Imaging prices at CHI Health St. Francis
Grand Island, NE · every code in this section with a posted price and a Medicare benchmark.
382 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) | $7,402.14 | $12,546 | 5.2× |
| Abdomen 1 View (74018) | $292.05 | $495 | 3.2× |
| Abdomen 2 views (74019) | $402.97 | $683 | 3.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,124.54 | $1,906 | 2.7× |
| Adrenal Cortex & Medulla Img (78075) | $1,627.22 | $2,758 | 1.2× |
| Angio pulmonary bilat (75743) | $1,641.38 | $2,782 | 0.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,171.79 | $3,681 | 0.7× |
| Angiography extremity bilateral rs&i (75716) | $4,028.52 | $6,828 | 1.2× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$2,996.02–$3,718.77 | $5,078–$6,303 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,369.39 | $2,321 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,332.22 | $2,258 | 0.4× |
| Ankle 2 views (73600) | $263.73 | $447 | 2.9× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,619.01 | $4,439 | 0.5× |
| Aortography thoracic w/o serialography rs&i (75600) | $3,100.45 | $5,255 | 0.9× |
| Artery X-Rays Abdomen (75726) | $3,237.33 | $5,487 | 0.6× |
| Artery X-Rays Adrenal Gland (75731) | $1,641.38 | $2,782 | 0.5× |
| Artery X-Rays Pelvis (75736) | $2,975.96 | $5,044 | 0.5× |
| Artery X-Rays Spine (75705) | $2,931.12 | $4,968 | 0.5× |
| Arthrogram ankle (73615) | $539.26 | $914 | 1.5× |
| Arthrogram hip (73525) | $1,030.73 | $1,747 | 2.8× |
| Arthrogram Wrist (73115) | $853.73 | $1,447 | 2.4× |
| Basic radiation dosimetry calculation (77300) | $664.34 | $1,126 | 4.8× |
| Bone age studies (77072) | $155.17 | $263 | 1.4× |
| Bone Imaging 3 Phase (78315) | $1,827.82 | $3,098 | 4.4× |
| Bone Imaging Limited Area (78300) | $824.82 | $1,398 | 2.0× |
| Bone Imaging Multiple Areas (78305) | $922.17 | $1,563 | 2.2× |
| Bone Imaging Whole Body (78306) | $1,617.19 | $2,741 | 3.9× |
| Bone survey infant (77076) | $362.85 | $615 | 3.3× |
| Brachytx isodose complex (77318) | $2,251.44 | $3,816 | 5.8× |
| Brachytx Isodose Plan Simple (77316) | $1,500.37 | $2,543 | 3.9× |
| Brain Image W/Flow < 4 Views (78601) | $856.68 | $1,452 | 2.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $788.24 | $1,336 | 1.4× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,103.30 | $1,870 | 2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,142.39 | $7,021 | 2.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $539.85 | $915 | 1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,918.09 | $3,251 | 5.3× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,071.49 | $3,511 | 2.5× |
| Cardiac Shunt Detection (78428) | $489.70 | $830 | 1.2× |
| Cat Scan Follow-Up Study (76380) | $742.81 | $1,259 | 8.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $724.52 | $1,228 | 1.3× |
| Cerebrospinal Fluid Scan (78630) | $1,621.91 | $2,749 | 2.9× |
| Chest 1 view (71045) | $202.37 | $343 | 2.2× |
| Chest 2 views (71046) | $316.83 | $537 | 3.5× |
| Chest 3 views (71047) range across 2 matching MRF lines |
$250.75–$316.83 | $425–$537 | varies |
| Chest 4 or more views (71048) | $472 | $800 | 4.3× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $470.23 | $797 | 4.3× |
| Clavicle complete (73000) | $302.08 | $512 | 3.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,239 | $2,100 | 11.4× |
| Continuing medical physics consltj pr wk (77336) | $1,008.90 | $1,710 | 7.2× |
| Contrast Exam Abdominl Aorta (75625) | $3,275.09 | $5,551 | 1.0× |
| Contrast X-Ray Bladder (74430) | $538.67 | $913 | 1.5× |
| Contrast X-Ray Of Elbow (73085) | $571.12 | $968 | 1.6× |
| Contrast X-Ray Of Knee Joint (73580) | $854.32 | $1,448 | 2.4× |
| CT abdomen and pelvis without and with contrast (74178) | $5,089.34 | $8,626 | 14.0× |
| CT abdomen and pelvis without contrast (74176) | $2,704.56 | $4,584 | 10.9× |
| CT abdomen w contrast (74160) | $2,191.85 | $3,715 | 12.0× |
| CT abdomen w wo contrast (74170) | $2,449.68 | $4,152 | 13.4× |
| CT abdomen w/o contrast (74150) | $1,654.36 | $2,804 | 15.2× |
| CT Angio Abdomen and Pelvis (74174) | $2,614.88 | $4,432 | 7.2× |
| CT Angio Chest (71275) | $2,439.65 | $4,135 | 13.4× |
| CT Angio Head (70496) | $1,967.65 | $3,335 | 10.8× |
| CT angio hrt w/3d image (75574) | $238.36 | $404 | 0.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,040.22 | $3,458 | 11.2× |
| CT Angio Neck (70498) | $2,139.93 | $3,627 | 11.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,044.35 | $3,465 | 11.2× |
| CT bone density (77078) | $251.93 | $427 | 2.8× |
| CT cervical spine w/ contrast (72126) | $1,993.02 | $3,378 | 5.5× |
| CT cervical spine w/o contrast (72125) | $1,581.79 | $2,681 | 14.6× |
| CT cervical spine w/wo cont (72127) | $1,803.63 | $3,057 | 9.9× |
| CT chest w contrast (71260) | $2,211.91 | $3,749 | 12.1× |
| CT chest w/wo contrast (71270) | $1,946.41 | $3,299 | 10.7× |
| CT colonography screening (74263) | $2,793.06 | $4,734 | 11.3× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,643.74 | $2,786 | 9.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,316.29 | $2,231 | 12.1× |
| CT head/brain with contrast (70460) | $1,610.70 | $2,730 | 8.8× |
| CT head/brain without and with contrast (70470) | $1,923.99 | $3,261 | 10.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $214.76 | $364 | 0.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $171.69 | $291 | 1.9× |
| CT hrt w/3d image congen (75573) | $214.76 | $364 | 0.6× |
| CT iac w contrast (70481) | $2,053.79 | $3,481 | 11.3× |
| CT l-spine w&w/o contrast (72133) | $2,011.90 | $3,410 | 11.0× |
| CT lower ext w/o (73700) | $1,422.49 | $2,411 | 13.1× |
| CT lower extremity w/contrast material (73701) | $1,840.80 | $3,120 | 10.1× |
| CT lumbar spine w contrast (72132) | $1,910.42 | $3,238 | 5.3× |
| CT lumbar spine w/o contrast (72131) | $1,639.61 | $2,779 | 15.1× |
| CT maxillofacial w contrast (70487) | $1,746.99 | $2,961 | 9.6× |
| CT maxillofacial wo contrast (70486) | $1,370.57 | $2,323 | 12.6× |
| CT neck tissue combo (70492) | $2,349.97 | $3,983 | 12.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,431.98 | $4,122 | 13.4× |
| CT orbits w/o contrast (70480) | $1,837.85 | $3,115 | 16.9× |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$171.10–$2,193.03 | $290–$3,717 | varies |
| CT pelvis w/o contrast (72192) | $1,452.58 | $2,462 | 13.4× |
| CT scan of leg combo (73702) | $2,050.25 | $3,475 | 11.3× |
| CT scans face/jaw combo (70488) | $1,787.11 | $3,029 | 9.8× |
| CT soft tissue neck w contrast (70491) | $1,917.50 | $3,250 | 10.5× |
| CT soft tissue neck w/o contrast (70490) | $1,466.74 | $2,486 | 13.5× |
| CT thoracic spine w contrast (72129) | $1,920.45 | $3,255 | 10.5× |
| CT thoracic spine w/o contrast (72128) | $1,674.42 | $2,838 | 15.4× |
| CT thoracic spine w/wo cont (72130) | $1,936.97 | $3,283 | 10.6× |
| CT thorax w/o contrast (71250) | $1,172.33 | $1,987 | 10.8× |
| CT upper ext wo (73200) | $1,515.12 | $2,568 | 14.0× |
| CT upper extremity w/o & w/contrast material (73202) | $2,124.59 | $3,601 | 11.7× |
| CT upper extremity with contrast (73201) | $1,767.64 | $2,996 | 4.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,568.27 | $4,353 | 14.1× |
| Cta Abdomen (74175) | $3,111.66 | $5,274 | 17.1× |
| CTA pelvis (72191) | $1,031.32 | $1,748 | 5.7× |
| Dilation ureters/urethra rs&i (74485) | $1,253.75 | $2,125 | 0.6× |
| Diskography lumbar (72295) | $2,091.55 | $3,545 | 1.0× |
| Dxa Bone Density Axial (77080) | $367.57 | $623 | 3.4× |
| Dxa bone density study (77085) | $425.39 | $721 | 3.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$153.25–$227.15 | $259.74–$385 | varies |
| Echo exam uterus (76831) | $247.21 | $419 | 1.0× |
| Echo Guide For Artery Repair (76936) | $929.84 | $1,576 | 4.1× |
| Esophagram (74220) | $658.44 | $1,116 | 3.6× |
| Fetal Biophys Profile W/Nst (76818) | $502.09 | $851 | 4.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $415.36 | $704 | 3.8× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$444.86–$528.05 | $754–$895 | varies |
| Follow-Up Angiography (75898) | $961.70 | $1,630 | 0.3× |
| Foot 2 views (73620) | $213.58 | $362 | 2.4× |
| Forearm 2 views (73090) | $275.53 | $467 | 3.0× |
| Gastric emptying imaging study (78264) | $1,591.82 | $2,698 | 3.8× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $372.88 | $632 | 0.9× |
| Gastroesophageal Reflux Exam (78262) | $613.60 | $1,040 | 1.5× |
| Gated Heart Planar Single (78472) | $1,581.79 | $2,681 | 3.8× |
| Gated Heart, Multiple (78473) | $2,047.30 | $3,470 | 4.9× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $463.15 | $785 | 0.8× |
| Hand 2 views (73120) | $312.70 | $530 | 2.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,299.18 | $2,202 | 1.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,886.28 | $4,892 | 4.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $3,419.64 | $5,796 | 4.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,560.55 | $2,645 | 0.5× |
| Hepatobil Syst Image W/Drug (78227) | $1,604.80 | $2,720 | 2.8× |
| Hepatobiliary System Imaging (78226) | $1,420.13 | $2,407 | 3.4× |
| Ht Musc Image Planar Mult (78454) | $2,080.93 | $3,527 | 1.5× |
| Ht Muscle Image Spect Sing (78451) | $1,657.31 | $2,809 | 1.2× |
| Hysterosalpingogram (74740) | $914.50 | $1,550 | 3.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $415.36 | $704 | 4.6× |
| Infant hip ultrasound, limited static exam (76886) | $415.36 | $704 | 4.6× |
| Interstitial radiation source applic complex (77778) | $3,489.26 | $5,914 | 4.8× |
| K Flow/Funct Image Multiple (78709) | $1,250.21 | $2,119 | 2.2× |
| K Flow/Funct Image W/Drug (78708) | $1,465.56 | $2,484 | 2.6× |
| K Flow/Funct Image W/O Drug (78707) | $1,307.44 | $2,216 | 2.3× |
| Knee 3 Views (73562) | $405.33 | $687 | 4.5× |
| Leveen/Shunt Patency Exam (78291) | $533.36 | $904 | 1.3× |
| Liver & Spleen Imaging Static Only (78215) | $690.30 | $1,170 | 1.7× |
| Liver imaging static only (78201) | $610.65 | $1,035 | 1.1× |
| Liver imaging w/vascular flow (78202) | $849.01 | $1,439 | 1.5× |
| Lung Perf&Ventilat Diferentl (78598) | $1,516.30 | $2,570 | 2.7× |
| Lung perfusion differential (78597) | $801.81 | $1,359 | 1.9× |
| Lung Ventilat&Perfus Imaging (78582) | $1,442.55 | $2,445 | 2.6× |
| Lymph System Imaging (78195) | $1,459.66 | $2,474 | 2.6× |
| Magnetic Image Jaw Joint (70336) | $1,577.07 | $2,673 | 6.4× |
| Meckels Divert Exam (78290) | $824.82 | $1,398 | 2.0× |
| Mlc imrt design & construction per imrt plan (77338) | $3,543.54 | $6,006 | 9.1× |
| Mr safety determination physician/other qhp (76016) | $72.57 | $123 | 0.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $20.06 | $34 | 0.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $76.11 | $129 | 0.8× |
| Mr safety implt pos&/immoblj (76019) | $48.97 | $83 | 0.8× |
| Mr safety med physics xm customization plng&mntr (76017) | $199.42 | $338 | 0.8× |
| Mra Head W/O & W/Contrast Material (70546) | $3,655.64 | $6,196 | 10.1× |
| MRA head w/o contrast (70544) | $2,502.19 | $4,241 | 10.1× |
| MRA head with contrast (70545) | $2,575.94 | $4,366 | 7.1× |
| MRA neck w contrast (70548) | $2,112.20 | $3,580 | 5.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,708.10 | $4,590 | 7.5× |
| MRA neck w/o contrast (70547) | $1,759.97 | $2,983 | 7.1× |
| MRI abdomen w contrast (74182) | $2,570.04 | $4,356 | 7.1× |
| MRI abdomen w/o contrast (74181) | $2,444.37 | $4,143 | 9.9× |
| MRI any jt lower extrem w/contrast material (73722) | $3,168.89 | $5,371 | 3.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,372.44 | $5,716 | 9.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,847.34 | $4,826 | 3.5× |
| MRI brain functional w/o physician admnistration (70554) | $1,696.25 | $2,875 | 6.8× |
| MRI brain functional w/physician admnistration (70555) | $1,852.01 | $3,139 | 7.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,844.39 | $4,821 | 11.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,952.31 | $3,309 | 7.9× |
| MRI cardiac w/o contrast (75557) | $824.23 | $1,397 | 3.3× |
| MRI cervical spine w contrast (72142) | $3,185.41 | $5,399 | 8.8× |
| MRI cervical spine w/o cont (72141) | $2,413.10 | $4,090 | 9.7× |
| MRI chest w/o contrast (71550) | $2,631.40 | $4,460 | 10.6× |
| MRI chest with contrast (71551) | $2,916.37 | $4,943 | 3.6× |
| MRI chest wo w contrast (71552) | $3,170.07 | $5,373 | 8.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,419.59 | $4,101 | 6.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,601.90 | $4,410 | 7.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,263.24 | $3,836 | 9.1× |
| MRI lumbar spine w contrast (72149) | $2,871.53 | $4,867 | 7.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,523.48 | $5,972 | 9.7× |
| MRI orbit face &/neck w/o contrast (70540) | $3,270.96 | $5,544 | 13.2× |
| MRI orbit face neck w contrast (70542) | $3,185.41 | $5,399 | 8.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,594.28 | $6,092 | 9.9× |
| MRI pelvis w contrast (72196) | $3,354.15 | $5,685 | 9.3× |
| MRI pelvis w/o & w contrast (72197) | $3,456.22 | $5,858 | 9.5× |
| MRI pelvis w/o contrast (72195) | $2,944.10 | $4,990 | 11.9× |
| MRI spectroscopy (76390) | $830.13 | $1,407 | 9.2× |
| MRI thoracic spine w/o contrast (72146) | $2,419 | $4,100 | 9.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,279.17 | $3,863 | 6.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,126.95 | $3,605 | 8.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,532.28 | $4,292 | 7.0× |
| MRI, abdomen, combo (74183) | $3,134.08 | $5,312 | 8.7× |
| MRI, dorsal spine combo (72157) | $2,709.28 | $4,592 | 7.5× |
| MRI, dorsal spine contrast (72147) | $2,443.19 | $4,141 | 6.7× |
| MRI, joint upper extrem (73221) | $2,406.61 | $4,079 | 9.7× |
| MRI, joint upper extrem combo (73223) | $3,050.30 | $5,170 | 8.4× |
| MRI, lumbar spine combo (72158) | $3,330.55 | $5,645 | 9.2× |
| Myelogram cervical (72240) | $935.15 | $1,585 | 1.1× |
| Myelogram Lumbar (72265) | $1,120.41 | $1,899 | 1.4× |
| Myelography thoracic (72255) | $900.34 | $1,526 | 1.1× |
| Myelograpy 2/more regions rs&i (72270) | $1,194.16 | $2,024 | 1.5× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,054.92 | $1,788 | 2.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,142.39 | $7,021 | 3.1× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$2,543.49–$3,892.23 | $4,311–$6,597 | varies |
| N-invas est c ffr sw aly CTA (75580) | $1,022.47 | $1,733 | 1.1× |
| Neck soft tissue (70360) | $279.07 | $473 | 3.1× |
| Nm myocard infarct spect (78469) | $333.35 | $565 | 0.6× |
| Nonvascular Shunt X-Ray (75809) | $774.08 | $1,312 | 7.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $8,046.42 | $13,638 | 5.6× |
| Nuclear Rx Intra-Arterial (79445) | $422.44 | $716 | 1.7× |
| Nuclear Rx Oral Admin (79005) | $703.28 | $1,192 | 2.9× |
| Ob us nuchal meas 1 gest (76813) | $343.97 | $583 | 3.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $800.04 | $1,356 | 1.4× |
| Parathyroid Planar Imaging (78070) | $1,049.61 | $1,779 | 2.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,013.03 | $1,717 | 2.4× |
| Pelvis 1 or 2 views (72170) | $294.41 | $499 | 2.7× |
| Peritoneogram Rs&I (74190) | $918.04 | $1,556 | 1.6× |
| Pet Image W/Ct Lmtd (78814) | $4,821.48 | $8,172 | 3.2× |
| PET image w/CT, full body (78816) | $5,280.50 | $8,950 | 3.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$5,395.55–$5,739.52 | $9,145–$9,728 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,211.86 | $2,054 | 2.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $527.46 | $894 | 4.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,097.99 | $1,861 | 1.9× |
| Radex Ankle Complete Minimum 3 Views (73610) | $346.92 | $588 | 3.8× |
| Radex Calcaneus Minimum 2 Views (73650) | $181.13 | $307 | 2.0× |
| Radex elbow complete minimum 3 views (73080) | $369.93 | $627 | 4.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $367.57 | $623 | 3.4× |
| Radex fingr minimum 2 views (73140) | $231.87 | $393 | 2.6× |
| Radex foot complete minimum 3 views (73630) | $350.46 | $594 | 3.9× |
| Radex Hand Minimum 3 Views (73130) | $359.31 | $609 | 4.0× |
| Radex lower extremity infant minimum 2 views (73592) | $127.44 | $216 | 1.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $237.18 | $402 | 2.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $261.96 | $444 | 2.9× |
| Radex Ribs Unilateral 2 Views (71100) | $281.43 | $477 | 3.1× |
| Radex shoulder complete minimum 2 views (73030) | $346.92 | $588 | 3.8× |
| Radex Sinuses Paransl < 3 Views (70210) | $236.59 | $401 | 2.6× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $480.26 | $814 | 2.6× |
| Radex Spine 1 View Specify Level (72020) | $295.59 | $501 | 3.3× |
| Radex Sternum Minimum 2 Views (71120) | $108.56 | $184 | 1.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $1,040.76 | $1,764 | 11.5× |
| Radex Toe Minimum 2 Views (73660) | $259.60 | $440 | 2.9× |
| Radex upper extremity infant minimum 2 views (73092) | $156.35 | $265 | 1.4× |
| Radex Wrist Complete Minimum 3 Views (73110) | $326.86 | $554 | 3.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $234.82 | $398 | 2.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $15,042.64 | $25,496 | 2.0× |
| Radiation treatment delivery level 1 (77402) | $443.68 | $752 | 4.2× |
| Radiation treatment delivery level 2 (77407) | $530.41 | $899 | 1.3× |
| Radiation treatment delivery level 3 (77412) | $1,422.49 | $2,411 | 2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $354.59 | $601 | 3.3× |
| Radiologic exam colon double contrast study (74280) | $1,205.96 | $2,044 | 6.6× |
| Radiologic exam colon single contrast study (74270) | $949.31 | $1,609 | 5.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $658.44 | $1,116 | 3.6× |
| Radiologic exam knee complete 4/more views (73564) | $416.54 | $706 | 3.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $329.81 | $559 | 3.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $592.36 | $1,004 | 3.3× |
| Radiologic exam swallow function contrast study (74230) | $448.40 | $760 | 2.5× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $104.43 | $177 | 0.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $684.99 | $1,161 | 3.8× |
| Radiologic examination femur 1 view (73551) | $139.83 | $237 | 1.5× |
| Radiologic examination femur minimum 2 views (73552) | $233.64 | $396 | 2.6× |
| Radiologic examination knee 1/2 views (73560) | $378.78 | $642 | 4.2× |
| Radiologic Examination Osseous Survey Limited (77074) | $232.46 | $394 | 2.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $317.42 | $538 | 3.5× |
| Renal Cyst Study (74470) | $791.19 | $1,341 | 1.4× |
| Ribs bilateral 3 views (71110) | $430.11 | $729 | 4.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,299.18 | $2,202 | 3.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,329.27 | $2,253 | 3.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,150.55 | $3,645 | 3.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,285.07 | $3,873 | 4.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$1,493.29–$2,103.94 | $2,531–$3,566 | varies |
| Rp Therapy Intravenous Administration (79101) | $569.35 | $965 | 2.3× |
| Scapula (73010) | $317.42 | $538 | 2.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $41.30 | $70 | 1.8× |
| Shoulder 1 view (73020) | $228.92 | $388 | 2.5× |
| Shoulder Arthrography (73040) | $886.77 | $1,503 | 2.4× |
| Sialogram (70390) | $458.43 | $777 | 1.9× |
| Skull less than 4 views (70250) | $323.91 | $549 | 3.0× |
| Special Physics Consult (77370) | $1,298 | $2,200 | 9.3× |
| Special teletherapy port plan (77321) | $1,436.06 | $2,434 | 3.7× |
| Special treatment procedure (77470) | $2,770.64 | $4,696 | 4.8× |
| Stereotactic Body Radiation Delivery (77373) | $10,762.19 | $18,241 | 5.8× |
| Sternoclavicular joints (71130) | $197.06 | $334 | 2.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,535.23 | $4,297 | 6.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,424.26 | $2,414 | 3.7× |
| Temporomandble Jt Arthrography Rs&I (70332) | $445.45 | $755 | 1.8× |
| Testicular Imaging W/Flow (78761) | $880.87 | $1,493 | 2.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,241.41 | $3,799 | 5.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,473.23 | $2,497 | 3.8× |
| Ther rad simulaj-aided field setting simple (77280) | $1,277.35 | $2,165 | 9.2× |
| Thoracic spine 2 views (72070) | $292.05 | $495 | 2.7× |
| Thoracic spine 3 views (72072) | $434.83 | $737 | 4.0× |
| Thoracolumbar 2 views (72080) | $276.12 | $468 | 3.1× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $602.98 | $1,022 | 1.5× |
| Thyroid Imaging With Vascular Flow (78013) | $576.43 | $977 | 1.4× |
| Thyroid Met Imaging Body (78018) | $1,514.53 | $2,567 | 2.7× |
| Thyroid Uptake Measurement (78012) | $315.06 | $534 | 0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $994.15 | $1,685 | 2.4× |
| Tx Devices Design & Construction Complex (77334) | $1,298.59 | $2,201 | 3.3× |
| Tx devices design & construction intermediate (77333) | $623.04 | $1,056 | 4.5× |
| Tx devices design & construction simple (77332) | $545.16 | $924 | 3.9× |
| Ultrasound Breast Limited (76642) | $485.57 | $823 | 5.4× |
| Ultrasound Exam Aaa Screen (76706) | $185.26 | $314 | 1.7× |
| Ultrasound, abdomen limited (76705) | $570.53 | $967 | 5.3× |
| Unlisted Dx Radiographic Procedure (76499) | $36.58 | $62 | 0.4× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$546.34–$677.91 | $926–$1,149 | varies |
| Urethrocystogram voiding (74455) | $785.88 | $1,332 | 3.2× |
| Urethrocystography retrograde (74450) | $770.54 | $1,306 | 3.1× |
| Us breast unilateral complete (76641) | $485.57 | $823 | 4.5× |
| Us chest (76604) | $401.20 | $680 | 3.7× |
| Us complete joint (76881) | $680.27 | $1,153 | 6.3× |
| Us exam, pelvic, limited (76857) | $408.87 | $693 | 3.8× |
| Us head (76506) | $588.23 | $997 | 5.4× |
| Us kidney transplant (76776) | $672.60 | $1,140 | 6.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $198.83 | $337 | 1.8× |
| Us ob detailed single fetus (76811) | $1,053.74 | $1,786 | 4.3× |
| Us ob limited 1 or more fetuses (76815) | $414.18 | $702 | 3.8× |
| Us ob transvaginal (76817) | $637.20 | $1,080 | 5.9× |
| Us pelvic non ob complete (76856) | $786.47 | $1,333 | 7.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $679.68 | $1,152 | 6.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $388.81 | $659 | 3.6× |
| Us retroperitoneal complete (76770) | $793.55 | $1,345 | 7.3× |
| Us retroperitoneal limited (76775) | $521.56 | $884 | 4.8× |
| Us scrotum and contents (76870) | $709.77 | $1,203 | 6.5× |
| Us spinal canal and contents (76800) | $484.98 | $822 | 4.5× |
| Us thyroid (76536) | $604.16 | $1,024 | 5.6× |
| Us transrectal (76872) | $463.15 | $785 | 4.3× |
| Vein X-Ray Chest (75827) | $1,571.76 | $2,664 | 1.0× |
| Venogram Sinus/Jugular (75860) | $2,362.36 | $4,004 | 0.7× |
| Venography caval inferior serialography rs&i (75825) | $2,534.05 | $4,295 | 0.8× |
| Venography extremity bilateral rs&i (75822) | $1,619.55 | $2,745 | 1.0× |
| Venography extremity unilateral rs&i (75820) | $1,315.11 | $2,229 | 0.8× |
| Venography Renal Bilateral (75833) | $2,230.20 | $3,780 | 0.7× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,686.22 | $2,858 | 0.3× |
| Venous thrombosis imaging (78457) | $421.85 | $715 | 0.7× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $489.70 | $830 | 1.2× |
| Wrist 2 views (73100) | $225.38 | $382 | 2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $276.12 | $468 | 3.1× |
| X-ray antegrade pyelogram tube (74425) | $713.90 | $1,210 | 2.0× |
| X-Ray Aorta Leg Arteries (75630) | $2,759.43 | $4,677 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $550.47 | $933 | 5.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $291.46 | $494 | 3.2× |
| X-Ray Exam Breast Specimen (76098) | $329.22 | $558 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $282.02 | $478 | 3.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $358.13 | $607 | 3.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $223.02 | $378 | 2.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $126.26 | $214 | 1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$113.87–$153.99 | $193–$261 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $207.68 | $352 | 1.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $243.08 | $412 | 2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $329.81 | $559 | 3.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $394.12 | $668 | 3.6× |
| X-Ray Exam L-S Spine Bending (72114) | $600.03 | $1,017 | 5.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $369.93 | $627 | 4.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $695.61 | $1,179 | 6.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $380.55 | $645 | 3.5× |
| X-ray humerus (73060) | $394.12 | $668 | 4.4× |
| X-ray IV pyelogram (ivp) (74400) | $849.01 | $1,439 | 4.7× |
| X-ray IV pyelogram+tomography (74415) | $1,015.39 | $1,721 | 5.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $170.51 | $289 | 1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $204.73 | $347 | 2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $450.76 | $764 | 4.2× |
| X-ray nose-rectum child f.b. (76010) | $284.97 | $483 | 3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $502.09 | $851 | 4.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $454.30 | $770 | 4.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $217.12 | $368 | 2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $272.58 | $462 | 3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $320.37 | $543 | 3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $463.15 | $785 | 4.3× |
| X-Ray Stress View (77071) | $153.40 | $260 | 1.7× |
| X-ray thoracic spine 4 vw (72074) | $285.56 | $484 | 2.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $793.55 | $1,345 | 2.2× |
| X-Rays Bone Length Studies (77073) | $266.68 | $452 | 2.5× |
| X-Rays Bone Survey Complete (77075) | $933.97 | $1,583 | 8.6× |
| Xr c-spine 4 or 5 views (72050) | $510.35 | $865 | 4.7× |
| Xr facial bones less than 3 views (70140) | $87.32 | $148 | 1.0× |
| Xr orbits complete 4 views (70200) | $374.65 | $635 | 3.5× |
| Xr Tomogram Single Plane (76100) | $259.01 | $439 | 2.4× |
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.