Imaging prices at Baptist Memorial Hospital-Union City
Union City, TN · every code in this section with a posted price and a Medicare benchmark.
301 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) | $1,282 | $6,410 | 1.0× |
| Abdomen 1 View (74018) | $77 | $385 | 1.0× |
| Abdomen 2 views (74019) | $89.60 | $448 | 0.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $298.80 | $1,494 | 0.8× |
| Angiography extremity bilateral rs&i (75716) | $1,574.60 | $7,873 | 0.5× |
| Angiography extremity unilateral rs&i (75710) | $1,094.80 | $5,474 | 0.4× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$48.40–$83.40 | $242–$417 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,619.20 | $8,096 | 0.3× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$1,561 | $7,805 | 0.3× |
| Arthrogram hip (73525) | $242.60 | $1,213 | 0.8× |
| Arthrogram Wrist (73115) | $234.80 | $1,174 | 0.7× |
| Basic radiation dosimetry calculation (77300) | $146 | $730 | 1.2× |
| Bone age studies (77072) | $57 | $285 | 0.6× |
| Bone Imaging 3 Phase (78315) | $369 | $1,845 | 1.0× |
| Bone Imaging Limited Area (78300) | $302 | $1,510 | 0.8× |
| Bone Imaging Whole Body (78306) | $466 | $2,330 | 1.3× |
| Bone survey infant (77076) | $104.60 | $523 | 1.1× |
| Brachytx isodose complex (77318) | $569.20 | $2,846 | 1.7× |
| Brachytx isodose intermed (77317) | $476.40 | $2,382 | 1.4× |
| Brachytx Isodose Plan Simple (77316) | $334.20 | $1,671 | 1.0× |
| Cat Scan Follow-Up Study (76380) | $286.80 | $1,434 | 3.6× |
| Chest 1 view (71045) | $77 | $385 | 1.0× |
| Chest 2 views (71046) | $81.80 | $409 | 1.0× |
| Chest 3 views (71047) | $83.40 | $417 | 1.1× |
| Chest 4 or more views (71048) | $98.80 | $494 | 1.0× |
| Clavicle complete (73000) | $84.40 | $422 | 1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $42.60 | $213 | 0.4× |
| Continuing medical physics consltj pr wk (77336) | $229.40 | $1,147 | 1.9× |
| Contrast Exam Abdominl Aorta (75625) | $1,574.60 | $7,873 | 0.5× |
| Contrast X-Ray Bladder (74430) | $223.80 | $1,119 | 0.7× |
| Contrast X-Ray Of Elbow (73085) | $254.80 | $1,274 | 0.8× |
| Contrast X-Ray Of Knee Joint (73580) | $242.60 | $1,213 | 0.8× |
| CT abdomen and pelvis without and with contrast (74178) | $1,709.80 | $8,549 | 5.4× |
| CT abdomen and pelvis without contrast (74176) | $1,259.20 | $6,296 | 5.8× |
| CT abdomen w contrast (74160) | $738.60 | $3,693 | 4.6× |
| CT abdomen w wo contrast (74170) | $855 | $4,275 | 5.4× |
| CT abdomen w/o contrast (74150) | $630.40 | $3,152 | 6.6× |
| CT Angio Abdomen and Pelvis (74174) | $1,648.80 | $8,244 | 5.2× |
| CT Angio Chest (71275) | $823.60 | $4,118 | 5.2× |
| CT Angio Head (70496) | $663.40 | $3,317 | 4.2× |
| CT angio hrt w/3d image (75574) | $951.20 | $4,756 | 3.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$587–$714 | $2,935–$3,570 | varies |
| CT Angio Neck (70498) | $663.40 | $3,317 | 4.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $714 | $3,570 | 4.5× |
| CT cervical spine w/ contrast (72126) | $691.60 | $3,458 | 2.2× |
| CT cervical spine w/o contrast (72125) | $645.20 | $3,226 | 6.8× |
| CT cervical spine w/wo cont (72127) | $720.60 | $3,603 | 4.5× |
| CT chest w contrast (71260) | $738.60 | $3,693 | 4.6× |
| CT chest w/wo contrast (71270) | $855 | $4,275 | 5.4× |
| CT head/brain with contrast (70460) | $738.60 | $3,693 | 4.6× |
| CT head/brain without and with contrast (70470) | $855 | $4,275 | 5.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $53.80 | $269 | 0.7× |
| CT iac w contrast (70481) | $579 | $2,895 | 3.6× |
| CT l-spine w&w/o contrast (72133) | $890.20 | $4,451 | 5.6× |
| CT lower ext w/o (73700) | $630.40 | $3,152 | 6.6× |
| CT lower extremity w/contrast material (73701) | $855.20 | $4,276 | 5.4× |
| CT lumbar spine w contrast (72132) | $691.60 | $3,458 | 2.2× |
| CT lumbar spine w/o contrast (72131) | $661.60 | $3,308 | 7.0× |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$468.60–$771 | $2,343–$3,855 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$430.60–$765 | $2,153–$3,825 | varies |
| CT neck tissue combo (70492) | $861.20 | $4,306 | 5.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $873.60 | $4,368 | 5.5× |
| CT orbits w/o contrast (70480) range across 4 matching MRF lines |
$354–$700 | $1,770–$3,500 | varies |
| CT pelvis w&w/o contrast (72194) | $855 | $4,275 | 5.4× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$561.80–$630.40 | $2,809–$3,152 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$643.80–$855 | $3,219–$4,275 | varies |
| CT scans face/jaw combo (70488) | $740.60 | $3,703 | 4.7× |
| CT soft tissue neck w contrast (70491) | $738.60 | $3,693 | 4.6× |
| CT soft tissue neck w/o contrast (70490) | $630.40 | $3,152 | 6.6× |
| CT thoracic spine w contrast (72129) | $726 | $3,630 | 4.6× |
| CT thoracic spine w/o contrast (72128) | $630.40 | $3,152 | 6.6× |
| CT thoracic spine w/wo cont (72130) | $777.20 | $3,886 | 4.9× |
| CT thorax w/o contrast (71250) | $630.40 | $3,152 | 6.6× |
| CT upper ext wo (73200) | $630.40 | $3,152 | 6.6× |
| CT upper extremity w/o & w/contrast material (73202) | $777.20 | $3,886 | 4.9× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$634.40–$738.60 | $3,172–$3,693 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $823.60 | $4,118 | 5.2× |
| Cta Abdomen (74175) | $823.60 | $4,118 | 5.2× |
| CTA pelvis (72191) | $823.60 | $4,118 | 5.2× |
| Dxa Bone Density Axial (77080) | $96 | $480 | 1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $37.60 | $188 | 0.5× |
| Echograp Trans R Pros Study (76873) | $210.80 | $1,054 | 2.2× |
| Esophagram (74220) | $138.60 | $693 | 0.9× |
| Fetal Biophys Profile W/Nst (76818) | $290 | $1,450 | 3.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $237.60 | $1,188 | 2.5× |
| Fluoroscopy up to 1 hr (76000) | $192.40 | $962 | 0.9× |
| Follow-Up Angiography (75898) | $380 | $1,900 | 0.1× |
| Foot 2 views (73620) | $54.40 | $272 | 0.7× |
| Forearm 2 views (73090) | $75 | $375 | 0.9× |
| Gastric emptying imaging study (78264) | $474.80 | $2,374 | 1.3× |
| Gated Heart Planar Single (78472) | $368.60 | $1,843 | 1.0× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$38.40–$56.60 | $192–$283 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $2,149.80 | $10,749 | 3.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,073.80 | $10,369 | 3.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,918.80 | $9,594 | 3.0× |
| Hepatobil Syst Image W/Drug (78227) | $367.40 | $1,837 | 0.7× |
| Hepatobiliary System Imaging (78226) | $329.80 | $1,649 | 0.9× |
| Ht Muscle Image Spect Sing (78451) | $965.60 | $4,828 | 0.8× |
| Hysterosalpingogram (74740) | $156 | $780 | 0.7× |
| Image fusion (77399) | $111.40 | $557 | 0.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $165.40 | $827 | 2.1× |
| Infant hip ultrasound, limited static exam (76886) | $113.80 | $569 | 1.4× |
| Interstitial radiation source applic complex (77778) | $2,621.40 | $13,107 | 4.1× |
| K Flow/Funct Image Multiple (78709) | $526.80 | $2,634 | 1.1× |
| K Flow/Funct Image W/Drug (78708) | $520.60 | $2,603 | 1.1× |
| K Flow/Funct Image W/O Drug (78707) | $409.80 | $2,049 | 0.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $317 | $1,585 | 0.9× |
| Knee 3 Views (73562) | $93.80 | $469 | 1.2× |
| Liver & Spleen Imaging Static Only (78215) | $223.60 | $1,118 | 0.6× |
| Lung Perf&Ventilat Diferentl (78598) | $615.20 | $3,076 | 1.2× |
| Lung perfusion differential (78597) | $402.40 | $2,012 | 1.1× |
| Lung Ventilat&Perfus Imaging (78582) | $615.20 | $3,076 | 1.2× |
| Lung Ventilation Imaging (78579) | $213.20 | $1,066 | 0.6× |
| Lymph System Imaging (78195) | $286.80 | $1,434 | 0.6× |
| Magnetic Image Jaw Joint (70336) | $761.60 | $3,808 | 3.5× |
| Mammary ductogram or galactogram multiple (77054) | $194.80 | $974 | 0.9× |
| Mammary ductogram or galactogram single (77053) | $113.20 | $566 | 0.5× |
| Meckels Divert Exam (78290) | $304.60 | $1,523 | 0.8× |
| Mlc imrt design & construction per imrt plan (77338) | $650.40 | $3,252 | 1.9× |
| Mra Head W/O & W/Contrast Material (70546) | $1,218.60 | $6,093 | 3.8× |
| MRA head w/o contrast (70544) | $802.40 | $4,012 | 3.7× |
| MRA neck w contrast (70548) | $924 | $4,620 | 2.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,237.40 | $6,187 | 3.9× |
| MRA neck w/o contrast (70547) | $802.40 | $4,012 | 3.7× |
| MRI abdomen w contrast (74182) | $825.40 | $4,127 | 2.6× |
| MRI abdomen w/o contrast (74181) | $802.40 | $4,012 | 3.7× |
| MRI any jt lower extrem w/contrast material (73722) | $948 | $4,740 | 1.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,237.40 | $6,187 | 3.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $948 | $4,740 | 1.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $847 | $4,235 | 3.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $662.80 | $3,314 | 3.1× |
| MRI cervical spine w contrast (72142) | $948 | $4,740 | 3.0× |
| MRI cervical spine w/o cont (72141) | $802.40 | $4,012 | 3.7× |
| MRI chest w/o contrast (71550) | $802.40 | $4,012 | 3.7× |
| MRI chest wo w contrast (71552) | $1,237.40 | $6,187 | 3.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $858.40 | $4,292 | 2.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,237.40 | $6,187 | 3.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $802.40 | $4,012 | 3.7× |
| MRI lumbar spine w contrast (72149) | $948 | $4,740 | 3.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,017.80 | $5,089 | 3.2× |
| MRI orbit face &/neck w/o contrast (70540) | $802.40 | $4,012 | 3.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$825.40–$1,237.40 | $4,127–$6,187 | varies |
| MRI pelvis w contrast (72196) | $825.40 | $4,127 | 2.6× |
| MRI pelvis w/o & w contrast (72197) | $948 | $4,740 | 3.0× |
| MRI pelvis w/o contrast (72195) | $802.40 | $4,012 | 3.7× |
| MRI thoracic spine w/o contrast (72146) | $822.40 | $4,112 | 3.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $802.40 | $4,012 | 3.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,237.40 | $6,187 | 3.9× |
| MRI, abdomen, combo (74183) | $1,237.40 | $6,187 | 3.9× |
| MRI, dorsal spine combo (72157) | $1,017.80 | $5,089 | 3.2× |
| MRI, dorsal spine contrast (72147) | $948 | $4,740 | 3.0× |
| MRI, joint upper extrem (73221) | $802.40 | $4,012 | 3.7× |
| MRI, joint upper extrem combo (73223) | $1,237.40 | $6,187 | 3.9× |
| MRI, lumbar spine combo (72158) | $1,076.80 | $5,384 | 3.4× |
| Myocardial Spect Multiple Studies (78452) | $1,343.40 | $6,717 | 1.1× |
| Neck soft tissue (70360) | $71.60 | $358 | 0.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $133.20 | $666 | 0.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,265.20 | $6,326 | 1.0× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$92–$315.40 | $460–$1,577 | varies |
| Parathyroid Planar Imaging (78070) | $227.40 | $1,137 | 0.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $359.40 | $1,797 | 1.0× |
| Pelvis 1 or 2 views (72170) | $77.40 | $387 | 0.8× |
| PET image w/CT, full body (78816) | $2,495.60 | $12,478 | 1.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,495.60 | $12,478 | 1.9× |
| PET whole body (78813) | $2,211.60 | $11,058 | 1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $340 | $1,700 | 0.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $151.20 | $756 | 1.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $241.20 | $1,206 | 0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) | $84.40 | $422 | 1.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $52.80 | $264 | 0.7× |
| Radex elbow complete minimum 3 views (73080) | $89 | $445 | 1.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $158.20 | $791 | 1.7× |
| Radex fingr minimum 2 views (73140) | $65.40 | $327 | 0.8× |
| Radex foot complete minimum 3 views (73630) | $83.40 | $417 | 1.1× |
| Radex Hand Minimum 3 Views (73130) | $81.40 | $407 | 1.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $120 | $600 | 1.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $84.40 | $422 | 1.1× |
| Radex Ribs Unilateral 2 Views (71100) | $96.40 | $482 | 1.2× |
| Radex shoulder complete minimum 2 views (73030) | $94 | $470 | 1.2× |
| Radex Sinuses Paransl < 3 Views (70210) | $64.20 | $321 | 0.8× |
| Radex Spine 1 View Specify Level (72020) | $54.40 | $272 | 0.7× |
| Radex Sternum Minimum 2 Views (71120) | $103.20 | $516 | 1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $113.80 | $569 | 1.4× |
| Radex Toe Minimum 2 Views (73660) | $58 | $290 | 0.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $83.60 | $418 | 1.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $140 | $700 | 1.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $3,365.60 | $16,828 | 0.5× |
| Radiation treatment delivery level 1 (77402) | $153 | $765 | 1.7× |
| Radiation treatment delivery level 2 (77407) | $190.80 | $954 | 0.5× |
| Radiation treatment delivery level 3 (77412) | $223.60 | $1,118 | 0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $114.20 | $571 | 1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $114.60 | $573 | 1.2× |
| Radiologic exam colon double contrast study (74280) | $196.80 | $984 | 1.2× |
| Radiologic exam colon single contrast study (74270) | $159.20 | $796 | 1.0× |
| Radiologic exam knee complete 4/more views (73564) | $101.20 | $506 | 1.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $106.80 | $534 | 1.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $225.80 | $1,129 | 1.4× |
| Radiologic exam swallow function contrast study (74230) | $128.20 | $641 | 0.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $320.40 | $1,602 | 2.0× |
| Radiologic examination femur 1 view (73551) | $45.40 | $227 | 0.6× |
| Radiologic examination femur minimum 2 views (73552) | $82 | $410 | 1.0× |
| Radiologic examination knee 1/2 views (73560) | $83.20 | $416 | 1.1× |
| Radiologic Examination Osseous Survey Limited (77074) | $183.60 | $918 | 1.9× |
| Radiologic examination tibia & fibula 2 views (73590) | $83.40 | $417 | 1.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $97.80 | $489 | 0.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $97.80 | $489 | 0.3× |
| Ribs bilateral 3 views (71110) | $118.40 | $592 | 1.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,086.60 | $5,433 | 2.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $489.60 | $2,448 | 1.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $770 | $3,850 | 1.6× |
| Rp Therapy Intravenous Administration (79101) | $258.80 | $1,294 | 1.2× |
| Scapula (73010) range across 2 matching MRF lines |
$89.80–$94 | $449–$470 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $20.20 | $101 | 0.9× |
| Shoulder 1 view (73020) | $54.40 | $272 | 0.7× |
| Shoulder Arthrography (73040) | $254.80 | $1,274 | 0.8× |
| Skull less than 4 views (70250) | $93.80 | $469 | 1.0× |
| Special dosimetry (77331) | $79.60 | $398 | 0.7× |
| Special Physics Consult (77370) | $255 | $1,275 | 2.1× |
| Special teletherapy port plan (77321) | $246.60 | $1,233 | 0.7× |
| Special treatment procedure (77470) | $792.40 | $3,962 | 1.6× |
| Stereotactic Body Radiation Delivery (77373) | $2,459 | $12,295 | 1.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $485.80 | $2,429 | 1.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $390.60 | $1,953 | 1.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $406.20 | $2,031 | 1.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $277.40 | $1,387 | 0.8× |
| Ther rad simulaj-aided field setting simple (77280) | $252.80 | $1,264 | 2.1× |
| Thoracic spine 2 views (72070) | $107.40 | $537 | 1.1× |
| Thoracic spine 3 views (72072) | $115.40 | $577 | 1.2× |
| Thoracolumbar 2 views (72080) | $102.60 | $513 | 1.3× |
| Thyroid Imaging With Vascular Flow (78013) | $269.80 | $1,349 | 0.7× |
| Thyroid Met Imaging Body (78018) | $307.80 | $1,539 | 0.6× |
| Thyroid Uptake Measurement (78012) | $244.40 | $1,222 | 0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $190.80 | $954 | 0.5× |
| Tx Devices Design & Construction Complex (77334) | $406.20 | $2,031 | 1.2× |
| Tx devices design & construction intermediate (77333) | $136.80 | $684 | 1.1× |
| Tx devices design & construction simple (77332) | $129.20 | $646 | 1.1× |
| Ultrasound Breast Limited (76642) | $121.40 | $607 | 1.5× |
| Ultrasound Elastography Parenchyma (76981) | $75.60 | $378 | 0.8× |
| Ultrasound Exam Aaa Screen (76706) | $77 | $385 | 0.8× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$131.80–$196.80 | $659–$984 | varies |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$318.60–$331.40 | $1,593–$1,657 | varies |
| Upper gi w/o kub (74240) | $168.60 | $843 | 1.1× |
| Urethrocystogram voiding (74455) | $150.20 | $751 | 0.7× |
| Us breast unilateral complete (76641) | $158.40 | $792 | 1.7× |
| Us chest (76604) | $99.40 | $497 | 1.0× |
| Us complete joint (76881) | $147.80 | $739 | 1.6× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$122.60–$122.80 | $613–$614 | varies |
| Us head (76506) | $147.80 | $739 | 1.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$93.60–$108 | $468–$540 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$93.40–$191.20 | $467–$956 | varies |
| Us ob transvaginal (76817) | $221.60 | $1,108 | 2.3× |
| Us pelvic non ob complete (76856) | $241 | $1,205 | 2.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $231.60 | $1,158 | 2.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $144.60 | $723 | 1.5× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$223.60–$234.80 | $1,118–$1,174 | varies |
| Us retroperitoneal limited (76775) | $152.80 | $764 | 1.6× |
| Us scrotum and contents (76870) | $268 | $1,340 | 2.8× |
| Us spinal canal and contents (76800) | $99.40 | $497 | 1.0× |
| Us thyroid (76536) | $196.60 | $983 | 2.1× |
| Us transrectal (76872) | $210.80 | $1,054 | 2.2× |
| Vein X-Ray Chest (75827) | $557.80 | $2,789 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $1,574.60 | $7,873 | 0.5× |
| Venography extremity bilateral rs&i (75822) | $510.20 | $2,551 | 0.4× |
| Venography extremity unilateral rs&i (75820) | $485.80 | $2,429 | 0.3× |
| Wrist 2 views (73100) | $54.40 | $272 | 0.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $93.80 | $469 | 1.2× |
| X-Ray Aorta Leg Arteries (75630) | $1,574.60 | $7,873 | 0.5× |
| X-Ray Bend Only L-S Spine (72120) | $77.40 | $387 | 0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$36.80–$83.60 | $184–$418 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$274.40–$291.40 | $1,372–$1,457 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $76.40 | $382 | 1.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $84.60 | $423 | 0.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $121.40 | $607 | 1.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $50.60 | $253 | 0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $98.80 | $494 | 1.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $109.40 | $547 | 1.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $95.80 | $479 | 1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $109.40 | $547 | 1.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $126.80 | $634 | 1.3× |
| X-Ray Exam L-S Spine Bending (72114) | $133 | $665 | 1.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $94 | $470 | 1.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $145.20 | $726 | 1.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $145.20 | $726 | 1.5× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$48.20–$89 | $241–$445 | varies |
| X-ray IV pyelogram (ivp) (74400) | $214.40 | $1,072 | 1.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $74.60 | $373 | 0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $57 | $285 | 0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $115.40 | $577 | 1.2× |
| X-ray nose-rectum child f.b. (76010) | $84.60 | $423 | 1.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $194.80 | $974 | 2.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $82 | $410 | 0.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $75.20 | $376 | 0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $78 | $390 | 1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $106.80 | $534 | 1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $124 | $620 | 1.3× |
| X-ray thoracic spine 4 vw (72074) | $129 | $645 | 1.4× |
| X-Ray Tmj Unilat (70328) | $33.20 | $166 | 0.4× |
| X-Rays Bone Survey Complete (77075) | $183.20 | $916 | 1.9× |
| Xr c-spine 4 or 5 views (72050) | $114.20 | $571 | 1.2× |
| Xr facial bones less than 3 views (70140) | $77.40 | $387 | 1.0× |
| Xr orbits complete 4 views (70200) | $110 | $550 | 1.2× |
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.