Imaging prices at CHRISTUS Santa Rosa Medical Center
San Antonio, TX · every code in this section with a posted price and a Medicare benchmark.
360 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $231.66 | $702 | 2.6× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$210.54–$402.93 | $638–$1,221 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,300.53 | $3,941 | 3.2× |
| Adrenal Cortex & Medulla Img (78075) | $1,097.58 | $3,326 | 0.8× |
| Angio internal mammary (75756) | $1,184.04 | $3,588 | 0.4× |
| Angio pulmonary bilat (75743) | $3,366.66 | $10,202 | 1.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,346.20 | $10,140 | 1.1× |
| Angiography extremity bilateral rs&i (75716) | $3,754.41 | $11,377 | 1.2× |
| Angiography extremity unilateral rs&i (75710) | $4,350.06 | $13,182 | 1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,366.66 | $10,202 | 1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,184.04 | $3,588 | 0.4× |
| Ankle 2 views (73600) range across 7 matching MRF lines |
$79.86–$605.22 | $242–$1,834 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$3,346.20–$3,580.17 | $10,140–$10,849 | varies |
| Aortography thoracic w/o serialography rs&i (75600) range across 2 matching MRF lines |
$1,434.18–$3,346.20 | $4,346–$10,140 | varies |
| Artery X-Rays Abdomen (75726) | $4,350.06 | $13,182 | 0.8× |
| Artery X-Rays Pelvis (75736) | $4,350.06 | $13,182 | 0.8× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$1.32 | $4 | 0.0× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$408.87–$1,170.51 | $1,239–$3,547 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$356.73–$452.76 | $1,081–$1,372 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$469.26–$986.70 | $1,422–$2,990 | varies |
| Bone age studies (77072) range across 3 matching MRF lines |
$210.54–$932.58 | $638–$2,826 | varies |
| Bone Imaging 3 Phase (78315) | $1,325.94 | $4,018 | 3.3× |
| Bone Imaging Limited Area (78300) | $1,181.07 | $3,579 | 2.9× |
| Bone Imaging Multiple Areas (78305) | $1,242.12 | $3,764 | 3.1× |
| Bone Imaging Whole Body (78306) | $1,308.12 | $3,964 | 3.3× |
| Bone marrow imaging; multiple areas (78103) | $785.07 | $2,379 | 2.0× |
| Bone marrow imaging; whole body (78104) | $825.66 | $2,502 | 2.1× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$929.61–$953.70 | $2,817–$2,890 | varies |
| Brain Flow Imaging Only (78610) | $465.63 | $1,411 | 0.9× |
| Brain Image W/Flow < 4 Views (78601) | $452.76 | $1,372 | 1.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$442.20–$1,181.07 | $1,340–$3,579 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,483.58 | $7,526 | 1.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 3 matching MRF lines |
$947.43–$1,790.91 | $2,871–$5,427 | varies |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$310.53–$570.24 | $941–$1,728 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,278.42 | $3,874 | 2.3× |
| Cerebrospinal Fluid Scan (78630) | $481.47 | $1,459 | 0.9× |
| Chest 1 view (71045) | $336.93 | $1,021 | 3.9× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$144.21–$425.70 | $437–$1,290 | varies |
| Chest 3 views (71047) | $459.69 | $1,393 | 5.3× |
| Chest 4 or more views (71048) | $472.23 | $1,431 | 4.5× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$150.15–$699.27 | $455–$2,119 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $406.56 | $1,232 | 3.9× |
| Contrast Exam Abdominl Aorta (75625) | $4,350.06 | $13,182 | 1.4× |
| Contrast X-Ray Bladder (74430) | $1,274.13 | $3,861 | 3.6× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$452.76–$490.71 | $1,372–$1,487 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $1,510.41 | $4,577 | 4.3× |
| CT abdomen and pelvis without and with contrast (74178) | $1,957.23 | $5,931 | 5.6× |
| CT abdomen and pelvis without contrast (74176) | $1,797.18 | $5,446 | 7.5× |
| CT abdomen w contrast (74160) | $1,031.91 | $3,127 | 5.9× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,066.23–$1,131.24 | $3,231–$3,428 | varies |
| CT abdomen w/o contrast (74150) | $953.70 | $2,890 | 9.1× |
| CT Angio Abdomen and Pelvis (74174) | $1,976.70 | $5,990 | 5.6× |
| CT Angio Chest (71275) | $949.74 | $2,878 | 5.4× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$846.12–$1,249.05 | $2,564–$3,785 | varies |
| CT angio hrt w/3d image (75574) | $986.70 | $2,990 | 2.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,092.96 | $3,312 | 6.2× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$846.12–$1,078.77 | $2,564–$3,269 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $796.95 | $2,415 | 4.5× |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$752.73–$943.14 | $2,281–$2,858 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$651.09–$931.26 | $1,973–$2,822 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$821.37–$1,126.29 | $2,489–$3,413 | varies |
| CT chest w contrast (71260) | $871.86 | $2,642 | 4.9× |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$989.01–$1,015.41 | $2,997–$3,077 | varies |
| CT colonography screening (74263) | $882.42 | $2,674 | 3.7× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $621.39 | $1,883 | 3.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $400.62 | $1,214 | 3.8× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$515.13–$932.91 | $1,561–$2,827 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$581.46–$1,180.41 | $1,762–$3,577 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $673.86 | $2,042 | 1.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $110.55 | $335 | 1.3× |
| CT hrt w/3d image congen (75573) | $549.12 | $1,664 | 1.6× |
| CT iac w contrast (70481) range across 11 matching MRF lines |
$574.86–$807.51 | $1,742–$2,447 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$936.21–$1,155 | $2,837–$3,500 | varies |
| CT lower ext w/o (73700) | $794.97 | $2,409 | 7.6× |
| CT lower extremity w/contrast material (73701) | $1,024.65 | $3,105 | 5.8× |
| CT lumbar spine w contrast (72132) | $989.67 | $2,999 | 2.8× |
| CT lumbar spine w/o contrast (72131) | $826.98 | $2,506 | 7.9× |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$520.08–$831.60 | $1,576–$2,520 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$479.49–$740.52 | $1,453–$2,244 | varies |
| CT neck tissue combo (70492) range across 4 matching MRF lines |
$776.49–$1,010.46 | $2,353–$3,062 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 8 matching MRF lines |
$633.93–$933.57 | $1,921–$2,829 | varies |
| CT orbits w/o contrast (70480) range across 8 matching MRF lines |
$554.73–$726.33 | $1,681–$2,201 | varies |
| CT pelvis w&w/o contrast (72194) | $891 | $2,700 | 5.1× |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$675.84–$821.37 | $2,048–$2,489 | varies |
| CT scan of leg combo (73702) | $1,107.15 | $3,355 | 6.3× |
| CT scans face/jaw combo (70488) range across 4 matching MRF lines |
$559.35–$924 | $1,695–$2,800 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$542.19–$846.12 | $1,643–$2,564 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$503.91–$705.21 | $1,527–$2,137 | varies |
| CT thoracic spine w contrast (72129) | $751.41 | $2,277 | 4.3× |
| CT thoracic spine w/o contrast (72128) | $685.08 | $2,076 | 6.5× |
| CT thoracic spine w/wo cont (72130) | $1,067.88 | $3,236 | 6.1× |
| CT thorax w/o contrast (71250) | $797.61 | $2,417 | 7.6× |
| CT upper ext wo (73200) | $668.58 | $2,026 | 6.4× |
| CT upper extremity w/o & w/contrast material (73202) | $742.17 | $2,249 | 4.2× |
| CT upper extremity with contrast (73201) | $686.73 | $2,081 | 2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,365.87 | $4,139 | 7.8× |
| Cta Abdomen (74175) | $1,134.54 | $3,438 | 6.4× |
| CTA pelvis (72191) range across 3 matching MRF lines |
$843.15–$1,022.34 | $2,555–$3,098 | varies |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$1,795.53–$3,734.61 | $5,441–$11,317 | varies |
| Discography Cerv/Thor Spine (72285) | $4,325.97 | $13,109 | 2.2× |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$3,247.53–$4,325.97 | $9,841–$13,109 | varies |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$103.62–$741.84 | $314–$2,248 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $691.35 | $2,095 | 7.9× |
| Echo exam of fetal heart (76825) | $1,651.65 | $5,005 | 3.0× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$514.14–$523.71 | $1,558–$1,587 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$477.51–$746.79 | $1,447–$2,263 | varies |
| Esophagram (74220) | $607.53 | $1,841 | 3.4× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$774.18–$1,049.73 | $2,346–$3,181 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$402.60–$443.85 | $1,220–$1,345 | varies |
| Fluoroscopy up to 1 hr (76000) | $754.05 | $2,285 | 3.1× |
| Follow-Up Angiography (75898) | $894.30 | $2,710 | 0.3× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$150.15–$621.06 | $455–$1,882 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$150.15–$595.32 | $455–$1,804 | varies |
| Gastric emptying imaging study (78264) | $1,165.89 | $3,533 | 2.9× |
| Gastroesophageal Reflux Exam (78262) range across 2 matching MRF lines |
$487.41–$1,320 | $1,477–$4,000 | varies |
| Gated Heart Planar Single (78472) | $1,408.11 | $4,267 | 3.5× |
| Gated Heart, Multiple (78473) | $1,429.56 | $4,332 | 3.6× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$210.54–$545.82 | $638–$1,654 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,346.20 | $10,140 | 1.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$3,346.20–$4,350.06 | $10,140–$13,182 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,379.07 | $4,179 | 2.5× |
| Hepatobiliary System Imaging (78226) | $1,199.55 | $3,635 | 3.0× |
| Ht Musc Image Planar Mult (78454) | $1,730.52 | $5,244 | 1.3× |
| Ht Muscle Image Spect Sing (78451) | $2,507.01 | $7,597 | 1.9× |
| Hysterosalpingogram (74740) | $1,155.66 | $3,502 | 4.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$514.14–$765.27 | $1,558–$2,319 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$288.75–$617.43 | $875–$1,871 | varies |
| Infusion Ivp (74410) range across 2 matching MRF lines |
$570.57–$745.14 | $1,729–$2,258 | varies |
| Joint Survey Single View (77077) | $1,350.03 | $4,091 | 12.9× |
| K Flow/Funct Image Multiple (78709) | $749.76 | $2,272 | 1.4× |
| K Flow/Funct Image W/Drug (78708) | $1,141.14 | $3,458 | 2.1× |
| K Flow/Funct Image W/O Drug (78707) | $866.58 | $2,626 | 1.6× |
| Kidney Imaging Morphol (78700) | $525.03 | $1,591 | 1.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $798.60 | $2,420 | 2.0× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$106.26–$838.86 | $322–$2,542 | varies |
| Liver & Spleen Imaging Static Only (78215) | $957.66 | $2,902 | 2.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,052.70 | $3,190 | 2.6× |
| Lung Perf&Ventilat Diferentl (78598) | $2,541.99 | $7,703 | 4.7× |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$419.43–$1,779.36 | $1,271–$5,392 | varies |
| Lung Ventilat&Perfus Imaging (78582) | $1,040.49 | $3,153 | 1.9× |
| Lung Ventilation Imaging (78579) | $419.43 | $1,271 | 1.0× |
| Lymph System Imaging (78195) | $1,550.67 | $4,699 | 2.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $643.83 | $1,951 | 0.4× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,578.06–$1,614.03 | $4,782–$4,891 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$725.34–$1,128.27 | $2,198–$3,419 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$532.62–$985.71 | $1,614–$2,987 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$381.48–$943.14 | $1,156–$2,858 | varies |
| Mra Head W/O & W/Contrast Material (70546) | $1,179.09 | $3,573 | 3.4× |
| MRA head w/o contrast (70544) | $974.82 | $2,954 | 4.1× |
| MRA head with contrast (70545) | $1,071.84 | $3,248 | 3.1× |
| MRA neck w contrast (70548) | $1,031.25 | $3,125 | 2.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,134.21 | $3,437 | 3.2× |
| MRA neck w/o contrast (70547) | $937.20 | $2,840 | 3.9× |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$1,918.62–$3,638.91 | $5,814–$11,027 | varies |
| MRI abdomen w/o contrast (74181) range across 5 matching MRF lines |
$537.57–$3,220.80 | $1,629–$9,760 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$1,823.58–$3,675.54 | $5,526–$11,138 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$1,844.37–$3,852.75 | $5,589–$11,675 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 5 matching MRF lines |
$1,775.73–$3,740.55 | $5,381–$11,335 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$1,625.25–$2,066.46 | $4,925–$6,262 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 3 matching MRF lines |
$408.87–$1,477.41 | $1,239–$4,477 | varies |
| MRI cardiac w/o contrast (75557) | $1,790.91 | $5,427 | 7.5× |
| MRI cervical spine w contrast (72142) | $1,808.40 | $5,480 | 5.2× |
| MRI cervical spine w/o cont (72141) | $1,628.55 | $4,935 | 6.8× |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$1,526.91–$3,377.22 | $4,627–$10,234 | varies |
| MRI chest with contrast (71551) range across 3 matching MRF lines |
$1,614.03–$3,883.77 | $4,891–$11,769 | varies |
| MRI chest wo w contrast (71552) range across 4 matching MRF lines |
$1,863.84–$4,415.40 | $5,648–$13,380 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 5 matching MRF lines |
$1,812.03–$3,318.48 | $5,491–$10,056 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$823.68–$3,618.78 | $2,496–$10,966 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 5 matching MRF lines |
$537.57–$3,043.92 | $1,629–$9,224 | varies |
| MRI lumbar spine w contrast (72149) range across 3 matching MRF lines |
$2,348.61–$3,872.88 | $7,117–$11,736 | varies |
| Mri Neck Spine W/O & W/Dye (72156) | $1,988.25 | $6,025 | 5.7× |
| MRI orbit face &/neck w/o contrast (70540) range across 5 matching MRF lines |
$1,507.44–$1,514.04 | $4,568–$4,588 | varies |
| MRI orbit face neck w contrast (70542) range across 4 matching MRF lines |
$585.75–$1,666.50 | $1,775–$5,050 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,832.82 | $5,554 | 5.2× |
| MRI pelvis w contrast (72196) range across 3 matching MRF lines |
$1,930.50–$2,645.28 | $5,850–$8,016 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$2,061.84–$3,592.38 | $6,248–$10,886 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,490.61–$2,299.44 | $4,517–$6,968 | varies |
| MRI spectroscopy (76390) | $879.12 | $2,664 | 10.1× |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$537.57–$2,922.81 | $1,629–$8,857 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$1,641.42–$3,198.69 | $4,974–$9,693 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 6 matching MRF lines |
$537.57–$3,105.96 | $1,629–$9,412 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,862.85–$3,294.72 | $5,645–$9,984 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,993.20–$4,088.70 | $6,040–$12,390 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$2,135.43–$5,105.43 | $6,471–$15,471 | varies |
| MRI, dorsal spine contrast (72147) range across 3 matching MRF lines |
$2,045.01–$4,105.20 | $6,197–$12,440 | varies |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$537.57–$3,338.94 | $1,629–$10,118 | varies |
| MRI, joint upper extrem combo (73223) range across 5 matching MRF lines |
$1,691.25–$4,157.34 | $5,125–$12,598 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$823.68–$4,181.43 | $2,496–$12,671 | varies |
| Myelogram cervical (72240) | $1,529.88 | $4,636 | 1.9× |
| Myelogram Lumbar (72265) | $1,845.69 | $5,593 | 2.3× |
| Myelography thoracic (72255) | $1,164.57 | $3,529 | 1.5× |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$1,216.38–$2,327.49 | $3,686–$7,053 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $481.47 | $1,459 | 1.2× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,289.97 | $3,909 | 1.0× |
| Myocardial Spect Multiple Studies (78452) | $3,092.43 | $9,371 | 2.4× |
| Neck soft tissue (70360) | $384.45 | $1,165 | 4.4× |
| Nm csf leak detection (78650) | $622.71 | $1,887 | 0.5× |
| Nm myocard infarct spect (78469) | $1,504.80 | $4,560 | 2.8× |
| Nm unlisted gi procedure (78299) | $1,007.49 | $3,053 | 2.5× |
| Nonvascular Shunt X-Ray (75809) | $244.86 | $742 | 2.3× |
| Nuclear Rx Intra-Arterial (79445) | $168.30 | $510 | 0.7× |
| Nuclear Rx Oral Admin (79005) | $1,000.23 | $3,031 | 4.3× |
| Ob us nuchal meas 1 gest (76813) | $119.79 | $363 | 1.1× |
| Optic foramina (70190) range across 2 matching MRF lines |
$357.72–$399.96 | $1,084–$1,212 | varies |
| Parathyroid Planar Imaging (78070) | $773.52 | $2,344 | 1.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,407.12 | $4,264 | 3.5× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$210.54–$631.29 | $638–$1,913 | varies |
| Peritoneogram Rs&I (74190) | $422.07 | $1,279 | 0.8× |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$1,608.75–$3,519.12 | $4,875–$10,664 | varies |
| PET image w/CT, full body (78816) range across 4 matching MRF lines |
$1,819.62–$5,581.95 | $5,514–$16,915 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 4 matching MRF lines |
$1,819.62–$4,802.49 | $5,514–$14,553 | varies |
| PET whole body (78813) range across 2 matching MRF lines |
$1,259.94–$4,498.89 | $3,818–$13,633 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,346.20 | $10,140 | 1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $822.36 | $2,492 | 2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $499.95 | $1,515 | 4.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,155.66 | $3,502 | 2.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$150.15–$631.29 | $455–$1,913 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$89.76–$548.79 | $272–$1,663 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$179.52–$696.63 | $544–$2,111 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$126.72–$1,096.26 | $384–$3,322 | varies |
| Radex fingr minimum 2 views (73140) range across 5 matching MRF lines |
$150.15–$535.26 | $455–$1,622 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$140.58–$654.06 | $426–$1,982 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$220.44–$679.80 | $668–$2,060 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $604.56 | $1,832 | 6.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$138.60–$422.07 | $420–$1,279 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$126.72–$663.96 | $384–$2,012 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$150.15–$787.05 | $455–$2,385 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$144.21–$735.57 | $437–$2,229 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$150.15–$577.17 | $455–$1,749 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$150.15–$497.31 | $455–$1,507 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$425.04–$766.26 | $1,288–$2,322 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$349.80–$916.41 | $1,060–$2,777 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$150.15–$587.07 | $455–$1,779 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $348.15 | $1,055 | 3.3× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$150.15–$654.06 | $455–$1,982 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 3 matching MRF lines |
$129.69–$820.38 | $393–$2,486 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$162.03–$1,083.39 | $491–$3,283 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $402.93 | $1,221 | 3.8× |
| Radiologic exam colon double contrast study (74280) | $1,409.43 | $4,271 | 8.0× |
| Radiologic exam colon single contrast study (74270) | $1,147.74 | $3,478 | 6.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $465.30 | $1,410 | 2.6× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$210.54–$920.37 | $638–$2,789 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$82.50–$680.13 | $250–$2,061 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,033.56 | $3,132 | 5.9× |
| Radiologic exam swallow function contrast study (74230) | $860.31 | $2,607 | 4.9× |
| Radiologic exam teeth complete full mouth (70320) | $315.15 | $955 | 1.3× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $161.70 | $490 | 0.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $550.11 | $1,667 | 3.1× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$440.22–$707.85 | $1,334–$2,145 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$122.43–$707.85 | $371–$2,145 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$115.50–$602.58 | $350–$1,826 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$969.87–$1,323.96 | $2,939–$4,012 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $171.93 | $521 | 2.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$150.15–$626.67 | $455–$1,899 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $213.18 | $646 | 0.4× |
| Renal Cyst Study (74470) | $683.76 | $2,072 | 1.2× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$498.30–$1,651.32 | $1,510–$5,004 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $705.54 | $2,138 | 1.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,052.70 | $3,190 | 2.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,779.36 | $5,392 | 3.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,356.63 | $4,111 | 2.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,167.21 | $3,537 | 2.1× |
| Scapula (73010) range across 3 matching MRF lines |
$102.30–$787.05 | $310–$2,385 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 4 matching MRF lines |
$34.98–$88.77 | $106–$269 | varies |
| Sella turcica (70240) | $170.28 | $516 | 1.9× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$334.62–$558.69 | $1,014–$1,693 | varies |
| Shoulder Arthrography (73040) | $588.72 | $1,784 | 1.7× |
| Sialogram (70390) range across 2 matching MRF lines |
$581.79–$683.76 | $1,763–$2,072 | varies |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$156.09–$646.47 | $473–$1,959 | varies |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$331.32–$355.41 | $1,004–$1,077 | varies |
| Superior sagittal sinus venogram (75870) | $1,184.04 | $3,588 | 0.4× |
| Temporomandble Jt Arthrography Rs&I (70332) | $750.09 | $2,273 | 3.1× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$210.54–$803.55 | $638–$2,435 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$210.54–$932.58 | $638–$2,826 | varies |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$118.80–$871.20 | $360–$2,640 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $272.25 | $825 | 0.7× |
| Thyroid Met Imaging Body (78018) | $1,560.90 | $4,730 | 2.9× |
| Thyroid Uptake Measurement (78012) | $883.41 | $2,677 | 2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $883.41 | $2,677 | 2.2× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$26.07–$393.03 | $79–$1,191 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$123.75–$561.66 | $375–$1,702 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$156.09–$968.22 | $473–$2,934 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$198.33–$423.72 | $601–$1,284 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $304.26 | $922 | 3.5× |
| Upper gi w/o kub (74240) | $825.33 | $2,501 | 4.7× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$502.26–$558.69 | $1,522–$1,693 | varies |
| Urethrocystography retrograde (74450) | $541.86 | $1,642 | 2.3× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$151.80–$393.03 | $460–$1,191 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$156.09–$701.58 | $473–$2,126 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$132.66–$571.89 | $402–$1,733 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$90.09–$633.60 | $273–$1,920 | varies |
| Us head (76506) range across 2 matching MRF lines |
$412.50–$514.80 | $1,250–$1,560 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$824.34–$931.59 | $2,498–$2,823 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$52.80–$544.50 | $160–$1,650 | varies |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$137.28–$946.44 | $416–$2,868 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$251.13–$413.82 | $761–$1,254 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$88.77–$621.06 | $269–$1,882 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$156.09–$1,030.92 | $473–$3,124 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$109.23–$723.69 | $331–$2,193 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$330.33–$344.19 | $1,001–$1,043 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$156.09–$839.85 | $473–$2,545 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$140.25–$797.28 | $425–$2,416 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$156.09–$746.79 | $473–$2,263 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$348.15–$900.24 | $1,055–$2,728 | varies |
| Us thyroid (76536) range across 4 matching MRF lines |
$156.09–$715.44 | $473–$2,168 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$494.01–$504.57 | $1,497–$1,529 | varies |
| Vascular Flow Imaging (78445) | $414.48 | $1,256 | 1.0× |
| Vein X-Ray Chest (75827) | $1,539.12 | $4,664 | 1.0× |
| Vein X-Ray Spleen/Liver (75810) | $3,346.20 | $10,140 | 1.1× |
| Venogram Sinus/Jugular (75860) | $1,184.04 | $3,588 | 0.4× |
| Venography Adrenal Unilateral (75840) | $3,346.20 | $10,140 | 1.1× |
| Venography caval inferior serialography rs&i (75825) | $4,350.06 | $13,182 | 1.4× |
| Venography extremity bilateral rs&i (75822) | $1,539.12 | $4,664 | 1.0× |
| Venography extremity unilateral rs&i (75820) | $1,539.12 | $4,664 | 1.0× |
| Venography Orbital Rs&I (75880) | $1,184.04 | $3,588 | 1.9× |
| Venography Renal Bilateral (75833) | $3,366.66 | $10,202 | 1.1× |
| Venous sampling by catheter (75893) | $3,346.20 | $10,140 | 0.6× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$150.15–$602.58 | $455–$1,826 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$349.80–$741.51 | $1,060–$2,247 | varies |
| X-ray antegrade pyelogram tube (74425) | $1,019.37 | $3,089 | 2.9× |
| X-Ray Aorta Leg Arteries (75630) | $3,346.20 | $10,140 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$210.54–$990.99 | $638–$3,003 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$150.15–$620.40 | $455–$1,880 | varies |
| X-Ray Exam Breast Specimen (76098) | $626.67 | $1,899 | 1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 3 matching MRF lines |
$69.63–$441.21 | $211–$1,337 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines |
$210.54–$1,366.53 | $638–$4,141 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 3 matching MRF lines |
$108.57–$778.47 | $329–$2,359 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$140.58–$476.52 | $426–$1,444 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$150.15–$707.85 | $455–$2,145 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $772.20 | $2,340 | 7.4× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 4 matching MRF lines |
$144.54–$901.89 | $438–$2,733 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$204.93–$901.89 | $621–$2,733 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $500.28 | $1,516 | 4.8× |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$210.54–$1,185.36 | $638–$3,592 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$150.15–$735.90 | $455–$2,230 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$210.54–$1,300.20 | $638–$3,940 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$210.54–$831.27 | $638–$2,519 | varies |
| X-ray eye for foreign body (70030) | $199.32 | $604 | 2.3× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$150.15–$631.29 | $455–$1,913 | varies |
| X-ray IV pyelogram (ivp) (74400) | $534.93 | $1,621 | 3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 3 matching MRF lines |
$98.67–$808.83 | $299–$2,451 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$148.83–$522.06 | $451–$1,582 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$210.54–$874.17 | $638–$2,649 | varies |
| X-ray nose-rectum child f.b. (76010) | $247.50 | $750 | 2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$203.94–$1,745.70 | $618–$5,290 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$210.54–$862.95 | $638–$2,615 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$210.54–$590.37 | $638–$1,789 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$150.15–$707.85 | $455–$2,145 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$179.19–$892.65 | $543–$2,705 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$585.42–$1,019.04 | $1,774–$3,088 | varies |
| X-Ray Stress View (77071) | $120.12 | $364 | 1.4× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$66.66–$1,135.20 | $202–$3,440 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$331.32–$437.91 | $1,004–$1,327 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,158.63 | $3,511 | 3.3× |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$197.34–$987.69 | $598–$2,993 | varies |
| X-Rays Bone Survey Complete (77075) range across 3 matching MRF lines |
$212.85–$2,277.33 | $645–$6,901 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$210.54–$1,116.39 | $638–$3,383 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$378.51–$824.34 | $1,147–$2,498 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$490.38–$969.21 | $1,486–$2,937 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$509.52–$916.74 | $1,544–$2,778 | 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.