Imaging prices at Franciscan Health Crawfordsville
Crawfordsville, IN · every code in this section with a posted price and a Medicare benchmark.
356 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) | $2,243.34 | $8,278 | 1.5× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$76.69–$131.44 | $283–$485 | varies |
| Abdomen 2 views (74019) | $262.87 | $970 | 2.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $710.29 | $2,621 | 1.7× |
| Angio internal mammary (75756) | $1,185.35 | $4,374 | 0.4× |
| Angio pulmonary bilat (75743) | $2,243.34 | $8,278 | 0.7× |
| Angiography extremity bilateral rs&i (75716) | $1,862.31 | $6,872 | 0.6× |
| Angiography extremity unilateral rs&i (75710) | $1,820.04 | $6,716 | 0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $2,243.34 | $8,278 | 0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,989.41 | $7,341 | 0.6× |
| Ankle 2 views (73600) | $173.98 | $642 | 1.9× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,031.69 | $7,497 | 0.3× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,073.69 | $7,652 | 0.4× |
| Artery X-Rays Adrenal Gland (75731) | $1,608.39 | $5,935 | 0.5× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,073.69 | $7,652 | 0.4× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$1,650.93 | $6,092 | 0.3× |
| Arthrogram ankle (73615) | $465.58 | $1,718 | 1.3× |
| Arthrogram hip (73525) | $508.13 | $1,875 | 1.4× |
| Arthrogram Wrist (73115) | $308.94 | $1,140 | 0.8× |
| Basic radiation dosimetry calculation (77300) | $209.75 | $774 | 1.5× |
| Bone age studies (77072) | $178.32 | $658 | 1.6× |
| Bone Imaging 3 Phase (78315) | $1,383.18 | $5,104 | 3.3× |
| Bone Imaging Limited Area (78300) | $560.97 | $2,070 | 1.3× |
| Bone Imaging Multiple Areas (78305) | $486.17 | $1,794 | 1.1× |
| Bone Imaging Whole Body (78306) | $1,159.34 | $4,278 | 2.7× |
| Bone marrow imaging limited area (78102) | $269.65 | $995 | 0.6× |
| Bone survey infant (77076) | $127.37 | $470 | 1.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $785.36 | $2,898 | 1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,010.55 | $7,419 | 1.3× |
| Cardiac Shunt Detection (78428) | $411.38 | $1,518 | 1.0× |
| Cat Scan Follow-Up Study (76380) | $158.81 | $586 | 1.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $448.78 | $1,656 | 0.8× |
| Cerebrospinal Fluid Scan (78630) | $523.57 | $1,932 | 0.9× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$76.69–$173.98 | $283–$642 | varies |
| Chest 2 views (71046) | $195.12 | $720 | 2.1× |
| Chest 3 views (71047) | $241.46 | $891 | 2.6× |
| Chest 4 or more views (71048) | $254.47 | $939 | 2.3× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$245.53–$491.05 | $906–$1,812 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $13.28 | $49 | 0.1× |
| Continuing medical physics consltj pr wk (77336) | $303.52 | $1,120 | 2.1× |
| Contrast Exam Abdominl Aorta (75625) | $1,946.86 | $7,184 | 0.6× |
| Contrast X-Ray Bladder (74430) | $317.61 | $1,172 | 0.9× |
| Contrast X-Ray Of Elbow (73085) | $419.24 | $1,547 | 1.1× |
| Contrast X-Ray Of Knee Joint (73580) | $677.50 | $2,500 | 1.8× |
| CT abdomen and pelvis without and with contrast (74178) | $1,067.20 | $3,938 | 2.9× |
| CT abdomen and pelvis without contrast (74176) | $816.25 | $3,012 | 3.2× |
| CT abdomen w contrast (74160) | $634.68 | $2,342 | 3.4× |
| CT abdomen w wo contrast (74170) | $730.62 | $2,696 | 3.9× |
| CT abdomen w/o contrast (74150) | $507.85 | $1,874 | 4.6× |
| CT Angio Abdomen and Pelvis (74174) | $634.68 | $2,342 | 1.7× |
| CT Angio Chest (71275) | $952.02 | $3,513 | 5.1× |
| CT Angio Head (70496) | $952.02 | $3,513 | 5.1× |
| CT angio hrt w/3d image (75574) | $634.68 | $2,342 | 1.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,111.10 | $4,100 | 6.0× |
| CT Angio Neck (70498) | $952.02 | $3,513 | 5.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,111.10 | $4,100 | 6.0× |
| CT cervical spine w/ contrast (72126) | $634.68 | $2,342 | 1.7× |
| CT cervical spine w/o contrast (72125) | $507.85 | $1,874 | 4.6× |
| CT cervical spine w/wo cont (72127) | $730.62 | $2,696 | 3.9× |
| CT chest w contrast (71260) | $634.68 | $2,342 | 3.4× |
| CT chest w/wo contrast (71270) | $730.62 | $2,696 | 3.9× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $476.15 | $1,757 | 4.3× |
| CT head/brain with contrast (70460) | $549.32 | $2,027 | 3.0× |
| CT head/brain without and with contrast (70470) | $628.18 | $2,318 | 3.4× |
| CT heart contrast eval cardiac structure&morph (75572) | $476.15 | $1,757 | 1.3× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$13.28–$13.55 | $49–$50 | varies |
| CT hrt w/3d image congen (75573) | $476.15 | $1,757 | 1.3× |
| CT iac w contrast (70481) | $634.68 | $2,342 | 3.4× |
| CT l-spine w&w/o contrast (72133) | $634.68 | $2,342 | 3.4× |
| CT lower ext w/o (73700) | $507.85 | $1,874 | 4.6× |
| CT lower extremity w/contrast material (73701) | $634.68 | $2,342 | 3.4× |
| CT lumbar spine w contrast (72132) | $507.85 | $1,874 | 1.4× |
| CT lumbar spine w/o contrast (72131) | $507.85 | $1,874 | 4.6× |
| CT maxillofacial w contrast (70487) | $507.85 | $1,874 | 2.7× |
| CT maxillofacial wo contrast (70486) | $507.85 | $1,874 | 4.6× |
| CT neck tissue combo (70492) | $730.62 | $2,696 | 3.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $730.62 | $2,696 | 3.9× |
| CT orbits w/o contrast (70480) | $507.85 | $1,874 | 4.6× |
| CT pelvis w&w/o contrast (72194) | $859.88 | $3,173 | 4.6× |
| CT pelvis w/o contrast (72192) | $549.32 | $2,027 | 5.0× |
| CT scan of leg combo (73702) | $730.62 | $2,696 | 3.9× |
| CT scans face/jaw combo (70488) | $730.62 | $2,696 | 3.9× |
| CT soft tissue neck w contrast (70491) | $634.68 | $2,342 | 3.4× |
| CT soft tissue neck w/o contrast (70490) | $507.85 | $1,874 | 4.6× |
| CT thoracic spine w contrast (72129) | $634.68 | $2,342 | 3.4× |
| CT thoracic spine w/o contrast (72128) | $507.85 | $1,874 | 4.6× |
| CT thoracic spine w/wo cont (72130) | $730.62 | $2,696 | 3.9× |
| CT thorax w/o contrast (71250) | $507.85 | $1,874 | 4.6× |
| CT unlisted procedure (76497) | $68.56 | $253 | 0.7× |
| CT upper ext wo (73200) | $507.85 | $1,874 | 4.6× |
| CT upper extremity w/o & w/contrast material (73202) | $634.68 | $2,342 | 3.4× |
| CT upper extremity with contrast (73201) | $507.85 | $1,874 | 1.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $952.02 | $3,513 | 5.1× |
| Cta Abdomen (74175) | $730.62 | $2,696 | 3.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,904.05 | $7,026 | 5.2× |
| CTA pelvis (72191) | $471 | $1,738 | 2.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $241.46 | $891 | 2.2× |
| Dxa Bone Density Axial (77080) | $190.24 | $702 | 1.7× |
| Dxa bone density study (77085) | $123.85 | $457 | 1.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $114.90 | $424 | 1.2× |
| Echo exam uterus (76831) | $1,139.28 | $4,204 | 4.5× |
| Echo Guide For Artery Repair (76936) | $569.64 | $2,102 | 2.5× |
| Esophagram (74220) | $390.24 | $1,440 | 2.1× |
| Fetal Biophys Profile W/Nst (76818) | $469.37 | $1,732 | 4.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $335.23 | $1,237 | 3.0× |
| Fluoroscopy up to 1 hr (76000) | $368.83 | $1,361 | 1.5× |
| Follow-Up Angiography (75898) | $190.24 | $702 | 0.1× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$148.24–$296.47 | $547–$1,094 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$190.24–$380.48 | $702–$1,404 | varies |
| Gastric emptying imaging study (78264) | $971.81 | $3,586 | 2.3× |
| Gastroesophageal Reflux Exam (78262) | $971.81 | $3,586 | 2.3× |
| Gated Heart Planar Single (78472) | $1,831.96 | $6,760 | 4.3× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $448.78 | $1,656 | 0.8× |
| Hand 2 views (73120) | $182.38 | $673 | 1.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,904.86 | $7,029 | 0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,820.04 | $6,716 | 0.5× |
| Hepatobil Syst Image W/Drug (78227) | $635.77 | $2,346 | 1.1× |
| Hepatobiliary System Imaging (78226) | $486.17 | $1,794 | 1.1× |
| Ht Muscle Image Spect Sing (78451) | $1,682.64 | $6,209 | 1.2× |
| Hysterosalpingogram (74740) | $131.44 | $485 | 0.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $502.71 | $1,855 | 5.5× |
| Infant hip ultrasound, limited static exam (76886) | $97.83 | $361 | 1.1× |
| Joint Survey Single View (77077) | $190.24 | $702 | 1.7× |
| K Flow/Funct Image Multiple (78709) | $1,121.67 | $4,139 | 2.0× |
| K Flow/Funct Image W/Drug (78708) | $672.89 | $2,483 | 1.2× |
| K Flow/Funct Image W/O Drug (78707) | $560.97 | $2,070 | 1.0× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$254.47–$508.94 | $939–$1,878 | varies |
| Liver & Spleen Imaging Static Only (78215) | $822.21 | $3,034 | 1.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $897.55 | $3,312 | 2.1× |
| Liver imaging static only (78201) | $295.93 | $1,092 | 0.5× |
| Lung Perf&Ventilat Diferentl (78598) | $785.36 | $2,898 | 1.4× |
| Lung perfusion differential (78597) | $303.52 | $1,120 | 0.7× |
| Lung Ventilat&Perfus Imaging (78582) | $785.36 | $2,898 | 1.4× |
| Lung Ventilation Imaging (78579) | $298.91 | $1,103 | 0.7× |
| Lymph System Imaging (78195) | $598.10 | $2,207 | 1.0× |
| Magnetic Image Jaw Joint (70336) | $984.54 | $3,633 | 3.9× |
| Mammary ductogram or galactogram single (77053) | $338.48 | $1,249 | 1.3× |
| Meckels Divert Exam (78290) | $635.77 | $2,346 | 1.5× |
| Mlc imrt design & construction per imrt plan (77338) | $291.87 | $1,077 | 0.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $20.87 | $77 | 0.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $68.02 | $251 | 0.7× |
| Mra Head W/O & W/Contrast Material (70546) | $984.54 | $3,633 | 2.7× |
| MRA head w/o contrast (70544) | $793.49 | $2,928 | 3.1× |
| MRA head with contrast (70545) | $889.15 | $3,281 | 2.4× |
| MRA neck w contrast (70548) | $889.15 | $3,281 | 2.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $984.54 | $3,633 | 2.7× |
| MRA neck w/o contrast (70547) | $793.49 | $2,928 | 3.1× |
| MRI abdomen w contrast (74182) | $889.15 | $3,281 | 2.4× |
| MRI abdomen w/o contrast (74181) | $793.49 | $2,928 | 3.1× |
| MRI any jt lower extrem w/contrast material (73722) | $1,047.14 | $3,864 | 1.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,159.34 | $4,278 | 3.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $889.15 | $3,281 | 1.1× |
| MRI bone marrow blood supply (77084) | $1,270.45 | $4,688 | 5.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $222.22 | $820 | 0.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $222.22 | $820 | 0.9× |
| MRI cardiac w/o contrast (75557) | $476.15 | $1,757 | 1.9× |
| MRI cervical spine w contrast (72142) | $889.15 | $3,281 | 2.4× |
| MRI cervical spine w/o cont (72141) | $793.49 | $2,928 | 3.1× |
| MRI chest w/o contrast (71550) | $793.49 | $2,928 | 3.1× |
| MRI chest with contrast (71551) | $889.15 | $3,281 | 1.1× |
| MRI chest wo w contrast (71552) | $984.54 | $3,633 | 2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $889.15 | $3,281 | 2.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $984.54 | $3,633 | 2.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $793.49 | $2,928 | 3.1× |
| MRI lumbar spine w contrast (72149) | $784.82 | $2,896 | 2.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $984.54 | $3,633 | 2.7× |
| MRI orbit face &/neck w/o contrast (70540) | $793.49 | $2,928 | 3.1× |
| MRI orbit face neck w contrast (70542) | $889.15 | $3,281 | 2.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $984.54 | $3,633 | 2.7× |
| MRI pelvis w contrast (72196) | $889.15 | $3,281 | 2.4× |
| MRI pelvis w/o & w contrast (72197) | $984.54 | $3,633 | 2.7× |
| MRI pelvis w/o contrast (72195) | $793.49 | $2,928 | 3.1× |
| MRI thoracic spine w/o contrast (72146) | $793.49 | $2,928 | 3.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $889.15 | $3,281 | 2.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $793.49 | $2,928 | 3.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $984.54 | $3,633 | 2.7× |
| MRI, abdomen, combo (74183) | $984.54 | $3,633 | 2.7× |
| MRI, dorsal spine combo (72157) | $984.54 | $3,633 | 2.7× |
| MRI, dorsal spine contrast (72147) | $889.15 | $3,281 | 2.4× |
| MRI, joint upper extrem (73221) | $793.49 | $2,928 | 3.1× |
| MRI, joint upper extrem combo (73223) | $984.54 | $3,633 | 2.7× |
| MRI, lumbar spine combo (72158) | $878.85 | $3,243 | 2.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $2,257.97 | $8,332 | 1.6× |
| Myocardial Spect Multiple Studies (78452) | $2,168.27 | $8,001 | 1.6× |
| Neck soft tissue (70360) | $173.98 | $642 | 1.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $266.12 | $982 | 0.6× |
| Nm myocard infarct spect (78469) | $1,383.18 | $5,104 | 2.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,579.38 | $9,518 | 1.8× |
| Nuclear Rx Oral Admin (79005) | $486.17 | $1,794 | 2.0× |
| Ob us nuchal meas 1 gest (76813) | $194.31 | $717 | 1.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $86.99 | $321 | 0.8× |
| Parathyroid Planar Imaging (78070) | $486.17 | $1,794 | 1.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $486.17 | $1,794 | 1.1× |
| Pelvis 1 or 2 views (72170) | $271 | $1,000 | 2.5× |
| Peritoneogram Rs&I (74190) | $326.28 | $1,204 | 0.6× |
| PET image w/CT, full body (78816) | $1,516.79 | $5,597 | 1.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,516.79 | $5,597 | 1.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,989.41 | $7,341 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $284.55 | $1,050 | 0.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $368.83 | $1,361 | 3.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $360.16 | $1,329 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$220.59–$441.19 | $814–$1,628 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$211.38–$422.76 | $780–$1,560 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$203.52–$407.04 | $751–$1,502 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $220.59 | $814 | 2.0× |
| Radex fingr minimum 2 views (73140) | $190.24 | $702 | 2.1× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$207.86–$415.71 | $767–$1,534 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$211.38–$422.76 | $780–$1,560 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $182.38 | $673 | 2.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $186.99 | $690 | 1.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $211.38 | $780 | 2.3× |
| Radex Ribs Unilateral 2 Views (71100) | $224.39 | $828 | 2.4× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$233.06–$466.12 | $860–$1,720 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $207.86 | $767 | 2.3× |
| Radex Spine 1 View Specify Level (72020) | $190.24 | $702 | 2.1× |
| Radex Sternum Minimum 2 Views (71120) | $173.98 | $642 | 1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $203.52 | $751 | 2.2× |
| Radex Toe Minimum 2 Views (73660) | $131.44 | $485 | 1.4× |
| Radex upper extremity infant minimum 2 views (73092) | $156.91 | $579 | 1.4× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$186.99–$373.98 | $690–$1,380 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $229.27 | $846 | 2.1× |
| Radiation treatment delivery level 1 (77402) | $146.07 | $539 | 1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $207.86 | $767 | 1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $296.47 | $1,094 | 2.7× |
| Radiologic exam colon double contrast study (74280) | $804.06 | $2,967 | 4.3× |
| Radiologic exam colon single contrast study (74270) | $508.13 | $1,875 | 2.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $508.13 | $1,875 | 2.7× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$296.47–$592.95 | $1,094–$2,188 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $275.61 | $1,017 | 2.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $329.81 | $1,217 | 1.8× |
| Radiologic exam swallow function contrast study (74230) | $411.11 | $1,517 | 2.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $508.13 | $1,875 | 2.7× |
| Radiologic examination femur 1 view (73551) | $76.69 | $283 | 0.8× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$114.90–$229.81 | $424–$848 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$211.38–$422.76 | $780–$1,560 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $195.12 | $720 | 1.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$203.52–$407.04 | $751–$1,502 | varies |
| Ribs bilateral 3 views (71110) | $254.47 | $939 | 2.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $523.57 | $1,932 | 1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $935.22 | $3,451 | 2.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,430.33 | $8,968 | 4.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,345.79 | $4,966 | 2.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$523.57–$1,234.68 | $1,932–$4,556 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,234.68 | $4,556 | 0.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,410.83 | $5,206 | 0.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,102.70 | $4,069 | 0.8× |
| Rp Therapy Intravenous Administration (79101) | $560.97 | $2,070 | 2.3× |
| Scapula (73010) | $267.21 | $986 | 2.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $27.10 | $100 | 1.2× |
| Shoulder 1 view (73020) | $169.38 | $625 | 1.8× |
| Shoulder Arthrography (73040) | $634.68 | $2,342 | 1.7× |
| Sialogram (70390) | $411.11 | $1,517 | 1.6× |
| Skull less than 4 views (70250) | $207.86 | $767 | 1.9× |
| Special dosimetry (77331) | $194.85 | $719 | 1.4× |
| Special Physics Consult (77370) | $213.82 | $789 | 1.5× |
| Special teletherapy port plan (77321) | $261.79 | $966 | 0.7× |
| Special treatment procedure (77470) | $672.89 | $2,483 | 1.2× |
| Sternoclavicular joints (71130) | $211.38 | $780 | 2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $411.38 | $1,518 | 1.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $310.02 | $1,144 | 0.8× |
| Testicular Imaging W/Flow (78761) | $411.38 | $1,518 | 1.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $672.89 | $2,483 | 1.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $373.71 | $1,379 | 0.9× |
| Ther rad simulaj-aided field setting simple (77280) | $310.02 | $1,144 | 2.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $279.13 | $1,030 | 1.5× |
| Thoracic spine 2 views (72070) | $203.52 | $751 | 1.8× |
| Thoracic spine 3 views (72072) | $317.61 | $1,172 | 2.9× |
| Thoracolumbar 2 views (72080) | $169.38 | $625 | 1.8× |
| Thyroid Imaging With Vascular Flow (78013) | $448.78 | $1,656 | 1.1× |
| Thyroid Met Imaging Body (78018) | $971.81 | $3,586 | 1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $785.36 | $2,898 | 1.9× |
| Tx Devices Design & Construction Complex (77334) | $448.78 | $1,656 | 1.1× |
| Tx devices design & construction intermediate (77333) | $236.04 | $871 | 1.7× |
| Tx devices design & construction simple (77332) | $307.04 | $1,133 | 2.2× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$150.95–$301.89 | $557–$1,114 | varies |
| Ultrasound elastography first target lesion (76982) | $114.36 | $422 | 1.0× |
| Ultrasound Elastography Parenchyma (76981) | $114.36 | $422 | 1.0× |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$6.23–$288.34 | $23–$1,064 | varies |
| Ultrasound, abdomen limited (76705) | $402.44 | $1,485 | 3.6× |
| Umbilical-artery Doppler (OB) (76820) | $217.88 | $804 | 2.0× |
| Upper gi w/o kub (74240) | $508.13 | $1,875 | 2.7× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $205.42 | $758 | 18.6× |
| Urethrocystogram voiding (74455) | $376.96 | $1,391 | 1.5× |
| Urethrocystography retrograde (74450) | $411.11 | $1,517 | 1.6× |
| Us breast unilateral complete (76641) | $150.95 | $557 | 1.4× |
| Us chest (76604) | $201.08 | $742 | 1.8× |
| Us complete joint (76881) | $281.84 | $1,040 | 2.5× |
| Us exam, pelvic, limited (76857) | $268.02 | $989 | 2.4× |
| Us head (76506) | $265.58 | $980 | 2.4× |
| Us kidney transplant (76776) | $402.44 | $1,485 | 3.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$191.60–$383.19 | $707–$1,414 | varies |
| Us ob detailed single fetus (76811) | $238.48 | $880 | 0.9× |
| Us ob limited 1 or more fetuses (76815) | $231.16 | $853 | 2.1× |
| Us ob transvaginal (76817) | $231.16 | $853 | 2.1× |
| Us pelvic non ob complete (76856) | $435.50 | $1,607 | 3.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $261.24 | $964 | 2.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $160.97 | $594 | 1.5× |
| Us retroperitoneal complete (76770) | $368.29 | $1,359 | 3.3× |
| Us retroperitoneal limited (76775) | $335.23 | $1,237 | 3.0× |
| Us scrotum and contents (76870) | $402.44 | $1,485 | 3.6× |
| Us spinal canal and contents (76800) | $224.66 | $829 | 2.0× |
| Us thyroid (76536) | $368.29 | $1,359 | 3.3× |
| Us transrectal (76872) | $335.23 | $1,237 | 3.0× |
| Vein X-Ray Chest (75827) | $1,397.01 | $5,155 | 0.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,904.86 | $7,029 | 0.6× |
| Venogram Sinus/Jugular (75860) | $930.89 | $3,435 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $1,566.11 | $5,779 | 0.5× |
| Venography extremity bilateral rs&i (75822) | $930.89 | $3,435 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $592.95 | $2,188 | 0.4× |
| Venography Renal Bilateral (75833) | $1,989.41 | $7,341 | 0.6× |
| Venography Renal Unilateral (75831) | $1,270.18 | $4,687 | 0.4× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$592.95 | $2,188 | 0.1× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $560.97 | $2,070 | 1.3× |
| Vertebral fracture assessment via dxa (77086) | $66.40 | $245 | 0.7× |
| Wrist 2 views (73100) | $139.84 | $516 | 1.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $220.59 | $814 | 2.4× |
| X-ray antegrade pyelogram tube (74425) | $105.69 | $390 | 0.3× |
| X-Ray Aorta Leg Arteries (75630) | $2,666.64 | $9,840 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $305.15 | $1,126 | 2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$182.38–$364.77 | $673–$1,346 | varies |
| X-Ray Exam Breast Specimen (76098) | $169.38 | $625 | 0.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $80.76 | $298 | 0.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $178.32 | $658 | 1.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $245.53 | $906 | 2.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $80.76 | $298 | 0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $254.47 | $939 | 2.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $381.30 | $1,407 | 3.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $381.30 | $1,407 | 3.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $381.30 | $1,407 | 3.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $592.95 | $2,188 | 5.4× |
| X-Ray Exam L-S Spine Bending (72114) | $213.55 | $788 | 1.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $267.21 | $986 | 2.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $169.38 | $625 | 1.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $271 | $1,000 | 2.5× |
| X-ray eye for foreign body (70030) | $102.17 | $377 | 1.1× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$203.52–$407.04 | $751–$1,502 | varies |
| X-ray IV pyelogram (ivp) (74400) | $423.57 | $1,563 | 2.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $190.24 | $702 | 2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $254.47 | $939 | 2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $210.03 | $775 | 1.9× |
| X-ray nose-rectum child f.b. (76010) | $118.70 | $438 | 1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $284.28 | $1,049 | 2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $245.53 | $906 | 2.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $127.37 | $470 | 1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $250.13 | $923 | 2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $402.44 | $1,485 | 4.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $275.61 | $1,017 | 2.5× |
| X-Ray Stress View (77071) | $80.76 | $298 | 0.9× |
| X-ray thoracic spine 4 vw (72074) | $275.61 | $1,017 | 2.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $229.27 | $846 | 0.6× |
| X-Rays Bone Length Studies (77073) | $220.59 | $814 | 2.0× |
| X-Rays Bone Survey Complete (77075) | $338.48 | $1,249 | 3.1× |
| Xr c-spine 4 or 5 views (72050) | $292.41 | $1,079 | 2.6× |
| Xr facial bones less than 3 views (70140) | $203.52 | $751 | 2.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $110.57 | $408 | 1.0× |
| Xr orbits complete 4 views (70200) | $254.47 | $939 | 2.3× |
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.