Imaging prices at Vandalia Health Davis Medical Center
Elkins, WV · every code in this section with a posted price and a Medicare benchmark.
343 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $3,723.36 | $5,319.08 | 2.8× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$228.67–$348.52 | $326.67–$497.88 | varies |
| Abdomen 2 views (74019) | $421.66 | $602.37 | 4.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,581.84 | $2,259.77 | 4.1× |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$232.25–$348.52 | $331.78–$497.88 | varies |
| Arthrogram ankle (73615) | $927.48 | $1,324.96 | 2.8× |
| Arthrogram hip (73525) | $927.48 | $1,324.96 | 2.8× |
| Arthrogram Wrist (73115) | $927.48 | $1,324.96 | 2.8× |
| Basic radiation dosimetry calculation (77300) | $344.81 | $492.58 | 2.7× |
| Bone age studies (77072) | $421.66 | $602.37 | 4.2× |
| Bone Imaging 3 Phase (78315) | $1,581.84 | $2,259.77 | 4.1× |
| Bone Imaging Limited Area (78300) | $1,581.84 | $2,259.77 | 4.1× |
| Bone Imaging Multiple Areas (78305) | $1,581.84 | $2,259.77 | 4.1× |
| Bone Imaging Whole Body (78306) | $1,581.84 | $2,259.77 | 4.1× |
| Bone survey infant (77076) | $281.96 | $402.80 | 2.8× |
| Brachytx isodose complex (77318) | $950.70 | $1,358.13 | 2.6× |
| Brachytx isodose intermed (77317) | $950.70 | $1,358.13 | 2.6× |
| Brachytx Isodose Plan Simple (77316) | $950.70 | $1,358.13 | 2.6× |
| Brain imaging < 4 static views (78600) | $1,581.84 | $2,259.77 | 4.1× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,581.84 | $2,259.77 | 3.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,245.11 | $4,635.86 | 9.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,245.11 | $4,635.86 | 4.3× |
| Cat Scan Follow-Up Study (76380) | $1,238.06 | $1,768.65 | 14.8× |
| Cerebrospinal Fluid Scan (78630) | $2,073.02 | $2,961.45 | 4.0× |
| Chest 1 view (71045) | $348.52 | $497.88 | 4.2× |
| Chest 2 views (71046) | $379.71 | $542.44 | 4.5× |
| Chest 3 views (71047) range across 2 matching MRF lines |
$287.90–$421.66 | $411.28–$602.37 | varies |
| Chest 4 or more views (71048) | $421.66 | $602.37 | 4.2× |
| Cholecystography Oral Contrast (74290) | $462.32 | $660.45 | 2.7× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$302–$348.52 | $431.42–$497.88 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$276.17–$443.72 | $394.52–$633.88 | varies |
| Continuing medical physics consltj pr wk (77336) | $671.51 | $959.30 | 5.2× |
| Contrast X-Ray Bladder (74430) | $927.48 | $1,324.96 | 2.8× |
| Contrast X-Ray Of Elbow (73085) | $927.48 | $1,324.96 | 2.8× |
| Contrast X-Ray Of Knee Joint (73580) | $927.48 | $1,324.96 | 2.8× |
| Contrast Xray Throat/Cerv Esopha (74210) | $462.32 | $660.45 | 2.7× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$2,507.96–$3,152.64 | $3,582.80–$4,503.77 | varies |
| CT abdomen and pelvis without contrast (74176) | $1,979.66 | $2,828.08 | 8.6× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,665.05–$2,090.22 | $2,378.64–$2,986.02 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,665.05–$2,495.35 | $2,378.64–$3,564.78 | varies |
| CT abdomen w/o contrast (74150) | $1,884.68 | $2,692.40 | 18.8× |
| CT Angio Abdomen and Pelvis (74174) | $2,558.10 | $3,654.42 | 7.6× |
| CT Angio Chest (71275) | $2,399.63 | $3,428.04 | 14.3× |
| CT Angio Head (70496) | $1,602.72 | $2,289.60 | 9.5× |
| CT angio hrt w/3d image (75574) | $2,090.22 | $2,986.02 | 6.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,558.86 | $3,655.51 | 15.2× |
| CT Angio Neck (70498) | $1,438 | $2,054.28 | 8.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,838.20 | $4,054.56 | 16.9× |
| CT cervical spine w/ contrast (72126) | $2,151.80 | $3,074 | 6.4× |
| CT cervical spine w/o contrast (72125) | $1,966.30 | $2,809 | 19.6× |
| CT cervical spine w/wo cont (72127) | $2,399.63 | $3,428.04 | 14.3× |
| CT chest w contrast (71260) | $1,817.90 | $2,597 | 10.8× |
| CT chest w/wo contrast (71270) | $2,522.06 | $3,602.94 | 15.0× |
| CT head/brain with contrast (70460) | $2,139.93 | $3,057.04 | 12.7× |
| CT head/brain without and with contrast (70470) | $2,507.96 | $3,582.80 | 14.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,090.22 | $2,986.02 | 6.2× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$228.67–$2,090.22 | $326.67–$2,986.02 | varies |
| CT hrt w/3d image congen (75573) | $2,090.22 | $2,986.02 | 6.2× |
| CT iac w contrast (70481) range across 4 matching MRF lines |
$1,325.22–$1,966.30 | $1,893.16–$2,809 | varies |
| CT l-spine w&w/o contrast (72133) | $2,461.22 | $3,516.02 | 14.6× |
| CT lower ext w/o (73700) | $2,183.98 | $3,119.96 | 21.8× |
| CT lower extremity w/contrast material (73701) | $2,435.51 | $3,479.29 | 14.5× |
| CT lumbar spine w contrast (72132) | $2,151.80 | $3,074 | 6.4× |
| CT lumbar spine w/o contrast (72131) | $1,966.30 | $2,809 | 19.6× |
| CT maxillofacial w contrast (70487) | $1,438 | $2,054.28 | 8.5× |
| CT maxillofacial wo contrast (70486) | $1,979.66 | $2,828.08 | 19.7× |
| CT neck tissue combo (70492) | $1,664.31 | $2,377.58 | 9.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,424.86 | $3,464.08 | 14.4× |
| CT orbits w/o contrast (70480) range across 4 matching MRF lines |
$1,818.65–$1,979.66 | $2,598.06–$2,828.08 | varies |
| CT pelvis w&w/o contrast (72194) | $2,341.01 | $3,344.30 | 13.9× |
| CT pelvis w/o contrast (72192) | $1,664.31 | $2,377.58 | 16.6× |
| CT scan of leg combo (73702) | $2,719.69 | $3,885.26 | 16.2× |
| CT scans face/jaw combo (70488) | $1,664.31 | $2,377.58 | 9.9× |
| CT soft tissue neck w contrast (70491) | $1,966.30 | $2,809 | 11.7× |
| CT soft tissue neck w/o contrast (70490) | $1,979.66 | $2,828.08 | 19.7× |
| CT thoracic spine w contrast (72129) | $2,151.80 | $3,074 | 12.8× |
| CT thoracic spine w/o contrast (72128) | $1,966.30 | $2,809 | 19.6× |
| CT thoracic spine w/wo cont (72130) | $2,399.63 | $3,428.04 | 14.3× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$276.17–$1,966.30 | $394.52–$2,809 | varies |
| CT upper ext wo (73200) | $1,966.30 | $2,809 | 19.6× |
| CT upper extremity w/o & w/contrast material (73202) | $2,448.81 | $3,498.30 | 14.6× |
| CT upper extremity with contrast (73201) | $2,183.98 | $3,119.96 | 6.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,665.05 | $2,378.64 | 9.9× |
| Cta Abdomen (74175) | $2,399.63 | $3,428.04 | 14.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,040.72 | $4,343.88 | 9.1× |
| CTA pelvis (72191) range across 2 matching MRF lines |
$2,399.63–$2,461.22 | $3,428.04–$3,516.02 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $627.75 | $896.78 | 2.7× |
| Dilation ureters/urethra rs&i (74485) | $5,319.99 | $7,599.98 | 2.7× |
| Dxa Bone Density Axial (77080) | $484.53 | $692.18 | 4.8× |
| Echo exam uterus (76831) | $627.75 | $896.78 | 2.7× |
| Echograp Trans R Pros Study (76873) | $401.43 | $573.46 | 4.0× |
| Esophageal Motility Study (78258) | $1,581.84 | $2,259.77 | 4.1× |
| Esophagram (74220) | $704.68 | $1,006.68 | 4.2× |
| Fetal Biophys Profile W/Nst (76818) | $543.89 | $776.98 | 5.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $321.29 | $458.98 | 3.2× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$627.75–$939.80 | $896.78–$1,342.56 | varies |
| Foot 2 views (73620) | $348.52 | $497.88 | 4.2× |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$276.77–$348.52 | $395.38–$497.88 | varies |
| Gastric emptying imaging study (78264) | $1,581.84 | $2,259.77 | 4.1× |
| Gastroesophageal Reflux Exam (78262) | $1,581.84 | $2,259.77 | 4.1× |
| Gated Heart Planar Single (78472) | $2,662.30 | $3,803.28 | 6.9× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$276.77–$421.66 | $395.38–$602.37 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,073.02 | $2,961.45 | 4.0× |
| Hepatobiliary System Imaging (78226) | $1,581.84 | $2,259.77 | 4.1× |
| Ht Muscle Image Spect Sing (78451) | $2,808.10 | $4,011.57 | 2.3× |
| Hysterosalpingogram (74740) | $939.80 | $1,342.56 | 4.1× |
| Image fusion (77399) | $496.40 | $709.14 | 3.9× |
| Interstitial radiation source applic complex (77778) | $1,801.83 | $2,574.04 | 2.7× |
| K Flow/Funct Image Multiple (78709) | $2,073.02 | $2,961.45 | 4.0× |
| K Flow/Funct Image W/Drug (78708) | $2,073.02 | $2,961.45 | 4.0× |
| K Flow/Funct Image W/O Drug (78707) | $2,073.02 | $2,961.45 | 4.0× |
| Kidney Imaging Morphol (78700) | $2,073.02 | $2,961.45 | 5.4× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$302–$348.52 | $431.42–$497.88 | varies |
| Leveen/Shunt Patency Exam (78291) | $3,455.50 | $4,936.42 | 9.0× |
| Liver & Spleen Imaging Static Only (78215) | $1,581.84 | $2,259.77 | 4.1× |
| Lung Perf&Ventilat Diferentl (78598) | $2,073.02 | $2,961.45 | 4.0× |
| Lung perfusion differential (78597) | $1,581.84 | $2,259.77 | 4.1× |
| Lung Ventilat&Perfus Imaging (78582) | $2,073.02 | $2,961.45 | 4.0× |
| Lung Ventilation Imaging (78579) | $1,581.84 | $2,259.77 | 4.1× |
| Lymph System Imaging (78195) | $2,073.02 | $2,961.45 | 4.0× |
| Magnetic Image Jaw Joint (70336) | $3,245.11 | $4,635.86 | 14.2× |
| Mammary ductogram or galactogram multiple (77054) | $646.29 | $923.26 | 2.8× |
| Mammary ductogram or galactogram single (77053) | $661.87 | $945.52 | 2.9× |
| Meckels Divert Exam (78290) | $1,581.84 | $2,259.77 | 4.1× |
| Mlc imrt design & construction per imrt plan (77338) | $950.70 | $1,358.13 | 2.6× |
| Mra Head W/O & W/Contrast Material (70546) | $3,373.88 | $4,819.82 | 10.1× |
| MRA head w/o contrast (70544) | $3,245.11 | $4,635.86 | 14.2× |
| MRA head with contrast (70545) | $3,478.66 | $4,969.51 | 10.4× |
| MRA neck w contrast (70548) | $3,478.66 | $4,969.51 | 10.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,373.88 | $4,819.82 | 10.1× |
| MRA neck w/o contrast (70547) | $3,245.11 | $4,635.86 | 14.2× |
| MRI abdomen w contrast (74182) | $3,070.86 | $4,386.94 | 9.2× |
| MRI abdomen w/o contrast (74181) | $3,245.11 | $4,635.86 | 14.2× |
| MRI any jt lower extrem w/contrast material (73722) | $3,070.86 | $4,386.94 | 4.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,478.66 | $4,969.51 | 10.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,070.86 | $4,386.94 | 4.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $3,245.11 | $4,635.86 | 14.2× |
| MRI cardiac w/o cont stress (75559) | $3,245.11 | $4,635.86 | 6.2× |
| MRI cardiac w/o contrast (75557) | $3,245.11 | $4,635.86 | 14.2× |
| MRI cervical spine w contrast (72142) | $3,245.11 | $4,635.86 | 9.7× |
| MRI cervical spine w/o cont (72141) | $3,245.11 | $4,635.86 | 14.2× |
| MRI chest w/o contrast (71550) | $3,245.11 | $4,635.86 | 14.2× |
| MRI chest with contrast (71551) | $3,070.86 | $4,386.94 | 4.1× |
| MRI chest wo w contrast (71552) | $3,478.66 | $4,969.51 | 10.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,070.86 | $4,386.94 | 9.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,070.86 | $4,386.94 | 9.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,245.11 | $4,635.86 | 14.2× |
| MRI lumbar spine w contrast (72149) | $2,497.58 | $3,567.96 | 7.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,058.84 | $7,226.91 | 15.1× |
| MRI orbit face &/neck w/o contrast (70540) | $3,245.11 | $4,635.86 | 14.2× |
| MRI orbit face neck w contrast (70542) | $3,478.66 | $4,969.51 | 10.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,070.86 | $4,386.94 | 9.2× |
| MRI pelvis w contrast (72196) | $3,478.66 | $4,969.51 | 10.4× |
| MRI pelvis w/o & w contrast (72197) | $3,478.66 | $4,969.51 | 10.4× |
| MRI pelvis w/o contrast (72195) | $3,245.11 | $4,635.86 | 14.2× |
| MRI thoracic spine w/o contrast (72146) | $3,245.11 | $4,635.86 | 14.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,406.70 | $3,438.13 | 7.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,245.11 | $4,635.86 | 14.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,245.11 | $4,635.86 | 9.7× |
| MRI, abdomen, combo (74183) | $3,478.66 | $4,969.51 | 10.4× |
| MRI, dorsal spine combo (72157) | $5,058.84 | $7,226.91 | 15.1× |
| MRI, dorsal spine contrast (72147) | $3,245.11 | $4,635.86 | 9.7× |
| MRI, joint upper extrem (73221) | $3,245.11 | $4,635.86 | 14.2× |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$3,070.86–$3,478.66 | $4,386.94–$4,969.51 | varies |
| MRI, lumbar spine combo (72158) | $5,058.84 | $7,226.91 | 15.1× |
| Myelogram cervical (72240) | $2,051.79 | $2,931.12 | 2.7× |
| Myelogram Lumbar (72265) | $2,051.79 | $2,931.12 | 2.7× |
| Myelography thoracic (72255) | $2,051.79 | $2,931.12 | 2.7× |
| Myelograpy 2/more regions rs&i (72270) | $2,051.79 | $2,931.12 | 2.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,581.84 | $2,259.77 | 4.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,808.10 | $4,011.57 | 2.3× |
| Myocardial Spect Multiple Studies (78452) | $5,446.03 | $7,780.03 | 4.4× |
| N-invas est c ffr sw aly CTA (75580) | $2,642.17 | $3,774.52 | 3.2× |
| Neck soft tissue (70360) | $241.90 | $345.56 | 2.9× |
| Nonvascular Shunt X-Ray (75809) | $276.17 | $394.52 | 2.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,613.54 | $5,162.20 | 2.7× |
| Nuclear Rx Oral Admin (79005) | $1,451.90 | $2,074.14 | 6.5× |
| Ob us nuchal meas 1 gest (76813) | $457.82 | $654.02 | 4.6× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $325.56 | $465.08 | 3.2× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $352.45 | $503.50 | 3.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $325.56 | $465.08 | 3.2× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $76.06 | $108.65 | 2.7× |
| Optic foramina (70190) | $261.19 | $373.12 | 3.1× |
| Panoramic X-ray of jaws (70355) | $636.64 | $909.48 | 7.6× |
| Parathyroid Planar Imaging (78070) | $3,455.50 | $4,936.42 | 9.0× |
| Pelvis 1 or 2 views (72170) | $421.66 | $602.37 | 4.2× |
| PET image w/CT, full body (78816) | $5,007.02 | $7,152.88 | 3.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,007.02 | $7,152.88 | 3.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,581.84 | $2,259.77 | 4.1× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) range across 2 matching MRF lines |
$630.70–$3,450.30 | $901–$4,929 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $434.82 | $621.16 | 4.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,115.85 | $3,022.63 | 4.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$348.52–$435.66 | $497.88–$622.36 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $348.52 | $497.88 | 4.2× |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$276.77–$348.52 | $395.38–$497.88 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $421.66 | $602.37 | 4.2× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$276.77–$348.52 | $395.38–$497.88 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$348.52–$435.66 | $497.88–$622.36 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$276.77–$348.52 | $395.38–$497.88 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$232.25–$348.52 | $331.78–$497.88 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $577.83 | $825.46 | 5.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $421.66 | $602.37 | 5.1× |
| Radex Ribs Unilateral 2 Views (71100) | $348.52 | $497.88 | 4.2× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$261.19–$348.52 | $373.12–$497.88 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $348.52 | $497.88 | 4.2× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $816.20 | $1,166 | 4.9× |
| Radex Spine 1 View Specify Level (72020) | $348.52 | $497.88 | 4.2× |
| Radex Sternum Minimum 2 Views (71120) | $348.52 | $497.88 | 4.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $421.66 | $602.37 | 5.1× |
| Radex Toe Minimum 2 Views (73660) | $348.52 | $497.88 | 4.2× |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$334.25–$421.66 | $477.49–$602.37 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$276.77–$348.52 | $395.38–$497.88 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$348.52–$680.70 | $497.88–$972.42 | varies |
| Radiation treatment delivery level 1 (77402) | $284.38 | $406.25 | 2.9× |
| Radiation treatment delivery level 2 (77407) | $682.97 | $975.66 | 1.8× |
| Radiation treatment delivery level 3 (77412) | $682.97 | $975.66 | 1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $421.66 | $602.37 | 4.2× |
| Radiologic exam colon double contrast study (74280) | $1,261.06 | $1,801.51 | 7.5× |
| Radiologic exam colon single contrast study (74270) | $704.68 | $1,006.68 | 4.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $704.68 | $1,006.68 | 4.2× |
| Radiologic exam knee complete 4/more views (73564) | $421.66 | $602.37 | 4.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$424.28–$514.43 | $606.11–$734.89 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $704.68 | $1,006.68 | 4.2× |
| Radiologic exam swallow function contrast study (74230) | $704.68 | $1,006.68 | 4.2× |
| Radiologic exam upr gi trc double contrast study (74246) range across 4 matching MRF lines |
$704.68–$1,099.65 | $1,006.68–$1,570.92 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$302–$324.13 | $431.42–$463.03 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$325.35–$348.52 | $464.78–$497.88 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$276.77–$348.52 | $395.38–$497.88 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $316.10 | $451.56 | 3.2× |
| Radiologic Examination Salivary Gland Calculus (70380) | $261.19 | $373.12 | 3.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $348.52 | $497.88 | 4.2× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $1,423.94 | $2,034.19 | 2.7× |
| Renal Cyst Study (74470) | $1,423.94 | $2,034.19 | 2.7× |
| Ribs bilateral 3 views (71110) | $421.66 | $602.37 | 4.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $3,455.50 | $4,936.42 | 9.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$2,073.02–$3,455.50 | $2,961.45–$4,936.42 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,446.03 | $7,780.03 | 10.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$2,073.02–$3,455.50 | $2,961.45–$4,936.42 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 5 matching MRF lines |
$1,581.84–$3,455.50 | $2,259.77–$4,936.42 | varies |
| Rp Therapy Intravenous Administration (79101) | $1,740.93 | $2,487.04 | 7.8× |
| Scapula (73010) range across 3 matching MRF lines |
$276.77–$421.66 | $395.38–$602.37 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$106.85–$109.08 | $152.64–$155.82 | varies |
| Sella turcica (70240) | $261.19 | $373.12 | 3.1× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$261.19–$348.52 | $373.12–$497.88 | varies |
| Shoulder Arthrography (73040) | $927.48 | $1,324.96 | 2.8× |
| Sialogram (70390) | $627.75 | $896.78 | 2.7× |
| Skull less than 4 views (70250) | $421.66 | $602.37 | 4.2× |
| Special dosimetry (77331) | $461.53 | $659.32 | 3.6× |
| Special Physics Consult (77370) | $481.56 | $687.94 | 3.7× |
| Special teletherapy port plan (77321) | $950.70 | $1,358.13 | 2.6× |
| Special treatment procedure (77470) | $2,419.67 | $3,456.66 | 4.6× |
| Stereotactic Body Radiation Delivery (77373) | $4,560.11 | $6,514.43 | 2.7× |
| Sternoclavicular joints (71130) | $348.52 | $497.88 | 4.2× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) | $255.39 | $364.84 | 2.6× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $93.50 | $133.56 | 2.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $950.70 | $1,358.13 | 2.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $950.70 | $1,358.13 | 2.6× |
| Testicular Imaging W/Flow (78761) | $2,073.02 | $2,961.45 | 5.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,073.68 | $1,533.82 | 3.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $950.70 | $1,358.13 | 2.6× |
| Ther rad simulaj-aided field setting simple (77280) | $517.18 | $738.82 | 4.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $462.32 | $660.45 | 2.7× |
| Thoracic spine 2 views (72070) | $421.66 | $602.37 | 4.2× |
| Thoracic spine 3 views (72072) | $348.52 | $497.88 | 3.5× |
| Thoracolumbar 2 views (72080) | $266.38 | $380.54 | 3.2× |
| Thyroid Imaging With Vascular Flow (78013) | $1,581.84 | $2,259.77 | 4.1× |
| Thyroid Met Imaging Body (78018) | $1,581.84 | $2,259.77 | 3.0× |
| Thyroid Uptake Measurement (78012) | $1,581.84 | $2,259.77 | 4.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,581.84 | $2,259.77 | 4.1× |
| Tx Devices Design & Construction Complex (77334) | $950.70 | $1,358.13 | 2.6× |
| Tx devices design & construction intermediate (77333) | $344.81 | $492.58 | 2.7× |
| Tx devices design & construction simple (77332) | $344.81 | $492.58 | 2.7× |
| Ultrasound Breast Limited (76642) | $348 | $497.14 | 4.2× |
| Ultrasound Exam Aaa Screen (76706) | $652.22 | $931.74 | 6.5× |
| Ultrasound, abdomen limited (76705) | $493.43 | $704.90 | 4.9× |
| Unlisted us procedure (76999) | $279.74 | $399.62 | 3.4× |
| Upper gi w/o kub (74240) range across 4 matching MRF lines |
$704.68–$1,023.96 | $1,006.68–$1,462.80 | varies |
| Urethrocystogram voiding (74455) | $627.75 | $896.78 | 2.7× |
| Urethrocystography retrograde (74450) | $1,474.97 | $2,107.10 | 6.4× |
| Us breast unilateral complete (76641) | $348 | $497.14 | 3.5× |
| Us chest (76604) | $299.03 | $427.18 | 3.0× |
| Us complete joint (76881) | $471.17 | $673.10 | 4.7× |
| Us exam, pelvic, limited (76857) | $316.84 | $452.62 | 3.2× |
| Us kidney transplant (76776) | $621.80 | $888.28 | 6.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $442.82 | $632.59 | 4.4× |
| Us ob detailed single fetus (76811) | $819.91 | $1,171.30 | 3.6× |
| Us ob limited 1 or more fetuses (76815) | $408.10 | $583 | 4.1× |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$348.52–$381.39 | $497.88–$544.84 | varies |
| Us pelvic non ob complete (76856) | $546.86 | $781.22 | 5.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $315.35 | $450.50 | 3.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $359.13 | $513.04 | 3.6× |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$276.17–$652.22 | $394.52–$931.74 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$276.17–$596.57 | $394.52–$852.24 | varies |
| Us scrotum and contents (76870) | $510.50 | $729.28 | 5.1× |
| Us thyroid (76536) | $483.05 | $690.06 | 4.8× |
| Us transrectal (76872) | $276.17 | $394.52 | 2.8× |
| Vein X-Ray Chest (75827) | $9,887.13 | $14,124.46 | 6.5× |
| Venography caval inferior serialography rs&i (75825) | $10,442.09 | $14,917.26 | 3.4× |
| Venography extremity bilateral rs&i (75822) | $12,284.81 | $17,549.72 | 8.1× |
| Venography extremity unilateral rs&i (75820) | $6,142.41 | $8,774.86 | 4.1× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$276.77–$348.52 | $395.38–$497.88 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$276.77–$348.52 | $395.38–$497.88 | varies |
| X-ray antegrade pyelogram tube (74425) | $927.48 | $1,324.96 | 2.8× |
| X-Ray Bend Only L-S Spine (72120) | $348.52 | $497.88 | 3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$276.77–$348.52 | $395.38–$497.88 | varies |
| X-Ray Exam Breast Specimen (76098) | $2,115.85 | $3,022.63 | 4.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $348.52 | $497.88 | 4.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$348.52–$435.66 | $497.88–$622.36 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$348.52–$544.56 | $497.88–$777.94 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$276.77–$348.52 | $395.38–$497.88 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$286.37–$348.52 | $409.10–$497.88 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$315.19–$383.59 | $450.26–$547.98 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$316.06–$385.10 | $451.51–$550.13 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$346.62–$421.66 | $495.16–$602.37 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$380.66–$463.09 | $543.80–$661.55 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $611.78 | $873.97 | 6.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $348.52 | $497.88 | 4.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$403.65–$421.66 | $576.64–$602.37 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) | $421.66 | $602.37 | 4.2× |
| X-ray eye for foreign body (70030) | $348.52 | $497.88 | 4.2× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$276.77–$348.52 | $395.38–$497.88 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$617.35–$704.68 | $881.92–$1,006.68 | varies |
| X-ray IV pyelogram+tomography (74415) | $728.65 | $1,040.92 | 4.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $421.66 | $602.37 | 5.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $348.52 | $497.88 | 4.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $421.66 | $602.37 | 4.2× |
| X-ray nose-rectum child f.b. (76010) | $228.67 | $326.67 | 2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $690.19 | $985.98 | 6.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$421.66–$623.32 | $602.37–$890.45 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$348.52–$424.28 | $497.88–$606.11 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$348.52–$400.71 | $497.88–$572.43 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $348.52 | $497.88 | 4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $593.45 | $847.78 | 5.9× |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$228.67–$348.52 | $326.67–$497.88 | varies |
| X-Ray Tmj Unilat (70328) | $348.52 | $497.88 | 4.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $927.48 | $1,324.96 | 2.8× |
| X-Rays Bone Length Studies (77073) | $421.66 | $602.37 | 4.2× |
| X-Rays Bone Survey Complete (77075) | $546.86 | $781.22 | 5.5× |
| Xr c-spine 4 or 5 views (72050) | $421.66 | $602.37 | 4.2× |
| Xr facial bones less than 3 views (70140) | $421.66 | $602.37 | 5.1× |
| XR Mastoids < 3 Views Bilateral (70120) | $421.66 | $602.37 | 4.2× |
| Xr orbits complete 4 views (70200) | $421.66 | $602.37 | 4.2× |
| Xr Tomogram Single Plane (76100) | $537.21 | $767.44 | 5.4× |
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.