Imaging prices at Colquitt Regional Medical Center (Moultrie, GA)

289 codes. Prices are the hospital's own posted facility charges.

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Procedure	Posted cash	Posted gross	× Medicare
3-D radiotherapy plan dose-volume histograms (77295) range across 2 matching MRF lines	$2,873–$3,049	$2,873–$3,049	varies
Abdomen 1 View (74018) range across 2 matching MRF lines	$212–$226	$212–$226	varies
Abdomen 2 views (74019) range across 4 matching MRF lines	$237–$252	$237–$252	varies
Acute Gastrointestinal Blood Loss Imaging (78278) range across 4 matching MRF lines	$1,257–$5,950	$1,257–$5,950	varies
Angio pulmonary bilat (75743) range across 2 matching MRF lines	$7,458–$7,912	$7,458–$7,912	varies
Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines	$6,831–$7,247	$6,831–$7,247	varies
Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines	$7,034–$7,463	$7,034–$7,463	varies
Ankle 2 views (73600) range across 3 matching MRF lines	$287–$305	$287–$305	varies
Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines	$11,692–$12,404	$11,692–$12,404	varies
Artery X-Rays Abdomen (75726) range across 2 matching MRF lines	$11,689–$12,401	$11,689–$12,401	varies
Artery X-Rays Pelvis (75736) range across 2 matching MRF lines	$6,160–$6,535	$6,160–$6,535	varies
Arthrogram hip (73525) range across 3 matching MRF lines	$1,000–$1,061	$1,000–$1,061	varies
Arthrogram Wrist (73115) range across 2 matching MRF lines	$1,145–$1,215	$1,145–$1,215	varies
Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines	$294–$312	$294–$312	varies
Bone age studies (77072) range across 2 matching MRF lines	$278–$296	$278–$296	varies
Bone Imaging 3 Phase (78315) range across 3 matching MRF lines	$2,490–$2,642	$2,490–$2,642	varies
Bone Imaging Limited Area (78300) range across 2 matching MRF lines	$2,066–$2,192	$2,066–$2,192	varies
Bone Imaging Whole Body (78306) range across 3 matching MRF lines	$2,301–$2,442	$2,301–$2,442	varies
Bone survey infant (77076) range across 3 matching MRF lines	$787–$835	$787–$835	varies
Brachytx isodose complex (77318) range across 2 matching MRF lines	$925–$982	$925–$982	varies
Brachytx isodose intermed (77317)	$913	$913	2.7×
Brachytx Isodose Plan Simple (77316)	$913	$913	2.7×
Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines	$10,367–$10,999	$10,367–$10,999	varies
Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines	$1,583–$1,680	$1,583–$1,680	varies
Chest 1 view (71045) range across 4 matching MRF lines	$299–$317	$299–$317	varies
Chest 2 views (71046) range across 4 matching MRF lines	$299–$317	$299–$317	varies
Chest 3 views (71047) range across 2 matching MRF lines	$368–$391	$368–$391	varies
Clavicle complete (73000) range across 3 matching MRF lines	$348–$370	$348–$370	varies
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines	$344–$366	$344–$366	varies
Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines	$294–$312	$294–$312	varies
Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines	$7,034–$7,463	$7,034–$7,463	varies
Contrast X-Ray Bladder (74430) range across 2 matching MRF lines	$544–$578	$544–$578	varies
Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines	$1,103–$1,171	$1,103–$1,171	varies
CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines	$6,175–$6,552	$6,175–$6,552	varies
CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines	$2,450–$2,600	$2,450–$2,600	varies
CT abdomen w contrast (74160) range across 3 matching MRF lines	$2,959–$3,139	$2,959–$3,139	varies
CT abdomen w wo contrast (74170) range across 5 matching MRF lines	$3,809–$4,042	$3,809–$4,042	varies
CT abdomen w/o contrast (74150) range across 3 matching MRF lines	$2,450–$2,600	$2,450–$2,600	varies
CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines	$4,590–$4,870	$4,590–$4,870	varies
CT Angio Chest (71275) range across 3 matching MRF lines	$2,042–$2,167	$2,042–$2,167	varies
CT Angio Head (70496) range across 2 matching MRF lines	$2,280–$2,419	$2,280–$2,419	varies
CT angio hrt w/3d image (75574) range across 5 matching MRF lines	$3,642–$3,865	$3,642–$3,865	varies
Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines	$2,623–$2,783	$2,623–$2,783	varies
CT Angio Neck (70498) range across 2 matching MRF lines	$2,360–$2,504	$2,360–$2,504	varies
Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines	$2,623–$2,783	$2,623–$2,783	varies
CT cervical spine w/ contrast (72126) range across 2 matching MRF lines	$2,849–$3,445	$2,849–$3,445	varies
CT cervical spine w/o contrast (72125) range across 2 matching MRF lines	$3,247–$3,445	$3,247–$3,445	varies
CT chest w contrast (71260) range across 2 matching MRF lines	$2,042–$2,167	$2,042–$2,167	varies
CT chest w/wo contrast (71270) range across 2 matching MRF lines	$2,726–$2,892	$2,726–$2,892	varies
CT head/brain with contrast (70460) range across 2 matching MRF lines	$2,647–$2,809	$2,647–$2,809	varies
CT head/brain without and with contrast (70470) range across 2 matching MRF lines	$3,256–$3,455	$3,256–$3,455	varies
CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines	$1,888–$2,003	$1,888–$2,003	varies
CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines	$614–$652	$614–$652	varies
CT hrt w/3d image congen (75573) range across 2 matching MRF lines	$3,642–$3,865	$3,642–$3,865	varies
CT iac w contrast (70481) range across 3 matching MRF lines	$2,117–$2,246	$2,117–$2,246	varies
CT lower ext w/o (73700) range across 17 matching MRF lines	$2,257–$2,467	$2,257–$2,467	varies
CT lower extremity w/contrast material (73701) range across 2 matching MRF lines	$2,461–$2,611	$2,461–$2,611	varies
CT lumbar spine w contrast (72132) range across 3 matching MRF lines	$2,796–$3,103	$2,796–$3,103	varies
CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines	$3,186–$3,380	$3,186–$3,380	varies
CT maxillofacial wo contrast (70486) range across 5 matching MRF lines	$2,507–$2,660	$2,507–$2,660	varies
CT neck tissue combo (70492) range across 2 matching MRF lines	$2,599–$2,757	$2,599–$2,757	varies
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines	$2,440–$2,589	$2,440–$2,589	varies
CT orbits w/o contrast (70480) range across 3 matching MRF lines	$2,022–$2,145	$2,022–$2,145	varies
CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines	$3,530–$3,745	$3,530–$3,745	varies
CT pelvis w/o contrast (72192) range across 4 matching MRF lines	$2,763–$2,931	$2,763–$2,931	varies
CT scan of leg combo (73702) range across 2 matching MRF lines	$2,623–$2,783	$2,623–$2,783	varies
CT soft tissue neck w contrast (70491) range across 2 matching MRF lines	$2,235–$2,372	$2,235–$2,372	varies
CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines	$2,185–$2,319	$2,185–$2,319	varies
CT thoracic spine w contrast (72129) range across 2 matching MRF lines	$3,187–$3,381	$3,187–$3,381	varies
CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines	$3,112–$3,302	$3,112–$3,302	varies
CT thorax w/o contrast (71250) range across 2 matching MRF lines	$1,962–$2,082	$1,962–$2,082	varies
CT upper ext wo (73200) range across 17 matching MRF lines	$2,325–$2,467	$2,325–$2,467	varies
CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines	$2,696–$2,860	$2,696–$2,860	varies
CT upper extremity with contrast (73201) range across 4 matching MRF lines	$2,530–$2,684	$2,530–$2,684	varies
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines	$3,145–$3,337	$3,145–$3,337	varies
Diskography lumbar (72295) range across 2 matching MRF lines	$4,258–$4,518	$4,258–$4,518	varies
Dxa Bone Density Axial (77080) range across 2 matching MRF lines	$681–$723	$681–$723	varies
Echo exam uterus (76831) range across 2 matching MRF lines	$735–$781	$735–$781	varies
Esophageal Motility Study (78258) range across 2 matching MRF lines	$870–$924	$870–$924	varies
Esophagram (74220) range across 4 matching MRF lines	$672–$714	$672–$714	varies
Fetal Biophys Profile W/Nst (76818)	$266	$266	2.8×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines	$576–$612	$576–$612	varies
Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines	$705–$749	$705–$749	varies
Foot 2 views (73620)	$308	$308	3.9×
Forearm 2 views (73090) range across 3 matching MRF lines	$290–$308	$290–$308	varies
Gastric emptying imaging study (78264) range across 2 matching MRF lines	$2,432–$2,580	$2,432–$2,580	varies
Gated Heart Planar Single (78472) range across 2 matching MRF lines	$2,113–$2,242	$2,113–$2,242	varies
Hand 2 views (73120)	$81	$81	0.9×
Hdr Rdncl Ntrstl/Icav Brchtx (77772)	$1,773	$1,773	2.8×
Hdr Rdncl Ntrstl/Icav Brchtx (77771)	$1,773	$1,773	2.8×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770)	$1,773	$1,773	2.8×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889)	$2,096	$2,096	0.7×
Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines	$2,669–$2,833	$2,669–$2,833	varies
Hepatobiliary System Imaging (78226) range across 2 matching MRF lines	$2,258–$2,396	$2,258–$2,396	varies
Ht Musc Image Planar Mult (78454) range across 3 matching MRF lines	$4,058–$4,305	$4,058–$4,305	varies
Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines	$3,401–$3,609	$3,401–$3,609	varies
Hysterosalpingogram (74740) range across 2 matching MRF lines	$940–$998	$940–$998	varies
Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines	$518–$550	$518–$550	varies
Infusion Ivp (74410) range across 3 matching MRF lines	$938–$996	$938–$996	varies
Interstitial radiation source applic complex (77778) range across 2 matching MRF lines	$878–$932	$878–$932	varies
K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines	$2,049–$2,174	$2,049–$2,174	varies
K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines	$1,824–$1,935	$1,824–$1,935	varies
K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines	$2,137–$2,268	$2,137–$2,268	varies
Knee 3 Views (73562)	$107	$107	1.4×
Labeled RBC Sequestration Differntl Organ/Tissue (78140) range across 2 matching MRF lines	$1,447–$1,536	$1,447–$1,536	varies
Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines	$1,707–$1,812	$1,707–$1,812	varies
Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines	$2,300–$2,440	$2,300–$2,440	varies
Lung Ventilation Imaging (78579) range across 2 matching MRF lines	$1,492–$1,583	$1,492–$1,583	varies
Lymph System Imaging (78195) range across 2 matching MRF lines	$1,719–$1,824	$1,719–$1,824	varies
Meckels Divert Exam (78290) range across 2 matching MRF lines	$954–$1,012	$954–$1,012	varies
Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines	$774–$822	$774–$822	varies
MRA head w/o contrast (70544) range across 3 matching MRF lines	$3,556–$3,773	$3,556–$3,773	varies
MRA neck w/o contrast (70547) range across 2 matching MRF lines	$3,556–$3,773	$3,556–$3,773	varies
MRI abdomen w contrast (74182) range across 3 matching MRF lines	$3,740–$3,969	$3,740–$3,969	varies
MRI abdomen w/o contrast (74181) range across 2 matching MRF lines	$3,589–$3,808	$3,589–$3,808	varies
MRI any jt lower extrem w/contrast material (73722)	$2,936	$2,936	4.1×
MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines	$2,726–$2,892	$2,726–$2,892	varies
MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines	$2,682–$2,846	$2,682–$2,846	varies
MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines	$1,476–$3,115	$1,476–$3,115	varies
MRI Breast Without Contrast Material Unilateral (77046) range across 4 matching MRF lines	$739–$1,570	$739–$1,570	varies
MRI cervical spine w contrast (72142) range across 2 matching MRF lines	$3,739–$3,968	$3,739–$3,968	varies
MRI cervical spine w/o cont (72141) range across 3 matching MRF lines	$3,589–$3,808	$3,589–$3,808	varies
MRI chest w/o contrast (71550) range across 2 matching MRF lines	$2,799–$2,969	$2,799–$2,969	varies
MRI chest wo w contrast (71552) range across 2 matching MRF lines	$3,065–$3,252	$3,065–$3,252	varies
MRI lower extrem oth/thn jt w/contrast matrl (73719)	$2,776	$2,776	8.8×
MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 9 matching MRF lines	$2,616–$2,776	$2,616–$2,776	varies
MRI lumbar spine w contrast (72149) range across 2 matching MRF lines	$3,617–$3,838	$3,617–$3,838	varies
Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines	$3,898–$4,135	$3,898–$4,135	varies
MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines	$3,556–$3,925	$3,556–$3,925	varies
Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines	$2,561–$3,773	$2,561–$3,773	varies
MRI pelvis w contrast (72196) range across 2 matching MRF lines	$3,090–$3,278	$3,090–$3,278	varies
MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines	$3,265–$3,464	$3,265–$3,464	varies
MRI pelvis w/o contrast (72195) range across 3 matching MRF lines	$2,939–$3,119	$2,939–$3,119	varies
MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines	$3,323–$3,526	$3,323–$3,526	varies
MRI upper extremity oth than jt w/o contr matrl (73218) range across 9 matching MRF lines	$2,616–$2,776	$2,616–$2,776	varies
MRI, abdomen, combo (74183) range across 2 matching MRF lines	$4,355–$4,621	$4,355–$4,621	varies
MRI, dorsal spine combo (72157) range across 2 matching MRF lines	$3,610–$3,831	$3,610–$3,831	varies
MRI, dorsal spine contrast (72147) range across 2 matching MRF lines	$3,463–$3,674	$3,463–$3,674	varies
MRI, joint upper extrem (73221) range across 7 matching MRF lines	$2,616–$2,776	$2,616–$2,776	varies
MRI, joint upper extrem combo (73223) range across 3 matching MRF lines	$2,726–$2,892	$2,726–$2,892	varies
MRI, lumbar spine combo (72158) range across 2 matching MRF lines	$3,898–$4,135	$3,898–$4,135	varies
Myelogram Lumbar (72265) range across 2 matching MRF lines	$1,869–$1,984	$1,869–$1,984	varies
Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines	$1,869–$1,984	$1,869–$1,984	varies
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) range across 2 matching MRF lines	$1,849–$1,962	$1,849–$1,962	varies
Myocardial Imaging Pet Metabolic Evaluation (78459) range across 3 matching MRF lines	$10,367–$10,999	$10,367–$10,999	varies
Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines	$7,580–$8,042	$7,580–$8,042	varies
Neck soft tissue (70360) range across 2 matching MRF lines	$290–$308	$290–$308	varies
Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines	$2,873–$3,049	$2,873–$3,049	varies
Nuclear Rx Oral Admin (79005) range across 4 matching MRF lines	$646–$2,188	$646–$2,188	varies
Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines	$672–$714	$672–$714	varies
Pelvis 1 or 2 views (72170) range across 3 matching MRF lines	$378–$402	$378–$402	varies
PET image w/CT, full body (78816) range across 2 matching MRF lines	$10,048–$10,661	$10,048–$10,661	varies
PET imaging CT attenuation skull base mid-thigh (78815) range across 41 matching MRF lines	$10,367–$10,999	$10,367–$10,999	varies
Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines	$1,304–$1,384	$1,304–$1,384	varies
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines	$399–$423	$399–$423	varies
Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines	$342–$364	$342–$364	varies
Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines	$348–$370	$348–$370	varies
Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines	$313–$333	$313–$333	varies
Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines	$323–$343	$323–$343	varies
Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines	$576–$612	$576–$612	varies
Radex fingr minimum 2 views (73140) range across 12 matching MRF lines	$296–$314	$296–$314	varies
Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines	$351–$731	$351–$731	varies
Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines	$348–$370	$348–$370	varies
Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines	$262–$278	$262–$278	varies
Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines	$320–$340	$320–$340	varies
Radex Ribs Unilateral 2 Views (71100)	$101	$101	1.3×
Radex shoulder complete minimum 2 views (73030) range across 7 matching MRF lines	$443–$471	$443–$471	varies
Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines	$334–$355	$334–$355	varies
Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines	$1,404–$1,490	$1,404–$1,490	varies
Radex Spine 1 View Specify Level (72020) range across 5 matching MRF lines	$476–$506	$476–$506	varies
Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines	$299–$317	$299–$317	varies
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines	$426–$452	$426–$452	varies
Radex Toe Minimum 2 Views (73660) range across 11 matching MRF lines	$272–$289	$272–$289	varies
Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines	$341–$363	$341–$363	varies
Radiation treatment delivery level 1 (77402)	$272	$272	2.9×
Radiation treatment delivery level 2 (77407)	$985	$985	2.8×
Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines	$546–$1,411	$546–$1,411	varies
Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines	$563–$597	$563–$597	varies
Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines	$1,272–$1,350	$1,272–$1,350	varies
Radiologic exam colon single contrast study (74270) range across 3 matching MRF lines	$858–$911	$858–$911	varies
Radiologic exam knee complete 4/more views (73564) range across 5 matching MRF lines	$347–$733	$347–$733	varies
Radiologic exam pelvis compl minimum 3 views (72190)	$150	$150	1.6×
Radiologic Exam Small Int Single Contrast Study (74250) range across 4 matching MRF lines	$810–$860	$810–$860	varies
Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines	$658–$698	$658–$698	varies
Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines	$1,024–$1,087	$1,024–$1,087	varies
Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines	$337–$358	$337–$358	varies
Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines	$295–$313	$295–$313	varies
Radiologic Examination Osseous Survey Limited (77074) range across 3 matching MRF lines	$1,152–$1,223	$1,152–$1,223	varies
Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines	$299–$317	$299–$317	varies
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768)	$665	$665	1.9×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767)	$665	$665	1.9×
Renal Cyst Study (74470) range across 2 matching MRF lines	$898–$953	$898–$953	varies
Ribs bilateral 3 views (71110)	$145	$145	1.5×
Rp loclzj tum plnr 1 area single day imaging (78800) range across 3 matching MRF lines	$3,388–$3,595	$3,388–$3,595	varies
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines	$1,508–$1,601	$1,508–$1,601	varies
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines	$819–$2,190	$819–$2,190	varies
Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines	$656–$696	$656–$696	varies
Scapula (73010) range across 4 matching MRF lines	$331–$351	$331–$351	varies
Screening Digital Breast Tomosynthesis Bi (77063) range across 6 matching MRF lines	$151–$370	$151–$370	varies
Sella turcica (70240) range across 2 matching MRF lines	$381–$405	$381–$405	varies
Shoulder 1 view (73020) range across 3 matching MRF lines	$215–$229	$215–$229	varies
Shoulder Arthrography (73040) range across 3 matching MRF lines	$1,151–$1,222	$1,151–$1,222	varies
Sialogram (70390) range across 2 matching MRF lines	$305–$324	$305–$324	varies
Skull less than 4 views (70250) range across 2 matching MRF lines	$426–$452	$426–$452	varies
Special dosimetry (77331) range across 3 matching MRF lines	$88–$312	$88–$312	varies
Special Physics Consult (77370) range across 2 matching MRF lines	$294–$312	$294–$312	varies
Special teletherapy port plan (77321) range across 2 matching MRF lines	$774–$822	$774–$822	varies
Special treatment procedure (77470) range across 3 matching MRF lines	$1,244–$1,858	$1,244–$1,858	varies
Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines	$4,079–$4,328	$4,079–$4,328	varies
Sternoclavicular joints (71130) range across 2 matching MRF lines	$159–$169	$159–$169	varies
Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines	$774–$822	$774–$822	varies
Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines	$774–$822	$774–$822	varies
Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines	$874–$928	$874–$928	varies
Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines	$294–$312	$294–$312	varies
Thoracic spine 2 views (72070)	$86	$86	0.9×
Thoracic spine 3 views (72072) range across 2 matching MRF lines	$456–$484	$456–$484	varies
Thoracolumbar 2 views (72080) range across 2 matching MRF lines	$456–$484	$456–$484	varies
Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines	$842–$894	$842–$894	varies
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines	$1,679–$1,782	$1,679–$1,782	varies
Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines	$774–$822	$774–$822	varies
Tx devices design & construction intermediate (77333) range across 2 matching MRF lines	$774–$822	$774–$822	varies
Tx devices design & construction simple (77332) range across 3 matching MRF lines	$294–$344	$294–$344	varies
Ultrasound Breast Limited (76642) range across 3 matching MRF lines	$356–$378	$356–$378	varies
Ultrasound Elastography Parenchyma (76981)	$206	$206	2.2×
Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines	$889–$943	$889–$943	varies
Ultrasound, abdomen limited (76705) range across 11 matching MRF lines	$1,220–$1,295	$1,220–$1,295	varies
Unlisted magnetic resonance procedure (76498)	$225	$225	2.9×
Upper gi w/o kub (74240) range across 5 matching MRF lines	$905–$1,760	$905–$1,760	varies
Urethrocystogram voiding (74455) range across 2 matching MRF lines	$630–$668	$630–$668	varies
Urethrocystography retrograde (74450) range across 2 matching MRF lines	$508–$540	$508–$540	varies
Us breast unilateral complete (76641) range across 6 matching MRF lines	$356–$755	$356–$755	varies
Us chest (76604) range across 3 matching MRF lines	$381–$405	$381–$405	varies
Us complete joint (76881) range across 5 matching MRF lines	$613–$651	$613–$651	varies
Us exam, pelvic, limited (76857) range across 2 matching MRF lines	$304–$323	$304–$323	varies
Us head (76506) range across 2 matching MRF lines	$317–$337	$317–$337	varies
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines	$613–$651	$613–$651	varies
Us ob detailed single fetus (76811)	$453	$453	2.1×
Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines	$344–$366	$344–$366	varies
Us ob transvaginal (76817) range across 2 matching MRF lines	$702–$746	$702–$746	varies
Us pelvic non ob complete (76856) range across 2 matching MRF lines	$748–$794	$748–$794	varies
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801)	$251	$251	2.7×
Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines	$501–$533	$501–$533	varies
Us retroperitoneal complete (76770)	$553	$553	5.8×
Us retroperitoneal limited (76775) range across 4 matching MRF lines	$945–$1,003	$945–$1,003	varies
Us scrotum and contents (76870) range across 2 matching MRF lines	$649–$689	$649–$689	varies
Us spinal canal and contents (76800) range across 2 matching MRF lines	$503–$535	$503–$535	varies
Us thyroid (76536) range across 5 matching MRF lines	$613–$651	$613–$651	varies
Us transrectal (76872)	$293	$293	3.1×
Vein X-Ray Chest (75827) range across 2 matching MRF lines	$3,730–$3,957	$3,730–$3,957	varies
Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines	$7,480–$7,957	$7,480–$7,957	varies
Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines	$3,665–$3,888	$3,665–$3,888	varies
Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines	$3,557–$3,774	$3,557–$3,774	varies
Venous Thrombosis Imaging Venogram Bilateral (78458) range across 2 matching MRF lines	$810–$860	$810–$860	varies
Wrist 2 views (73100) range across 4 matching MRF lines	$287–$305	$287–$305	varies
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 5 matching MRF lines	$276–$294	$276–$294	varies
X-ray antegrade pyelogram tube (74425) range across 3 matching MRF lines	$877–$931	$877–$931	varies
X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines	$7,034–$7,463	$7,034–$7,463	varies
X-Ray Bend Only L-S Spine (72120)	$112	$112	1.2×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines	$296–$314	$296–$314	varies
X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines	$224–$238	$224–$238	varies
X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines	$456–$484	$456–$484	varies
X-Ray Exam Entire Spi 2/3 Vw (72082)	$96	$96	1.0×
X-Ray Exam Hip Uni 1 View (73501)	$113	$113	1.4×
X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines	$364–$1,310	$364–$1,310	varies
X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines	$723–$767	$723–$767	varies
X-Ray Exam L-S Spine Bending (72114)	$208	$208	2.2×
X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines	$476–$506	$476–$506	varies
X-Ray Exam Neck Spine 6/>Vws (72052)	$187	$187	2.0×
X-Ray Exam Unilat Ribs/Chest (71101) range across 4 matching MRF lines	$470–$500	$470–$500	varies
X-ray humerus (73060) range across 3 matching MRF lines	$299–$317	$299–$317	varies
X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines	$996–$1,057	$996–$1,057	varies
X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines	$692–$734	$692–$734	varies
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565)	$733	$733	9.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines	$462–$490	$462–$490	varies
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines	$568–$604	$568–$604	varies
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines	$260–$276	$260–$276	varies
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200)	$101	$101	1.1×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines	$398–$422	$398–$422	varies
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines	$553–$587	$553–$587	varies
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines	$513–$545	$513–$545	varies
X-Ray Stress View (77071) range across 3 matching MRF lines	$243–$259	$243–$259	varies
X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines	$906–$962	$906–$962	varies
X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines	$478–$508	$478–$508	varies
X-Rays Bone Length Studies (77073) range across 3 matching MRF lines	$757–$803	$757–$803	varies
X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines	$1,051–$1,115	$1,051–$1,115	varies
Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines	$667–$709	$667–$709	varies
Xr facial bones less than 3 views (70140) range across 2 matching MRF lines	$529–$561	$529–$561	varies
Xr orbits complete 4 views (70200) range across 3 matching MRF lines	$484–$514	$484–$514	varies
Xr Tomogram Single Plane (76100) range across 2 matching MRF lines	$394–$418	$394–$418	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.