Imaging prices at Frisbie Memorial Hospital
Rochester, NH · every code in this section with a posted price and a Medicare benchmark.
334 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) | $718 | $718 | 7.7× |
| Abdomen 2 views (74019) | $972 | $972 | 8.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,753 | $1,753 | 4.1× |
| Adrenal Cortex & Medulla Img (78075) | $4,764 | $4,764 | 3.4× |
| Angio internal mammary (75756) | $13,174 | $13,174 | 3.9× |
| Angio pulmonary bilat (75743) | $8,521 | $8,521 | 2.5× |
| Angiography extremity bilateral rs&i (75716) | $13,174 | $13,174 | 3.9× |
| Angiography extremity unilateral rs&i (75710) | $18,256 | $18,256 | 5.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $18,256 | $18,256 | 5.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $6,391 | $6,391 | 1.9× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$1,012–$1,828 | $1,012–$1,828 | varies |
| Aortography thoracic serialography rs&i (75605) | $22,537 | $22,537 | 3.8× |
| Artery X-Rays Abdomen (75726) | $22,537 | $22,537 | 3.8× |
| Artery X-Rays Pelvis (75736) | $22,537 | $22,537 | 3.8× |
| Arthrogram ankle (73615) | $2,237 | $2,237 | 6.0× |
| Arthrogram hip (73525) | $1,524 | $1,524 | 4.1× |
| Arthrogram Wrist (73115) | $1,693 | $1,693 | 4.5× |
| Bone age studies (77072) | $463 | $463 | 4.1× |
| Bone Imaging 3 Phase (78315) | $3,213 | $3,213 | 7.5× |
| Bone Imaging Limited Area (78300) | $2,383 | $2,383 | 5.6× |
| Bone Imaging Multiple Areas (78305) | $956 | $956 | 2.2× |
| Bone Imaging Whole Body (78306) | $2,665 | $2,665 | 6.2× |
| Bone survey infant (77076) | $1,044 | $1,044 | 9.4× |
| Brain Image W/Flow < 4 Views (78601) | $1,384 | $1,384 | 3.2× |
| Brain imaging < 4 static views (78600) | $1,384 | $1,384 | 3.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,708 | $1,708 | 2.9× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,794 | $1,794 | 3.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$12,548–$12,566 | $12,548–$12,566 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,088 | $3,088 | 8.3× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $4,087 | $4,087 | 4.9× |
| Cerebrospinal Fluid Scan (78630) | $1,794 | $1,794 | 3.1× |
| Chest 1 view (71045) | $512 | $512 | 5.5× |
| Chest 2 views (71046) | $915 | $915 | 9.8× |
| Chest 3 views (71047) | $442 | $442 | 4.8× |
| Chest 4 or more views (71048) | $1,062 | $1,062 | 9.5× |
| Cholecystography Oral Contrast (74290) | $880 | $880 | 4.7× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$691–$1,145 | $691–$1,145 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $601 | $601 | 5.4× |
| Contrast Exam Abdominl Aorta (75625) | $13,174 | $13,174 | 3.9× |
| Contrast X-Ray Bladder (74430) | $1,332 | $1,332 | 3.6× |
| Contrast X-Ray Of Elbow (73085) | $1,524 | $1,524 | 4.1× |
| Contrast X-Ray Of Knee Joint (73580) | $2,237 | $2,237 | 6.0× |
| CT abdomen and pelvis without and with contrast (74178) | $8,745 | $8,745 | 23.5× |
| CT abdomen and pelvis without contrast (74176) | $6,662 | $6,662 | 26.1× |
| CT abdomen w contrast (74160) | $6,045 | $6,045 | 32.3× |
| CT abdomen w wo contrast (74170) | $7,164 | $7,164 | 38.3× |
| CT abdomen w/o contrast (74150) | $4,716 | $4,716 | 42.2× |
| CT Angio Abdomen and Pelvis (74174) | $3,941 | $3,941 | 10.6× |
| CT Angio Chest (71275) | $7,607 | $7,607 | 40.6× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$6,279–$7,748 | $6,279–$7,748 | varies |
| CT angio hrt w/3d image (75574) | $1,847 | $1,847 | 5.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$6,006–$12,013 | $6,006–$12,013 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$6,279–$7,748 | $6,279–$7,748 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $6,006 | $6,006 | 32.1× |
| CT cervical spine w/ contrast (72126) | $6,283 | $6,283 | 16.9× |
| CT cervical spine w/o contrast (72125) | $6,072 | $6,072 | 54.4× |
| CT cervical spine w/wo cont (72127) | $6,670 | $6,670 | 35.6× |
| CT chest w contrast (71260) | $6,047 | $6,047 | 32.3× |
| CT chest w/wo contrast (71270) | $6,030 | $6,030 | 32.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,657 | $1,657 | 8.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,330 | $1,330 | 11.9× |
| CT head/brain with contrast (70460) | $5,550 | $5,550 | 29.6× |
| CT head/brain without and with contrast (70470) | $7,744 | $7,744 | 41.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,537 | $1,537 | 4.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $279 | $279 | 3.0× |
| CT hrt w/3d image congen (75573) | $1,537 | $1,537 | 4.1× |
| CT iac w contrast (70481) | $7,269 | $7,269 | 38.8× |
| CT l-spine w&w/o contrast (72133) | $6,670 | $6,670 | 35.6× |
| CT lower ext w/o (73700) | $5,207 | $5,207 | 46.6× |
| CT lower extremity w/contrast material (73701) | $5,633 | $5,633 | 30.1× |
| CT lumbar spine w contrast (72132) | $6,283 | $6,283 | 16.9× |
| CT lumbar spine w/o contrast (72131) | $5,488 | $5,488 | 49.2× |
| CT maxillofacial w contrast (70487) | $5,976 | $5,976 | 31.9× |
| CT maxillofacial wo contrast (70486) | $5,059 | $5,059 | 45.3× |
| CT neck tissue combo (70492) | $7,380 | $7,380 | 39.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $7,638 | $7,638 | 40.8× |
| CT orbits w/o contrast (70480) | $6,896 | $6,896 | 61.8× |
| CT pelvis w&w/o contrast (72194) | $6,846 | $6,846 | 36.6× |
| CT pelvis w/o contrast (72192) | $5,517 | $5,517 | 49.4× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,306–$6,805 | $2,306–$6,805 | varies |
| CT scans face/jaw combo (70488) | $6,591 | $6,591 | 35.2× |
| CT soft tissue neck w contrast (70491) | $6,811 | $6,811 | 36.4× |
| CT soft tissue neck w/o contrast (70490) | $4,839 | $4,839 | 43.3× |
| CT thoracic spine w contrast (72129) | $6,329 | $6,329 | 33.8× |
| CT thoracic spine w/o contrast (72128) | $5,808 | $5,808 | 52.0× |
| CT thoracic spine w/wo cont (72130) | $7,596 | $7,596 | 40.6× |
| CT thorax w/o contrast (71250) | $4,606 | $4,606 | 41.3× |
| CT upper ext wo (73200) | $4,807 | $4,807 | 43.1× |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,306–$6,805 | $2,306–$6,805 | varies |
| CT upper extremity with contrast (73201) | $5,606 | $5,606 | 15.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $5,235 | $5,235 | 28.0× |
| Cta Abdomen (74175) | $6,006 | $6,006 | 32.1× |
| CTA pelvis (72191) | $6,006 | $6,006 | 32.1× |
| Dilation ureters/urethra rs&i (74485) | $12,158 | $12,158 | 5.4× |
| Dxa Bone Density Axial (77080) | $2,056 | $2,056 | 18.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $1,748 | $1,748 | 18.8× |
| Echo exam uterus (76831) | $728 | $728 | 2.9× |
| Esophagram (74220) | $1,137 | $1,137 | 6.1× |
| Fetal Biophys Profile W/Nst (76818) | $831 | $831 | 7.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,775 | $1,775 | 15.9× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$937–$1,062 | $937–$1,062 | varies |
| Follow-Up Angiography (75898) | $5,193 | $5,193 | 1.5× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$1,012–$1,828 | $1,012–$1,828 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$691–$1,376 | $691–$1,376 | varies |
| Gastric emptying imaging study (78264) | $1,971 | $1,971 | 4.6× |
| Gastric Mucosa Imaging (78261) | $3,005 | $3,005 | 7.0× |
| Gated Heart Planar Single (78472) | $2,496 | $2,496 | 5.8× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$1,012–$1,828 | $1,012–$1,828 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,929 | $2,929 | 5.1× |
| Hepatobiliary System Imaging (78226) | $2,929 | $2,929 | 6.9× |
| Ht Musc Image Planar Mult (78454) | $7,215 | $7,215 | 5.2× |
| Ht Muscle Image Spect Sing (78451) | $5,399 | $5,399 | 3.9× |
| Hysterosalpingogram (74740) | $1,064 | $1,064 | 4.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,844 | $1,844 | 19.8× |
| Infant hip ultrasound, limited static exam (76886) | $1,593 | $1,593 | 17.1× |
| K Flow/Funct Image Multiple (78709) | $1,574 | $1,574 | 2.7× |
| K Flow/Funct Image W/Drug (78708) | $1,574 | $1,574 | 2.7× |
| K Flow/Funct Image W/O Drug (78707) | $2,233 | $2,233 | 3.9× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $266 | $266 | 0.6× |
| Kidney Imaging Morphol (78700) | $833 | $833 | 2.0× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$895–$1,493 | $895–$1,493 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,295 | $1,295 | 3.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,759 | $1,759 | 4.1× |
| Liver imaging static only (78201) | $4,764 | $4,764 | 8.2× |
| Liver imaging w/vascular flow (78202) | $4,764 | $4,764 | 8.2× |
| Lung Perf&Ventilat Diferentl (78598) | $2,526 | $2,526 | 4.4× |
| Lung perfusion differential (78597) | $1,016 | $1,016 | 2.4× |
| Lung Ventilat&Perfus Imaging (78582) | $2,526 | $2,526 | 4.4× |
| Lung Ventilation Imaging (78579) | $917 | $917 | 2.1× |
| Lymph System Imaging (78195) | $3,202 | $3,202 | 5.5× |
| Magnetic Image Jaw Joint (70336) | $7,400 | $7,400 | 29.0× |
| Mammary ductogram or galactogram multiple (77054) | $3,555 | $3,555 | 14.0× |
| Mammary ductogram or galactogram single (77053) | $3,091 | $3,091 | 12.1× |
| Meckels Divert Exam (78290) | $2,565 | $2,565 | 6.0× |
| Mr safety determination physician/other qhp (76016) | $407 | $407 | 4.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $113 | $113 | 3.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $425 | $425 | 4.2× |
| Mr safety implt pos&/immoblj (76019) | $275 | $275 | 4.4× |
| Mr safety med physics xm customization plng&mntr (76017) | $1,117 | $1,117 | 4.4× |
| Mra Head W/O & W/Contrast Material (70546) | $9,603 | $9,603 | 25.8× |
| MRA head w/o contrast (70544) | $6,398 | $6,398 | 25.1× |
| MRA head with contrast (70545) | $7,712 | $7,712 | 20.7× |
| MRA neck w contrast (70548) | $7,712 | $7,712 | 20.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $9,603 | $9,603 | 25.8× |
| MRA neck w/o contrast (70547) | $6,398 | $6,398 | 25.1× |
| MRI abdomen w contrast (74182) | $7,712 | $7,712 | 20.7× |
| MRI abdomen w/o contrast (74181) | $6,398 | $6,398 | 25.1× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$6,329–$11,327 | $6,329–$11,327 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$8,219–$12,836 | $8,219–$12,836 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $6,329 | $6,329 | 7.6× |
| MRI Breast W/O Contrast Bilateral (77047) | $3,182 | $3,182 | 12.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,792 | $2,792 | 11.0× |
| MRI cardiac w/o cont stress (75559) | $3,959 | $3,959 | 6.8× |
| MRI cardiac w/o contrast (75557) | $3,704 | $3,704 | 14.5× |
| MRI cervical spine w contrast (72142) | $9,253 | $9,253 | 24.8× |
| MRI cervical spine w/o cont (72141) | $6,018 | $6,018 | 23.6× |
| MRI chest w/o contrast (71550) | $6,398 | $6,398 | 25.1× |
| MRI chest with contrast (71551) | $7,712 | $7,712 | 9.2× |
| MRI chest wo w contrast (71552) | $9,603 | $9,603 | 25.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$8,219–$11,327 | $8,219–$11,327 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$8,878–$14,818 | $8,878–$14,818 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$6,018–$11,327 | $6,018–$11,327 | varies |
| MRI lumbar spine w contrast (72149) | $7,905 | $7,905 | 21.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $9,603 | $9,603 | 25.8× |
| MRI orbit face &/neck w/o contrast (70540) | $6,398 | $6,398 | 25.1× |
| MRI orbit face neck w contrast (70542) | $7,712 | $7,712 | 20.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $9,603 | $9,603 | 25.8× |
| MRI pelvis w contrast (72196) | $7,712 | $7,712 | 20.7× |
| MRI pelvis w/o & w contrast (72197) | $9,603 | $9,603 | 25.8× |
| MRI pelvis w/o contrast (72195) | $7,525 | $7,525 | 29.5× |
| MRI thoracic spine w/o contrast (72146) | $6,018 | $6,018 | 23.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $6,331 | $6,331 | 17.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $6,329 | $6,329 | 24.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$8,219–$13,816 | $8,219–$13,816 | varies |
| MRI, abdomen, combo (74183) | $9,603 | $9,603 | 25.8× |
| MRI, dorsal spine combo (72157) | $9,603 | $9,603 | 25.8× |
| MRI, dorsal spine contrast (72147) | $7,712 | $7,712 | 20.7× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$6,398–$10,032 | $6,398–$10,032 | varies |
| MRI, joint upper extrem combo (73223) | $8,175 | $8,175 | 21.9× |
| MRI, lumbar spine combo (72158) | $9,603 | $9,603 | 25.8× |
| Myelogram cervical (72240) | $2,200 | $2,200 | 2.6× |
| Myelogram Lumbar (72265) | $2,067 | $2,067 | 2.5× |
| Myelography thoracic (72255) | $4,014 | $4,014 | 4.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,352 | $1,352 | 3.2× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $3,983 | $3,983 | 2.9× |
| Myocardial Spect Multiple Studies (78452) | $6,477 | $6,477 | 4.7× |
| Neck soft tissue (70360) | $627 | $627 | 6.7× |
| Nuclear Rx Oral Admin (79005) | $1,285 | $1,285 | 5.2× |
| Optic foramina (70190) | $501 | $501 | 5.4× |
| Parathyroid Planar Imaging (78070) | $2,669 | $2,669 | 6.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,306 | $1,306 | 3.1× |
| Pelvis 1 or 2 views (72170) | $877 | $877 | 7.9× |
| Pet Image W/Ct Lmtd (78814) | $23,367 | $23,367 | 15.3× |
| PET image w/CT, full body (78816) | $23,367 | $23,367 | 15.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $23,367 | $23,367 | 15.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,121 | $2,121 | 5.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,090 | $1,090 | 9.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,682 | $1,682 | 2.9× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$847–$1,538 | $847–$1,538 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$680–$1,130 | $680–$1,130 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$789–$1,577 | $789–$1,577 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,101 | $1,101 | 9.9× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$647–$1,079 | $647–$1,079 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$868–$1,577 | $868–$1,577 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$787–$1,571 | $787–$1,571 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$1,009–$1,869 | $1,009–$1,869 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $625 | $625 | 5.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $811 | $811 | 8.7× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $603 | $603 | 6.5× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$564–$680 | $564–$680 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$888–$2,129 | $888–$2,129 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $551 | $551 | 5.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,276 | $1,276 | 6.8× |
| Radex Spine 1 View Specify Level (72020) | $795 | $795 | 8.6× |
| Radex Sternum Minimum 2 Views (71120) | $917 | $917 | 9.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $987 | $987 | 10.6× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$568–$1,140 | $568–$1,140 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$618–$1,236 | $618–$1,236 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 5 matching MRF lines |
$523–$706 | $523–$706 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,263 | $1,263 | 11.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,365 | $1,365 | 12.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $526 | $526 | 4.7× |
| Radiologic exam colon double contrast study (74280) | $2,696 | $2,696 | 14.4× |
| Radiologic exam colon single contrast study (74270) | $1,761 | $1,761 | 9.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $2,242 | $2,242 | 12.0× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$1,027–$1,869 | $1,027–$1,869 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $922 | $922 | 8.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,151 | $1,151 | 6.1× |
| Radiologic exam swallow function contrast study (74230) | $1,060 | $1,060 | 5.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,491 | $1,491 | 8.0× |
| Radiologic examination femur 1 view (73551) | $351 | $351 | 3.8× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$421–$1,011 | $421–$1,011 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$548–$1,243 | $548–$1,243 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $739 | $739 | 6.6× |
| Radiologic Examination Salivary Gland Calculus (70380) | $647 | $647 | 7.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$706–$1,411 | $706–$1,411 | varies |
| Ribs bilateral 3 views (71110) | $957 | $957 | 8.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $884 | $884 | 2.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,202 | $1,202 | 2.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,595 | $3,595 | 6.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,532 | $2,532 | 4.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,822 | $1,822 | 3.1× |
| Salivary Gland Imaging (78230) | $1,436 | $1,436 | 3.4× |
| Scapula (73010) range across 3 matching MRF lines |
$706–$1,411 | $706–$1,411 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $56 | $56 | 2.4× |
| Sella turcica (70240) | $403 | $403 | 4.3× |
| Shoulder 1 view (73020) | $480 | $480 | 5.2× |
| Shoulder Arthrography (73040) | $1,718 | $1,718 | 4.6× |
| Sialogram (70390) | $970 | $970 | 3.8× |
| Skull less than 4 views (70250) | $748 | $748 | 6.7× |
| Sternoclavicular joints (71130) | $704 | $704 | 7.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,213 | $1,213 | 6.5× |
| Thoracic spine 2 views (72070) | $1,176 | $1,176 | 10.5× |
| Thoracic spine 3 views (72072) | $1,162 | $1,162 | 10.4× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $778 | $778 | 1.8× |
| Thyroid Imaging With Vascular Flow (78013) | $2,527 | $2,527 | 5.9× |
| Thyroid Met Imaging Body (78018) | $1,684 | $1,684 | 2.9× |
| Thyroid Uptake Measurement (78012) | $1,384 | $1,384 | 3.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,166 | $1,166 | 2.7× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$252–$2,033 | $252–$2,033 | varies |
| Ultrasound Exam Aaa Screen (76706) | $608 | $608 | 5.4× |
| Ultrasound, abdomen limited (76705) | $1,788 | $1,788 | 16.0× |
| Umbilical-artery Doppler (OB) (76820) | $772 | $772 | 6.9× |
| Upper gi w/o kub (74240) | $1,915 | $1,915 | 10.2× |
| Ureteral Reflux Study (78740) | $1,588 | $1,588 | 3.7× |
| Urethrocystogram voiding (74455) | $1,932 | $1,932 | 7.6× |
| Urethrocystography retrograde (74450) | $1,885 | $1,885 | 7.4× |
| Us breast unilateral complete (76641) | $1,139 | $1,139 | 10.2× |
| Us chest (76604) | $2,266 | $2,266 | 20.3× |
| Us complete joint (76881) | $1,332 | $1,332 | 11.9× |
| Us exam, pelvic, limited (76857) | $1,519 | $1,519 | 13.6× |
| Us head (76506) | $1,462 | $1,462 | 13.1× |
| Us kidney transplant (76776) | $736 | $736 | 6.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $605 | $605 | 5.4× |
| Us ob detailed single fetus (76811) | $1,775 | $1,775 | 7.0× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$669–$1,367 | $669–$1,367 | varies |
| Us ob transvaginal (76817) | $1,009 | $1,009 | 9.0× |
| Us pelvic non ob complete (76856) | $1,823 | $1,823 | 16.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,722 | $1,722 | 15.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,555 | $1,555 | 13.9× |
| Us retroperitoneal complete (76770) | $876 | $876 | 7.8× |
| Us retroperitoneal limited (76775) | $1,200 | $1,200 | 10.7× |
| Us scrotum and contents (76870) | $1,751 | $1,751 | 15.7× |
| Us spinal canal and contents (76800) | $794 | $794 | 7.1× |
| Us thyroid (76536) | $2,215 | $2,215 | 19.8× |
| Us transrectal (76872) | $1,847 | $1,847 | 16.5× |
| Vascular Flow Imaging (78445) | $1,384 | $1,384 | 3.2× |
| Vein X-Ray Chest (75827) | $3,944 | $3,944 | 2.3× |
| Venography caval inferior serialography rs&i (75825) | $14,665 | $14,665 | 4.3× |
| Venography extremity bilateral rs&i (75822) | $4,282 | $4,282 | 2.5× |
| Venography extremity unilateral rs&i (75820) | $9,549 | $9,549 | 5.7× |
| Venography Renal Bilateral (75833) | $14,665 | $14,665 | 4.3× |
| Venography Renal Unilateral (75831) | $14,665 | $14,665 | 4.3× |
| Vertebral fracture assessment via dxa (77086) | $549 | $549 | 5.9× |
| Wrist 2 views (73100) | $1,012 | $1,012 | 10.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $737 | $737 | 7.9× |
| X-ray antegrade pyelogram tube (74425) | $928 | $928 | 2.5× |
| X-Ray Aorta Leg Arteries (75630) | $13,174 | $13,174 | 3.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$1,005–$1,828 | $1,005–$1,828 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$976–$2,861 | $976–$2,861 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $421 | $421 | 4.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $704 | $704 | 6.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,123 | $1,123 | 10.1× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$351–$603 | $351–$603 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $351 | $351 | 3.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $592 | $592 | 5.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $592 | $592 | 5.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $592 | $592 | 5.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,123 | $1,123 | 10.1× |
| X-Ray Exam L-S Spine Bending (72114) | $1,162 | $1,162 | 10.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $1,301 | $1,301 | 14.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,176 | $1,176 | 10.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,247 | $1,247 | 11.2× |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$647–$925 | $647–$925 | varies |
| X-ray humerus (73060) | $618 | $618 | 6.7× |
| X-ray IV pyelogram (ivp) (74400) | $1,647 | $1,647 | 8.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $734 | $734 | 7.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $669 | $669 | 7.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $959 | $959 | 8.6× |
| X-ray nose-rectum child f.b. (76010) | $326 | $326 | 3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,254 | $1,254 | 11.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,000 | $1,000 | 9.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $762 | $762 | 8.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,167 | $1,167 | 12.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,112 | $1,112 | 10.0× |
| X-ray thoracic spine 4 vw (72074) | $987 | $987 | 8.8× |
| X-Ray Tmj Unilat (70328) | $279 | $279 | 3.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,685 | $2,685 | 7.2× |
| X-Rays Bone Length Studies (77073) | $551 | $551 | 4.9× |
| X-Rays Bone Survey Complete (77075) | $2,162 | $2,162 | 19.4× |
| Xr c-spine 4 or 5 views (72050) | $1,104 | $1,104 | 9.9× |
| Xr facial bones less than 3 views (70140) | $293 | $293 | 3.2× |
| Xr orbits complete 4 views (70200) | $1,020 | $1,020 | 9.1× |
| Xr Tomogram Single Plane (76100) | $1,367 | $1,367 | 12.2× |
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.