Imaging prices at Beloit Memorial Hospital
Beloit, WI · every code in this section with a posted price and a Medicare benchmark.
329 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) | $3,075.30 | $10,251 | 2.2× |
| Abdomen 1 View (74018) | $159.30 | $531 | 1.8× |
| Abdomen 2 views (74019) | $159 | $530 | 1.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$799.20–$862.80 | $2,664–$2,876 | varies |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) range across 2 matching MRF lines |
$844.50–$878.40 | $2,815–$2,928 | varies |
| Angiography extremity bilateral rs&i (75716) range across 4 matching MRF lines |
$1,524.60–$5,941.50 | $5,082–$19,805 | varies |
| Angiography extremity unilateral rs&i (75710) range across 5 matching MRF lines |
$1,323–$4,107 | $4,410–$13,690 | varies |
| Ankle 2 views (73600) range across 14 matching MRF lines |
$144–$288.60 | $480–$962 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,972.50 | $6,575 | 0.4× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$725.10 | $2,417 | 0.1× |
| Artery X-Rays Pelvis (75736) range across 3 matching MRF lines |
$866.40–$2,912.10 | $2,888–$9,707 | varies |
| Arthrogram ankle (73615) | $511.50 | $1,705 | 1.4× |
| Arthrogram Wrist (73115) | $365.40 | $1,218 | 1.0× |
| Basic radiation dosimetry calculation (77300) | $339 | $1,130 | 2.5× |
| Bone age studies (77072) range across 2 matching MRF lines |
$192.60–$208.20 | $642–$694 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$781.80–$844.20 | $2,606–$2,814 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$553.20–$575.40 | $1,844–$1,918 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$799.80–$863.40 | $2,666–$2,878 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$200.70–$208.80 | $669–$696 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$622.80–$672.60 | $2,076–$2,242 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$922.80–$959.70 | $3,076–$3,199 | varies |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,964.40 | $6,548 | 4.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 2 matching MRF lines |
$553.80–$576 | $1,846–$1,920 | varies |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$704.70–$732.90 | $2,349–$2,443 | varies |
| Chest 1 view (71045) range across 9 matching MRF lines |
$123.90–$371.40 | $413–$1,238 | varies |
| Chest 2 views (71046) range across 5 matching MRF lines |
$143.40–$371.10 | $478–$1,237 | varies |
| Chest 3 views (71047) | $210.30 | $701 | 2.4× |
| Chest 4 or more views (71048) range across 5 matching MRF lines |
$226.20–$371.40 | $754–$1,238 | varies |
| Cisternography Positive Contrast Rs&I (70015) range across 2 matching MRF lines |
$389.40–$405 | $1,298–$1,350 | varies |
| Clavicle complete (73000) range across 6 matching MRF lines |
$165–$330 | $550–$1,100 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,015.80 | $3,386 | 9.6× |
| Continuing medical physics consltj pr wk (77336) | $374.70 | $1,249 | 2.8× |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$1,646.10–$1,939.80 | $5,487–$6,466 | varies |
| Contrast X-Ray Bladder (74430) | $293.10 | $977 | 0.8× |
| Contrast X-Ray Of Elbow (73085) | $509.10 | $1,697 | 1.4× |
| Contrast X-Ray Of Knee Joint (73580) | $528.90 | $1,763 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) range across 9 matching MRF lines |
$2,261.10–$2,367.90 | $7,537–$7,893 | varies |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$1,561.20–$1,788.30 | $5,204–$5,961 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$989.70–$1,130.10 | $3,299–$3,767 | varies |
| CT abdomen w wo contrast (74170) range across 6 matching MRF lines |
$1,333.80–$1,359 | $4,446–$4,530 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$784.80–$930.30 | $2,616–$3,101 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 3 matching MRF lines |
$2,376.60–$2,506.50 | $7,922–$8,355 | varies |
| CT Angio Chest (71275) range across 8 matching MRF lines |
$1,255.20–$2,216.10 | $4,184–$7,387 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$1,508.70–$1,617.30 | $5,029–$5,391 | varies |
| CT angio hrt w/3d image (75574) | $1,464.90 | $4,883 | 4.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 6 matching MRF lines |
$2,038.50–$4,077.60 | $6,795–$13,592 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$1,222.50–$1,371.60 | $4,075–$4,572 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$892.20–$1,018.80 | $2,974–$3,396 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,284.90–$1,309.20 | $4,283–$4,364 | varies |
| CT cervical spine w/o contrast (72125) range across 4 matching MRF lines |
$252.30–$1,164.90 | $841–$3,883 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$1,544.40–$1,573.80 | $5,148–$5,246 | varies |
| CT chest w contrast (71260) range across 4 matching MRF lines |
$1,005.90–$1,157.40 | $3,353–$3,858 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$1,119–$1,508.40 | $3,730–$5,028 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$918–$935.10 | $3,060–$3,117 | varies |
| CT head/brain without and with contrast (70470) range across 5 matching MRF lines |
$1,008.60–$1,122 | $3,362–$3,740 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$48.60–$62.70 | $162–$209 | varies |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$979.50–$1,016.70 | $3,265–$3,389 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$1,515.60–$1,544.40 | $5,052–$5,148 | varies |
| CT lower ext w/o (73700) range across 45 matching MRF lines |
$761.10–$1,551.30 | $2,537–$5,171 | varies |
| CT lower extremity w/contrast material (73701) range across 49 matching MRF lines |
$842.40–$1,721.10 | $2,808–$5,737 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,175.10–$1,345.20 | $3,917–$4,484 | varies |
| CT lumbar spine w/o contrast (72131) range across 4 matching MRF lines |
$959.40–$1,122.60 | $3,198–$3,742 | varies |
| CT maxillofacial w contrast (70487) range across 10 matching MRF lines |
$926.70–$1,888.80 | $3,089–$6,296 | varies |
| CT maxillofacial wo contrast (70486) range across 14 matching MRF lines |
$457.50–$1,567.50 | $1,525–$5,225 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,053–$1,219.20 | $3,510–$4,064 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,196.10–$1,219.20 | $3,987–$4,064 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$803.10–$923.10 | $2,677–$3,077 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,327.80–$1,352.70 | $4,426–$4,509 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$875.40–$979.80 | $2,918–$3,266 | varies |
| CT scan of leg combo (73702) range across 43 matching MRF lines |
$1,131.90–$2,307 | $3,773–$7,690 | varies |
| CT scans face/jaw combo (70488) range across 10 matching MRF lines |
$1,142.40–$2,329.80 | $3,808–$7,766 | varies |
| CT soft tissue neck w contrast (70491) range across 3 matching MRF lines |
$994.20–$1,016.70 | $3,314–$3,389 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$808.80–$883.50 | $2,696–$2,945 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,284.90–$1,309.20 | $4,283–$4,364 | varies |
| CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines |
$1,003.20–$1,138.20 | $3,344–$3,794 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$1,515.60–$1,544.40 | $5,052–$5,148 | varies |
| CT thorax w/o contrast (71250) range across 5 matching MRF lines |
$848.40–$1,015.80 | $2,828–$3,386 | varies |
| CT upper ext wo (73200) range across 46 matching MRF lines |
$792.30–$2,129.10 | $2,641–$7,097 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 44 matching MRF lines |
$1,230.60–$2,508 | $4,102–$8,360 | varies |
| CT upper extremity with contrast (73201) range across 44 matching MRF lines |
$761.10–$2,507.40 | $2,537–$8,358 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$2,038.50–$2,044.80 | $6,795–$6,816 | varies |
| Cta Abdomen (74175) range across 4 matching MRF lines |
$1,673.70–$2,301 | $5,579–$7,670 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$1,590.60–$1,621.50 | $5,302–$5,405 | varies |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$218.70–$219.60 | $729–$732 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $142.50 | $475 | 1.6× |
| Esophagram (74220) range across 4 matching MRF lines |
$300.90–$368.10 | $1,003–$1,227 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 4 matching MRF lines |
$470.10–$507.60 | $1,567–$1,692 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $507.60 | $1,692 | 4.8× |
| Fluoroscopy up to 1 hr (76000) range across 24 matching MRF lines |
$294.30–$691.50 | $981–$2,305 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$2,071.80–$2,863.80 | $6,906–$9,546 | varies |
| Foot 2 views (73620) range across 13 matching MRF lines |
$135–$270.30 | $450–$901 | varies |
| Forearm 2 views (73090) range across 8 matching MRF lines |
$151.80–$303.90 | $506–$1,013 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$863.40–$933 | $2,878–$3,110 | varies |
| Gastric Mucosa Imaging (78261) | $631.20 | $2,104 | 1.6× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$1,113.90–$1,654.80 | $3,713–$5,516 | varies |
| Hand 2 views (73120) range across 6 matching MRF lines |
$104.70–$210 | $349–$700 | varies |
| Hepatobil Syst Image W/Drug (78227) | $708 | $2,360 | 1.3× |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$680.70–$735 | $2,269–$2,450 | varies |
| Ht Musc Image Planar Mult (78454) | $2,208.60 | $7,362 | 1.7× |
| Ht Muscle Image Spect Sing (78451) | $1,302.90 | $4,343 | 1.0× |
| Hysterosalpingogram (74740) | $305.10 | $1,017 | 1.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$374.70–$405 | $1,249–$1,350 | varies |
| Infant hip ultrasound, limited static exam (76886) | $269.70 | $899 | 3.1× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$197.70–$205.50 | $659–$685 | varies |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$980.10–$1,058.10 | $3,267–$3,527 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$822.60–$843.60 | $2,742–$2,812 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$684.30–$739.20 | $2,281–$2,464 | varies |
| Kidney Imaging Morphol (78700) range across 2 matching MRF lines |
$553.20–$575.40 | $1,844–$1,918 | varies |
| Knee 3 Views (73562) range across 8 matching MRF lines |
$175.80–$351 | $586–$1,170 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$725.40–$783.60 | $2,418–$2,612 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $880.80 | $2,936 | 2.2× |
| Lung Perf&Ventilat Diferentl (78598) | $945.60 | $3,152 | 1.7× |
| Lung perfusion differential (78597) | $909.30 | $3,031 | 2.2× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$963.60–$999.90 | $3,212–$3,333 | varies |
| Lung Ventilation Imaging (78579) | $423.60 | $1,412 | 1.0× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$497.40–$646.80 | $1,658–$2,156 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,824–$1,858.20 | $6,080–$6,194 | varies |
| Mammary ductogram or galactogram multiple (77054) | $573 | $1,910 | 2.4× |
| Mammary ductogram or galactogram single (77053) | $485.70 | $1,619 | 2.0× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$606.90–$631.20 | $2,023–$2,104 | varies |
| Mlc imrt design & construction per imrt plan (77338) | $929.40 | $3,098 | 2.5× |
| Mra Head W/O & W/Contrast Material (70546) | $1,836.30 | $6,121 | 5.2× |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$1,287.90–$1,789.50 | $4,293–$5,965 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$1,403.70–$1,804.50 | $4,679–$6,015 | varies |
| MRA neck w contrast (70548) range across 3 matching MRF lines |
$1,509–$1,864.80 | $5,030–$6,216 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 3 matching MRF lines |
$1,647.30–$2,194.80 | $5,491–$7,316 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$1,403.70–$1,727.40 | $4,679–$5,758 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$1,467–$2,055 | $4,890–$6,850 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,204.20–$1,383.30 | $4,014–$4,611 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 25 matching MRF lines |
$1,496.40–$3,050.70 | $4,988–$10,169 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 28 matching MRF lines |
$1,789.50–$3,648 | $5,965–$12,160 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 25 matching MRF lines |
$1,406.10–$2,812.80 | $4,687–$9,376 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $702.60 | $2,342 | 2.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,353 | $4,510 | 5.6× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$1,789.50–$1,824 | $5,965–$6,080 | varies |
| MRI cervical spine w/o cont (72141) range across 4 matching MRF lines |
$1,389.90–$1,789.50 | $4,633–$5,965 | varies |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$1,995.60–$2,034 | $6,652–$6,780 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$2,194.80–$2,237.10 | $7,316–$7,457 | varies |
| MRI chest wo w contrast (71552) range across 3 matching MRF lines |
$2,685–$2,736.60 | $8,950–$9,122 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 24 matching MRF lines |
$1,414.20–$2,883.60 | $4,714–$9,612 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 27 matching MRF lines |
$1,789.50–$3,648 | $5,965–$12,160 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 26 matching MRF lines |
$1,284.60–$2,742.60 | $4,282–$9,142 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$1,824–$1,858.20 | $6,080–$6,194 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 4 matching MRF lines |
$1,764–$1,905.30 | $5,880–$6,351 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,824–$1,858.20 | $6,080–$6,194 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$2,046–$2,085.30 | $6,820–$6,951 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$1,838.70–$2,130 | $6,129–$7,100 | varies |
| MRI pelvis w contrast (72196) range across 4 matching MRF lines |
$1,789.50–$1,824 | $5,965–$6,080 | varies |
| MRI pelvis w/o & w contrast (72197) range across 6 matching MRF lines |
$1,827.60–$2,083.80 | $6,092–$6,946 | varies |
| MRI pelvis w/o contrast (72195) range across 6 matching MRF lines |
$1,372.80–$1,574.40 | $4,576–$5,248 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,388.10–$1,623 | $4,627–$5,410 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 24 matching MRF lines |
$1,518.90–$3,096.60 | $5,063–$10,322 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 33 matching MRF lines |
$1,389.30–$2,832.30 | $4,631–$9,441 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 29 matching MRF lines |
$1,643.70–$3,460.50 | $5,479–$11,535 | varies |
| MRI, abdomen, combo (74183) range across 4 matching MRF lines |
$1,738.50–$1,909.50 | $5,795–$6,365 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,870.50–$2,001 | $6,235–$6,670 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$1,824–$1,858.20 | $6,080–$6,194 | varies |
| MRI, joint upper extrem (73221) range across 27 matching MRF lines |
$1,368.30–$2,736.60 | $4,561–$9,122 | varies |
| MRI, joint upper extrem combo (73223) range across 27 matching MRF lines |
$1,755.30–$3,510.90 | $5,851–$11,703 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$1,870.50–$1,905.30 | $6,235–$6,351 | varies |
| Myelogram cervical (72240) | $934.80 | $3,116 | 1.2× |
| Myelogram Lumbar (72265) | $526.80 | $1,756 | 0.7× |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$870.30–$1,232.40 | $2,901–$4,108 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,018.80 | $3,396 | 0.8× |
| Myocardial Spect Multiple Studies (78452) range across 4 matching MRF lines |
$369.30–$2,241 | $1,231–$7,470 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$139.50–$150.60 | $465–$502 | varies |
| Nm csf leak detection (78650) range across 2 matching MRF lines |
$775.50–$806.40 | $2,585–$2,688 | varies |
| Nm myocard infarct spect (78469) | $1,043.70 | $3,479 | 1.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,594.30 | $11,981 | 2.6× |
| Nuclear Rx Oral Admin (79005) range across 5 matching MRF lines |
$632.40–$746.40 | $2,108–$2,488 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $166.80 | $556 | 1.6× |
| Optic foramina (70190) range across 4 matching MRF lines |
$146.70–$152.70 | $489–$509 | varies |
| Panoramic X-ray of jaws (70355) range across 2 matching MRF lines |
$143.70–$155.10 | $479–$517 | varies |
| Parathyroid Planar Imaging (78070) | $257.10 | $857 | 0.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $334.50 | $1,115 | 0.8× |
| Pelvis 1 or 2 views (72170) range across 5 matching MRF lines |
$160.50–$173.10 | $535–$577 | varies |
| PET image w/CT, full body (78816) range across 6 matching MRF lines |
$2,613.30–$2,834.40 | $8,711–$9,448 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 32 matching MRF lines |
$2,613.30–$2,834.40 | $8,711–$9,448 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$558.60–$602.70 | $1,862–$2,009 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$283.50–$306 | $945–$1,020 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$255.90–$648.60 | $853–$2,162 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 14 matching MRF lines |
$160.50–$321 | $535–$1,070 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 10 matching MRF lines |
$94.80–$260.40 | $316–$868 | varies |
| Radex elbow complete minimum 3 views (73080) range across 7 matching MRF lines |
$165.60–$331.20 | $552–$1,104 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$209.10–$225.90 | $697–$753 | varies |
| Radex fingr minimum 2 views (73140) range across 20 matching MRF lines |
$119.70–$129.30 | $399–$431 | varies |
| Radex foot complete minimum 3 views (73630) range across 12 matching MRF lines |
$154.80–$309.60 | $516–$1,032 | varies |
| Radex Hand Minimum 3 Views (73130) range across 6 matching MRF lines |
$153.30–$306.60 | $511–$1,022 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 7 matching MRF lines |
$160.50–$321 | $535–$1,070 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 6 matching MRF lines |
$194.70–$389.40 | $649–$1,298 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$114.90–$123.90 | $383–$413 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 5 matching MRF lines |
$156.90–$186 | $523–$620 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 15 matching MRF lines |
$186.30–$372.60 | $621–$1,242 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$111.90–$121.20 | $373–$404 | varies |
| Radex Spine 1 View Specify Level (72020) range across 10 matching MRF lines |
$129–$168 | $430–$560 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$138–$149.10 | $460–$497 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$203.10–$376.20 | $677–$1,254 | varies |
| Radex Toe Minimum 2 Views (73660) range across 40 matching MRF lines |
$117.30–$122.10 | $391–$407 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 7 matching MRF lines |
$138.30–$276.60 | $461–$922 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 10 matching MRF lines |
$143.70–$287.70 | $479–$959 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $365.40 | $1,218 | 3.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $5,545.20 | $18,484 | 0.7× |
| Radiation treatment delivery level 1 (77402) | $304.80 | $1,016 | 3.0× |
| Radiation treatment delivery level 2 (77407) | $307.50 | $1,025 | 0.8× |
| Radiation treatment delivery level 3 (77412) | $480.60 | $1,602 | 0.9× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$103.20–$111.30 | $344–$371 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 5 matching MRF lines |
$176.40–$183 | $588–$610 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$504.90–$545.40 | $1,683–$1,818 | varies |
| Radiologic exam colon single contrast study (74270) range across 4 matching MRF lines |
$385.80–$416.10 | $1,286–$1,387 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 14 matching MRF lines |
$228–$456 | $760–$1,520 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$205.20–$213.30 | $684–$711 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$273.60–$295.50 | $912–$985 | varies |
| Radiologic exam swallow function contrast study (74230) range across 3 matching MRF lines |
$297.60–$332.10 | $992–$1,107 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 4 matching MRF lines |
$352.20–$383.40 | $1,174–$1,278 | varies |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$130.50–$135.60 | $435–$452 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$189–$214.20 | $630–$714 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$157.80–$315.60 | $526–$1,052 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$321–$346.50 | $1,070–$1,155 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) range across 6 matching MRF lines |
$171.90–$343.80 | $573–$1,146 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 7 matching MRF lines |
$168.60–$336.90 | $562–$1,123 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$357.90–$387 | $1,193–$1,290 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 8 matching MRF lines |
$589.50–$687.90 | $1,965–$2,293 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 5 matching MRF lines |
$589.50–$1,169.70 | $1,965–$3,899 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 6 matching MRF lines |
$1,051.20–$1,097.70 | $3,504–$3,659 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,288.20 | $4,294 | 2.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,013.70 | $3,379 | 1.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,720.30 | $12,401 | 2.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,299.10 | $10,997 | 2.5× |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$633.90–$659.40 | $2,113–$2,198 | varies |
| Scapula (73010) range across 7 matching MRF lines |
$173.10–$345.90 | $577–$1,153 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $24.90 | $83 | 1.1× |
| Sella turcica (70240) range across 2 matching MRF lines |
$126–$131.10 | $420–$437 | varies |
| Shoulder 1 view (73020) range across 7 matching MRF lines |
$132.30–$287.70 | $441–$959 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$348.60–$724.80 | $1,162–$2,416 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$170.40–$175.80 | $568–$586 | varies |
| Special dosimetry (77331) | $223.50 | $745 | 1.6× |
| Special Physics Consult (77370) | $462.60 | $1,542 | 3.4× |
| Special teletherapy port plan (77321) | $486.60 | $1,622 | 1.3× |
| Special treatment procedure (77470) | $422.70 | $1,409 | 0.8× |
| Speech evaluation, complex (70371) | $165.30 | $551 | 0.7× |
| Stereotactic Body Radiation Delivery (77373) | $3,714.30 | $12,381 | 2.1× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$166.50–$179.40 | $555–$598 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $996.90 | $3,323 | 2.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $159 | $530 | 0.4× |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$574.20–$619.50 | $1,914–$2,065 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,428.30 | $4,761 | 3.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,785.90 | $5,953 | 4.7× |
| Ther rad simulaj-aided field setting simple (77280) | $610.80 | $2,036 | 4.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$440.40–$458.10 | $1,468–$1,527 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$177.90–$192.30 | $593–$641 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$221.10–$235.50 | $737–$785 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$160.50–$173.10 | $535–$577 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $302.40 | $1,008 | 0.7× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$691.20–$777.90 | $2,304–$2,593 | varies |
| Thyroid Uptake Measurement (78012) | $267.30 | $891 | 0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $617.10 | $2,057 | 1.5× |
| Tx Devices Design & Construction Complex (77334) | $654.30 | $2,181 | 1.7× |
| Tx devices design & construction intermediate (77333) | $197.40 | $658 | 1.5× |
| Tx devices design & construction simple (77332) | $227.10 | $757 | 1.7× |
| Ultrasound Breast Limited (76642) | $242.10 | $807 | 2.7× |
| Ultrasound Exam Aaa Screen (76706) | $141.30 | $471 | 1.3× |
| Ultrasound, abdomen limited (76705) range across 23 matching MRF lines |
$162.90–$528.90 | $543–$1,763 | varies |
| Umbilical-artery Doppler (OB) (76820) | $187.80 | $626 | 1.8× |
| Unlisted magnetic resonance procedure (76498) | $1,516.80 | $5,056 | 17.2× |
| Unlisted us procedure (76999) | $551.70 | $1,839 | 6.3× |
| Upper gi w/o kub (74240) range across 6 matching MRF lines |
$327.60–$582 | $1,092–$1,940 | varies |
| Ureteral Reflux Study (78740) range across 2 matching MRF lines |
$429.90–$447 | $1,433–$1,490 | varies |
| Urethrocystogram voiding (74455) | $348.30 | $1,161 | 1.4× |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$204.90–$216 | $683–$720 | varies |
| Us breast unilateral complete (76641) range across 11 matching MRF lines |
$143.70–$978 | $479–$3,260 | varies |
| Us chest (76604) range across 8 matching MRF lines |
$115.80–$413.70 | $386–$1,379 | varies |
| Us complete joint (76881) range across 7 matching MRF lines |
$269.40–$291.30 | $898–$971 | varies |
| Us exam, pelvic, limited (76857) range across 7 matching MRF lines |
$116.10–$366.30 | $387–$1,221 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$399.60–$414.90 | $1,332–$1,383 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 13 matching MRF lines |
$165.60–$338.40 | $552–$1,128 | varies |
| Us ob limited 1 or more fetuses (76815) range across 8 matching MRF lines |
$131.40–$349.80 | $438–$1,166 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$123.60–$340.80 | $412–$1,136 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$453.90–$536.70 | $1,513–$1,789 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 6 matching MRF lines |
$512.70–$553.80 | $1,709–$1,846 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 4 matching MRF lines |
$272.70–$396.60 | $909–$1,322 | varies |
| Us retroperitoneal complete (76770) range across 5 matching MRF lines |
$309.60–$494.70 | $1,032–$1,649 | varies |
| Us retroperitoneal limited (76775) range across 12 matching MRF lines |
$96.60–$613.20 | $322–$2,044 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$161.10–$432.60 | $537–$1,442 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$207.90–$224.40 | $693–$748 | varies |
| Us thyroid (76536) range across 11 matching MRF lines |
$197.10–$507.30 | $657–$1,691 | varies |
| Us transrectal (76872) range across 3 matching MRF lines |
$326.40–$453.90 | $1,088–$1,513 | varies |
| Vein X-Ray Chest (75827) range across 3 matching MRF lines |
$1,963.20–$2,713.20 | $6,544–$9,044 | varies |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$2,239.50–$3,215.10 | $7,465–$10,717 | varies |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$516.90–$1,835.40 | $1,723–$6,118 | varies |
| Venography extremity unilateral rs&i (75820) range across 5 matching MRF lines |
$376.80–$1,334.70 | $1,256–$4,449 | varies |
| Vertebral fracture assessment via dxa (77086) | $135.60 | $452 | 1.5× |
| Wrist 2 views (73100) range across 7 matching MRF lines |
$131.40–$262.50 | $438–$875 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$165–$178.20 | $550–$594 | varies |
| X-ray antegrade pyelogram tube (74425) range across 4 matching MRF lines |
$229.80–$309.60 | $766–$1,032 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$2,373.60–$3,407.40 | $7,912–$11,358 | varies |
| X-Ray Bend Only L-S Spine (72120) | $174 | $580 | 1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$150.90–$301.80 | $503–$1,006 | varies |
| X-Ray Exam Breast Specimen (76098) range across 6 matching MRF lines |
$114.30–$148.20 | $381–$494 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$180.30–$195 | $601–$650 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $187.50 | $625 | 1.8× |
| X-Ray Exam Hip Uni 1 View (73501) range across 13 matching MRF lines |
$73.50–$372 | $245–$1,240 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $225.30 | $751 | 2.6× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 4 matching MRF lines |
$193.80–$331.20 | $646–$1,104 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$379.50–$410.10 | $1,265–$1,367 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$184.50–$199.50 | $615–$665 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$341.40–$444.30 | $1,138–$1,481 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 5 matching MRF lines |
$218.70–$236.10 | $729–$787 | varies |
| X-ray eye for foreign body (70030) range across 7 matching MRF lines |
$178.50–$357.30 | $595–$1,191 | varies |
| X-ray humerus (73060) range across 8 matching MRF lines |
$154.50–$309 | $515–$1,030 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$423.60–$457.50 | $1,412–$1,525 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$174–$187.80 | $580–$626 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$67.80–$193.80 | $226–$646 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 4 matching MRF lines |
$203.40–$219.60 | $678–$732 | varies |
| X-ray nose-rectum child f.b. (76010) | $164.10 | $547 | 1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$299.70–$554.40 | $999–$1,848 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$81–$115.80 | $270–$386 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$105–$134.10 | $350–$447 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 4 matching MRF lines |
$174–$187.80 | $580–$626 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$161.40–$201.30 | $538–$671 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$206.10–$222.90 | $687–$743 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$219–$227.70 | $730–$759 | varies |
| X-Ray Tmj Unilat (70328) range across 4 matching MRF lines |
$187.80–$195.30 | $626–$651 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 7 matching MRF lines |
$300.60–$375.60 | $1,002–$1,252 | varies |
| X-Rays Bone Length Studies (77073) range across 4 matching MRF lines |
$161.40–$164.10 | $538–$547 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$427.80–$461.70 | $1,426–$1,539 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$234.60–$279.60 | $782–$932 | varies |
| Xr facial bones less than 3 views (70140) range across 4 matching MRF lines |
$149.10–$161.10 | $497–$537 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 7 matching MRF lines |
$103.20–$206.10 | $344–$687 | varies |
| Xr orbits complete 4 views (70200) range across 6 matching MRF lines |
$185.70–$371.40 | $619–$1,238 | 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.