Imaging prices at Dukes Memorial Hospital
Peru, IN · every code in this section with a posted price and a Medicare benchmark.
286 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) | $258 | $516 | 2.8× |
| Abdomen 2 views (74019) | $441.50 | $883 | 4.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$733.50–$755.50 | $1,467–$1,511 | varies |
| Adrenal Cortex & Medulla Img (78075) | $2,653.50 | $5,307 | 1.9× |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$83.50–$341 | $167–$682 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$70.50–$266.50 | $141–$533 | varies |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$11–$302 | $22–$604 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$73–$272 | $146–$544 | varies |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$73 | $146 | 0.0× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$74.50 | $149 | 0.0× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$140 | $280 | 0.0× |
| Arthrogram hip (73525) | $916 | $1,832 | 2.5× |
| Arthrogram Wrist (73115) | $713.50 | $1,427 | 1.9× |
| Bone age studies (77072) | $232.50 | $465 | 2.1× |
| Bone Imaging 3 Phase (78315) | $1,191 | $2,382 | 2.8× |
| Bone Imaging Limited Area (78300) | $736 | $1,472 | 1.7× |
| Bone Imaging Multiple Areas (78305) | $709.50 | $1,419 | 1.7× |
| Bone Imaging Whole Body (78306) | $1,268.50 | $2,537 | 3.0× |
| Bone survey infant (77076) | $226.50 | $453 | 2.0× |
| Brain Image W/Flow < 4 Views (78601) | $771.50 | $1,543 | 1.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $167.50 | $335 | 0.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) range across 3 matching MRF lines |
$192.50–$869.50 | $385–$1,739 | varies |
| Cardiac Shunt Detection (78428) | $771.50 | $1,543 | 1.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $999.50 | $1,999 | 1.7× |
| Cerebrospinal Fluid Scan (78630) | $999.50 | $1,999 | 1.7× |
| Chest 1 view (71045) range across 6 matching MRF lines |
$11–$265 | $22–$530 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$20–$368.50 | $40–$737 | varies |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $26 | $52 | 0.2× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$11.50–$361.50 | $23–$723 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $257.50 | $515 | 2.3× |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$73–$272 | $146–$544 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$70–$482 | $140–$964 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $4,496.50 | $8,993 | 12.2× |
| CT abdomen and pelvis without contrast (74176) range across 5 matching MRF lines |
$2,542.50–$2,616 | $5,085–$5,232 | varies |
| CT abdomen w contrast (74160) | $1,945.50 | $3,891 | 10.5× |
| CT abdomen w wo contrast (74170) | $2,323.50 | $4,647 | 12.5× |
| CT abdomen w/o contrast (74150) | $1,476 | $2,952 | 13.3× |
| CT Angio Abdomen and Pelvis (74174) | $4,496.50 | $8,993 | 12.2× |
| CT Angio Chest (71275) range across 4 matching MRF lines |
$2,626–$2,686 | $5,252–$5,372 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$2,458–$2,531.50 | $4,916–$5,063 | varies |
| CT angio hrt w/3d image (75574) | $145 | $290 | 0.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $4,496.50 | $8,993 | 24.2× |
| CT Angio Neck (70498) | $2,531.50 | $5,063 | 13.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,436.50 | $4,873 | 13.1× |
| CT cervical spine w/ contrast (72126) | $2,117.50 | $4,235 | 5.7× |
| CT cervical spine w/o contrast (72125) | $1,738 | $3,476 | 15.7× |
| CT cervical spine w/wo cont (72127) | $2,330.50 | $4,661 | 12.6× |
| CT chest w contrast (71260) | $2,076.50 | $4,153 | 11.2× |
| CT chest w/wo contrast (71270) | $2,388 | $4,776 | 12.9× |
| CT head/brain with contrast (70460) | $1,492.50 | $2,985 | 8.0× |
| CT head/brain without and with contrast (70470) | $2,283 | $4,566 | 12.3× |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$113.50–$371 | $227–$742 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 6 matching MRF lines |
$25–$38 | $50–$76 | varies |
| CT hrt w/3d image congen (75573) | $163.50 | $327 | 0.4× |
| CT iac w contrast (70481) | $1,927.50 | $3,855 | 10.4× |
| CT l-spine w&w/o contrast (72133) | $2,851 | $5,702 | 15.4× |
| CT lower ext w/o (73700) | $1,416.50 | $2,833 | 12.8× |
| CT lower extremity w/contrast material (73701) | $1,826.50 | $3,653 | 9.8× |
| CT lumbar spine w contrast (72132) | $2,697 | $5,394 | 7.3× |
| CT lumbar spine w/o contrast (72131) | $1,499.50 | $2,999 | 13.6× |
| CT maxillofacial w contrast (70487) | $1,927.50 | $3,855 | 10.4× |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$1,295–$1,325 | $2,590–$2,650 | varies |
| CT neck tissue combo (70492) | $2,117.50 | $4,235 | 11.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,283 | $4,566 | 12.3× |
| CT orbits w/o contrast (70480) | $1,295 | $2,590 | 11.7× |
| CT pelvis w&w/o contrast (72194) | $2,732 | $5,464 | 14.7× |
| CT pelvis w/o contrast (72192) | $1,350 | $2,700 | 12.2× |
| CT scan of leg combo (73702) | $2,184.50 | $4,369 | 11.8× |
| CT scans face/jaw combo (70488) | $2,283 | $4,566 | 12.3× |
| CT soft tissue neck w contrast (70491) | $1,745.50 | $3,491 | 9.4× |
| CT soft tissue neck w/o contrast (70490) | $1,413.50 | $2,827 | 12.8× |
| CT thoracic spine w contrast (72129) | $1,970 | $3,940 | 10.6× |
| CT thoracic spine w/o contrast (72128) | $1,413.50 | $2,827 | 12.8× |
| CT thoracic spine w/wo cont (72130) | $2,330.50 | $4,661 | 12.6× |
| CT thorax w/o contrast (71250) | $1,657 | $3,314 | 15.0× |
| CT upper ext wo (73200) | $1,471.50 | $2,943 | 13.3× |
| CT upper extremity w/o & w/contrast material (73202) | $2,184.50 | $4,369 | 11.8× |
| CT upper extremity with contrast (73201) | $2,019.50 | $4,039 | 5.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,496.50 | $8,993 | 24.2× |
| Cta Abdomen (74175) | $3,034.50 | $6,069 | 16.4× |
| CTA pelvis (72191) | $2,457 | $4,914 | 13.2× |
| Dilation ureters/urethra rs&i (74485) | $49.50 | $99 | 0.0× |
| Dxa Bone Density Axial (77080) range across 5 matching MRF lines |
$18.50–$527.50 | $37–$1,055 | varies |
| Dxa bone density study (77085) | $544.50 | $1,089 | 4.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $18.50 | $37 | 0.2× |
| Echo exam uterus (76831) range across 3 matching MRF lines |
$105.50–$241 | $211–$482 | varies |
| Echo Guide For Artery Repair (76936) | $412 | $824 | 1.8× |
| Esophagram (74220) | $431.50 | $863 | 2.3× |
| Fetal Biophys Profile W/Nst (76818) range across 4 matching MRF lines |
$71–$660 | $142–$1,320 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$61.50–$172 | $123–$344 | varies |
| Fluoroscopy up to 1 hr (76000) range across 5 matching MRF lines |
$98.50–$792 | $20–$1,584 | varies |
| Follow-Up Angiography (75898) | $109.50 | $219 | 0.0× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$32.50–$297.50 | $65–$595 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$11–$302 | $22–$604 | varies |
| Gastric emptying imaging study (78264) | $1,061 | $2,122 | 2.5× |
| Gastroesophageal Reflux Exam (78262) | $771.50 | $1,543 | 1.8× |
| Gated Heart Planar Single (78472) range across 3 matching MRF lines |
$59–$1,308 | $118–$2,616 | varies |
| Gated Heart, Multiple (78473) | $771.50 | $1,543 | 1.8× |
| Hand 2 views (73120) | $377.50 | $755 | 3.4× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,715.50–$1,767 | $3,431–$3,534 | varies |
| Hepatobiliary System Imaging (78226) | $1,524 | $3,048 | 3.6× |
| Ht Musc Image Planar Mult (78454) | $86.50 | $173 | 0.1× |
| Ht Muscle Image Spect Sing (78451) range across 6 matching MRF lines |
$82–$436 | $164–$872 | varies |
| Hysterosalpingogram (74740) | $904 | $1,808 | 3.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $645 | $1,290 | 7.0× |
| Infusion Ivp (74410) | $718 | $1,436 | 3.9× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$48.50–$77 | $97–$154 | varies |
| K Flow/Funct Image W/Drug (78708) | $1,023.50 | $2,047 | 1.8× |
| K Flow/Funct Image W/O Drug (78707) | $971.50 | $1,943 | 1.7× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$13–$350 | $26–$700 | varies |
| Leveen/Shunt Patency Exam (78291) | $771.50 | $1,543 | 1.8× |
| Liver & Spleen Imaging Static Only (78215) | $1,016 | $2,032 | 2.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $771.50 | $1,543 | 1.8× |
| Liver imaging static only (78201) | $2,653.50 | $5,307 | 4.6× |
| Lung Perf&Ventilat Diferentl (78598) | $2,329.50 | $4,659 | 4.1× |
| Lung Ventilat&Perfus Imaging (78582) | $2,143 | $4,286 | 3.7× |
| Lung Ventilation Imaging (78579) | $1,164.50 | $2,329 | 2.8× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$76.50–$919.50 | $153–$1,839 | varies |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $4,332.50 | $8,665 | 1.3× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,709 | $3,418 | 0.5× |
| Magnetic Image Jaw Joint (70336) | $2,401.50 | $4,803 | 9.5× |
| Mammary ductogram or galactogram single (77053) | $461 | $922 | 1.8× |
| Mra Head W/O & W/Contrast Material (70546) | $3,608.50 | $7,217 | 9.8× |
| MRA head w/o contrast (70544) | $1,806 | $3,612 | 7.2× |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$1,258.50–$1,296.50 | $2,517–$2,593 | varies |
| Mra Neck W/O &W/Contrast Material (70549) | $3,187.50 | $6,375 | 8.6× |
| MRA neck w/o contrast (70547) | $555.50 | $1,111 | 2.2× |
| MRI abdomen w contrast (74182) | $2,400.50 | $4,801 | 6.5× |
| MRI abdomen w/o contrast (74181) | $2,209 | $4,418 | 8.8× |
| MRI any jt lower extrem w/contrast material (73722) | $2,263.50 | $4,527 | 2.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,143.50 | $6,287 | 8.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,263.50 | $4,527 | 2.7× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,209 | $4,418 | 8.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,054 | $2,108 | 4.2× |
| MRI cardiac w/o cont stress (75559) | $187 | $374 | 0.3× |
| MRI cardiac w/o contrast (75557) | $142 | $284 | 0.6× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$2,144.50–$2,209 | $4,289–$4,418 | varies |
| MRI chest w/o contrast (71550) | $2,209 | $4,418 | 8.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,143.50 | $6,287 | 8.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,035.50 | $4,071 | 8.1× |
| MRI lumbar spine w contrast (72149) | $2,400.50 | $4,801 | 6.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,608.50 | $7,217 | 9.8× |
| MRI orbit face &/neck w/o contrast (70540) | $2,035.50 | $4,071 | 8.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,143.50 | $6,287 | 8.5× |
| MRI pelvis w/o & w contrast (72197) | $249.50 | $499 | 0.7× |
| MRI pelvis w/o contrast (72195) | $2,209 | $4,418 | 8.8× |
| MRI thoracic spine w/o contrast (72146) range across 4 matching MRF lines |
$732–$2,038.50 | $1,464–$4,077 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,209 | $4,418 | 6.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,035.50 | $4,071 | 8.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,143.50 | $6,287 | 8.5× |
| MRI, abdomen, combo (74183) | $3,143.50 | $6,287 | 8.5× |
| MRI, dorsal spine combo (72157) | $3,608.50 | $7,217 | 9.8× |
| MRI, joint upper extrem (73221) | $2,035.50 | $4,071 | 8.1× |
| MRI, joint upper extrem combo (73223) | $3,143.50 | $6,287 | 8.5× |
| MRI, lumbar spine combo (72158) | $3,608.50 | $7,217 | 9.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) range across 3 matching MRF lines |
$45.50–$771.50 | $91–$1,543 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $64 | $128 | 0.0× |
| Myocardial Spect Multiple Studies (78452) range across 13 matching MRF lines |
$90–$4,270.50 | $180–$8,541 | varies |
| Neck soft tissue (70360) range across 5 matching MRF lines |
$11–$297.50 | $22–$595 | varies |
| Nm csf leak detection (78650) | $2,653.50 | $5,307 | 1.9× |
| Nm whole blood volume (78122) | $911 | $1,822 | 1.6× |
| Nuclear Rx Oral Admin (79005) | $114 | $228 | 0.5× |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$153.50–$216.50 | $307–$433 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $40.50 | $81 | 0.4× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $118 | $236 | 1.1× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $19.50 | $39 | 0.6× |
| Parathyroid Planar Imaging (78070) | $927 | $1,854 | 2.2× |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$12–$232.50 | $24–$465 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,251.50 | $2,503 | 3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$21–$557.50 | $42–$1,115 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $557.50 | $1,115 | 1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$12–$324 | $24–$648 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$10.50–$302 | $21–$604 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$12–$302 | $24–$604 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 6 matching MRF lines |
$17.50–$441.50 | $35–$883 | varies |
| Radex fingr minimum 2 views (73140) range across 11 matching MRF lines |
$9.50–$208 | $19–$416 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$11–$302 | $22–$604 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$11.50–$302 | $23–$604 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$36–$281.50 | $72–$563 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 4 matching MRF lines |
$11.50–$261 | $23–$522 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$15–$331 | $30–$662 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$13–$297.50 | $26–$595 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 5 matching MRF lines |
$11.50–$194 | $23–$388 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $206.50 | $413 | 1.1× |
| Radex Spine 1 View Specify Level (72020) range across 9 matching MRF lines |
$10.50–$318 | $21–$636 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$13.50–$349.50 | $27–$699 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $456.50 | $913 | 5.0× |
| Radex Toe Minimum 2 Views (73660) range across 11 matching MRF lines |
$9–$208 | $18–$416 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $260.50 | $521 | 2.4× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 5 matching MRF lines |
$12–$302 | $24–$604 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$16.50–$32 | $33–$64 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $441.50 | $883 | 4.0× |
| Radiologic exam colon double contrast study (74280) | $1,122 | $2,244 | 6.0× |
| Radiologic exam colon single contrast study (74270) | $470 | $940 | 2.5× |
| Radiologic exam knee complete 4/more views (73564) range across 13 matching MRF lines |
$15.50–$370 | $31–$740 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 6 matching MRF lines |
$14.50–$206.50 | $29–$413 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 3 matching MRF lines |
$129–$460.50 | $258–$921 | varies |
| Radiologic exam swallow function contrast study (74230) | $392 | $784 | 2.1× |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$759–$782 | $1,518–$1,564 | varies |
| Radiologic examination femur minimum 2 views (73552) | $288 | $576 | 3.1× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$12.50–$285 | $25–$570 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $483 | $966 | 4.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$11.50–$281.50 | $23–$563 | varies |
| Ribs bilateral 3 views (71110) range across 6 matching MRF lines |
$18–$206.50 | $36–$413 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 4 matching MRF lines |
$43–$2,653.50 | $86–$5,307 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,428.50 | $2,857 | 2.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 11 matching MRF lines |
$64.50–$999.50 | $129–$1,999 | varies |
| Scapula (73010) range across 4 matching MRF lines |
$37.50–$383 | $75–$766 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 9 matching MRF lines |
$41–$42 | $82–$84 | varies |
| Shoulder 1 view (73020) | $222 | $444 | 2.4× |
| Shoulder Arthrography (73040) | $798.50 | $1,597 | 2.2× |
| Sialogram (70390) | $426.50 | $853 | 1.7× |
| Skull less than 4 views (70250) range across 4 matching MRF lines |
$16.50–$258 | $33–$516 | varies |
| Sternoclavicular joints (71130) range across 4 matching MRF lines |
$15–$213 | $30–$426 | varies |
| Superior sagittal sinus venogram (75870) | $74 | $148 | 0.0× |
| Temporomandble Jt Arthrography Rs&I (70332) | $426.50 | $853 | 1.7× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$15–$29 | $30–$58 | varies |
| Thoracic spine 3 views (72072) range across 4 matching MRF lines |
$14.50–$412.50 | $29–$825 | varies |
| Thoracolumbar 2 views (72080) range across 5 matching MRF lines |
$15.50–$70 | $31–$140 | varies |
| Thyroid Met Imaging Body (78018) | $999.50 | $1,999 | 1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,031 | $2,062 | 2.4× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$41.50–$562.50 | $83–$1,125 | varies |
| Ultrasound Exam Aaa Screen (76706) | $239 | $478 | 2.2× |
| Ultrasound, abdomen limited (76705) range across 10 matching MRF lines |
$38.50–$704 | $77–$1,408 | varies |
| Umbilical-artery Doppler (OB) (76820) | $56.50 | $113 | 0.5× |
| Upper gi w/o kub (74240) | $1,073.50 | $2,147 | 5.8× |
| Urethrocystogram voiding (74455) | $860 | $1,720 | 3.4× |
| Us breast unilateral complete (76641) | $737 | $1,474 | 6.7× |
| Us chest (76604) range across 2 matching MRF lines |
$36–$1,354.50 | $72–$2,709 | varies |
| Us complete joint (76881) range across 8 matching MRF lines |
$41.50–$499 | $83–$998 | varies |
| Us exam, pelvic, limited (76857) range across 6 matching MRF lines |
$110.50–$523 | $221–$1,046 | varies |
| Us kidney transplant (76776) | $49.50 | $99 | 0.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 8 matching MRF lines |
$32–$241.50 | $64–$483 | varies |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$230–$814.50 | $460–$1,629 | varies |
| Us ob limited 1 or more fetuses (76815) range across 11 matching MRF lines |
$106.50–$388.50 | $213–$777 | varies |
| Us ob transvaginal (76817) range across 5 matching MRF lines |
$122.50–$331 | $245–$662 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$129–$783 | $258–$1,566 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 6 matching MRF lines |
$156–$785.50 | $312–$1,571 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 6 matching MRF lines |
$144.50–$388.50 | $289–$777 | varies |
| Us retroperitoneal complete (76770) | $1,012.50 | $2,025 | 9.2× |
| Us retroperitoneal limited (76775) range across 10 matching MRF lines |
$34–$704 | $68–$1,408 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$855.50–$881 | $1,711–$1,762 | varies |
| Us spinal canal and contents (76800) | $660 | $1,320 | 6.0× |
| Us thyroid (76536) range across 7 matching MRF lines |
$36.50–$773.50 | $73–$1,547 | varies |
| Us transrectal (76872) range across 3 matching MRF lines |
$44–$138 | $88–$276 | varies |
| Vein X-Ray Chest (75827) range across 4 matching MRF lines |
$72–$264.50 | $144–$529 | varies |
| Venogram Sinus/Jugular (75860) | $73 | $146 | 0.0× |
| Venography caval inferior serialography rs&i (75825) | $73 | $146 | 0.0× |
| Venography extremity bilateral rs&i (75822) | $68 | $136 | 0.0× |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$45.50–$159.50 | $91–$319 | varies |
| Venography Renal Bilateral (75833) | $97 | $194 | 0.0× |
| Venography Renal Unilateral (75831) | $71 | $142 | 0.0× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$35.50 | $71 | 0.0× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$37.50–$218.50 | $75–$437 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 5 matching MRF lines |
$14–$350 | $28–$700 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$115–$318.50 | $230–$637 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$15.50–$46 | $31–$92 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$11–$282 | $22–$564 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$19.50–$409 | $39–$818 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $497.50 | $995 | 4.5× |
| X-Ray Exam Hip Uni 1 View (73501) range across 5 matching MRF lines |
$13–$125.50 | $26–$251 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 5 matching MRF lines |
$15–$251 | $30–$502 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 7 matching MRF lines |
$15.50–$449.50 | $31–$899 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 4 matching MRF lines |
$20.50–$41 | $41–$82 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$22.50–$639 | $45–$1,278 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$15–$305 | $30–$610 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 4 matching MRF lines |
$24.50–$641 | $49–$1,282 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$17.50–$408.50 | $35–$817 | varies |
| X-ray eye for foreign body (70030) | $333.50 | $667 | 3.6× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$34–$265.50 | $68–$531 | varies |
| X-ray IV pyelogram+tomography (74415) | $937 | $1,874 | 5.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 4 matching MRF lines |
$12–$350 | $24–$700 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 5 matching MRF lines |
$12.50–$297.50 | $25–$595 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 4 matching MRF lines |
$15–$504 | $30–$1,008 | varies |
| X-ray nose-rectum child f.b. (76010) range across 3 matching MRF lines |
$12–$170 | $24–$340 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 4 matching MRF lines |
$21.50–$583 | $43–$1,166 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 4 matching MRF lines |
$12.50–$226.50 | $25–$453 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 4 matching MRF lines |
$11.50–$385.50 | $23–$771 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 6 matching MRF lines |
$16.50–$412.50 | $33–$825 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 6 matching MRF lines |
$23–$412.50 | $46–$825 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 4 matching MRF lines |
$23.50–$1,162.50 | $47–$2,325 | varies |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$45–$514.50 | $90–$1,029 | varies |
| X-Rays Bone Survey Complete (77075) | $483 | $966 | 4.4× |
| Xr c-spine 4 or 5 views (72050) range across 4 matching MRF lines |
$21–$564.50 | $42–$1,129 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$14–$24 | $28–$48 | varies |
| Xr orbits complete 4 views (70200) | $271 | $542 | 2.5× |
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.