Imaging prices at CHI St. Vincent Infirmary
Little Rock, AR · every code in this section with a posted price and a Medicare benchmark.
371 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 |
$812.91–$1,983.52 | $3,168–$7,730 | varies |
| Abdomen 1 View (74018) | $100.34 | $391 | 1.2× |
| Abdomen 2 views (74019) | $139.60 | $544 | 1.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $381.06 | $1,485 | 1.0× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $655.62 | $2,555 | 0.5× |
| Angio pulmonary bilat (75743) | $1,288.39 | $5,021 | 0.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $1,177.03 | $4,587 | 0.4× |
| Angiography extremity bilateral rs&i (75716) | $1,411.05 | $5,499 | 0.5× |
| Angiography extremity unilateral rs&i (75710) | $1,213.47 | $4,729 | 0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $811.63 | $3,163 | 0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $811.63 | $3,163 | 0.3× |
| Ankle 2 views (73600) | $95.20 | $371 | 1.1× |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$993.30–$2,456.69 | $3,871–$9,574 | varies |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,130.81 | $8,304 | 0.4× |
| Artery X-Rays Adrenal Gland (75731) | $1,012.29 | $3,945 | 0.3× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$1,527.03 | $5,951 | 0.3× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$2,456.69 | $9,574 | 0.5× |
| Arthrogram ankle (73615) | $273.54 | $1,066 | 0.8× |
| Arthrogram hip (73525) | $183.47 | $715 | 0.5× |
| Arthrogram Wrist (73115) | $188.35 | $734 | 0.6× |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$84.94–$168.85 | $331–$658 | varies |
| Bone age studies (77072) | $101.36 | $395 | 1.0× |
| Bone Imaging 3 Phase (78315) | $672.55 | $2,621 | 1.8× |
| Bone Imaging Limited Area (78300) | $377.98 | $1,473 | 1.0× |
| Bone Imaging Whole Body (78306) | $640.48 | $2,496 | 1.7× |
| Bone marrow imaging limited area (78102) | $347.44 | $1,354 | 0.9× |
| Brachytx isodose complex (77318) range across 2 matching MRF lines |
$197.84–$230.94 | $771–$900 | varies |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$170.13–$230.94 | $663–$900 | varies |
| Brachytx Isodose Plan Simple (77316) range across 2 matching MRF lines |
$84.94–$142.42 | $331–$555 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,758.48 | $6,853 | 1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $993.30 | $3,871 | 3.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $814.71 | $3,175 | 1.1× |
| Cat Scan Follow-Up Study (76380) | $317.68 | $1,238 | 3.8× |
| Cerebrospinal Fluid Scan (78630) | $777.50 | $3,030 | 1.5× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$74.68–$116.50 | $291–$454 | varies |
| Chest 2 views (71046) | $128.30 | $500 | 1.5× |
| Chest 3 views (71047) | $135.23 | $527 | 1.6× |
| Clavicle complete (73000) | $103.93 | $405 | 1.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $73.39 | $286 | 0.7× |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$80.06–$178.86 | $312–$697 | varies |
| Contrast Exam Abdominl Aorta (75625) | $918.12 | $3,578 | 0.3× |
| Contrast X-Ray Bladder (74430) | $171.16 | $667 | 0.5× |
| Contrast X-Ray Of Elbow (73085) | $205.28 | $800 | 0.6× |
| Contrast X-Ray Of Knee Joint (73580) | $228.38 | $890 | 0.7× |
| CT abdomen and pelvis without and with contrast (74178) | $1,712.30 | $6,673 | 5.1× |
| CT abdomen and pelvis without contrast (74176) | $1,496.50 | $5,832 | 6.6× |
| CT abdomen w contrast (74160) | $847.04 | $3,301 | 5.0× |
| CT abdomen w wo contrast (74170) | $923.51 | $3,599 | 5.5× |
| CT abdomen w/o contrast (74150) | $796.23 | $3,103 | 8.0× |
| CT Angio Abdomen and Pelvis (74174) | $983.04 | $3,831 | 2.9× |
| CT Angio Chest (71275) | $692.57 | $2,699 | 4.1× |
| CT Angio Head (70496) | $686.67 | $2,676 | 4.1× |
| CT angio hrt w/3d image (75574) | $292.53 | $1,140 | 0.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $804.45 | $3,135 | 4.8× |
| CT Angio Neck (70498) | $835.49 | $3,256 | 5.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $787 | $3,067 | 4.7× |
| CT cervical spine w/ contrast (72126) | $741.32 | $2,889 | 2.2× |
| CT cervical spine w/o contrast (72125) | $705.91 | $2,751 | 7.1× |
| CT cervical spine w/wo cont (72127) | $826 | $3,219 | 4.9× |
| CT chest w contrast (71260) | $734.14 | $2,861 | 4.4× |
| CT chest w/wo contrast (71270) | $851.66 | $3,319 | 5.1× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $643.81 | $2,509 | 3.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $573.25 | $2,234 | 5.7× |
| CT head/brain with contrast (70460) | $798.54 | $3,112 | 4.8× |
| CT head/brain without and with contrast (70470) | $1,011.01 | $3,940 | 6.0× |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$584.54–$585.05 | $2,278–$2,280 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $58.51 | $228 | 0.7× |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$368.23–$368.74 | $1,435–$1,437 | varies |
| CT iac w contrast (70481) | $636.63 | $2,481 | 3.8× |
| CT l-spine w&w/o contrast (72133) | $850.63 | $3,315 | 5.1× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$569.40–$601.48 | $2,219–$2,344 | varies |
| CT lower extremity w/contrast material (73701) | $646.89 | $2,521 | 3.9× |
| CT lumbar spine w contrast (72132) | $763.39 | $2,975 | 2.3× |
| CT lumbar spine w/o contrast (72131) | $727.21 | $2,834 | 7.3× |
| CT maxillofacial w contrast (70487) | $836.78 | $3,261 | 5.0× |
| CT maxillofacial wo contrast (70486) | $767.50 | $2,991 | 7.7× |
| CT neck tissue combo (70492) | $862.95 | $3,363 | 5.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $732.60 | $2,855 | 4.4× |
| CT orbits w/o contrast (70480) | $600.45 | $2,340 | 6.0× |
| CT pelvis w&w/o contrast (72194) | $737.73 | $2,875 | 4.4× |
| CT pelvis w/o contrast (72192) | $550.41 | $2,145 | 5.5× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$711.81–$776.48 | $2,774–$3,026 | varies |
| CT scans face/jaw combo (70488) | $905.80 | $3,530 | 5.4× |
| CT soft tissue neck w contrast (70491) | $743.89 | $2,899 | 4.4× |
| CT soft tissue neck w/o contrast (70490) | $691.80 | $2,696 | 6.9× |
| CT thoracic spine w contrast (72129) | $763.39 | $2,975 | 4.6× |
| CT thoracic spine w/o contrast (72128) | $727.21 | $2,834 | 7.3× |
| CT thoracic spine w/wo cont (72130) | $850.63 | $3,315 | 5.1× |
| CT thorax w/o contrast (71250) | $601.99 | $2,346 | 6.0× |
| CT unlisted procedure (76497) | $526.03 | $2,050 | 6.3× |
| CT upper ext wo (73200) | $567.86 | $2,213 | 5.7× |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$675.63–$709.76 | $2,633–$2,766 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$647.15–$675.63 | $2,522–$2,633 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $628.42 | $2,449 | 3.7× |
| Cta Abdomen (74175) | $658.70 | $2,567 | 3.9× |
| CTA pelvis (72191) | $847.81 | $3,304 | 5.1× |
| Dilation ureters/urethra rs&i (74485) | $496.78 | $1,936 | 0.2× |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$865.52–$1,557.31 | $3,373–$6,069 | varies |
| Diskography lumbar (72295) | $944.55 | $3,681 | 0.5× |
| Dxa Bone Density Axial (77080) | $109.57 | $427 | 1.1× |
| Echo exam uterus (76831) | $148.06 | $577 | 0.6× |
| Echo Guide For Artery Repair (76936) | $118.81 | $463 | 0.6× |
| Echograp Trans R Pros Study (76873) | $150.37 | $586 | 1.5× |
| Esophagram (74220) | $148.06 | $577 | 0.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $126.25 | $492 | 1.3× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$155.76–$231.97 | $607–$904 | varies |
| Follow-Up Angiography (75898) range across 3 matching MRF lines |
$264.56–$1,425.16 | $1,031–$5,554 | varies |
| Foot 2 views (73620) | $85.71 | $334 | 1.0× |
| Forearm 2 views (73090) | $121.12 | $472 | 1.5× |
| Gastric emptying imaging study (78264) | $589.93 | $2,299 | 1.5× |
| Gastroesophageal Reflux Exam (78262) | $364.89 | $1,422 | 1.0× |
| Gated Heart Planar Single (78472) | $289.71 | $1,129 | 0.8× |
| GI Endoscopic US S&I (76975) | $177.06 | $690 | 0.8× |
| Hand 2 views (73120) | $109.32 | $426 | 1.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $519.62 | $2,025 | 0.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $519.62 | $2,025 | 0.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $519.62 | $2,025 | 0.8× |
| Heart first pass single,planar (78481) | $492.42 | $1,919 | 0.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $865.52 | $3,373 | 0.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $865.52 | $3,373 | 0.3× |
| Hepatobil Syst Image W/Drug (78227) | $659.72 | $2,571 | 1.3× |
| Hepatobiliary System Imaging (78226) | $602.25 | $2,347 | 1.6× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$1,152.91–$1,309.18 | $4,493–$5,102 | varies |
| Hysterosalpingogram (74740) | $261.99 | $1,021 | 1.1× |
| Image fusion (77399) range across 2 matching MRF lines |
$62.10–$80.06 | $242–$312 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $132.15 | $515 | 1.6× |
| Infant hip ultrasound, limited static exam (76886) | $115.47 | $450 | 1.4× |
| Interstitial radiation source applic complex (77778) range across 2 matching MRF lines |
$1,624.54–$1,674.06 | $6,331–$6,524 | varies |
| Intracavitary Radiation Source Applic Complex (77763) range across 2 matching MRF lines |
$519.62–$1,063.36 | $2,025–$4,144 | varies |
| Intracavitary Radiation Source Applic Intermed (77762) range across 2 matching MRF lines |
$377.21–$854.23 | $1,470–$3,329 | varies |
| Intracavitary radiation source applic simple (77761) range across 2 matching MRF lines |
$377.21–$803.16 | $1,470–$3,130 | varies |
| K Flow/Funct Image Multiple (78709) | $586.59 | $2,286 | 1.1× |
| K Flow/Funct Image W/Drug (78708) | $419.03 | $1,633 | 0.8× |
| Knee 3 Views (73562) | $119.32 | $465 | 1.4× |
| Leveen/Shunt Patency Exam (78291) | $318.96 | $1,243 | 0.8× |
| Liver & Spleen Imaging Static Only (78215) | $296.12 | $1,154 | 0.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $290.48 | $1,132 | 0.8× |
| Liver imaging w/vascular flow (78202) | $439.82 | $1,714 | 0.8× |
| Lung Perf&Ventilat Diferentl (78598) | $459.32 | $1,790 | 0.9× |
| Lung perfusion differential (78597) | $431.09 | $1,680 | 1.1× |
| Lung Ventilat&Perfus Imaging (78582) | $676.92 | $2,638 | 1.3× |
| Lung Ventilation Imaging (78579) | $338.46 | $1,319 | 0.9× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$402.61–$463.17 | $1,569–$1,805 | varies |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $865.52 | $3,373 | 0.3× |
| Magnetic Image Jaw Joint (70336) | $926.84 | $3,612 | 4.1× |
| Meckels Divert Exam (78290) | $332.82 | $1,297 | 0.9× |
| Mlc imrt design & construction per imrt plan (77338) | $217.60 | $848 | 0.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $18.74 | $73 | 0.7× |
| Mra Head W/O & W/Contrast Material (70546) | $1,249.39 | $4,869 | 3.7× |
| MRA head w/o contrast (70544) | $939.42 | $3,661 | 4.1× |
| MRA head with contrast (70545) | $1,249.39 | $4,869 | 3.7× |
| MRA neck w contrast (70548) | $844.99 | $3,293 | 2.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $956.35 | $3,727 | 2.9× |
| MRA neck w/o contrast (70547) | $655.10 | $2,553 | 2.9× |
| MRI abdomen w contrast (74182) | $1,203.97 | $4,692 | 3.6× |
| MRI abdomen w/o contrast (74181) | $1,203.97 | $4,692 | 5.3× |
| MRI any jt lower extrem w/contrast material (73722) | $1,159.32 | $4,518 | 1.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,284.80 | $5,007 | 3.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,203.72 | $4,691 | 1.6× |
| MRI bone marrow blood supply (77084) | $926.84 | $3,612 | 4.1× |
| MRI brain functional w/o physician admnistration (70554) | $235.05 | $916 | 1.0× |
| MRI brain functional w/physician admnistration (70555) | $235.05 | $916 | 1.0× |
| MRI cardiac w/o cont stress (75559) | $774.94 | $3,020 | 1.5× |
| MRI cardiac w/o contrast (75557) | $715.41 | $2,788 | 3.1× |
| MRI cervical spine w contrast (72142) | $1,210.64 | $4,718 | 3.6× |
| MRI cervical spine w/o cont (72141) | $1,052.58 | $4,102 | 4.6× |
| MRI chest w/o contrast (71550) | $794.44 | $3,096 | 3.5× |
| MRI chest with contrast (71551) | $970.98 | $3,784 | 1.3× |
| MRI chest wo w contrast (71552) | $1,260.68 | $4,913 | 3.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,104.67 | $4,305 | 3.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,240.92 | $4,836 | 3.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,017.68 | $3,966 | 4.5× |
| MRI lumbar spine w contrast (72149) | $1,175.23 | $4,580 | 3.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,442.10 | $5,620 | 4.3× |
| MRI orbit face &/neck w/o contrast (70540) | $575.05 | $2,241 | 2.5× |
| MRI orbit face neck w contrast (70542) | $873.21 | $3,403 | 2.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,064.89 | $4,150 | 3.2× |
| MRI pelvis w contrast (72196) | $1,014.86 | $3,955 | 3.0× |
| MRI pelvis w/o & w contrast (72197) | $1,252.73 | $4,882 | 3.8× |
| MRI pelvis w/o contrast (72195) | $939.67 | $3,662 | 4.1× |
| MRI spectroscopy (76390) | $580.18 | $2,261 | 7.0× |
| MRI thoracic spine w/o contrast (72146) | $1,022.04 | $3,983 | 4.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $995.10 | $3,878 | 3.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $872.70 | $3,401 | 3.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,178.31 | $4,592 | 3.5× |
| MRI, abdomen, combo (74183) | $1,252.21 | $4,880 | 3.8× |
| MRI, dorsal spine combo (72157) | $1,400.01 | $5,456 | 4.2× |
| MRI, dorsal spine contrast (72147) | $1,175.23 | $4,580 | 3.5× |
| MRI, joint upper extrem (73221) | $1,046.68 | $4,079 | 4.6× |
| MRI, joint upper extrem combo (73223) | $1,256.06 | $4,895 | 3.8× |
| MRI, lumbar spine combo (72158) | $1,400.01 | $5,456 | 4.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,540.12 | $6,002 | 1.2× |
| Myocardial Spect Multiple Studies (78452) | $1,984.55 | $7,734 | 1.6× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $1,647.12 | $6,419 | 0.8× |
| Neck soft tissue (70360) | $63.13 | $246 | 0.8× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) range across 2 matching MRF lines |
$144.98–$197.33 | $565–$769 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $302.54 | $1,179 | 0.8× |
| Nm csf leak detection (78650) | $622.26 | $2,425 | 0.5× |
| Nm whole blood volume (78122) | $419.80 | $1,636 | 0.8× |
| Nonvascular Shunt X-Ray (75809) | $274.05 | $1,068 | 2.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $766.21 | $2,986 | 0.6× |
| Nuclear Rx Intra-Arterial (79445) | $259.43 | $1,011 | 1.2× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$273.03–$390.55 | $1,064–$1,522 | varies |
| Optic foramina (70190) | $84.17 | $328 | 1.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $444.18 | $1,731 | 0.9× |
| Parathyroid Planar Imaging (78070) | $446.49 | $1,740 | 1.2× |
| Pelvis 1 or 2 views (72170) | $88.02 | $343 | 0.9× |
| Peritoneogram Rs&I (74190) | $312.29 | $1,217 | 0.6× |
| Pet Image W/Ct Lmtd (78814) | $1,360.50 | $5,302 | 1.0× |
| PET image w/CT, full body (78816) | $1,360.50 | $5,302 | 1.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,700.49 | $6,627 | 1.2× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,412.84 | $5,506 | 1.1× |
| PET whole body (78813) | $1,412.59 | $5,505 | 1.0× |
| Platelet survival study Non-Facility (78191) | $713.35 | $2,780 | 1.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $865.52 | $3,373 | 0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $419.80 | $1,636 | 1.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $204.77 | $798 | 2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $216.83 | $845 | 0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) | $136 | $530 | 1.6× |
| Radex Calcaneus Minimum 2 Views (73650) | $67.49 | $263 | 0.8× |
| Radex elbow complete minimum 3 views (73080) | $105.72 | $412 | 1.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $119.32 | $465 | 1.2× |
| Radex fingr minimum 2 views (73140) | $62.10 | $242 | 0.7× |
| Radex foot complete minimum 3 views (73630) | $136 | $530 | 1.6× |
| Radex Hand Minimum 3 Views (73130) | $125.74 | $490 | 1.5× |
| Radex lower extremity infant minimum 2 views (73592) | $83.40 | $325 | 1.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $107.78 | $420 | 1.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $105.21 | $410 | 1.3× |
| Radex Ribs Unilateral 2 Views (71100) | $71.85 | $280 | 0.9× |
| Radex shoulder complete minimum 2 views (73030) | $117.53 | $458 | 1.4× |
| Radex Sinuses Paransl < 3 Views (70210) | $66.98 | $261 | 0.8× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $404.92 | $1,578 | 2.4× |
| Radex Spine 1 View Specify Level (72020) | $100.59 | $392 | 1.2× |
| Radex Sternum Minimum 2 Views (71120) | $111.88 | $436 | 1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $120.35 | $469 | 1.4× |
| Radex Toe Minimum 2 Views (73660) | $108.03 | $421 | 1.3× |
| Radex upper extremity infant minimum 2 views (73092) | $54.15 | $211 | 0.5× |
| Radex Wrist Complete Minimum 3 Views (73110) | $120.61 | $470 | 1.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) unusually low: confirm this is the full procedure |
$2,360.47 | $9,199 | 0.3× |
| Radiation treatment delivery level 1 (77402) range across 5 matching MRF lines |
$87.25–$276.11 | $340–$1,076 | varies |
| Radiation treatment delivery level 2 (77407) range across 5 matching MRF lines |
$87.25–$323.06 | $340–$1,259 | varies |
| Radiation treatment delivery level 3 (77412) range across 5 matching MRF lines |
$144.98–$454.96 | $565–$1,773 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $130.61 | $509 | 1.3× |
| Radiologic exam colon double contrast study (74280) | $293.04 | $1,142 | 1.7× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$187.84–$219.91 | $732–$857 | varies |
| Radiologic exam knee complete 4/more views (73564) | $138.57 | $540 | 1.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $114.45 | $446 | 1.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $240.95 | $939 | 1.4× |
| Radiologic exam swallow function contrast study (74230) | $134.72 | $525 | 0.8× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$182.45–$372.07 | $711–$1,450 | varies |
| Radiologic examination femur minimum 2 views (73552) | $123.17 | $480 | 1.5× |
| Radiologic examination knee 1/2 views (73560) | $101.36 | $395 | 1.2× |
| Radiologic Examination Osseous Survey Limited (77074) | $131.64 | $513 | 1.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $112.14 | $437 | 1.3× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $1,067.72 | $4,161 | 4.8× |
| Ribs bilateral 3 views (71110) | $91.35 | $356 | 0.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $850.89 | $3,316 | 2.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $720.02 | $2,806 | 1.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$1,324.06–$1,389.75 | $5,160–$5,416 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$815.74–$1,168.05 | $3,179–$4,552 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 5 matching MRF lines |
$503.45–$1,142.90 | $1,962–$4,454 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $986.63 | $3,845 | 4.4× |
| Rp Therapy Intravenous Administration (79101) | $1,106.98 | $4,314 | 5.0× |
| Scapula (73010) | $75.45 | $294 | 0.8× |
| Shoulder 1 view (73020) | $58.77 | $229 | 0.7× |
| Shoulder Arthrography (73040) | $212.47 | $828 | 0.6× |
| Skull less than 4 views (70250) | $122.66 | $478 | 1.2× |
| Special dosimetry (77331) range across 2 matching MRF lines |
$80.06–$95.46 | $312–$372 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$124.46–$510.13 | $485–$1,988 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$170.13–$230.94 | $663–$900 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$377.21–$672.81 | $1,470–$2,622 | varies |
| Stereotactic Body Radiation Delivery (77373) | $1,247.59 | $4,862 | 0.7× |
| Sternoclavicular joints (71130) | $72.11 | $281 | 0.9× |
| Superior sagittal sinus venogram (75870) | $746.71 | $2,910 | 0.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) range across 2 matching MRF lines |
$79.29–$82.37 | $309–$321 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $230.94 | $900 | 0.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$62.10–$131.90 | $242–$514 | varies |
| Testicular Imaging W/Flow (78761) | $349.75 | $1,363 | 0.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 3 matching MRF lines |
$230.94–$516.03 | $900–$2,011 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$230.94–$305.10 | $900–$1,189 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$131.90–$266.10 | $514–$1,037 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $223.25 | $870 | 1.3× |
| Thoracic spine 2 views (72070) | $113.42 | $442 | 1.1× |
| Thoracolumbar 2 views (72080) | $116.76 | $455 | 1.4× |
| Thyroid Imaging With Vascular Flow (78013) | $221.96 | $865 | 0.6× |
| Thyroid Met Imaging Body (78018) | $616.61 | $2,403 | 1.2× |
| Thyroid Uptake Measurement (78012) | $120.09 | $468 | 0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $426.73 | $1,663 | 1.1× |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$217.60–$315.88 | $848–$1,231 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$124.46–$214.78 | $485–$837 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$80.06–$159.61 | $312–$622 | varies |
| Ultrasound Breast Limited (76642) | $88.28 | $344 | 1.1× |
| Ultrasound, abdomen limited (76705) | $251.47 | $980 | 2.5× |
| Umbilical-artery Doppler (OB) (76820) | $113.94 | $444 | 1.1× |
| Unlisted Dx Radiographic Procedure (76499) | $79.55 | $310 | 1.0× |
| Unlisted fluoroscopic procedure (76496) | $111.11 | $433 | 1.3× |
| Unlisted magnetic resonance procedure (76498) | $581.20 | $2,265 | 7.0× |
| Unlisted Procedure Clinical Brachytherapy (77799) range across 3 matching MRF lines |
$82.37–$1,847.52 | $321–$7,200 | varies |
| Unlisted us procedure (76999) | $100.85 | $393 | 1.2× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$140.11–$269.18 | $546–$1,049 | varies |
| Ureteral Reflux Study (78740) | $349.75 | $1,363 | 0.9× |
| Urethrocystogram voiding (74455) | $192.45 | $750 | 0.8× |
| Urethrocystography retrograde (74450) | $134.72 | $525 | 0.6× |
| Us bone density measurement (76977) | $56.71 | $221 | 0.6× |
| Us breast unilateral complete (76641) | $88.28 | $344 | 0.9× |
| Us chest (76604) | $162.43 | $633 | 1.6× |
| Us complete joint (76881) | $155.50 | $606 | 1.6× |
| Us exam, pelvic, limited (76857) | $80.58 | $314 | 0.8× |
| Us head (76506) | $163.97 | $639 | 1.6× |
| Us kidney transplant (76776) | $224.53 | $875 | 2.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $136.77 | $533 | 1.4× |
| Us ob detailed single fetus (76811) | $204.26 | $796 | 0.9× |
| Us ob limited 1 or more fetuses (76815) | $109.32 | $426 | 1.1× |
| Us ob transvaginal (76817) | $154.22 | $601 | 1.5× |
| Us pelvic non ob complete (76856) | $297.66 | $1,160 | 3.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $96.23 | $375 | 1.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$111.11–$138.83 | $433–$541 | varies |
| Us retroperitoneal complete (76770) | $222.22 | $866 | 2.2× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$206.57–$215.55 | $805–$840 | varies |
| Us scrotum and contents (76870) | $199.38 | $777 | 2.0× |
| Us spinal canal and contents (76800) | $83.91 | $327 | 0.8× |
| Us thyroid (76536) | $154.22 | $601 | 1.5× |
| Us transrectal (76872) | $120.61 | $470 | 1.2× |
| Vein X-Ray Chest (75827) | $726.95 | $2,833 | 0.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,425.16 | $5,554 | 0.5× |
| Venogram Sinus/Jugular (75860) | $933.26 | $3,637 | 0.3× |
| Venography Adrenal Unilateral (75840) | $865.52 | $3,373 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $1,483.67 | $5,782 | 0.5× |
| Venography extremity bilateral rs&i (75822) | $457.78 | $1,784 | 0.3× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$397.99–$716.18 | $1,551–$2,791 | varies |
| Venography Renal Bilateral (75833) | $1,194.22 | $4,654 | 0.4× |
| Venography Renal Unilateral (75831) | $865.52 | $3,373 | 0.3× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$2,456.69 | $9,574 | 0.5× |
| Wrist 2 views (73100) | $107.26 | $418 | 1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $119.84 | $467 | 1.4× |
| X-ray antegrade pyelogram tube (74425) | $168.33 | $656 | 0.5× |
| X-Ray Aorta Leg Arteries (75630) | $1,120.06 | $4,365 | 0.4× |
| X-Ray Bend Only L-S Spine (72120) | $131.90 | $514 | 1.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $82.63 | $322 | 1.0× |
| X-Ray Exam Breast Specimen (76098) | $260.20 | $1,014 | 0.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$152.17–$331.79 | $593–$1,293 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$59.02–$121.63 | $230–$474 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $120.61 | $470 | 1.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $184.76 | $720 | 1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$136.26–$184.76 | $531–$720 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $369.25 | $1,439 | 3.7× |
| X-Ray Exam L-S Spine Bending (72114) | $209.90 | $818 | 2.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $120.61 | $470 | 1.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $176.29 | $687 | 1.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $78.78 | $307 | 0.8× |
| X-ray humerus (73060) | $125.23 | $488 | 1.5× |
| X-ray IV pyelogram (ivp) (74400) | $206.82 | $806 | 1.2× |
| X-ray IV pyelogram+tomography (74415) | $328.45 | $1,280 | 2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $38.24 | $149 | 0.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $77.75 | $303 | 0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $119.84 | $467 | 1.2× |
| X-ray nose-rectum child f.b. (76010) | $62.10 | $242 | 0.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $163.97 | $639 | 1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $111.88 | $436 | 1.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $56.46 | $220 | 0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $104.44 | $407 | 1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $126.25 | $492 | 1.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $138.57 | $540 | 1.4× |
| X-ray thoracic spine 4 vw (72074) | $90.84 | $354 | 0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $168.33 | $656 | 0.5× |
| X-Rays Bone Length Studies (77073) | $110.34 | $430 | 1.1× |
| X-Rays Bone Survey Complete (77075) | $170.90 | $666 | 1.7× |
| Xr c-spine 4 or 5 views (72050) | $176.29 | $687 | 1.8× |
| Xr facial bones less than 3 views (70140) | $53.63 | $209 | 0.6× |
| XR Mastoids < 3 Views Bilateral (70120) | $31.82 | $124 | 0.3× |
| Xr orbits complete 4 views (70200) | $162.43 | $633 | 1.6× |
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.