Imaging prices at Central Montana Medical Center
Lewistown, MT · every code in this section with a posted price and a Medicare benchmark.
288 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) range across 2 matching MRF lines |
$493–$4,607 | $580–$5,420 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$28.90–$251.81 | $34–$296.25 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$44.63–$392.91 | $52.50–$462.25 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $884 | $1,040 | 2.2× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$26.99–$235.66 | $31.75–$277.25 | varies |
| Arthrogram hip (73525) | $761.60 | $896 | 2.1× |
| Arthrogram Wrist (73115) | $688.93 | $810.50 | 1.9× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$72.25–$425 | $85–$500 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$30.39–$334.48 | $35.75–$393.50 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$213.99–$1,423.75 | $251.75–$1,675 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$183.18–$1,222.51 | $215.50–$1,438.25 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$232.48–$1,546.58 | $273.50–$1,819.50 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$52.06–$371.45 | $61.25–$437 | varies |
| Cat Scan Follow-Up Study (76380) | $952 | $1,120 | 10.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,473.26 | $1,733.25 | 2.7× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$26.14–$221.43 | $30.75–$260.50 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$34.85–$298.78 | $41–$351.50 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$43.78–$378.68 | $51.50–$445.50 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$24.23–$378.68 | $28.50–$445.50 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$26.99–$235.66 | $31.75–$277.25 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$249.05–$1,662.81 | $293–$1,956.25 | varies |
| Continuing medical physics consltj pr wk (77336) | $429.25 | $505 | 3.1× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$63.75–$453.69 | $75–$533.75 | varies |
| Contrast X-Ray Of Elbow (73085) | $761.60 | $896 | 2.1× |
| Contrast X-Ray Of Knee Joint (73580) | $1,031.05 | $1,213 | 2.9× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$486.20–$3,247 | $572–$3,820 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$220.36–$1,470.71 | $259.25–$1,730.25 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$287.73–$1,918.88 | $338.50–$2,257.50 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$359.13–$2,399.76 | $422.50–$2,823.25 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$231.63–$1,543.18 | $272.50–$1,815.50 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$476.43–$3,179 | $560.50–$3,740 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$277.53–$1,850.88 | $326.50–$2,177.50 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$306.21–$2,045.31 | $360.25–$2,406.25 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$308.98–$2,064.65 | $363.50–$2,429 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$306.21–$2,045.31 | $360.25–$2,406.25 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$289.64–$2,064.65 | $340.75–$2,429 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$266.26–$1,899.96 | $313.25–$2,235.25 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$247.35–$1,646.24 | $291–$1,936.75 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$355.51–$2,378.09 | $418.25–$2,797.75 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$291.34–$1,945.65 | $342.75–$2,289 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$314.08–$2,095.46 | $369.50–$2,465.25 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$209.74–$1,399.74 | $246.75–$1,646.75 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$310.89–$2,074.64 | $365.75–$2,440.75 | varies |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$85.64–$1,562.73 | $100.75–$1,838.50 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$356.36–$2,378.09 | $419.25–$2,797.75 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$210.80–$1,405.05 | $248–$1,653 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$242.25–$1,611.60 | $285–$1,896 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$285.18–$1,899.96 | $335.50–$2,235.25 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$247.35–$1,646.24 | $291–$1,936.75 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$227.16–$1,620.53 | $267.25–$1,906.50 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$209.74–$1,397.61 | $246.75–$1,644.25 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$310.89–$2,074.64 | $365.75–$2,440.75 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$95.20–$1,999.20 | $112–$2,352 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$96.26–$1,347.68 | $113.25–$1,585.50 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$353.60–$2,357.05 | $416–$2,773 | varies |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$251.18–$3,247 | $295.50–$3,820 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$254.15–$1,693.20 | $299–$1,992 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$281.56–$1,879.99 | $331.25–$2,211.75 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$243.10–$1,620.53 | $286–$1,906.50 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$209.74–$1,397.61 | $246.75–$1,644.25 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$92.01–$1,899.96 | $108.25–$2,235.25 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$247.35–$1,646.24 | $291–$1,936.75 | varies |
| CT thoracic spine w/wo cont (72130) | $2,378.09 | $2,797.75 | 13.3× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$249.05–$1,662.81 | $293–$1,956.25 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$210.80–$1,405.05 | $248–$1,653 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$328.95–$2,191.30 | $387–$2,578 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$241.40–$1,611.60 | $284–$1,896 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$321.09–$2,142.64 | $377.75–$2,520.75 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$277.53–$1,850.88 | $326.50–$2,177.50 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$277.53–$1,850.88 | $326.50–$2,177.50 | varies |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$583.10–$4,158.41 | $686–$4,892.25 | varies |
| Diskography lumbar (72295) | $752.04 | $884.75 | 0.4× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$77.14–$507.66 | $90.75–$597.25 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$58.65–$514.25 | $69–$605 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$67.36–$588.84 | $79.25–$692.75 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$33.79–$224.61 | $39.75–$264.25 | varies |
| Echo exam uterus (76831) | $724.20 | $852 | 3.0× |
| Echograp Trans R Pros Study (76873) | $814.73 | $958.50 | 7.6× |
| Esophagram (74220) range across 2 matching MRF lines |
$60.35–$534.23 | $71–$628.50 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$129.54–$406.73 | $152.40–$478.50 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$93.28–$406.73 | $109.74–$478.50 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$70.98–$626.88 | $83.50–$737.50 | varies |
| Foot 2 views (73620) range across 2 matching MRF lines |
$26.14–$221.43 | $30.75–$260.50 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$26.99–$235.66 | $31.75–$277.25 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$135.15–$900.15 | $159–$1,059 | varies |
| Gated Heart Planar Single (78472) | $1,443.94 | $1,698.75 | 3.5× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$26.14–$221.43 | $30.75–$260.50 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$216.54–$1,445.43 | $254.75–$1,700.50 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$188.06–$1,254.39 | $221.25–$1,475.75 | varies |
| Ht Muscle Image Spect Sing (78451) | $2,437.59 | $2,867.75 | 1.8× |
| Hysterosalpingogram (74740) | $858.71 | $1,010.25 | 3.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $688.08 | $809.50 | 7.7× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$49.30–$436.90 | $58–$514 | varies |
| K Flow/Funct Image Multiple (78709) | $1,435.86 | $1,689.25 | 2.6× |
| K Flow/Funct Image W/Drug (78708) | $1,199.56 | $1,411.25 | 2.2× |
| K Flow/Funct Image W/O Drug (78707) | $1,159.40 | $1,364 | 2.1× |
| Kidney Imaging Morphol (78700) | $1,156.43 | $1,360.50 | 2.8× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$32.51–$289.43 | $38.25–$340.50 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,065.05 | $1,253 | 2.6× |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$294.31–$1,960.95 | $346.25–$2,307 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$294.95–$1,135.18 | $347–$1,335.50 | varies |
| Lung Ventilation Imaging (78579) | $1,092.46 | $1,285.25 | 2.7× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$125.38–$833.43 | $147.50–$980.50 | varies |
| Meckels Divert Exam (78290) | $884 | $1,040 | 2.2× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$493–$1,377 | $580–$1,620 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$327.68–$2,188.11 | $385.50–$2,574.25 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$268.18–$1,791.16 | $315.50–$2,107.25 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$298.56–$1,989.85 | $351.25–$2,341 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$297.93–$1,989.85 | $350.50–$2,341 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$307.06–$2,188.11 | $361.25–$2,574.25 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$268.81–$1,791.16 | $316.25–$2,107.25 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$333.84–$2,220.63 | $392.75–$2,612.50 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$296.01–$1,978.59 | $348.25–$2,327.75 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$333.20–$2,220.63 | $392–$2,612.50 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$376.76–$2,513.45 | $443.25–$2,957 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$311.31–$2,220.63 | $366.25–$2,612.50 | varies |
| MRI cardiac w/o contrast (75557) | $1,998.35 | $2,351 | 8.2× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$332.99–$2,220.63 | $391.75–$2,612.50 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$296.01–$1,978.59 | $348.25–$2,327.75 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$299.20–$1,998.35 | $352–$2,351 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$333.20–$2,220.63 | $392–$2,612.50 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$365.50–$2,442.05 | $430–$2,873 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,220.63 | $2,612.50 | 6.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$365.50–$2,513.45 | $430–$2,957 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$299.63–$1,998.35 | $352.50–$2,351 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$332.14–$2,220.63 | $390.75–$2,612.50 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$379.53–$2,533.43 | $446.50–$2,980.50 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$294.95–$1,978.59 | $347–$2,327.75 | varies |
| MRI orbit face neck w contrast (70542) | $2,220.63 | $2,612.50 | 6.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$379.53–$2,533.43 | $446.50–$2,980.50 | varies |
| MRI pelvis w contrast (72196) | $2,220.63 | $2,612.50 | 6.2× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$365.50–$2,442.05 | $430–$2,873 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$296.01–$1,978.59 | $348.25–$2,327.75 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$296.01–$1,978.59 | $348.25–$2,327.75 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,220.63 | $2,612.50 | 6.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$299.63–$1,998.35 | $352.50–$2,351 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$365.50–$2,442.05 | $430–$2,873 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$365.50–$2,442.05 | $430–$2,873 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$379.53–$2,533.43 | $446.50–$2,980.50 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$332.99–$2,220.63 | $391.75–$2,612.50 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$299.63–$1,998.35 | $352.50–$2,351 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$365.50–$2,442.05 | $430–$2,873 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$379.53–$2,533.43 | $446.50–$2,980.50 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$591.39–$3,948.89 | $695.75–$4,645.75 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$26.14–$221.43 | $30.75–$260.50 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$918–$5,185 | $1,080–$6,100 | varies |
| Nuclear Rx Oral Admin (79005) | $836.40 | $984 | 3.5× |
| Ob us nuchal meas 1 gest (76813) | $593.51 | $698.25 | 5.6× |
| Optic foramina (70190) | $303.45 | $357 | 3.4× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$120.28–$802.61 | $141.50–$944.25 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$122.61–$874.65 | $144.25–$1,029 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$30.60–$271.79 | $36–$319.75 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $978.35 | $1,151 | 2.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$46.54–$408.43 | $54.75–$480.50 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$121.55–$436.90 | $143–$514 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$32.51–$282.63 | $38.25–$332.50 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$26.99–$235.66 | $31.75–$277.25 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$30.60–$267.11 | $36–$314.25 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$46.54–$408.43 | $54.75–$480.50 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$23.80–$205.06 | $28–$241.25 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$29.75–$260.95 | $35–$307 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$32.51–$283.69 | $38.25–$333.75 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$31.24–$222.06 | $36.75–$261.25 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$35.91–$314.29 | $42.25–$369.75 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$37.61–$328.74 | $44.25–$386.75 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$31.66–$280.50 | $37.25–$330 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $271.79 | $319.75 | 3.1× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$23.80–$211.23 | $28–$248.50 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$35.91–$314.29 | $42.25–$369.75 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $394.19 | $463.75 | 4.4× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$28.90–$251.81 | $34–$296.25 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$31.24–$222.06 | $36.75–$261.25 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$31.66–$275.19 | $37.25–$323.75 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $724.20 | $852 | 6.8× |
| Radiation treatment delivery level 1 (77402) | $595 | $700 | 5.7× |
| Radiation treatment delivery level 2 (77407) | $680 | $800 | 1.7× |
| Radiation treatment delivery level 3 (77412) | $765 | $900 | 1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$51.64–$449.86 | $60.75–$529.25 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$114.11–$1,017.88 | $134.25–$1,197.50 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$78.63–$546.13 | $92.50–$642.50 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$60.35–$534.23 | $71–$628.50 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$38.68–$341.91 | $45.50–$402.25 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$35.91–$312.16 | $42.25–$367.25 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$58.65–$517.65 | $69–$609 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$92.01–$811.96 | $108.25–$955.25 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 4 matching MRF lines |
$86.70–$1,115.41 | $102–$1,312.25 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$34–$157.25 | $40–$185 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$32.51–$283.69 | $38.25–$333.75 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$32.51–$283.69 | $38.25–$333.75 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$30.60–$267.11 | $36–$314.25 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $499.16 | $587.25 | 0.9× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$65.03–$573.33 | $76.50–$674.50 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,016.18 | $1,195.50 | 2.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,785.85 | $2,101 | 4.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,785.85 | $2,101 | 3.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$268.60–$1,794.35 | $316–$2,111 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$31.66–$275.19 | $37.25–$323.75 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$22.74–$69.70 | $26.75–$82 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$26.14–$221.43 | $30.75–$260.50 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$85.85–$761.60 | $101–$896 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$32.51–$283.69 | $38.25–$333.75 | varies |
| Special Physics Consult (77370) | $469.20 | $552 | 3.4× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$110.50–$212.50 | $130–$250 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$233.75–$1,020 | $275–$1,200 | varies |
| Stereotactic Body Radiation Delivery (77373) | $5,780 | $6,800 | 3.2× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$42.71–$303.45 | $50.25–$357 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$335.75–$569.50 | $395–$670 | varies |
| Testicular Imaging W/Flow (78761) | $1,156.43 | $1,360.50 | 2.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$182.75–$1,530 | $215–$1,800 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$81.60–$754.80 | $96–$888 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $904.83 | $1,064.50 | 5.0× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$35.91–$314.29 | $42.25–$369.75 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$44.63–$392.91 | $52.50–$462.25 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$30.60–$271.79 | $36–$319.75 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$123.04–$816.43 | $144.75–$960.50 | varies |
| Thyroid Met Imaging Body (78018) | $1,375.30 | $1,618 | 2.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$37.19–$404.39 | $43.75–$475.75 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$131.75–$845.75 | $155–$995 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$55.25–$658.75 | $65–$775 | varies |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$79.05–$520.84 | $93–$612.75 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$83.94–$553.56 | $98.75–$651.25 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$83.94–$553.56 | $98.75–$651.25 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$77.14–$507.66 | $90.75–$597.25 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $63.75 | $75 | 0.7× |
| Upper gi w/o kub (74240) range across 5 matching MRF lines |
$72.89–$911.41 | $85.75–$1,072.25 | varies |
| Urethrocystogram voiding (74455) | $720.59 | $847.75 | 3.0× |
| Urethrocystography retrograde (74450) | $668.74 | $786.75 | 2.7× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$102.43–$729.30 | $120.50–$858 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$47.39–$310.89 | $55.75–$365.75 | varies |
| Us complete joint (76881) | $852.76 | $1,003.25 | 8.0× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$51.64–$341.49 | $60.75–$401.75 | varies |
| Us head (76506) | $335.54 | $394.75 | 3.1× |
| Us kidney transplant (76776) | $252.88 | $297.50 | 2.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$77.14–$512.34 | $90.75–$602.75 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$231.51–$847.88 | $272.37–$997.50 | varies |
| Us ob limited 1 or more fetuses (76815) range across 5 matching MRF lines |
$63.11–$432.65 | $74.25–$509 | varies |
| Us ob transvaginal (76817) range across 5 matching MRF lines |
$83.09–$566.10 | $97.75–$666 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$99.88–$658.33 | $117.50–$774.50 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$89.68–$593.51 | $105.50–$698.25 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$47.39–$312.59 | $55.75–$367.75 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$107.53–$711.88 | $126.50–$837.50 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$83.94–$553.56 | $98.75–$651.25 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$92.86–$613.49 | $109.25–$721.75 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$90.95–$241.83 | $107–$284.50 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$79.90–$527.64 | $94–$620.75 | varies |
| Us transrectal (76872) | $844.69 | $993.75 | 7.9× |
| Vein X-Ray Chest (75827) | $1,133.69 | $1,333.75 | 0.7× |
| Venography extremity bilateral rs&i (75822) | $1,297.53 | $1,526.50 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $942.01 | $1,108.25 | 0.6× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$58.65–$385.69 | $69–$453.75 | varies |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$26.99–$235.66 | $31.75–$277.25 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$35.91–$314.29 | $42.25–$369.75 | varies |
| X-ray antegrade pyelogram tube (74425) | $626.88 | $737.50 | 1.8× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$44.63–$392.91 | $52.50–$462.25 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$32.51–$283.69 | $38.25–$333.75 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$156.61–$1,117.11 | $184.25–$1,314.25 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$35.91–$314.29 | $42.25–$369.75 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$63.11–$555.69 | $74.25–$653.75 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $555.69 | $653.75 | 5.2× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$23.80–$204.21 | $28–$240.25 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$53.34–$471.11 | $62.75–$554.25 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $547.40 | $644 | 5.1× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$70.98–$627.73 | $83.50–$738.50 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$88.83–$784.34 | $104.50–$922.75 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$106.25–$940.53 | $125–$1,106.50 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$82.45–$686.59 | $97–$807.75 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$35.91–$314.29 | $42.25–$369.75 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$70.98–$626.88 | $83.50–$737.50 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$54.19–$481.10 | $63.75–$566 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$14.03–$348.93 | $16.50–$410.50 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$32.51–$283.69 | $38.25–$333.75 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$42.71–$303.45 | $50.25–$357 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$24.65–$216.75 | $29–$255 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$35.91–$314.29 | $42.25–$369.75 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$26.99–$235.66 | $31.75–$277.25 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$47.39–$414.59 | $55.75–$487.75 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$34.85–$301.33 | $41–$354.50 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$26.99–$230.56 | $31.75–$271.25 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$34–$294.53 | $40–$346.50 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$38.68–$343.19 | $45.50–$403.75 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$59.50–$523.39 | $70–$615.75 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$26.35–$187.85 | $31–$221 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $867.43 | $1,020.50 | 2.4× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$51.64–$449.86 | $60.75–$529.25 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$65.03–$609.24 | $76.50–$716.75 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$55.46–$485.99 | $65.25–$571.75 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$27.84–$244.38 | $32.75–$287.50 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$47.39–$416.50 | $55.75–$490 | 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.