Imaging prices at Decatur Memorial Hospital
Decatur, IL · every code in this section with a posted price and a Medicare benchmark.
382 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) | $11,427 | $11,427 | 7.7× |
| Abdomen 1 View (74018) | $664 | $664 | 7.1× |
| Abdomen 2 views (74019) | $809 | $809 | 7.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,324 | $1,324 | 3.1× |
| Angio internal mammary (75756) | $5,456 | $5,456 | 1.6× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$8,070–$8,184 | $8,070–$8,184 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $5,456 | $5,456 | 1.6× |
| Angiography extremity bilateral rs&i (75716) | $8,184 | $8,184 | 2.4× |
| Angiography extremity unilateral rs&i (75710) | $5,456 | $5,456 | 1.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$5,380–$5,456 | $5,380–$5,456 | varies |
| Ankle 2 views (73600) | $730 | $730 | 7.8× |
| Aortography thoracic serialography rs&i (75605) | $9,439 | $9,439 | 1.6× |
| Artery X-Rays Abdomen (75726) range across 4 matching MRF lines |
$8,650–$10,489 | $8,650–$10,489 | varies |
| Artery X-Rays Pelvis (75736) | $9,615 | $9,615 | 1.6× |
| Artery X-Rays Spine (75705) | $9,439 | $9,439 | 1.6× |
| Arthrogram ankle (73615) | $757 | $757 | 2.0× |
| Arthrogram hip (73525) | $1,102 | $1,102 | 2.9× |
| Arthrogram Wrist (73115) | $976 | $976 | 2.6× |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$1,172–$1,175 | $1,172–$1,175 | varies |
| Bone age studies (77072) | $911 | $911 | 8.1× |
| Bone Imaging 3 Phase (78315) | $3,171 | $3,171 | 7.4× |
| Bone Imaging Limited Area (78300) | $1,555 | $1,555 | 3.6× |
| Bone Imaging Whole Body (78306) | $3,020 | $3,020 | 7.0× |
| Bone marrow imaging limited area (78102) | $921 | $921 | 2.1× |
| Bone survey infant (77076) | $1,064 | $1,064 | 9.5× |
| Brachytx isodose complex (77318) | $2,095 | $2,095 | 5.2× |
| Brachytx isodose intermed (77317) | $1,273 | $1,273 | 3.2× |
| Brachytx Isodose Plan Simple (77316) | $878 | $878 | 2.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,389 | $1,389 | 2.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,286 | $7,286 | 4.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,590 | $3,590 | 9.6× |
| Cat Scan Follow-Up Study (76380) range across 7 matching MRF lines |
$1,650–$2,176 | $1,650–$2,176 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,579 | $1,579 | 2.7× |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$1,916–$2,451 | $1,916–$2,451 | varies |
| Chest 1 view (71045) | $393 | $393 | 4.2× |
| Chest 2 views (71046) | $529 | $529 | 5.7× |
| Chest 3 views (71047) | $658 | $658 | 7.1× |
| Chest 4 or more views (71048) | $703 | $703 | 6.3× |
| Cholecystography Oral Contrast (74290) | $757 | $757 | 4.0× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $378 | $378 | 3.4× |
| Clavicle complete (73000) | $660 | $660 | 7.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $629 | $629 | 5.6× |
| Continuing medical physics consltj pr wk (77336) range across 3 matching MRF lines |
$1,404–$1,444 | $1,404–$1,444 | varies |
| Contrast Exam Abdominl Aorta (75625) | $5,456 | $5,456 | 1.6× |
| Contrast X-Ray Bladder (74430) | $1,652 | $1,652 | 4.4× |
| Contrast X-Ray Of Elbow (73085) | $1,128 | $1,128 | 3.0× |
| Contrast X-Ray Of Knee Joint (73580) | $1,277 | $1,277 | 3.4× |
| CT abdomen and pelvis without and with contrast (74178) | $8,137 | $8,137 | 21.8× |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$6,425–$6,857 | $6,425–$6,857 | varies |
| CT abdomen w contrast (74160) | $4,869 | $4,869 | 25.9× |
| CT abdomen w wo contrast (74170) | $5,422 | $5,422 | 28.8× |
| CT abdomen w/o contrast (74150) range across 4 matching MRF lines |
$3,600–$3,948 | $3,600–$3,948 | varies |
| CT Angio Abdomen and Pelvis (74174) | $8,188 | $8,188 | 21.9× |
| CT Angio Chest (71275) range across 11 matching MRF lines |
$4,454–$4,561 | $4,454–$4,561 | varies |
| CT Angio Head (70496) | $5,130 | $5,130 | 27.3× |
| CT angio hrt w/3d image (75574) | $4,990 | $4,990 | 13.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $5,034 | $5,034 | 26.8× |
| CT Angio Neck (70498) | $4,274 | $4,274 | 22.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $5,776 | $5,776 | 30.7× |
| CT cervical spine w/ contrast (72126) | $4,879 | $4,879 | 13.1× |
| CT cervical spine w/o contrast (72125) | $4,546 | $4,546 | 40.6× |
| CT cervical spine w/wo cont (72127) | $5,129 | $5,129 | 27.3× |
| CT chest w contrast (71260) | $4,585 | $4,585 | 24.4× |
| CT chest w/wo contrast (71270) | $5,221 | $5,221 | 27.8× |
| CT colonography screening (74263) | $2,002 | $2,002 | 7.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $5,335 | $5,335 | 47.6× |
| CT head/brain with contrast (70460) | $3,694 | $3,694 | 19.7× |
| CT head/brain without and with contrast (70470) | $4,627 | $4,627 | 24.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,461 | $1,461 | 3.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $151 | $151 | 1.6× |
| CT iac w contrast (70481) | $4,499 | $4,499 | 23.9× |
| CT l-spine w&w/o contrast (72133) | $5,177 | $5,177 | 27.5× |
| CT lower ext w/o (73700) | $4,348 | $4,348 | 38.8× |
| CT lower extremity w/contrast material (73701) | $4,566 | $4,566 | 24.3× |
| CT lumbar spine w contrast (72132) | $4,930 | $4,930 | 13.2× |
| CT lumbar spine w/o contrast (72131) | $4,529 | $4,529 | 40.4× |
| CT maxillofacial w contrast (70487) | $4,246 | $4,246 | 22.6× |
| CT maxillofacial wo contrast (70486) | $3,564 | $3,564 | 31.8× |
| CT neck tissue combo (70492) | $5,067 | $5,067 | 27.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $4,635 | $4,635 | 24.7× |
| CT orbits w/o contrast (70480) | $4,488 | $4,488 | 40.1× |
| CT pelvis w&w/o contrast (72194) | $5,201 | $5,201 | 27.7× |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$2,690–$2,971 | $2,690–$2,971 | varies |
| CT scan of leg combo (73702) | $4,795 | $4,795 | 25.5× |
| CT scans face/jaw combo (70488) | $5,197 | $5,197 | 27.6× |
| CT soft tissue neck w contrast (70491) | $3,460 | $3,460 | 18.4× |
| CT soft tissue neck w/o contrast (70490) range across 3 matching MRF lines |
$2,735–$3,490 | $2,735–$3,490 | varies |
| CT thoracic spine w contrast (72129) | $5,085 | $5,085 | 27.1× |
| CT thoracic spine w/o contrast (72128) | $4,560 | $4,560 | 40.7× |
| CT thoracic spine w/wo cont (72130) | $5,339 | $5,339 | 28.4× |
| CT thorax w/o contrast (71250) range across 9 matching MRF lines |
$3,372–$4,443 | $3,372–$4,443 | varies |
| CT upper ext wo (73200) | $3,959 | $3,959 | 35.3× |
| CT upper extremity w/o & w/contrast material (73202) | $5,566 | $5,566 | 29.6× |
| CT upper extremity with contrast (73201) | $5,060 | $5,060 | 13.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,283 | $4,283 | 22.8× |
| Cta Abdomen (74175) | $5,985 | $5,985 | 31.8× |
| CTA pelvis (72191) | $5,274 | $5,274 | 28.1× |
| Dilation ureters/urethra rs&i (74485) | $3,993 | $3,993 | 1.8× |
| Discography Cerv/Thor Spine (72285) | $4,028 | $4,028 | 1.9× |
| Diskography lumbar (72295) | $4,028 | $4,028 | 1.9× |
| Dxa Bone Density Axial (77080) | $912 | $912 | 8.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $353 | $353 | 3.8× |
| Echo exam uterus (76831) | $809 | $809 | 3.2× |
| Echo Guide For Artery Repair (76936) range across 3 matching MRF lines |
$861–$1,841 | $861–$1,841 | varies |
| Echograp Trans R Pros Study (76873) | $796 | $796 | 7.1× |
| Esophageal Motility Study (78258) | $1,304 | $1,304 | 3.0× |
| Esophagram (74220) | $1,274 | $1,274 | 6.8× |
| Fetal Biophys Profile W/Nst (76818) range across 3 matching MRF lines |
$1,222–$1,248 | $1,222–$1,248 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $4,637 | $4,637 | 18.1× |
| Fluoroscopy up to 1 hr (76000) range across 6 matching MRF lines |
$725–$1,086 | $725–$1,086 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$3,255–$5,456 | $3,255–$5,456 | varies |
| Foot 2 views (73620) | $793 | $793 | 8.5× |
| Forearm 2 views (73090) | $726 | $726 | 7.8× |
| Gastric emptying imaging study (78264) | $3,033 | $3,033 | 7.1× |
| Gated Heart Planar Single (78472) | $1,577 | $1,577 | 3.7× |
| Hand 2 views (73120) | $779 | $779 | 7.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $8,539 | $8,539 | 11.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $8,005 | $8,005 | 10.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $5,732 | $5,732 | 7.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,456 | $5,456 | 1.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $5,456 | $5,456 | 1.6× |
| Hepatobil Syst Image W/Drug (78227) | $3,557 | $3,557 | 6.1× |
| Hepatobiliary System Imaging (78226) | $2,920 | $2,920 | 6.8× |
| Hysterosalpingogram (74740) | $1,478 | $1,478 | 5.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $355 | $355 | 3.8× |
| Interstitial radiation source applic complex (77778) | $7,294 | $7,294 | 9.8× |
| K Flow/Funct Image W/Drug (78708) | $2,914 | $2,914 | 5.0× |
| K Flow/Funct Image W/O Drug (78707) | $2,084 | $2,084 | 3.6× |
| Kidney Imaging Morphol (78700) | $1,739 | $1,739 | 4.1× |
| Knee 3 Views (73562) | $867 | $867 | 9.3× |
| Liver & Spleen Imaging Static Only (78215) | $1,422 | $1,422 | 3.3× |
| Liver imaging static only (78201) | $2,236 | $2,236 | 3.8× |
| Lung Perf&Ventilat Diferentl (78598) | $1,967 | $1,967 | 3.4× |
| Lung Ventilat&Perfus Imaging (78582) | $1,977 | $1,977 | 3.4× |
| Lung Ventilation Imaging (78579) | $1,919 | $1,919 | 4.5× |
| Lymph System Imaging (78195) | $2,991 | $2,991 | 5.1× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,871 | $1,871 | 1.1× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,247 | $1,247 | 1.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $8,184 | $8,184 | 2.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $5,456 | $5,456 | 1.6× |
| Magnetic Image Jaw Joint (70336) | $3,858 | $3,858 | 15.1× |
| Magnetic Resonance Elastography (76391) | $1,975 | $1,975 | 7.7× |
| Mammary ductogram or galactogram multiple (77054) | $1,201 | $1,201 | 4.7× |
| Mammary ductogram or galactogram single (77053) | $717 | $717 | 2.8× |
| Meckels Divert Exam (78290) | $1,780 | $1,780 | 4.2× |
| Mlc imrt design & construction per imrt plan (77338) | $2,649 | $2,649 | 6.6× |
| Mr safety determination physician/other qhp (76016) | $229 | $229 | 2.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $64 | $64 | 2.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $239 | $239 | 2.3× |
| Mr safety implt pos&/immoblj (76019) | $155 | $155 | 2.5× |
| Mr safety med physics xm customization plng&mntr (76017) | $630 | $630 | 2.5× |
| Mra Head W/O & W/Contrast Material (70546) | $8,212 | $8,212 | 22.0× |
| MRA head w/o contrast (70544) | $5,950 | $5,950 | 23.3× |
| MRA head with contrast (70545) | $6,060 | $6,060 | 16.2× |
| MRA neck w contrast (70548) | $5,834 | $5,834 | 15.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $8,762 | $8,762 | 23.4× |
| MRA neck w/o contrast (70547) | $5,206 | $5,206 | 20.4× |
| MRI abdomen w contrast (74182) | $5,600 | $5,600 | 15.0× |
| MRI abdomen w/o contrast (74181) | $4,404 | $4,404 | 17.2× |
| MRI any jt lower extrem w/contrast material (73722) | $7,672 | $7,672 | 9.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $8,190 | $8,190 | 21.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $7,522 | $7,522 | 9.0× |
| MRI brain functional w/o physician admnistration (70554) | $2,707 | $2,707 | 10.6× |
| MRI Breast W/O Contrast Bilateral (77047) | $3,053 | $3,053 | 11.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,035 | $2,035 | 8.0× |
| MRI cardiac w/o contrast (75557) | $1,857 | $1,857 | 7.3× |
| MRI cervical spine w contrast (72142) | $6,273 | $6,273 | 16.8× |
| MRI cervical spine w/o cont (72141) | $5,686 | $5,686 | 22.2× |
| MRI chest w/o contrast (71550) | $6,508 | $6,508 | 25.5× |
| MRI chest with contrast (71551) | $5,502 | $5,502 | 6.5× |
| MRI chest wo w contrast (71552) | $8,533 | $8,533 | 22.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $6,457 | $6,457 | 17.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $8,142 | $8,142 | 21.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $5,507 | $5,507 | 21.5× |
| MRI lumbar spine w contrast (72149) | $8,084 | $8,084 | 21.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $9,164 | $9,164 | 24.5× |
| MRI orbit face &/neck w/o contrast (70540) | $4,377 | $4,377 | 17.1× |
| MRI orbit face neck w contrast (70542) | $5,175 | $5,175 | 13.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $8,258 | $8,258 | 22.1× |
| MRI pelvis w contrast (72196) | $6,638 | $6,638 | 17.8× |
| MRI pelvis w/o & w contrast (72197) | $8,320 | $8,320 | 22.3× |
| MRI pelvis w/o contrast (72195) | $5,680 | $5,680 | 22.2× |
| MRI spectroscopy (76390) | $3,052 | $3,052 | 32.7× |
| MRI thoracic spine w/o contrast (72146) | $5,849 | $5,849 | 22.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $6,949 | $6,949 | 18.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $6,501 | $6,501 | 25.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $8,100 | $8,100 | 21.7× |
| MRI, abdomen, combo (74183) | $7,708 | $7,708 | 20.6× |
| MRI, dorsal spine combo (72157) | $8,089 | $8,089 | 21.6× |
| MRI, dorsal spine contrast (72147) | $6,899 | $6,899 | 18.5× |
| MRI, joint upper extrem (73221) | $6,424 | $6,424 | 25.1× |
| MRI, joint upper extrem combo (73223) | $7,799 | $7,799 | 20.9× |
| MRI, lumbar spine combo (72158) | $8,116 | $8,116 | 21.7× |
| Myelograpy 2/more regions rs&i (72270) | $2,580 | $2,580 | 3.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $4,158 | $4,158 | 3.0× |
| Myocardial Spect Multiple Studies (78452) | $7,602 | $7,602 | 5.5× |
| N-invas est c ffr sw aly CTA (75580) | $2,668 | $2,668 | 2.9× |
| Neck soft tissue (70360) | $721 | $721 | 7.7× |
| Nonvascular Shunt X-Ray (75809) | $1,028 | $1,028 | 9.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $11,154 | $11,154 | 7.5× |
| Nuclear Rx Intra-Arterial (79445) | $1,912 | $1,912 | 7.6× |
| Nuclear Rx Oral Admin (79005) | $3,317 | $3,317 | 13.3× |
| Ob us nuchal meas 1 gest (76813) | $668 | $668 | 6.0× |
| Panoramic X-ray of jaws (70355) | $339 | $339 | 3.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,139 | $3,139 | 5.4× |
| Parathyroid Planar Imaging (78070) | $1,272 | $1,272 | 3.0× |
| Pelvis 1 or 2 views (72170) | $825 | $825 | 7.4× |
| Peritoneogram Rs&I (74190) | $1,144 | $1,144 | 2.0× |
| Pet Image Skull-Thigh (78812) | $11,898 | $11,898 | 7.8× |
| Pet Image W/Ct Lmtd (78814) | $7,618 | $7,618 | 5.0× |
| PET image w/CT, full body (78816) | $11,738 | $11,738 | 7.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $11,486 | $11,486 | 7.5× |
| PET whole body (78813) | $8,846 | $8,846 | 5.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $5,456 | $5,456 | 1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,432 | $1,432 | 3.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,318 | $2,318 | 4.0× |
| Radex Ankle Complete Minimum 3 Views (73610) | $829 | $829 | 8.9× |
| Radex Calcaneus Minimum 2 Views (73650) | $711 | $711 | 7.6× |
| Radex elbow complete minimum 3 views (73080) | $751 | $751 | 8.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,032 | $1,032 | 9.2× |
| Radex fingr minimum 2 views (73140) | $649 | $649 | 7.0× |
| Radex foot complete minimum 3 views (73630) | $835 | $835 | 9.0× |
| Radex Hand Minimum 3 Views (73130) | $802 | $802 | 8.6× |
| Radex lower extremity infant minimum 2 views (73592) | $711 | $711 | 7.6× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $383 | $383 | 3.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $805 | $805 | 8.6× |
| Radex Ribs Unilateral 2 Views (71100) | $741 | $741 | 7.9× |
| Radex shoulder complete minimum 2 views (73030) | $773 | $773 | 8.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $420 | $420 | 4.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,056 | $1,056 | 5.6× |
| Radex Spine 1 View Specify Level (72020) | $699 | $699 | 7.5× |
| Radex Sternum Minimum 2 Views (71120) | $441 | $441 | 4.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $496 | $496 | 5.3× |
| Radex Toe Minimum 2 Views (73660) | $655 | $655 | 7.0× |
| Radex upper extremity infant minimum 2 views (73092) | $764 | $764 | 6.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $798 | $798 | 8.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,560 | $1,560 | 13.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $28,338 | $28,338 | 3.6× |
| Radiation treatment delivery level 1 (77402) | $644 | $644 | 5.9× |
| Radiation treatment delivery level 2 (77407) | $685 | $685 | 1.7× |
| Radiation treatment delivery level 3 (77412) | $1,871 | $1,871 | 3.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,045 | $1,045 | 9.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $934 | $934 | 8.3× |
| Radiologic exam colon double contrast study (74280) | $1,086 | $1,086 | 5.8× |
| Radiologic exam colon single contrast study (74270) | $770 | $770 | 4.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,275 | $1,275 | 6.8× |
| Radiologic exam knee complete 4/more views (73564) | $966 | $966 | 8.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $971 | $971 | 8.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $824 | $824 | 4.4× |
| Radiologic exam swallow function contrast study (74230) | $730 | $730 | 3.9× |
| Radiologic exam teeth complete full mouth (70320) | $504 | $504 | 2.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,514 | $1,514 | 8.1× |
| Radiologic examination femur 1 view (73551) | $234 | $234 | 2.5× |
| Radiologic examination femur minimum 2 views (73552) | $832 | $832 | 8.9× |
| Radiologic examination knee 1/2 views (73560) | $738 | $738 | 7.9× |
| Radiologic Examination Osseous Survey Limited (77074) | $558 | $558 | 5.0× |
| Radiologic Examination Salivary Gland Calculus (70380) | $261 | $261 | 2.8× |
| Radiologic examination tibia & fibula 2 views (73590) | $749 | $749 | 8.0× |
| Radiopharm Dacryocystography (78660) | $1,165 | $1,165 | 2.7× |
| Ribs bilateral 3 views (71110) | $955 | $955 | 8.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,796 | $1,796 | 4.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,646 | $2,646 | 6.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,360 | $3,360 | 5.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,738 | $3,738 | 6.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $5,428 | $5,428 | 3.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $6,991 | $6,991 | 4.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 5 matching MRF lines |
$4,528–$4,607 | $4,528–$4,607 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $846 | $846 | 3.4× |
| Rp Therapy Intravenous Administration (79101) | $1,073 | $1,073 | 4.3× |
| Salivary Gland Imaging Serial Images (78231) | $1,298 | $1,298 | 3.0× |
| Scapula (73010) | $814 | $814 | 7.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $249 | $249 | 10.7× |
| Sella turcica (70240) | $339 | $339 | 3.6× |
| Shoulder 1 view (73020) | $381 | $381 | 4.1× |
| Shoulder Arthrography (73040) | $1,316 | $1,316 | 3.5× |
| Sialogram (70390) | $1,068 | $1,068 | 4.2× |
| Skull less than 4 views (70250) | $490 | $490 | 4.4× |
| Special dosimetry (77331) | $1,055 | $1,055 | 7.3× |
| Special Physics Consult (77370) | $1,142 | $1,142 | 7.9× |
| Special teletherapy port plan (77321) | $2,944 | $2,944 | 7.3× |
| Special treatment procedure (77470) range across 3 matching MRF lines |
$3,485–$3,687 | $3,485–$3,687 | varies |
| Spleen Imaging (78185) | $839 | $839 | 2.0× |
| Stereotactic Body Radiation Delivery (77373) | $8,567 | $8,567 | 4.5× |
| Sternoclavicular joints (71130) | $459 | $459 | 4.9× |
| Superior sagittal sinus venogram (75870) | $5,456 | $5,456 | 1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,955 | $2,955 | 7.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,229 | $1,229 | 3.1× |
| Testicular Imaging W/Flow (78761) | $1,371 | $1,371 | 3.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $4,077 | $4,077 | 10.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $2,069 | $2,069 | 5.2× |
| Ther rad simulaj-aided field setting simple (77280) range across 3 matching MRF lines |
$2,038–$2,052 | $2,038–$2,052 | varies |
| Thoracic spine 2 views (72070) | $784 | $784 | 7.0× |
| Thoracic spine 3 views (72072) | $1,016 | $1,016 | 9.1× |
| Thoracolumbar 2 views (72080) | $697 | $697 | 7.5× |
| Thyroid Imaging With Vascular Flow (78013) | $1,290 | $1,290 | 3.0× |
| Thyroid Met Imaging Body (78018) | $3,259 | $3,259 | 5.6× |
| Thyroid Uptake Measurement (78012) | $959 | $959 | 2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,074 | $2,074 | 4.8× |
| Tx Devices Design & Construction Complex (77334) | $2,990 | $2,990 | 7.5× |
| Tx devices design & construction intermediate (77333) | $1,682 | $1,682 | 11.7× |
| Tx devices design & construction simple (77332) | $1,490 | $1,490 | 10.3× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$1,156–$2,332 | $1,156–$2,332 | varies |
| Ultrasound elastography first target lesion (76982) | $301 | $301 | 2.7× |
| Ultrasound Elastography Parenchyma (76981) | $350 | $350 | 3.1× |
| Ultrasound Exam Aaa Screen (76706) | $679 | $679 | 6.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $1,182 | $1,182 | 3.2× |
| Ultrasound, abdomen limited (76705) | $1,569 | $1,569 | 14.0× |
| Umbilical-artery Doppler (OB) (76820) | $543 | $543 | 4.8× |
| Unlisted Dx Radiographic Procedure (76499) range across 3 matching MRF lines |
$50–$459 | $50–$459 | varies |
| Unlisted fluoroscopic procedure (76496) | $1,551 | $1,551 | 16.6× |
| Unlisted magnetic resonance procedure (76498) | $528 | $528 | 5.7× |
| Upper gi w/o kub (74240) | $1,311 | $1,311 | 7.0× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$1,201–$1,723 | $1,201–$1,723 | varies |
| Urethrocystography retrograde (74450) range across 5 matching MRF lines |
$1,232–$1,639 | $1,232–$1,639 | varies |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$2,216–$4,432 | $2,216–$4,432 | varies |
| Us chest (76604) range across 5 matching MRF lines |
$1,124–$1,144 | $1,124–$1,144 | varies |
| Us complete joint (76881) | $1,292 | $1,292 | 11.5× |
| Us exam, pelvic, limited (76857) | $707 | $707 | 6.3× |
| Us head (76506) | $766 | $766 | 6.8× |
| Us kidney transplant (76776) | $670 | $670 | 6.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 6 matching MRF lines |
$1,345–$1,350 | $1,345–$1,350 | varies |
| Us ob detailed single fetus (76811) | $1,479 | $1,479 | 5.8× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$1,135–$1,216 | $1,135–$1,216 | varies |
| Us ob transvaginal (76817) | $1,279 | $1,279 | 11.4× |
| Us pelvic non ob complete (76856) | $1,784 | $1,784 | 15.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,320 | $1,320 | 11.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $976 | $976 | 8.7× |
| Us retroperitoneal complete (76770) | $1,905 | $1,905 | 17.0× |
| Us retroperitoneal limited (76775) range across 5 matching MRF lines |
$1,104–$1,565 | $1,104–$1,565 | varies |
| Us scrotum and contents (76870) | $1,468 | $1,468 | 13.1× |
| Us spinal canal and contents (76800) | $523 | $523 | 4.7× |
| Us thyroid (76536) | $1,377 | $1,377 | 12.3× |
| Us transrectal (76872) | $1,726 | $1,726 | 15.4× |
| Vasogram (74440) | $504 | $504 | 2.0× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$3,297–$3,907 | $3,297–$3,907 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $5,456 | $5,456 | 1.6× |
| Venogram Sinus/Jugular (75860) | $5,456 | $5,456 | 1.6× |
| Venography Adrenal Unilateral (75840) | $5,456 | $5,456 | 1.6× |
| Venography caval inferior serialography rs&i (75825) | $6,719 | $6,719 | 2.0× |
| Venography extremity bilateral rs&i (75822) | $4,005 | $4,005 | 2.4× |
| Venography extremity unilateral rs&i (75820) range across 4 matching MRF lines |
$2,670–$3,374 | $2,670–$3,374 | varies |
| Venography Renal Bilateral (75833) | $8,184 | $8,184 | 2.4× |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$5,456–$5,571 | $5,456–$5,571 | varies |
| Venous sampling by catheter (75893) | $9,439 | $9,439 | 1.6× |
| Wrist 2 views (73100) | $652 | $652 | 7.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $617 | $617 | 6.6× |
| X-ray antegrade pyelogram tube (74425) | $1,067 | $1,067 | 2.9× |
| X-Ray Aorta Leg Arteries (75630) | $5,456 | $5,456 | 1.6× |
| X-Ray Bend Only L-S Spine (72120) | $915 | $915 | 8.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $712 | $712 | 7.6× |
| X-Ray Exam Breast Specimen (76098) | $1,144 | $1,144 | 2.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $753 | $753 | 8.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $1,373 | $1,373 | 12.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,547 | $1,547 | 13.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $334 | $334 | 3.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $870 | $870 | 9.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $900 | $900 | 8.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $891 | $891 | 8.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $973 | $973 | 8.7× |
| X-Ray Exam L-S Spine Bending (72114) | $1,371 | $1,371 | 12.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $832 | $832 | 8.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,409 | $1,409 | 12.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $904 | $904 | 8.1× |
| X-ray humerus (73060) | $751 | $751 | 8.1× |
| X-ray IV pyelogram (ivp) (74400) | $1,414 | $1,414 | 7.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $422 | $422 | 4.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $778 | $778 | 8.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $876 | $876 | 7.8× |
| X-ray nose-rectum child f.b. (76010) | $317 | $317 | 3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,058 | $1,058 | 9.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $825 | $825 | 7.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $750 | $750 | 8.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,018 | $1,018 | 10.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,098 | $1,098 | 9.8× |
| X-Ray Stress View (77071) | $399 | $399 | 4.3× |
| X-ray thoracic spine 4 vw (72074) | $1,156 | $1,156 | 10.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$1,573–$1,575 | $1,573–$1,575 | varies |
| X-Rays Bone Length Studies (77073) | $1,158 | $1,158 | 10.3× |
| X-Rays Bone Survey Complete (77075) | $1,054 | $1,054 | 9.4× |
| Xr c-spine 4 or 5 views (72050) | $1,012 | $1,012 | 9.0× |
| Xr facial bones less than 3 views (70140) | $705 | $705 | 7.6× |
| Xr orbits complete 4 views (70200) | $969 | $969 | 8.6× |
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.