Imaging prices at CaroMont Regional Medical Center

Gastonia, NC · every code in this section with a posted price and a Medicare benchmark.

387 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) $8,133 $8,133 6.0×
Abdomen 1 View (74018) $387 $387 4.6×
Abdomen 2 views (74019) $461 $461 4.5×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,952 $1,952 5.0×
Angio pulmonary bilat (75743) $10,972 $10,972 3.6×
Angiography extremity bilateral rs&i (75716) $7,705 $7,705 2.5×
Angiography extremity unilateral rs&i (75710) $7,705 $7,705 2.5×
Angiography pulmonary unilateral slctv rs&i (75741) $8,412 $8,412 2.7×
Ankle 2 views (73600) $355 $355 4.2×
Aortography thoracic serialography rs&i (75605) $6,461 $6,461 1.2×
Aortography thoracic w/o serialography rs&i (75600) $10,861 $10,861 3.5×
Artery X-Rays Abdomen (75726) $6,806 $6,806 1.3×
Artery X-Rays Adrenal Gland (75731) $8,516 $8,516 2.8×
Artery X-Rays Pelvis (75736) $6,993 $6,993 1.3×
Artery X-Rays Spine (75705) $12,411 $12,411 2.3×
Arthrogram hip (73525) $1,207 $1,207 3.6×
Arthrogram Wrist (73115) $1,148 $1,148 3.4×
Basic radiation dosimetry calculation (77300) $1,004 $1,004 7.7×
Bone age studies (77072) $422 $422 4.2×
Bone Imaging 3 Phase (78315) $2,908 $2,908 7.5×
Bone Imaging Limited Area (78300) $1,667 $1,667 4.3×
Bone Imaging Whole Body (78306) $2,581 $2,581 6.6×
Bone marrow imaging limited area (78102) $974 $974 2.5×
Bone marrow imaging; whole body (78104) $1,923 $1,923 5.0×
Bone survey infant (77076) $537 $537 5.3×
Brachytx isodose complex (77318) $2,339 $2,339 6.4×
Brachytx isodose intermed (77317) $2,240 $2,240 6.2×
Brachytx Isodose Plan Simple (77316) $805 $805 2.2×
Brain Image W/Flow < 4 Views (78601) $2,044 $2,044 5.3×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $1,767 $1,767 3.3×
Brain Imaging Minimum 4 Static Views (78605) $1,289 $1,289 2.4×
Brain Imaging Pet Metabolic Evaluation (78608) $7,688 $7,688 5.5×
Cardiac MRI w/w/o contrast & further seq (75561) $5,518 $5,518 16.3×
Cardiac MRI w/w/o contrast w/stress (75563) $7,275 $7,275 9.6×
Cardiac Shunt Detection (78428) $1,116 $1,116 2.9×
Cat Scan Follow-Up Study (76380)
range across 2 matching MRF lines		 $1,708–$1,713 $1,708–$1,713 varies
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $2,294 $2,294 4.3×
Cerebrospinal Fluid Scan (78630) $4,412 $4,412 8.4×
Chest 1 view (71045) $387 $387 4.6×
Chest 2 views (71046) $400 $400 4.7×
Chest 3 views (71047) $420 $420 5.0×
Chest 4 or more views (71048) $691 $691 6.8×
Clavicle complete (73000)
range across 3 matching MRF lines		 $335–$668 $335–$668 varies
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $2,794 $2,794 27.5×
Continuing medical physics consltj pr wk (77336) $1,070 $1,070 8.2×
Contrast Exam Abdominl Aorta (75625) $7,093 $7,093 2.3×
Contrast X-Ray Bladder (74430) $1,105 $1,105 3.3×
Contrast X-Ray Of Elbow (73085) $989 $989 2.9×
Contrast X-Ray Of Knee Joint (73580) $1,381 $1,381 4.1×
CT abdomen and pelvis without and with contrast (74178) $9,150 $9,150 27.0×
CT abdomen and pelvis without contrast (74176) $5,835 $5,835 25.2×
CT abdomen w contrast (74160) $3,941 $3,941 23.1×
CT abdomen w wo contrast (74170)
range across 2 matching MRF lines		 $4,407–$4,847 $4,407–$4,847 varies
CT abdomen w/o contrast (74150) $2,518 $2,518 24.8×
CT Angio Abdomen and Pelvis (74174) $5,054 $5,054 14.9×
CT Angio Chest (71275) $3,538 $3,538 20.8×
CT Angio Head (70496) $4,062 $4,062 23.8×
CT angio hrt w/3d image (75574) $2,064 $2,064 6.1×
Ct Angio Lwr Extr W/O&W/Dye (73706) $3,215 $3,215 18.9×
CT Angio Neck (70498) $4,580 $4,580 26.9×
Ct Angio Upr Extrm W/O&W/Dye (73206) $3,187 $3,187 18.7×
CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) $681 $681 4.0×
CT cervical spine w/ contrast (72126) $4,599 $4,599 13.6×
CT cervical spine w/o contrast (72125) $3,901 $3,901 38.4×
CT cervical spine w/wo cont (72127) $6,351 $6,351 37.3×
CT chest w contrast (71260) $4,034 $4,034 23.7×
CT chest w/wo contrast (71270) $5,160 $5,160 30.3×
CT head/brain with contrast (70460) $3,192 $3,192 18.7×
CT head/brain without and with contrast (70470) $3,978 $3,978 23.3×
CT heart contrast eval cardiac structure&morph (75572) $1,877 $1,877 5.5×
CT heart no contrast quant eval coronry calcium (75571) $407 $407 4.8×
CT hrt w/3d image congen (75573) $1,975 $1,975 5.8×
CT iac w contrast (70481) $4,340 $4,340 25.5×
CT l-spine w&w/o contrast (72133) $8,768 $8,768 51.4×
CT lower ext w/o (73700) $3,024 $3,024 29.8×
CT lower extremity w/contrast material (73701) $3,563 $3,563 20.9×
CT lumbar spine w contrast (72132) $4,687 $4,687 13.8×
CT lumbar spine w/o contrast (72131) $3,921 $3,921 38.6×
CT maxillofacial w contrast (70487) $3,838 $3,838 22.5×
CT maxillofacial wo contrast (70486) $3,076 $3,076 30.3×
CT neck tissue combo (70492) $4,880 $4,880 28.6×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $4,568 $4,568 26.8×
CT orbits w/o contrast (70480) $2,831 $2,831 27.9×
CT pelvis w&w/o contrast (72194) $4,746 $4,746 27.8×
CT pelvis w/o contrast (72192) $3,194 $3,194 31.4×
CT scan of leg combo (73702) $3,773 $3,773 22.1×
CT scans face/jaw combo (70488) $4,220 $4,220 24.8×
CT soft tissue neck w contrast (70491) $3,835 $3,835 22.5×
CT soft tissue neck w/o contrast (70490) $2,816 $2,816 27.7×
CT thoracic spine w contrast (72129) $3,060 $3,060 18.0×
CT thoracic spine w/o contrast (72128) $2,193 $2,193 21.6×
CT thoracic spine w/wo cont (72130) $3,277 $3,277 19.2×
CT thorax w/o contrast (71250) $2,943 $2,943 29.0×
CT unlisted procedure (76497) $436 $436 5.2×
CT upper ext wo (73200) $3,024 $3,024 29.8×
CT upper extremity w/o & w/contrast material (73202) $3,582 $3,582 21.0×
CT upper extremity with contrast (73201) $3,916 $3,916 11.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $4,531 $4,531 26.6×
Cta Abdomen (74175) $3,060 $3,060 18.0×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $1,354 $1,354 4.0×
CTA pelvis (72191) $3,905 $3,905 22.9×
Dilation ureters/urethra rs&i (74485) $2,945 $2,945 1.4×
Discography Cerv/Thor Spine (72285) $4,878 $4,878 2.6×
Diskography lumbar (72295) $5,302 $5,302 2.8×
Doppler Fetal Mid Cerebral Artery (76821) $592 $592 5.8×
Dxa Bone Density Axial (77080) $1,086 $1,086 10.7×
Dxa bone density study 1/>sites appendiclr skel (77081) $357 $357 4.2×
Echo exam of fetal heart (76825) $1,515 $1,515 2.9×
Echo Guide For Artery Repair (76936) $2,028 $2,028 9.7×
Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) $1,175 $1,175 5.1×
Echograp Trans R Pros Study (76873) $1,806 $1,806 17.8×
Esophagram (74220) $830 $830 4.9×
Fetal Biophys Profile W/Nst (76818) $742 $742 7.3×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $641 $641 6.3×
Fluoroscopy up to 1 hr (76000) $1,042 $1,042 4.5×
Follow-Up Angiography (75898) $1,365 $1,365 0.4×
Foot 2 views (73620)
range across 3 matching MRF lines		 $355–$709 $355–$709 varies
Forearm 2 views (73090) $382 $382 4.5×
Gastric emptying imaging study (78264) $3,067 $3,067 7.9×
Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) $2,255 $2,255 5.8×
Gastroesophageal Reflux Exam (78262) $2,290 $2,290 5.9×
Gated Heart Planar Single (78472) $3,644 $3,644 9.4×
Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) $2,995 $2,995 5.7×
Hand 2 views (73120) $335 $335 3.3×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $4,724 $4,724 7.0×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $4,936 $4,936 7.3×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $4,936 $4,936 7.3×
Hepatobil Syst Image W/Drug (78227) $2,561 $2,561 4.9×
Hepatobiliary System Imaging (78226) $2,561 $2,561 6.6×
Ht Muscle Image Spect Sing (78451) $4,406 $4,406 3.5×
Hysterosalpingogram (74740) $1,242 $1,242 5.4×
Image fusion (77399) $820 $820 6.3×
Infant hip ultrasound with hip movement (dynamic) (76885) $617 $617 7.3×
Infant hip ultrasound, limited static exam (76886) $1,044 $1,044 12.3×
Interstitial radiation source applic complex (77778) $9,733 $9,733 14.4×
Joint Survey Single View (77077) $333 $333 3.3×
K Flow/Funct Image Multiple (78709) $3,461 $3,461 6.6×
K Flow/Funct Image W/Drug (78708) $2,993 $2,993 5.7×
K Flow/Funct Image W/O Drug (78707) $2,421 $2,421 4.6×
Kidney Imaging Morphol (78700) $2,371 $2,371 6.1×
Knee 3 Views (73562)
range across 3 matching MRF lines		 $367–$736 $367–$736 varies
Leveen/Shunt Patency Exam (78291) $1,329 $1,329 3.4×
Liver & Spleen Imaging Static Only (78215) $1,847 $1,847 4.8×
Lung perfusion differential (78597) $1,772 $1,772 4.6×
Lung Ventilat&Perfus Imaging (78582) $2,766 $2,766 5.2×
Lung Ventilation Imaging (78579) $1,697 $1,697 4.4×
Lymph System Imaging (78195) $2,486 $2,486 4.7×
Magnetic Image Jaw Joint (70336) $5,713 $5,713 24.6×
Mammary ductogram or galactogram multiple (77054) $1,604 $1,604 6.9×
Mammary ductogram or galactogram single (77053) $877 $877 3.8×
Meckels Divert Exam (78290) $1,884 $1,884 4.8×
Mlc imrt design & construction per imrt plan (77338) $8,580 $8,580 23.6×
Mra Head W/O & W/Contrast Material (70546) $5,199 $5,199 15.3×
MRA head w/o contrast (70544) $4,186 $4,186 18.1×
MRA head with contrast (70545) $4,915 $4,915 14.5×
MRA neck w contrast (70548) $4,691 $4,691 13.8×
Mra Neck W/O &W/Contrast Material (70549) $5,596 $5,596 16.5×
MRA neck w/o contrast (70547) $4,273 $4,273 18.4×
MRI abdomen w contrast (74182) $3,634 $3,634 10.7×
MRI abdomen w/o contrast (74181) $4,708 $4,708 20.3×
MRI any jt lower extrem w/contrast material (73722) $6,431 $6,431 8.4×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $6,780 $6,780 20.0×
MRI any jt upper extremity w/contrast matrl (73222) $5,703 $5,703 7.5×
MRI Breast W/O Contrast Bilateral (77047) $7,060 $7,060 30.4×
MRI Breast Without Contrast Material Unilateral (77046) $3,661 $3,661 15.8×
MRI cardiac w/o contrast (75557) $2,839 $2,839 12.2×
MRI cervical spine w contrast (72142) $6,574 $6,574 19.4×
MRI cervical spine w/o cont (72141) $5,054 $5,054 21.8×
MRI chest w/o contrast (71550) $4,618 $4,618 19.9×
MRI chest with contrast (71551) $6,184 $6,184 8.1×
MRI chest wo w contrast (71552) $6,336 $6,336 18.7×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $6,769 $6,769 20.0×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $6,780 $6,780 20.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $5,241 $5,241 22.6×
MRI lumbar spine w contrast (72149) $6,467 $6,467 19.1×
Mri Neck Spine W/O & W/Dye (72156) $7,145 $7,145 21.1×
MRI orbit face &/neck w/o contrast (70540) $4,847 $4,847 20.9×
MRI orbit face neck w contrast (70542) $5,643 $5,643 16.6×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $6,542 $6,542 19.3×
MRI pelvis w contrast (72196) $5,511 $5,511 16.3×
MRI pelvis w/o & w contrast (72197) $6,559 $6,559 19.3×
MRI pelvis w/o contrast (72195) $4,716 $4,716 20.3×
MRI spectroscopy (76390) $3,989 $3,989 47.2×
MRI thoracic spine w/o contrast (72146) $5,290 $5,290 22.8×
MRI upper extremity oth than jt w/contr matrl (73219) $6,542 $6,542 19.3×
MRI upper extremity oth than jt w/o contr matrl (73218) $5,341 $5,341 23.0×
Mri Uppr Extremity W/O&W/Dye (73220) $6,780 $6,780 20.0×
MRI, abdomen, combo (74183) $6,620 $6,620 19.5×
MRI, dorsal spine combo (72157) $7,686 $7,686 22.7×
MRI, dorsal spine contrast (72147) $6,325 $6,325 18.7×
MRI, joint upper extrem (73221) $5,290 $5,290 22.8×
MRI, joint upper extrem combo (73223) $6,780 $6,780 20.0×
MRI, lumbar spine combo (72158) $7,482 $7,482 22.1×
Myelogram cervical (72240) $2,467 $2,467 3.2×
Myelogram Lumbar (72265) $2,390 $2,390 3.1×
Myelography thoracic (72255) $2,670 $2,670 3.5×
Myelograpy 2/more regions rs&i (72270) $2,649 $2,649 3.5×
Myocardial Spect Multiple Studies (78452) $5,713 $5,713 4.5×
N-invas est c ffr sw aly CTA (75580) $5,057 $5,057 6.1×
Neck soft tissue (70360) $476 $476 5.6×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $1,267 $1,267 3.4×
Nm csf leak detection (78650) $4,644 $4,644 3.7×
Ntsty modul radthx pln dose-vol histos (77301) $8,760 $8,760 6.5×
Nuclear medicine study of endocrine organs (78099) $847 $847 2.2×
Nuclear Rx Intra-Arterial (79445) $851 $851 3.8×
Nuclear Rx Oral Admin (79005) $2,473 $2,473 10.9×
Optic foramina (70190) $188 $188 2.2×
Panoramic X-ray of jaws (70355) $436 $436 5.2×
Parathyroid imaging w/tomographic spect & CT (78072) $2,675 $2,675 5.1×
Parathyroid Planar Imaging (78070) $2,332 $2,332 6.0×
Parathyroid planar imaging w/wo subtraction (78071) $2,675 $2,675 6.9×
Pelvis 1 or 2 views (72170) $476 $476 4.7×
Pet Image W/Ct Lmtd (78814) $5,928 $5,928 4.3×
PET image w/CT, full body (78816) $8,575 $8,575 6.2×
PET imaging CT attenuation skull base mid-thigh (78815) $7,898 $7,898 5.7×
Pet Imaging Limited Area Chest Head/Neck (78811) $5,928 $5,928 4.7×
PET whole body (78813) $8,188 $8,188 5.9×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $9,127 $9,127 3.0×
Pulmonary Perfusion Imaging Particulate (78580) $1,638 $1,638 4.2×
Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) $2,708 $2,708 3.0×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $830 $830 8.2×
Radex abscess/fistula/sinus tract rs&i (76080) $1,520 $1,520 2.9×
Radex Ankle Complete Minimum 3 Views (73610) $382 $382 4.5×
Radex Calcaneus Minimum 2 Views (73650)
range across 3 matching MRF lines		 $339–$680 $339–$680 varies
Radex elbow complete minimum 3 views (73080) $382 $382 4.5×
Radex Facial Bones Complete Minimum 3 Views (70150) $643 $643 6.3×
Radex fingr minimum 2 views (73140)
range across 3 matching MRF lines		 $307–$611 $307–$611 varies
Radex foot complete minimum 3 views (73630)
range across 3 matching MRF lines		 $382–$559 $382–$559 varies
Radex Hand Minimum 3 Views (73130)
range across 3 matching MRF lines		 $388–$777 $388–$777 varies
Radex lower extremity infant minimum 2 views (73592) $408 $408 4.8×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $472 $472 4.6×
Radex Nasal Bones Complete Minimum 3 Views (70160) $505 $505 6.0×
Radex Ribs Unilateral 2 Views (71100) $387 $387 4.6×
Radex shoulder complete minimum 2 views (73030)
range across 3 matching MRF lines		 $367–$736 $367–$736 varies
Radex Sinuses Paransl < 3 Views (70210) $392 $392 4.6×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $1,723 $1,723 10.1×
Radex Spine 1 View Specify Level (72020) $467 $467 5.5×
Radex Sternum Minimum 2 Views (71120) $579 $579 6.8×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $456 $456 5.4×
Radex Toe Minimum 2 Views (73660) $307 $307 3.6×
Radex upper extremity infant minimum 2 views (73092) $529 $529 5.2×
Radex Wrist Complete Minimum 3 Views (73110) $388 $388 4.6×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $1,302 $1,302 12.8×
Radiation Delivery Stereotactic Cranial Linear (77372) $26,497 $26,497 3.7×
Radiation treatment delivery level 1 (77402) $1,752 $1,752 17.7×
Radiation treatment delivery level 2 (77407) $2,650 $2,650 7.1×
Radiation treatment delivery level 3 (77412) $3,614 $3,614 6.7×
Radiolog exam mandible compl minimum 4 views (70110) $541 $541 5.3×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $506 $506 5.0×
Radiologic exam colon double contrast study (74280) $1,931 $1,931 11.3×
Radiologic exam colon single contrast study (74270) $1,642 $1,642 9.6×
Radiologic Exam Esophagus Double Contrast Study (74221) $645 $645 3.8×
Radiologic exam knee complete 4/more views (73564)
range across 3 matching MRF lines		 $537–$1,078 $537–$1,078 varies
Radiologic exam pelvis compl minimum 3 views (72190) $732 $732 7.2×
Radiologic Exam Small Int Single Contrast Study (74250) $1,111 $1,111 6.5×
Radiologic exam swallow function contrast study (74230) $821 $821 4.8×
Radiologic exam upr gi trc double contrast study (74246) $1,492 $1,492 8.8×
Radiologic examination femur 1 view (73551) $377 $377 4.5×
Radiologic examination femur minimum 2 views (73552) $426 $426 5.0×
Radiologic examination knee 1/2 views (73560)
range across 3 matching MRF lines		 $339–$680 $339–$680 varies
Radiologic Examination Osseous Survey Limited (77074) $556 $556 5.5×
Radiologic examination tibia & fibula 2 views (73590) $397 $397 4.7×
Ribs bilateral 3 views (71110) $672 $672 6.6×
Rp loclzj tum plnr 1 area single day imaging (78800) $4,351 $4,351 11.2×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $4,351 $4,351 11.2×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $6,049 $6,049 11.5×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $2,931 $2,931 5.6×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $3,884 $3,884 7.4×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $4,052 $4,052 3.2×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $4,293 $4,293 3.1×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $3,603 $3,603 2.9×
Rp Therapy Intravenous Administration (79101) $2,482 $2,482 10.9×
Salivary Gland Function Study (78232) $1,371 $1,371 3.5×
Scapula (73010) $337 $337 3.3×
Screening Digital Breast Tomosynthesis Bi (77063)
range across 2 matching MRF lines		 $250–$376 $250–$376 varies
Sella turcica (70240) $314 $314 3.7×
Shoulder 1 view (73020) $272 $272 3.2×
Shoulder Arthrography (73040) $1,435 $1,435 4.2×
Skull less than 4 views (70250) $779 $779 7.7×
Special dosimetry (77331) $1,004 $1,004 7.7×
Special Physics Consult (77370) $1,278 $1,278 9.8×
Special teletherapy port plan (77321) $2,292 $2,292 6.3×
Special treatment procedure (77470) $3,998 $3,998 7.4×
Stereotactic Body Radiation Delivery (77373) $15,242 $15,242 8.8×
Sternoclavicular joints (71130) $517 $517 6.1×
Surface Applic Low Dose Rate Radionuclide Source (77789) $910 $910 9.2×
Telethx isodose pln cplx w/basic dosimetry (77307) $841 $841 2.3×
Telethx isodose pln smpl w/dosimetry calculation (77306) $764 $764 2.1×
Testicular Imaging W/Flow (78761) $1,588 $1,588 4.1×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $2,666 $2,666 7.3×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $2,129 $2,129 5.9×
Ther rad simulaj-aided field setting simple (77280)
range across 2 matching MRF lines		 $1,405–$1,474 $1,405–$1,474 varies
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $901 $901 5.3×
Thoracic spine 2 views (72070) $633 $633 6.2×
Thoracic spine 3 views (72072) $555 $555 5.5×
Thoracolumbar 2 views (72080) $541 $541 6.4×
Thyroid Imaging With Vascular Flow (78013) $1,245 $1,245 3.2×
Thyroid Met Imaging Body (78018) $3,075 $3,075 5.8×
Thyroid Uptake Measurement (78012) $949 $949 2.4×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,938 $1,938 5.0×
Tx Devices Design & Construction Complex (77334) $1,874 $1,874 5.2×
Tx devices design & construction intermediate (77333) $1,784 $1,784 13.7×
Tx devices design & construction simple (77332) $1,702 $1,702 13.0×
Ultrasound Breast Limited (76642) $638 $638 7.5×
Ultrasound elastography first target lesion (76982) $463 $463 4.6×
Ultrasound Elastography Parenchyma (76981) $463 $463 4.6×
Ultrasound Exam Aaa Screen (76706) $726 $726 7.1×
Ultrasound, abdomen limited (76705) $1,227 $1,227 12.1×
Umbilical-artery Doppler (OB) (76820) $576 $576 5.7×
Unlisted fluoroscopic procedure (76496) $497 $497 5.9×
Unlisted magnetic resonance procedure (76498) $1,761 $1,761 20.8×
Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) $1,279 $1,279 3.3×
Unlisted Procedure Clinical Brachytherapy (77799) $7,879 $7,879 79.5×
Upper gi w/o kub (74240) $1,333 $1,333 7.8×
Ureteral Reflux Study (78740) $1,177 $1,177 3.0×
Urethrocystogram voiding (74455) $1,607 $1,607 6.9×
Urethrocystography retrograde (74450) $1,260 $1,260 5.4×
Us breast unilateral complete (76641)
range across 3 matching MRF lines		 $618–$644 $618–$644 varies
Us chest (76604) $887 $887 8.7×
Us complete joint (76881) $895 $895 8.8×
Us exam, pelvic, limited (76857)
range across 2 matching MRF lines		 $520–$562 $520–$562 varies
Us head (76506) $654 $654 6.4×
Us kidney transplant (76776) $795 $795 7.8×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $579 $579 5.7×
Us ob detailed single fetus (76811) $1,488 $1,488 6.4×
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines		 $609–$704 $609–$704 varies
Us ob transvaginal (76817) $1,034 $1,034 10.2×
Us pelvic non ob complete (76856) $1,276 $1,276 12.6×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $952 $952 9.4×
Us preg uterus real time f/u trnsabdl per fetus (76816) $586 $586 5.8×
Us retroperitoneal complete (76770) $1,196 $1,196 11.8×
Us retroperitoneal limited (76775)
range across 2 matching MRF lines		 $1,020–$1,196 $1,020–$1,196 varies
Us scrotum and contents (76870) $1,140 $1,140 11.2×
Us spinal canal and contents (76800) $986 $986 9.7×
Us thyroid (76536) $1,145 $1,145 11.3×
Us transrectal (76872) $940 $940 9.3×
Vein X-Ray Chest (75827) $3,008 $3,008 2.0×
Vein X-Ray Liver W/O Hemodyn (75887) $8,604 $8,604 2.8×
Venogram Sinus/Jugular (75860) $4,699 $4,699 1.5×
Venography caval inferior serialography rs&i (75825) $4,494 $4,494 1.5×
Venography extremity bilateral rs&i (75822) $2,982 $2,982 1.9×
Venography extremity unilateral rs&i (75820) $2,982 $2,982 1.9×
Venography Renal Bilateral (75833) $10,811 $10,811 3.5×
Venography Renal Unilateral (75831) $4,705 $4,705 1.5×
Wrist 2 views (73100) $357 $357 4.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $326 $326 3.9×
X-ray antegrade pyelogram tube (74425)
range across 3 matching MRF lines		 $893–$989 $893–$989 varies
X-Ray Aorta Leg Arteries (75630) $6,285 $6,285 2.0×
X-Ray Bend Only L-S Spine (72120) $392 $392 3.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $373 $373 4.4×
X-Ray Exam Breast Specimen (76098) $1,093 $1,093 2.1×
X-Ray Exam Entire Spi 1 Vw (72081) $426 $426 5.0×
X-Ray Exam Entire Spi 2/3 Vw (72082) $716 $716 7.0×
X-Ray Exam Entire Spi 4/5 Vw (72083) $1,114 $1,114 11.0×
X-Ray Exam Hip Uni 1 View (73501) $377 $377 4.5×
X-Ray Exam Hip Uni 2-3 Views (73502) $426 $426 5.0×
X-Ray Exam Hip Uni 4/> Views (73503) $484 $484 4.8×
X-Ray Exam Hips Bi 2 Views (73521) $626 $626 6.2×
X-Ray Exam Hips Bi 3-4 Views (73522) $716 $716 7.0×
X-Ray Exam Hips Bi 5/> Views (73523) $1,302 $1,302 12.8×
X-Ray Exam L-S Spine Bending (72114) $779 $779 7.7×
X-Ray Exam Neck Spine 2-3 Vw (72040) $525 $525 6.2×
X-Ray Exam Neck Spine 6/>Vws (72052) $979 $979 9.6×
X-Ray Exam Unilat Ribs/Chest (71101) $424 $424 4.2×
X-ray eye for foreign body (70030) $630 $630 7.4×
X-ray humerus (73060) $363 $363 4.3×
X-ray IV pyelogram (ivp) (74400) $1,833 $1,833 10.8×
X-ray IV pyelogram+tomography (74415) $1,891 $1,891 11.1×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $444 $444 5.3×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $268 $268 3.2×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $747 $747 7.4×
X-ray nose-rectum child f.b. (76010) $231 $231 2.7×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $574 $574 5.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $517 $517 5.1×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $476 $476 5.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $494 $494 5.8×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $609 $609 6.0×
X-ray thoracic spine 4 vw (72074) $647 $647 6.4×
X-Ray Tmj Unilat (70328) $224 $224 2.6×
X-Ray Urinary Tract Exam With Contrast Material (74420) $1,520 $1,520 4.5×
X-Rays Bone Length Studies (77073) $931 $931 9.2×
X-Rays Bone Survey Complete (77075) $1,629 $1,629 16.0×
Xr c-spine 4 or 5 views (72050) $751 $751 7.4×
Xr facial bones less than 3 views (70140) $364 $364 4.3×
XR Mastoids < 3 Views Bilateral (70120) $271 $271 2.7×
Xr orbits complete 4 views (70200) $499 $499 4.9×
Xr Tomogram Single Plane (76100) $609 $609 6.0×

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.