Imaging prices at CommonSpirit Saint Joseph Hospital - Bardstown
Bardstown, KY · every code in this section with a posted price and a Medicare benchmark.
297 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) | $1,146.84 | $2,703 | 0.8× |
| Abdomen 1 View (74018) | $383.98 | $905 | 4.5× |
| Abdomen 2 views (74019) | $437.44 | $1,031 | 4.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,016.58 | $2,396 | 2.6× |
| Ankle 2 views (73600) | $344.95 | $813 | 4.0× |
| Arthrogram hip (73525) | $649.58 | $1,531 | 1.9× |
| Basic radiation dosimetry calculation (77300) | $136.62 | $322 | 1.0× |
| Bone age studies (77072) | $247.79 | $584 | 2.4× |
| Bone Imaging 3 Phase (78315) | $2,202.45 | $5,191 | 5.6× |
| Bone Imaging Limited Area (78300) | $1,209.21 | $2,850 | 3.1× |
| Bone Imaging Multiple Areas (78305) | $1,641.12 | $3,868 | 4.2× |
| Bone Imaging Whole Body (78306) | $2,159.60 | $5,090 | 5.5× |
| Bone survey infant (77076) | $227.84 | $537 | 2.2× |
| Brain Image W/Flow < 4 Views (78601) | $537.14 | $1,266 | 1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $584.24 | $1,377 | 1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,770.56 | $6,530 | 2.0× |
| Chest 1 view (71045) | $246.94 | $582 | 2.9× |
| Chest 2 views (71046) | $303.79 | $716 | 3.5× |
| Chest 4 or more views (71048) | $145.96 | $344 | 1.4× |
| Cholecystography Oral Contrast (74290) | $308.46 | $727 | 1.8× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$229.12–$387.80 | $540–$914 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $961 | $2,265 | 9.3× |
| Continuing medical physics consltj pr wk (77336) | $168.87 | $398 | 1.3× |
| Contrast X-Ray Bladder (74430) | $282.15 | $665 | 0.8× |
| Contrast X-Ray Of Knee Joint (73580) | $353.01 | $832 | 1.0× |
| CT abdomen and pelvis without and with contrast (74178) | $2,332.70 | $5,498 | 6.8× |
| CT abdomen and pelvis without contrast (74176) | $1,638.15 | $3,861 | 7.0× |
| CT abdomen w contrast (74160) | $831.60 | $1,960 | 4.8× |
| CT abdomen w wo contrast (74170) | $1,006.40 | $2,372 | 5.8× |
| CT abdomen w/o contrast (74150) | $840.08 | $1,980 | 8.2× |
| CT Angio Abdomen and Pelvis (74174) | $1,529.96 | $3,606 | 4.5× |
| CT Angio Chest (71275) | $734.86 | $1,732 | 4.3× |
| CT Angio Head (70496) | $1,047.13 | $2,468 | 6.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $579.15 | $1,365 | 3.4× |
| CT Angio Neck (70498) | $1,277.51 | $3,011 | 7.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $793.41 | $1,870 | 4.6× |
| CT cervical spine w/ contrast (72126) | $1,573.66 | $3,709 | 4.6× |
| CT cervical spine w/o contrast (72125) | $1,269.03 | $2,991 | 12.3× |
| CT chest w contrast (71260) | $961 | $2,265 | 5.6× |
| CT chest w/wo contrast (71270) | $1,143.87 | $2,696 | 6.6× |
| CT head/brain with contrast (70460) | $725.53 | $1,710 | 4.2× |
| CT head/brain without and with contrast (70470) | $1,267.33 | $2,987 | 7.3× |
| CT iac w contrast (70481) | $1,104.83 | $2,604 | 6.4× |
| CT lower ext w/o (73700) | $791.71 | $1,866 | 7.7× |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$799.77–$934.27 | $1,885–$2,202 | varies |
| CT lumbar spine w contrast (72132) | $1,433.65 | $3,379 | 4.2× |
| CT lumbar spine w/o contrast (72131) | $1,280.06 | $3,017 | 12.4× |
| CT maxillofacial w contrast (70487) | $1,279.21 | $3,015 | 7.4× |
| CT maxillofacial wo contrast (70486) | $1,266.48 | $2,985 | 12.3× |
| CT neck tissue combo (70492) | $1,044.58 | $2,462 | 6.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,325.46 | $3,124 | 7.7× |
| CT orbits w/o contrast (70480) | $1,104.83 | $2,604 | 10.7× |
| CT pelvis w&w/o contrast (72194) | $865.96 | $2,041 | 5.0× |
| CT pelvis w/o contrast (72192) | $963.12 | $2,270 | 9.4× |
| CT scan of leg combo (73702) | $918.57 | $2,165 | 5.3× |
| CT scans face/jaw combo (70488) | $1,127.32 | $2,657 | 6.5× |
| CT soft tissue neck w contrast (70491) | $829.05 | $1,954 | 4.8× |
| CT soft tissue neck w/o contrast (70490) | $829.05 | $1,954 | 8.0× |
| CT thoracic spine w contrast (72129) | $1,147.26 | $2,704 | 6.6× |
| CT thoracic spine w/o contrast (72128) | $1,260.97 | $2,972 | 12.2× |
| CT thoracic spine w/wo cont (72130) | $1,026.34 | $2,419 | 5.9× |
| CT thorax w/o contrast (71250) | $961 | $2,265 | 9.3× |
| CT upper ext wo (73200) | $758.20 | $1,787 | 7.4× |
| CT upper extremity w/o & w/contrast material (73202) | $841.35 | $1,983 | 4.9× |
| CT upper extremity with contrast (73201) | $765.83 | $1,805 | 2.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $731.04 | $1,723 | 4.2× |
| Cta Abdomen (74175) | $1,790.47 | $4,220 | 10.4× |
| CTA pelvis (72191) | $857.48 | $2,021 | 5.0× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$316.52–$471.81 | $746–$1,112 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $459.08 | $1,082 | 5.4× |
| Esophagram (74220) | $451.86 | $1,065 | 2.6× |
| Fetal Biophys Profile W/Nst (76818) | $660.61 | $1,557 | 6.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $125.59 | $296 | 1.2× |
| Fluoroscopy up to 1 hr (76000) | $561.75 | $1,324 | 2.4× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$279.61–$344.95 | $659–$813 | varies |
| Forearm 2 views (73090) | $302.94 | $714 | 3.5× |
| Gastric emptying imaging study (78264) | $1,142.59 | $2,693 | 2.9× |
| Gastroesophageal Reflux Exam (78262) | $929.60 | $2,191 | 2.4× |
| Gated Heart Planar Single (78472) | $923.66 | $2,177 | 2.3× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$241.42–$271.97 | $569–$641 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,051.83 | $4,836 | 3.8× |
| Hepatobiliary System Imaging (78226) | $1,292.79 | $3,047 | 3.3× |
| Ht Musc Image Planar Mult (78454) | $1,393.77 | $3,285 | 1.1× |
| Ht Muscle Image Spect Sing (78451) | $1,469.29 | $3,463 | 1.2× |
| Hysterosalpingogram (74740) | $544.36 | $1,283 | 2.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $263.91 | $622 | 3.1× |
| Infusion Ivp (74410) | $552.42 | $1,302 | 3.2× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,258.85 | $2,967 | 1.8× |
| Intracavitary Radiation Source Applic Intermed (77762) | $885.48 | $2,087 | 1.6× |
| Intracavitary radiation source applic simple (77761) | $649.15 | $1,530 | 1.2× |
| K Flow/Funct Image Multiple (78709) | $629.21 | $1,483 | 1.2× |
| K Flow/Funct Image W/Drug (78708) | $917.72 | $2,163 | 1.7× |
| K Flow/Funct Image W/O Drug (78707) | $918.15 | $2,164 | 1.7× |
| Kidney Imaging Morphol (78700) | $1,065.37 | $2,511 | 2.7× |
| Knee 3 Views (73562) | $324.16 | $764 | 3.8× |
| Leveen/Shunt Patency Exam (78291) | $1,091.68 | $2,573 | 2.8× |
| Liver & Spleen Imaging Static Only (78215) | $659.76 | $1,555 | 1.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $749.29 | $1,766 | 1.9× |
| Lung perfusion differential (78597) | $2,088.74 | $4,923 | 5.3× |
| Lung Ventilat&Perfus Imaging (78582) | $596.97 | $1,407 | 1.1× |
| Lung Ventilation Imaging (78579) | $1,146.41 | $2,702 | 2.9× |
| Lymph System Imaging (78195) | $637.27 | $1,502 | 1.2× |
| Magnetic Image Jaw Joint (70336) | $1,361.95 | $3,210 | 5.8× |
| Meckels Divert Exam (78290) | $669.94 | $1,579 | 1.7× |
| Mlc imrt design & construction per imrt plan (77338) | $1,037.80 | $2,446 | 2.8× |
| Mr safety determination physician/other qhp (76016) | $94.62 | $223 | 1.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $26.31 | $62 | 0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $98.86 | $233 | 1.1× |
| Mr safety med physics xm customization plng&mntr (76017) | $259.66 | $612 | 1.1× |
| Mra Head W/O & W/Contrast Material (70546) | $1,258 | $2,965 | 3.7× |
| MRA head w/o contrast (70544) | $2,062.43 | $4,861 | 8.8× |
| MRA head with contrast (70545) | $1,691.19 | $3,986 | 4.9× |
| MRA neck w contrast (70548) | $1,781.98 | $4,200 | 5.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,163.41 | $5,099 | 6.3× |
| MRA neck w/o contrast (70547) | $1,599.54 | $3,770 | 6.8× |
| MRI abdomen w contrast (74182) | $940.21 | $2,216 | 2.7× |
| MRI abdomen w/o contrast (74181) | $1,566.87 | $3,693 | 6.7× |
| MRI any jt lower extrem w/contrast material (73722) | $1,096.35 | $2,584 | 1.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,090.01 | $4,926 | 6.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,249.51 | $2,945 | 1.6× |
| MRI Breast W/O Contrast Bilateral (77047) | $577.45 | $1,361 | 2.5× |
| MRI cervical spine w contrast (72142) | $1,987.76 | $4,685 | 5.8× |
| MRI cervical spine w/o cont (72141) | $1,461.65 | $3,445 | 6.2× |
| MRI chest w/o contrast (71550) | $581.69 | $1,371 | 2.5× |
| MRI chest with contrast (71551) | $640.67 | $1,510 | 0.8× |
| MRI chest wo w contrast (71552) | $703.89 | $1,659 | 2.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,601.67 | $3,775 | 4.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,799.38 | $4,241 | 5.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$899.90–$1,259.70 | $2,121–$2,969 | varies |
| MRI lumbar spine w contrast (72149) | $1,728.10 | $4,073 | 5.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,090.01 | $4,926 | 6.1× |
| MRI orbit face &/neck w/o contrast (70540) | $1,458.68 | $3,438 | 6.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,084.07 | $4,912 | 6.1× |
| MRI pelvis w/o & w contrast (72197) | $1,804.05 | $4,252 | 5.2× |
| MRI pelvis w/o contrast (72195) | $1,262.67 | $2,976 | 5.4× |
| MRI thoracic spine w/o contrast (72146) | $1,263.09 | $2,977 | 5.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,262.67 | $2,976 | 5.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,856.23 | $4,375 | 5.4× |
| MRI, abdomen, combo (74183) | $2,089.16 | $4,924 | 6.1× |
| MRI, dorsal spine combo (72157) | $1,806.17 | $4,257 | 5.3× |
| MRI, joint upper extrem (73221) | $1,262.24 | $2,975 | 5.4× |
| MRI, joint upper extrem combo (73223) | $1,981.40 | $4,670 | 5.8× |
| MRI, lumbar spine combo (72158) | $1,902.48 | $4,484 | 5.5× |
| Myelogram Lumbar (72265) | $1,047.55 | $2,469 | 1.4× |
| Myelography thoracic (72255) | $1,047.55 | $2,469 | 1.4× |
| Myelograpy 2/more regions rs&i (72270) | $713.65 | $1,682 | 0.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,130.29 | $2,664 | 0.9× |
| Myocardial Spect Multiple Studies (78452) | $3,766.77 | $8,878 | 3.0× |
| N-invas est c ffr sw aly CTA (75580) | $1,056.46 | $2,490 | 1.2× |
| Neck soft tissue (70360) | $335.61 | $791 | 3.9× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $641.09 | $1,511 | 1.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,599.57 | $6,127 | 1.9× |
| Nuclear Rx Oral Admin (79005) | $852.81 | $2,010 | 3.7× |
| Parathyroid Planar Imaging (78070) | $526.54 | $1,241 | 1.3× |
| Pelvis 1 or 2 views (72170) | $414.53 | $977 | 4.0× |
| Perineogram (74775) | $231.24 | $545 | 1.0× |
| PET image w/CT, full body (78816) | $2,965.30 | $6,989 | 2.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,753.62 | $8,847 | 2.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $943.18 | $2,223 | 2.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $663.58 | $1,564 | 6.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $352.58 | $831 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) | $383.13 | $903 | 4.5× |
| Radex Calcaneus Minimum 2 Views (73650) | $266.45 | $628 | 3.1× |
| Radex elbow complete minimum 3 views (73080) | $433.62 | $1,022 | 5.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$233.36–$386.52 | $550–$911 | varies |
| Radex fingr minimum 2 views (73140) | $332.22 | $783 | 3.9× |
| Radex foot complete minimum 3 views (73630) | $383.13 | $903 | 4.5× |
| Radex Hand Minimum 3 Views (73130) | $383.13 | $903 | 4.5× |
| Radex lower extremity infant minimum 2 views (73592) | $228.27 | $538 | 2.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $249.06 | $587 | 2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $299.55 | $706 | 3.5× |
| Radex Ribs Unilateral 2 Views (71100) | $495.57 | $1,168 | 5.8× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$276.64–$658.91 | $652–$1,553 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$72.56–$280.88 | $171–$662 | varies |
| Radex Spine 1 View Specify Level (72020) | $263.06 | $620 | 3.1× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$212.99–$278.33 | $502–$656 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $211.30 | $498 | 2.5× |
| Radex Toe Minimum 2 Views (73660) | $332.22 | $783 | 3.9× |
| Radex upper extremity infant minimum 2 views (73092) | $179.90 | $424 | 1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $377.62 | $890 | 4.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $8,096.98 | $19,084 | 1.1× |
| Radiation treatment delivery level 1 (77402) | $438.29 | $1,033 | 4.4× |
| Radiation treatment delivery level 2 (77407) | $472.65 | $1,114 | 1.2× |
| Radiation treatment delivery level 3 (77412) | $581.69 | $1,371 | 1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$324.58–$367.01 | $765–$865 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $187.96 | $443 | 1.8× |
| Radiologic exam colon double contrast study (74280) | $683.52 | $1,611 | 4.0× |
| Radiologic exam colon single contrast study (74270) | $610.12 | $1,438 | 3.5× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$191.78–$661.46 | $452–$1,559 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $356.83 | $841 | 3.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$565.15–$600.79 | $1,332–$1,416 | varies |
| Radiologic exam swallow function contrast study (74230) | $615.64 | $1,451 | 3.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $924.09 | $2,178 | 5.3× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$323.31–$492.17 | $762–$1,160 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$271.12–$330.94 | $639–$780 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $334.76 | $789 | 3.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $357.67 | $843 | 4.2× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$304.64–$334.34 | $718–$788 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,713.25 | $4,038 | 4.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $596.12 | $1,405 | 1.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,558.81 | $3,674 | 2.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,157.05 | $5,084 | 4.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$949.55–$1,467.59 | $2,238–$3,459 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $575.75 | $1,357 | 0.5× |
| Salivary Gland Imaging (78230) | $369.13 | $870 | 0.9× |
| Scapula (73010) | $313.97 | $740 | 3.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $58.98 | $139 | 2.5× |
| Shoulder 1 view (73020) | $348.34 | $821 | 4.1× |
| Shoulder Arthrography (73040) | $571.51 | $1,347 | 1.7× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$255.85–$342.82 | $603–$808 | varies |
| Special dosimetry (77331) | $125.59 | $296 | 0.9× |
| Special Physics Consult (77370) | $263.48 | $621 | 2.0× |
| Special teletherapy port plan (77321) | $197.72 | $466 | 0.5× |
| Special treatment procedure (77470) | $402.65 | $949 | 0.7× |
| Spleen Imaging (78185) | $659.76 | $1,555 | 1.7× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$1,361.52–$2,110.38 | $3,209–$4,974 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $303.79 | $716 | 0.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $275.36 | $649 | 0.7× |
| Testicular Imaging W/Flow (78761) | $465.87 | $1,098 | 1.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $816.32 | $1,924 | 2.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $612.24 | $1,443 | 1.7× |
| Ther rad simulaj-aided field setting simple (77280) | $400.10 | $943 | 3.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $529.08 | $1,247 | 3.1× |
| Thoracic spine 2 views (72070) | $341.13 | $804 | 3.3× |
| Thoracic spine 3 views (72072) | $487.08 | $1,148 | 4.7× |
| Thoracolumbar 2 views (72080) | $189.23 | $446 | 2.2× |
| Thyroid Imaging With Vascular Flow (78013) | $525.69 | $1,239 | 1.3× |
| Thyroid Met Imaging Body (78018) | $907.54 | $2,139 | 1.7× |
| Thyroid Uptake Measurement (78012) | $852.81 | $2,010 | 2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $367.86 | $867 | 0.9× |
| Tx Devices Design & Construction Complex (77334) | $401.80 | $947 | 1.1× |
| Tx devices design & construction intermediate (77333) | $128.56 | $303 | 1.0× |
| Tx devices design & construction simple (77332) | $176.93 | $417 | 1.3× |
| Ultrasound Breast Limited (76642) | $455.26 | $1,073 | 5.3× |
| Ultrasound Exam Aaa Screen (76706) | $336.04 | $792 | 3.3× |
| Ultrasound, abdomen limited (76705) | $656.79 | $1,548 | 6.4× |
| Upper gi w/o kub (74240) | $437.86 | $1,032 | 2.5× |
| Ureteral Reflux Study (78740) | $414.95 | $978 | 1.1× |
| Urethrocystogram voiding (74455) | $574.91 | $1,355 | 2.4× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$455.26–$568.97 | $1,073–$1,341 | varies |
| Us chest (76604) | $302.09 | $712 | 2.9× |
| Us complete joint (76881) | $776.01 | $1,829 | 7.5× |
| Us exam, pelvic, limited (76857) | $609.27 | $1,436 | 5.9× |
| Us head (76506) | $304.21 | $717 | 3.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$295.73–$441.26 | $697–$1,040 | varies |
| Us ob limited 1 or more fetuses (76815) | $195.60 | $461 | 1.9× |
| Us ob transvaginal (76817) | $543.08 | $1,280 | 5.3× |
| Us pelvic non ob complete (76856) | $622 | $1,466 | 6.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $383.98 | $905 | 3.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $184.99 | $436 | 1.8× |
| Us retroperitoneal complete (76770) | $1,193.08 | $2,812 | 11.6× |
| Us retroperitoneal limited (76775) | $345.79 | $815 | 3.4× |
| Us scrotum and contents (76870) | $638.12 | $1,504 | 6.2× |
| Us spinal canal and contents (76800) | $539.27 | $1,271 | 5.2× |
| Us thyroid (76536) | $631.34 | $1,488 | 6.1× |
| Us transrectal (76872) | $1,798.96 | $4,240 | 17.5× |
| Venography extremity unilateral rs&i (75820) | $775.17 | $1,827 | 0.5× |
| Venous thrombosis imaging (78457) | $900.75 | $2,123 | 1.7× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,316.12 | $3,102 | 3.3× |
| Wrist 2 views (73100) | $343.67 | $810 | 4.0× |
| X-ray antegrade pyelogram tube (74425) | $423.86 | $999 | 1.2× |
| X-Ray Bend Only L-S Spine (72120) | $619.88 | $1,461 | 6.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $390.34 | $920 | 4.6× |
| X-Ray Exam Breast Specimen (76098) | $279.18 | $658 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $219.78 | $518 | 2.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $283 | $667 | 2.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $164.63 | $388 | 1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$205.78–$342.82 | $485–$808 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $168.02 | $396 | 1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $706.01 | $1,664 | 6.9× |
| X-Ray Exam L-S Spine Bending (72114) | $695.40 | $1,639 | 6.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $470.96 | $1,110 | 5.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$456.96–$772.62 | $1,077–$1,821 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) | $596.97 | $1,407 | 5.8× |
| X-ray eye for foreign body (70030) | $134.08 | $316 | 1.6× |
| X-ray humerus (73060) | $433.62 | $1,022 | 5.1× |
| X-ray IV pyelogram+tomography (74415) | $580.42 | $1,368 | 3.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $160.81 | $379 | 1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $205.36 | $484 | 2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$327.97–$574.06 | $773–$1,353 | varies |
| X-ray nose-rectum child f.b. (76010) | $247.79 | $584 | 2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$411.98–$531.20 | $971–$1,252 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$279.61–$441.68 | $659–$1,041 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $222.75 | $525 | 2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $377.62 | $890 | 4.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$301.24–$400.10 | $710–$943 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$421.74–$552.42 | $994–$1,302 | varies |
| X-Ray Stress View (77071) | $83.59 | $197 | 1.0× |
| X-ray thoracic spine 4 vw (72074) | $409.01 | $964 | 4.0× |
| X-Ray Tmj Unilat (70328) | $142.56 | $336 | 1.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $362.34 | $854 | 1.1× |
| X-Rays Bone Length Studies (77073) | $202.39 | $477 | 2.0× |
| X-Rays Bone Survey Complete (77075) | $358.52 | $845 | 3.5× |
| Xr c-spine 4 or 5 views (72050) | $654.67 | $1,543 | 6.4× |
| Xr facial bones less than 3 views (70140) | $156.56 | $369 | 1.8× |
| Xr orbits complete 4 views (70200) | $179.05 | $422 | 1.7× |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$353.86–$673.76 | $834–$1,588 | 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.