Imaging prices at Ascension St. Vincent Mercy
Elwood, IN · every code in this section with a posted price and a Medicare benchmark.
291 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) | $241.80 | $403 | 2.6× |
| Abdomen 2 views (74019) | $321.60 | $536 | 2.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,761 | $2,935 | 4.2× |
| Adrenal Cortex & Medulla Img (78075) | $3,267.60 | $5,446 | 2.4× |
| Angiography extremity bilateral rs&i (75716) | $6,081.60 | $10,136 | 1.8× |
| Angiography extremity unilateral rs&i (75710) | $3,040.80 | $5,068 | 0.9× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$193.80–$387.60 | $323–$646 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$542.40–$1,084.80 | $904–$1,808 | varies |
| Arthrogram hip (73525) | $748.80 | $1,248 | 2.0× |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$663–$1,326 | $1,105–$2,210 | varies |
| Bone age studies (77072) | $239.40 | $399 | 2.2× |
| Bone Imaging 3 Phase (78315) | $2,406.60 | $4,011 | 5.7× |
| Bone Imaging Limited Area (78300) | $1,411.20 | $2,352 | 3.3× |
| Bone Imaging Multiple Areas (78305) | $1,455.60 | $2,426 | 3.4× |
| Bone Imaging Whole Body (78306) | $2,103 | $3,505 | 5.0× |
| Bone survey infant (77076) | $792 | $1,320 | 7.2× |
| Brain Flow Imaging Only (78610) | $3,070.20 | $5,117 | 5.3× |
| Cat Scan Follow-Up Study (76380) | $269.40 | $449 | 2.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,479.60 | $2,466 | 2.6× |
| Chest 1 view (71045) | $153.60 | $256 | 1.7× |
| Chest 2 views (71046) | $195 | $325 | 2.1× |
| Chest 3 views (71047) | $227.40 | $379 | 2.5× |
| Chest 4 or more views (71048) | $235.80 | $393 | 2.1× |
| Cholecystography Oral Contrast (74290) | $312 | $520 | 1.7× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$249–$498 | $415–$830 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $574.80 | $958 | 5.2× |
| Contrast X-Ray Bladder (74430) | $530.40 | $884 | 1.4× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$701.40–$1,402.80 | $1,169–$2,338 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $740.40 | $1,234 | 2.0× |
| CT abdomen and pelvis without and with contrast (74178) | $3,788.40 | $6,314 | 10.3× |
| CT abdomen and pelvis without contrast (74176) | $2,651.40 | $4,419 | 10.5× |
| CT abdomen w contrast (74160) | $1,787.40 | $2,979 | 9.6× |
| CT abdomen w wo contrast (74170) | $2,145 | $3,575 | 11.6× |
| CT abdomen w/o contrast (74150) | $1,430.40 | $2,384 | 12.9× |
| CT Angio Abdomen and Pelvis (74174) | $5,182.80 | $8,638 | 14.0× |
| CT Angio Chest (71275) | $2,370.60 | $3,951 | 12.8× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$2,794.80–$3,418.80 | $4,658–$5,698 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$2,496.60–$4,993.20 | $4,161–$8,322 | varies |
| CT Angio Neck (70498) | $2,395.80 | $3,993 | 12.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,136.60 | $3,561 | 11.5× |
| CT bone density (77078) | $279 | $465 | 3.0× |
| CT cervical spine w/ contrast (72126) | $1,908 | $3,180 | 5.2× |
| CT cervical spine w/o contrast (72125) | $1,526.40 | $2,544 | 13.8× |
| CT cervical spine w/wo cont (72127) | $2,290.20 | $3,817 | 12.3× |
| CT chest w contrast (71260) | $1,611.60 | $2,686 | 8.7× |
| CT chest w/wo contrast (71270) | $2,014.80 | $3,358 | 10.9× |
| CT head/brain with contrast (70460) | $1,726.20 | $2,877 | 9.3× |
| CT head/brain without and with contrast (70470) | $2,073 | $3,455 | 11.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $366.60 | $611 | 4.0× |
| CT iac w contrast (70481) | $1,689 | $2,815 | 9.1× |
| CT l-spine w&w/o contrast (72133) | $2,417.40 | $4,029 | 13.0× |
| CT lower ext w/o (73700) | $1,248.60 | $2,081 | 11.3× |
| CT lower extremity w/contrast material (73701) | $1,560.60 | $2,601 | 8.4× |
| CT lumbar spine w contrast (72132) | $2,014.80 | $3,358 | 5.5× |
| CT lumbar spine w/o contrast (72131) | $1,611.60 | $2,686 | 14.6× |
| CT maxillofacial w contrast (70487) | $1,505.40 | $2,509 | 8.1× |
| CT maxillofacial wo contrast (70486) | $1,204.80 | $2,008 | 10.9× |
| CT neck tissue combo (70492) | $2,054.40 | $3,424 | 11.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,027.40 | $3,379 | 10.9× |
| CT orbits w/o contrast (70480) | $1,351.20 | $2,252 | 12.2× |
| CT pelvis w&w/o contrast (72194) | $1,834.80 | $3,058 | 9.9× |
| CT pelvis w/o contrast (72192) | $1,222.20 | $2,037 | 11.0× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$2,185.80–$4,371.60 | $3,643–$7,286 | varies |
| CT scans face/jaw combo (70488) | $1,806.60 | $3,011 | 9.7× |
| CT soft tissue neck w contrast (70491) | $1,711.20 | $2,852 | 9.2× |
| CT soft tissue neck w/o contrast (70490) | $1,369.20 | $2,282 | 12.4× |
| CT thoracic spine w contrast (72129) | $1,829.40 | $3,049 | 9.9× |
| CT thoracic spine w/o contrast (72128) | $1,464 | $2,440 | 13.2× |
| CT thoracic spine w/wo cont (72130) | $2,195.40 | $3,659 | 11.8× |
| CT thorax w/o contrast (71250) | $1,209 | $2,015 | 10.9× |
| CT upper ext wo (73200) | $1,220.40 | $2,034 | 11.0× |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,830.60–$3,661.20 | $3,051–$6,102 | varies |
| CT upper extremity with contrast (73201) | $1,525.80 | $2,543 | 4.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,824.20 | $4,707 | 15.2× |
| Cta Abdomen (74175) | $2,501.40 | $4,169 | 13.5× |
| CTA pelvis (72191) | $2,139.60 | $3,566 | 11.5× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $485.40 | $809 | 1.9× |
| Discography Cerv/Thor Spine (72285) | $1,591.80 | $2,653 | 0.8× |
| Diskography lumbar (72295) | $2,056.20 | $3,427 | 1.0× |
| Dxa Bone Density Axial (77080) | $403.20 | $672 | 3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $213 | $355 | 2.3× |
| Esophagram (74220) | $484.80 | $808 | 2.6× |
| Fetal Biophys Profile W/Nst (76818) | $795 | $1,325 | 7.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $604.20 | $1,007 | 5.5× |
| Fluoroscopy up to 1 hr (76000) | $569.40 | $949 | 2.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$195.60–$391.20 | $326–$652 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$236.40–$472.80 | $394–$788 | varies |
| Gastric emptying imaging study (78264) | $2,382 | $3,970 | 5.6× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $2,382 | $3,970 | 5.6× |
| Gastroesophageal Reflux Exam (78262) | $1,833 | $3,055 | 4.3× |
| Gated Heart Planar Single (78472) | $2,365.20 | $3,942 | 5.6× |
| GI Endoscopic US S&I (76975) | $419.40 | $699 | 1.7× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,382 | $3,970 | 4.1× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$204.60–$409.20 | $341–$682 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,320.80 | $3,868 | 4.0× |
| Hepatobiliary System Imaging (78226) | $1,882.80 | $3,138 | 4.5× |
| Ht Muscle Image Spect Sing (78451) | $4,173 | $6,955 | 3.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $188.40 | $314 | 2.0× |
| Infant hip ultrasound, limited static exam (76886) | $113.40 | $189 | 1.2× |
| Infusion Ivp (74410) | $551.40 | $919 | 3.0× |
| Joint Survey Single View (77077) | $250.20 | $417 | 2.3× |
| K Flow/Funct Image Multiple (78709) | $2,457.60 | $4,096 | 4.3× |
| K Flow/Funct Image W/Drug (78708) | $1,897.20 | $3,162 | 3.3× |
| K Flow/Funct Image W/O Drug (78707) | $1,951.80 | $3,253 | 3.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,617.60 | $2,696 | 3.8× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$176.40–$352.80 | $294–$588 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,792.20 | $2,987 | 4.2× |
| Lung Perf&Ventilat Diferentl (78598) | $3,495 | $5,825 | 6.1× |
| Lung perfusion differential (78597) | $2,193 | $3,655 | 5.2× |
| Lung Ventilat&Perfus Imaging (78582) | $2,741.40 | $4,569 | 4.8× |
| Lung Ventilation Imaging (78579) | $1,491 | $2,485 | 3.5× |
| Lymph System Imaging (78195) | $1,969.20 | $3,282 | 3.4× |
| Magnetic Image Jaw Joint (70336) | $2,643.60 | $4,406 | 10.5× |
| Meckels Divert Exam (78290) | $1,544.40 | $2,574 | 3.7× |
| Mra Head W/O & W/Contrast Material (70546) | $3,135.60 | $5,226 | 8.5× |
| MRA head w/o contrast (70544) | $1,881 | $3,135 | 7.5× |
| MRA head with contrast (70545) | $2,508 | $4,180 | 6.8× |
| MRA neck w contrast (70548) | $3,367.80 | $5,613 | 9.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,930 | $6,550 | 10.6× |
| MRA neck w/o contrast (70547) | $2,806.20 | $4,677 | 11.1× |
| MRI abdomen w contrast (74182) | $2,850.60 | $4,751 | 7.7× |
| MRI abdomen w/o contrast (74181) | $2,280.60 | $3,801 | 9.0× |
| MRI any jt lower extrem w/contrast material (73722) | $1,581.60 | $2,636 | 1.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,898.40–$3,796.80 | $3,164–$6,328 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,015.40–$4,030.80 | $3,359–$6,718 | varies |
| MRI cervical spine w contrast (72142) | $2,239.80 | $3,733 | 6.1× |
| MRI cervical spine w/o cont (72141) | $1,791.60 | $2,986 | 7.1× |
| MRI chest w/o contrast (71550) | $2,424.60 | $4,041 | 9.6× |
| MRI chest with contrast (71551) | $3,031.80 | $5,053 | 3.7× |
| MRI chest wo w contrast (71552) | $3,637.20 | $6,062 | 9.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,078.40 | $3,464 | 5.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,495.40–$4,990.80 | $4,159–$8,318 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,663.20–$3,326.40 | $2,772–$5,544 | varies |
| MRI lumbar spine w contrast (72149) | $2,239.80 | $3,733 | 6.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,687.40 | $4,479 | 7.3× |
| MRI orbit face &/neck w/o contrast (70540) | $2,245.20 | $3,742 | 8.9× |
| MRI orbit face neck w contrast (70542) | $2,806.20 | $4,677 | 7.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,367.80 | $5,613 | 9.1× |
| MRI pelvis w contrast (72196) | $2,766 | $4,610 | 7.5× |
| MRI pelvis w/o & w contrast (72197) | $3,318 | $5,530 | 9.0× |
| MRI pelvis w/o contrast (72195) | $2,211.60 | $3,686 | 8.8× |
| MRI thoracic spine w/o contrast (72146) | $2,384.40 | $3,974 | 9.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,950.20 | $4,917 | 8.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$2,360.40–$4,720.80 | $3,934–$7,868 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$3,540–$7,080 | $5,900–$11,800 | varies |
| MRI, abdomen, combo (74183) | $3,420 | $5,700 | 9.3× |
| MRI, dorsal spine combo (72157) | $3,577.80 | $5,963 | 9.7× |
| MRI, dorsal spine contrast (72147) | $2,980.80 | $4,968 | 8.1× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,612.20–$3,224.40 | $2,687–$5,374 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$2,418.60–$4,837.20 | $4,031–$8,062 | varies |
| MRI, lumbar spine combo (72158) | $2,687.40 | $4,479 | 7.3× |
| Myocardial Spect Multiple Studies (78452) | $5,283 | $8,805 | 3.9× |
| Neck soft tissue (70360) | $221.40 | $369 | 2.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $232.80 | $388 | 0.6× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $298.20 | $497 | 2.7× |
| Optic foramina (70190) | $206.40 | $344 | 2.2× |
| Parathyroid Planar Imaging (78070) | $1,593 | $2,655 | 3.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,531.80 | $2,553 | 3.6× |
| Pelvis 1 or 2 views (72170) | $224.40 | $374 | 2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,340.40 | $2,234 | 3.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $333 | $555 | 3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $423 | $705 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$258–$516 | $430–$860 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$241.20–$482.40 | $402–$804 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$262.20–$524.40 | $437–$874 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $351 | $585 | 3.2× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$199.20–$398.40 | $332–$664 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$261–$522 | $435–$870 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$271.80–$543.60 | $453–$906 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$212.40–$424.80 | $354–$708 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $550.80 | $918 | 5.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $268.80 | $448 | 2.9× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $326.40 | $544 | 3.5× |
| Radex Ribs Unilateral 2 Views (71100) | $270 | $450 | 2.9× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$271.80–$543.60 | $453–$906 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $275.40 | $459 | 3.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $639.60 | $1,066 | 3.4× |
| Radex Spine 1 View Specify Level (72020) | $282 | $470 | 3.1× |
| Radex Sternum Minimum 2 Views (71120) | $255 | $425 | 2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $351 | $585 | 3.8× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$199.20–$398.40 | $332–$664 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$155.40–$310.80 | $259–$518 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$255–$510 | $425–$850 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $559.20 | $932 | 5.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $376.20 | $627 | 3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $339 | $565 | 3.1× |
| Radiologic exam colon double contrast study (74280) | $804.60 | $1,341 | 4.3× |
| Radiologic exam colon single contrast study (74270) | $679.20 | $1,132 | 3.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $520.80 | $868 | 2.8× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$411–$822 | $685–$1,370 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $274.20 | $457 | 2.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $509.40 | $849 | 2.7× |
| Radiologic exam swallow function contrast study (74230) | $406.20 | $677 | 2.2× |
| Radiologic exam teeth complete full mouth (70320) | $149.40 | $249 | 0.6× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $142.20 | $237 | 0.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $704.40 | $1,174 | 3.8× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$127.80–$255.60 | $213–$426 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$255–$510 | $425–$850 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$117.60–$235.20 | $196–$392 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $421.80 | $703 | 3.8× |
| Radiologic Examination Salivary Gland Calculus (70380) | $172.20 | $287 | 1.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$247.80–$495.60 | $413–$826 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $132.60 | $221 | 0.2× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $113.40 | $189 | 1.2× |
| Ribs bilateral 3 views (71110) | $350.40 | $584 | 3.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,927.80 | $3,213 | 4.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,292.40 | $2,154 | 3.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,421.80 | $5,703 | 6.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,988 | $4,980 | 5.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,494.80 | $4,158 | 4.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,893.20 | $4,822 | 2.1× |
| Scapula (73010) range across 2 matching MRF lines |
$249–$498 | $415–$830 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $53.40 | $89 | 2.3× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$204.60–$409.20 | $341–$682 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$757.80–$1,515.60 | $1,263–$2,526 | varies |
| Sialogram (70390) | $470.40 | $784 | 1.9× |
| Skull less than 4 views (70250) | $291.60 | $486 | 2.6× |
| Speech evaluation, complex (70371) | $485.40 | $809 | 1.9× |
| Sternoclavicular joints (71130) | $264.60 | $441 | 2.9× |
| Tbs technical calculation only (77091) | $153.60 | $256 | 1.7× |
| Temporomandble Jt Arthrography Rs&I (70332) | $333.60 | $556 | 1.3× |
| Thoracic spine 2 views (72070) | $287.40 | $479 | 2.6× |
| Thoracic spine 3 views (72072) | $342 | $570 | 3.1× |
| Thoracolumbar 2 views (72080) | $250.80 | $418 | 2.7× |
| Thyroid Imaging With Vascular Flow (78013) | $900 | $1,500 | 2.1× |
| Thyroid Uptake Measurement (78012) | $583.80 | $973 | 1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,368.60 | $2,281 | 3.2× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$399–$798 | $665–$1,330 | varies |
| Ultrasound Exam Aaa Screen (76706) | $479.40 | $799 | 4.3× |
| Ultrasound, abdomen limited (76705) | $554.40 | $924 | 5.0× |
| Upper gi w/o kub (74240) | $659.40 | $1,099 | 3.6× |
| Urethrocystogram voiding (74455) | $569.40 | $949 | 2.3× |
| Urethrocystography retrograde (74450) | $596.40 | $994 | 2.4× |
| Us bone density measurement (76977) | $111.60 | $186 | 1.0× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$588–$1,176 | $980–$1,960 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$205.20–$410.40 | $342–$684 | varies |
| Us complete joint (76881) | $475.80 | $793 | 4.3× |
| Us exam, pelvic, limited (76857) | $430.80 | $718 | 3.9× |
| Us kidney transplant (76776) | $575.40 | $959 | 5.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $383.40 | $639 | 3.5× |
| Us ob limited 1 or more fetuses (76815) | $481.20 | $802 | 4.4× |
| Us ob transvaginal (76817) | $425.40 | $709 | 3.8× |
| Us pelvic non ob complete (76856) | $565.80 | $943 | 5.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $588.60 | $981 | 5.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $476.40 | $794 | 4.3× |
| Us retroperitoneal complete (76770) | $559.80 | $933 | 5.1× |
| Us retroperitoneal limited (76775) | $475.20 | $792 | 4.3× |
| Us scrotum and contents (76870) | $552.60 | $921 | 5.0× |
| Us thyroid (76536) | $520.20 | $867 | 4.7× |
| Vascular Flow Imaging (78445) | $1,266 | $2,110 | 3.0× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$191.40–$382.80 | $319–$638 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $264.60 | $441 | 2.9× |
| X-ray antegrade pyelogram tube (74425) | $529.80 | $883 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $396.60 | $661 | 3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$196.20–$392.40 | $327–$654 | varies |
| X-Ray Exam Breast Specimen (76098) | $682.80 | $1,138 | 1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $319.20 | $532 | 3.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $417 | $695 | 3.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $430.20 | $717 | 3.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $170.40 | $284 | 1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $270 | $450 | 2.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $370.80 | $618 | 3.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $270 | $450 | 2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $370.80 | $618 | 3.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $471.60 | $786 | 4.3× |
| X-Ray Exam L-S Spine Bending (72114) | $426.60 | $711 | 3.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $308.40 | $514 | 3.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $453 | $755 | 4.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $299.40 | $499 | 2.7× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$261–$522 | $435–$870 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$235.80–$471.60 | $393–$786 | varies |
| X-ray IV pyelogram (ivp) (74400) | $838.20 | $1,397 | 4.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $203.40 | $339 | 2.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $117.60 | $196 | 1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $245.40 | $409 | 2.2× |
| X-ray nose-rectum child f.b. (76010) | $241.80 | $403 | 2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $370.20 | $617 | 3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $265.20 | $442 | 2.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $175.20 | $292 | 1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $261 | $435 | 2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $404.40 | $674 | 4.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $384 | $640 | 3.5× |
| X-ray thoracic spine 4 vw (72074) | $438 | $730 | 4.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $842.40 | $1,404 | 2.3× |
| X-Rays Bone Length Studies (77073) | $355.20 | $592 | 3.2× |
| X-Rays Bone Survey Complete (77075) | $703.20 | $1,172 | 6.4× |
| Xr c-spine 4 or 5 views (72050) | $427.80 | $713 | 3.9× |
| Xr facial bones less than 3 views (70140) | $235.80 | $393 | 2.6× |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$155.40–$310.80 | $259–$518 | varies |
| Xr orbits complete 4 views (70200) | $328.20 | $547 | 3.0× |
| Xr Tomogram Single Plane (76100) | $510 | $850 | 4.6× |
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.