Imaging prices at Golden Valley Memorial Healthcare
Clinton, MO · every code in this section with a posted price and a Medicare benchmark.
259 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) range across 2 matching MRF lines |
$2,620.91–$3,028.39 | $4,368.18–$5,047.31 | varies |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$14.58–$227.35 | $24.30–$378.92 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$18.51–$300 | $30.85–$500 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 3 matching MRF lines |
$78.13–$1,038.13 | $130.22–$1,730.22 | varies |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$13.41–$229.68 | $22.35–$382.80 | varies |
| Basic radiation dosimetry calculation (77300) range across 4 matching MRF lines |
$60–$619.72 | $100–$1,032.86 | varies |
| Bone age studies (77072) range across 3 matching MRF lines |
$15.16–$225.16 | $25.26–$375.26 | varies |
| Bone Imaging 3 Phase (78315) range across 3 matching MRF lines |
$79.88–$1,219.88 | $133.13–$2,033.13 | varies |
| Bone Imaging Multiple Areas (78305) range across 3 matching MRF lines |
$65.80–$1,145.80 | $109.67–$1,909.67 | varies |
| Bone Imaging Whole Body (78306) range across 3 matching MRF lines |
$67.47–$1,387.47 | $112.45–$2,312.45 | varies |
| Bone survey infant (77076) range across 3 matching MRF lines |
$56.15–$302.15 | $93.59–$503.59 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 3 matching MRF lines |
$50.05–$873.55 | $83.42–$1,455.92 | varies |
| Chest 1 view (71045) range across 4 matching MRF lines |
$14.58–$221.58 | $24.30–$369.30 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$17.41–$266.41 | $29.01–$444.01 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$22.34–$193.94 | $37.23–$323.23 | varies |
| Clavicle complete (73000) range across 4 matching MRF lines |
$13.41–$217.41 | $22.35–$362.35 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 3 matching MRF lines |
$93.20–$1,293.20 | $155.34–$2,155.34 | varies |
| Continuing medical physics consltj pr wk (77336) | $256.64 | $427.74 | 1.9× |
| Contrast X-Ray Bladder (74430) range across 3 matching MRF lines |
$25.82–$505.82 | $43.04–$843.04 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 5 matching MRF lines |
$45.89–$924.11 | $76.49–$1,540.19 | varies |
| Corpora cavernosography (74445) range across 3 matching MRF lines |
$88.23–$904.23 | $147.05–$1,507.05 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$160.09–$3,760.09 | $266.82–$6,266.82 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$139.27–$2,839.27 | $232.12–$4,732.12 | varies |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$101.62–$1,901.62 | $169.37–$3,169.37 | varies |
| CT abdomen w wo contrast (74170) range across 4 matching MRF lines |
$111.79–$2,194.20 | $186.31–$3,657 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$95.46–$1,715.46 | $159.10–$2,859.10 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 3 matching MRF lines |
$174.33–$2,334.33 | $290.55–$3,890.55 | varies |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$145.44–$2,005.44 | $242.40–$3,342.40 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$139.85–$2,059.85 | $233.08–$3,433.08 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$150.68–$1,950.68 | $251.13–$3,251.13 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$139.85–$2,059.85 | $233.08–$3,433.08 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$143.35–$1,583.35 | $238.91–$2,638.91 | varies |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$97.72–$1,837.72 | $162.86–$3,062.86 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$85.38–$1,825.38 | $142.30–$3,042.30 | varies |
| CT cervical spine w/wo cont (72127) range across 4 matching MRF lines |
$101.12–$1,841.12 | $168.53–$3,068.53 | varies |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$99.38–$1,959.38 | $165.63–$3,265.63 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$110.62–$1,790.62 | $184.36–$2,984.36 | varies |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$90.96–$1,470.96 | $151.60–$2,451.60 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$101.62–$2,081.62 | $169.37–$3,469.37 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $39 | $65 | 0.4× |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$110.62–$1,580.62 | $184.36–$2,634.36 | varies |
| CT l-spine w&w/o contrast (72133) range across 3 matching MRF lines |
$101.69–$1,841.69 | $169.49–$3,069.49 | varies |
| CT lower ext w/o (73700) range across 7 matching MRF lines |
$67.20–$1,560.90 | $112–$2,601.50 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$93.20–$1,503.20 | $155.34–$2,505.34 | varies |
| CT lumbar spine w contrast (72132) range across 3 matching MRF lines |
$97.72–$1,837.72 | $162.86–$3,062.86 | varies |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$80.29–$1,820.29 | $133.82–$3,033.82 | varies |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$89.87–$1,799.87 | $149.78–$2,999.78 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$68.48–$1,508.48 | $114.13–$2,514.13 | varies |
| CT neck tissue combo (70492) range across 3 matching MRF lines |
$129.19–$1,689.19 | $215.32–$2,815.32 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$115.70–$1,675.70 | $192.83–$2,792.83 | varies |
| CT orbits w/o contrast (70480) range across 6 matching MRF lines |
$102.21–$1,550.68 | $170.35–$2,584.46 | varies |
| CT pelvis w&w/o contrast (72194) range across 3 matching MRF lines |
$97.21–$1,777.21 | $162.01–$2,962.01 | varies |
| CT pelvis w/o contrast (72192) range across 5 matching MRF lines |
$87.05–$2,247.05 | $145.08–$3,745.08 | varies |
| CT scan of leg combo (73702) range across 7 matching MRF lines |
$97.21–$1,537.21 | $162.01–$2,562.01 | varies |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$101.62–$1,811.62 | $169.37–$3,019.37 | varies |
| CT soft tissue neck w contrast (70491) range across 3 matching MRF lines |
$110.62–$1,790.62 | $184.36–$2,984.36 | varies |
| CT soft tissue neck w/o contrast (70490) range across 5 matching MRF lines |
$102.21–$1,722.21 | $170.35–$2,870.35 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$97.72–$1,837.72 | $162.86–$3,062.86 | varies |
| CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines |
$80.29–$1,820.29 | $133.82–$3,033.82 | varies |
| CT thoracic spine w/wo cont (72130) range across 3 matching MRF lines |
$101.12–$1,841.12 | $168.53–$3,068.53 | varies |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$93.20–$1,653.20 | $155.34–$2,755.34 | varies |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$67.20–$1,520.29 | $112–$2,533.82 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$97.72–$1,537.72 | $162.86–$2,562.86 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$93.20–$1,533.20 | $155.34–$2,555.34 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$189.56–$2,049.56 | $315.94–$3,415.94 | varies |
| Cta Abdomen (74175) range across 3 matching MRF lines |
$144.44–$2,184.44 | $240.74–$3,640.74 | varies |
| CTA pelvis (72191) range across 3 matching MRF lines |
$143.92–$1,703.92 | $239.87–$2,839.87 | varies |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$15.74–$357.74 | $26.24–$596.24 | varies |
| Echo exam uterus (76831) range across 3 matching MRF lines |
$58.38–$630.93 | $97.30–$1,051.55 | varies |
| Esophagram (74220) range across 3 matching MRF lines |
$53.89–$455.89 | $89.82–$759.82 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 6 matching MRF lines |
$62.89–$542.89 | $104.81–$904.81 | varies |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$24.74–$504.74 | $41.24–$841.24 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$12.41–$198.41 | $20.68–$330.68 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$13.41–$223.41 | $22.35–$372.35 | varies |
| Gastric emptying imaging study (78264) range across 3 matching MRF lines |
$61.88–$1,186.88 | $103.14–$1,978.14 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) range across 3 matching MRF lines |
$77.04–$638.64 | $128.40–$1,064.40 | varies |
| Gated Heart Planar Single (78472) range across 3 matching MRF lines |
$77.04–$1,277.04 | $128.40–$2,128.40 | varies |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) range across 3 matching MRF lines |
$84.96–$830.16 | $141.60–$1,383.60 | varies |
| Hand 2 views (73120) range across 4 matching MRF lines |
$13.41–$208.41 | $22.35–$347.35 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 3 matching MRF lines |
$71.39–$1,151.39 | $118.98–$1,918.98 | varies |
| Hepatobiliary System Imaging (78226) range across 3 matching MRF lines |
$58.48–$1,288.48 | $97.46–$2,147.46 | varies |
| Ht Muscle Image Spect Sing (78451) range across 3 matching MRF lines |
$107.45–$2,807.45 | $179.09–$4,679.09 | varies |
| Hysterosalpingogram (74740) range across 3 matching MRF lines |
$30.32–$1,079.39 | $50.53–$1,798.98 | varies |
| Infusion Ivp (74410) range across 3 matching MRF lines |
$38.82–$853.62 | $64.70–$1,422.70 | varies |
| K Flow/Funct Image W/Drug (78708) range across 3 matching MRF lines |
$94.54–$1,234.54 | $157.57–$2,057.57 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 3 matching MRF lines |
$74.38–$975.28 | $123.96–$1,625.46 | varies |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$15.08–$231.08 | $25.14–$385.14 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 3 matching MRF lines |
$38.82–$1,163.82 | $64.70–$1,939.70 | varies |
| Lung Perf&Ventilat Diferentl (78598) range across 3 matching MRF lines |
$65.88–$894.10 | $109.80–$1,490.16 | varies |
| Lung perfusion differential (78597) range across 3 matching MRF lines |
$56.97–$695.75 | $94.95–$1,159.59 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 3 matching MRF lines |
$84.38–$1,464.38 | $140.64–$2,440.64 | varies |
| Lung Ventilation Imaging (78579) range across 3 matching MRF lines |
$38.23–$798.73 | $63.72–$1,331.22 | varies |
| Lymph System Imaging (78195) range across 3 matching MRF lines |
$94.03–$1,264.03 | $156.72–$2,106.72 | varies |
| Magnetic Image Jaw Joint (70336) range across 3 matching MRF lines |
$117.44–$1,677.44 | $195.74–$2,795.74 | varies |
| Mammary ductogram or galactogram single (77053) range across 3 matching MRF lines |
$28.65–$694.35 | $47.75–$1,157.25 | varies |
| Meckels Divert Exam (78290) range across 3 matching MRF lines |
$53.48–$784.28 | $89.13–$1,307.13 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$698.90–$1,106.98 | $1,164.84–$1,844.97 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 3 matching MRF lines |
$117.96–$2,097.96 | $196.60–$3,496.60 | varies |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$96.05–$1,956.05 | $160.08–$3,260.08 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 5 matching MRF lines |
$143.78–$2,003.78 | $239.63–$3,339.63 | varies |
| MRA neck w/o contrast (70547) range across 5 matching MRF lines |
$96.05–$1,956.05 | $160.08–$3,260.08 | varies |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$116.78–$1,976.78 | $194.64–$3,294.64 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$171.35–$2,331.35 | $285.58–$3,885.58 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$130.20–$2,290.20 | $217–$3,817 | varies |
| MRI cervical spine w contrast (72142) range across 3 matching MRF lines |
$143.19–$2,123.19 | $238.65–$3,538.65 | varies |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$119.02–$1,979.02 | $198.37–$3,298.37 | varies |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$116.27–$2,576.27 | $193.79–$4,293.79 | varies |
| MRI chest wo w contrast (71552) range across 3 matching MRF lines |
$180.33–$2,469.93 | $300.55–$4,116.55 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$129.71–$1,989.71 | $216.18–$3,316.18 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$171.35–$2,331.35 | $285.58–$3,885.58 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$107.88–$1,967.88 | $179.80–$3,279.80 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 3 matching MRF lines |
$182.59–$2,222.59 | $304.32–$3,704.32 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 7 matching MRF lines |
$107.88–$1,967.88 | $179.80–$3,279.80 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$170.84–$2,030.84 | $284.74–$3,384.74 | varies |
| MRI pelvis w/o & w contrast (72197) range across 3 matching MRF lines |
$175.84–$2,215.84 | $293.06–$3,693.06 | varies |
| MRI pelvis w/o contrast (72195) range across 3 matching MRF lines |
$116.78–$1,976.78 | $194.64–$3,294.64 | varies |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$119.02–$1,979.02 | $198.37–$3,298.37 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 5 matching MRF lines |
$108.38–$1,968.38 | $180.63–$3,280.63 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$171.35–$2,031.35 | $285.58–$3,385.58 | varies |
| MRI, abdomen, combo (74183) range across 3 matching MRF lines |
$175.84–$2,335.84 | $293.06–$3,893.06 | varies |
| MRI, dorsal spine combo (72157) range across 3 matching MRF lines |
$182.59–$2,222.59 | $304.32–$3,704.32 | varies |
| MRI, dorsal spine contrast (72147) range across 3 matching MRF lines |
$142.61–$2,122.61 | $237.69–$3,537.69 | varies |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$108.88–$1,968.88 | $181.46–$3,281.46 | varies |
| MRI, joint upper extrem combo (73223) range across 5 matching MRF lines |
$1,560–$2,315.12 | $2,600–$3,858.53 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$182.59–$2,222.59 | $304.32–$3,704.32 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) range across 3 matching MRF lines |
$55.49–$798.89 | $92.49–$1,331.49 | varies |
| Myocardial Spect Multiple Studies (78452) range across 7 matching MRF lines |
$125.96–$3,425.96 | $209.94–$5,709.94 | varies |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$13.49–$265.49 | $22.49–$442.49 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$2,620.91–$3,380.50 | $4,368.18–$5,634.17 | varies |
| Nuclear Rx Oral Admin (79005) range across 3 matching MRF lines |
$140.62–$866.62 | $234.36–$1,444.36 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$103.01–$152.12 | $171.69–$253.53 | varies |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 2 matching MRF lines |
$40.23–$58.93 | $67.05–$98.22 | varies |
| Panoramic X-ray of jaws (70355) range across 3 matching MRF lines |
$17.33–$167.33 | $28.88–$278.88 | varies |
| Parathyroid Planar Imaging (78070) range across 3 matching MRF lines |
$62.47–$842.47 | $104.12–$1,404.12 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 3 matching MRF lines |
$93.97–$732.75 | $156.61–$1,221.25 | varies |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$13.99–$235.99 | $23.32–$393.32 | varies |
| PET image w/CT, full body (78816) range across 3 matching MRF lines |
$192.73–$4,392.73 | $321.21–$7,321.21 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 3 matching MRF lines |
$190.23–$4,210.23 | $317.05–$7,017.05 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 3 matching MRF lines |
$58.48–$711.65 | $97.46–$1,186.09 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$25.82–$457.82 | $43.04–$763.04 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 3 matching MRF lines |
$41.72–$641.72 | $69.54–$1,069.54 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$13.99–$253.99 | $23.32–$423.32 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$12.92–$192.92 | $21.53–$321.53 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$13.99–$225 | $23.32–$375 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$21.25–$369.25 | $35.41–$615.41 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$11.16–$167.16 | $18.60–$278.60 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$13.49–$229.49 | $22.49–$382.49 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$13.99–$259.99 | $23.32–$433.32 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$12.92–$234.92 | $21.53–$391.53 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$27.50–$255.50 | $45.83–$425.83 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$13.99–$241.99 | $23.32–$403.32 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 5 matching MRF lines |
$17.93–$251.93 | $29.88–$419.88 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$15.08–$225.08 | $25.14–$375.14 | varies |
| Radex Spine 1 View Specify Level (72020) range across 5 matching MRF lines |
$12.33–$234.33 | $20.55–$390.55 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$16.24–$268.24 | $27.06–$447.06 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$19.58–$189.68 | $32.64–$316.14 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$10.67–$154.67 | $17.78–$257.78 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 4 matching MRF lines |
$12.92–$234.92 | $21.53–$391.53 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$13.99–$223.99 | $23.32–$373.32 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 3 matching MRF lines |
$33.66–$402.66 | $56.10–$671.10 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $12,625.34 | $21,042.24 | 1.7× |
| Radiation treatment delivery level 1 (77402) | $226.80 | $378 | 2.2× |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$508.33–$670.52 | $847.21–$1,117.53 | varies |
| Radiation treatment delivery level 3 (77412) | $508.33 | $847.21 | 0.9× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$20.17–$321.37 | $33.62–$535.62 | varies |
| Radiologic exam colon double contrast study (74280) range across 3 matching MRF lines |
$79.21–$679.21 | $132.02–$1,132.02 | varies |
| Radiologic exam colon single contrast study (74270) range across 3 matching MRF lines |
$55.06–$590.63 | $91.76–$984.39 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 4 matching MRF lines |
$55.06–$616.06 | $91.76–$1,026.76 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$17.93–$245.93 | $29.88–$409.88 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$17.35–$269.35 | $28.91–$448.91 | varies |
| Radiologic exam swallow function contrast study (74230) range across 3 matching MRF lines |
$42.65–$442.56 | $71.08–$737.60 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$72.47–$627.47 | $120.79–$1,045.79 | varies |
| Radiologic examination femur 1 view (73551) range across 5 matching MRF lines |
$13.41–$223.41 | $22.35–$372.35 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$14.58–$272.58 | $24.30–$454.30 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$13.41–$223.41 | $22.35–$372.35 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$12.92–$264.92 | $21.53–$441.53 | varies |
| Ribs bilateral 3 views (71110) range across 4 matching MRF lines |
$23.50–$435 | $39.16–$725 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 3 matching MRF lines |
$63.05–$813.65 | $105.09–$1,356.09 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 3 matching MRF lines |
$66.47–$1,355.27 | $110.78–$2,258.78 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$83.71–$1,193.71 | $139.51–$1,989.51 | varies |
| Scapula (73010) range across 4 matching MRF lines |
$14.50–$240 | $24.17–$400 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$47.74–$113.74 | $79.57–$189.57 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$12.83–$234.83 | $21.39–$391.39 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$43.75–$660.25 | $72.91–$1,100.41 | varies |
| Special dosimetry (77331) range across 2 matching MRF lines |
$256.64–$619.72 | $427.74–$1,032.86 | varies |
| Special Physics Consult (77370) | $256.64 | $427.74 | 1.9× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$698.90–$789.52 | $1,164.84–$1,315.87 | varies |
| Special treatment procedure (77470) range across 3 matching MRF lines |
$193.39–$1,647.89 | $322.31–$2,746.49 | varies |
| Stereotactic Body Radiation Delivery (77373) | $3,375.10 | $5,625.16 | 1.9× |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$17.41–$234.31 | $29.01–$390.51 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$698.90–$974.40 | $1,164.84–$1,624 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$698.90–$965.12 | $1,164.84–$1,608.53 | varies |
| Testicular Imaging W/Flow (78761) | $1,500 | $2,500 | 3.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$698.90–$847.90 | $1,164.84–$1,413.16 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$698.90–$1,490.38 | $1,164.84–$2,483.96 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$256.64–$685.34 | $427.73–$1,142.24 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$17.41–$332.41 | $29.01–$554.01 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 3 matching MRF lines |
$29.23–$463.96 | $48.72–$773.27 | varies |
| Thyroid Uptake Measurement (78012) range across 3 matching MRF lines |
$300–$315.16 | $25.26–$525.26 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 3 matching MRF lines |
$39.40–$1,029.40 | $65.66–$1,715.66 | varies |
| Tx Devices Design & Construction Complex (77334) range across 4 matching MRF lines |
$698.90–$1,397.81 | $1,164.84–$2,329.68 | varies |
| Tx devices design & construction intermediate (77333) range across 3 matching MRF lines |
$256.64–$619.72 | $427.74–$1,032.86 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$256.64–$619.72 | $427.74–$1,032.86 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$54.47–$474.47 | $90.78–$790.78 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 4 matching MRF lines |
$43.82–$391.82 | $73.03–$653.03 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$46.65–$646.65 | $77.75–$1,077.75 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$40.97–$340.97 | $68.29–$568.29 | varies |
| Unlis px ther radiol clinical tx planning (77299) range across 2 matching MRF lines |
$256.64–$756.17 | $427.74–$1,260.29 | varies |
| Upper gi w/o kub (74240) range across 6 matching MRF lines |
$55.06–$708.56 | $91.76–$1,180.94 | varies |
| Urethrocystography retrograde (74450) range across 3 matching MRF lines |
$26.40–$451.06 | $44–$751.76 | varies |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$58.39–$478.39 | $97.32–$797.32 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$43.31–$523.31 | $72.18–$872.18 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$39.89–$459.89 | $66.49–$766.49 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$39.32–$339.32 | $65.53–$565.53 | varies |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$155.57–$425.57 | $259.29–$709.29 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$52.23–$472.23 | $87.05–$787.05 | varies |
| Us ob transvaginal (76817) range across 7 matching MRF lines |
$60.64–$540.64 | $101.07–$901.07 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$55.06–$730.06 | $91.76–$1,216.76 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$79.72–$645.57 | $132.86–$1,075.95 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$69.64–$384.64 | $116.06–$641.06 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$58.97–$628.97 | $98.29–$1,048.29 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$46.06–$556.06 | $76.77–$926.77 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$51.14–$621.14 | $85.24–$1,035.24 | varies |
| Us spinal canal and contents (76800) range across 3 matching MRF lines |
$94.58–$528.08 | $157.64–$880.14 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$44.91–$644.91 | $74.85–$1,074.85 | varies |
| Us transrectal (76872) range across 3 matching MRF lines |
$53.41–$533.41 | $89.02–$889.02 | varies |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$13.41–$199.41 | $22.35–$332.35 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$16.74–$262.74 | $27.90–$437.90 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$17.93–$412.73 | $29.88–$687.88 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$12.83–$228.83 | $21.39–$381.39 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$953.70–$966.62 | $1,589.50–$1,611.03 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 3 matching MRF lines |
$21.83–$124.43 | $36.39–$207.39 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines |
$25.74–$229.74 | $42.90–$382.90 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 3 matching MRF lines |
$29.08–$407.26 | $48.46–$678.76 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$15.08–$213.08 | $25.14–$355.14 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$17.93–$239.93 | $29.88–$399.88 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$22.42–$238.42 | $37.36–$397.36 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$17.93–$227.93 | $29.88–$379.88 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 3 matching MRF lines |
$24.08–$276.08 | $40.13–$460.13 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 4 matching MRF lines |
$25.74–$367.74 | $42.90–$612.90 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$26.33–$506.33 | $43.88–$843.88 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$17.93–$275.93 | $29.88–$459.88 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$29.15–$480 | $48.59–$800 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 4 matching MRF lines |
$21.91–$322.46 | $36.52–$537.43 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$13.49–$247.49 | $22.49–$412.49 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$13.41–$223.41 | $22.35–$372.35 | varies |
| X-ray IV pyelogram+tomography (74415) range across 3 matching MRF lines |
$39.32–$812.12 | $65.53–$1,353.53 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$17.93–$329.93 | $29.88–$549.88 | varies |
| X-ray nose-rectum child f.b. (76010) range across 3 matching MRF lines |
$14.58–$180 | $24.30–$300 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$26.33–$461.33 | $43.88–$768.88 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$15.16–$210 | $25.26–$350 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$13.99–$247.99 | $23.32–$413.32 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$20.17–$329.17 | $33.62–$548.62 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$27.98–$375.98 | $46.64–$626.64 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$40.99–$574.99 | $68.32–$958.32 | varies |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$22.91–$99.71 | $38.18–$166.18 | varies |
| X-Rays Bone Survey Complete (77075) range across 3 matching MRF lines |
$43.25–$523.25 | $72.08–$872.08 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$25.24–$399.64 | $42.06–$666.06 | varies |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$22.42–$244.42 | $37.36–$407.36 | varies |
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.