Imaging prices at Foothills Hospital
Boulder, CO · every code in this section with a posted price and a Medicare benchmark.
351 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) | $2,591 | $5,182 | 1.8× |
| Abdomen 1 View (74018) | $621.50 | $1,243 | 6.7× |
| Abdomen 2 views (74019) | $819 | $1,638 | 7.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,629.50 | $5,259 | 6.2× |
| Angio internal mammary (75756) | $4,462.50 | $8,925 | 1.3× |
| Angio pulmonary bilat (75743) | $5,045 | $10,090 | 1.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $4,462.50 | $8,925 | 1.3× |
| Angiography extremity bilateral rs&i (75716) range across 4 matching MRF lines |
$9,837 | $179–$19,674 | 2.9× |
| Angiography extremity unilateral rs&i (75710) | $10,112.50 | $20,225 | 3.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $4,212.50 | $8,425 | 1.3× |
| Ankle 2 views (73600) | $599.50 | $1,199 | 6.5× |
| Aortography thoracic serialography rs&i (75605) | $4,070.50 | $8,141 | 0.7× |
| Aortography thoracic w/o serialography rs&i (75600) | $32.50 | $65 | 0.0× |
| Artery X-Rays Abdomen (75726) | $4,422.50 | $8,845 | 0.7× |
| Artery X-Rays Adrenal Gland (75731) | $3,545 | $7,090 | 1.1× |
| Artery X-Rays Pelvis (75736) | $4,422.50 | $8,845 | 0.7× |
| Artery X-Rays Spine (75705) range across 3 matching MRF lines |
$6,630 | $511–$13,260 | 1.1× |
| Arthrogram ankle (73615) | $1,754 | $3,508 | 4.7× |
| Arthrogram hip (73525) | $2,017 | $4,034 | 5.4× |
| Arthrogram Wrist (73115) | $1,643 | $3,286 | 4.4× |
| Basic radiation dosimetry calculation (77300) | $1,779 | $3,558 | 12.4× |
| Bone age studies (77072) | $661 | $1,322 | 5.9× |
| Bone Imaging 3 Phase (78315) | $3,772.50 | $7,545 | 8.8× |
| Bone Imaging Limited Area (78300) | $1,992 | $3,984 | 4.7× |
| Bone Imaging Multiple Areas (78305) | $2,404 | $4,808 | 5.6× |
| Bone Imaging Whole Body (78306) | $3,136 | $6,272 | 7.4× |
| Bone marrow imaging; whole body (78104) | $2,252 | $4,504 | 5.3× |
| Bone survey infant (77076) | $814 | $1,628 | 7.3× |
| Brain Flow Imaging Only (78610) | $2,070.50 | $4,141 | 3.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,542.50 | $5,085 | 6.8× |
| Cardiac Shunt Detection (78428) | $3,378 | $6,756 | 7.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $3,042.50 | $6,085 | 5.3× |
| Cerebrospinal Fluid Scan (78630) | $3,415 | $6,830 | 5.9× |
| Chest 1 view (71045) | $599.50 | $1,199 | 6.5× |
| Chest 2 views (71046) | $680.50 | $1,361 | 7.3× |
| Chest 3 views (71047) | $700 | $1,400 | 7.5× |
| Chest 4 or more views (71048) | $680.50 | $1,361 | 6.1× |
| Clavicle complete (73000) | $642.50 | $1,285 | 6.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $622 | $1,244 | 5.6× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$4,070.50–$12,873 | $8,141–$25,746 | varies |
| Contrast X-Ray Bladder (74430) | $1,468.50 | $2,937 | 3.9× |
| Contrast X-Ray Of Elbow (73085) | $2,037.50 | $4,075 | 5.5× |
| Contrast X-Ray Of Knee Joint (73580) | $1,681.50 | $3,363 | 4.5× |
| Corpora cavernosography (74445) | $7,214.50 | $14,429 | 64.7× |
| CT abdomen and pelvis without and with contrast (74178) | $2,102 | $4,204 | 5.6× |
| CT abdomen and pelvis without contrast (74176) | $2,102 | $4,204 | 8.3× |
| CT abdomen w contrast (74160) | $2,102 | $4,204 | 11.2× |
| CT abdomen w wo contrast (74170) | $2,102 | $4,204 | 11.2× |
| CT abdomen w/o contrast (74150) | $2,102 | $4,204 | 18.9× |
| CT Angio Abdomen and Pelvis (74174) | $2,102 | $4,204 | 5.6× |
| CT Angio Chest (71275) | $2,102 | $4,204 | 11.2× |
| CT Angio Head (70496) | $2,102 | $4,204 | 11.2× |
| CT angio hrt w/3d image (75574) | $2,102 | $4,204 | 5.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,102 | $4,204 | 11.2× |
| CT Angio Neck (70498) | $2,102 | $4,204 | 11.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,102 | $4,204 | 11.2× |
| CT cervical spine w/ contrast (72126) | $2,102 | $4,204 | 5.6× |
| CT cervical spine w/o contrast (72125) | $2,102 | $4,204 | 18.9× |
| CT cervical spine w/wo cont (72127) | $2,102 | $4,204 | 11.2× |
| CT chest w contrast (71260) | $2,102 | $4,204 | 11.2× |
| CT colonography screening (74263) | $622 | $1,244 | 2.4× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $286 | $572 | 1.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,944.50 | $3,889 | 17.4× |
| CT head/brain with contrast (70460) | $2,102 | $4,204 | 11.2× |
| CT head/brain without and with contrast (70470) | $2,102 | $4,204 | 11.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,102 | $4,204 | 5.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $622 | $1,244 | 6.7× |
| CT iac w contrast (70481) | $2,102 | $4,204 | 11.2× |
| CT l-spine w&w/o contrast (72133) | $2,102 | $4,204 | 11.2× |
| CT lower ext w/o (73700) | $2,102 | $4,204 | 18.9× |
| CT lower extremity w/contrast material (73701) | $2,102 | $4,204 | 11.2× |
| CT lumbar spine w contrast (72132) | $2,102 | $4,204 | 5.6× |
| CT lumbar spine w/o contrast (72131) | $2,102 | $4,204 | 18.9× |
| CT maxillofacial w contrast (70487) | $2,102 | $4,204 | 11.2× |
| CT maxillofacial wo contrast (70486) | $2,102 | $4,204 | 18.9× |
| CT neck tissue combo (70492) | $2,102 | $4,204 | 11.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,102 | $4,204 | 11.2× |
| CT orbits w/o contrast (70480) | $2,102 | $4,204 | 18.9× |
| CT pelvis w&w/o contrast (72194) | $2,102 | $4,204 | 11.2× |
| CT pelvis w/o contrast (72192) | $2,102 | $4,204 | 18.9× |
| CT scan of leg combo (73702) | $2,102 | $4,204 | 11.2× |
| CT scans face/jaw combo (70488) | $1,944.50 | $3,889 | 10.4× |
| CT soft tissue neck w contrast (70491) | $2,102 | $4,204 | 11.2× |
| CT soft tissue neck w/o contrast (70490) | $2,102 | $4,204 | 18.9× |
| CT thoracic spine w contrast (72129) | $2,102 | $4,204 | 11.2× |
| CT thoracic spine w/o contrast (72128) | $2,102 | $4,204 | 18.9× |
| CT thoracic spine w/wo cont (72130) | $2,102 | $4,204 | 11.2× |
| CT thorax w/o contrast (71250) | $1,944.50 | $3,889 | 17.4× |
| CT upper ext wo (73200) | $2,102 | $4,204 | 18.9× |
| CT upper extremity w/o & w/contrast material (73202) | $2,102 | $4,204 | 11.2× |
| CT upper extremity with contrast (73201) | $2,102 | $4,204 | 5.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,102 | $4,204 | 11.2× |
| Cta Abdomen (74175) | $2,102 | $4,204 | 11.2× |
| CTA pelvis (72191) | $2,102 | $4,204 | 11.2× |
| Dilation ureters/urethra rs&i (74485) | $2,082 | $4,164 | 0.9× |
| Discography Cerv/Thor Spine (72285) | $3,995.50 | $7,991 | 1.9× |
| Diskography lumbar (72295) | $2,772 | $5,544 | 1.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $840.50 | $1,681 | 7.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $263.50 | $527 | 2.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $504 | $1,008 | 4.5× |
| Dxa Bone Density Axial (77080) | $503 | $1,006 | 4.5× |
| Dxa bone density study (77085) | $533.50 | $1,067 | 4.8× |
| Echo exam of fetal heart (76825) | $792 | $1,584 | 1.4× |
| Echo exam uterus (76831) | $718.50 | $1,437 | 2.8× |
| Echo Guide For Artery Repair (76936) | $2,311 | $4,622 | 10.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $792 | $1,584 | 3.1× |
| Echograp Trans R Pros Study (76873) | $398.50 | $797 | 3.6× |
| Esophagram (74220) | $1,271 | $2,542 | 6.8× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$49.50–$1,317 | $99–$2,634 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$36–$792 | $72–$1,584 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$15–$1,776 | $30–$3,552 | varies |
| Follow-Up Angiography (75898) range across 3 matching MRF lines |
$5,097.50 | $176–$10,195 | 1.5× |
| Foot 2 views (73620) | $599.50 | $1,199 | 6.5× |
| Forearm 2 views (73090) | $642.50 | $1,285 | 6.9× |
| Gastric emptying imaging study (78264) | $2,947 | $5,894 | 6.9× |
| Gated Heart Planar Single (78472) range across 11 matching MRF lines |
$44.50–$3,584 | $89–$7,168 | varies |
| Hand 2 views (73120) | $680.50 | $1,361 | 6.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,688.50 | $7,377 | 1.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,983 | $7,966 | 1.2× |
| Hepatobil Syst Image W/Drug (78227) | $3,136 | $6,272 | 5.4× |
| Hepatobiliary System Imaging (78226) | $2,737.50 | $5,475 | 6.4× |
| Ht Muscle Image Spect Sing (78451) range across 10 matching MRF lines |
$6,526.50 | $125–$13,053 | 4.7× |
| Hysterosalpingogram (74740) | $935 | $1,870 | 3.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,692.50 | $3,385 | 18.2× |
| K Flow/Funct Image W/Drug (78708) | $3,172 | $6,344 | 5.5× |
| K Flow/Funct Image W/O Drug (78707) | $3,097.50 | $6,195 | 5.3× |
| Kidney Imaging Morphol (78700) | $2,106.50 | $4,213 | 4.9× |
| Knee 3 Views (73562) | $760 | $1,520 | 8.2× |
| Liver & Spleen Imaging Static Only (78215) | $2,685.50 | $5,371 | 6.3× |
| Liver imaging static only (78201) | $2,383.50 | $4,767 | 4.1× |
| Lung Perf&Ventilat Diferentl (78598) | $4,086.50 | $8,173 | 7.1× |
| Lung Ventilat&Perfus Imaging (78582) | $3,980.50 | $7,961 | 6.9× |
| Lymph System Imaging (78195) | $2,311 | $4,622 | 4.0× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $4,367 | $8,734 | 2.6× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,188.50 | $2,377 | 1.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $5,062 | $10,124 | 1.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $4,367 | $8,734 | 1.3× |
| Magnetic Image Jaw Joint (70336) | $2,542.50 | $5,085 | 10.0× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $2,542.50 | $5,085 | 4.4× |
| Mammary ductogram or galactogram multiple (77054) | $861.50 | $1,723 | 3.4× |
| Mammary ductogram or galactogram single (77053) | $654.50 | $1,309 | 2.6× |
| Meckels Divert Exam (78290) | $2,570.50 | $5,141 | 6.0× |
| Mra Head W/O & W/Contrast Material (70546) | $2,542.50 | $5,085 | 6.8× |
| MRA head w/o contrast (70544) | $2,542.50 | $5,085 | 10.0× |
| MRA neck w contrast (70548) | $2,542.50 | $5,085 | 6.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,542.50 | $5,085 | 6.8× |
| MRA neck w/o contrast (70547) | $2,542.50 | $5,085 | 10.0× |
| MRI abdomen w contrast (74182) | $2,542.50 | $5,085 | 6.8× |
| MRI abdomen w/o contrast (74181) | $2,542.50 | $5,085 | 10.0× |
| MRI any jt lower extrem w/contrast material (73722) | $2,542.50 | $5,085 | 3.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,542.50 | $5,085 | 6.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,542.50 | $5,085 | 3.0× |
| MRI bone marrow blood supply (77084) | $2,542.50 | $5,085 | 10.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,647 | $3,294 | 6.5× |
| MRI cardiac w/o contrast (75557) | $2,542.50 | $5,085 | 10.0× |
| MRI cervical spine w contrast (72142) | $2,542.50 | $5,085 | 6.8× |
| MRI cervical spine w/o cont (72141) | $2,542.50 | $5,085 | 10.0× |
| MRI chest w/o contrast (71550) | $2,542.50 | $5,085 | 10.0× |
| MRI chest with contrast (71551) | $2,542.50 | $5,085 | 3.0× |
| MRI chest wo w contrast (71552) | $2,542.50 | $5,085 | 6.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,542.50 | $5,085 | 6.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,542.50 | $5,085 | 6.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,542.50 | $5,085 | 10.0× |
| MRI lumbar spine w contrast (72149) | $2,542.50 | $5,085 | 6.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,542.50 | $5,085 | 6.8× |
| MRI orbit face &/neck w/o contrast (70540) | $2,542.50 | $5,085 | 10.0× |
| MRI orbit face neck w contrast (70542) | $2,542.50 | $5,085 | 6.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,542.50 | $5,085 | 6.8× |
| MRI pelvis w contrast (72196) | $2,542.50 | $5,085 | 6.8× |
| MRI pelvis w/o & w contrast (72197) | $2,542.50 | $5,085 | 6.8× |
| MRI pelvis w/o contrast (72195) | $2,542.50 | $5,085 | 10.0× |
| MRI spectroscopy (76390) | $2,542.50 | $5,085 | 27.4× |
| MRI thoracic spine w/o contrast (72146) | $2,542.50 | $5,085 | 10.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,542.50 | $5,085 | 6.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,542.50 | $5,085 | 10.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,542.50 | $5,085 | 6.8× |
| MRI, abdomen, combo (74183) | $2,542.50 | $5,085 | 6.8× |
| MRI, dorsal spine combo (72157) | $2,542.50 | $5,085 | 6.8× |
| MRI, dorsal spine contrast (72147) | $2,542.50 | $5,085 | 6.8× |
| MRI, joint upper extrem (73221) | $2,542.50 | $5,085 | 10.0× |
| MRI, joint upper extrem combo (73223) | $2,542.50 | $5,085 | 6.8× |
| MRI, lumbar spine combo (72158) | $2,542.50 | $5,085 | 6.8× |
| Myelogram cervical (72240) | $3,004 | $6,008 | 3.6× |
| Myelogram Lumbar (72265) | $2,889.50 | $5,779 | 3.5× |
| Myelography thoracic (72255) | $2,845.50 | $5,691 | 3.4× |
| Myelograpy 2/more regions rs&i (72270) | $3,760 | $7,520 | 4.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $10,312.50 | $20,625 | 7.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) range across 3 matching MRF lines |
$2,737.50 | $90–$5,475 | 2.0× |
| Myocardial Spect Multiple Studies (78452) range across 10 matching MRF lines |
$73.50–$8,193.50 | $147–$16,387 | varies |
| N-invas est c ffr sw aly CTA (75580) | $1,591.50 | $3,183 | 1.7× |
| Neck soft tissue (70360) | $621.50 | $1,243 | 6.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $329 | $658 | 0.8× |
| Nm csf leak detection (78650) | $2,721 | $5,442 | 2.0× |
| Nonvascular Shunt X-Ray (75809) | $216 | $432 | 1.9× |
| Nuclear Rx Intra-Arterial (79445) | $1,590.50 | $3,181 | 6.4× |
| Nuclear Rx Oral Admin (79005) | $2,385.50 | $4,771 | 9.6× |
| Ob us nuchal meas 1 gest (76813) | $792 | $1,584 | 7.1× |
| Optic foramina (70190) | $167.50 | $335 | 1.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,649 | $5,298 | 4.6× |
| Parathyroid Planar Imaging (78070) | $2,421 | $4,842 | 5.7× |
| Pelvis 1 or 2 views (72170) | $642.50 | $1,285 | 5.8× |
| Peritoneogram Rs&I (74190) | $1,050.50 | $2,101 | 1.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,726 | $9,452 | 1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,629.50 | $5,259 | 6.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,055.50 | $2,111 | 9.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,077 | $2,154 | 1.8× |
| Radex Ankle Complete Minimum 3 Views (73610) | $680.50 | $1,361 | 7.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $661 | $1,322 | 7.1× |
| Radex elbow complete minimum 3 views (73080) | $719.50 | $1,439 | 7.8× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $959 | $1,918 | 8.6× |
| Radex fingr minimum 2 views (73140) | $599.50 | $1,199 | 6.5× |
| Radex foot complete minimum 3 views (73630) | $680.50 | $1,361 | 7.3× |
| Radex Hand Minimum 3 Views (73130) | $719.50 | $1,439 | 7.8× |
| Radex lower extremity infant minimum 2 views (73592) | $621.50 | $1,243 | 6.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $819 | $1,638 | 7.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $664 | $1,328 | 7.2× |
| Radex Ribs Unilateral 2 Views (71100) | $923 | $1,846 | 9.9× |
| Radex shoulder complete minimum 2 views (73030) | $741 | $1,482 | 8.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $642.50 | $1,285 | 6.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,732.50 | $3,465 | 9.3× |
| Radex Spine 1 View Specify Level (72020) | $680.50 | $1,361 | 7.3× |
| Radex Sternum Minimum 2 Views (71120) | $719.50 | $1,439 | 7.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $918.50 | $1,837 | 9.9× |
| Radex Toe Minimum 2 Views (73660) | $599.50 | $1,199 | 6.5× |
| Radex upper extremity infant minimum 2 views (73092) | $478.50 | $957 | 4.3× |
| Radex Wrist Complete Minimum 3 Views (73110) | $700 | $1,400 | 7.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,155.50 | $2,311 | 10.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $918.50 | $1,837 | 8.2× |
| Radiologic exam colon double contrast study (74280) | $2,008.50 | $4,017 | 10.7× |
| Radiologic exam colon single contrast study (74270) | $1,575 | $3,150 | 8.4× |
| Radiologic exam knee complete 4/more views (73564) | $878.50 | $1,757 | 7.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $798 | $1,596 | 7.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,576.50 | $3,153 | 8.4× |
| Radiologic exam swallow function contrast study (74230) | $1,623.50 | $3,247 | 8.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,575 | $3,150 | 8.4× |
| Radiologic examination femur 1 view (73551) | $700 | $1,400 | 7.5× |
| Radiologic examination femur minimum 2 views (73552) | $700 | $1,400 | 7.5× |
| Radiologic examination knee 1/2 views (73560) | $621.50 | $1,243 | 6.7× |
| Radiologic examination tibia & fibula 2 views (73590) | $680.50 | $1,361 | 7.3× |
| Renal Cyst Study (74470) | $1,863 | $3,726 | 3.2× |
| Ribs bilateral 3 views (71110) | $301.50 | $603 | 2.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $3,117.50 | $6,235 | 7.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,069.50 | $8,139 | 7.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,269.50 | $6,539 | 5.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 5 matching MRF lines |
$49–$3,695.50 | $98–$7,391 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,836 | $7,672 | 2.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $5,096.50 | $10,193 | 3.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $4,956 | $9,912 | 3.6× |
| Rp Therapy Intravenous Administration (79101) | $1,410.50 | $2,821 | 5.7× |
| Salivary Gland Imaging (78230) | $678 | $1,356 | 1.6× |
| Scapula (73010) | $661 | $1,322 | 5.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $26.50 | $53 | 1.1× |
| Sella turcica (70240) | $362.50 | $725 | 3.9× |
| Shoulder 1 view (73020) | $599.50 | $1,199 | 6.5× |
| Shoulder Arthrography (73040) | $1,709.50 | $3,419 | 4.6× |
| Sialogram (70390) | $1,358 | $2,716 | 5.3× |
| Skull less than 4 views (70250) | $700 | $1,400 | 6.3× |
| Special Physics Consult (77370) | $280.50 | $561 | 2.0× |
| Sternoclavicular joints (71130) | $680.50 | $1,361 | 7.3× |
| Tbs technical calculation only (77091) | $110 | $220 | 1.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $700.50 | $1,401 | 1.8× |
| Temporomandble Jt Arthrography Rs&I (70332) | $441.50 | $883 | 1.7× |
| Testicular Imaging W/Flow (78761) | $1,954.50 | $3,909 | 4.6× |
| Thoracic spine 2 views (72070) | $798 | $1,596 | 7.2× |
| Thoracic spine 3 views (72072) | $878.50 | $1,757 | 7.9× |
| Thoracolumbar 2 views (72080) | $726.50 | $1,453 | 7.8× |
| Thyroid Imaging With Vascular Flow (78013) | $1,576.50 | $3,153 | 3.7× |
| Thyroid Met Imaging Body (78018) | $3,415 | $6,830 | 5.9× |
| Thyroid Uptake Measurement (78012) | $1,429 | $2,858 | 3.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,703.50 | $5,407 | 6.3× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$32–$254 | $64–$508 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 4 matching MRF lines |
$25.50–$100 | $51–$200 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$27.50–$1,662.50 | $55–$3,325 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$23.50–$594 | $47–$1,188 | varies |
| Upper gi w/o kub (74240) | $1,642.50 | $3,285 | 8.8× |
| Urethrocystogram voiding (74455) | $1,448 | $2,896 | 5.7× |
| Urethrocystography retrograde (74450) | $7,214.50 | $14,429 | 28.3× |
| Us bone density measurement (76977) | $3 | $6 | 0.0× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$34.50–$403 | $69–$806 | varies |
| Us chest (76604) | $1,281 | $2,562 | 11.5× |
| Us complete joint (76881) | $43 | $86 | 0.4× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$23–$1,014.50 | $46–$2,029 | varies |
| Us head (76506) | $1,453 | $2,906 | 13.0× |
| Us kidney transplant (76776) | $763.50 | $1,527 | 6.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$32.50–$1,129 | $65–$2,258 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$89–$1,005 | $178–$2,010 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$30.50–$491.50 | $61–$983 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$35.50–$594 | $71–$1,188 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$32–$1,854 | $64–$3,708 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$46.50–$792 | $93–$1,584 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$40–$439 | $80–$878 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$34.50–$1,756 | $69–$3,512 | varies |
| Us retroperitoneal limited (76775) range across 6 matching MRF lines |
$27–$1,318 | $54–$2,636 | varies |
| Us scrotum and contents (76870) | $1,604 | $3,208 | 14.4× |
| Us spinal canal and contents (76800) | $1,293.50 | $2,587 | 11.6× |
| Us thyroid (76536) range across 3 matching MRF lines |
$26.50–$1,491 | $53–$2,982 | varies |
| Us transrectal (76872) | $1,642.50 | $3,285 | 14.7× |
| Vein X-Ray Chest (75827) | $4,070.50 | $8,141 | 2.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $4,047.50 | $8,095 | 1.2× |
| Vein X-Ray Skull Epidural (75872) | $1,188.50 | $2,377 | 1.8× |
| Venogram Sinus/Jugular (75860) | $3,497 | $6,994 | 1.0× |
| Venography Adrenal Unilateral (75840) | $3,348.50 | $6,697 | 1.0× |
| Venography caval inferior serialography rs&i (75825) | $4,070.50 | $8,141 | 1.2× |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$3,328 | $134–$6,656 | 2.0× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$2,237 | $96–$4,474 | 1.3× |
| Venography Orbital Rs&I (75880) | $1,188.50 | $2,377 | 1.8× |
| Venography Renal Bilateral (75833) | $4,898.50 | $9,797 | 1.5× |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$4,047.50–$4,194 | $8,095–$8,388 | varies |
| Venous sampling by catheter (75893) | $4,047.50 | $8,095 | 0.7× |
| Venous thrombosis imaging (78457) | $3,028.50 | $6,057 | 5.2× |
| Wrist 2 views (73100) | $661 | $1,322 | 7.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $680.50 | $1,361 | 7.3× |
| X-ray antegrade pyelogram tube (74425) | $2,516 | $5,032 | 6.8× |
| X-Ray Aorta Leg Arteries (75630) range across 4 matching MRF lines |
$5,533.50–$12,873 | $182–$25,746 | varies |
| X-Ray Bend Only L-S Spine (72120) | $301.50 | $603 | 2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $599.50 | $1,199 | 6.5× |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$350–$449 | $700–$898 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $167.50 | $335 | 1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $1,155.50 | $2,311 | 10.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $599.50 | $1,199 | 6.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $719.50 | $1,439 | 7.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $976.50 | $1,953 | 8.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $785 | $1,570 | 7.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $978 | $1,956 | 8.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $978 | $1,956 | 8.8× |
| X-Ray Exam L-S Spine Bending (72114) | $1,393.50 | $2,787 | 12.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $798 | $1,596 | 8.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,491 | $2,982 | 13.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $878.50 | $1,757 | 7.9× |
| X-ray eye for foreign body (70030) | $167.50 | $335 | 1.8× |
| X-ray humerus (73060) | $642.50 | $1,285 | 6.9× |
| X-ray IV pyelogram (ivp) (74400) | $1,831 | $3,662 | 9.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $167.50 | $335 | 1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $599.50 | $1,199 | 6.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $878.50 | $1,757 | 7.9× |
| X-ray nose-rectum child f.b. (76010) | $794 | $1,588 | 8.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $719.50 | $1,439 | 6.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $580.50 | $1,161 | 5.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $741 | $1,482 | 8.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $903 | $1,806 | 9.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,077.50 | $2,155 | 9.7× |
| X-ray thoracic spine 4 vw (72074) | $998 | $1,996 | 8.9× |
| X-Ray Tmj Unilat (70328) | $661 | $1,322 | 7.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,613.50 | $3,227 | 4.3× |
| X-Rays Bone Length Studies (77073) | $878.50 | $1,757 | 7.9× |
| X-Rays Bone Survey Complete (77075) | $794 | $1,588 | 7.1× |
| Xr c-spine 4 or 5 views (72050) | $1,293.50 | $2,587 | 11.6× |
| Xr facial bones less than 3 views (70140) | $700 | $1,400 | 7.5× |
| XR Mastoids < 3 Views Bilateral (70120) | $301.50 | $603 | 2.7× |
| Xr orbits complete 4 views (70200) | $918.50 | $1,837 | 8.2× |
| Xr Tomogram Single Plane (76100) | $1,316.50 | $2,633 | 11.8× |
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.