Imaging prices at Memorial Hospital of Converse County
Douglas, WY · every code in this section with a posted price and a Medicare benchmark.
242 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 2 matching MRF lines |
$245.10–$457.14 | $430–$802 | varies |
| Abdomen 2 views (74019) | $277.59 | $487 | 2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $943.35 | $1,655 | 2.3× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$135.66–$432.06 | $238–$758 | varies |
| Arthrogram ankle (73615) | $438.90 | $770 | 1.2× |
| Arthrogram hip (73525) | $664.05 | $1,165 | 1.9× |
| Arthrogram Wrist (73115) | $484.50 | $850 | 1.4× |
| Bone age studies (77072) range across 2 matching MRF lines |
$226.86–$242.82 | $398–$426 | varies |
| Bone Imaging 3 Phase (78315) range across 3 matching MRF lines |
$1,645.02–$1,760.73 | $2,886–$3,089 | varies |
| Bone Imaging Limited Area (78300) | $1,557.81 | $2,733 | 3.8× |
| Bone Imaging Multiple Areas (78305) | $1,700.88 | $2,984 | 4.2× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,555.53–$1,664.97 | $2,729–$2,921 | varies |
| Bone survey infant (77076) | $229.71 | $403 | 2.2× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $978.12 | $1,716 | 2.4× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$186.39–$199.50 | $327–$350 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$253.08–$271.32 | $444–$476 | varies |
| Chest 4 or more views (71048) | $346.56 | $608 | 3.2× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$234.84–$251.37 | $412–$441 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $172.71 | $303 | 1.6× |
| Contrast X-Ray Bladder (74430) | $385.89 | $677 | 1.1× |
| Contrast X-Ray Of Knee Joint (73580) | $524.97 | $921 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$2,932.08–$3,137.85 | $5,144–$5,505 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$2,832.33–$3,030.69 | $4,969–$5,317 | varies |
| CT abdomen w contrast (74160) | $1,784.67 | $3,131 | 10.0× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$2,069.67–$2,215.02 | $3,631–$3,886 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,529.88–$1,637.04 | $2,684–$2,872 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$3,872.58–$4,143.90 | $6,794–$7,270 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,824–$1,951.68 | $3,200–$3,424 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,707.15–$1,826.85 | $2,995–$3,205 | varies |
| CT angio hrt w/3d image (75574) | $1,224.93 | $2,149 | 3.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,273.16 | $3,988 | 12.7× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,833.12–$1,961.94 | $3,216–$3,442 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,962.51 | $3,443 | 11.0× |
| CT bone density (77078) | $482.22 | $846 | 5.4× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,971.06–$2,109.57 | $3,458–$3,701 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$1,665.54–$1,782.39 | $2,922–$3,127 | varies |
| CT cervical spine w/wo cont (72127) | $2,803.26 | $4,918 | 15.6× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,650.72–$1,766.43 | $2,896–$3,099 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$2,038.32–$2,181.39 | $3,576–$3,827 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,373.70–$1,470.03 | $2,410–$2,579 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,893.54–$2,026.35 | $3,322–$3,555 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $107.73 | $189 | 1.2× |
| CT iac w contrast (70481) | $1,781.82 | $3,126 | 9.9× |
| CT l-spine w&w/o contrast (72133) | $2,972.55 | $5,215 | 16.6× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,395.93–$1,493.97 | $2,449–$2,621 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,491.12–$1,596 | $2,616–$2,800 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,877.01–$2,008.68 | $3,293–$3,524 | varies |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$1,615.38–$1,728.81 | $2,834–$3,033 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,678.08–$1,796.07 | $2,944–$3,151 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,223.79–$1,309.86 | $2,147–$2,298 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,935.72–$2,071.38 | $3,396–$3,634 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,417.59–$2,624.28 | $2,487–$4,604 | varies |
| CT orbits w/o contrast (70480) | $1,352.04 | $2,372 | 12.7× |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$2,175.12–$2,327.88 | $3,816–$4,084 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,439.82–$1,540.71 | $2,526–$2,703 | varies |
| CT scan of leg combo (73702) | $3,559.08 | $6,244 | 19.9× |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$2,281.71–$2,441.88 | $4,003–$4,284 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,630.20–$1,744.77 | $2,860–$3,061 | varies |
| CT soft tissue neck w/o contrast (70490) | $1,534.44 | $2,692 | 14.4× |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$2,083.35–$2,229.27 | $3,655–$3,911 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$2,035.47–$2,177.97 | $3,571–$3,821 | varies |
| CT thoracic spine w/wo cont (72130) | $2,595.21 | $4,553 | 14.5× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$1,317.84–$1,410.18 | $2,312–$2,474 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,338.36–$1,432.41 | $2,348–$2,513 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $2,754.81 | $4,833 | 15.4× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,748.19–$1,870.74 | $3,067–$3,282 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$2,185.95–$2,339.28 | $3,835–$4,104 | varies |
| Cta Abdomen (74175) | $2,255.49 | $3,957 | 12.6× |
| CTA pelvis (72191) | $2,876.79 | $5,047 | 16.1× |
| Discography Cerv/Thor Spine (72285) | $110.58 | $194 | 0.1× |
| Diskography lumbar (72295) | $78.09 | $137 | 0.0× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$299.25–$320.34 | $525–$562 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$406.41–$502.74 | $713–$882 | varies |
| Echograp Trans R Pros Study (76873) | $124.26 | $218 | 1.2× |
| Esophagram (74220) range across 2 matching MRF lines |
$456.57–$489.06 | $801–$858 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 3 matching MRF lines |
$344.85–$527.25 | $605–$925 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $545.49 | $957 | 5.1× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$198.36–$212.61 | $348–$373 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$231.42–$247.95 | $406–$435 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,083.57–$1,159.95 | $1,901–$2,035 | varies |
| Gastric Mucosa Imaging (78261) | $719.34 | $1,262 | 1.8× |
| Gated Heart Planar Single (78472) | $1,654.14 | $2,902 | 4.0× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$235.41–$251.94 | $413–$442 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$864.69–$925.68 | $1,517–$1,624 | varies |
| Hepatobiliary System Imaging (78226) | $788.88 | $1,384 | 1.9× |
| Ht Muscle Image Spect Sing (78451) | $5,527.86 | $9,698 | 4.2× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$789.45–$844.74 | $1,385–$1,482 | varies |
| Joint Survey Single View (77077) | $242.82 | $426 | 2.3× |
| K Flow/Funct Image W/O Drug (78707) | $939.93 | $1,649 | 1.7× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$314.64–$535.23 | $552–$939 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,106.37 | $1,941 | 2.7× |
| Lung Ventilat&Perfus Imaging (78582) | $1,387.95 | $2,435 | 2.5× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,062.48–$1,137.15 | $1,864–$1,995 | varies |
| Magnetic Image Jaw Joint (70336) | $1,452.36 | $2,548 | 6.0× |
| Mammary ductogram or galactogram multiple (77054) | $718.20 | $1,260 | 2.9× |
| Mammary ductogram or galactogram single (77053) | $538.65 | $945 | 2.2× |
| Meckels Divert Exam (78290) | $691.41 | $1,213 | 1.7× |
| Mra Head W/O & W/Contrast Material (70546) | $2,743.41 | $4,813 | 7.7× |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$1,554.39–$1,663.26 | $2,727–$2,918 | varies |
| MRA head with contrast (70545) | $2,447.58 | $4,294 | 6.9× |
| MRA neck w contrast (70548) | $2,458.41 | $4,313 | 6.9× |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$2,576.40–$2,757.09 | $4,520–$4,837 | varies |
| MRA neck w/o contrast (70547) | $1,858.77 | $3,261 | 7.6× |
| MRI abdomen w contrast (74182) | $2,976.54 | $5,222 | 8.4× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$2,157.45–$2,308.50 | $3,785–$4,050 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$2,200.77–$2,355.24 | $3,861–$4,132 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$2,192.79–$2,346.69 | $3,847–$4,117 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,698.03 | $2,979 | 2.1× |
| MRI cervical spine w contrast (72142) | $2,536.50 | $4,450 | 7.1× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,800.06–$1,926.60 | $3,158–$3,380 | varies |
| MRI chest w/o contrast (71550) | $1,742.49 | $3,057 | 7.1× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$2,123.25–$2,272.02 | $3,725–$3,986 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,218.44 | $3,892 | 6.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,313.06–$2,475.51 | $4,058–$4,343 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,541.28–$1,649.58 | $2,704–$2,894 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$2,571.84–$2,751.96 | $4,512–$4,828 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$2,384.31–$2,551.32 | $4,183–$4,476 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $1,541.28 | $2,704 | 6.3× |
| MRI orbit face neck w contrast (70542) | $1,863.33 | $3,269 | 5.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$2,222.43–$2,378.04 | $3,899–$4,172 | varies |
| MRI pelvis w contrast (72196) | $2,534.79 | $4,447 | 7.1× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$2,412.81–$2,582.10 | $4,233–$4,530 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,798.92–$1,924.89 | $3,156–$3,377 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,751.61–$1,874.73 | $3,073–$3,289 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,488.27–$1,592.58 | $2,611–$2,794 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$2,261.19–$2,419.65 | $3,967–$4,245 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$2,823.21–$3,021 | $4,953–$5,300 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$2,856.27–$3,056.34 | $5,011–$5,362 | varies |
| MRI, dorsal spine contrast (72147) | $2,716.62 | $4,766 | 7.6× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,658.13–$1,774.41 | $2,909–$3,113 | varies |
| MRI, joint upper extrem combo (73223) | $2,118.12 | $3,716 | 5.9× |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$2,522.82–$2,699.52 | $4,426–$4,736 | varies |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$3,118.47–$3,336.78 | $5,471–$5,854 | varies |
| Neck soft tissue (70360) | $260.49 | $457 | 2.9× |
| Nonvascular Shunt X-Ray (75809) | $35.91 | $63 | 0.3× |
| Ob us nuchal meas 1 gest (76813) | $538.08 | $944 | 5.0× |
| Optic foramina (70190) | $127.11 | $223 | 1.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$717.63–$768.36 | $1,259–$1,348 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$1,126.32–$1,205.55 | $1,976–$2,115 | varies |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$249.09–$465.12 | $437–$816 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$804.84–$861.27 | $1,412–$1,511 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$398.43–$426.36 | $699–$748 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $410.40 | $720 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$156.75–$311.22 | $275–$546 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$134.52–$230.28 | $236–$404 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$271.32–$290.70 | $476–$510 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $423.51 | $743 | 4.0× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$174.42–$186.96 | $306–$328 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$154.47–$269.61 | $271–$473 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$254.79–$273.03 | $447–$479 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $176.13 | $309 | 2.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $310.65 | $545 | 3.5× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$233.13–$249.66 | $409–$438 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$266.19–$285 | $467–$500 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$208.62–$223.44 | $366–$392 | varies |
| Radex Spine 1 View Specify Level (72020) | $167.01 | $293 | 1.9× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$342.57–$367.08 | $601–$644 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$125.40–$199.50 | $220–$350 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $242.82 | $426 | 2.3× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$261.63–$280.44 | $459–$492 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $255.93 | $449 | 2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$272.46–$291.84 | $478–$512 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$707.37–$756.96 | $1,241–$1,328 | varies |
| Radiologic exam colon single contrast study (74270) | $529.53 | $929 | 3.0× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$327.75–$351.12 | $575–$616 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $320.34 | $562 | 3.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $473.10 | $830 | 2.6× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$706.23–$755.82 | $1,239–$1,326 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$256.50–$274.74 | $450–$482 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$233.70–$250.23 | $410–$439 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $372.21 | $653 | 3.5× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$258.21–$276.45 | $453–$485 | varies |
| Ribs bilateral 3 views (71110) | $360.24 | $632 | 3.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $573.42 | $1,006 | 1.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $808.26 | $1,418 | 1.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,342.92 | $2,356 | 2.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,764.72 | $3,096 | 1.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,287.98 | $4,014 | 1.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,180.25 | $3,825 | 1.6× |
| Scapula (73010) | $307.23 | $539 | 2.9× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$183.54–$196.65 | $322–$345 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$738.15–$790.02 | $1,295–$1,386 | varies |
| Skull less than 4 views (70250) | $283.86 | $498 | 2.7× |
| Sternoclavicular joints (71130) | $203.49 | $357 | 2.3× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$275.31–$294.69 | $483–$517 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$355.68–$380.76 | $624–$668 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$251.37–$269.04 | $441–$472 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$600.78–$642.96 | $1,054–$1,128 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$552.90–$591.66 | $970–$1,038 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$530.67–$568.29 | $931–$997 | varies |
| Urethrocystogram voiding (74455) | $607.05 | $1,065 | 2.5× |
| Urethrocystography retrograde (74450) | $315.21 | $553 | 1.3× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$346.56–$371.07 | $608–$651 | varies |
| Us chest (76604) | $456 | $800 | 4.3× |
| Us complete joint (76881) range across 3 matching MRF lines |
$23.37–$465.69 | $41–$817 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$328.89–$352.26 | $577–$618 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$18.81–$308.94 | $33–$542 | varies |
| Us ob detailed single fetus (76811) | $912.57 | $1,601 | 3.7× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$394.44–$469.68 | $692–$824 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$467.40–$522.69 | $820–$917 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$406.41–$594.51 | $713–$1,043 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$534.66–$572.28 | $938–$1,004 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$352.83–$443.46 | $619–$778 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$609.33–$652.08 | $1,069–$1,144 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$392.16–$420.09 | $688–$737 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$480.51–$514.71 | $843–$903 | varies |
| Us spinal canal and contents (76800) | $319.77 | $561 | 3.0× |
| Us thyroid (76536) range across 2 matching MRF lines |
$515.85–$552.33 | $905–$969 | varies |
| Us transrectal (76872) | $62.70 | $110 | 0.6× |
| Venous thrombosis imaging (78457) | $1,085.28 | $1,904 | 2.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$196.65–$210.90 | $345–$370 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $288.42 | $506 | 3.2× |
| X-Ray Bend Only L-S Spine (72120) | $328.89 | $577 | 3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$205.77–$220.59 | $361–$387 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$402.42–$430.92 | $706–$756 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $148.77 | $261 | 1.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$312.93–$335.16 | $549–$588 | varies |
| X-Ray Exam Hip Uni 1 View (73501) | $230.28 | $404 | 2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$240.54–$257.64 | $422–$452 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$363.09–$388.74 | $637–$682 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$412.68–$441.75 | $724–$775 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$286.14–$306.66 | $502–$538 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$495.90–$530.67 | $870–$931 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$321.48–$344.28 | $564–$604 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$243.96–$261.06 | $428–$458 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$198.93–$213.18 | $349–$374 | varies |
| X-ray IV pyelogram (ivp) (74400) | $830.49 | $1,457 | 4.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $219.45 | $385 | 2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $344.85 | $605 | 3.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$327.18–$350.55 | $574–$615 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$431.49–$461.70 | $757–$810 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$425.22–$455.43 | $746–$799 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$266.19–$285 | $467–$500 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$259.35–$277.59 | $455–$487 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $372.78 | $654 | 4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $518.13 | $909 | 4.9× |
| X-Ray Tmj Unilat (70328) | $171.57 | $301 | 1.9× |
| X-Rays Bone Length Studies (77073) | $246.81 | $433 | 2.3× |
| X-Rays Bone Survey Complete (77075) | $581.40 | $1,020 | 5.4× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$368.22–$394.44 | $646–$692 | varies |
| Xr facial bones less than 3 views (70140) | $277.02 | $486 | 3.1× |
| Xr orbits complete 4 views (70200) | $410.40 | $720 | 3.8× |
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.