Imaging prices at Box Butte General Hospital
Alliance, NE · every code in this section with a posted price and a Medicare benchmark.
242 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 3 matching MRF lines |
$315.90–$419.40 | $351–$466 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$394.20–$425.70 | $438–$473 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,423.70 | $2,693 | 5.8× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$299.70–$458.10 | $333–$509 | varies |
| Arthrogram ankle (73615) | $943.20 | $1,048 | 2.6× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$847.80–$915.30 | $942–$1,017 | varies |
| Arthrogram Wrist (73115) | $943.20 | $1,048 | 2.6× |
| Bone age studies (77072) | $274.50 | $305 | 2.5× |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$2,484.90–$2,680.20 | $2,761–$2,978 | varies |
| Bone Imaging Multiple Areas (78305) | $1,831.50 | $2,035 | 4.4× |
| Bone Imaging Whole Body (78306) | $2,317.50 | $2,575 | 5.6× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,660.50 | $1,845 | 2.9× |
| Cat Scan Follow-Up Study (76380) | $1,503.90 | $1,671 | 16.6× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$286.20–$394.20 | $318–$438 | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$353.70–$437.40 | $393–$486 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$308.70–$475.20 | $343–$528 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $322.20 | $358 | 3.0× |
| Contrast X-Ray Bladder (74430) | $1,607.40 | $1,786 | 4.4× |
| Contrast X-Ray Of Knee Joint (73580) | $1,399.50 | $1,555 | 3.9× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$5,541.30–$6,984.90 | $6,157–$7,761 | varies |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$4,221.90–$5,041.80 | $4,691–$5,602 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$2,793.60–$3,013.20 | $3,104–$3,348 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$3,214.80–$3,466.80 | $3,572–$3,852 | varies |
| CT abdomen w/o contrast (74150) | $2,501.10 | $2,779 | 23.0× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$5,884.20–$6,344.10 | $6,538–$7,049 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$3,405.60–$3,672.90 | $3,784–$4,081 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$3,276.90–$3,534.30 | $3,641–$3,927 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $3,419.10 | $3,799 | 18.8× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$3,276.90–$3,534.30 | $3,641–$3,927 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$3,310.20–$3,569.40 | $3,678–$3,966 | varies |
| CT cervical spine w/ contrast (72126) | $2,817.90 | $3,131 | 7.8× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$2,513.70–$2,710.80 | $2,793–$3,012 | varies |
| CT cervical spine w/wo cont (72127) | $3,434.40 | $3,816 | 18.9× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$2,685.60–$2,896.20 | $2,984–$3,218 | varies |
| CT chest w/wo contrast (71270) | $3,538.80 | $3,932 | 19.4× |
| CT head/brain with contrast (70460) | $2,497.50 | $2,775 | 13.7× |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$2,583.90–$2,786.40 | $2,871–$3,096 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$2,916–$3,143.70 | $3,240–$3,493 | varies |
| CT l-spine w&w/o contrast (72133) | $3,434.40 | $3,816 | 18.9× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$2,252.70–$2,664 | $2,503–$2,960 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$2,496.60–$2,691.90 | $2,774–$2,991 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$2,849.40–$3,072.60 | $3,166–$3,414 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$2,446.20–$2,637.90 | $2,718–$2,931 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$2,554.20–$2,754 | $2,838–$3,060 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$2,285.10–$2,464.20 | $2,539–$2,738 | varies |
| CT neck tissue combo (70492) | $3,370.50 | $3,745 | 18.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,466.80 | $3,852 | 19.0× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$2,285.10–$2,464.20 | $2,539–$2,738 | varies |
| CT pelvis w&w/o contrast (72194) | $3,466.80 | $3,852 | 19.0× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$2,319.30–$2,501.10 | $2,577–$2,779 | varies |
| CT scan of leg combo (73702) | $3,466.80 | $3,852 | 19.0× |
| CT scans face/jaw combo (70488) | $3,466.80 | $3,852 | 19.0× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$2,464.20–$2,656.80 | $2,738–$2,952 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$2,252.70–$2,430 | $2,503–$2,700 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$2,450.70–$2,643.30 | $2,723–$2,937 | varies |
| CT thoracic spine w/wo cont (72130) | $3,538.80 | $3,932 | 19.4× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$2,451.60–$2,644.20 | $2,724–$2,938 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$2,252.70–$2,430 | $2,503–$2,700 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $3,466.80 | $3,852 | 19.0× |
| CT upper extremity with contrast (73201) | $2,691.90 | $2,991 | 7.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$3,668.40–$3,955.50 | $4,076–$4,395 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$3,374.10–$3,638.70 | $3,749–$4,043 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$3,339–$3,600.90 | $3,710–$4,001 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$520.20–$694.80 | $578–$772 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$651.60–$703.80 | $724–$782 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$571.50–$616.50 | $635–$685 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $520.20 | $578 | 4.8× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$584.10–$790.20 | $649–$878 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$286.20–$439.20 | $318–$488 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$299.70–$475.20 | $333–$528 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$2,139.30–$2,306.70 | $2,377–$2,563 | varies |
| Gated Heart Planar Single (78472) | $2,117.70 | $2,353 | 5.1× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$299.70–$458.10 | $333–$509 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,962.90–$2,117.70 | $2,181–$2,353 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$3,814.20–$4,112.10 | $4,238–$4,569 | varies |
| Hysterosalpingogram (74740) | $740.70 | $823 | 3.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $531 | $590 | 5.9× |
| K Flow/Funct Image W/Drug (78708) | $1,791 | $1,990 | 3.2× |
| K Flow/Funct Image W/O Drug (78707) | $1,915.20 | $2,128 | 3.4× |
| Kidney Imaging Morphol (78700) | $1,493.10 | $1,659 | 3.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$375.30–$625.50 | $417–$695 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,812.60 | $2,014 | 4.4× |
| Lung Ventilat&Perfus Imaging (78582) | $2,577.60 | $2,864 | 4.6× |
| Lung Ventilation Imaging (78579) | $1,764 | $1,960 | 4.2× |
| Lymph System Imaging (78195) | $2,074.50 | $2,305 | 3.7× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$3,731.40–$4,023.90 | $4,146–$4,471 | varies |
| Mra Head W/O & W/Contrast Material (70546) | $4,132.80 | $4,592 | 11.4× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$3,438–$3,707.10 | $3,820–$4,119 | varies |
| MRA head with contrast (70545) | $3,989.70 | $4,433 | 11.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,342.50 | $4,825 | 12.0× |
| MRA neck w/o contrast (70547) | $3,504.60 | $3,894 | 14.1× |
| MRI abdomen w contrast (74182) | $4,023.90 | $4,471 | 11.1× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$3,283.20–$3,540.60 | $3,648–$3,934 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$3,622.50–$3,906 | $4,025–$4,340 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$3,996–$4,308.30 | $4,440–$4,787 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$3,622.50–$3,906 | $4,025–$4,340 | varies |
| MRI cervical spine w contrast (72142) | $3,989.70 | $4,433 | 11.0× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$3,622.50–$3,906 | $4,025–$4,340 | varies |
| MRI chest with contrast (71551) | $4,023.90 | $4,471 | 4.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,906 | $4,340 | 10.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$3,996–$4,308.30 | $4,440–$4,787 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$3,187.80–$3,438 | $3,542–$3,820 | varies |
| MRI lumbar spine w contrast (72149) | $3,873.60 | $4,304 | 10.7× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$4,336.20–$4,675.50 | $4,818–$5,195 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $3,540.60 | $3,934 | 14.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$3,996–$4,308.30 | $4,440–$4,787 | varies |
| MRI pelvis w contrast (72196) | $4,023.90 | $4,471 | 11.1× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$4,114.80–$4,437 | $4,572–$4,930 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$3,187.80–$3,438 | $3,542–$3,820 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$3,622.50–$3,906 | $4,025–$4,340 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $4,023.90 | $4,471 | 11.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$3,187.80–$3,438 | $3,542–$3,820 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$3,996–$4,308.30 | $4,440–$4,787 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$4,155.30–$4,480.20 | $4,617–$4,978 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$4,276.80–$4,611.60 | $4,752–$5,124 | varies |
| MRI, dorsal spine contrast (72147) | $3,952.80 | $4,392 | 10.9× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$3,187.80–$3,438 | $3,542–$3,820 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$4,114.80–$4,437 | $4,572–$4,930 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$4,217.40–$4,547.70 | $4,686–$5,053 | varies |
| Myelogram Lumbar (72265) | $1,386.90 | $1,541 | 1.7× |
| Myelography thoracic (72255) | $3,311.10 | $3,679 | 4.1× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$4,374.90–$4,717.80 | $4,861–$5,242 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$308.70–$333.90 | $343–$371 | varies |
| Ob us nuchal meas 1 gest (76813) | $616.50 | $685 | 5.7× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$1,321.20–$1,425.60 | $1,468–$1,584 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$1,321.20–$1,425.60 | $1,468–$1,584 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$326.70–$353.70 | $363–$393 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,710.90 | $1,901 | 4.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$554.40–$648.90 | $616–$721 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,609.20 | $1,788 | 2.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$342.90–$685.80 | $381–$762 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$324–$458.10 | $360–$509 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$381.60–$598.50 | $424–$665 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$440.10–$475.20 | $489–$528 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$269.10–$369 | $299–$410 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$332.10–$598.50 | $369–$665 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$332.10–$531 | $369–$590 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $461.70 | $513 | 5.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $353.70 | $393 | 3.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $376.20 | $418 | 4.2× |
| Radex Ribs Unilateral 2 Views (71100) | $338.40 | $376 | 3.7× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$356.40–$630.90 | $396–$701 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$261–$282.60 | $290–$314 | varies |
| Radex Spine 1 View Specify Level (72020) | $412.20 | $458 | 4.6× |
| Radex Sternum Minimum 2 Views (71120) | $359.10 | $399 | 4.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $542.70 | $603 | 6.0× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$253.80–$274.50 | $282–$305 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$341.10–$475.20 | $379–$528 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$364.50–$598.50 | $405–$665 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$410.40–$442.80 | $456–$492 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$585.90–$632.70 | $651–$703 | varies |
| Radiologic exam colon double contrast study (74280) | $1,087.20 | $1,208 | 6.0× |
| Radiologic exam colon single contrast study (74270) | $892.80 | $992 | 4.9× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$411.30–$822.60 | $457–$914 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$427.50–$461.70 | $475–$513 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$698.40–$753.30 | $776–$837 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$619.20–$668.70 | $688–$743 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$883.80–$1,193.40 | $982–$1,326 | varies |
| Radiologic examination femur 1 view (73551) | $337.50 | $375 | 3.7× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$345.60–$616.50 | $384–$685 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$326.70–$653.40 | $363–$726 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $458.10 | $509 | 5.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$308.70–$531 | $343–$590 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) | $632.70 | $703 | 7.0× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$471.60–$509.40 | $524–$566 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,507.50 | $1,675 | 3.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,069.10 | $2,299 | 5.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,872.90–$2,020.50 | $2,081–$2,245 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$353.70–$616.50 | $393–$685 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$59.40–$64.80 | $66–$72 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$299.70–$387.90 | $333–$431 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$847.80–$915.30 | $942–$1,017 | varies |
| Skull less than 4 views (70250) | $376.20 | $418 | 3.5× |
| Sternoclavicular joints (71130) | $412.20 | $458 | 4.6× |
| Testicular Imaging W/Flow (78761) | $1,005.30 | $1,117 | 2.4× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$368.10–$397.80 | $409–$442 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$503.10–$542.70 | $559–$603 | varies |
| Thoracolumbar 2 views (72080) | $376.20 | $418 | 4.2× |
| Thyroid Imaging With Vascular Flow (78013) | $1,425.60 | $1,584 | 3.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$1,590.30–$1,715.40 | $1,767–$1,906 | varies |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$459.90–$496.80 | $511–$552 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$789.30–$851.40 | $877–$946 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$659.70–$711.90 | $733–$791 | varies |
| Umbilical-artery Doppler (OB) (76820) | $227.70 | $253 | 2.1× |
| Unlisted Dx Radiographic Procedure (76499) | $116.10 | $129 | 1.3× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$733.50–$791.10 | $815–$879 | varies |
| Ureteral Reflux Study (78740) | $1,782 | $1,980 | 4.3× |
| Urethrocystogram voiding (74455) | $801.90 | $891 | 3.2× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$531–$573.30 | $590–$637 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$536.40–$578.70 | $596–$643 | varies |
| Us complete joint (76881) | $892.80 | $992 | 8.2× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$487.80–$598.50 | $542–$665 | varies |
| Us head (76506) | $531 | $590 | 4.9× |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$948.60–$1,023.30 | $1,054–$1,137 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$650.70–$702.90 | $723–$781 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$471.60–$509.40 | $524–$566 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$558.90–$603.90 | $621–$671 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$801.90–$864.90 | $891–$961 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$651.60–$703.80 | $724–$782 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$554.40–$598.50 | $616–$665 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$811.80–$876.60 | $902–$974 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$633.60–$684 | $704–$760 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$711.90–$768.60 | $791–$854 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$425.70–$459.90 | $473–$511 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$711.90–$768.60 | $791–$854 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$757.80–$818.10 | $842–$909 | varies |
| Venography extremity bilateral rs&i (75822) | $856.80 | $952 | 0.5× |
| Venography extremity unilateral rs&i (75820) | $783 | $870 | 0.5× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$315.90–$475.20 | $351–$528 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $394.20 | $438 | 4.4× |
| X-ray antegrade pyelogram tube (74425) | $740.70 | $823 | 2.0× |
| X-Ray Bend Only L-S Spine (72120) | $561.60 | $624 | 5.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$299.70–$599.40 | $333–$666 | varies |
| X-Ray Exam Breast Specimen (76098) | $255.60 | $284 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$321.30–$347.40 | $357–$386 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $608.40 | $676 | 5.6× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$315.90–$341.10 | $351–$379 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$381.60–$763.20 | $424–$848 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $457.20 | $508 | 4.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $651.60 | $724 | 6.0× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$651.60–$703.80 | $724–$782 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$381.60–$412.20 | $424–$458 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $684 | $760 | 6.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$413.10–$445.50 | $459–$495 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$243–$262.80 | $270–$292 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$326.70–$353.70 | $363–$393 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $313.20 | $348 | 3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$253.80–$274.50 | $282–$305 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$475.20–$566.10 | $528–$629 | varies |
| X-ray nose-rectum child f.b. (76010) | $353.70 | $393 | 3.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$532.80–$575.10 | $592–$639 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$364.50–$394.20 | $405–$438 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$332.10–$359.10 | $369–$399 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$391.50–$423 | $435–$470 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$427.50–$461.70 | $475–$513 | varies |
| X-ray thoracic spine 4 vw (72074) | $438.30 | $487 | 4.0× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$342.90–$370.80 | $381–$412 | varies |
| X-Rays Bone Survey Complete (77075) | $892.80 | $992 | 8.2× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$512.10–$552.60 | $569–$614 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$315.90–$341.10 | $351–$379 | varies |
| Xr orbits complete 4 views (70200) | $462.60 | $514 | 4.3× |
| Xr Tomogram Single Plane (76100) | $740.70 | $823 | 6.8× |
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.