Imaging prices at Ascension St. Vincent's Southside
Jacksonville, FL · 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) | $203.78 | $550.75 | 2.2× |
| Abdomen 2 views (74019) | $218.12 | $589.50 | 2.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,550.95 | $4,191.75 | 3.7× |
| Angio internal mammary (75756) | $1,745.20 | $4,716.75 | 0.5× |
| Angio pulmonary bilat (75743) | $2,192.25 | $5,925 | 0.7× |
| Angiography extremity bilateral rs&i (75716) | $1,990.79 | $5,380.50 | 0.6× |
| Angiography extremity unilateral rs&i (75710) | $1,729.01 | $4,673 | 0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $907.06 | $2,451.50 | 0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$1,213.88–$2,211.12 | $3,280.75–$5,976 | varies |
| Ankle 2 views (73600) | $191.48 | $517.50 | 2.1× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,767.68 | $4,777.50 | 0.3× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$1,320.35 | $3,568.50 | 0.2× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$1,832.61 | $4,953 | 0.3× |
| Bone age studies (77072) | $206.28 | $557.50 | 1.9× |
| Bone Imaging 3 Phase (78315) | $1,550.95 | $4,191.75 | 3.7× |
| Bone Imaging Limited Area (78300) | $1,436.06 | $3,881.25 | 3.4× |
| Bone Imaging Multiple Areas (78305) | $668.87 | $1,807.75 | 1.6× |
| Bone Imaging Whole Body (78306) | $1,665.83 | $4,502.25 | 4.0× |
| Bone marrow imaging limited area (78102) | $1,550.95 | $4,191.75 | 3.7× |
| Bone survey infant (77076) | $763.59 | $2,063.75 | 7.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,550.95 | $4,191.75 | 2.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) range across 2 matching MRF lines |
$999–$1,550.95 | $2,700–$4,191.75 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$761.46–$951.83 | $2,058–$2,572.50 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,100.75 | $2,975 | 1.3× |
| Chest 1 view (71045) | $163.73 | $442.50 | 1.8× |
| Chest 2 views (71046) | $177.42 | $479.50 | 2.0× |
| Chest 3 views (71047) | $195.73 | $529 | 2.2× |
| Chest 4 or more views (71048) | $214.23 | $579 | 2.0× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$179.64–$224.59 | $485.50–$607 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $647.32 | $1,749.50 | 5.9× |
| Contrast Exam Abdominl Aorta (75625) | $1,281.31 | $3,463 | 0.4× |
| Contrast X-Ray Bladder (74430) | $366.02 | $989.25 | 1.0× |
| CT abdomen and pelvis without and with contrast (74178) | $738.98 | $1,997.25 | 2.0× |
| CT abdomen and pelvis without contrast (74176) | $647.32 | $1,749.50 | 2.6× |
| CT abdomen w contrast (74160) | $647.32 | $1,749.50 | 3.5× |
| CT abdomen w wo contrast (74170) | $693.10 | $1,873.25 | 3.8× |
| CT abdomen w/o contrast (74150) | $601.44 | $1,625.50 | 5.5× |
| CT Angio Abdomen and Pelvis (74174) | $647.32 | $1,749.50 | 1.8× |
| CT Angio Chest (71275) | $647.32 | $1,749.50 | 3.5× |
| CT Angio Head (70496) | $647.32 | $1,749.50 | 3.5× |
| CT angio hrt w/3d image (75574) | $647.32 | $1,749.50 | 1.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $647.32 | $1,749.50 | 3.5× |
| CT Angio Neck (70498) | $647.32 | $1,749.50 | 3.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $647.32 | $1,749.50 | 3.5× |
| CT cervical spine w/ contrast (72126) | $693.10 | $1,873.25 | 1.9× |
| CT cervical spine w/o contrast (72125) | $647.32 | $1,749.50 | 5.9× |
| CT cervical spine w/wo cont (72127) | $785.70 | $2,123.50 | 4.3× |
| CT chest w contrast (71260) | $693.10 | $1,873.25 | 3.8× |
| CT chest w/wo contrast (71270) | $738.98 | $1,997.25 | 4.0× |
| CT head/brain with contrast (70460) | $722.43 | $1,952.50 | 3.9× |
| CT head/brain without and with contrast (70470) | $768.31 | $2,076.50 | 4.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $647.32 | $1,749.50 | 1.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $38.85 | $105 | 0.4× |
| CT iac w contrast (70481) | $624.28 | $1,687.25 | 3.4× |
| CT l-spine w&w/o contrast (72133) | $693.10 | $1,873.25 | 3.8× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$555.56–$833.24 | $1,501.50–$2,252 | varies |
| CT lower extremity w/contrast material (73701) | $601.44 | $1,625.50 | 3.3× |
| CT lumbar spine w contrast (72132) | $647.32 | $1,749.50 | 1.8× |
| CT lumbar spine w/o contrast (72131) | $601.44 | $1,625.50 | 5.5× |
| CT maxillofacial w contrast (70487) | $647.32 | $1,749.50 | 3.5× |
| CT maxillofacial wo contrast (70486) | $601.44 | $1,625.50 | 5.5× |
| CT neck tissue combo (70492) | $693.10 | $1,873.25 | 3.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $670.16 | $1,811.25 | 3.7× |
| CT orbits w/o contrast (70480) | $578.40 | $1,563.25 | 5.3× |
| CT pelvis w&w/o contrast (72194) | $716.04 | $1,935.25 | 3.9× |
| CT pelvis w/o contrast (72192) | $624.28 | $1,687.25 | 5.7× |
| CT scan of leg combo (73702) | $647.32 | $1,749.50 | 3.5× |
| CT scans face/jaw combo (70488) | $693.10 | $1,873.25 | 3.8× |
| CT soft tissue neck w contrast (70491) | $647.32 | $1,749.50 | 3.5× |
| CT soft tissue neck w/o contrast (70490) | $601.44 | $1,625.50 | 5.5× |
| CT thoracic spine w contrast (72129) | $624.28 | $1,687.25 | 3.4× |
| CT thoracic spine w/o contrast (72128) | $578.40 | $1,563.25 | 5.3× |
| CT thoracic spine w/wo cont (72130) | $670.16 | $1,811.25 | 3.7× |
| CT thorax w/o contrast (71250) | $647.32 | $1,749.50 | 5.9× |
| CT upper ext wo (73200) | $601.44 | $1,625.50 | 5.5× |
| CT upper extremity w/o & w/contrast material (73202) | $693.10 | $1,873.25 | 3.8× |
| CT upper extremity with contrast (73201) | $647.32 | $1,749.50 | 1.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $647.32 | $1,749.50 | 3.5× |
| Cta Abdomen (74175) | $647.32 | $1,749.50 | 3.5× |
| CTA pelvis (72191) | $647.32 | $1,749.50 | 3.5× |
| Diskography lumbar (72295) | $3,630.07 | $9,811 | 1.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $273.80 | $740 | 2.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $283.42 | $766 | 2.6× |
| Doppler Fetal Mid Cerebral Artery (76821) | $196.01 | $529.75 | 1.8× |
| Dxa Bone Density Axial (77080) | $250.40 | $676.75 | 2.3× |
| Dxa bone density study (77085) | $245.68 | $664 | 2.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$129.69–$162.06 | $350.50–$438 | varies |
| Echo exam of fetal heart (76825) | $439.65 | $1,188.25 | 0.8× |
| Echo exam uterus (76831) | $460.93 | $1,245.75 | 1.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $274.91 | $743 | 1.1× |
| Echograp Trans R Pros Study (76873) | $1,963.78 | $5,307.50 | 18.0× |
| Esophagram (74220) | $419.77 | $1,134.50 | 2.3× |
| Fetal Biophys Profile W/Nst (76818) range across 5 matching MRF lines |
$446.41–$616.05 | $1,206.50–$1,665 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 5 matching MRF lines |
$640.38–$883.65 | $1,730.75–$2,388.25 | varies |
| Fluoroscopy up to 1 hr (76000) | $248.27 | $671 | 1.0× |
| Foot 2 views (73620) | $194.90 | $526.75 | 2.1× |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$185.37–$231.71 | $501–$626.25 | varies |
| Gastric emptying imaging study (78264) | $1,550.95 | $4,191.75 | 3.7× |
| Gated Heart Planar Single (78472) range across 3 matching MRF lines |
$999–$1,550.95 | $2,700–$4,191.75 | varies |
| Hand 2 views (73120) | $189.53 | $512.25 | 1.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,359.25 | $11,781.75 | 1.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,550.95 | $4,191.75 | 2.7× |
| Hepatobiliary System Imaging (78226) | $1,550.95 | $4,191.75 | 3.7× |
| Ht Muscle Image Spect Sing (78451) range across 3 matching MRF lines |
$962–$1,493.51 | $2,600–$4,036.50 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$591.54–$739.45 | $1,598.75–$1,998.50 | varies |
| K Flow/Funct Image W/Drug (78708) | $1,550.95 | $4,191.75 | 2.7× |
| K Flow/Funct Image W/O Drug (78707) | $1,550.95 | $4,191.75 | 2.7× |
| Knee 3 Views (73562) range across 5 matching MRF lines |
$235.51–$294.43 | $636.50–$795.75 | varies |
| Leveen/Shunt Patency Exam (78291) | $752.49 | $2,033.75 | 1.8× |
| Liver & Spleen Imaging Static Only (78215) | $1,550.95 | $4,191.75 | 3.7× |
| Lung perfusion differential (78597) | $1,550.95 | $4,191.75 | 3.7× |
| Lung Ventilat&Perfus Imaging (78582) | $1,550.95 | $4,191.75 | 2.7× |
| Lymph System Imaging (78195) | $1,550.95 | $4,191.75 | 2.7× |
| Magnetic Image Jaw Joint (70336) | $590.15 | $1,595 | 2.4× |
| Meckels Divert Exam (78290) | $1,550.95 | $4,191.75 | 3.7× |
| Mr safety determination physician/other qhp (76016) | $156.42 | $422.75 | 1.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $135.88 | $367.25 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $638.34 | $1,725.25 | 1.8× |
| MRA head w/o contrast (70544) | $574.06 | $1,551.50 | 2.3× |
| MRA head with contrast (70545) | $606.15 | $1,638.25 | 1.7× |
| MRA neck w contrast (70548) | $590.15 | $1,595 | 1.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $622.25 | $1,681.75 | 1.7× |
| MRA neck w/o contrast (70547) | $558.05 | $1,508.25 | 2.2× |
| MRI abdomen w contrast (74182) | $590.15 | $1,595 | 1.6× |
| MRI abdomen w/o contrast (74181) | $558.05 | $1,508.25 | 2.2× |
| MRI any jt lower extrem w/contrast material (73722) | $622.25 | $1,681.75 | 0.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $654.35 | $1,768.50 | 1.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $622.25 | $1,681.75 | 0.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $566.01 | $1,529.75 | 2.3× |
| MRI cardiac w/o cont stress (75559) | $675.53 | $1,825.75 | 1.2× |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$388.59–$485.72 | $1,050.25–$1,312.75 | varies |
| MRI cervical spine w contrast (72142) | $574.06 | $1,551.50 | 1.6× |
| MRI cervical spine w/o cont (72141) | $558.05 | $1,508.25 | 2.2× |
| MRI chest w/o contrast (71550) | $590.15 | $1,595 | 2.4× |
| MRI chest wo w contrast (71552) | $654.35 | $1,768.50 | 1.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $622.25 | $1,681.75 | 1.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $654.35 | $1,768.50 | 1.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $590.15 | $1,595 | 2.4× |
| MRI lumbar spine w contrast (72149) | $622.25 | $1,681.75 | 1.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $606.15 | $1,638.25 | 1.7× |
| MRI orbit face &/neck w/o contrast (70540) | $525.86 | $1,421.25 | 2.1× |
| MRI orbit face neck w contrast (70542) | $558.05 | $1,508.25 | 1.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $590.15 | $1,595 | 1.6× |
| MRI pelvis w contrast (72196) | $720.02 | $1,946 | 2.0× |
| MRI pelvis w/o & w contrast (72197) | $590.15 | $1,595 | 1.6× |
| MRI pelvis w/o contrast (72195) | $525.86 | $1,421.25 | 2.1× |
| MRI thoracic spine w/o contrast (72146) | $558.05 | $1,508.25 | 2.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$843.05–$1,359.75 | $2,278.50–$3,675 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $558.05 | $1,508.25 | 2.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $622.25 | $1,681.75 | 1.7× |
| MRI, abdomen, combo (74183) | $622.25 | $1,681.75 | 1.7× |
| MRI, dorsal spine combo (72157) | $622.25 | $1,681.75 | 1.7× |
| MRI, dorsal spine contrast (72147) | $590.15 | $1,595 | 1.6× |
| MRI, joint upper extrem (73221) | $1,136.27 | $3,071 | 4.6× |
| MRI, joint upper extrem combo (73223) | $654.35 | $1,768.50 | 1.8× |
| MRI, lumbar spine combo (72158) | $654.35 | $1,768.50 | 1.8× |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$1,036–$1,608.39 | $2,800–$4,347 | varies |
| N-invas est c ffr sw aly CTA (75580) | $1,210.55 | $3,271.76 | 1.3× |
| Neck soft tissue (70360) | $199.25 | $538.50 | 2.2× |
| Nonvascular Shunt X-Ray (75809) | $249.10 | $673.25 | 2.3× |
| Nuclear Rx Intra-Arterial (79445) | $403.39 | $1,090.25 | 1.7× |
| Ob us nuchal meas 1 gest (76813) | $196.01 | $529.75 | 1.8× |
| Parathyroid Planar Imaging (78070) | $1,550.95 | $4,191.75 | 3.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,723.28 | $4,657.50 | 4.1× |
| Pelvis 1 or 2 views (72170) | $188.15 | $508.50 | 1.7× |
| Peritoneogram Rs&I (74190) | $466.11 | $1,259.75 | 0.8× |
| Pet Image W/Ct Lmtd (78814) | $1,979.50 | $5,350 | 1.3× |
| PET image w/CT, full body (78816) | $2,016.50 | $5,450 | 1.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,998 | $5,400 | 1.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,370.04 | $6,405.50 | 0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,550.95 | $4,191.75 | 3.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $507.55 | $1,371.75 | 0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$206.83–$258.54 | $559–$698.75 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$181.12–$226.44 | $489.50–$612 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$145.50–$181.86 | $393.25–$491.50 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $204.06 | $551.50 | 1.9× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$156.60–$195.73 | $423.25–$529 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$197.03–$246.33 | $532.50–$665.75 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$199.15–$248.92 | $538.25–$672.75 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 6 matching MRF lines |
$110.08–$137.64 | $297.50–$372 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $217.19 | $587 | 2.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $269.55 | $728.50 | 3.0× |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$267.23–$334.02 | $722.25–$902.75 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$210.90–$263.63 | $570–$712.50 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $169.09 | $457 | 1.9× |
| Radex Spine 1 View Specify Level (72020) | $302.29 | $817 | 3.3× |
| Radex Sternum Minimum 2 Views (71120) | $259.09 | $700.25 | 2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $148.46 | $401.25 | 1.6× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$130.98–$163.73 | $354–$442.50 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 4 matching MRF lines |
$109.80–$137.27 | $296.75–$371 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$220.24–$275.28 | $595.25–$744 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $299.79 | $810.25 | 2.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $258.08 | $697.50 | 2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $232.45 | $628.25 | 2.1× |
| Radiologic exam colon double contrast study (74280) | $948.87 | $2,564.50 | 5.2× |
| Radiologic exam colon single contrast study (74270) | $538.17 | $1,454.50 | 2.9× |
| Radiologic exam knee complete 4/more views (73564) | $275.74 | $745.25 | 2.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $148.37 | $401 | 1.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $480.17 | $1,297.75 | 2.6× |
| Radiologic exam swallow function contrast study (74230) | $216.82 | $586 | 1.2× |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$114.89–$143.65 | $310.50–$388.25 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$227.83–$284.81 | $615.75–$769.75 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$210.62–$263.26 | $569.25–$711.50 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$215.53–$269.45 | $582.50–$728.25 | varies |
| Ribs bilateral 3 views (71110) | $301.09 | $813.75 | 2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,493.51 | $4,036.50 | 3.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,608.39 | $4,347 | 2.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,608.39 | $4,347 | 2.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$962–$1,493.51 | $2,600–$4,036.50 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,064.53 | $8,282.50 | 2.1× |
| Scapula (73010) range across 6 matching MRF lines |
$221.72–$277.13 | $599.25–$749 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$76.04–$114.15 | $205.50–$308.50 | varies |
| Shoulder 1 view (73020) | $110.08 | $297.50 | 1.2× |
| Skull less than 4 views (70250) | $267.14 | $722 | 2.4× |
| Sternoclavicular joints (71130) | $307.01 | $829.75 | 3.4× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) range across 2 matching MRF lines |
$145.23–$156.42 | $392.50–$422.75 | varies |
| Tbs technical calculation only (77091) range across 2 matching MRF lines |
$145.23–$156.42 | $392.50–$422.75 | varies |
| Thoracic spine 2 views (72070) | $124.51 | $336.50 | 1.1× |
| Thoracic spine 3 views (72072) | $179.45 | $485 | 1.6× |
| Thoracolumbar 2 views (72080) | $197.86 | $534.75 | 2.2× |
| Thyroid Met Imaging Body (78018) | $1,665.83 | $4,502.25 | 2.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,550.95 | $4,191.75 | 3.7× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$333–$666 | $900–$1,800 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$173.62–$263.63 | $469.25–$712.50 | varies |
| Ultrasound, abdomen limited (76705) | $875.70 | $2,366.75 | 8.0× |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$452.33–$624.28 | $1,222.50–$1,687.25 | varies |
| Upper gi w/o kub (74240) | $581.27 | $1,571 | 3.2× |
| Urethrocystogram voiding (74455) | $432.81 | $1,169.75 | 1.7× |
| Urethrocystography retrograde (74450) | $370 | $1,000 | 1.5× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$377.40–$754.80 | $1,020–$2,040 | varies |
| Us chest (76604) | $444.56 | $1,201.50 | 4.1× |
| Us complete joint (76881) | $693.29 | $1,873.75 | 6.4× |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$311.36–$429.66 | $841.50–$1,161.25 | varies |
| Us head (76506) | $659.80 | $1,783.25 | 6.0× |
| Us kidney transplant (76776) | $513.93 | $1,389 | 4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $684.22 | $1,849.25 | 6.3× |
| Us ob detailed single fetus (76811) | $617.90 | $1,670 | 2.5× |
| Us ob limited 1 or more fetuses (76815) range across 5 matching MRF lines |
$247.07–$340.96 | $667.75–$921.50 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$398.03–$549.27 | $1,075.75–$1,484.50 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$552.78–$762.76 | $1,494–$2,061.50 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 4 matching MRF lines |
$393.03–$542.33 | $1,062.25–$1,465.75 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 5 matching MRF lines |
$247.07–$340.96 | $667.75–$921.50 | varies |
| Us retroperitoneal complete (76770) | $565.36 | $1,528 | 5.2× |
| Us retroperitoneal limited (76775) | $444.56 | $1,201.50 | 4.1× |
| Us scrotum and contents (76870) | $632.61 | $1,709.75 | 5.8× |
| Us thyroid (76536) | $656.01 | $1,773 | 6.0× |
| Us transrectal (76872) | $750.36 | $2,028 | 6.9× |
| Vein X-Ray Chest (75827) | $1,312.11 | $3,546.25 | 0.8× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$840.92–$4,867.81 | $2,272.75–$13,156.25 | varies |
| Venography caval inferior serialography rs&i (75825) | $1,115.09 | $3,013.75 | 0.3× |
| Venography extremity bilateral rs&i (75822) | $590.24 | $1,595.25 | 0.4× |
| Venography extremity unilateral rs&i (75820) | $581.83 | $1,572.50 | 0.4× |
| Venography Renal Bilateral (75833) | $4,043.45 | $10,928.25 | 1.2× |
| Venography Renal Unilateral (75831) | $4,043.45 | $10,928.25 | 1.2× |
| Venous sampling by catheter (75893) | $4,416.78 | $11,937.25 | 0.8× |
| Wrist 2 views (73100) | $210.62 | $569.25 | 2.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $287.95 | $778.25 | 3.2× |
| X-ray antegrade pyelogram tube (74425) | $588.49 | $1,590.50 | 1.6× |
| X-Ray Aorta Leg Arteries (75630) | $1,235.43 | $3,339 | 0.4× |
| X-Ray Bend Only L-S Spine (72120) | $448.16 | $1,211.25 | 4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$130.24–$162.80 | $352–$440 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $130.98 | $354 | 1.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $233.19 | $630.25 | 2.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $263.35 | $711.75 | 2.4× |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$159.47–$199.34 | $431–$538.75 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$175.38–$219.23 | $474–$592.50 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 5 matching MRF lines |
$148–$239.39 | $400–$647 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $254.28 | $687.25 | 2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $265.75 | $718.25 | 2.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $278.52 | $752.75 | 2.6× |
| X-Ray Exam L-S Spine Bending (72114) | $474.43 | $1,282.25 | 4.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $293.50 | $793.25 | 3.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $478.69 | $1,293.75 | 4.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$272.04–$340.03 | $735.25–$919 | varies |
| X-ray eye for foreign body (70030) | $130.98 | $354 | 1.4× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$157.53–$196.93 | $425.75–$532.25 | varies |
| X-ray IV pyelogram (ivp) (74400) | $743.33 | $2,009 | 4.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $149.57 | $404.25 | 1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $236.43 | $639 | 2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $327.27 | $884.50 | 3.0× |
| X-ray nose-rectum child f.b. (76010) | $199.71 | $539.75 | 2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $496.08 | $1,340.75 | 4.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $177.05 | $478.50 | 1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $207.57 | $561 | 2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $263.44 | $712 | 2.9× |
| X-ray thoracic spine 4 vw (72074) | $148.83 | $402.25 | 1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$555.83–$833.70 | $1,502.25–$2,253.25 | varies |
| X-Rays Bone Length Studies (77073) | $273.62 | $739.50 | 2.5× |
| X-Rays Bone Survey Complete (77075) | $689.50 | $1,863.50 | 6.3× |
| Xr c-spine 4 or 5 views (72050) | $440.39 | $1,190.25 | 4.0× |
| Xr orbits complete 4 views (70200) | $180.65 | $488.25 | 1.7× |
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.