Imaging prices at Citizens Memorial Hospital
Bolivar, MO · every code in this section with a posted price and a Medicare benchmark.
276 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) range across 4 matching MRF lines |
$68–$320.40 | $85–$400.50 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$30.40–$413.60 | $38–$517 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $664.80 | $831 | 1.7× |
| Angio pulmonary bilat (75743) | $2,570.40 | $3,213 | 0.8× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$3,962.20–$4,160.40 | $4,952.75–$5,200.50 | varies |
| Angiography extremity unilateral rs&i (75710) range across 4 matching MRF lines |
$3,659.80–$7,685.60 | $4,574.75–$9,607 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,586.20 | $1,982.75 | 0.5× |
| Ankle 2 views (73600) range across 8 matching MRF lines |
$52–$517.60 | $65–$647 | varies |
| Aortography thoracic serialography rs&i (75605) | $3,626 | $4,532.50 | 0.7× |
| Artery X-Rays Abdomen (75726) | $3,485.40 | $4,356.75 | 0.6× |
| Bone age studies (77072) range across 3 matching MRF lines |
$64–$308.20 | $80–$385.25 | varies |
| Bone Imaging 3 Phase (78315) range across 3 matching MRF lines |
$359.20–$1,864.40 | $449–$2,330.50 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$984.40–$1,033.80 | $1,230.50–$1,292.25 | varies |
| Bone Imaging Multiple Areas (78305) | $1,082.40 | $1,353 | 2.7× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,529.80–$1,606.40 | $1,912.25–$2,008 | varies |
| Bone survey infant (77076) | $424.60 | $530.75 | 4.1× |
| Brain Imaging Minimum 4 Static Views (78605) | $881.60 | $1,102 | 1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,859.80 | $7,324.75 | 4.1× |
| Cat Scan Follow-Up Study (76380) | $770.60 | $963.25 | 8.8× |
| Chest 1 view (71045) range across 6 matching MRF lines |
$48–$475.60 | $60–$594.50 | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$64.80–$333.20 | $81–$416.50 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$33.60–$200.60 | $42–$250.75 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$35.20–$357 | $44–$446.25 | varies |
| Cholecystography Oral Contrast (74290) | $269.20 | $336.50 | 1.5× |
| Clavicle complete (73000) range across 7 matching MRF lines |
$54.40–$735.60 | $68–$919.50 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,215.60 | $1,519.50 | 11.6× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$3,186.40–$3,345.80 | $3,983–$4,182.25 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$133.60–$840.40 | $167–$1,050.50 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$61.60–$662 | $77–$827.50 | varies |
| Corpora cavernosography (74445) | $512.20 | $640.25 | 4.9× |
| CT abdomen and pelvis without and with contrast (74178) | $5,640 | $7,050 | 16.1× |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$4,060.80–$4,087.40 | $5,076–$5,109.25 | varies |
| CT abdomen w contrast (74160) | $2,730.60 | $3,413.25 | 15.5× |
| CT abdomen w wo contrast (74170) | $3,269 | $4,086.25 | 18.6× |
| CT abdomen w/o contrast (74150) | $2,172.20 | $2,715.25 | 20.7× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$4,891.80–$5,136.40 | $6,114.75–$6,420.50 | varies |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$2,358–$2,476 | $2,947.50–$3,095 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$2,721–$2,857.20 | $3,401.25–$3,571.50 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$1,593.60–$1,673.40 | $1,992–$2,091.75 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,508 | $3,135 | 14.3× |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$2,665–$2,798.40 | $3,331.25–$3,498 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,819.20 | $3,524 | 16.0× |
| CT cervical spine w/ contrast (72126) | $2,735.60 | $3,419.50 | 7.8× |
| CT cervical spine w/o contrast (72125) | $2,506.80 | $3,133.50 | 23.9× |
| CT cervical spine w/wo cont (72127) | $2,154.40 | $2,693 | 12.3× |
| CT chest w contrast (71260) | $2,582.80 | $3,228.50 | 14.7× |
| CT chest w/wo contrast (71270) | $3,254 | $4,067.50 | 18.5× |
| CT head/brain with contrast (70460) | $2,109.80 | $2,637.25 | 12.0× |
| CT head/brain without and with contrast (70470) | $2,839.80 | $3,549.75 | 16.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $58.82 | $73.53 | 0.7× |
| CT iac w contrast (70481) | $2,157.40 | $2,696.75 | 12.3× |
| CT l-spine w&w/o contrast (72133) | $2,537.60 | $3,172 | 14.4× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$1,911.80–$3,823.40 | $2,389.75–$4,779.25 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$2,264.60–$2,265 | $2,830.75–$2,831.25 | varies |
| CT lumbar spine w contrast (72132) | $2,766 | $3,457.50 | 7.9× |
| CT lumbar spine w/o contrast (72131) | $2,368.20 | $2,960.25 | 22.6× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$2,333.60–$2,398.20 | $2,917–$2,997.75 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$2,019.80–$2,031.60 | $2,524.75–$2,539.50 | varies |
| CT neck tissue combo (70492) | $3,155.60 | $3,944.50 | 18.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$2,946.60–$3,094 | $3,683.25–$3,867.50 | varies |
| CT orbits w/o contrast (70480) | $2,019.20 | $2,524 | 19.3× |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$3,304.20–$3,469.60 | $4,130.25–$4,337 | varies |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$2,156.20–$2,178.40 | $2,695.25–$2,723 | varies |
| CT scan of leg combo (73702) | $1,879.80 | $2,349.75 | 10.7× |
| CT scans face/jaw combo (70488) | $2,944.20 | $3,680.25 | 16.8× |
| CT soft tissue neck w contrast (70491) | $2,515.20 | $3,144 | 14.3× |
| CT soft tissue neck w/o contrast (70490) | $2,115.60 | $2,644.50 | 20.2× |
| CT thoracic spine w contrast (72129) | $2,711.60 | $3,389.50 | 15.4× |
| CT thoracic spine w/o contrast (72128) | $2,427.20 | $3,034 | 23.2× |
| CT thoracic spine w/wo cont (72130) | $2,006.20 | $2,507.75 | 11.4× |
| CT thorax w/o contrast (71250) | $2,278.60 | $2,848.25 | 21.8× |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$1,922.60–$3,845.20 | $2,403.25–$4,806.50 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$3,271.60–$3,435.20 | $4,089.50–$4,294 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$2,195.40–$2,253 | $2,744.25–$2,816.25 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,952.80 | $4,941 | 22.5× |
| Cta Abdomen (74175) | $2,469.20 | $3,086.50 | 14.1× |
| Dilation ureters/urethra rs&i (74485) | $571.80 | $714.75 | 0.3× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$457.60–$533.40 | $572–$666.75 | varies |
| Echo exam of fetal heart (76825) | $1,053.60 | $1,317 | 1.9× |
| Echo exam uterus (76831) | $108.80 | $136 | 0.5× |
| Esophagram (74220) range across 2 matching MRF lines |
$91.20–$606.20 | $114–$757.75 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$88–$538.20 | $110–$672.75 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$104–$639 | $130–$798.75 | varies |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$160–$651.80 | $200–$814.75 | varies |
| Follow-Up Angiography (75898) | $1,222.80 | $1,528.50 | 0.4× |
| Foot 2 views (73620) range across 7 matching MRF lines |
$52–$645.60 | $65–$807 | varies |
| Forearm 2 views (73090) range across 9 matching MRF lines |
$54.40–$698 | $68–$872.50 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,554.60–$1,632.40 | $1,943.25–$2,040.50 | varies |
| Gastric Mucosa Imaging (78261) | $971 | $1,213.75 | 2.4× |
| Gated Heart Planar Single (78472) | $1,608.60 | $2,010.75 | 4.0× |
| Hand 2 views (73120) range across 7 matching MRF lines |
$52–$550.40 | $65–$688 | varies |
| Heart first pass single,planar (78481) | $1,422.80 | $1,778.50 | 2.6× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$2,063.40–$2,125.60 | $2,579.25–$2,657 | varies |
| Hepatobiliary System Imaging (78226) | $2,050.80 | $2,563.50 | 5.1× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$694.40–$729.20 | $868–$911.50 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $880.80 | $1,101 | 10.1× |
| Infusion Ivp (74410) | $720.60 | $900.75 | 4.1× |
| K Flow/Funct Image Multiple (78709) | $2,620 | $3,275 | 4.8× |
| K Flow/Funct Image W/Drug (78708) | $1,745.60 | $2,182 | 3.2× |
| K Flow/Funct Image W/O Drug (78707) | $1,295.60 | $1,619.50 | 2.4× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $454.80 | $568.50 | 1.1× |
| Kidney Imaging Morphol (78700) | $866 | $1,082.50 | 2.2× |
| Knee 3 Views (73562) range across 9 matching MRF lines |
$60.80–$830 | $76–$1,037.50 | varies |
| Liver & Spleen Imaging Static Only (78215) | $958.60 | $1,198.25 | 2.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,027.60 | $1,284.50 | 2.6× |
| Liver imaging static only (78201) | $646.80 | $808.50 | 1.2× |
| Lung perfusion differential (78597) | $1,878.60 | $2,348.25 | 4.7× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$1,539.80–$1,616.80 | $1,924.75–$2,021 | varies |
| Lung Ventilation Imaging (78579) | $829.60 | $1,037 | 2.1× |
| Lymph System Imaging (78195) | $1,878.20 | $2,347.75 | 3.5× |
| Magnetic Image Jaw Joint (70336) | $3,081.80 | $3,852.25 | 12.9× |
| Meckels Divert Exam (78290) | $933.40 | $1,166.75 | 2.3× |
| Mra Head W/O & W/Contrast Material (70546) | $1,868.60 | $2,335.75 | 5.3× |
| MRA head w/o contrast (70544) | $2,613.40 | $3,266.75 | 10.9× |
| MRA head with contrast (70545) | $1,717 | $2,146.25 | 4.9× |
| MRA neck w contrast (70548) | $2,328.40 | $2,910.50 | 6.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,486.20 | $3,107.75 | 7.1× |
| MRA neck w/o contrast (70547) | $2,538.40 | $3,173 | 10.6× |
| MRI abdomen w contrast (74182) | $3,039.80 | $3,799.75 | 8.7× |
| MRI abdomen w/o contrast (74181) | $2,726.80 | $3,408.50 | 11.4× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$2,976.60–$3,125.60 | $3,720.75–$3,907 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,737.80–$7,475.60 | $4,672.25–$9,344.50 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,325.80 | $4,157.25 | 4.2× |
| MRI bone marrow blood supply (77084) | $2,269 | $2,836.25 | 9.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,394 | $2,992.50 | 10.0× |
| MRI cardiac w/o contrast (75557) | $1,856.20 | $2,320.25 | 7.8× |
| MRI cervical spine w contrast (72142) | $3,332.20 | $4,165.25 | 9.5× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$2,958.60–$3,041.80 | $3,698.25–$3,802.25 | varies |
| MRI chest w/o contrast (71550) | $2,540.20 | $3,175.25 | 10.6× |
| MRI chest wo w contrast (71552) | $4,384.80 | $5,481 | 12.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,874.40 | $3,593 | 8.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$3,684.80–$7,369.60 | $4,606–$9,212 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$2,801.80–$5,603.60 | $3,502.25–$7,004.50 | varies |
| MRI lumbar spine w contrast (72149) | $3,482.40 | $4,353 | 10.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,031.60 | $5,039.50 | 11.5× |
| MRI orbit face &/neck w/o contrast (70540) | $2,304.20 | $2,880.25 | 9.6× |
| MRI orbit face neck w contrast (70542) | $2,614 | $3,267.50 | 7.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,050.20 | $5,062.75 | 11.6× |
| MRI pelvis w contrast (72196) | $2,614 | $3,267.50 | 7.5× |
| MRI pelvis w/o & w contrast (72197) | $3,889 | $4,861.25 | 11.1× |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$3,005.80–$3,024.40 | $3,757.25–$3,780.50 | varies |
| MRI thoracic spine w/o contrast (72146) | $3,129.40 | $3,911.75 | 13.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,614 | $3,267.50 | 7.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$2,749.60–$2,806 | $3,437–$3,507.50 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,515 | $4,393.75 | 10.1× |
| MRI, abdomen, combo (74183) | $4,048.20 | $5,060.25 | 11.6× |
| MRI, dorsal spine combo (72157) | $3,968.80 | $4,961 | 11.4× |
| MRI, dorsal spine contrast (72147) | $3,520.40 | $4,400.50 | 10.1× |
| MRI, joint upper extrem (73221) range across 5 matching MRF lines |
$2,921.60–$5,890 | $3,652–$7,362.50 | varies |
| MRI, joint upper extrem combo (73223) | $3,873.80 | $4,842.25 | 11.1× |
| MRI, lumbar spine combo (72158) | $3,870 | $4,837.50 | 11.1× |
| Myelogram Lumbar (72265) | $1,444.40 | $1,805.50 | 1.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $777.60 | $972 | 1.9× |
| Myocardial Spect Multiple Studies (78452) | $4,598.20 | $5,747.75 | 3.5× |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$47.20–$323.20 | $59–$404 | varies |
| Nm myocard infarct spect (78469) | $2,353.20 | $2,941.50 | 4.3× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$1,088.40–$1,143 | $1,360.50–$1,428.75 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$103.20–$154.40 | $129–$193 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$174.40–$348 | $218–$435 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$975.60–$1,024.40 | $1,219.50–$1,280.50 | varies |
| Pelvis 1 or 2 views (72170) range across 5 matching MRF lines |
$52–$335.60 | $65–$419.50 | varies |
| Pet Image W/Ct Lmtd (78814) range across 3 matching MRF lines |
$1,018.58–$1,940 | $1,273.23–$2,425 | varies |
| PET image w/CT, full body (78816) | $6,985 | $8,731.25 | 4.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,958.20 | $8,697.75 | 4.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $881.60 | $1,102 | 2.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$55.20–$558.40 | $69–$698 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $594.40 | $743 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 9 matching MRF lines |
$55.20–$848.40 | $69–$1,060.50 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 9 matching MRF lines |
$54.40–$492 | $68–$615 | varies |
| Radex elbow complete minimum 3 views (73080) range across 8 matching MRF lines |
$61.60–$793.20 | $77–$991.50 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$61.60–$520.20 | $77–$650.25 | varies |
| Radex fingr minimum 2 views (73140) range across 8 matching MRF lines |
$45.60–$591.40 | $57–$739.25 | varies |
| Radex foot complete minimum 3 views (73630) range across 9 matching MRF lines |
$55.20–$800.80 | $69–$1,001 | varies |
| Radex Hand Minimum 3 Views (73130) range across 9 matching MRF lines |
$55.20–$823.20 | $69–$1,029 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$48.60–$565.20 | $60.75–$706.50 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$54.40–$357 | $68–$446.25 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 4 matching MRF lines |
$37.60–$368 | $47–$460 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$57.60–$474 | $72–$592.50 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 10 matching MRF lines |
$62.40–$784.40 | $78–$980.50 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $204.60 | $255.75 | 2.3× |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$29.60–$260.80 | $37–$326 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$67.20–$367 | $84–$458.75 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$50.40–$486.40 | $63–$608 | varies |
| Radex Toe Minimum 2 Views (73660) range across 6 matching MRF lines |
$65.60–$575.60 | $82–$719.50 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 6 matching MRF lines |
$92.80–$538.20 | $116–$672.75 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 8 matching MRF lines |
$55.20–$702.40 | $69–$878 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$73.60–$391.20 | $92–$489 | varies |
| Radiologic exam colon double contrast study (74280) | $1,214.40 | $1,518 | 6.9× |
| Radiologic exam colon single contrast study (74270) | $933.60 | $1,167 | 5.3× |
| Radiologic exam knee complete 4/more views (73564) range across 9 matching MRF lines |
$62.40–$989.20 | $78–$1,236.50 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $100.80 | $126 | 1.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $664.60 | $830.75 | 3.8× |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$150.40–$623.80 | $188–$779.75 | varies |
| Radiologic exam upr gi trc double contrast study (74246) | $860.80 | $1,076 | 4.9× |
| Radiologic examination femur minimum 2 views (73552) range across 8 matching MRF lines |
$37.60–$779.60 | $47–$974.50 | varies |
| Radiologic examination knee 1/2 views (73560) range across 9 matching MRF lines |
$52–$680.40 | $65–$850.50 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $664.40 | $830.50 | 6.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 10 matching MRF lines |
$52–$737.60 | $65–$922 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) | $187.60 | $234.50 | 2.2× |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$82.40–$500.80 | $103–$626 | varies |
| Scapula (73010) range across 4 matching MRF lines |
$52–$423.40 | $65–$529.25 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $114.20 | $142.75 | 4.9× |
| Shoulder 1 view (73020) range across 5 matching MRF lines |
$49.60–$521.80 | $62–$652.25 | varies |
| Shoulder Arthrography (73040) | $777 | $971.25 | 2.2× |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$72.80–$370.60 | $91–$463.25 | varies |
| Thoracic spine 2 views (72070) range across 4 matching MRF lines |
$64–$391.80 | $80–$489.75 | varies |
| Thoracic spine 3 views (72072) range across 5 matching MRF lines |
$44–$491.60 | $55–$614.50 | varies |
| Thoracolumbar 2 views (72080) | $345.80 | $432.25 | 4.0× |
| Thyroid Imaging With Vascular Flow (78013) | $585.40 | $731.75 | 1.5× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$1,703–$1,788.20 | $2,128.75–$2,235.25 | varies |
| Thyroid Uptake Measurement (78012) | $538.20 | $672.75 | 1.3× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$532.80–$1,119.20 | $666–$1,399 | varies |
| Ultrasound Elastography Parenchyma (76981) | $385.20 | $481.50 | 3.7× |
| Ultrasound Exam Aaa Screen (76706) | $525.40 | $656.75 | 5.0× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$96–$749.40 | $120–$936.75 | varies |
| Unlisted us procedure (76999) | $533.80 | $667.25 | 6.1× |
| Upper gi w/o kub (74240) | $792.80 | $991 | 4.5× |
| Urethrocystogram voiding (74455) | $931.40 | $1,164.25 | 3.9× |
| Us chest (76604) | $610.20 | $762.75 | 5.8× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$35.20–$606.40 | $44–$758 | varies |
| Us head (76506) | $392.20 | $490.25 | 3.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 6 matching MRF lines |
$58.40–$1,071.60 | $73–$1,339.50 | varies |
| Us ob detailed single fetus (76811) | $1,087.80 | $1,359.75 | 4.6× |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$96–$439.80 | $120–$549.75 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$104–$604.20 | $130–$755.25 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$264.80–$938.40 | $331–$1,173 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$232–$782.80 | $290–$978.50 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$181.60–$356.40 | $227–$445.50 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$118.40–$955.60 | $148–$1,194.50 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$44–$689.80 | $55–$862.25 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$885.80–$899.80 | $1,107.25–$1,124.75 | varies |
| Us spinal canal and contents (76800) | $519.40 | $649.25 | 5.0× |
| Us thyroid (76536) range across 5 matching MRF lines |
$52.80–$815.20 | $66–$1,019 | varies |
| Us transrectal (76872) range across 4 matching MRF lines |
$240.80–$1,717.60 | $301–$2,147 | varies |
| Vascular Flow Imaging (78445) | $511 | $638.75 | 1.3× |
| Venogram Sinus/Jugular (75860) | $2,057.40 | $2,571.75 | 0.7× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$2,956.30–$3,071.80 | $3,695.37–$3,839.75 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$153.60–$1,860.40 | $192–$2,325.50 | varies |
| Wrist 2 views (73100) range across 9 matching MRF lines |
$52–$638.40 | $65–$798 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$44.80–$354 | $56–$442.50 | varies |
| X-ray antegrade pyelogram tube (74425) | $520.40 | $650.50 | 1.5× |
| X-Ray Aorta Leg Arteries (75630) | $3,119.80 | $3,899.75 | 1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 7 matching MRF lines |
$54.40–$615.80 | $68–$769.75 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$225.40–$236.80 | $281.75–$296 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 4 matching MRF lines |
$74.40–$381.80 | $93–$477.25 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 5 matching MRF lines |
$46.40–$284.60 | $58–$355.75 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 7 matching MRF lines |
$60–$356.80 | $75–$446 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$64.80–$694.40 | $81–$868 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 4 matching MRF lines |
$54.40–$692.20 | $68–$865.25 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 3 matching MRF lines |
$65.60–$923.40 | $82–$1,154.25 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $672.60 | $840.75 | 6.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$60.80–$460.80 | $76–$576 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 4 matching MRF lines |
$52.80–$699.60 | $66–$874.50 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 5 matching MRF lines |
$41.60–$406.20 | $52–$507.75 | varies |
| X-ray eye for foreign body (70030) | $229 | $286.25 | 2.6× |
| X-ray humerus (73060) range across 7 matching MRF lines |
$58.40–$737.20 | $73–$921.50 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,174.20 | $1,467.75 | 6.7× |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$155.20–$1,377.60 | $194–$1,722 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$48.80–$346.60 | $61–$433.25 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 4 matching MRF lines |
$67.20–$456 | $84–$570 | varies |
| X-ray nose-rectum child f.b. (76010) range across 4 matching MRF lines |
$104.80–$207.40 | $131–$259.25 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 4 matching MRF lines |
$52.80–$395.20 | $66–$494 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$44–$400.60 | $55–$500.75 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$60.80–$233.60 | $76–$292 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$61.60–$365 | $77–$456.25 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$47.20–$438.40 | $59–$548 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$47.20–$517.80 | $59–$647.25 | varies |
| X-ray thoracic spine 4 vw (72074) | $452.80 | $566 | 4.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$37.60–$661.60 | $47–$827 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$37.60–$461 | $47–$576.25 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$91.20–$1,067.80 | $114–$1,334.75 | varies |
| Xr c-spine 4 or 5 views (72050) range across 4 matching MRF lines |
$68.80–$505.40 | $86–$631.75 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$88.80–$337.80 | $111–$422.25 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $281.40 | $351.75 | 2.7× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$44–$479.80 | $55–$599.75 | varies |
| Xr Tomogram Single Plane (76100) | $1,067.40 | $1,334.25 | 10.2× |
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.