Imaging prices at Bertrand Chaffee Hospital
Springville, NY · every code in this section with a posted price and a Medicare benchmark.
263 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 4 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| Abdomen 2 views (74019) range across 4 matching MRF lines |
$17–$133.56 | $20–$157.13 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $261.40 | $307.53 | 0.5× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$8.50–$105.33 | $10–$123.92 | varies |
| Arthrogram hip (73525) range across 6 matching MRF lines |
$34–$467.18 | $40–$549.63 | varies |
| Bone age studies (77072) range across 4 matching MRF lines |
$17–$133.56 | $20–$157.13 | varies |
| Bone Imaging 3 Phase (78315) range across 4 matching MRF lines |
$59.50–$432.08 | $70–$508.34 | varies |
| Bone Imaging Limited Area (78300) range across 4 matching MRF lines |
$34–$501.04 | $40–$589.46 | varies |
| Bone Imaging Multiple Areas (78305) | $174.60 | $205.42 | 0.3× |
| Bone Imaging Whole Body (78306) range across 4 matching MRF lines |
$51–$432.08 | $60–$508.34 | varies |
| Bone survey infant (77076) range across 4 matching MRF lines |
$42.50–$161.50 | $50–$190 | varies |
| Cardiac Shunt Detection (78428) | $288.15 | $339 | 0.6× |
| Cat Scan Follow-Up Study (76380) | $271.15 | $319 | 2.5× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$17–$105.33 | $20–$123.92 | varies |
| Chest 3 views (71047) range across 4 matching MRF lines |
$17–$85.85 | $20–$101 | varies |
| Chest 4 or more views (71048) range across 4 matching MRF lines |
$17–$109.65 | $20–$129 | varies |
| Clavicle complete (73000) range across 6 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 4 matching MRF lines |
$59.50–$146.38 | $70–$172.22 | varies |
| Contrast X-Ray Bladder (74430) | $168.30 | $198 | 0.4× |
| Contrast X-Ray Of Knee Joint (73580) range across 5 matching MRF lines |
$275.40–$479.51 | $324–$564.14 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 4 matching MRF lines |
$110.50–$553.84 | $130–$651.58 | varies |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$93.50–$293.35 | $110–$345.12 | varies |
| CT abdomen w contrast (74160) range across 4 matching MRF lines |
$68–$821.10 | $80–$966 | varies |
| CT abdomen w wo contrast (74170) range across 4 matching MRF lines |
$76.50–$930.75 | $90–$1,095 | varies |
| CT abdomen w/o contrast (74150) range across 4 matching MRF lines |
$68–$821.10 | $80–$966 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 4 matching MRF lines |
$119–$2,228.70 | $140–$2,622 | varies |
| CT Angio Chest (71275) range across 4 matching MRF lines |
$102–$344.13 | $120–$404.87 | varies |
| CT Angio Head (70496) range across 4 matching MRF lines |
$93.50–$782 | $110–$920 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$102–$418.20 | $120–$492 | varies |
| CT Angio Neck (70498) range across 4 matching MRF lines |
$93.50–$1,016.60 | $110–$1,196 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$93.50–$232.60 | $110–$273.65 | varies |
| CT cervical spine w/ contrast (72126) range across 4 matching MRF lines |
$68–$793.90 | $80–$934 | varies |
| CT cervical spine w/o contrast (72125) range across 4 matching MRF lines |
$59.50–$146.38 | $70–$172.22 | varies |
| CT cervical spine w/wo cont (72127) | $935 | $1,100 | 4.3× |
| CT chest w contrast (71260) range across 4 matching MRF lines |
$68–$821.10 | $80–$966 | varies |
| CT chest w/wo contrast (71270) range across 4 matching MRF lines |
$68–$930.75 | $80–$1,095 | varies |
| CT head/brain with contrast (70460) range across 4 matching MRF lines |
$59.50–$751.40 | $70–$884 | varies |
| CT head/brain without and with contrast (70470) range across 4 matching MRF lines |
$68–$821.10 | $80–$966 | varies |
| CT iac w contrast (70481) range across 4 matching MRF lines |
$59.50–$782 | $70–$920 | varies |
| CT l-spine w&w/o contrast (72133) range across 4 matching MRF lines |
$68–$935 | $80–$1,100 | varies |
| CT lower ext w/o (73700) range across 6 matching MRF lines |
$59.50–$821.10 | $70–$966 | varies |
| CT lower extremity w/contrast material (73701) range across 6 matching MRF lines |
$68–$821.10 | $80–$966 | varies |
| CT lumbar spine w contrast (72132) range across 4 matching MRF lines |
$68–$690.20 | $80–$812 | varies |
| CT lumbar spine w/o contrast (72131) range across 4 matching MRF lines |
$59.50–$821.10 | $70–$966 | varies |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$59.50–$751.40 | $70–$884 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$51–$146.20 | $60–$172 | varies |
| CT neck tissue combo (70492) range across 4 matching MRF lines |
$85–$821.10 | $100–$966 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 4 matching MRF lines |
$68–$821.10 | $80–$966 | varies |
| CT orbits w/o contrast (70480) range across 4 matching MRF lines |
$68–$751.40 | $80–$884 | varies |
| CT pelvis w&w/o contrast (72194) range across 4 matching MRF lines |
$613.64–$901 | $721.94–$1,060 | varies |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$59.50–$821.10 | $70–$966 | varies |
| CT scan of leg combo (73702) range across 6 matching MRF lines |
$68–$821.10 | $80–$966 | varies |
| CT scans face/jaw combo (70488) range across 4 matching MRF lines |
$68–$821.10 | $80–$966 | varies |
| CT soft tissue neck w contrast (70491) range across 4 matching MRF lines |
$76.50–$821.10 | $90–$966 | varies |
| CT soft tissue neck w/o contrast (70490) range across 4 matching MRF lines |
$68–$821.10 | $80–$966 | varies |
| CT thoracic spine w contrast (72129) range across 4 matching MRF lines |
$68–$690.20 | $80–$812 | varies |
| CT thoracic spine w/o contrast (72128) range across 4 matching MRF lines |
$59.50–$821.10 | $70–$966 | varies |
| CT thoracic spine w/wo cont (72130) range across 4 matching MRF lines |
$68–$935 | $80–$1,100 | varies |
| CT thorax w/o contrast (71250) range across 4 matching MRF lines |
$59.50–$821.10 | $70–$966 | varies |
| CT upper ext wo (73200) range across 6 matching MRF lines |
$59.50–$821.10 | $70–$966 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 6 matching MRF lines |
$68–$821.10 | $80–$966 | varies |
| CT upper extremity with contrast (73201) range across 6 matching MRF lines |
$93.50–$821.10 | $110–$966 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 4 matching MRF lines |
$127.50–$2,228.70 | $150–$2,622 | varies |
| Cta Abdomen (74175) | $930.75 | $1,095 | 4.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) range across 2 matching MRF lines |
$212.50–$1,275 | $250–$1,500 | varies |
| CTA pelvis (72191) range across 4 matching MRF lines |
$68–$1,007.25 | $80–$1,185 | varies |
| Dxa Bone Density Axial (77080) range across 4 matching MRF lines |
$17–$146.38 | $20–$172.22 | varies |
| Dxa bone density study (77085) range across 4 matching MRF lines |
$17–$132.60 | $20–$156 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 4 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| Echo Guide For Artery Repair (76936) | $256.70 | $302 | 1.0× |
| Esophagram (74220) range across 4 matching MRF lines |
$34–$117.30 | $40–$138 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $213.35 | $251 | 1.6× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$17–$297.67 | $20–$350.21 | varies |
| Foot 2 views (73620) range across 6 matching MRF lines |
$8.50–$105.33 | $10–$123.92 | varies |
| Forearm 2 views (73090) range across 7 matching MRF lines |
$8.50–$110.38 | $10–$129.87 | varies |
| Gastric emptying imaging study (78264) range across 4 matching MRF lines |
$42.50–$501.04 | $50–$589.46 | varies |
| Gastroesophageal Reflux Exam (78262) | $229.50 | $270 | 0.5× |
| Gated Heart Planar Single (78472) range across 4 matching MRF lines |
$51–$432.08 | $60–$508.34 | varies |
| Hand 2 views (73120) range across 6 matching MRF lines |
$17–$141.77 | $20–$166.79 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 4 matching MRF lines |
$51–$557.24 | $60–$655.58 | varies |
| Hepatobiliary System Imaging (78226) range across 4 matching MRF lines |
$42.50–$501.04 | $50–$589.46 | varies |
| Ht Musc Image Planar Mult (78454) range across 7 matching MRF lines |
$167.45–$636.65 | $197–$749 | varies |
| Ht Muscle Image Spect Sing (78451) range across 4 matching MRF lines |
$76.50–$1,724.99 | $90–$2,029.40 | varies |
| Hysterosalpingogram (74740) | $272.85 | $321 | 0.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 4 matching MRF lines |
$42.50–$143.65 | $50–$169 | varies |
| K Flow/Funct Image Multiple (78709) | $375.74 | $442.05 | 0.6× |
| K Flow/Funct Image W/Drug (78708) | $557.24 | $655.58 | 0.8× |
| K Flow/Funct Image W/O Drug (78707) range across 4 matching MRF lines |
$51–$614.11 | $60–$722.49 | varies |
| Knee 3 Views (73562) range across 6 matching MRF lines |
$17–$102 | $20–$120 | varies |
| Leveen/Shunt Patency Exam (78291) | $258.40 | $304 | 0.5× |
| Liver & Spleen Imaging Static Only (78215) | $152.61 | $179.55 | 0.3× |
| Liver imaging static only (78201) | $149.20 | $175.53 | 0.2× |
| Lung Ventilat&Perfus Imaging (78582) range across 4 matching MRF lines |
$59.50–$557.32 | $70–$655.68 | varies |
| Lung Ventilation Imaging (78579) | $217.60 | $256 | 0.4× |
| Lymph System Imaging (78195) | $312.12 | $367.20 | 0.5× |
| Magnetic Image Jaw Joint (70336) | $510.85 | $601 | 1.7× |
| Mammary ductogram or galactogram multiple (77054) | $298.35 | $351 | 1.0× |
| Mammary ductogram or galactogram single (77053) | $267.75 | $315 | 0.9× |
| Meckels Divert Exam (78290) | $258.40 | $304 | 0.5× |
| Mra Head W/O & W/Contrast Material (70546) range across 4 matching MRF lines |
$76.50–$861.90 | $90–$1,014 | varies |
| MRA head w/o contrast (70544) range across 4 matching MRF lines |
$68–$293.35 | $80–$345.12 | varies |
| MRA head with contrast (70545) | $651.95 | $767 | 1.5× |
| MRA neck w contrast (70548) | $651.95 | $767 | 1.5× |
| Mra Neck W/O &W/Contrast Material (70549) range across 4 matching MRF lines |
$93.50–$861.90 | $110–$1,014 | varies |
| MRA neck w/o contrast (70547) | $565.25 | $665 | 1.9× |
| MRI abdomen w contrast (74182) | $651.95 | $767 | 1.5× |
| MRI abdomen w/o contrast (74181) range across 4 matching MRF lines |
$76.50–$293.35 | $90–$345.12 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $651.95 | $767 | 0.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 6 matching MRF lines |
$119–$861.90 | $140–$1,014 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $617.95 | $727 | 0.6× |
| MRI cervical spine w contrast (72142) | $651.95 | $767 | 1.5× |
| MRI cervical spine w/o cont (72141) range across 4 matching MRF lines |
$85–$565.25 | $100–$665 | varies |
| MRI chest w/o contrast (71550) | $565.25 | $665 | 1.9× |
| MRI chest with contrast (71551) | $853.02 | $1,003.56 | 0.9× |
| MRI chest wo w contrast (71552) | $861.90 | $1,014 | 2.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $651.95 | $767 | 1.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 7 matching MRF lines |
$119–$861.90 | $140–$1,014 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 6 matching MRF lines |
$76.50–$565.25 | $90–$665 | varies |
| MRI lumbar spine w contrast (72149) range across 4 matching MRF lines |
$93.50–$651.95 | $110–$767 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 4 matching MRF lines |
$127.50–$861.90 | $150–$1,014 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 4 matching MRF lines |
$76.50–$565.25 | $90–$665 | varies |
| MRI orbit face neck w contrast (70542) | $651.95 | $767 | 1.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 4 matching MRF lines |
$119–$861.90 | $140–$1,014 | varies |
| MRI pelvis w contrast (72196) | $651.95 | $767 | 1.5× |
| MRI pelvis w/o & w contrast (72197) range across 4 matching MRF lines |
$119–$861.90 | $140–$1,014 | varies |
| MRI pelvis w/o contrast (72195) range across 4 matching MRF lines |
$76.50–$565.25 | $90–$665 | varies |
| MRI thoracic spine w/o contrast (72146) range across 4 matching MRF lines |
$85–$565.25 | $100–$665 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $651.95 | $767 | 1.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 7 matching MRF lines |
$76.50–$565.25 | $90–$665 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 5 matching MRF lines |
$119–$861.90 | $140–$1,014 | varies |
| MRI, abdomen, combo (74183) range across 4 matching MRF lines |
$119–$861.90 | $140–$1,014 | varies |
| MRI, dorsal spine combo (72157) range across 4 matching MRF lines |
$127.50–$861.90 | $150–$1,014 | varies |
| MRI, dorsal spine contrast (72147) | $651.95 | $767 | 1.5× |
| MRI, joint upper extrem (73221) range across 6 matching MRF lines |
$76.50–$565.25 | $90–$665 | varies |
| MRI, joint upper extrem combo (73223) range across 6 matching MRF lines |
$119–$861.90 | $140–$1,014 | varies |
| MRI, lumbar spine combo (72158) range across 4 matching MRF lines |
$127.50–$861.90 | $150–$1,014 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $293.25 | $345 | 0.2× |
| Myocardial Spect Multiple Studies (78452) range across 4 matching MRF lines |
$85–$1,478.96 | $100–$1,739.96 | varies |
| Neck soft tissue (70360) range across 4 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| Ob us nuchal meas 1 gest (76813) | $99.45 | $117 | 0.8× |
| Parathyroid Planar Imaging (78070) range across 4 matching MRF lines |
$42.50–$501.04 | $50–$589.46 | varies |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$17–$133.56 | $20–$157.13 | varies |
| Peritoneogram Rs&I (74190) | $272.85 | $321 | 0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $243.95 | $287 | 0.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 4 matching MRF lines |
$17–$146.38 | $20–$172.22 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $124.10 | $146 | 0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 6 matching MRF lines |
$17–$105.33 | $20–$123.92 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 6 matching MRF lines |
$8.50–$105.33 | $10–$123.92 | varies |
| Radex elbow complete minimum 3 views (73080) range across 7 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 4 matching MRF lines |
$17–$102 | $20–$120 | varies |
| Radex fingr minimum 2 views (73140) range across 27 matching MRF lines |
$8.50–$110.38 | $10–$129.87 | varies |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$17–$105.33 | $20–$123.92 | varies |
| Radex Hand Minimum 3 Views (73130) range across 7 matching MRF lines |
$17–$127.50 | $20–$150 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $105.33 | $123.92 | 1.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $102 | $120 | 0.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 4 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 7 matching MRF lines |
$17–$1,104.03 | $20–$1,298.87 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 7 matching MRF lines |
$17–$102 | $20–$120 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $57.80 | $68 | 0.5× |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$8.50–$57.80 | $10–$68 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 4 matching MRF lines |
$17–$85 | $20–$100 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 4 matching MRF lines |
$17–$102 | $20–$120 | varies |
| Radex Toe Minimum 2 Views (73660) range across 27 matching MRF lines |
$7.97–$105.33 | $9.38–$123.92 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 6 matching MRF lines |
$8.50–$133.56 | $10–$157.13 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$17–$105.33 | $20–$123.92 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $157.25 | $185 | 1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 4 matching MRF lines |
$17–$85.85 | $20–$101 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 4 matching MRF lines |
$17–$133.56 | $20–$157.13 | varies |
| Radiologic exam colon double contrast study (74280) | $202.30 | $238 | 0.9× |
| Radiologic exam colon single contrast study (74270) | $152.15 | $179 | 0.7× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$17–$133.56 | $20–$157.13 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 4 matching MRF lines |
$17–$133.56 | $20–$157.13 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 4 matching MRF lines |
$42.50–$223.20 | $50–$262.59 | varies |
| Radiologic examination femur 1 view (73551) range across 9 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 4 matching MRF lines |
$25.50–$137.70 | $30–$162 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$8.50–$105.33 | $10–$123.92 | varies |
| Ribs bilateral 3 views (71110) range across 4 matching MRF lines |
$17–$116.45 | $20–$137 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $283.90 | $334 | 0.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 4 matching MRF lines |
$51–$1,724.99 | $60–$2,029.40 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines |
$319.60–$354.45 | $376–$417 | varies |
| Scapula (73010) range across 6 matching MRF lines |
$17–$133.56 | $20–$157.13 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $30.71 | $36.13 | 1.3× |
| Shoulder 1 view (73020) range across 6 matching MRF lines |
$8.50–$110.38 | $10–$129.87 | varies |
| Shoulder Arthrography (73040) | $249.05 | $293 | 0.6× |
| Skull less than 4 views (70250) range across 4 matching MRF lines |
$17–$133.56 | $20–$157.13 | varies |
| Spleen Imaging (78185) | $268.60 | $316 | 0.5× |
| Sternoclavicular joints (71130) range across 4 matching MRF lines |
$17–$85 | $20–$100 | varies |
| Testicular Imaging W/Flow (78761) | $160.97 | $189.38 | 0.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $163.20 | $192 | 0.7× |
| Thoracic spine 2 views (72070) range across 4 matching MRF lines |
$17–$133.56 | $20–$157.13 | varies |
| Thoracic spine 3 views (72072) range across 4 matching MRF lines |
$17–$133.56 | $20–$157.13 | varies |
| Thoracolumbar 2 views (72080) range across 4 matching MRF lines |
$17–$85 | $20–$100 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $501.04 | $589.46 | 1.0× |
| Ultrasound Breast Limited (76642) range across 9 matching MRF lines |
$42.50–$255 | $50–$300 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 4 matching MRF lines |
$34–$146.38 | $40–$172.22 | varies |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$34–$127.50 | $40–$150 | varies |
| Urethrocystogram voiding (74455) | $197.20 | $232 | 0.7× |
| Us breast unilateral complete (76641) range across 9 matching MRF lines |
$42.50–$297.50 | $50–$350 | varies |
| Us chest (76604) range across 4 matching MRF lines |
$34–$170.85 | $40–$201 | varies |
| Us complete joint (76881) range across 6 matching MRF lines |
$51–$170.85 | $60–$201 | varies |
| Us exam, pelvic, limited (76857) range across 6 matching MRF lines |
$34–$239.70 | $40–$282 | varies |
| Us head (76506) range across 6 matching MRF lines |
$34–$202.30 | $40–$238 | varies |
| Us kidney transplant (76776) | $130.90 | $154 | 1.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$42.50–$143.65 | $50–$169 | varies |
| Us ob detailed single fetus (76811) range across 4 matching MRF lines |
$292.40–$652.89 | $344–$768.11 | varies |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$34–$177.65 | $40–$209 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$42.50–$146.38 | $50–$172.22 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$42.50–$112.26 | $50–$132.08 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 4 matching MRF lines |
$59.50–$146.38 | $70–$172.22 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $129.20 | $152 | 1.0× |
| Us retroperitoneal complete (76770) range across 4 matching MRF lines |
$42.50–$146.38 | $50–$172.22 | varies |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$34–$99.22 | $40–$116.73 | varies |
| Us scrotum and contents (76870) range across 4 matching MRF lines |
$34–$146.38 | $40–$172.22 | varies |
| Us spinal canal and contents (76800) range across 4 matching MRF lines |
$68–$187 | $80–$220 | varies |
| Us thyroid (76536) range across 4 matching MRF lines |
$34–$146.38 | $40–$172.22 | varies |
| Vascular Flow Imaging (78445) | $222.70 | $262 | 0.4× |
| Venous thrombosis imaging (78457) | $143.65 | $169 | 0.2× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $217.60 | $256 | 0.4× |
| Vertebral fracture assessment via dxa (77086) | $88.40 | $104 | 0.8× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 4 matching MRF lines |
$17–$77.35 | $20–$91 | varies |
| X-ray antegrade pyelogram tube (74425) | $168.30 | $198 | 0.4× |
| X-Ray Bend Only L-S Spine (72120) range across 4 matching MRF lines |
$17–$119 | $20–$140 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 7 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| X-Ray Exam Breast Specimen (76098) range across 5 matching MRF lines |
$68.85–$260.95 | $81–$307 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 4 matching MRF lines |
$17–$93.50 | $20–$110 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 4 matching MRF lines |
$17–$106.25 | $20–$125 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 4 matching MRF lines |
$25.50–$131.75 | $30–$155 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 6 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 10 matching MRF lines |
$17–$131.75 | $20–$155 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 6 matching MRF lines |
$17–$178.50 | $20–$210 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 4 matching MRF lines |
$17–$191.25 | $20–$225 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 4 matching MRF lines |
$17–$146.38 | $20–$172.22 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 4 matching MRF lines |
$17–$267.75 | $20–$315 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 4 matching MRF lines |
$17–$139.40 | $20–$164 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$17–$77.35 | $20–$91 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 4 matching MRF lines |
$17–$99.45 | $20–$117 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 7 matching MRF lines |
$17–$146.38 | $20–$172.22 | varies |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$17–$99.45 | $20–$117 | varies |
| X-ray humerus (73060) range across 7 matching MRF lines |
$8.50–$110.38 | $10–$129.87 | varies |
| X-ray IV pyelogram (ivp) (74400) | $197.20 | $232 | 0.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 4 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 4 matching MRF lines |
$17–$105.33 | $20–$123.92 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 4 matching MRF lines |
$17–$133.56 | $20–$157.13 | varies |
| X-ray nose-rectum child f.b. (76010) range across 4 matching MRF lines |
$17–$110.38 | $20–$129.87 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 4 matching MRF lines |
$17–$152.15 | $20–$179 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 4 matching MRF lines |
$17–$133.56 | $20–$157.13 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 4 matching MRF lines |
$17–$133.56 | $20–$157.13 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 4 matching MRF lines |
$17–$77.35 | $20–$91 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 4 matching MRF lines |
$17–$77.73 | $20–$91.45 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 4 matching MRF lines |
$17–$124.95 | $20–$147 | varies |
| X-ray thoracic spine 4 vw (72074) | $96.90 | $114 | 0.7× |
| X-Ray Tmj Unilat (70328) | $68 | $80 | 0.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $168.30 | $198 | 0.4× |
| X-Rays Bone Length Studies (77073) range across 6 matching MRF lines |
$17–$133.56 | $20–$157.13 | varies |
| X-Rays Bone Survey Complete (77075) range across 4 matching MRF lines |
$34–$161.50 | $40–$190 | varies |
| Xr c-spine 4 or 5 views (72050) range across 4 matching MRF lines |
$17–$146.38 | $20–$172.22 | varies |
| Xr facial bones less than 3 views (70140) range across 4 matching MRF lines |
$17–$51.85 | $20–$61 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $62.90 | $74 | 0.5× |
| Xr orbits complete 4 views (70200) range across 4 matching MRF lines |
$17–$133.56 | $20–$157.13 | 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.