Imaging prices at CentraCare - St. Cloud Hospital
Saint Cloud, MN · every code in this section with a posted price and a Medicare benchmark.
274 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) | $2,986.42 | $5,149 | 2.1× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$146.16–$417.60 | $252–$720 | varies |
| Abdomen 2 views (74019) | $168.20 | $290 | 1.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $803.88 | $1,386 | 1.9× |
| Angio pulmonary bilat (75743) | $3,948.64 | $6,808 | 1.2× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$3,948.64–$5,073.26 | $6,808–$8,747 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$817.80–$7,073.68 | $1,410–$12,196 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,433.60 | $5,920 | 1.1× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$144.42–$288.84 | $249–$498 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$4,884.18–$4,933.48 | $8,421–$8,506 | varies |
| Artery X-Rays Abdomen (75726) | $7,848.56 | $13,532 | 1.4× |
| Artery X-Rays Pelvis (75736) | $8,152.48 | $14,056 | 1.4× |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$11,718.90–$80,480.80 | $20,205–$138,760 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$3,375.60–$6,751.20 | $5,820–$11,640 | varies |
| Bone age studies (77072) | $127.89 | $220.50 | 1.2× |
| Bone Imaging 3 Phase (78315) | $969.76 | $1,672 | 2.3× |
| Bone Imaging Limited Area (78300) | $666.42 | $1,149 | 1.6× |
| Bone Imaging Whole Body (78306) | $841.58 | $1,451 | 2.0× |
| Bone survey infant (77076) | $252.30 | $435 | 2.3× |
| Brain Image W/Flow < 4 Views (78601) | $785.32 | $1,354 | 1.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,318.92 | $2,274 | 3.7× |
| Cat Scan Follow-Up Study (76380) | $880.44 | $1,518 | 9.8× |
| Chest 1 view (71045) range across 5 matching MRF lines |
$163.56–$841 | $282–$1,450 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$167.62–$337.56 | $289–$582 | varies |
| Chest 3 views (71047) | $178.06 | $307 | 2.0× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$144.42–$288.84 | $249–$498 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $537.08 | $926 | 5.0× |
| Continuing medical physics consltj pr wk (77336) | $368.30 | $635 | 2.6× |
| Contrast Exam Abdominl Aorta (75625) | $3,790.88 | $6,536 | 1.2× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$457.04–$904.80 | $788–$1,560 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $1,686.06 | $2,907 | 4.7× |
| CT abdomen and pelvis without contrast (74176) | $1,246.42 | $2,149 | 5.0× |
| CT abdomen w contrast (74160) | $867.68 | $1,496 | 4.8× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$979.04–$1,020.80 | $1,688–$1,760 | varies |
| CT abdomen w/o contrast (74150) | $752.84 | $1,298 | 7.0× |
| CT Angio Abdomen and Pelvis (74174) | $1,520.18 | $2,621 | 4.2× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$966.28–$1,932.56 | $1,666–$3,332 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,123.46–$2,246.92 | $1,937–$3,874 | varies |
| CT angio hrt w/3d image (75574) range across 3 matching MRF lines |
$1,407.66–$1,592.10 | $2,427–$2,745 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,027.76 | $1,772 | 5.7× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,123.46–$2,246.92 | $1,937–$3,874 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,003.40 | $1,730 | 5.5× |
| CT cervical spine w/ contrast (72126) | $944.82 | $1,629 | 2.6× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$821.28–$1,642.56 | $1,416–$2,832 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$932.64–$1,865.28 | $1,608–$3,216 | varies |
| CT chest w/wo contrast (71270) | $1,072.42 | $1,849 | 5.9× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $571.88 | $986 | 5.3× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$864.49–$890.45 | $1,490.50–$1,535.25 | varies |
| CT head/brain without and with contrast (70470) | $1,006.59 | $1,735.50 | 5.5× |
| CT heart contrast eval cardiac structure&morph (75572) | $951.20 | $1,640 | 2.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $49 | $84.48 | 0.5× |
| CT iac w contrast (70481) | $850.43 | $1,466.25 | 4.7× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$743.56–$1,487.12 | $1,282–$2,564 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$855.21–$1,710.42 | $1,474.50–$2,949 | varies |
| CT lumbar spine w contrast (72132) | $961.64 | $1,658 | 2.7× |
| CT lumbar spine w/o contrast (72131) | $836.36 | $1,442 | 7.7× |
| CT maxillofacial w contrast (70487) | $895.11 | $1,543.30 | 4.9× |
| CT maxillofacial wo contrast (70486) | $778.36 | $1,342 | 7.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $933.51 | $1,609.50 | 5.1× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$718.04–$739.50 | $1,238–$1,275 | varies |
| CT pelvis w&w/o contrast (72194) | $923.94 | $1,593 | 5.1× |
| CT pelvis w/o contrast (72192) | $731.96 | $1,262 | 6.8× |
| CT soft tissue neck w contrast (70491) | $796.34 | $1,373 | 4.4× |
| CT soft tissue neck w/o contrast (70490) | $676.86 | $1,167 | 6.3× |
| CT thoracic spine w contrast (72129) | $961.64 | $1,658 | 5.3× |
| CT thoracic spine w/o contrast (72128) | $836.36 | $1,442 | 7.7× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$789.96–$794.02 | $1,362–$1,369 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$758.64–$1,517.28 | $1,308–$2,616 | varies |
| CT upper extremity with contrast (73201) | $872.32 | $1,504 | 2.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,218 | $2,100 | 6.7× |
| Cta Abdomen (74175) | $1,038.20 | $1,790 | 5.7× |
| Dilation ureters/urethra rs&i (74485) | $1,818.88 | $3,136 | 0.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 3 matching MRF lines |
$204.74–$429.20 | $353–$740 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 3 matching MRF lines |
$208.80–$429.20 | $360–$740 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$208.80–$417.60 | $360–$720 | varies |
| Echo exam of fetal heart (76825) | $972.08 | $1,676 | 1.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $472.12 | $814 | 1.9× |
| Esophagram (74220) | $311.46 | $537 | 1.7× |
| Fetal Biophys Profile W/Nst (76818) | $777.20 | $1,340 | 7.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$716.88–$2,150.64 | $1,236–$3,708 | varies |
| Fluoroscopy up to 1 hr (76000) | $387.44 | $668 | 1.6× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$138.04–$276.08 | $238–$476 | varies |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$147.90–$610.16 | $255–$1,052 | varies |
| Gastric emptying imaging study (78264) | $1,005.72 | $1,734 | 2.4× |
| Gated Heart Planar Single (78472) | $908.28 | $1,566 | 2.2× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$138.04–$276.08 | $238–$476 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,881.44 | $4,968 | 0.9× |
| Hepatobil Syst Image W/Drug (78227) | $1,056.18 | $1,821 | 1.9× |
| Hepatobiliary System Imaging (78226) | $988.90 | $1,705 | 2.4× |
| Ht Muscle Image Spect Sing (78451) | $1,502.20 | $2,590 | 1.1× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$206.77–$366.56 | $356.50–$632 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $257.52 | $444 | 2.9× |
| Infant hip ultrasound, limited static exam (76886) | $257.52 | $444 | 2.9× |
| Joint Survey Single View (77077) range across 3 matching MRF lines |
$122.96–$284.20 | $212–$490 | varies |
| K Flow/Funct Image W/Drug (78708) | $1,003.40 | $1,730 | 1.8× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$200.10–$577.10 | $345–$995 | varies |
| Lung perfusion differential (78597) | $666.42 | $1,149 | 1.6× |
| Lung Ventilat&Perfus Imaging (78582) | $1,013.84 | $1,748 | 1.8× |
| Lymph System Imaging (78195) | $883.92 | $1,524 | 1.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,948.64 | $6,808 | 1.2× |
| Magnetic Image Jaw Joint (70336) | $1,085.18 | $1,871 | 4.4× |
| Mlc imrt design & construction per imrt plan (77338) | $713.40 | $1,230 | 1.8× |
| Mra Head W/O & W/Contrast Material (70546) | $1,668.08 | $2,876 | 4.6× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,282.96–$2,565.92 | $2,212–$4,424 | varies |
| MRA neck w contrast (70548) | $1,316.75 | $2,270.25 | 3.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,549.18 | $2,671 | 4.3× |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$1,084.46–$1,157.10 | $1,869.75–$1,995 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,347.34–$2,694.68 | $2,323–$4,646 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $1,534.10 | $2,645 | 1.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,734.20–$3,468.40 | $2,990–$5,980 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,562.52 | $2,694 | 1.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,010.94 | $1,743 | 4.1× |
| MRI cardiac w/o contrast (75557) | $989.48 | $1,706 | 4.0× |
| MRI cervical spine w contrast (72142) | $1,566.58 | $2,701 | 4.3× |
| MRI cervical spine w/o cont (72141) | $1,362.42 | $2,349 | 5.5× |
| MRI chest w/o contrast (71550) | $1,130.42 | $1,949 | 4.6× |
| MRI chest wo w contrast (71552) | $1,513.80 | $2,610 | 4.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,782.92–$3,565.84 | $3,074–$6,148 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$1,248.16–$2,496.32 | $2,152–$4,304 | varies |
| Mri Neck Spine W/O & W/Dye (72156) | $1,771.32 | $3,054 | 4.9× |
| MRI orbit face &/neck w/o contrast (70540) | $1,160.58 | $2,001 | 4.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,657.64 | $2,858 | 4.6× |
| MRI pelvis w/o & w contrast (72197) | $1,771.90 | $3,055 | 4.9× |
| MRI pelvis w/o contrast (72195) | $1,323.56 | $2,282 | 5.4× |
| MRI spectroscopy (76390) | $860.14 | $1,483 | 9.5× |
| MRI thoracic spine w/o contrast (72146) | $1,362.42 | $2,349 | 5.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,231.34–$2,462.68 | $2,123–$4,246 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,758.56–$3,517.12 | $3,032–$6,064 | varies |
| MRI, abdomen, combo (74183) | $1,796.26 | $3,097 | 5.0× |
| MRI, dorsal spine combo (72157) | $1,771.32 | $3,054 | 4.9× |
| MRI, dorsal spine contrast (72147) | $1,566.58 | $2,701 | 4.3× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,358.94–$2,717.88 | $2,343–$4,686 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,766.68–$3,533.36 | $3,046–$6,092 | varies |
| MRI, lumbar spine combo (72158) | $1,771.32 | $3,054 | 4.9× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$1,502.20–$4,292 | $2,590–$7,400 | varies |
| Neck soft tissue (70360) | $129.34 | $223 | 1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,777.54 | $6,513 | 2.6× |
| Nuclear Rx Intra-Arterial (79445) | $658.88 | $1,136 | 2.7× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$471.54–$486.04 | $813–$838 | varies |
| Ob us nuchal meas 1 gest (76813) | $187.92 | $324 | 1.7× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $175.74 | $303 | 2.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $215.18 | $371 | 2.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,251.06 | $2,157 | 2.2× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$164.14–$328.28 | $283–$566 | varies |
| PET image w/CT, full body (78816) | $3,415.62 | $5,889 | 2.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$3,391.26–$8,750.46 | $5,847–$15,087 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $666.42 | $1,149 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $241.28 | $416 | 2.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $375.84 | $648 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$165.88–$508.08 | $286–$876 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$133.40–$280.72 | $230–$484 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$164.72–$342.20 | $284–$590 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $192.56 | $332 | 1.8× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$128.18–$269.12 | $221–$464 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$161.82–$323.64 | $279–$558 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$154.86–$2,025.36 | $267–$3,492 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $173.42 | $299 | 1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $161.24 | $278 | 1.8× |
| Radex Ribs Unilateral 2 Views (71100) | $151.96 | $262 | 1.7× |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$171.68–$581.45 | $296–$1,002.50 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $110.20 | $190 | 1.2× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$143.84–$287.68 | $248–$496 | varies |
| Radex Sternum Minimum 2 Views (71120) | $140.36 | $242 | 1.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$146.74–$151.38 | $253–$261 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$133.40–$266.80 | $230–$460 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $178.64 | $308 | 1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$168.20–$672.80 | $290–$1,160 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $251.49 | $433.60 | 2.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,754.60 | $13,370 | 1.0× |
| Radiation treatment delivery level 1 (77402) | $436.16 | $752 | 4.1× |
| Radiation treatment delivery level 2 (77407) | $1,368.22 | $2,359 | 3.4× |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$1,442.46–$2,884.92 | $2,487–$4,974 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $190.82 | $329 | 1.8× |
| Radiologic exam colon single contrast study (74270) | $399.62 | $689 | 2.2× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$45.24–$806.20 | $78–$1,390 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$196.62–$393.24 | $339–$678 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$287.68–$330.60 | $496–$570 | varies |
| Radiologic exam swallow function contrast study (74230) | $331.18 | $571 | 1.8× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$146.45–$292.90 | $252.50–$505 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$167.04–$344.52 | $288–$594 | varies |
| Radiologic examination knee 1/2 views (73560) range across 7 matching MRF lines |
$144.42–$696 | $249–$1,200 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$173.42–$672.80 | $299–$1,160 | varies |
| Renal Cyst Study (74470) | $557.96 | $962 | 1.0× |
| Ribs bilateral 3 views (71110) | $231.42 | $399 | 2.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,006.80 | $3,460 | 3.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,314.20 | $3,990 | 1.7× |
| Rp Therapy Intravenous Administration (79101) | $560.28 | $966 | 2.3× |
| Scapula (73010) | $155.44 | $268 | 1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$107.30–$145 | $185–$250 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$149.06–$150.37 | $257–$259.25 | varies |
| Skull less than 4 views (70250) | $171.68 | $296 | 1.6× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$412.38–$434.42 | $711–$749 | varies |
| Special teletherapy port plan (77321) | $1,345.60 | $2,320 | 3.5× |
| Special treatment procedure (77470) | $1,246.42 | $2,149 | 2.2× |
| Stereotactic Body Radiation Delivery (77373) | $3,761.88 | $6,486 | 2.0× |
| Sternoclavicular joints (71130) | $161.82 | $279 | 1.8× |
| Superior sagittal sinus venogram (75870) | $1,800.32 | $3,104 | 0.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $926.26 | $1,597 | 2.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,100.26 | $1,897 | 2.8× |
| Ther rad simulaj-aided field setting simple (77280) | $785.90 | $1,355 | 5.6× |
| Thoracic spine 2 views (72070) | $169.65 | $292.50 | 1.6× |
| Thoracic spine 3 views (72072) | $199.52 | $344 | 1.8× |
| Thoracolumbar 2 views (72080) | $149.64 | $258 | 1.7× |
| Thyroid Met Imaging Body (78018) | $934.96 | $1,612 | 1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $741.24 | $1,278 | 1.8× |
| Tx Devices Design & Construction Complex (77334) range across 3 matching MRF lines |
$1,308.48–$7,196.64 | $2,256–$12,408 | varies |
| Tx devices design & construction simple (77332) | $458.20 | $790 | 3.3× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$237.22–$489.52 | $409–$844 | varies |
| Ultrasound Exam Aaa Screen (76706) | $260.42 | $449 | 2.4× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $362.50 | $625 | 1.0× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$324.22–$648.44 | $559–$1,118 | varies |
| Umbilical-artery Doppler (OB) (76820) | $208.80 | $360 | 1.9× |
| Unlisted Dx Radiographic Procedure (76499) | $176.32 | $304 | 2.0× |
| Unlisted magnetic resonance procedure (76498) | $1,159.42 | $1,999 | 12.9× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$112.52–$225.04 | $194–$388 | varies |
| Upper gi w/o kub (74240) | $357.86 | $617 | 2.0× |
| Urethrocystogram voiding (74455) | $457.04 | $788 | 1.9× |
| Urethrocystography retrograde (74450) | $457.04 | $788 | 1.9× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$284.20–$568.40 | $490–$980 | varies |
| Us chest (76604) | $265.06 | $457 | 2.4× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$236.06–$243.60 | $407–$420 | varies |
| Us head (76506) | $380.48 | $656 | 3.5× |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$385.70–$397.30 | $665–$685 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$263.90–$527.80 | $455–$910 | varies |
| Us ob detailed single fetus (76811) | $997.60 | $1,720 | 4.0× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$300.44–$600.88 | $518–$1,036 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$297.54–$595.08 | $513–$1,026 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$330.60–$340.46 | $570–$587 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$314.94–$334.95 | $543–$577.50 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$325.96–$651.92 | $562–$1,124 | varies |
| Us retroperitoneal complete (76770) | $321.90 | $555 | 3.0× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$266.22–$532.44 | $459–$918 | varies |
| Us scrotum and contents (76870) | $318.42 | $549 | 2.9× |
| Us spinal canal and contents (76800) | $279.56 | $482 | 2.6× |
| Us thyroid (76536) range across 2 matching MRF lines |
$289.42–$578.84 | $499–$998 | varies |
| Vein X-Ray Chest (75827) | $1,648.36 | $2,842 | 1.0× |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$2,070.60–$4,141.20 | $3,570–$7,140 | varies |
| Venography caval inferior serialography rs&i (75825) | $3,296.72 | $5,684 | 1.0× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$1,542.22–$1,588.62 | $2,659–$2,739 | varies |
| Venography extremity unilateral rs&i (75820) | $1,201.18 | $2,071 | 0.7× |
| Venography Renal Bilateral (75833) | $2,908.12 | $5,014 | 0.9× |
| Venography Renal Unilateral (75831) | $2,418.60 | $4,170 | 0.7× |
| Venous sampling by catheter (75893) | $7,727.92 | $13,324 | 1.3× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$146.16–$438.48 | $252–$756 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $158.34 | $273 | 1.8× |
| X-ray antegrade pyelogram tube (74425) range across 5 matching MRF lines |
$435–$1,371.12 | $750–$2,364 | varies |
| X-Ray Aorta Leg Arteries (75630) | $4,048.40 | $6,980 | 1.2× |
| X-Ray Bend Only L-S Spine (72120) | $176.90 | $305 | 1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$145.58–$291.16 | $251–$502 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$305.66–$1,222.64 | $527–$2,108 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$168.78–$181.54 | $291–$313 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $213.44 | $368 | 2.0× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$146.16–$292.32 | $252–$504 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$171.68–$686.72 | $296–$1,184 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $197.20 | $340 | 1.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $193.72 | $334 | 1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$227.65–$455.30 | $392.50–$785 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $261.58 | $451 | 2.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$165.30–$330.60 | $285–$570 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $268.54 | $463 | 2.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $211.12 | $364 | 2.0× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$166.46–$343.36 | $287–$592 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $171.68 | $296 | 1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $182.70 | $315 | 2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $176.90 | $305 | 1.6× |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$131.66–$135.72 | $227–$234 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $254.04 | $438 | 2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $151.38 | $261 | 1.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $128.76 | $222 | 1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $149.06 | $257 | 1.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$457.04–$3,096.62 | $788–$5,339 | varies |
| X-Rays Bone Length Studies (77073) | $229.68 | $396 | 2.1× |
| X-Rays Bone Survey Complete (77075) | $364.24 | $628 | 3.4× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$211.70–$216.92 | $365–$374 | varies |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.