Imaging prices at Fulton County Health Center
Wauseon, OH · every code in this section with a posted price and a Medicare benchmark.
286 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $166.95 | $238.50 | 2.0× |
| Abdomen 2 views (74019) | $165.55 | $236.50 | 1.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $935.13 | $1,335.90 | 2.5× |
| Angio internal mammary (75756) | $2,865.24 | $4,093.20 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $2,462.75 | $3,518.22 | 0.8× |
| Angiography extremity unilateral rs&i (75710) | $2,280.84 | $3,258.34 | 0.8× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$164.50–$280 | $235–$400 | varies |
| Aortography thoracic serialography rs&i (75605) | $3,740.52 | $5,343.60 | 0.7× |
| Aortography thoracic w/o serialography rs&i (75600) | $2,865.24 | $4,093.20 | 1.0× |
| Artery X-Rays Abdomen (75726) | $3,740.52 | $5,343.60 | 0.7× |
| Artery X-Rays Pelvis (75736) | $3,740.52 | $5,343.60 | 0.7× |
| Artery X-Rays Spine (75705) | $4,297.86 | $6,139.80 | 0.8× |
| Bone age studies (77072) | $218.70 | $312.43 | 2.2× |
| Bone Imaging 3 Phase (78315) | $1,169.48 | $1,670.69 | 3.1× |
| Bone Imaging Limited Area (78300) | $752.30 | $1,074.72 | 2.0× |
| Bone Imaging Whole Body (78306) | $1,121.39 | $1,601.99 | 3.0× |
| Bone survey infant (77076) | $218.70 | $312.43 | 2.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,329.82 | $4,756.89 | 2.5× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $932.08 | $1,331.54 | 2.5× |
| Chest 1 view (71045) | $154 | $220 | 1.9× |
| Chest 2 views (71046) | $172.20 | $246 | 2.1× |
| Chest 3 views (71047) | $183.75 | $262.50 | 2.2× |
| Chest 4 or more views (71048) | $201.25 | $287.50 | 2.0× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$185.50–$350 | $265–$500 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,279.80 | $1,828.28 | 12.9× |
| Contrast Exam Abdominl Aorta (75625) | $2,371.42 | $3,387.74 | 0.8× |
| Contrast X-Ray Bladder (74430) | $419.86 | $599.80 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) | $2,137.44 | $3,053.49 | 6.5× |
| CT abdomen and pelvis without contrast (74176) | $1,506.13 | $2,151.62 | 6.7× |
| CT abdomen w contrast (74160) | $1,388.95 | $1,984.22 | 8.4× |
| CT abdomen w wo contrast (74170) | $1,529.04 | $2,184.34 | 9.2× |
| CT abdomen w/o contrast (74150) | $1,204.99 | $1,721.41 | 12.2× |
| CT Angio Abdomen and Pelvis (74174) | $2,442.41 | $3,489.16 | 7.4× |
| CT Angio Chest (71275) | $1,702.32 | $2,431.88 | 10.3× |
| CT Angio Head (70496) | $1,652.70 | $2,361 | 10.0× |
| CT angio hrt w/3d image (75574) | $1,702.32 | $2,431.88 | 5.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,592.77 | $2,275.39 | 9.6× |
| CT Angio Neck (70498) | $1,702.32 | $2,431.88 | 10.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,592.77 | $2,275.39 | 9.6× |
| CT cervical spine w/ contrast (72126) | $1,426.36 | $2,037.66 | 4.3× |
| CT cervical spine w/o contrast (72125) | $1,279.80 | $1,828.28 | 12.9× |
| CT cervical spine w/wo cont (72127) | $1,529.04 | $2,184.34 | 9.2× |
| CT chest w contrast (71260) | $1,119.10 | $1,598.72 | 6.7× |
| CT chest w/wo contrast (71270) | $916.05 | $1,308.64 | 5.5× |
| CT colonography screening (74263) | $1,332.46 | $1,903.52 | 5.9× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,502.32 | $2,146.17 | 9.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,332.46 | $1,903.52 | 13.5× |
| CT head/brain with contrast (70460) | $984.93 | $1,407.04 | 5.9× |
| CT head/brain without and with contrast (70470) | $1,489.33 | $2,127.62 | 9.0× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,294.29 | $1,848.99 | 3.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $76.34 | $109.05 | 0.9× |
| CT iac w contrast (70481) | $1,324.45 | $1,892.07 | 8.0× |
| CT l-spine w&w/o contrast (72133) | $1,529.04 | $2,184.34 | 9.2× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,279.80–$1,977.51 | $1,828.28–$2,825.02 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,382.46–$2,022.17 | $1,974.95–$2,888.82 | varies |
| CT lumbar spine w contrast (72132) | $1,426.36 | $2,037.66 | 4.3× |
| CT lumbar spine w/o contrast (72131) | $1,279.80 | $1,828.28 | 12.9× |
| CT maxillofacial w contrast (70487) | $1,306.52 | $1,866.45 | 7.9× |
| CT maxillofacial wo contrast (70486) | $1,274.46 | $1,820.65 | 12.9× |
| CT neck tissue combo (70492) | $1,352.32 | $1,931.88 | 8.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,490.10 | $2,128.72 | 9.0× |
| CT orbits w/o contrast (70480) | $1,279.80 | $1,828.28 | 12.9× |
| CT pelvis w&w/o contrast (72194) | $1,529.04 | $2,184.34 | 9.2× |
| CT pelvis w/o contrast (72192) | $1,199.64 | $1,713.77 | 12.1× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,521.78–$2,351.94 | $2,173.97–$3,359.92 | varies |
| CT scans face/jaw combo (70488) | $1,525.22 | $2,178.88 | 9.2× |
| CT soft tissue neck w contrast (70491) | $1,382.46 | $1,974.95 | 8.3× |
| CT soft tissue neck w/o contrast (70490) | $1,279.80 | $1,828.28 | 12.9× |
| CT thoracic spine w contrast (72129) | $1,426.36 | $2,037.66 | 8.6× |
| CT thoracic spine w/o contrast (72128) | $1,279.80 | $1,828.28 | 12.9× |
| CT thoracic spine w/wo cont (72130) | $1,488.58 | $2,126.54 | 9.0× |
| CT thorax w/o contrast (71250) | $687.04 | $981.48 | 6.9× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,272.92–$1,966.83 | $1,818.46–$2,809.76 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,352.32–$2,351.94 | $1,931.88–$3,359.92 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,382.46–$2,022.17 | $1,974.95–$2,888.82 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,063.76 | $1,519.65 | 6.4× |
| Cta Abdomen (74175) | $1,702.32 | $2,431.88 | 10.3× |
| CTA pelvis (72191) | $1,702.32 | $2,431.88 | 10.3× |
| Dilation ureters/urethra rs&i (74485) | $1,681.32 | $2,401.89 | 0.9× |
| Discography Cerv/Thor Spine (72285) | $1,673.31 | $2,390.44 | 0.9× |
| Diskography lumbar (72295) | $1,673.31 | $2,390.44 | 0.9× |
| Dxa Bone Density Axial (77080) | $348.48 | $497.83 | 3.5× |
| Dxa bone density study (77085) | $267.18 | $381.69 | 2.7× |
| Esophagram (74220) | $281.05 | $401.50 | 1.7× |
| Fetal Biophys Profile W/Nst (76818) | $494.28 | $706.12 | 5.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $335.89 | $479.84 | 3.4× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$202.29–$207.79 | $288.99–$296.84 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$171.50–$294 | $245–$420 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$215.60–$420 | $308–$600 | varies |
| Gastric emptying imaging study (78264) | $1,547.35 | $2,210.50 | 4.1× |
| Gated Heart Planar Single (78472) | $1,062.61 | $1,518.01 | 2.8× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$170.45–$340.90 | $243.50–$487 | varies |
| Hepatobil Syst Image W/Drug (78227) | $970.24 | $1,386.06 | 1.9× |
| Ht Muscle Image Spect Sing (78451) | $1,666.44 | $2,380.63 | 1.4× |
| Hysterosalpingogram (74740) | $538.56 | $769.37 | 2.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $248.09 | $354.42 | 3.0× |
| Infant hip ultrasound, limited static exam (76886) | $229.01 | $327.16 | 2.8× |
| Joint Survey Single View (77077) | $218.70 | $312.43 | 2.2× |
| K Flow/Funct Image Multiple (78709) | $821.39 | $1,173.41 | 1.6× |
| K Flow/Funct Image W/Drug (78708) | $921.01 | $1,315.73 | 1.8× |
| K Flow/Funct Image W/O Drug (78707) | $749.24 | $1,070.35 | 1.5× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$202.30–$422.10 | $289–$603 | varies |
| Liver & Spleen Imaging Static Only (78215) | $775.21 | $1,107.44 | 2.0× |
| Liver imaging static only (78201) | $954.22 | $1,363.17 | 1.9× |
| Lung Perf&Ventilat Diferentl (78598) | $921.01 | $1,315.73 | 1.8× |
| Lung perfusion differential (78597) | $704.59 | $1,006.56 | 1.9× |
| Lung Ventilat&Perfus Imaging (78582) | $1,314.53 | $1,877.90 | 2.6× |
| Lymph System Imaging (78195) | $1,145.06 | $1,635.80 | 2.2× |
| Magnetic Image Jaw Joint (70336) | $1,631.32 | $2,330.46 | 7.2× |
| Mammary ductogram or galactogram multiple (77054) | $449.63 | $642.33 | 2.0× |
| Mammary ductogram or galactogram single (77053) | $386.26 | $551.80 | 1.7× |
| Meckels Divert Exam (78290) | $374.82 | $535.45 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $1,788.96 | $2,555.66 | 5.4× |
| MRA head w/o contrast (70544) | $1,464.15 | $2,091.64 | 6.5× |
| MRA head with contrast (70545) | $1,464.15 | $2,091.64 | 4.4× |
| MRA neck w contrast (70548) | $1,464.15 | $2,091.64 | 4.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,788.96 | $2,555.66 | 5.4× |
| MRA neck w/o contrast (70547) | $1,464.15 | $2,091.64 | 6.5× |
| MRI abdomen w/o contrast (74181) | $1,842.78 | $2,632.54 | 8.2× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$1,842.78–$2,072.56 | $2,632.54–$2,960.80 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$2,167.21–$2,535.16 | $3,096.01–$3,621.65 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$1,114.90–$1,282.08 | $1,592.72–$1,831.54 | varies |
| MRI cervical spine w contrast (72142) | $1,842.78 | $2,632.54 | 5.6× |
| MRI cervical spine w/o cont (72141) | $1,842.78 | $2,632.54 | 8.2× |
| MRI chest w/o contrast (71550) | $1,631.32 | $2,330.46 | 7.2× |
| MRI chest with contrast (71551) | $1,631.32 | $2,330.46 | 2.2× |
| MRI chest wo w contrast (71552) | $2,035.53 | $2,907.90 | 6.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$1,631.32–$1,641.26 | $2,330.46–$2,344.65 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,842.78–$2,290.11 | $2,632.54–$3,271.59 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$1,631.32–$3,261.50 | $2,330.46–$4,659.29 | varies |
| MRI lumbar spine w contrast (72149) | $1,842.78 | $2,632.54 | 5.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,276.38 | $3,251.97 | 6.9× |
| MRI orbit face &/neck w/o contrast (70540) | $1,631.32 | $2,330.46 | 7.2× |
| MRI orbit face neck w contrast (70542) | $1,631.32 | $2,330.46 | 4.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,788.96 | $2,555.66 | 5.4× |
| MRI pelvis w contrast (72196) | $1,755.38 | $2,507.68 | 5.3× |
| MRI pelvis w/o & w contrast (72197) | $1,972.17 | $2,817.39 | 6.0× |
| MRI pelvis w/o contrast (72195) | $1,755.38 | $2,507.68 | 7.8× |
| MRI thoracic spine w/o contrast (72146) | $1,842.78 | $2,632.54 | 8.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$1,631.32–$1,641.26 | $2,330.46–$2,344.65 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,631.32–$1,641.26 | $2,330.46–$2,344.65 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$1,842.78–$2,288.59 | $2,632.54–$3,269.41 | varies |
| MRI, abdomen, combo (74183) | $1,972.17 | $2,817.39 | 6.0× |
| MRI, dorsal spine combo (72157) | $2,276.38 | $3,251.97 | 6.9× |
| MRI, dorsal spine contrast (72147) | $1,842.78 | $2,632.54 | 5.6× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$1,842.78–$3,244.33 | $2,632.54–$4,634.76 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$2,167.21–$2,213.78 | $3,096.01–$3,162.54 | varies |
| MRI, lumbar spine combo (72158) | $2,276.38 | $3,251.97 | 6.9× |
| Myelogram cervical (72240) | $1,254.60 | $1,792.29 | 1.7× |
| Myelogram Lumbar (72265) | $1,254.60 | $1,792.29 | 1.7× |
| Myelography thoracic (72255) | $1,254.60 | $1,792.29 | 1.7× |
| Myelograpy 2/more regions rs&i (72270) | $1,344.30 | $1,920.43 | 1.8× |
| Myocardial Spect Multiple Studies (78452) | $2,819.90 | $4,028.43 | 2.3× |
| Neck soft tissue (70360) | $185.50 | $265 | 2.3× |
| Ob us nuchal meas 1 gest (76813) | $391.23 | $558.90 | 4.0× |
| Optic foramina (70190) | $123.66 | $176.66 | 1.5× |
| Parathyroid Planar Imaging (78070) | $749.24 | $1,070.35 | 2.0× |
| Pelvis 1 or 2 views (72170) | $180.25 | $257.50 | 1.8× |
| Pet Image W/Ct Lmtd (78814) | $2,481.72 | $3,545.31 | 1.8× |
| PET image w/CT, full body (78816) | $3,216.85 | $4,595.50 | 2.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,757.30 | $3,939 | 2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $907.65 | $1,296.64 | 2.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $337.40 | $482 | 3.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$180.25–$245 | $257.50–$350 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$185.50–$369.95 | $265–$528.50 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$219.10–$420 | $313–$600 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $226.10 | $323 | 2.3× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$151.55–$280 | $216.50–$400 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$180.25–$359.80 | $257.50–$514 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$179.20–$357.70 | $256–$511 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$257.60–$341.25 | $368–$487.50 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $246.57 | $352.24 | 2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $164.50 | $235 | 2.0× |
| Radex Ribs Unilateral 2 Views (71100) | $180.25 | $257.50 | 2.2× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$250.25–$499.80 | $357.50–$714 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $90.84 | $129.77 | 1.1× |
| Radex Spine 1 View Specify Level (72020) | $177.45 | $253.50 | 2.2× |
| Radex Sternum Minimum 2 Views (71120) | $185.50 | $265 | 2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $246.57 | $352.24 | 3.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$164.50–$204.32 | $235–$291.88 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $257.60 | $368 | 2.6× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$179.20–$357.70 | $256–$511 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $380.45 | $543.50 | 3.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $226.10 | $323 | 2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $219.85 | $314.07 | 2.2× |
| Radiologic exam colon double contrast study (74280) | $491.23 | $701.76 | 3.0× |
| Radiologic exam colon single contrast study (74270) | $396.95 | $567.07 | 2.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $324.43 | $463.47 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$281.40–$562.45 | $402–$803.50 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $185.50 | $265 | 1.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $350 | $500 | 2.1× |
| Radiologic exam swallow function contrast study (74230) | $380.54 | $543.63 | 2.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $472.53 | $675.04 | 2.8× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$189.35–$350 | $270.50–$500 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$217–$432.95 | $310–$618.50 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$226.10–$450.45 | $323–$643.50 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $394.67 | $563.81 | 4.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$209.65–$280 | $299.50–$400 | varies |
| Ribs bilateral 3 views (71110) | $292.37 | $417.67 | 3.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $744.29 | $1,063.27 | 2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $931.31 | $1,330.44 | 2.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,137.44 | $3,053.49 | 4.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,325.60 | $1,893.71 | 2.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,245.82 | $1,779.74 | 2.4× |
| Scapula (73010) range across 3 matching MRF lines |
$257.60–$514.85 | $368–$735.50 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $48.09 | $68.70 | 2.1× |
| Sella turcica (70240) | $202.29 | $288.99 | 2.5× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$177.45–$369.95 | $253.50–$528.50 | varies |
| Shoulder Arthrography (73040) | $347.72 | $496.74 | 1.1× |
| Skull less than 4 views (70250) | $107.80 | $154 | 1.1× |
| Spleen Imaging (78185) | $641.61 | $916.59 | 1.7× |
| Sternoclavicular joints (71130) | $202.29 | $288.99 | 2.5× |
| Tbs technical calculation only (77091) | $143.26 | $204.66 | 1.7× |
| Thoracic spine 2 views (72070) | $200.55 | $286.50 | 2.0× |
| Thoracic spine 3 views (72072) | $281.75 | $402.50 | 2.8× |
| Thoracolumbar 2 views (72080) | $185.50 | $265 | 2.3× |
| Thyroid Imaging With Vascular Flow (78013) | $749.24 | $1,070.35 | 2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $945.06 | $1,350.08 | 2.5× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$320.24–$373.29 | $457.48–$533.27 | varies |
| Ultrasound Exam Aaa Screen (76706) | $434.74 | $621.06 | 4.4× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$469.48–$482.22 | $670.68–$688.89 | varies |
| Upper gi w/o kub (74240) | $346.57 | $495.10 | 2.1× |
| Urethrocystogram voiding (74455) | $300.01 | $428.58 | 1.3× |
| Urethrocystography retrograde (74450) | $259.92 | $371.32 | 1.2× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$282.07–$485.88 | $402.96–$694.12 | varies |
| Us chest (76604) | $388.93 | $555.62 | 3.9× |
| Us exam, pelvic, limited (76857) | $319.09 | $455.84 | 3.2× |
| Us kidney transplant (76776) | $163.36 | $233.37 | 1.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$412.60–$509.94 | $589.43–$728.48 | varies |
| Us ob limited 1 or more fetuses (76815) | $406.95 | $581.36 | 4.1× |
| Us ob transvaginal (76817) | $508.41 | $726.30 | 5.1× |
| Us pelvic non ob complete (76856) | $526.72 | $752.46 | 5.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $396.19 | $565.99 | 4.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $532.46 | $760.65 | 5.4× |
| Us retroperitoneal complete (76770) | $601.54 | $859.34 | 6.1× |
| Us retroperitoneal limited (76775) | $434.74 | $621.06 | 4.4× |
| Us scrotum and contents (76870) | $564.52 | $806.45 | 5.7× |
| Us spinal canal and contents (76800) | $247.72 | $353.88 | 2.5× |
| Us thyroid (76536) | $419.86 | $599.80 | 4.2× |
| Us transrectal (76872) | $649.25 | $927.50 | 6.6× |
| Vein X-Ray Chest (75827) | $2,031.11 | $2,901.58 | 1.4× |
| Venogram Sinus/Jugular (75860) | $2,686.17 | $3,837.38 | 0.9× |
| Venography caval inferior serialography rs&i (75825) | $2,412.18 | $3,445.97 | 0.8× |
| Venography extremity bilateral rs&i (75822) | $1,472.47 | $2,103.53 | 1.0× |
| Venography extremity unilateral rs&i (75820) | $1,609.95 | $2,299.93 | 1.1× |
| Vertebral fracture assessment via dxa (77086) | $171.76 | $245.37 | 2.1× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$164.50–$327.60 | $235–$468 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $257.60 | $368 | 3.1× |
| X-ray antegrade pyelogram tube (74425) | $330.54 | $472.20 | 1.0× |
| X-Ray Aorta Leg Arteries (75630) | $2,371.42 | $3,387.74 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $226.10 | $323 | 2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$164.50–$280 | $235–$400 | varies |
| X-Ray Exam Breast Specimen (76098) | $393.14 | $561.63 | 0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $197.75 | $282.50 | 2.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $201.14 | $287.35 | 2.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $225.75 | $322.50 | 2.3× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$121.45–$146.65 | $173.50–$209.50 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $177.45 | $253.50 | 2.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $291.55 | $416.50 | 2.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $329.70 | $471 | 3.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $366.80 | $524 | 3.7× |
| X-Ray Exam L-S Spine Bending (72114) | $363.30 | $519 | 3.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $219.10 | $313 | 2.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $345.80 | $494 | 3.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $227.85 | $325.50 | 2.3× |
| X-ray eye for foreign body (70030) | $114.51 | $163.58 | 1.4× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$226.10–$420 | $323–$600 | varies |
| X-ray IV pyelogram (ivp) (74400) | $336.64 | $480.92 | 2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $203.06 | $290.09 | 2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $185.50 | $265 | 2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $180.25 | $257.50 | 1.8× |
| X-ray nose-rectum child f.b. (76010) | $210.70 | $301 | 2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $246.40 | $352 | 2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $185.50 | $265 | 1.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $185.50 | $265 | 1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $184.45 | $263.50 | 2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $226.10 | $323 | 2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $257.60 | $368 | 2.6× |
| X-Ray Stress View (77071) | $126.72 | $181.03 | 1.5× |
| X-ray thoracic spine 4 vw (72074) | $294.70 | $421 | 3.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$374.05–$742 | $534.36–$1,060 | varies |
| X-Rays Bone Length Studies (77073) | $282.45 | $403.50 | 2.9× |
| X-Rays Bone Survey Complete (77075) | $267.18 | $381.69 | 2.7× |
| Xr c-spine 4 or 5 views (72050) | $294.70 | $421 | 3.0× |
| Xr facial bones less than 3 views (70140) | $83.30 | $119 | 1.0× |
| Xr orbits complete 4 views (70200) | $226.10 | $323 | 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.