Imaging prices at Bothwell Regional Health Center
Sedalia, MO · every code in this section with a posted price and a Medicare benchmark.
308 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) range across 2 matching MRF lines |
$4,871.25–$5,163.75 | $6,495–$6,885 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$244.50–$257.25 | $326–$343 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$417–$438 | $556–$584 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$1,939.50–$2,056.50 | $2,586–$2,742 | varies |
| Angiography extremity bilateral rs&i (75716) | $8,959.50 | $11,946 | 2.8× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$8,916.75–$9,273.75 | $11,889–$12,365 | varies |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$285–$594 | $380–$792 | varies |
| Artery X-Rays Abdomen (75726) | $9,273.75 | $12,365 | 1.7× |
| Arthrogram ankle (73615) | $362.25 | $483 | 1.0× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$345–$362.25 | $460–$483 | varies |
| Arthrogram Wrist (73115) | $321 | $428 | 0.9× |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$600–$1,696.50 | $800–$2,262 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$344.25–$361.50 | $459–$482 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,896–$2,010 | $2,528–$2,680 | varies |
| Bone Imaging Limited Area (78300) | $1,059 | $1,412 | 2.6× |
| Bone Imaging Multiple Areas (78305) | $1,535.25 | $2,047 | 3.8× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,855.50–$1,967.25 | $2,474–$2,623 | varies |
| Bone survey infant (77076) | $771 | $1,028 | 7.4× |
| Brachytx isodose intermed (77317) | $1,263.75 | $1,685 | 3.4× |
| Brachytx Isodose Plan Simple (77316) | $1,263.75 | $1,685 | 3.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,288.50 | $1,718 | 2.4× |
| Cat Scan Follow-Up Study (76380) | $394.50 | $526 | 4.5× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$244.50–$603 | $326–$804 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$323.25–$339.75 | $431–$453 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$396.75–$793.50 | $529–$1,058 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$232.50–$360 | $310–$480 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$919.50–$947.25 | $1,226–$1,263 | varies |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$565.50–$600 | $754–$800 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$183.75–$9,273.75 | $245–$12,365 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$160.50–$168.75 | $214–$225 | varies |
| Contrast X-Ray Of Elbow (73085) | $321 | $428 | 0.9× |
| Contrast X-Ray Of Knee Joint (73580) | $405 | $540 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$4,474.50–$4,608.75 | $5,966–$6,145 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$3,425.25–$3,528.75 | $4,567–$4,705 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$2,286–$2,355 | $3,048–$3,140 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$2,686.50–$2,767.50 | $3,582–$3,690 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$2,103.75–$2,167.50 | $2,805–$2,890 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$3,764.25–$3,877.50 | $5,019–$5,170 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$2,513.25–$2,589 | $3,351–$3,452 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$2,358.75–$2,430 | $3,145–$3,240 | varies |
| CT angio hrt w/3d image (75574) | $993.75 | $1,325 | 2.8× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$2,374.50–$2,445.75 | $3,166–$3,261 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,590 | $2,120 | 9.1× |
| CT bone density (77078) | $607.50 | $810 | 7.0× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$2,838.75–$2,924.25 | $3,785–$3,899 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$2,686.50–$2,767.50 | $3,582–$3,690 | varies |
| CT cervical spine w/wo cont (72127) | $2,660.25 | $3,547 | 15.1× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$2,286–$2,355 | $3,048–$3,140 | varies |
| CT chest w/wo contrast (71270) | $2,732.25 | $3,643 | 15.6× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$2,141.25–$2,205.75 | $2,855–$2,941 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$2,539.50–$2,616 | $3,386–$3,488 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $41.25 | $55 | 0.5× |
| CT iac w contrast (70481) range across 5 matching MRF lines |
$2,103.75–$2,859.75 | $2,805–$3,813 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$2,686.50–$2,767.50 | $3,582–$3,690 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,835.25–$1,890.75 | $2,447–$2,521 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,498.50–$1,543.50 | $1,998–$2,058 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$2,223.75–$2,290.50 | $2,965–$3,054 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$2,686.50–$2,767.50 | $3,582–$3,690 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$2,180.25–$2,246.25 | $2,907–$2,995 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,794.75–$1,848.75 | $2,393–$2,465 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,290–$1,329 | $1,720–$1,772 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$2,449.50–$3,119.25 | $3,266–$4,159 | varies |
| CT orbits w/o contrast (70480) range across 5 matching MRF lines |
$1,920–$2,594.25 | $2,560–$3,459 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$2,652–$2,732.25 | $3,536–$3,643 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$2,091–$2,154 | $2,788–$2,872 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,761.75–$1,890.75 | $2,349–$2,521 | varies |
| CT scans face/jaw combo (70488) | $2,246.25 | $2,995 | 12.8× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$2,157.75–$2,223 | $2,877–$2,964 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,920–$1,977.75 | $2,560–$2,637 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$2,198.25–$2,264.25 | $2,931–$3,019 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$2,686.50–$2,767.50 | $3,582–$3,690 | varies |
| CT thoracic spine w/wo cont (72130) | $2,732.25 | $3,643 | 15.6× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$2,091–$2,154 | $2,788–$2,872 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,908–$1,965.75 | $2,544–$2,621 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,761.75–$1,815 | $2,349–$2,420 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,543.50–$1,815 | $2,058–$2,420 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$2,234.25–$2,301.75 | $2,979–$3,069 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$2,513.25–$2,589 | $3,351–$3,452 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,642.75 | $4,857 | 10.4× |
| CTA pelvis (72191) | $2,589 | $3,452 | 14.7× |
| Dilation ureters/urethra rs&i (74485) | $362.25 | $483 | 0.2× |
| Discography Cerv/Thor Spine (72285) | $10,146.75 | $13,529 | 5.2× |
| Diskography lumbar (72295) | $9,663.75 | $12,885 | 4.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $131.25 | $175 | 1.3× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$363.75–$382.50 | $485–$510 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $195.75 | $261 | 2.2× |
| Echo Guide For Artery Repair (76936) | $1,230 | $1,640 | 5.7× |
| Esophagram (74220) range across 2 matching MRF lines |
$539.25–$566.25 | $719–$755 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$399–$423 | $532–$564 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$423–$709.50 | $564–$946 | varies |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$375–$681.75 | $500–$909 | varies |
| Follow-Up Angiography (75898) | $865.50 | $1,154 | 0.3× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$262.50–$413.25 | $350–$551 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$262.50–$408 | $350–$544 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,631.25–$1,729.50 | $2,175–$2,306 | varies |
| Gated Heart Planar Single (78472) | $2,310.75 | $3,081 | 5.8× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$262.50–$542.25 | $350–$723 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,790.75 | $3,721 | 4.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,663.25 | $3,551 | 3.8× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,629.75–$1,728 | $2,173–$2,304 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$1,467–$1,555.50 | $1,956–$2,074 | varies |
| Ht Musc Image Planar Mult (78454) | $1,984.50 | $2,646 | 1.5× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$2,958–$3,878.25 | $3,944–$5,171 | varies |
| Hysterosalpingogram (74740) | $277.50 | $370 | 1.2× |
| Image fusion (77399) range across 2 matching MRF lines |
$384.75–$408 | $513–$544 | varies |
| Joint Survey Single View (77077) | $376.50 | $502 | 3.6× |
| K Flow/Funct Image Multiple (78709) | $2,072.25 | $2,763 | 3.8× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,954.50–$2,072.25 | $2,606–$2,763 | varies |
| K Flow/Funct Image W/O Drug (78707) | $1,873.50 | $2,498 | 3.4× |
| Kidney Imaging Morphol (78700) | $1,526.25 | $2,035 | 3.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,526.25 | $2,035 | 3.8× |
| Knee 3 Views (73562) range across 5 matching MRF lines |
$344.25–$720.75 | $459–$961 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,224.75 | $1,633 | 3.1× |
| Lung Perf&Ventilat Diferentl (78598) | $2,986.50 | $3,982 | 5.5× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$1,373.25–$1,455.75 | $1,831–$1,941 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,605.75–$1,702.50 | $2,141–$2,270 | varies |
| Magnetic Image Jaw Joint (70336) | $2,301.75 | $3,069 | 9.6× |
| Meckels Divert Exam (78290) | $1,266.75 | $1,689 | 3.2× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$4,170–$4,420.50 | $5,560–$5,894 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $60.75 | $81 | 2.1× |
| Mra Head W/O & W/Contrast Material (70546) range across 3 matching MRF lines |
$964.50–$1,717.50 | $1,286–$2,290 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$900.75–$964.50 | $1,201–$1,286 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$1,605–$1,717.50 | $2,140–$2,290 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$900.75–$964.50 | $1,201–$1,286 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$900.75–$964.50 | $1,201–$1,286 | varies |
| MRI abdomen w contrast (74182) | $2,301.75 | $3,069 | 6.6× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$2,151–$2,301.75 | $2,868–$3,069 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,322.25–$1,415.25 | $1,763–$1,887 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$1,935.75–$2,877 | $2,581–$3,836 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$2,151–$2,301.75 | $2,868–$3,069 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$2,151–$2,301.75 | $2,868–$3,069 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,301.75 | $3,069 | 9.6× |
| MRI cervical spine w contrast (72142) | $2,254.50 | $3,006 | 6.5× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$2,151–$2,301.75 | $2,868–$3,069 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$2,151–$2,301.75 | $2,868–$3,069 | varies |
| MRI chest wo w contrast (71552) | $2,583 | $3,444 | 7.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,151–$2,877 | $2,868–$3,836 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,151–$2,877 | $2,868–$3,836 | varies |
| MRI lumbar spine w contrast (72149) | $2,254.50 | $3,006 | 6.5× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$2,413.50–$2,583 | $3,218–$3,444 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$2,151–$2,301.75 | $2,868–$3,069 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$2,413.50–$2,583 | $3,218–$3,444 | varies |
| MRI pelvis w contrast (72196) | $2,301.75 | $3,069 | 6.6× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$2,151–$2,301.75 | $2,868–$3,069 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$2,151–$2,301.75 | $2,868–$3,069 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$2,151–$2,301.75 | $2,868–$3,069 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,151–$2,877 | $2,868–$3,836 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$2,151–$2,877 | $2,868–$3,836 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$2,151–$2,301.75 | $2,868–$3,069 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$2,413.50–$2,583 | $3,218–$3,444 | varies |
| MRI, dorsal spine contrast (72147) | $2,254.50 | $3,006 | 6.5× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,151–$2,301.75 | $2,868–$3,069 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$2,151–$2,301.75 | $2,868–$3,069 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$2,413.50–$2,583 | $3,218–$3,444 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $6,382.50 | $8,510 | 4.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $987 | $1,316 | 0.8× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$5,880–$6,233.25 | $7,840–$8,311 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$207–$217.50 | $276–$290 | varies |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $842.25 | $1,123 | 2.2× |
| Nm whole blood volume (78122) | $1,949.25 | $2,599 | 3.6× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 3 matching MRF lines |
$2,055.75–$5,160.75 | $2,741–$6,881 | varies |
| Nuclear Rx Oral Admin (79005) range across 3 matching MRF lines |
$1,119.75–$1,916.25 | $1,493–$2,555 | varies |
| Panoramic X-ray of jaws (70355) | $168.75 | $225 | 1.9× |
| Parathyroid Planar Imaging (78070) | $1,251.75 | $1,669 | 3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$1,251.75–$1,327.50 | $1,669–$1,770 | varies |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$262.50–$525 | $350–$700 | varies |
| Pet Image W/Ct Lmtd (78814) | $6,382.50 | $8,510 | 4.5× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$6,021–$6,382.50 | $8,028–$8,510 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$6,021–$6,382.50 | $8,028–$8,510 | varies |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) | $506.25 | $675 | 0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 3 matching MRF lines |
$834.75–$1,614.75 | $1,113–$2,153 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$653.25–$686.25 | $871–$915 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $217.50 | $290 | 0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$358.50–$746.25 | $478–$995 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$244.50–$510 | $326–$680 | varies |
| Radex elbow complete minimum 3 views (73080) range across 5 matching MRF lines |
$262.50–$546 | $350–$728 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $447 | $596 | 4.3× |
| Radex fingr minimum 2 views (73140) | $424.50 | $566 | 4.9× |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$323.25–$675 | $431–$900 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$285–$424.50 | $380–$566 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$345.75–$404.25 | $461–$539 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $388.50 | $518 | 3.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$285–$299.25 | $380–$399 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$344.25–$361.50 | $459–$482 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$445.50–$935.25 | $594–$1,247 | varies |
| Radex Spine 1 View Specify Level (72020) | $225 | $300 | 2.6× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$344.25–$361.50 | $459–$482 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $376.50 | $502 | 4.3× |
| Radex Toe Minimum 2 Views (73660) | $510 | $680 | 5.9× |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$345.75–$404.25 | $461–$539 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$344.25–$720 | $459–$960 | varies |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$531–$563.25 | $708–$751 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$1,342.50–$1,423.50 | $1,790–$1,898 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$794.25–$1,941.75 | $1,059–$2,589 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$369.75–$388.50 | $493–$518 | varies |
| Radiologic exam colon double contrast study (74280) | $919.50 | $1,226 | 5.2× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$747.75–$785.25 | $997–$1,047 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$686.25–$720.75 | $915–$961 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $403.50 | $538 | 3.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$747.75–$785.25 | $997–$1,047 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$318.75–$335.25 | $425–$447 | varies |
| Radiologic examination femur 1 view (73551) | $236.25 | $315 | 2.7× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$358.50–$746.25 | $478–$995 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$315–$657 | $420–$876 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$344.25–$424.50 | $459–$566 | varies |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $922.50 | $1,230 | 2.3× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$417–$438 | $556–$584 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$1,199.25–$1,422 | $1,599–$1,896 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$1,422–$1,768.50 | $1,896–$2,358 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 3 matching MRF lines |
$2,179.50–$2,706 | $2,906–$3,608 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$1,476.75–$2,727 | $1,969–$3,636 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$1,056–$1,119.75 | $1,408–$1,493 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$344.25–$361.50 | $459–$482 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 4 matching MRF lines |
$136.50–$211.50 | $182–$282 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$301.50–$625.50 | $402–$834 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$345–$362.25 | $460–$483 | varies |
| Sialogram (70390) | $257.25 | $343 | 1.1× |
| Skull less than 4 views (70250) | $287.25 | $383 | 2.7× |
| Special dosimetry (77331) | $600 | $800 | 4.5× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$565.50–$600 | $754–$800 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$1,407.75–$1,492.50 | $1,877–$1,990 | varies |
| Special treatment procedure (77470) range across 3 matching MRF lines |
$57–$1,816.50 | $76–$2,422 | varies |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$4,000.50–$4,241.25 | $5,334–$5,655 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$1,407.75–$1,492.50 | $1,877–$1,990 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 3 matching MRF lines |
$565.50–$1,492.50 | $754–$1,990 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 3 matching MRF lines |
$82.50–$1,492.50 | $110–$1,990 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,492.50 | $1,990 | 4.0× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$565.50–$600 | $754–$800 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$369.75–$388.50 | $493–$518 | varies |
| Thoracic spine 3 views (72072) | $388.50 | $518 | 3.7× |
| Thoracolumbar 2 views (72080) | $217.50 | $290 | 2.5× |
| Thyroid Imaging With Vascular Flow (78013) | $772.50 | $1,030 | 1.9× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$2,142.75–$2,271.75 | $2,857–$3,029 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$1,239–$1,314 | $1,652–$1,752 | varies |
| Tx Devices Design & Construction Complex (77334) range across 4 matching MRF lines |
$1,046.25–$2,092.50 | $1,395–$2,790 | varies |
| Tx devices design & construction intermediate (77333) | $1,109.25 | $1,479 | 8.2× |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$1,046.25–$1,109.25 | $1,395–$1,479 | varies |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$560.25–$929.25 | $747–$1,239 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$374.25–$407.25 | $499–$543 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$991.50–$1,051.50 | $1,322–$1,402 | varies |
| Umbilical-artery Doppler (OB) (76820) | $417 | $556 | 4.0× |
| Unlis px ther radiol clinical tx planning (77299) range across 2 matching MRF lines |
$531–$568.50 | $708–$758 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $37.50 | $50 | 0.4× |
| Unlisted us procedure (76999) | $609 | $812 | 7.0× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$680.25–$714.75 | $907–$953 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $69 | $92 | 6.2× |
| Urea breath test c-14 isotopic analysis (78268) | $537.75 | $717 | 5.7× |
| Urethrocystogram voiding (74455) | $225 | $300 | 0.9× |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$273–$287.25 | $364–$383 | varies |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$560.25–$929.25 | $747–$1,239 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$1,160.25–$1,230 | $1,547–$1,640 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$1,160.25–$1,230 | $1,547–$1,640 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$497.25–$527.25 | $663–$703 | varies |
| Us head (76506) | $1,051.50 | $1,402 | 10.0× |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$1,160.25–$1,230 | $1,547–$1,640 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$1,160.25–$1,230 | $1,547–$1,640 | varies |
| Us ob detailed single fetus (76811) | $661.50 | $882 | 2.8× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$497.25–$690 | $663–$920 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$768.75–$815.25 | $1,025–$1,087 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$1,194.75–$1,266.75 | $1,593–$1,689 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$450.75–$478.50 | $601–$638 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$291.75–$414.75 | $389–$553 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$1,160.25–$1,230 | $1,547–$1,640 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$991.50–$1,051.50 | $1,322–$1,402 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$1,160.25–$1,230 | $1,547–$1,640 | varies |
| Us spinal canal and contents (76800) | $439.50 | $586 | 4.2× |
| Us thyroid (76536) range across 4 matching MRF lines |
$1,116.75–$1,230 | $1,489–$1,640 | varies |
| Us transrectal (76872) range across 5 matching MRF lines |
$248.25–$1,410.75 | $331–$1,881 | varies |
| Vascular Flow Imaging (78445) | $772.50 | $1,030 | 1.9× |
| Vein X-Ray Chest (75827) | $3,001.50 | $4,002 | 1.9× |
| Venography caval inferior serialography rs&i (75825) | $9,273.75 | $12,365 | 2.9× |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$600–$3,008.25 | $800–$4,011 | varies |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$232.50–$361.50 | $310–$482 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $339.75 | $453 | 3.9× |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$261.75–$1,036.50 | $349–$1,382 | varies |
| X-Ray Aorta Leg Arteries (75630) | $9,273.75 | $12,365 | 2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$272.25–$286.50 | $363–$382 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$198–$1,122 | $264–$1,496 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$244.50–$257.25 | $326–$343 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $765.75 | $1,021 | 7.3× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$262.50–$276 | $350–$368 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$358.50–$562.50 | $478–$750 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $579 | $772 | 5.5× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$376.50–$541.50 | $502–$722 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $609.75 | $813 | 5.8× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$580.50–$609.75 | $774–$813 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$323.25–$339.75 | $431–$453 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $609.75 | $813 | 5.8× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$262.50–$276 | $350–$368 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$273–$287.25 | $364–$383 | varies |
| X-ray IV pyelogram (ivp) (74400) | $824.25 | $1,099 | 4.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$144.75–$152.25 | $193–$203 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$527.25–$554.25 | $703–$739 | varies |
| X-ray nose-rectum child f.b. (76010) | $388.50 | $518 | 4.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $425.25 | $567 | 4.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$213.75–$225 | $285–$300 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$358.50–$376.50 | $478–$502 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$369.75–$388.50 | $493–$518 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$417–$438 | $556–$584 | varies |
| X-Ray Stress View (77071) | $207 | $276 | 2.4× |
| X-ray thoracic spine 4 vw (72074) | $388.50 | $518 | 3.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $614.25 | $819 | 1.8× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$154.50–$162.75 | $206–$217 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$734.25–$771 | $979–$1,028 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$499.50–$525 | $666–$700 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$344.25–$361.50 | $459–$482 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$369.75–$388.50 | $493–$518 | varies |
| Xr Tomogram Single Plane (76100) | $225 | $300 | 2.1× |
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.