Imaging prices at Eastern Idaho Regional Medical Center
Idaho Falls, ID · every code in this section with a posted price and a Medicare benchmark.
340 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) | $11,485.94 | $11,485.94 | 8.4× |
| Abdomen 1 View (74018) | $378.22 | $378.22 | 4.4× |
| Abdomen 2 views (74019) | $533.07 | $533.07 | 5.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,766.77 | $1,766.77 | 4.5× |
| Angio pulmonary bilat (75743) | $6,044.04 | $6,044.04 | 1.9× |
| Angiography extremity bilateral rs&i (75716) | $12,727.74 | $12,727.74 | 4.1× |
| Angiography extremity unilateral rs&i (75710) | $12,727.74 | $12,727.74 | 4.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $7,744.80 | $7,744.80 | 2.5× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$657.48–$954.47 | $657.48–$954.47 | varies |
| Artery X-Rays Abdomen (75726) | $6,044.04 | $6,044.04 | 1.1× |
| Artery X-Rays Pelvis (75736) | $6,044.04 | $6,044.04 | 1.1× |
| Artery X-Rays Spine (75705) | $7,744.80 | $7,744.80 | 1.4× |
| Arthrogram hip (73525) | $1,205.74 | $1,205.74 | 3.5× |
| Basic radiation dosimetry calculation (77300) | $537.06 | $537.06 | 4.0× |
| Bone age studies (77072) | $619.40 | $619.40 | 6.0× |
| Bone Imaging 3 Phase (78315) | $2,221.14 | $2,221.14 | 5.6× |
| Bone Imaging Limited Area (78300) | $1,111.84 | $1,111.84 | 2.8× |
| Bone Imaging Whole Body (78306) | $2,221.14 | $2,221.14 | 5.6× |
| Bone marrow imaging; whole body (78104) | $2,131.94 | $2,131.94 | 5.4× |
| Bone survey infant (77076) | $1,055.99 | $1,055.99 | 10.2× |
| Brachytx isodose complex (77318) | $2,981.10 | $2,981.10 | 8.1× |
| Brachytx isodose intermed (77317) | $2,385.31 | $2,385.31 | 6.4× |
| Brachytx Isodose Plan Simple (77316) | $1,967.82 | $1,967.82 | 5.3× |
| Brain Image W/Flow < 4 Views (78601) | $3,470.05 | $3,470.05 | 8.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,095.41 | $3,095.41 | 9.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $7,308.28 | $7,308.28 | 9.4× |
| Cat Scan Follow-Up Study (76380) | $609.65 | $609.65 | 7.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $627.26 | $627.26 | 1.2× |
| Cerebrospinal Fluid Scan (78630) | $3,470.05 | $3,470.05 | 6.5× |
| Chest 1 view (71045) | $436.61 | $436.61 | 5.1× |
| Chest 2 views (71046) | $558.45 | $558.45 | 6.5× |
| Chest 3 views (71047) | $752.37 | $752.37 | 8.8× |
| Chest 4 or more views (71048) | $984.92 | $984.92 | 9.5× |
| Clavicle complete (73000) | $708.22 | $708.22 | 8.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $417.12 | $417.12 | 4.0× |
| Continuing medical physics consltj pr wk (77336) | $1,151.74 | $1,151.74 | 8.7× |
| Contrast Exam Abdominl Aorta (75625) | $7,744.80 | $7,744.80 | 2.5× |
| Contrast X-Ray Bladder (74430) | $1,038.21 | $1,038.21 | 3.0× |
| Contrast X-Ray Of Knee Joint (73580) | $1,205.74 | $1,205.74 | 3.5× |
| CT abdomen and pelvis without and with contrast (74178) | $4,326.63 | $4,326.63 | 12.6× |
| CT abdomen and pelvis without contrast (74176) | $3,232.68 | $3,232.68 | 13.7× |
| CT abdomen w contrast (74160) | $1,750.33 | $1,750.33 | 10.1× |
| CT abdomen w wo contrast (74170) | $2,163.28 | $2,163.28 | 12.5× |
| CT abdomen w/o contrast (74150) | $1,615.11 | $1,615.11 | 15.6× |
| CT Angio Abdomen and Pelvis (74174) | $4,707.66 | $4,707.66 | 13.7× |
| CT Angio Chest (71275) | $4,331.54 | $4,331.54 | 25.0× |
| CT Angio Head (70496) | $2,994.22 | $2,994.22 | 17.3× |
| CT angio hrt w/3d image (75574) | $1,666.74 | $1,666.74 | 4.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $3,313.79 | $3,313.79 | 19.1× |
| CT Angio Neck (70498) | $4,348.73 | $4,348.73 | 25.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $3,313.79 | $3,313.79 | 19.1× |
| CT cervical spine w/ contrast (72126) | $2,959.80 | $2,959.80 | 8.6× |
| CT cervical spine w/o contrast (72125) | $2,151.02 | $2,151.02 | 20.8× |
| CT chest w contrast (71260) | $1,809.32 | $1,809.32 | 10.4× |
| CT chest w/wo contrast (71270) | $2,259.17 | $2,259.17 | 13.0× |
| CT head/brain with contrast (70460) | $2,868.86 | $2,868.86 | 16.6× |
| CT head/brain without and with contrast (70470) | $3,687.47 | $3,687.47 | 21.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,666.74 | $1,666.74 | 4.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $69 | $69 | 0.8× |
| CT hrt w/3d image congen (75573) | $1,396.52 | $1,396.52 | 4.1× |
| CT iac w contrast (70481) | $5,233.73 | $5,233.73 | 30.2× |
| CT l-spine w&w/o contrast (72133) | $1,991.21 | $1,991.21 | 11.5× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,204.57–$2,409.16 | $1,204.57–$2,409.16 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,907.66–$3,812.85 | $1,907.66–$3,812.85 | varies |
| CT lumbar spine w contrast (72132) | $2,959.80 | $2,959.80 | 8.6× |
| CT lumbar spine w/o contrast (72131) | $2,455.84 | $2,455.84 | 23.8× |
| CT maxillofacial w contrast (70487) | $3,468.67 | $3,468.67 | 20.0× |
| CT maxillofacial wo contrast (70486) | $3,018.78 | $3,018.78 | 29.2× |
| CT neck tissue combo (70492) | $2,259.17 | $2,259.17 | 13.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $5,909.77 | $5,909.77 | 34.1× |
| CT orbits w/o contrast (70480) | $2,822.13 | $2,822.13 | 27.3× |
| CT pelvis w&w/o contrast (72194) | $2,163.28 | $2,163.28 | 12.5× |
| CT pelvis w/o contrast (72192) | $1,615.11 | $1,615.11 | 15.6× |
| CT scan of leg combo (73702) | $1,919.73 | $1,919.73 | 11.1× |
| CT scans face/jaw combo (70488) | $4,265.17 | $4,265.17 | 24.6× |
| CT soft tissue neck w contrast (70491) | $1,811.75 | $1,811.75 | 10.5× |
| CT soft tissue neck w/o contrast (70490) | $1,514.29 | $1,514.29 | 14.7× |
| CT thoracic spine w contrast (72129) | $2,959.80 | $2,959.80 | 17.1× |
| CT thoracic spine w/o contrast (72128) | $2,202.65 | $2,202.65 | 21.3× |
| CT thoracic spine w/wo cont (72130) | $1,991.21 | $1,991.21 | 11.5× |
| CT thorax w/o contrast (71250) | $1,514.29 | $1,514.29 | 14.7× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,204.57–$2,409.13 | $1,204.57–$2,409.13 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $2,111.70 | $2,111.70 | 12.2× |
| CT upper extremity with contrast (73201) | $1,907.66 | $1,907.66 | 5.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,877.27 | $4,877.27 | 28.1× |
| Cta Abdomen (74175) | $2,627.91 | $2,627.91 | 15.2× |
| CTA pelvis (72191) | $2,077.28 | $2,077.28 | 12.0× |
| Discography Cerv/Thor Spine (72285) | $4,696.12 | $4,696.12 | 2.4× |
| Diskography lumbar (72295) | $4,696.12 | $4,696.12 | 2.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $381.97 | $381.97 | 3.7× |
| Doppler Fetal Mid Cerebral Artery (76821) | $466.98 | $466.98 | 4.5× |
| Dxa Bone Density Axial (77080) | $624.43 | $624.43 | 6.0× |
| Dxa bone density study (77085) | $871.29 | $871.29 | 8.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $246.86 | $246.86 | 2.9× |
| Echo exam uterus (76831) | $626.92 | $626.92 | 2.7× |
| Esophagram (74220) | $1,218.47 | $1,218.47 | 7.0× |
| Fetal Biophys Profile W/Nst (76818) | $600.63 | $600.63 | 5.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $576.90 | $576.90 | 5.6× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$469.59–$1,124.43 | $469.59–$1,124.43 | varies |
| Follow-Up Angiography (75898) | $8,655.90 | $8,655.90 | 2.8× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$477.20–$954.47 | $477.20–$954.47 | varies |
| Forearm 2 views (73090) | $690.46 | $690.46 | 8.0× |
| Gastric emptying imaging study (78264) | $1,310.76 | $1,310.76 | 3.3× |
| Gastric Mucosa Imaging (78261) | $1,634.74 | $1,634.74 | 4.1× |
| Gated Heart Planar Single (78472) | $4,168.15 | $4,168.15 | 10.6× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$477.20–$954.47 | $477.20–$954.47 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $3,415.09 | $3,415.09 | 5.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $3,415.09 | $3,415.09 | 5.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $3,415.09 | $3,415.09 | 5.0× |
| Heart first pass single,planar (78481) | $1,690.61 | $1,690.61 | 3.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $7,744.80 | $7,744.80 | 2.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $7,040.73 | $7,040.73 | 2.3× |
| Hepatobil Syst Image W/Drug (78227) | $2,444.49 | $2,444.49 | 4.6× |
| Hepatobiliary System Imaging (78226) | $2,030.73 | $2,030.73 | 5.1× |
| Ht Muscle Image Spect Sing (78451) | $5,021.02 | $5,021.02 | 3.9× |
| Hysterosalpingogram (74740) | $1,314.93 | $1,314.93 | 5.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $877.20 | $877.20 | 10.2× |
| K Flow/Funct Image Multiple (78709) | $5,561.75 | $5,561.75 | 10.4× |
| K Flow/Funct Image W/Drug (78708) | $1,949.52 | $1,949.52 | 3.6× |
| K Flow/Funct Image W/O Drug (78707) | $1,949.52 | $1,949.52 | 3.6× |
| Kidney Imaging Morphol (78700) | $2,695.43 | $2,695.43 | 6.8× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$774.24–$863.10 | $774.24–$863.10 | varies |
| Liver & Spleen Imaging Static Only (78215) | $2,190.67 | $2,190.67 | 5.5× |
| Lung Ventilat&Perfus Imaging (78582) | $1,685.53 | $1,685.53 | 3.1× |
| Lymph System Imaging (78195) | $1,551 | $1,551 | 2.9× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $1,862.91 | $1,862.91 | 1.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $8,655.90 | $8,655.90 | 2.8× |
| Magnetic Image Jaw Joint (70336) | $2,564.60 | $2,564.60 | 10.9× |
| Mlc imrt design & construction per imrt plan (77338) | $6,929.32 | $6,929.32 | 18.7× |
| MRA head w/o contrast (70544) | $2,442.46 | $2,442.46 | 10.4× |
| MRA head with contrast (70545) | $2,806.35 | $2,806.35 | 8.1× |
| MRA neck w contrast (70548) | $2,614.39 | $2,614.39 | 7.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,294.81 | $3,294.81 | 9.6× |
| MRA neck w/o contrast (70547) | $2,442.46 | $2,442.46 | 10.4× |
| MRI abdomen w/o contrast (74181) | $4,501.07 | $4,501.07 | 19.1× |
| MRI any jt lower extrem w/contrast material (73722) | $2,674.22 | $2,674.22 | 3.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,147.76–$4,722.89 | $3,147.76–$4,722.89 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,674.22 | $2,674.22 | 3.5× |
| MRI cardiac w/o cont stress (75559) | $1,668.43 | $1,668.43 | 3.1× |
| MRI cardiac w/o contrast (75557) | $1,835.27 | $1,835.27 | 7.8× |
| MRI cervical spine w contrast (72142) | $3,115.37 | $3,115.37 | 9.0× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$2,003.79–$2,711.59 | $2,003.79–$2,711.59 | varies |
| MRI chest w/o contrast (71550) | $4,673.05 | $4,673.05 | 19.8× |
| MRI chest wo w contrast (71552) | $5,966.55 | $5,966.55 | 17.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,674.22 | $2,674.22 | 7.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$3,147.76–$4,722.89 | $3,147.76–$4,722.89 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,420–$3,631.24 | $2,420–$3,631.24 | varies |
| MRI lumbar spine w contrast (72149) | $3,115.37 | $3,115.37 | 9.0× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$2,322.82–$4,922.26 | $2,322.82–$4,922.26 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $872.30 | $872.30 | 3.7× |
| MRI orbit face neck w contrast (70542) | $959.51 | $959.51 | 2.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,054.24 | $1,054.24 | 3.1× |
| MRI pelvis w contrast (72196) | $5,337.65 | $5,337.65 | 15.5× |
| MRI pelvis w/o & w contrast (72197) | $5,777.16 | $5,777.16 | 16.8× |
| MRI pelvis w/o contrast (72195) | $4,934.75 | $4,934.75 | 20.9× |
| MRI spectroscopy (76390) | $3,080.45 | $3,080.45 | 35.8× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$2,003.79–$2,711.59 | $2,003.79–$2,711.59 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,674.22 | $2,674.22 | 7.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,420–$3,631.24 | $2,420–$3,631.24 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,147.76 | $3,147.76 | 9.1× |
| MRI, abdomen, combo (74183) | $5,580.25 | $5,580.25 | 16.2× |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$2,322.82–$4,922.26 | $2,322.82–$4,922.26 | varies |
| MRI, dorsal spine contrast (72147) | $3,115.37 | $3,115.37 | 9.0× |
| MRI, joint upper extrem (73221) | $2,420 | $2,420 | 10.3× |
| MRI, joint upper extrem combo (73223) | $3,147.76 | $3,147.76 | 9.1× |
| MRI, lumbar spine combo (72158) | $4,922.26 | $4,922.26 | 14.3× |
| Myelogram cervical (72240) | $2,240.78 | $2,240.78 | 2.9× |
| Myelogram Lumbar (72265) | $1,302.21 | $1,302.21 | 1.7× |
| Myelograpy 2/more regions rs&i (72270) | $2,240.78 | $2,240.78 | 2.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $19,560.50 | $19,560.50 | 15.3× |
| Myocardial Spect Multiple Studies (78452) | $5,021.02 | $5,021.02 | 3.9× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $10,450.51 | $10,450.51 | 4.8× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $7,368.67 | $7,368.67 | 3.4× |
| N-invas est c ffr sw aly CTA (75580) | $2,390.48 | $2,390.48 | 2.8× |
| Neck soft tissue (70360) | $672.71 | $672.71 | 7.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $1,137.22 | $1,137.22 | 2.9× |
| Nonvascular Shunt X-Ray (75809) | $621.92 | $621.92 | 6.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,139.83 | $5,139.83 | 3.8× |
| Nuclear Rx Intra-Arterial (79445) | $1,135.77 | $1,135.77 | 4.9× |
| Nuclear Rx Oral Admin (79005) | $1,551 | $1,551 | 6.7× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $576.90 | $576.90 | 4.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $5,120.91 | $5,120.91 | 9.5× |
| Parathyroid Planar Imaging (78070) | $1,773.93 | $1,773.93 | 4.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,452.42 | $2,452.42 | 6.2× |
| Pelvis 1 or 2 views (72170) | $347.75 | $347.75 | 3.4× |
| Pet Image Skull-Thigh (78812) | $3,081.08 | $3,081.08 | 2.2× |
| Pet Image W/Ct Lmtd (78814) | $2,787.03 | $2,787.03 | 2.0× |
| PET image w/CT, full body (78816) | $2,533.66 | $2,533.66 | 1.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,787.03 | $2,787.03 | 2.0× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $3,081.08 | $3,081.08 | 2.4× |
| PET whole body (78813) | $3,081.08 | $3,081.08 | 2.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $7,744.80 | $7,744.80 | 2.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,634.74 | $1,634.74 | 4.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,944.47 | $1,944.47 | 3.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$753.91–$1,066.13 | $753.91–$1,066.13 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$647.27–$939.24 | $647.27–$939.24 | varies |
| Radex elbow complete minimum 3 views (73080) | $751.37 | $751.37 | 8.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,043.28 | $1,043.28 | 10.1× |
| Radex fingr minimum 2 views (73140) | $350.31 | $350.31 | 4.1× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$751.37–$1,089.01 | $751.37–$1,089.01 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$751.37–$1,089.01 | $751.37–$1,089.01 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$322.38–$355.38 | $322.38–$355.38 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $314.75 | $314.75 | 3.7× |
| Radex Ribs Unilateral 2 Views (71100) | $614.31 | $614.31 | 7.1× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$936.67–$1,406.30 | $936.67–$1,406.30 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $444.24 | $444.24 | 5.2× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,383.44 | $1,383.44 | 8.0× |
| Radex Spine 1 View Specify Level (72020) | $322.38 | $322.38 | 3.7× |
| Radex Sternum Minimum 2 Views (71120) | $708.22 | $708.22 | 8.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $901.13 | $901.13 | 10.5× |
| Radex Toe Minimum 2 Views (73660) | $322.38 | $322.38 | 3.7× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$500.07–$505.14 | $500.07–$505.14 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$751.37–$959.53 | $751.37–$959.53 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,253.36 | $1,253.36 | 12.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $43,126.74 | $43,126.74 | 5.9× |
| Radiation treatment delivery level 3 (77412) | $908.37 | $908.37 | 1.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,007.78 | $1,007.78 | 9.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $79.71 | $79.71 | 0.8× |
| Radiologic exam colon double contrast study (74280) | $1,731.24 | $1,731.24 | 10.0× |
| Radiologic exam colon single contrast study (74270) | $1,533.22 | $1,533.22 | 8.8× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$967.14–$1,017.94 | $967.14–$1,017.94 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $941.75 | $941.75 | 9.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,241.31 | $1,241.31 | 7.2× |
| Radiologic exam swallow function contrast study (74230) | $1,187.99 | $1,187.99 | 6.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,530.67 | $1,530.67 | 8.8× |
| Radiologic examination femur 1 view (73551) | $396.96 | $396.96 | 4.6× |
| Radiologic examination femur minimum 2 views (73552) | $396.96 | $396.96 | 4.6× |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$388.39–$583.85 | $388.39–$583.85 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$262.70–$1,299.71 | $262.70–$1,299.71 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $1,538.06 | $1,538.06 | 4.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $1,538.06 | $1,538.06 | 4.0× |
| Ribs bilateral 3 views (71110) | $1,226.08 | $1,226.08 | 11.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,977.47 | $1,977.47 | 5.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,774.96 | $5,774.96 | 10.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,061.38 | $3,061.38 | 5.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,061.38 | $3,061.38 | 5.7× |
| Rp Therapy Intravenous Administration (79101) | $1,477.38 | $1,477.38 | 6.4× |
| Scapula (73010) | $662.54 | $662.54 | 6.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $9.17 | $9.17 | 0.4× |
| Shoulder 1 view (73020) | $401.06 | $401.06 | 4.7× |
| Shoulder Arthrography (73040) | $1,205.74 | $1,205.74 | 3.5× |
| Sialogram (70390) | $1,071.26 | $1,071.26 | 4.5× |
| Skull less than 4 views (70250) | $642.24 | $642.24 | 6.2× |
| Special dosimetry (77331) | $423.78 | $423.78 | 3.2× |
| Special Physics Consult (77370) | $1,346.86 | $1,346.86 | 10.1× |
| Special teletherapy port plan (77321) | $1,545.16 | $1,545.16 | 4.2× |
| Special treatment procedure (77470) | $3,390.19 | $3,390.19 | 6.2× |
| Stereotactic Body Radiation Delivery (77373) | $8,402.13 | $8,402.13 | 4.8× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$689.99–$1,949.52 | $689.99–$1,949.52 | varies |
| Superior sagittal sinus venogram (75870) | $4,368.66 | $4,368.66 | 1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,251.03 | $2,251.03 | 6.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,995.09 | $1,995.09 | 5.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,102.10 | $2,102.10 | 5.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,697.20 | $1,697.20 | 4.6× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$257.75–$1,078.31 | $257.75–$1,078.31 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $601.62 | $601.62 | 3.5× |
| Thoracic spine 2 views (72070) | $662.54 | $662.54 | 6.4× |
| Thoracic spine 3 views (72072) | $741.22 | $741.22 | 7.2× |
| Thoracolumbar 2 views (72080) | $911.32 | $911.32 | 10.6× |
| Thyroid Imaging With Vascular Flow (78013) | $1,142.60 | $1,142.60 | 2.9× |
| Thyroid Met Imaging Body (78018) | $1,936.85 | $1,936.85 | 3.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,773.93 | $1,773.93 | 4.5× |
| Tx Devices Design & Construction Complex (77334) | $1,208.37 | $1,208.37 | 3.3× |
| Tx devices design & construction intermediate (77333) | $746.83 | $746.83 | 5.6× |
| Tx devices design & construction simple (77332) | $511.89 | $511.89 | 3.9× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$304.87–$609.72 | $304.87–$609.72 | varies |
| Ultrasound Exam Aaa Screen (76706) | $619.40 | $619.40 | 6.0× |
| Ultrasound, abdomen limited (76705) | $613.76 | $613.76 | 5.9× |
| Umbilical-artery Doppler (OB) (76820) | $634.83 | $634.83 | 6.1× |
| Unlisted fluoroscopic procedure (76496) | $322.38 | $322.38 | 3.7× |
| Upper gi w/o kub (74240) | $1,375.85 | $1,375.85 | 7.9× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $1,083.92 | $1,083.92 | 98.0× |
| Urea breath test c-14 isotopic analysis (78268) | $986.84 | $986.84 | 10.5× |
| Urethrocystogram voiding (74455) | $1,038.21 | $1,038.21 | 4.4× |
| Urethrocystography retrograde (74450) | $1,038.21 | $1,038.21 | 4.4× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$609.72–$1,219.48 | $609.72–$1,219.48 | varies |
| Us chest (76604) | $711.26 | $711.26 | 6.9× |
| Us complete joint (76881) | $590.07 | $590.07 | 5.7× |
| Us exam, pelvic, limited (76857) | $600.63 | $600.63 | 5.8× |
| Us head (76506) | $1,949.35 | $1,949.35 | 18.9× |
| Us kidney transplant (76776) | $1,156.41 | $1,156.41 | 11.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $381.97 | $381.97 | 3.7× |
| Us ob limited 1 or more fetuses (76815) | $413.59 | $413.59 | 4.0× |
| Us ob transvaginal (76817) | $613.76 | $613.76 | 5.9× |
| Us pelvic non ob complete (76856) | $1,169.60 | $1,169.60 | 11.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $648.03 | $648.03 | 6.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $381.97 | $381.97 | 3.7× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$1,282.88–$1,332.91 | $1,282.88–$1,332.91 | varies |
| Us retroperitoneal limited (76775) | $500.50 | $500.50 | 4.8× |
| Us scrotum and contents (76870) | $1,074.78 | $1,074.78 | 10.4× |
| Us spinal canal and contents (76800) | $626.92 | $626.92 | 6.1× |
| Us thyroid (76536) | $921.99 | $921.99 | 8.9× |
| Vein X-Ray Chest (75827) | $4,368.66 | $4,368.66 | 2.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $4,995.07 | $4,995.07 | 1.6× |
| Vein X-Ray Spleen/Liver (75810) | $6,400.66 | $6,400.66 | 2.1× |
| Venogram Sinus/Jugular (75860) | $4,368.66 | $4,368.66 | 1.4× |
| Venography caval inferior serialography rs&i (75825) | $11,806.29 | $11,806.29 | 3.8× |
| Venography extremity bilateral rs&i (75822) | $2,043.44 | $2,043.44 | 1.3× |
| Venography extremity unilateral rs&i (75820) | $2,043.44 | $2,043.44 | 1.3× |
| Venography Renal Bilateral (75833) | $11,801.20 | $11,801.20 | 3.8× |
| Venography Renal Unilateral (75831) | $7,744.80 | $7,744.80 | 2.5× |
| Venous sampling by catheter (75893) | $7,744.80 | $7,744.80 | 1.4× |
| Vertebral fracture assessment via dxa (77086) | $418.43 | $418.43 | 4.9× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$660–$685.41 | $660–$685.41 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,342.85 | $1,342.85 | 15.6× |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$1,030.59–$1,038.21 | $1,030.59–$1,038.21 | varies |
| X-Ray Aorta Leg Arteries (75630) | $7,744.80 | $7,744.80 | 2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$267.80–$568.60 | $267.80–$568.60 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,556.06 | $1,556.06 | 2.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $396.96 | $396.96 | 4.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $657.34 | $657.34 | 6.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $396.96 | $396.96 | 4.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $396.96 | $396.96 | 4.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $657.34 | $657.34 | 6.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $657.34 | $657.34 | 6.4× |
| X-Ray Exam L-S Spine Bending (72114) | $2,081.54 | $2,081.54 | 20.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $441.69 | $441.69 | 5.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,375.85 | $1,375.85 | 13.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $982.39 | $982.39 | 9.5× |
| X-ray eye for foreign body (70030) | $255.74 | $255.74 | 3.0× |
| X-ray humerus (73060) | $708.22 | $708.22 | 8.2× |
| X-ray IV pyelogram (ivp) (74400) | $1,820.05 | $1,820.05 | 10.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $538.15 | $538.15 | 6.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $411.25 | $411.25 | 4.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $736.15 | $736.15 | 7.1× |
| X-ray nose-rectum child f.b. (76010) | $281.80 | $281.80 | 3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,375.85 | $1,375.85 | 13.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $520.38 | $520.38 | 5.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $418.86 | $418.86 | 4.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $944.31 | $944.31 | 11.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $865.59 | $865.59 | 10.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,177.84 | $1,177.84 | 11.4× |
| X-ray thoracic spine 4 vw (72074) | $954.47 | $954.47 | 9.2× |
| X-Ray Tmj Unilat (70328) | $304.65 | $304.65 | 3.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$936.67–$2,127.21 | $936.67–$2,127.21 | varies |
| X-Rays Bone Length Studies (77073) | $860.53 | $860.53 | 8.3× |
| X-Rays Bone Survey Complete (77075) | $1,322.52 | $1,322.52 | 12.8× |
| Xr c-spine 4 or 5 views (72050) | $827.53 | $827.53 | 8.0× |
| Xr facial bones less than 3 views (70140) | $289.40 | $289.40 | 3.4× |
| Xr orbits complete 4 views (70200) | $855.46 | $855.46 | 8.3× |
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.