Imaging prices at Barton Memorial Hospital
South Lake Tahoe, CA · every code in this section with a posted price and a Medicare benchmark.
296 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) range across 2 matching MRF lines |
$742.70–$789.60 | $1,061–$1,128 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$759.50–$827.40 | $1,085–$1,182 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $3,376.80 | $4,824 | 6.5× |
| Angiography extremity bilateral rs&i (75716) | $10,332.70 | $14,761 | 2.5× |
| Angiography extremity unilateral rs&i (75710) | $10,332.70 | $14,761 | 2.5× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$812.70–$1,625.40 | $1,161–$2,322 | varies |
| Aortography thoracic serialography rs&i (75605) | $14,489.30 | $20,699 | 2.0× |
| Artery X-Rays Abdomen (75726) | $8,983.80 | $12,834 | 1.2× |
| Artery X-Rays Pelvis (75736) | $10,378.90 | $14,827 | 1.4× |
| Arthrogram ankle (73615) | $2,018.10 | $2,883 | 4.5× |
| Arthrogram hip (73525) | $1,940.40 | $2,772 | 4.3× |
| Arthrogram Wrist (73115) | $1,940.40 | $2,772 | 4.3× |
| Bone age studies (77072) range across 2 matching MRF lines |
$861–$939.40 | $1,230–$1,342 | varies |
| Bone Imaging 3 Phase (78315) | $2,993.20 | $4,276 | 5.8× |
| Bone Imaging Limited Area (78300) | $2,102.80 | $3,004 | 4.1× |
| Bone Imaging Multiple Areas (78305) | $1,138.20 | $1,626 | 2.2× |
| Bone Imaging Whole Body (78306) | $2,912 | $4,160 | 5.6× |
| Bone survey infant (77076) | $1,287.30 | $1,839 | 9.5× |
| Brain Flow Imaging Only (78610) | $3,486.70 | $4,981 | 4.9× |
| Brain Image W/Flow < 4 Views (78601) | $3,486.70 | $4,981 | 6.7× |
| Brain imaging < 4 static views (78600) | $3,486.70 | $4,981 | 6.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $3,486.70 | $4,981 | 4.9× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,660.40 | $2,372 | 2.4× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $2,867.20 | $4,096 | 5.5× |
| Cat Scan Follow-Up Study (76380) | $1,914.50 | $2,735 | 17.0× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$789.60–$1,579.20 | $1,128–$2,256 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$779.80–$827.40 | $1,114–$1,182 | varies |
| Chest 3 views (71047) | $861 | $1,230 | 7.6× |
| Chest 4 or more views (71048) | $1,083.60 | $1,548 | 8.0× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$683.20–$789.60 | $976–$1,128 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$12,618.90–$13,250.30 | $18,027–$18,929 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$2,403.80–$4,807.60 | $3,434–$6,868 | varies |
| Contrast X-Ray Of Elbow (73085) | $1,940.40 | $2,772 | 4.3× |
| Contrast X-Ray Of Knee Joint (73580) | $1,940.40 | $2,772 | 4.3× |
| Contrast Xray Throat/Cerv Esopha (74210) | $695.10 | $993 | 3.1× |
| CT abdomen and pelvis without and with contrast (74178) | $6,594.70 | $9,421 | 14.6× |
| CT abdomen and pelvis without contrast (74176) | $4,510.10 | $6,443 | 14.6× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$5,005.70–$5,065.90 | $7,151–$7,237 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$5,588.80–$5,957.70 | $7,984–$8,511 | varies |
| CT abdomen w/o contrast (74150) | $3,822 | $5,460 | 28.2× |
| CT Angio Abdomen and Pelvis (74174) | $6,552.70 | $9,361 | 14.5× |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$5,957.70–$11,915.40 | $8,511–$17,022 | varies |
| CT Angio Head (70496) | $5,957.70 | $8,511 | 26.2× |
| CT angio hrt w/3d image (75574) | $5,766.60 | $8,238 | 12.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $5,957.70 | $8,511 | 26.2× |
| CT Angio Neck (70498) | $5,957.70 | $8,511 | 26.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$4,667.60–$5,957.70 | $6,668–$8,511 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$5,065.90–$5,756.80 | $7,237–$8,224 | varies |
| CT cervical spine w/o contrast (72125) | $3,822 | $5,460 | 28.2× |
| CT cervical spine w/wo cont (72127) | $5,957.70 | $8,511 | 26.2× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$5,065.90–$5,105.80 | $7,237–$7,294 | varies |
| CT chest w/wo contrast (71270) | $5,957.70 | $8,511 | 26.2× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$5,005.70–$5,065.90 | $7,151–$7,237 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$5,588.80–$5,957.70 | $7,984–$8,511 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $3,007.20 | $4,296 | 6.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $949.20 | $1,356 | 8.4× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$5,005.70–$5,065.90 | $7,151–$7,237 | varies |
| CT lower ext w/o (73700) | $3,822 | $5,460 | 28.2× |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$5,065.90–$5,086.90 | $7,237–$7,267 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$5,005.70–$5,065.90 | $7,151–$7,237 | varies |
| CT lumbar spine w/o contrast (72131) | $3,822 | $5,460 | 28.2× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$5,005.70–$5,065.90 | $7,151–$7,237 | varies |
| CT maxillofacial wo contrast (70486) | $3,822 | $5,460 | 28.2× |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$5,030.20–$5,957.70 | $7,186–$8,511 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $5,957.70 | $8,511 | 26.2× |
| CT orbits w/o contrast (70480) | $3,822 | $5,460 | 28.2× |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$5,588.80–$5,957.70 | $7,984–$8,511 | varies |
| CT pelvis w/o contrast (72192) | $3,822 | $5,460 | 28.2× |
| CT scan of leg combo (73702) | $5,957.70 | $8,511 | 26.2× |
| CT scans face/jaw combo (70488) | $5,957.70 | $8,511 | 26.2× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$5,065.90–$5,105.80 | $7,237–$7,294 | varies |
| CT soft tissue neck w/o contrast (70490) | $3,822 | $5,460 | 28.2× |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$5,005.70–$5,065.90 | $7,151–$7,237 | varies |
| CT thoracic spine w/o contrast (72128) | $3,822 | $5,460 | 28.2× |
| CT thorax w/o contrast (71250) | $3,822 | $5,460 | 28.2× |
| CT upper ext wo (73200) | $3,822 | $5,460 | 28.2× |
| CT upper extremity w/o & w/contrast material (73202) | $5,957.70 | $8,511 | 26.2× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$5,065.90–$5,317.90 | $7,237–$7,597 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$5,361.30–$5,957.70 | $7,659–$8,511 | varies |
| Cta Abdomen (74175) | $5,957.70 | $8,511 | 26.2× |
| CTA pelvis (72191) | $5,030.20 | $7,186 | 22.1× |
| Diskography lumbar (72295) | $4,285.40 | $6,122 | 1.7× |
| Dxa Bone Density Axial (77080) | $578.90 | $827 | 4.3× |
| Dxa bone density study (77085) | $508.20 | $726 | 3.7× |
| Echo exam uterus (76831) | $1,256.50 | $1,795 | 4.1× |
| Esophagram (74220) range across 2 matching MRF lines |
$1,323.70–$1,376.90 | $1,891–$1,967 | varies |
| Fetal Biophys Profile W/Nst (76818) | $1,451.10 | $2,073 | 10.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,446.20 | $2,066 | 10.7× |
| Fluoroscopy up to 1 hr (76000) | $1,582 | $2,260 | 5.1× |
| Follow-Up Angiography (75898) | $7,847.70 | $11,211 | 1.9× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$690.90–$827.40 | $987–$1,182 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$826–$827.40 | $1,180–$1,182 | varies |
| Gastric emptying imaging study (78264) | $2,783.20 | $3,976 | 5.4× |
| Gated Heart Planar Single (78472) | $2,640.40 | $3,772 | 5.1× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$827.40–$891.10 | $1,182–$1,273 | varies |
| Hepatobil Syst Image W/Drug (78227) | $3,247.30 | $4,639 | 4.6× |
| Hepatobiliary System Imaging (78226) | $2,942.80 | $4,204 | 5.7× |
| Ht Muscle Image Spect Sing (78451) | $5,672.80 | $8,104 | 3.4× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$3,960.60–$4,118.80 | $5,658–$5,884 | varies |
| Infusion Ivp (74410) | $2,625 | $3,750 | 11.5× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$668.50–$789.60 | $955–$1,128 | varies |
| K Flow/Funct Image Multiple (78709) | $3,516.80 | $5,024 | 5.0× |
| K Flow/Funct Image W/Drug (78708) | $3,267.60 | $4,668 | 4.6× |
| K Flow/Funct Image W/O Drug (78707) | $2,915.50 | $4,165 | 4.1× |
| Kidney Imaging Morphol (78700) | $2,717.40 | $3,882 | 5.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $2,494.80 | $3,564 | 4.8× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$674.80–$861 | $964–$1,230 | varies |
| Liver & Spleen Imaging Static Only (78215) | $2,885.40 | $4,122 | 5.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,170.40 | $1,672 | 2.3× |
| Lung Perf&Ventilat Diferentl (78598) | $2,809.10 | $4,013 | 4.0× |
| Lung perfusion differential (78597) | $2,887.50 | $4,125 | 5.6× |
| Lung Ventilat&Perfus Imaging (78582) | $2,492 | $3,560 | 3.5× |
| Lung Ventilation Imaging (78579) | $1,663.20 | $2,376 | 3.2× |
| Lymph System Imaging (78195) | $3,992.80 | $5,704 | 5.7× |
| Magnetic Image Jaw Joint (70336) | $4,200.70 | $6,001 | 13.6× |
| Meckels Divert Exam (78290) | $2,081.10 | $2,973 | 4.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $19.60 | $28 | 0.5× |
| Mra Head W/O & W/Contrast Material (70546) | $5,655.30 | $8,079 | 12.5× |
| MRA head w/o contrast (70544) | $4,283.30 | $6,119 | 13.8× |
| MRA head with contrast (70545) | $4,940.60 | $7,058 | 10.9× |
| MRA neck w contrast (70548) | $4,624.20 | $6,606 | 10.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,655.30 | $8,079 | 12.5× |
| MRA neck w/o contrast (70547) | $4,200.70 | $6,001 | 13.6× |
| MRI abdomen w/o contrast (74181) | $4,200.70 | $6,001 | 13.6× |
| MRI any jt lower extrem w/contrast material (73722) | $4,750.90 | $6,787 | 4.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $5,655.30 | $8,079 | 12.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $4,750.90 | $6,787 | 4.7× |
| MRI Breast W/O Contrast Bilateral (77047) | $4,200.70 | $6,001 | 13.6× |
| MRI Breast Without Contrast Material Unilateral (77046) | $4,368.70 | $6,241 | 14.1× |
| MRI cervical spine w contrast (72142) | $4,750.90 | $6,787 | 10.5× |
| MRI cervical spine w/o cont (72141) | $4,200.70 | $6,001 | 13.6× |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$4,200.70–$4,830.70 | $6,001–$6,901 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$5,655.30–$6,503.70 | $8,079–$9,291 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $4,750.90 | $6,787 | 10.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$5,655.30–$11,310.60 | $8,079–$16,158 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $4,200.70 | $6,001 | 13.6× |
| MRI lumbar spine w contrast (72149) | $4,750.90 | $6,787 | 10.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,655.30 | $8,079 | 12.5× |
| MRI orbit face &/neck w/o contrast (70540) | $4,200.70 | $6,001 | 13.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,655.30 | $8,079 | 12.5× |
| MRI pelvis w contrast (72196) | $4,750.90 | $6,787 | 10.5× |
| MRI pelvis w/o & w contrast (72197) | $5,655.30 | $8,079 | 12.5× |
| MRI pelvis w/o contrast (72195) | $4,200.70 | $6,001 | 13.6× |
| MRI thoracic spine w/o contrast (72146) | $4,200.70 | $6,001 | 13.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $4,750.90 | $6,787 | 10.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $4,200.70 | $6,001 | 13.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $5,655.30 | $8,079 | 12.5× |
| MRI, abdomen, combo (74183) | $5,655.30 | $8,079 | 12.5× |
| MRI, dorsal spine combo (72157) | $5,655.30 | $8,079 | 12.5× |
| MRI, dorsal spine contrast (72147) | $4,940.60 | $7,058 | 10.9× |
| MRI, joint upper extrem (73221) | $4,200.70 | $6,001 | 13.6× |
| MRI, joint upper extrem combo (73223) | $5,655.30 | $8,079 | 12.5× |
| MRI, lumbar spine combo (72158) | $5,655.30 | $8,079 | 12.5× |
| Myelogram cervical (72240) | $2,622.20 | $3,746 | 2.6× |
| Myelogram Lumbar (72265) | $2,753.80 | $3,934 | 2.7× |
| Myelography thoracic (72255) | $3,403.40 | $4,862 | 3.3× |
| Myelograpy 2/more regions rs&i (72270) | $2,753.80 | $3,934 | 2.7× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$6,953.10–$7,231 | $9,933–$10,330 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$789.60–$854 | $1,128–$1,220 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$409.50–$425.60 | $585–$608 | varies |
| Panoramic X-ray of jaws (70355) | $557.20 | $796 | 4.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,539.20 | $5,056 | 5.0× |
| Parathyroid Planar Imaging (78070) | $2,081.80 | $2,974 | 4.0× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$793.10–$827.40 | $1,133–$1,182 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $6,364.40 | $9,092 | 1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,663.20 | $2,376 | 3.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$1,083.60–$1,122.10 | $1,548–$1,603 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,479.40 | $3,542 | 3.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$721–$861 | $1,030–$1,230 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$751.10–$789.60 | $1,073–$1,128 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$827.40–$2,482.20 | $1,182–$3,546 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $861 | $1,230 | 6.3× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$694.40–$827.40 | $992–$1,182 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$827.40–$861 | $1,182–$1,230 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$827.40–$861 | $1,182–$1,230 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $861 | $1,230 | 7.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$845.60–$861 | $1,208–$1,230 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$718.20–$827.40 | $1,026–$1,182 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$827.40–$861 | $1,182–$1,230 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $827.40 | $1,182 | 7.3× |
| Radex Spine 1 View Specify Level (72020) | $789.60 | $1,128 | 7.0× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$735–$827.40 | $1,050–$1,182 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$696.50–$827.40 | $995–$1,182 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$679–$827.40 | $970–$1,182 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $397.60 | $568 | 2.9× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$827.40–$1,654.80 | $1,182–$2,364 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,200.50 | $1,715 | 8.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,083.60 | $1,548 | 8.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,037.40 | $1,482 | 7.6× |
| Radiologic exam colon double contrast study (74280) | $2,113.30 | $3,019 | 9.3× |
| Radiologic exam colon single contrast study (74270) | $1,461.60 | $2,088 | 6.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,465.80 | $2,094 | 6.4× |
| Radiologic exam knee complete 4/more views (73564) | $1,083.60 | $1,548 | 8.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$814.10–$861 | $1,163–$1,230 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,390.90 | $1,987 | 6.1× |
| Radiologic exam swallow function contrast study (74230) | $1,390.90 | $1,987 | 6.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,068.90 | $1,527 | 4.7× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$789.60–$796.60 | $1,128–$1,138 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$721–$827.40 | $1,030–$1,182 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$707–$827.40 | $1,010–$1,182 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $394.10 | $563 | 2.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$770–$1,540 | $1,100–$2,200 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $3,362.80 | $4,804 | 6.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,826.60 | $4,038 | 5.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,615.80 | $6,594 | 6.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,667.30 | $5,239 | 5.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,966.90 | $5,667 | 5.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $4,185.30 | $5,979 | 2.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $4,423.30 | $6,319 | 2.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,898.30 | $5,569 | 2.3× |
| Scapula (73010) | $632.80 | $904 | 4.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$123.20–$126.70 | $176–$181 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$695.80–$789.60 | $994–$1,128 | varies |
| Shoulder Arthrography (73040) | $1,940.40 | $2,772 | 4.3× |
| Sialogram (70390) | $568.40 | $812 | 1.8× |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$258.30–$1,083.60 | $369–$1,548 | varies |
| Sternoclavicular joints (71130) | $861 | $1,230 | 7.6× |
| Tbs technical calculation only (77091) | $220.50 | $315 | 2.0× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$767.90–$827.40 | $1,097–$1,182 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$861–$906.50 | $1,230–$1,295 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$767.20–$827.40 | $1,096–$1,182 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $1,148.70 | $1,641 | 2.2× |
| Thyroid Met Imaging Body (78018) | $2,224.60 | $3,178 | 3.2× |
| Thyroid Uptake Measurement (78012) | $874.30 | $1,249 | 1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,081.10 | $2,973 | 4.0× |
| Ultrasound Breast Limited (76642) | $733.60 | $1,048 | 6.5× |
| Ultrasound Exam Aaa Screen (76706) | $2,032.10 | $2,903 | 15.0× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$1,515.50–$1,576.40 | $2,165–$2,252 | varies |
| Umbilical-artery Doppler (OB) (76820) | $774.90 | $1,107 | 5.7× |
| Unlisted Dx Radiographic Procedure (76499) | $774.90 | $1,107 | 6.9× |
| Unlisted magnetic resonance procedure (76498) | $3,473.40 | $4,962 | 30.8× |
| Upper gi w/o kub (74240) | $1,519.70 | $2,171 | 6.7× |
| Urethrocystogram voiding (74455) | $2,908.50 | $4,155 | 9.4× |
| Urethrocystography retrograde (74450) | $1,881.60 | $2,688 | 6.1× |
| Us breast unilateral complete (76641) | $952.70 | $1,361 | 7.0× |
| Us chest (76604) | $1,014.30 | $1,449 | 7.5× |
| Us complete joint (76881) | $1,340.50 | $1,915 | 9.9× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$1,087.10–$1,250.20 | $1,553–$1,786 | varies |
| Us head (76506) | $927.50 | $1,325 | 6.8× |
| Us kidney transplant (76776) | $962.50 | $1,375 | 7.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$863.10–$897.40 | $1,233–$1,282 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$2,517.20–$2,618 | $3,596–$3,740 | varies |
| Us ob limited 1 or more fetuses (76815) | $919.80 | $1,314 | 6.8× |
| Us ob transvaginal (76817) | $1,173.90 | $1,677 | 8.7× |
| Us pelvic non ob complete (76856) | $2,257.50 | $3,225 | 16.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,607.20 | $2,296 | 11.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$1,278.90–$1,330 | $1,827–$1,900 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$2,257.50–$2,347.80 | $3,225–$3,354 | varies |
| Us retroperitoneal limited (76775) | $1,033.20 | $1,476 | 7.6× |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$1,520.40–$1,581.30 | $2,172–$2,259 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$1,552.60–$1,614.90 | $2,218–$2,307 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$1,367.10–$1,421.70 | $1,953–$2,031 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$1,081.50–$1,124.90 | $1,545–$1,607 | varies |
| Vein X-Ray Chest (75827) | $5,356.40 | $7,652 | 2.6× |
| Venogram Sinus/Jugular (75860) | $4,003.30 | $5,719 | 1.0× |
| Venography caval inferior serialography rs&i (75825) | $9,340.80 | $13,344 | 2.3× |
| Venography extremity bilateral rs&i (75822) | $3,455.20 | $4,936 | 1.7× |
| Venography extremity unilateral rs&i (75820) | $3,560.20 | $5,086 | 1.7× |
| Venous sampling by catheter (75893) | $13,539.40 | $19,342 | 1.9× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$643.30–$827.40 | $919–$1,182 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $861 | $1,230 | 7.6× |
| X-Ray Aorta Leg Arteries (75630) | $11,312.70 | $16,161 | 2.8× |
| X-Ray Bend Only L-S Spine (72120) | $1,166.90 | $1,667 | 8.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$809.90–$1,619.80 | $1,157–$2,314 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$1,841.70–$4,654.30 | $2,631–$6,649 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$674.80–$789.60 | $964–$1,128 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $827.40 | $1,182 | 6.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,083.60 | $1,548 | 8.0× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$674.80–$789.60 | $964–$1,128 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$813.40–$861 | $1,162–$1,230 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,083.60 | $1,548 | 8.0× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$783.30–$827.40 | $1,119–$1,182 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,083.60 | $1,548 | 8.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,170.40 | $1,672 | 8.6× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$1,248.80–$1,571.50 | $1,784–$2,245 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$808.50–$827.40 | $1,155–$1,182 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$1,083.60–$1,122.10 | $1,548–$1,603 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$861–$906.50 | $1,230–$1,295 | varies |
| X-ray eye for foreign body (70030) | $363.30 | $519 | 3.2× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$789.60–$1,705.20 | $1,128–$2,436 | varies |
| X-ray IV pyelogram+tomography (74415) | $2,704.80 | $3,864 | 11.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $861 | $1,230 | 7.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$696.50–$827.40 | $995–$1,182 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$831.60–$861 | $1,188–$1,230 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$1,200.50–$1,248.80 | $1,715–$1,784 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$827.40–$861 | $1,182–$1,230 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$707–$827.40 | $1,010–$1,182 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$807.80–$861 | $1,154–$1,230 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$1,083.60–$1,268.40 | $1,548–$1,812 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$826–$1,083.60 | $1,180–$1,548 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,953.70 | $2,791 | 4.3× |
| X-Rays Bone Length Studies (77073) | $641.20 | $916 | 4.7× |
| X-Rays Bone Survey Complete (77075) | $1,155 | $1,650 | 8.5× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$1,083.60–$1,122.10 | $1,548–$1,603 | varies |
| Xr facial bones less than 3 views (70140) | $764.40 | $1,092 | 6.8× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$674.80–$1,083.60 | $964–$1,548 | varies |
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.