Imaging prices at Doctors Hospital of Manteca
Manteca, CA · every code in this section with a posted price and a Medicare benchmark.
269 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 |
$1,129.50–$1,418.25 | $1,506–$1,891 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$1,322.25–$1,418.25 | $1,763–$1,891 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $3,323.25 | $4,431 | 6.3× |
| Angiography extremity bilateral rs&i (75716) | $10,658.25 | $14,211 | 2.6× |
| Angiography extremity unilateral rs&i (75710) | $9,448.50 | $12,598 | 2.3× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$1,020–$1,867.50 | $1,360–$2,490 | varies |
| Aortography thoracic serialography rs&i (75605) | $5,031.75 | $6,709 | 0.7× |
| Artery X-Rays Abdomen (75726) | $5,031.75 | $6,709 | 0.7× |
| Arthrogram hip (73525) | $1,634.25 | $2,179 | 3.6× |
| Arthrogram Wrist (73115) | $1,767.75 | $2,357 | 3.8× |
| Basic radiation dosimetry calculation (77300) | $1,140.75 | $1,521 | 6.4× |
| Bone age studies (77072) | $1,287 | $1,716 | 9.3× |
| Bone Imaging 3 Phase (78315) | $5,379 | $7,172 | 10.2× |
| Bone Imaging Limited Area (78300) | $3,513 | $4,684 | 6.7× |
| Bone Imaging Whole Body (78306) | $4,545.75 | $6,061 | 8.6× |
| Bone survey infant (77076) | $1,159.50 | $1,546 | 8.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $3,234 | $4,312 | 4.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $9,586.50 | $12,782 | 5.1× |
| Cat Scan Follow-Up Study (76380) | $3,908.25 | $5,211 | 34.0× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$1,287–$1,745.25 | $1,716–$2,327 | varies |
| Chest 2 views (71046) | $2,472 | $3,296 | 21.5× |
| Chest 3 views (71047) | $2,599.50 | $3,466 | 22.6× |
| Chest 4 or more views (71048) | $3,068.25 | $4,091 | 22.3× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$1,131.75–$1,914.75 | $1,509–$2,553 | varies |
| Contrast Exam Abdominl Aorta (75625) | $3,034.50 | $4,046 | 0.7× |
| Contrast X-Ray Bladder (74430) | $956.25 | $1,275 | 2.1× |
| Contrast X-Ray Of Knee Joint (73580) | $1,452.75 | $1,937 | 3.2× |
| CT abdomen and pelvis without and with contrast (74178) | $23,138.25 | $30,851 | 50.3× |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$19,463.25–$23,105.25 | $25,951–$30,807 | varies |
| CT abdomen w contrast (74160) | $12,838.50 | $17,118 | 55.5× |
| CT abdomen w wo contrast (74170) | $12,838.50 | $17,118 | 55.5× |
| CT abdomen w/o contrast (74150) | $12,838.50 | $17,118 | 93.1× |
| CT Angio Abdomen and Pelvis (74174) | $9,297.75 | $12,397 | 20.2× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$12,552.75–$15,903 | $16,737–$21,204 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$4,217.25–$11,365.50 | $5,623–$15,154 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,092.50 | $2,790 | 9.0× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$4,217.25–$13,639.50 | $5,623–$18,186 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,092.50 | $2,790 | 9.0× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$12,731.25–$13,936.50 | $16,975–$18,582 | varies |
| CT cervical spine w/o contrast (72125) | $11,249.25 | $14,999 | 81.6× |
| CT cervical spine w/wo cont (72127) | $15,762 | $21,016 | 68.1× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$11,664–$12,731.25 | $15,552–$16,975 | varies |
| CT chest w/wo contrast (71270) | $12,395.25 | $16,527 | 53.6× |
| CT head/brain with contrast (70460) | $12,098.25 | $16,131 | 52.3× |
| CT head/brain without and with contrast (70470) | $11,365.50 | $15,154 | 49.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $1,033.50 | $1,378 | 9.0× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$7,906.50–$9,364.50 | $10,542–$12,486 | varies |
| CT l-spine w&w/o contrast (72133) | $14,457.75 | $19,277 | 62.5× |
| CT lower ext w/o (73700) | $5,306.25 | $7,075 | 38.5× |
| CT lower extremity w/contrast material (73701) | $5,875.50 | $7,834 | 25.4× |
| CT lumbar spine w contrast (72132) | $11,718.75 | $15,625 | 25.5× |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$11,284.50–$12,261.75 | $15,046–$16,349 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$8,198.25–$8,589.75 | $10,931–$11,453 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$4,066.50–$7,840.50 | $5,422–$10,454 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$14,109–$16,707 | $18,812–$22,276 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $11,482.50 | $15,310 | 49.6× |
| CT orbits w/o contrast (70480) | $8,852.25 | $11,803 | 64.2× |
| CT pelvis w&w/o contrast (72194) | $13,639.50 | $18,186 | 59.0× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$10,098.75–$11,249.25 | $13,465–$14,999 | varies |
| CT scan of leg combo (73702) | $7,065.75 | $9,421 | 30.5× |
| CT scans face/jaw combo (70488) | $9,877.50 | $13,170 | 42.7× |
| CT soft tissue neck w contrast (70491) | $11,664 | $15,552 | 50.4× |
| CT soft tissue neck w/o contrast (70490) | $11,249.25 | $14,999 | 81.6× |
| CT thoracic spine w contrast (72129) | $11,770.50 | $15,694 | 50.9× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$11,249.25–$12,261.75 | $14,999–$16,349 | varies |
| CT thorax w/o contrast (71250) | $11,249.25 | $14,999 | 81.6× |
| CT upper ext wo (73200) | $5,306.25 | $7,075 | 38.5× |
| CT upper extremity w/o & w/contrast material (73202) | $7,488.75 | $9,985 | 32.4× |
| CT upper extremity with contrast (73201) | $5,385.75 | $7,181 | 11.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$11,664–$13,692 | $15,552–$18,256 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$11,664–$14,923.50 | $15,552–$19,898 | varies |
| Dilation ureters/urethra rs&i (74485) | $4,187.25 | $5,583 | 1.5× |
| Dxa Bone Density Axial (77080) | $2,541.75 | $3,389 | 18.4× |
| Dxa bone density study (77085) | $2,541.75 | $3,389 | 18.4× |
| Echo exam of fetal heart (76825) | $4,071.75 | $5,429 | 5.6× |
| Echo exam uterus (76831) | $4,531.50 | $6,042 | 14.4× |
| Esophagram (74220) | $2,124.75 | $2,833 | 9.2× |
| Fetal Biophys Profile W/Nst (76818) | $484.50 | $646 | 3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $969 | $1,292 | 7.0× |
| Fluoroscopy up to 1 hr (76000) | $1,089 | $1,452 | 3.5× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$1,046.25–$1,622.25 | $1,395–$2,163 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$1,025.25–$1,983.75 | $1,367–$2,645 | varies |
| Gastric emptying imaging study (78264) | $4,545.75 | $6,061 | 8.6× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $3,612.75 | $4,817 | 6.9× |
| Gated Heart Planar Single (78472) | $4,288.50 | $5,718 | 8.1× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $4,792.50 | $6,390 | 6.7× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$993–$1,628.25 | $1,324–$2,171 | varies |
| Hepatobil Syst Image W/Drug (78227) | $5,870.25 | $7,827 | 8.2× |
| Hepatobiliary System Imaging (78226) | $2,568 | $3,424 | 4.9× |
| Ht Muscle Image Spect Sing (78451) | $8,577 | $11,436 | 5.0× |
| Hysterosalpingogram (74740) | $1,926 | $2,568 | 6.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $2,316 | $3,088 | 20.2× |
| Interstitial radiation source applic complex (77778) | $10,251 | $13,668 | 11.2× |
| K Flow/Funct Image Multiple (78709) | $3,699 | $4,932 | 5.2× |
| K Flow/Funct Image W/Drug (78708) | $2,688 | $3,584 | 3.8× |
| K Flow/Funct Image W/O Drug (78707) | $5,523.75 | $7,365 | 7.7× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$1,344–$2,097 | $1,792–$2,796 | varies |
| Liver & Spleen Imaging Static Only (78215) | $3,962.25 | $5,283 | 7.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $5,860.50 | $7,814 | 11.1× |
| Liver imaging w/vascular flow (78202) | $6,045.75 | $8,061 | 8.4× |
| Lung Perf&Ventilat Diferentl (78598) | $2,515.50 | $3,354 | 3.5× |
| Lung Ventilat&Perfus Imaging (78582) | $2,731.50 | $3,642 | 3.8× |
| Lung Ventilation Imaging (78579) | $3,589.50 | $4,786 | 6.8× |
| Lymph System Imaging (78195) | $2,294.25 | $3,059 | 3.2× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$10,377–$10,380 | $13,836–$13,840 | varies |
| Meckels Divert Exam (78290) | $4,013.25 | $5,351 | 7.6× |
| Mr safety determination physician/other qhp (76016) | $308.25 | $411 | 2.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $47.25 | $63 | 1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $488.25 | $651 | 3.9× |
| Mr safety implt pos&/immoblj (76019) | $639.75 | $853 | 8.2× |
| Mr safety med physics xm customization plng&mntr (76017) | $965.25 | $1,287 | 3.1× |
| Mra Head W/O & W/Contrast Material (70546) | $9,933.75 | $13,245 | 21.6× |
| MRA head w/o contrast (70544) | $5,953.50 | $7,938 | 18.9× |
| MRA head with contrast (70545) | $7,547.25 | $10,063 | 16.4× |
| MRA neck w contrast (70548) | $6,840.75 | $9,121 | 14.9× |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$7,400.25–$9,848.25 | $9,867–$13,131 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$5,953.50–$8,236.50 | $7,938–$10,982 | varies |
| MRI abdomen w contrast (74182) | $11,369.25 | $15,159 | 24.7× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$11,109–$13,945.50 | $14,812–$18,594 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $15,870.75 | $21,161 | 15.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $13,656 | $18,208 | 29.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $14,560.50 | $19,414 | 14.1× |
| MRI Breast W/O Contrast Bilateral (77047) | $16,115.25 | $21,487 | 51.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $7,908 | $10,544 | 25.1× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$11,833.50–$13,221.75 | $15,778–$17,629 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$8,211–$10,848 | $10,948–$14,464 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$10,331.25–$12,654 | $13,775–$16,872 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $8,625 | $11,500 | 18.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$7,610.25–$9,984 | $10,147–$13,312 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $9,267.75 | $12,357 | 29.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $17,522.25 | $23,363 | 38.1× |
| MRI orbit face &/neck w/o contrast (70540) | $4,484.25 | $5,979 | 14.2× |
| MRI orbit face neck w contrast (70542) | $5,648.25 | $7,531 | 12.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $6,148.50 | $8,198 | 13.4× |
| MRI pelvis w/o & w contrast (72197) | $12,286.50 | $16,382 | 26.7× |
| MRI pelvis w/o contrast (72195) | $9,255 | $12,340 | 29.4× |
| MRI thoracic spine w/o contrast (72146) | $9,716.25 | $12,955 | 30.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $9,267.75 | $12,357 | 29.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$14,973–$15,870.75 | $19,964–$21,161 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$14,223.75–$20,642.25 | $18,965–$27,523 | varies |
| MRI, dorsal spine combo (72157) | $17,522.25 | $23,363 | 38.1× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$9,267.75–$10,143.75 | $12,357–$13,525 | varies |
| MRI, joint upper extrem combo (73223) | $12,891.75 | $17,189 | 28.0× |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$13,656–$14,293.50 | $18,208–$19,058 | varies |
| Myelogram cervical (72240) | $2,217 | $2,956 | 2.1× |
| Myelogram Lumbar (72265) | $3,015 | $4,020 | 2.9× |
| Myelography thoracic (72255) | $1,383 | $1,844 | 1.3× |
| Myelograpy 2/more regions rs&i (72270) | $4,707.75 | $6,277 | 4.6× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $3,452.25 | $4,603 | 6.5× |
| Myocardial Spect Multiple Studies (78452) | $16,782 | $22,376 | 9.8× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$964.50–$1,492.50 | $1,286–$1,990 | varies |
| Nm myocard infarct spect (78469) | $3,452.25 | $4,603 | 4.8× |
| Nuclear Rx Oral Admin (79005) | $1,713 | $2,284 | 5.6× |
| Parathyroid Planar Imaging (78070) | $4,471.50 | $5,962 | 8.5× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$753–$1,038.75 | $1,004–$1,385 | varies |
| Pet Image W/Ct Lmtd (78814) | $6,220.50 | $8,294 | 3.3× |
| PET image w/CT, full body (78816) | $9,110.25 | $12,147 | 4.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $9,564.75 | $12,753 | 5.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $4,969.50 | $6,626 | 9.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $2,129.25 | $2,839 | 15.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$1,344–$2,240.25 | $1,792–$2,987 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$873.75–$1,325.25 | $1,165–$1,767 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$1,924.50–$2,099.25 | $2,566–$2,799 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $2,475.75 | $3,301 | 18.0× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$964.50–$1,569 | $1,286–$2,092 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$1,619.25–$1,785.75 | $2,159–$2,381 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$1,608–$1,990.50 | $2,144–$2,654 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$277.50–$339 | $370–$452 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$2,608.50–$3,089.25 | $3,478–$4,119 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$1,377.75–$1,718.25 | $1,837–$2,291 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$2,079–$2,286 | $2,772–$3,048 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$1,401.75–$2,175 | $1,869–$2,900 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $1,598.25 | $2,131 | 13.9× |
| Radex Sternum Minimum 2 Views (71120) | $1,269.75 | $1,693 | 11.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $717.75 | $957 | 6.3× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$774.75–$1,418.25 | $1,033–$1,891 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$369–$535.50 | $492–$714 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$1,401.75–$2,123.25 | $1,869–$2,831 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $2,203.50 | $2,938 | 16.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $2,177.25 | $2,903 | 15.8× |
| Radiologic exam colon double contrast study (74280) | $4,488 | $5,984 | 19.4× |
| Radiologic exam colon single contrast study (74270) | $3,444.75 | $4,593 | 14.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $2,124.75 | $2,833 | 9.2× |
| Radiologic exam knee complete 4/more views (73564) | $1,338.75 | $1,785 | 9.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $780.75 | $1,041 | 5.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $2,873.25 | $3,831 | 12.4× |
| Radiologic exam teeth complete full mouth (70320) | $3,829.50 | $5,106 | 12.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,335 | $1,780 | 5.8× |
| Radiologic examination femur 1 view (73551) | $532.50 | $710 | 4.6× |
| Radiologic examination femur minimum 2 views (73552) | $1,396.50 | $1,862 | 12.2× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$1,087.50–$1,480.50 | $1,450–$1,974 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $3,963.75 | $5,285 | 28.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$1,044–$1,971.75 | $1,392–$2,629 | varies |
| Ribs bilateral 3 views (71110) | $2,036.25 | $2,715 | 14.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,607 | $3,476 | 4.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,607 | $3,476 | 4.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,755.50 | $7,674 | 8.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $4,058.25 | $5,411 | 5.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,162.25 | $2,883 | 3.0× |
| Rp Therapy Intravenous Administration (79101) | $2,216.25 | $2,955 | 7.2× |
| Scapula (73010) | $1,347 | $1,796 | 9.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $279.75 | $373 | 12.0× |
| Shoulder 1 view (73020) | $893.25 | $1,191 | 7.8× |
| Shoulder Arthrography (73040) | $995.25 | $1,327 | 2.2× |
| Skull less than 4 views (70250) | $1,629 | $2,172 | 11.8× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$1,466.25–$1,688.25 | $1,955–$2,251 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $4,629.75 | $6,173 | 9.4× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$2,120.25–$2,580.75 | $2,827–$3,441 | varies |
| Thoracolumbar 2 views (72080) | $1,553.25 | $2,071 | 13.5× |
| Thyroid Imaging With Vascular Flow (78013) | $2,351.25 | $3,135 | 4.5× |
| Thyroid Met Imaging Body (78018) | $4,122 | $5,496 | 5.8× |
| Thyroid Uptake Measurement (78012) | $2,340 | $3,120 | 4.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $3,406.50 | $4,542 | 6.5× |
| Tx devices design & construction simple (77332) | $1,586.25 | $2,115 | 8.9× |
| Ultrasound Breast Limited (76642) | $1,128 | $1,504 | 9.8× |
| Ultrasound Exam Aaa Screen (76706) | $1,876.50 | $2,502 | 13.6× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$1,361.25–$2,085 | $1,815–$2,780 | varies |
| Upper gi w/o kub (74240) | $2,891.25 | $3,855 | 12.5× |
| Urethrocystogram voiding (74455) | $1,998 | $2,664 | 6.3× |
| Urethrocystography retrograde (74450) | $794.25 | $1,059 | 2.5× |
| Us breast unilateral complete (76641) | $2,111.25 | $2,815 | 15.3× |
| Us chest (76604) | $814.50 | $1,086 | 5.9× |
| Us complete joint (76881) | $1,968 | $2,624 | 14.3× |
| Us exam, pelvic, limited (76857) | $1,116 | $1,488 | 8.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$1,311–$1,640.25 | $1,748–$2,187 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$2,036.25–$3,495.75 | $2,715–$4,661 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$3,351.75–$3,763.50 | $4,469–$5,018 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,723.50 | $2,298 | 12.5× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$3,321.75–$4,271.25 | $4,429–$5,695 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$1,361.25–$2,421.75 | $1,815–$3,229 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$1,927.50–$3,525 | $2,570–$4,700 | varies |
| Us spinal canal and contents (76800) | $867 | $1,156 | 6.3× |
| Us thyroid (76536) range across 2 matching MRF lines |
$2,282.25–$2,811.75 | $3,043–$3,749 | varies |
| Vein X-Ray Chest (75827) | $5,273.25 | $7,031 | 2.5× |
| Venography extremity bilateral rs&i (75822) | $6,903 | $9,204 | 3.3× |
| Venography extremity unilateral rs&i (75820) | $2,955 | $3,940 | 1.4× |
| Vertebral fracture assessment via dxa (77086) | $2,541.75 | $3,389 | 22.1× |
| Wrist 2 views (73100) | $1,541.25 | $2,055 | 13.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,684.50 | $2,246 | 14.7× |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$1,392–$3,456.75 | $1,856–$4,609 | varies |
| X-Ray Aorta Leg Arteries (75630) | $3,034.50 | $4,046 | 0.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$1,005–$1,766.25 | $1,340–$2,355 | varies |
| X-Ray Exam Breast Specimen (76098) | $979.50 | $1,306 | 1.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $1,616.25 | $2,155 | 14.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $962.25 | $1,283 | 7.0× |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$393–$495.75 | $524–$661 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$454.50–$2,507.25 | $606–$3,343 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $886.50 | $1,182 | 6.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $2,337.75 | $3,117 | 17.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,017.75 | $1,357 | 7.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $2,040 | $2,720 | 14.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$1,219.50–$2,330.25 | $1,626–$3,107 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$2,032.50–$2,980.50 | $2,710–$3,974 | varies |
| X-ray eye for foreign body (70030) | $1,114.50 | $1,486 | 9.7× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$1,128–$1,583.25 | $1,504–$2,111 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$1,644.75–$2,242.50 | $2,193–$2,990 | varies |
| X-ray nose-rectum child f.b. (76010) | $538.50 | $718 | 4.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $2,442.75 | $3,257 | 17.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,646.25 | $2,195 | 11.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $2,040.75 | $2,721 | 17.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $4,015.50 | $5,354 | 35.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $2,659.50 | $3,546 | 19.3× |
| X-Ray Tmj Unilat (70328) | $571.50 | $762 | 5.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $3,472.50 | $4,630 | 7.5× |
| X-Rays Bone Length Studies (77073) | $2,304 | $3,072 | 16.7× |
| X-Rays Bone Survey Complete (77075) | $1,219.50 | $1,626 | 8.8× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$2,337.75–$3,092.25 | $3,117–$4,123 | varies |
| Xr facial bones less than 3 views (70140) | $1,688.25 | $2,251 | 14.7× |
| Xr orbits complete 4 views (70200) | $630.75 | $841 | 4.6× |
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.