Imaging prices at Carle Health Pekin Hospital

Pekin, IL · every code in this section with a posted price and a Medicare benchmark.

361 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $7,728 $7,728 5.2×
Abdomen 1 View (74018) $693 $693 7.4×
Abdomen 2 views (74019) $809 $809 7.2×
Acute Gastrointestinal Blood Loss Imaging (78278) $2,940 $2,940 6.9×
Angio pulmonary bilat (75743)
range across 2 matching MRF lines		 $7,487–$7,833 $7,487–$7,833 varies
Angiography extremity bilateral rs&i (75716)
range across 2 matching MRF lines		 $4,095–$8,589 $4,095–$8,589 varies
Angiography extremity unilateral rs&i (75710) $7,172 $7,172 2.1×
Angiography pulmonary unilateral slctv rs&i (75741) $4,557 $4,557 1.3×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $4,106 $4,106 1.2×
Ankle 2 views (73600) $662 $662 7.1×
Artery X-Rays Abdomen (75726) $10,763 $10,763 1.8×
Artery X-Rays Pelvis (75736) $9,555 $9,555 1.6×
Artery X-Rays Spine (75705)
range across 2 matching MRF lines		 $7,014–$13,766 $7,014–$13,766 varies
Basic radiation dosimetry calculation (77300)
range across 2 matching MRF lines		 $903–$945 $903–$945 varies
Bone age studies (77072) $756 $756 6.7×
Bone Imaging 3 Phase (78315) $3,381 $3,381 7.9×
Bone Imaging Limited Area (78300) $1,964 $1,964 4.6×
Bone Imaging Multiple Areas (78305) $2,321 $2,321 5.4×
Bone Imaging Whole Body (78306) $3,161 $3,161 7.4×
Bone survey infant (77076) $1,302 $1,302 11.6×
Brachytx isodose intermed (77317) $2,331 $2,331 5.8×
Brain Flow Imaging Only (78610) $1,701 $1,701 2.9×
Brain Image W/Flow < 4 Views (78601) $1,418 $1,418 3.3×
Brain Imaging Minimum 4 Static Views (78605) $1,491 $1,491 2.6×
Brain Imaging Pet Metabolic Evaluation (78608) $8,526 $8,526 5.6×
Cardiac MRI w/w/o contrast & further seq (75561) $8,558 $8,558 22.9×
Cardiac MRI w/w/o contrast w/stress (75563) $2,730 $2,730 3.2×
Cat Scan Follow-Up Study (76380) $2,153 $2,153 23.1×
Chest 1 view (71045) $536 $536 5.7×
Chest 2 views (71046) $546 $546 5.9×
Chest 3 views (71047) $567 $567 6.1×
Chest 4 or more views (71048) $620 $620 5.5×
Cholecystography Oral Contrast (74290) $557 $557 3.0×
Cineradiograpy/vidradiograpy xcpt where spec (76120) $330 $330 2.9×
Clavicle complete (73000) $672 $672 7.2×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $668 $668 6.0×
Continuing medical physics consltj pr wk (77336) $861 $861 6.0×
Contrast Exam Abdominl Aorta (75625)
range across 2 matching MRF lines		 $6,017–$8,925 $6,017–$8,925 varies
Contrast X-Ray Bladder (74430)
range across 2 matching MRF lines		 $1,071–$1,113 $1,071–$1,113 varies
CT abdomen and pelvis without and with contrast (74178) $8,285 $8,285 22.2×
CT abdomen and pelvis without contrast (74176) $6,993 $6,993 27.3×
CT abdomen w contrast (74160) $5,208 $5,208 27.7×
CT abdomen w wo contrast (74170) $6,185 $6,185 32.9×
CT abdomen w/o contrast (74150)
range across 2 matching MRF lines		 $3,297–$3,455 $3,297–$3,455 varies
CT Angio Abdomen and Pelvis (74174) $8,285 $8,285 22.2×
CT Angio Chest (71275) $6,122 $6,122 32.6×
CT Angio Head (70496) $7,886 $7,886 42.0×
CT angio hrt w/3d image (75574) $4,368 $4,368 11.7×
Ct Angio Lwr Extr W/O&W/Dye (73706) $5,345 $5,345 28.4×
CT Angio Neck (70498) $6,416 $6,416 34.1×
Ct Angio Upr Extrm W/O&W/Dye (73206) $6,374 $6,374 33.9×
CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) $940 $940 5.0×
CT cervical spine w/ contrast (72126) $5,282 $5,282 14.1×
CT cervical spine w/o contrast (72125) $5,219 $5,219 46.6×
CT cervical spine w/wo cont (72127) $6,174 $6,174 32.8×
CT chest w contrast (71260) $5,250 $5,250 27.9×
CT chest w/wo contrast (71270) $6,311 $6,311 33.6×
CT colonography screening (74263) $1,166 $1,166 4.6×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $1,785 $1,785 9.5×
CT colonogrphy dx image postprocess w/o contrast (74261) $4,515 $4,515 40.3×
CT head/brain with contrast (70460) $4,946 $4,946 26.3×
CT head/brain without and with contrast (70470) $5,523 $5,523 29.4×
CT heart contrast eval cardiac structure&morph (75572) $3,024 $3,024 8.1×
CT heart no contrast quant eval coronry calcium (75571) $221 $221 2.4×
CT iac w contrast (70481) $5,093 $5,093 27.1×
CT l-spine w&w/o contrast (72133) $6,080 $6,080 32.3×
CT lower ext w/o (73700) $4,998 $4,998 44.6×
CT lower extremity w/contrast material (73701) $5,114 $5,114 27.2×
CT lumbar spine w contrast (72132) $5,723 $5,723 15.3×
CT lumbar spine w/o contrast (72131) $5,345 $5,345 47.7×
CT maxillofacial w contrast (70487) $4,694 $4,694 25.0×
CT maxillofacial wo contrast (70486) $4,337 $4,337 38.7×
CT neck tissue combo (70492) $5,849 $5,849 31.1×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $5,292 $5,292 28.2×
CT orbits w/o contrast (70480) $4,977 $4,977 44.4×
CT pelvis w&w/o contrast (72194) $6,185 $6,185 32.9×
CT pelvis w/o contrast (72192) $5,313 $5,313 47.4×
CT scan of leg combo (73702) $5,219 $5,219 27.8×
CT scans face/jaw combo (70488) $5,544 $5,544 29.5×
CT soft tissue neck w contrast (70491) $5,229 $5,229 27.8×
CT soft tissue neck w/o contrast (70490) $4,956 $4,956 44.2×
CT thoracic spine w contrast (72129) $5,408 $5,408 28.8×
CT thoracic spine w/o contrast (72128) $4,778 $4,778 42.6×
CT thoracic spine w/wo cont (72130) $672 $672 3.6×
CT thorax w/o contrast (71250) $5,208 $5,208 46.5×
CT upper ext wo (73200) $4,841 $4,841 43.2×
CT upper extremity w/o & w/contrast material (73202) $5,807 $5,807 30.9×
CT upper extremity with contrast (73201) $5,408 $5,408 14.5×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $7,959 $7,959 42.3×
Cta Abdomen (74175) $7,980 $7,980 42.5×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,869 $1,869 5.0×
CTA pelvis (72191) $7,235 $7,235 38.5×
Doppler Fetal Mid Cerebral Artery (76821) $1,092 $1,092 9.7×
Dxa Bone Density Axial (77080) $851 $851 7.6×
Dxa bone density study 1/>sites appendiclr skel (77081) $294 $294 3.2×
Echo exam uterus (76831) $735 $735 2.9×
Esophagram (74220) $914 $914 4.9×
Fetal Biophys Profile W/Nst (76818) $819 $819 7.3×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $809 $809 7.2×
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $735 $735 2.9×
Fluoroscopy up to 1 hr (76000)
range across 3 matching MRF lines		 $714–$1,019 $714–$1,019 varies
Follow-Up Angiography (75898)
range across 2 matching MRF lines		 $5,030–$9,567 $5,030–$9,567 varies
Foot 2 views (73620) $746 $746 8.0×
Forearm 2 views (73090) $683 $683 7.3×
Gastric emptying imaging study (78264) $3,182 $3,182 7.4×
Gated Heart Planar Single (78472) $3,024 $3,024 7.1×
Hand 2 views (73120) $620 $620 5.5×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $3,854 $3,854 5.2×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889)
range across 2 matching MRF lines		 $7,676–$8,022 $7,676–$8,022 varies
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $10,049 $10,049 3.0×
Hepatobil Syst Image W/Drug (78227) $3,402 $3,402 5.8×
Hepatobiliary System Imaging (78226) $2,898 $2,898 6.8×
Ht Musc Image Planar Mult (78454) $4,179 $4,179 3.0×
Ht Muscle Image Spect Sing (78451) $4,746 $4,746 3.4×
Hysterosalpingogram (74740) $1,407 $1,407 5.5×
Image fusion (77399) $998 $998 6.9×
Infant hip ultrasound with hip movement (dynamic) (76885) $410 $410 4.4×
Infant hip ultrasound, limited static exam (76886) $567 $567 6.1×
Joint Survey Single View (77077) $662 $662 5.9×
K Flow/Funct Image Multiple (78709) $2,100 $2,100 3.6×
K Flow/Funct Image W/Drug (78708) $3,087 $3,087 5.3×
K Flow/Funct Image W/O Drug (78707) $1,985 $1,985 3.4×
Kidney Imaging Morphol (78700) $1,743 $1,743 4.1×
Knee 3 Views (73562) $756 $756 8.1×
Liver & Spleen Imaging Static Only (78215) $1,911 $1,911 4.5×
Liver imaging static only (78201) $2,552 $2,552 4.4×
Liver imaging w/vascular flow (78202) $3,518 $3,518 6.0×
Lung Perf&Ventilat Diferentl (78598) $1,622 $1,622 2.8×
Lung perfusion differential (78597) $1,197 $1,197 2.8×
Lung Ventilat&Perfus Imaging (78582) $3,728 $3,728 6.4×
Lymph System Imaging (78195) $2,982 $2,982 5.1×
Magnetic Image Jaw Joint (70336) $7,487 $7,487 29.3×
Mammary ductogram or galactogram single (77053) $756 $756 3.0×
Meckels Divert Exam (78290) $1,890 $1,890 4.4×
Mlc imrt design & construction per imrt plan (77338) $15,719 $15,719 39.2×
Mr safety determination physician/other qhp (76016) $294 $294 3.2×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $81 $81 2.6×
Mr safety implt electronics prepj supvj phys/qhp (76018) $305 $305 3.0×
Mr safety implt pos&/immoblj (76019) $200 $200 3.2×
Mr safety med physics xm customization plng&mntr (76017) $798 $798 3.1×
Mra Head W/O & W/Contrast Material (70546) $8,988 $8,988 24.0×
MRA head w/o contrast (70544) $7,035 $7,035 27.5×
MRA head with contrast (70545) $7,676 $7,676 20.5×
MRA neck w contrast (70548) $7,214 $7,214 19.3×
Mra Neck W/O &W/Contrast Material (70549) $8,915 $8,915 23.8×
MRA neck w/o contrast (70547) $7,214 $7,214 28.2×
MRI abdomen w contrast (74182) $7,529 $7,529 20.1×
MRI abdomen w/o contrast (74181) $7,424 $7,424 29.0×
MRI any jt lower extrem w/contrast material (73722) $8,516 $8,516 10.1×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $8,579 $8,579 22.9×
MRI any jt upper extremity w/contrast matrl (73222) $7,917 $7,917 9.4×
MRI Breast W/O Contrast Bilateral (77047) $6,195 $6,195 24.2×
MRI Breast Without Contrast Material Unilateral (77046) $2,132 $2,132 8.3×
MRI cardiac w/o contrast (75557) $6,269 $6,269 24.5×
MRI cervical spine w contrast (72142) $8,505 $8,505 22.7×
MRI cervical spine w/o cont (72141) $7,151 $7,151 28.0×
MRI chest w/o contrast (71550) $7,466 $7,466 29.2×
MRI chest with contrast (71551) $6,416 $6,416 7.6×
MRI chest wo w contrast (71552) $8,957 $8,957 24.0×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $8,327 $8,327 22.3×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $8,516 $8,516 22.8×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $7,308 $7,308 28.6×
MRI lumbar spine w contrast (72149) $7,581 $7,581 20.3×
Mri Neck Spine W/O & W/Dye (72156) $9,125 $9,125 24.4×
MRI orbit face &/neck w/o contrast (70540) $7,466 $7,466 29.2×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $8,526 $8,526 22.8×
MRI pelvis w contrast (72196) $7,875 $7,875 21.1×
MRI pelvis w/o & w contrast (72197) $8,831 $8,831 23.6×
MRI pelvis w/o contrast (72195) $7,140 $7,140 27.9×
MRI spectroscopy (76390) $5,082 $5,082 54.5×
MRI thoracic spine w/o contrast (72146) $7,172 $7,172 28.0×
MRI upper extremity oth than jt w/contr matrl (73219) $1,154 $1,154 3.1×
MRI upper extremity oth than jt w/o contr matrl (73218) $7,151 $7,151 28.0×
Mri Uppr Extremity W/O&W/Dye (73220) $8,463 $8,463 22.6×
MRI, abdomen, combo (74183) $8,285 $8,285 22.2×
MRI, dorsal spine combo (72157) $8,495 $8,495 22.7×
MRI, dorsal spine contrast (72147) $7,896 $7,896 21.1×
MRI, joint upper extrem (73221) $7,151 $7,151 28.0×
MRI, joint upper extrem combo (73223) $8,211 $8,211 22.0×
MRI, lumbar spine combo (72158) $8,516 $8,516 22.8×
Myocardial Imaging Pet Metabolic Evaluation (78459) $5,954 $5,954 4.3×
Myocardial Spect Multiple Studies (78452) $5,975 $5,975 4.3×
Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) $4,221 $4,221 2.8×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $5,586 $5,586 3.6×
Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) $6,153 $6,153 2.6×
N-invas est c ffr sw aly CTA (75580) $5,460 $5,460 5.9×
Neck soft tissue (70360) $693 $693 7.4×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $756 $756 1.8×
Nm myocard infarct spect (78469) $3,098 $3,098 5.3×
Nonvascular Shunt X-Ray (75809) $330 $330 2.9×
Ntsty modul radthx pln dose-vol histos (77301) $8,589 $8,589 5.8×
Nuclear Rx Intra-Arterial (79445)
range across 2 matching MRF lines		 $1,176–$1,187 $1,176–$1,187 varies
Nuclear Rx Oral Admin (79005) $2,919 $2,919 11.7×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $399 $399 3.6×
Panoramic X-ray of jaws (70355) $347 $347 3.7×
Parathyroid imaging w/tomographic spect & CT (78072) $2,573 $2,573 4.4×
Parathyroid Planar Imaging (78070) $840 $840 2.0×
Parathyroid planar imaging w/wo subtraction (78071) $1,775 $1,775 4.1×
Pelvis 1 or 2 views (72170) $672 $672 6.0×
Pet Image W/Ct Lmtd (78814) $7,413 $7,413 4.8×
PET image w/CT, full body (78816) $10,752 $10,752 7.0×
PET imaging CT attenuation skull base mid-thigh (78815) $12,411 $12,411 8.1×
Pulmonary Perfusion Imaging Particulate (78580) $2,520 $2,520 5.9×
Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) $4,985 $4,985 5.0×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $1,040 $1,040 9.3×
Radex abscess/fistula/sinus tract rs&i (76080)
range across 2 matching MRF lines		 $2,415–$2,520 $2,415–$2,520 varies
Radex Ankle Complete Minimum 3 Views (73610) $998 $998 10.7×
Radex Calcaneus Minimum 2 Views (73650) $725 $725 7.8×
Radex elbow complete minimum 3 views (73080) $788 $788 8.4×
Radex Facial Bones Complete Minimum 3 Views (70150) $1,071 $1,071 9.6×
Radex fingr minimum 2 views (73140) $509 $509 5.5×
Radex foot complete minimum 3 views (73630) $882 $882 9.5×
Radex Hand Minimum 3 Views (73130) $777 $777 8.3×
Radex lower extremity infant minimum 2 views (73592) $536 $536 5.7×
Radex Nasal Bones Complete Minimum 3 Views (70160) $819 $819 8.8×
Radex Ribs Unilateral 2 Views (71100) $714 $714 7.7×
Radex shoulder complete minimum 2 views (73030) $756 $756 8.1×
Radex Sinuses Paransl < 3 Views (70210) $714 $714 7.7×
Radex Spine 1 View Specify Level (72020) $609 $609 6.5×
Radex Sternum Minimum 2 Views (71120) $809 $809 8.7×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $788 $788 8.4×
Radex Toe Minimum 2 Views (73660) $525 $525 5.6×
Radex upper extremity infant minimum 2 views (73092) $462 $462 4.1×
Radex Wrist Complete Minimum 3 Views (73110) $788 $788 8.4×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $1,460 $1,460 13.0×
Radiation Delivery Stereotactic Cranial Linear (77372) $25,232 $25,232 3.2×
Radiation treatment delivery level 1 (77402) $1,203 $1,203 11.0×
Radiation treatment delivery level 2 (77407) $4,547 $4,547 11.0×
Radiation treatment delivery level 3 (77412) $1,439 $1,439 2.4×
Radiolog exam mandible compl minimum 4 views (70110) $945 $945 8.4×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $872 $872 7.8×
Radiologic exam colon double contrast study (74280) $2,090 $2,090 11.1×
Radiologic exam colon single contrast study (74270) $1,460 $1,460 7.8×
Radiologic Exam Esophagus Double Contrast Study (74221) $536 $536 2.9×
Radiologic exam knee complete 4/more views (73564) $1,008 $1,008 9.0×
Radiologic exam pelvis compl minimum 3 views (72190) $840 $840 7.5×
Radiologic Exam Small Int Single Contrast Study (74250) $1,124 $1,124 6.0×
Radiologic exam swallow function contrast study (74230) $851 $851 4.5×
Radiologic exam upr gi trc double contrast study (74246) $1,040 $1,040 5.5×
Radiologic examination femur 1 view (73551) $336 $336 3.6×
Radiologic examination femur minimum 2 views (73552) $882 $882 9.5×
Radiologic examination knee 1/2 views (73560) $725 $725 7.8×
Radiologic Examination Osseous Survey Limited (77074) $956 $956 8.5×
Radiologic examination tibia & fibula 2 views (73590) $767 $767 8.2×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) $966 $966 2.3×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) $693 $693 1.7×
Renal Cyst Study (74470) $3,024 $3,024 5.2×
Ribs bilateral 3 views (71110) $924 $924 8.2×
Rp loclzj tum plnr 1 area single day imaging (78800) $2,289 $2,289 5.3×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $2,898 $2,898 5.0×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $3,371 $3,371 5.8×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $3,129 $3,129 2.3×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $4,221 $4,221 2.8×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $3,717 $3,717 2.7×
Scapula (73010) $767 $767 6.8×
Screening Digital Breast Tomosynthesis Bi (77063) $110 $110 4.7×
Shoulder 1 view (73020) $557 $557 6.0×
Skull less than 4 views (70250) $473 $473 4.2×
Special dosimetry (77331) $956 $956 6.6×
Special teletherapy port plan (77321) $2,331 $2,331 5.8×
Special treatment procedure (77470) $3,245 $3,245 5.5×
Stereotactic Body Radiation Delivery (77373) $15,015 $15,015 7.8×
Sternoclavicular joints (71130) $693 $693 7.4×
Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) $547 $547 5.0×
Surf radj ther supfc dlvr<=150 kv per fraction (77437) $547 $547 5.0×
Surf radj ther supfc/orthvlt treatment planning (77436) $200 $200 5.0×
Tbs technical calculation only (77091) $284 $284 3.0×
Telethx isodose pln cplx w/basic dosimetry (77307) $956 $956 2.4×
Telethx isodose pln smpl w/dosimetry calculation (77306) $956 $956 2.4×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $2,583 $2,583 6.4×
Ther rad simulaj-aided field setting simple (77280) $861 $861 6.0×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $641 $641 3.4×
Thoracic spine 2 views (72070) $725 $725 6.5×
Thoracic spine 3 views (72072) $956 $956 8.5×
Thoracolumbar 2 views (72080) $746 $746 8.0×
Thyroid Carcinoma Metastases Img Lmtd Area (78015) $1,238 $1,238 2.9×
Thyroid Imaging With Vascular Flow (78013) $1,628 $1,628 3.8×
Thyroid Met Imaging Body (78018) $3,129 $3,129 5.4×
Thyroid Uptake Measurement (78012) $1,238 $1,238 2.9×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $2,142 $2,142 5.0×
Tx Devices Design & Construction Complex (77334) $1,743 $1,743 4.3×
Tx devices design & construction intermediate (77333) $1,607 $1,607 11.2×
Tx devices design & construction simple (77332) $1,607 $1,607 11.2×
Ultrasound Breast Limited (76642)
range across 2 matching MRF lines		 $578–$630 $578–$630 varies
Ultrasound Elastography Parenchyma (76981) $352 $352 3.1×
Ultrasound Exam Aaa Screen (76706) $446 $446 4.0×
Ultrasound, abdomen limited (76705)
range across 3 matching MRF lines		 $1,250–$1,302 $1,250–$1,302 varies
Umbilical-artery Doppler (OB) (76820) $851 $851 7.6×
Unlisted magnetic resonance procedure (76498) $1,313 $1,313 14.1×
Upper gi w/o kub (74240) $1,250 $1,250 6.7×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $62 $62 5.6×
Urea breath test c-14 isotopic analysis (78268) $326 $326 3.5×
Urethrocystogram voiding (74455) $1,176 $1,176 4.6×
Urethrocystography retrograde (74450) $1,722 $1,722 6.7×
Us breast unilateral complete (76641) $1,397 $1,397 12.5×
Us chest (76604)
range across 3 matching MRF lines		 $1,008–$1,050 $1,008–$1,050 varies
Us complete joint (76881) $630 $630 5.6×
Us exam, pelvic, limited (76857)
range across 3 matching MRF lines		 $924–$956 $924–$956 varies
Us head (76506) $1,880 $1,880 16.8×
Us kidney transplant (76776) $672 $672 6.0×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $525 $525 4.7×
Us ob detailed single fetus (76811) $2,153 $2,153 8.4×
Us ob limited 1 or more fetuses (76815)
range across 3 matching MRF lines		 $914–$956 $914–$956 varies
Us ob transvaginal (76817) $1,302 $1,302 11.6×
Us pelvic non ob complete (76856) $1,670 $1,670 14.9×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $1,271 $1,271 11.3×
Us preg uterus real time f/u trnsabdl per fetus (76816) $1,302 $1,302 11.6×
Us retroperitoneal complete (76770) $1,785 $1,785 15.9×
Us retroperitoneal limited (76775)
range across 2 matching MRF lines		 $1,302–$1,355 $1,302–$1,355 varies
Us scrotum and contents (76870)
range across 2 matching MRF lines		 $1,523–$1,533 $1,523–$1,533 varies
Us spinal canal and contents (76800) $1,586 $1,586 14.2×
Us thyroid (76536)
range across 3 matching MRF lines		 $147–$1,428 $147–$1,428 varies
Us transrectal (76872) $1,607 $1,607 14.3×
Vein X-Ray Chest (75827)
range across 2 matching MRF lines		 $4,169–$7,539 $4,169–$7,539 varies
Vein X-Ray Liver W/O Hemodyn (75887) $7,487 $7,487 2.2×
Venogram Sinus/Jugular (75860) $5,187 $5,187 1.5×
Venography caval inferior serialography rs&i (75825) $8,274 $8,274 2.4×
Venography extremity bilateral rs&i (75822) $5,943 $5,943 3.5×
Venography extremity unilateral rs&i (75820) $5,229 $5,229 3.1×
Venography Renal Bilateral (75833)
range across 2 matching MRF lines		 $7,550–$15,005 $7,550–$15,005 varies
Venography Renal Unilateral (75831)
range across 2 matching MRF lines		 $5,933–$15,005 $5,933–$15,005 varies
Wrist 2 views (73100) $630 $630 6.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $651 $651 7.0×
X-ray antegrade pyelogram tube (74425)
range across 2 matching MRF lines		 $2,132–$2,226 $2,132–$2,226 varies
X-Ray Aorta Leg Arteries (75630) $9,524 $9,524 2.8×
X-Ray Bend Only L-S Spine (72120) $252 $252 2.2×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $662 $662 7.1×
X-Ray Exam Breast Specimen (76098)
range across 2 matching MRF lines		 $1,439–$1,586 $1,439–$1,586 varies
X-Ray Exam Entire Spi 1 Vw (72081) $630 $630 6.8×
X-Ray Exam Entire Spi 2/3 Vw (72082) $557 $557 5.0×
X-Ray Exam Entire Spi 4/5 Vw (72083) $1,218 $1,218 10.9×
X-Ray Exam Hip Uni 1 View (73501) $336 $336 3.6×
X-Ray Exam Hip Uni 2-3 Views (73502) $336 $336 3.6×
X-Ray Exam Hip Uni 4/> Views (73503) $557 $557 5.0×
X-Ray Exam Hips Bi 2 Views (73521) $557 $557 5.0×
X-Ray Exam Hips Bi 3-4 Views (73522) $557 $557 5.0×
X-Ray Exam Hips Bi 5/> Views (73523) $1,050 $1,050 9.4×
X-Ray Exam L-S Spine Bending (72114) $1,365 $1,365 12.2×
X-Ray Exam Neck Spine 2-3 Vw (72040) $725 $725 7.8×
X-Ray Exam Neck Spine 6/>Vws (72052) $1,302 $1,302 11.6×
X-Ray Exam Unilat Ribs/Chest (71101) $809 $809 7.2×
X-ray eye for foreign body (70030) $226 $226 2.4×
X-ray humerus (73060) $714 $714 7.7×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $714 $714 7.7×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $830 $830 8.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $788 $788 7.0×
X-ray nose-rectum child f.b. (76010) $431 $431 4.6×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $1,061 $1,061 9.5×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $746 $746 6.7×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $672 $672 6.0×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $714 $714 7.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $1,040 $1,040 11.2×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $1,082 $1,082 9.7×
X-ray thoracic spine 4 vw (72074) $1,050 $1,050 9.4×
X-Ray Tmj Unilat (70328) $278 $278 3.0×
X-Ray Urinary Tract Exam With Contrast Material (74420) $1,323 $1,323 3.5×
X-Rays Bone Length Studies (77073) $1,124 $1,124 10.0×
X-Rays Bone Survey Complete (77075) $1,397 $1,397 12.5×
Xr c-spine 4 or 5 views (72050) $1,040 $1,040 9.3×
Xr facial bones less than 3 views (70140) $651 $651 7.0×
Xr orbits complete 4 views (70200) $966 $966 8.6×

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.