Imaging prices at Chi St. Lukes Health Memorial Livingston
Livingston, TX · every code in this section with a posted price and a Medicare benchmark.
336 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) | $1,514.40 | $10,096 | 1.1× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$160.90–$160.95 | $1,072.62–$1,073 | varies |
| Abdomen 2 views (74019) | $194.70 | $1,298 | 1.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $286.65 | $1,911 | 0.7× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $308.85 | $2,059 | 0.2× |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$1,228.35–$1,306.80 | $8,189–$8,712 | varies |
| Angiography extremity bilateral rs&i (75716) | $1,325.40 | $8,836 | 0.4× |
| Angiography extremity unilateral rs&i (75710) | $1,219.50 | $8,130 | 0.4× |
| Ankle 2 views (73600) | $137.55 | $917 | 1.6× |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$1,258.35–$1,258.50 | $8,389–$8,390 | varies |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$1,187.25 | $7,915 | 0.2× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$1,258.50 | $8,390 | 0.2× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$186.15–$198.15 | $1,241–$1,321 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$195–$227.70 | $1,300–$1,518 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$193.65–$206.10 | $1,291–$1,374 | varies |
| Basic radiation dosimetry calculation (77300) | $256.95 | $1,713 | 1.9× |
| Bone age studies (77072) | $60.29 | $401.88 | 0.6× |
| Bone Imaging 3 Phase (78315) | $1,004.40 | $6,696 | 2.5× |
| Bone Imaging Limited Area (78300) | $655.50 | $4,370 | 1.6× |
| Bone Imaging Multiple Areas (78305) | $791.70 | $5,278 | 2.0× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$851.19–$851.25 | $5,674.57–$5,675 | varies |
| Bone marrow imaging limited area (78102) | $210 | $1,400 | 0.5× |
| Brachytx isodose complex (77318) | $383.40 | $2,556 | 1.0× |
| Brachytx isodose intermed (77317) | $263.25 | $1,755 | 0.7× |
| Brachytx Isodose Plan Simple (77316) | $241.50 | $1,610 | 0.6× |
| Brain Image W/Flow < 4 Views (78601) | $277.50 | $1,850 | 0.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,109.70 | $7,398 | 0.8× |
| Cardiac Shunt Detection (78428) | $316.20 | $2,108 | 0.8× |
| Cerebrospinal Fluid Scan (78630) | $450.90 | $3,006 | 0.8× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$152.53–$152.55 | $1,016.85–$1,017 | varies |
| Chest 2 views (71046) | $199.95 | $1,333 | 2.3× |
| Chest 3 views (71047) | $251.70 | $1,678 | 2.9× |
| Chest 4 or more views (71048) | $271.50 | $1,810 | 2.6× |
| Cisternography Positive Contrast Rs&I (70015) | $336 | $2,240 | 0.4× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$234.60–$239.40 | $1,564–$1,596 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$26.25–$270.19 | $175–$1,801.25 | varies |
| Continuing medical physics consltj pr wk (77336) | $302.85 | $2,019 | 2.2× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$1,205.51–$1,205.55 | $8,036.71–$8,037 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$312.48–$312.60 | $2,083.20–$2,084 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$186.15–$198.15 | $1,241–$1,321 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$229.65–$247.71 | $1,531–$1,651.37 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) range across 2 matching MRF lines |
$129.96–$130.05 | $866.40–$867 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $2,242.50 | $14,950 | 6.4× |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$1,672.80–$1,672.82 | $11,152–$11,152.07 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,449.62–$1,449.75 | $9,664.11–$9,665 | varies |
| CT abdomen w wo contrast (74170) | $1,638.15 | $10,921 | 9.3× |
| CT abdomen w/o contrast (74150) | $840.90 | $5,606 | 8.0× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$1,857.60–$1,895.36 | $12,384–$12,635.73 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,202.25–$1,226.76 | $8,015–$8,178.36 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,084.20–$1,106.19 | $7,228–$7,374.60 | varies |
| CT angio hrt w/3d image (75574) | $201.30 | $1,342 | 0.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,881.25 | $12,541.65 | 10.7× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,170 | $7,799.94–$7,800 | 6.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$626.55–$639.09 | $4,177–$4,260.54 | varies |
| CT cervical spine w/ contrast (72126) | $1,341.15 | $8,941 | 3.8× |
| CT cervical spine w/o contrast (72125) | $1,031.70 | $6,878 | 9.8× |
| CT cervical spine w/wo cont (72127) | $1,568.25 | $10,455 | 8.9× |
| CT chest w contrast (71260) | $918.45 | $6,123 | 5.2× |
| CT chest w/wo contrast (71270) | $1,078.80 | $7,192 | 6.1× |
| CT head/brain with contrast (70460) | $1,141.50 | $7,610 | 6.5× |
| CT head/brain without and with contrast (70470) | $1,337.10 | $8,914 | 7.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $171.75 | $1,145 | 0.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $43.50 | $290 | 0.5× |
| CT hrt w/3d image congen (75573) | $167.85 | $1,119 | 0.5× |
| CT iac w contrast (70481) | $634.95 | $4,233 | 3.6× |
| CT l-spine w&w/o contrast (72133) | $1,557.30 | $10,382 | 8.8× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$625.62–$625.65 | $4,170.78–$4,171 | varies |
| CT lower extremity w/contrast material (73701) | $807.15 | $5,381 | 4.6× |
| CT lumbar spine w contrast (72132) | $1,324.80 | $8,832 | 3.8× |
| CT lumbar spine w/o contrast (72131) | $1,011.30 | $6,742 | 9.6× |
| CT maxillofacial w contrast (70487) | $1,126.65 | $7,511 | 6.4× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$946.77–$946.80 | $6,311.76–$6,312 | varies |
| CT neck tissue combo (70492) | $1,251.15 | $8,341 | 7.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $740.85 | $4,939 | 4.2× |
| CT orbits w/o contrast (70480) | $556.95 | $3,713 | 5.3× |
| CT pelvis w&w/o contrast (72194) | $1,636.50 | $10,910 | 9.3× |
| CT pelvis w/o contrast (72192) | $856.80 | $5,712 | 8.2× |
| CT scan of leg combo (73702) | $944.70 | $6,298 | 5.4× |
| CT scans face/jaw combo (70488) | $1,363.35 | $9,089 | 7.7× |
| CT soft tissue neck w contrast (70491) | $1,042.65 | $6,951 | 5.9× |
| CT soft tissue neck w/o contrast (70490) | $844.50 | $5,630 | 8.0× |
| CT thoracic spine w contrast (72129) | $1,149.30 | $7,662 | 6.5× |
| CT thoracic spine w/o contrast (72128) | $877.35 | $5,849 | 8.4× |
| CT thoracic spine w/wo cont (72130) | $1,351.05 | $9,007 | 7.7× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$728.90–$729 | $4,859.28–$4,860 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,020.71–$1,020.75 | $6,804.70–$6,805 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,582.20 | $10,548 | 9.0× |
| CT upper extremity with contrast (73201) | $1,275.90 | $8,506 | 3.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,728.60 | $11,523.95 | 9.8× |
| Cta Abdomen (74175) | $1,724.85 | $11,499 | 9.8× |
| CTA pelvis (72191) | $679.50 | $4,530 | 3.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $89.40 | $596 | 0.9× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$48.76–$48.90 | $325.03–$326 | varies |
| Dxa Bone Density Axial (77080) | $230.55 | $1,537 | 2.2× |
| Echo exam uterus (76831) | $241.05 | $1,607 | 1.0× |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$273.15–$289.50 | $1,821–$1,930 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$184.52–$184.65 | $1,230.12–$1,231 | varies |
| Fluoroscopy up to 1 hr (76000) | $161.70 | $1,078 | 0.7× |
| Follow-Up Angiography (75898) | $203.55 | $1,357 | 0.1× |
| Foot 2 views (73620) | $175.50 | $1,170 | 2.0× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$159.45–$162.60 | $1,063–$1,084 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$334.95–$418.69 | $2,233–$2,791.25 | varies |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$378.90–$386.48 | $2,526–$2,576.52 | varies |
| Hand 2 views (73120) | $217.80 | $1,452 | 2.1× |
| Heart Image (Pet) Multiple (78492) | $1,307.70 | $8,717.94 | 0.9× |
| Hepatobil Syst Image W/Drug (78227) | $1,229.25 | $8,195 | 2.3× |
| Hepatobiliary System Imaging (78226) | $897.30 | $5,982 | 2.2× |
| Ht Muscle Image Spect Sing (78451) | $1,829.55 | $12,197 | 1.4× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$245.10–$263.55 | $1,634–$1,757 | varies |
| Image fusion (77399) | $61.80 | $412 | 0.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $217.11 | $1,447.38 | 2.5× |
| Intracavitary Radiation Source Applic Complex (77763) | $850.65 | $5,671 | 1.2× |
| Intracavitary Radiation Source Applic Intermed (77762) | $618.90 | $4,126 | 1.1× |
| Intracavitary radiation source applic simple (77761) | $458.55 | $3,057 | 0.8× |
| K Flow/Funct Image W/Drug (78708) | $786 | $5,240 | 1.4× |
| K Flow/Funct Image W/O Drug (78707) | $974.70 | $6,498 | 1.8× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$194.30–$194.40 | $1,295.27–$1,296 | varies |
| Leveen/Shunt Patency Exam (78291) | $199.95 | $1,333 | 0.5× |
| Liver & Spleen Imaging Static Only (78215) | $390 | $2,600 | 1.0× |
| Lung Perf&Ventilat Diferentl (78598) | $362.40 | $2,416 | 0.7× |
| Lung Ventilat&Perfus Imaging (78582) | $914.85 | $6,099 | 1.7× |
| Lung Ventilation Imaging (78579) | $521.55 | $3,477 | 1.3× |
| Lymph System Imaging (78195) | $519.19 | $3,461.25 | 1.0× |
| Magnetic Image Jaw Joint (70336) | $3,037.65 | $20,251 | 12.7× |
| Mammary ductogram or galactogram multiple (77054) | $242.70 | $1,618 | 1.0× |
| Mammary ductogram or galactogram single (77053) | $170.25 | $1,135 | 0.7× |
| Meckels Divert Exam (78290) | $303.15 | $2,021 | 0.8× |
| Mlc imrt design & construction per imrt plan (77338) | $311.10 | $2,074 | 0.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $7.95 | $53 | 0.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $19.95 | $133 | 0.2× |
| Mra Head W/O & W/Contrast Material (70546) | $1,502.40 | $10,016 | 4.3× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$981.87–$981.90 | $6,545.76–$6,546 | varies |
| MRA head with contrast (70545) | $1,031.10 | $6,874 | 2.9× |
| MRA neck w contrast (70548) | $1,158.15 | $7,721 | 3.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,625.40 | $10,836 | 4.6× |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$1,015.88–$1,015.95 | $6,772.50–$6,773 | varies |
| MRI abdomen w contrast (74182) | $1,380.60 | $9,204 | 3.9× |
| MRI abdomen w/o contrast (74181) | $889.80 | $5,932 | 3.7× |
| MRI any jt lower extrem w/contrast material (73722) | $2,241.30 | $14,942 | 2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,608.50 | $17,390 | 7.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,223 | $14,820 | 2.8× |
| MRI cardiac w/o cont stress (75559) | $526.80 | $3,512 | 1.0× |
| MRI cervical spine w contrast (72142) | $1,782.60 | $11,884 | 5.1× |
| MRI cervical spine w/o cont (72141) | $1,229.40 | $8,196 | 5.1× |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$654.30–$667.39 | $4,362–$4,449.24 | varies |
| MRI chest with contrast (71551) | $796.80 | $5,312 | 1.0× |
| MRI chest wo w contrast (71552) | $1,189.65 | $7,931 | 3.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,513.65 | $10,091 | 4.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,936.95 | $12,913 | 5.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,282.80 | $8,552 | 5.4× |
| MRI lumbar spine w contrast (72149) | $1,671.60 | $11,144 | 4.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,065.35 | $13,769 | 5.9× |
| MRI orbit face &/neck w/o contrast (70540) | $673.65 | $4,491 | 2.8× |
| MRI orbit face neck w contrast (70542) | $794.25 | $5,295 | 2.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,005.30 | $6,702 | 2.9× |
| MRI pelvis w contrast (72196) | $1,267.50 | $8,450 | 3.6× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,584.36–$1,584.45 | $10,562.39–$10,563 | varies |
| MRI pelvis w/o contrast (72195) | $1,077.45 | $7,183 | 4.5× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,499.59–$1,499.70 | $9,997.25–$9,998 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,273.20 | $8,488 | 3.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,168.20 | $7,788 | 4.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,576.95 | $10,513 | 4.5× |
| MRI, abdomen, combo (74183) | $1,533.90 | $10,226 | 4.4× |
| MRI, dorsal spine combo (72157) | $2,534.40 | $16,896 | 7.2× |
| MRI, dorsal spine contrast (72147) | $2,159.55 | $14,397 | 6.2× |
| MRI, joint upper extrem (73221) | $1,434.15 | $9,561 | 6.0× |
| MRI, joint upper extrem combo (73223) | $2,739.30 | $18,262 | 7.8× |
| MRI, lumbar spine combo (72158) | $1,965.90 | $13,106 | 5.6× |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$373.80–$379.35 | $2,492–$2,529 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$355.35–$378.15 | $2,369–$2,521 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$522.15–$555.60 | $3,481–$3,704 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$680.55–$690.90 | $4,537–$4,606 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,022.85 | $6,819 | 0.8× |
| Myocardial Spect Multiple Studies (78452) | $2,204.25 | $14,695 | 1.7× |
| Neck soft tissue (70360) | $166.03 | $1,106.85 | 1.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $79.35 | $529 | 0.2× |
| Nm csf leak detection (78650) | $630.60 | $4,204 | 0.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,297.40 | $15,316 | 1.7× |
| Nuclear Rx Oral Admin (79005) range across 3 matching MRF lines |
$457.50–$494.65 | $3,050–$3,297.66 | varies |
| Optic foramina (70190) | $70.95 | $473 | 0.8× |
| Panoramic X-ray of jaws (70355) | $44.55 | $297 | 0.5× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$422.55–$528.19 | $2,817–$3,521.25 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) | $422.55 | $2,817 | 1.1× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$170.36–$170.40 | $1,135.67–$1,136 | varies |
| Pet Image W/Ct Lmtd (78814) | $1,023.30 | $6,822 | 0.7× |
| PET image w/CT, full body (78816) | $1,817.10 | $12,114 | 1.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,764.15 | $11,761 | 1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $658.80 | $4,392 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $194.70 | $1,298 | 1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $122.55 | $817 | 0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$259.05–$264.30 | $1,727–$1,762 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $134.67 | $897.75 | 1.5× |
| Radex elbow complete minimum 3 views (73080) | $254.40 | $1,696 | 2.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $225.57 | $1,503.75 | 2.1× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$201.75–$205.95 | $1,345–$1,373 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$272.91–$278.37 | $1,819.36–$1,855.74 | varies |
| Radex Hand Minimum 3 Views (73130) | $256.20 | $1,708 | 2.9× |
| Radex lower extremity infant minimum 2 views (73592) | $66.30 | $442 | 0.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $116.10 | $774 | 1.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $168.60 | $1,124 | 1.9× |
| Radex Ribs Unilateral 2 Views (71100) | $374.55 | $2,497 | 4.3× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$184.35–$188.10 | $1,229–$1,254 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $151.05 | $1,007 | 1.7× |
| Radex Spine 1 View Specify Level (72020) | $140.10 | $934 | 1.6× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$94.50–$96.39 | $630–$642.60 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $114.62 | $764.10 | 1.3× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$163.27–$166.54 | $1,088.44–$1,110.21 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $62.73 | $418.20 | 0.6× |
| Radex Wrist Complete Minimum 3 Views (73110) | $238.35 | $1,589 | 2.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $151.50 | $1,010 | 1.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $4,444.65 | $29,631 | 0.6× |
| Radiation treatment delivery level 1 (77402) | $97.65 | $651 | 1.0× |
| Radiation treatment delivery level 2 (77407) | $107.40 | $716 | 0.3× |
| Radiation treatment delivery level 3 (77412) | $307.05 | $2,047 | 0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $146.43 | $976.14 | 1.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $194.70 | $1,298 | 1.9× |
| Radiologic exam colon double contrast study (74280) | $422.85 | $2,819 | 2.4× |
| Radiologic exam colon single contrast study (74270) | $317.25 | $2,115 | 1.8× |
| Radiologic exam knee complete 4/more views (73564) | $223.50 | $1,490 | 2.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $257.25 | $1,715 | 2.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $588.85 | $3,925.66 | 3.3× |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$258.38–$258.45 | $1,722.50–$1,723 | varies |
| Radiologic exam upr gi trc double contrast study (74246) | $447.75 | $2,985 | 2.5× |
| Radiologic examination femur 1 view (73551) | $49.95 | $333 | 0.6× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$232.80–$237.45 | $1,552–$1,583 | varies |
| Radiologic examination knee 1/2 views (73560) | $161.40 | $1,076 | 1.8× |
| Radiologic Examination Osseous Survey Limited (77074) | $223.80 | $1,492 | 2.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$266.40–$271.80 | $1,776–$1,812 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $117.30 | $782 | 0.2× |
| Renal Cyst Study (74470) | $173.25 | $1,155 | 0.3× |
| Ribs bilateral 3 views (71110) | $447.75 | $2,985 | 4.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $401.70 | $2,678 | 1.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $425.85 | $2,839 | 1.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $483.90 | $3,226 | 0.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $536.55 | $3,577 | 1.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,028.25 | $6,855 | 0.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $750.15 | $5,001 | 0.6× |
| Salivary Gland Imaging (78230) | $175.35 | $1,169 | 0.4× |
| Scapula (73010) | $132.90 | $886 | 1.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$36.54–$36.60 | $243.60–$244 | varies |
| Shoulder 1 view (73020) | $171.15 | $1,141 | 2.0× |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$341.07–$341.10 | $2,273.75–$2,274 | varies |
| Sialogram (70390) | $144.90 | $966 | 0.6× |
| Skull less than 4 views (70250) | $110.25 | $735 | 1.0× |
| Special dosimetry (77331) | $169.50 | $1,130 | 1.3× |
| Special Physics Consult (77370) | $490.50 | $3,270 | 3.6× |
| Special teletherapy port plan (77321) | $272.07 | $1,813.75 | 0.7× |
| Special treatment procedure (77470) | $391.50 | $2,610 | 0.7× |
| Stereotactic Body Radiation Delivery (77373) | $1,068 | $7,120 | 0.6× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$74.40–$75.89 | $496–$505.92 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $558.26 | $3,721.68 | 1.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $206.70 | $1,378 | 0.5× |
| Temporomandble Jt Arthrography Rs&I (70332) | $198.15 | $1,321 | 0.8× |
| Testicular Imaging W/Flow (78761) | $286.95 | $1,913 | 0.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $771 | $5,140 | 2.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $763.20 | $5,088 | 2.0× |
| Ther rad simulaj-aided field setting simple (77280) | $462.60 | $3,084 | 3.4× |
| Thoracic spine 2 views (72070) | $227.29 | $1,515.23 | 2.2× |
| Thoracic spine 3 views (72072) | $299.03 | $1,993.48 | 2.8× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $229.65 | $1,531 | 0.6× |
| Thyroid Imaging With Vascular Flow (78013) | $545.70 | $3,638 | 1.4× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$599.55–$611.55 | $3,997–$4,076.94 | varies |
| Thyroid Uptake Measurement (78012) | $106.35 | $709 | 0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $690.75 | $4,605 | 1.7× |
| Tx Devices Design & Construction Complex (77334) | $469.50 | $3,130 | 1.2× |
| Tx devices design & construction intermediate (77333) | $511.80 | $3,412 | 3.8× |
| Tx devices design & construction simple (77332) | $145.65 | $971 | 1.1× |
| Ultrasound Breast Limited (76642) | $312.75 | $2,085 | 3.6× |
| Ultrasound Elastography Parenchyma (76981) | $37.51 | $250.02 | 0.4× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$91.69–$91.80 | $611.25–$612 | varies |
| Ultrasound, abdomen limited (76705) | $391.35 | $2,609 | 3.7× |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$94.80–$96.70 | $632–$644.64 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $90.60 | $604 | 0.2× |
| Upper gi w/o kub (74240) | $371.02 | $2,473.42 | 2.1× |
| Ureteral Reflux Study (78740) | $174.45 | $1,163 | 0.4× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$194.55–$198.45 | $1,297–$1,322.94 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$154.50–$157.59 | $1,030–$1,050.60 | varies |
| Us breast unilateral complete (76641) | $375.30 | $2,502 | 3.6× |
| Us chest (76604) range across 2 matching MRF lines |
$406.35–$414.56 | $2,709–$2,763.71 | varies |
| Us complete joint (76881) | $130.20 | $868 | 1.2× |
| Us exam, pelvic, limited (76857) | $282.45 | $1,883 | 2.7× |
| Us head (76506) | $182.40 | $1,216 | 1.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$154.92–$154.95 | $1,032.75–$1,033 | varies |
| Us ob detailed single fetus (76811) | $184.80 | $1,232 | 0.8× |
| Us ob limited 1 or more fetuses (76815) | $285.15 | $1,901 | 2.7× |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$324 | $2,159.97–$2,160 | 3.1× |
| Us pelvic non ob complete (76856) | $605.55 | $4,037 | 5.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$484.21–$484.35 | $3,228.02–$3,229 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $324 | $2,160 | 3.1× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$545.83–$545.85 | $3,638.81–$3,639 | varies |
| Us retroperitoneal limited (76775) | $300.30 | $2,002 | 2.9× |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$535.80–$546.75 | $3,572–$3,645 | varies |
| Us spinal canal and contents (76800) | $62.40 | $416 | 0.6× |
| Us thyroid (76536) | $522 | $3,480 | 5.0× |
| Us transrectal (76872) | $298.50 | $1,990 | 2.8× |
| Vein X-Ray Chest (75827) | $522.75 | $3,485 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $1,258.35 | $8,389 | 0.4× |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$404.70–$411 | $2,698–$2,740 | varies |
| Venography extremity unilateral rs&i (75820) range across 4 matching MRF lines |
$384–$433.65 | $2,560–$2,891 | varies |
| Venography Renal Bilateral (75833) | $1,258.35 | $8,389 | 0.4× |
| Wrist 2 views (73100) | $195.45 | $1,303 | 2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $81.60 | $544 | 0.9× |
| X-Ray Aorta Leg Arteries (75630) | $1,494.90 | $9,966 | 0.5× |
| X-Ray Bend Only L-S Spine (72120) | $401.70 | $2,678 | 3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $223.80 | $1,492 | 2.6× |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$229.55–$229.65 | $1,530.32–$1,531 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $65.55 | $437 | 0.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$107.41–$107.55 | $716.04–$717 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $121.50 | $810 | 1.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $90.90 | $606 | 1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$131.74–$131.85 | $878.22–$879 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $166.05 | $1,107 | 1.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $113.40 | $756 | 1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $148.95 | $993 | 1.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $171.30 | $1,142 | 1.6× |
| X-Ray Exam L-S Spine Bending (72114) | $607.65 | $4,051 | 5.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $374.10 | $2,494 | 4.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $591.45 | $3,943 | 5.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $430.50 | $2,870 | 4.1× |
| X-ray eye for foreign body (70030) | $71.10 | $474 | 0.8× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$240.36–$245.17 | $1,602.37–$1,634.41 | varies |
| X-ray IV pyelogram (ivp) (74400) | $240.60 | $1,604 | 1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $190.50 | $1,270 | 2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $396.60 | $2,644 | 3.8× |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$62.55–$63.81 | $417–$425.34 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $538.05 | $3,587 | 5.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $266.40 | $1,776 | 2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $222 | $1,480 | 2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $397.20 | $2,648 | 4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$136.02–$136.05 | $906.75–$907 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $501.15 | $3,341 | 1.4× |
| X-Rays Bone Length Studies (77073) | $40.80 | $272 | 0.4× |
| X-Rays Bone Survey Complete (77075) | $1,118.55 | $7,457 | 10.7× |
| Xr c-spine 4 or 5 views (72050) | $505.50 | $3,370 | 4.8× |
| Xr facial bones less than 3 views (70140) | $153.45 | $1,023 | 1.8× |
| Xr orbits complete 4 views (70200) | $137.86 | $919.02 | 1.3× |
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.