views (73660) $281.40 $469 3.1×
Radex upper extremity infant minimum 2 views (73092) $251.40 $419 2.3×
Radex Wrist Complete Minimum 3 Views (73110) $281.40 $469 3.1×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $519 $865 4.7×
Radiation Delivery Stereotactic Cranial Linear (77372) $13,756.20 $22,927 1.8×
Radiation treatment delivery level 1 (77402) $516 $860 4.8×
Radiation treatment delivery level 2 (77407) $602.40 $1,004 1.5×
Radiation treatment delivery level 3 (77412) $921 $1,535 1.6×
Radiolog exam mandible compl minimum 4 views (70110) $281.40 $469 2.5×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $281.40 $469 2.5×
Radiologic exam colon double contrast study (74280) $1,024.20 $1,707 5.5×
Radiologic exam colon single contrast study (74270) $718.20 $1,197 3.9×
Radiologic Exam Esophagus Double Contrast Study (74221) $599.40 $999 3.2×
Radiologic exam knee complete 4/more views (73564) $310.80 $518 2.8×
Radiologic exam pelvis compl minimum 3 views (72190) $281.40 $469 2.5×
Radiologic Exam Small Int Single Contrast Study (74250) $567 $945 3.1×
Radiologic exam swallow function contrast study (74230) $579.60 $966 3.1×
Radiologic exam upr gi trc double contrast study (74246) $694.20 $1,157 3.7×
Radiologic examination femur 1 view (73551) $281.40 $469 3.1×
Radiologic examination femur minimum 2 views (73552) $281.40 $469 3.1×
Radiologic examination knee 1/2 views (73560)
range across 2 matching MRF lines		 $281.40–$562.80 $469–$938 varies
Radiologic Examination Osseous Survey Limited (77074) $281.40 $469 2.5×
Radiologic examination tibia & fibula 2 views (73590) $281.40 $469 3.1×
Ribs bilateral 3 views (71110) $310.80 $518 2.8×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,261.80 $2,103 3.0×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,743 $2,905 4.1×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $3,321 $5,535 5.8×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $1,766.40 $2,944 3.1×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 2 matching MRF lines		 $1,968.60–$1,971.60 $3,281–$3,286 varies
Rp loclzj tum spect 2 area/sep acquisj img (78831) $2,808 $4,680 2.1×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $4,180.80 $6,968 2.8×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $2,404.20 $4,007 1.8×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $2,240.40 $3,734 9.1×
Scapula (73010) $251.40 $419 2.3×
Shoulder 1 view (73020) $281.40 $469 3.1×
Shoulder Arthrography (73040) $535.80 $893 1.5×
Skull less than 4 views (70250) $310.80 $518 2.8×
Special dosimetry (77331) $408 $680 2.9×
Special Physics Consult (77370) $868.20 $1,447 6.1×
Special teletherapy port plan (77321) $877.80 $1,463 2.2×
Special treatment procedure (77470) $1,909.80 $3,183 3.3×
Stereotactic Body Radiation Delivery (77373) $5,658 $9,430 3.0×
Sternoclavicular joints (71130) $281.40 $469 3.1×
Superior sagittal sinus venogram (75870) $1,755.60 $2,926 0.5×
Telethx isodose pln cplx w/basic dosimetry (77307) $877.80 $1,463 2.2×
Telethx isodose pln smpl w/dosimetry calculation (77306) $485.40 $809 1.2×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $1,615.80 $2,693 4.1×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $1,183.20 $1,972 3.0×
Ther rad simulaj-aided field setting simple (77280) $877.80 $1,463 6.2×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $769.20 $1,282 4.1×
Thoracic spine 2 views (72070) $281.40 $469 2.5×
Thoracic spine 3 views (72072) $310.80 $518 2.8×
Thoracolumbar 2 views (72080) $310.80 $518 3.4×
Thyroid Imaging With Vascular Flow (78013) $873.60 $1,456 2.1×
Thyroid Met Imaging Body (78018) $1,457.40 $2,429 2.5×
Thyroid Uptake Measurement (78012) $566.40 $944 1.3×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,113.60 $1,856 2.6×
Tx Devices Design & Construction Complex (77334) $1,063.20 $1,772 2.7×
Tx devices design & construction intermediate (77333) $583.80 $973 4.1×
Tx devices design & construction simple (77332) $435.60 $726 3.1×
Ultrasound Breast Limited (76642) $523.80 $873 5.7×
Ultrasound Elastography Parenchyma (76981) $523.80 $873 4.7×
Ultrasound Exam Aaa Screen (76706) $523.80 $873 4.7×
Ultrasound, abdomen limited (76705) $523.80 $873 4.7×
Umbilical-artery Doppler (OB) (76820) $544.20 $907 4.9×
Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) $2,244.60 $3,741 5.3×
Upper gi w/o kub (74240) $650.40 $1,084 3.5×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $137.40 $229 12.4×
Urethrocystogram voiding (74455) $966.60 $1,611 3.8×
Urethrocystography retrograde (74450) $678 $1,130 2.7×
Us breast unilateral complete (76641) $588 $980 5.3×
Us chest (76604)
range across 2 matching MRF lines		 $132.60–$265.20 $221–$442 varies
Us complete joint (76881) $523.80 $873 4.7×
Us exam, pelvic, limited (76857) $544.20 $907 4.9×
Us head (76506) $544.20 $907 4.9×
Us kidney transplant (76776) $544.20 $907 4.9×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $523.80 $873 4.7×
Us ob detailed single fetus (76811) $544.20 $907 2.2×
Us ob limited 1 or more fetuses (76815) $544.20 $907 4.9×
Us ob transvaginal (76817) $523.80 $873 4.7×
Us pelvic non ob complete (76856) $544.20 $907 4.9×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $523.80 $873 4.7×
Us preg uterus real time f/u trnsabdl per fetus (76816) $544.20 $907 4.9×
Us retroperitoneal complete (76770) $523.80 $873 4.7×
Us retroperitoneal limited (76775) $523.80 $873 4.7×
Us scrotum and contents (76870) $523.80 $873 4.7×
Us spinal canal and contents (76800) $523.80 $873 4.7×
Us thyroid (76536) $639.60 $1,066 5.8×
Us transrectal (76872) $529.20 $882 4.8×
Vein X-Ray Chest (75827) $2,376 $3,960 1.4×
Venogram Sinus/Jugular (75860) $1,612.80 $2,688 0.5×
Venography caval inferior serialography rs&i (75825) $2,204.40 $3,674 0.7×
Venography extremity bilateral rs&i (75822) $1,428 $2,380 0.9×
Venography extremity unilateral rs&i (75820) $756 $1,260 0.5×
Venography Renal Bilateral (75833) $2,764.80 $4,608 0.8×
Venography Renal Unilateral (75831) $1,767.60 $2,946 0.5×
Venous sampling by catheter (75893) $3,339 $5,565 0.6×
Wrist 2 views (73100) $281.40 $469 3.1×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $297 $495 3.2×
X-ray antegrade pyelogram tube (74425) $635.40 $1,059 1.7×
X-Ray Aorta Leg Arteries (75630) $3,084 $5,140 0.9×
X-Ray Bend Only L-S Spine (72120) $281.40 $469 2.5×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $281.40 $469 3.1×
X-Ray Exam Breast Specimen (76098) $251.40 $419 0.4×
X-Ray Exam Entire Spi 1 Vw (72081) $251.40 $419 2.7×
X-Ray Exam Entire Spi 2/3 Vw (72082) $310.80 $518 2.8×
X-Ray Exam Hip Uni 1 View (73501) $172.80 $288 1.9×
X-Ray Exam Hip Uni 2-3 Views (73502) $274.80 $458 3.0×
X-Ray Exam Hips Bi 2 Views (73521) $274.80 $458 2.5×
X-Ray Exam Hips Bi 3-4 Views (73522) $376.80 $628 3.4×
X-Ray Exam Hips Bi 5/> Views (73523) $478.80 $798 4.3×
X-Ray Exam Neck Spine 2-3 Vw (72040) $281.40 $469 3.1×
X-Ray Exam Unilat Ribs/Chest (71101) $281.40 $469 2.5×
X-ray eye for foreign body (70030) $251.40 $419 2.7×
X-ray humerus (73060) $281.40 $469 3.1×
X-ray IV pyelogram (ivp) (74400) $281.40 $469 1.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $310.80 $518 3.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $281.40 $469 3.1×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $281.40 $469 2.5×
X-ray nose-rectum child f.b. (76010) $251.40 $419 2.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $281.40 $469 2.5×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $281.40 $469 2.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $310.80 $518 3.4×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $281.40 $469 3.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $281.40 $469 2.5×
X-Ray Urinary Tract Exam With Contrast Material (74420) $281.40 $469 0.8×
X-Rays Bone Length Studies (77073) $281.40 $469 2.5×
X-Rays Bone Survey Complete (77075) $664.80 $1,108 6.0×
Xr c-spine 4 or 5 views (72050) $310.80 $518 2.8×
Xr facial bones less than 3 views (70140) $281.40 $469 3.1×
Xr orbits complete 4 views (70200) $281.40 $469 2.5×

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.