Imaging prices at Great Plains Health

North Platte, NE · every code in this section with a posted price and a Medicare benchmark.

355 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295)
range across 2 matching MRF lines		 $509–$6,938 $848–$12,412 varies
Abdomen 1 View (74018)
range across 2 matching MRF lines		 $67–$264 $112–$552 varies
Abdomen 2 views (74019)
range across 2 matching MRF lines		 $83–$319 $138–$670 varies
Acute Gastrointestinal Blood Loss Imaging (78278)
range across 2 matching MRF lines		 $103–$1,082 $171–$1,974 varies
Angio pulmonary bilat (75743)
range across 2 matching MRF lines		 $171–$7,799 $285–$13,284 varies
Angiography extremity bilateral rs&i (75716)
range across 2 matching MRF lines		 $204–$10,139 $340–$17,239 varies
Angiography extremity unilateral rs&i (75710)
range across 2 matching MRF lines		 $181–$10,139 $301–$17,200 varies
Angiography pulmonary unilateral slctv rs&i (75741)
range across 2 matching MRF lines		 $7,799 $220–$13,219 2.4×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746)
range across 2 matching MRF lines		 $7,799 $193–$13,192 2.4×
Ankle 2 views (73600)
range across 4 matching MRF lines		 $71–$396 $119–$839 varies
Aortography thoracic serialography rs&i (75605) $12,114 $20,387 2.1×
Artery X-Rays Abdomen (75726)
range across 2 matching MRF lines		 $13,460 $349–$22,783 2.3×
Artery X-Rays Pelvis (75736) $12,114 $20,381 2.1×
Arthrogram ankle (73615)
range across 3 matching MRF lines		 $91–$1,191 $152–$2,137 varies
Arthrogram hip (73525)
range across 5 matching MRF lines		 $93–$1,323 $155–$2,360 varies
Arthrogram Wrist (73115)
range across 3 matching MRF lines		 $91–$1,323 $152–$2,357 varies
Basic radiation dosimetry calculation (77300)
range across 2 matching MRF lines		 $74–$677 $123–$1,251 varies
Bone age studies (77072)
range across 2 matching MRF lines		 $20–$319 $34–$566 varies
Bone Imaging 3 Phase (78315)
range across 2 matching MRF lines		 $106–$1,508 $176–$2,689 varies
Bone Imaging Limited Area (78300)
range across 2 matching MRF lines		 $65–$1,082 $108–$1,911 varies
Bone Imaging Multiple Areas (78305) $1,082 $1,803 2.6×
Bone Imaging Whole Body (78306)
range across 2 matching MRF lines		 $89–$1,190 $148–$2,131 varies
Bone survey infant (77076)
range across 2 matching MRF lines		 $75–$341 $125–$693 varies
Brachytx isodose complex (77318)
range across 2 matching MRF lines		 $344–$1,862 $574–$3,677 varies
Brachytx isodose intermed (77317) $1,862 $3,103 4.8×
Brachytx Isodose Plan Simple (77316) $1,862 $3,103 4.8×
Brain Flow Imaging Only (78610)
range across 3 matching MRF lines		 $31–$1,696 $51–$2,877 varies
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $1,337 $2,228 2.4×
Brain Imaging Minimum 4 Static Views (78605) $1,696 $2,826 3.0×
Brain Imaging Pet Metabolic Evaluation (78608)
range across 2 matching MRF lines		 $152–$6,164 $254–$10,528 varies
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $1,337 $2,228 2.4×
Cerebrospinal Fluid Scan (78630)
range across 2 matching MRF lines		 $70–$1,337 $117–$2,345 varies
Chest 1 view (71045)
range across 2 matching MRF lines		 $58–$264 $97–$537 varies
Chest 2 views (71046)
range across 2 matching MRF lines		 $76–$264 $126–$566 varies
Chest 3 views (71047)
range across 2 matching MRF lines		 $94–$264 $157–$597 varies
Chest 4 or more views (71048)
range across 2 matching MRF lines		 $103–$319 $171–$703 varies
Cholecystography Oral Contrast (74290) $426 $710 2.3×
Clavicle complete (73000)
range across 4 matching MRF lines		 $73–$396 $122–$843 varies
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271)
range across 2 matching MRF lines		 $113–$1,212 $189–$2,209 varies
Continuing medical physics consltj pr wk (77336) $677 $1,128 4.9×
Contrast Exam Abdominl Aorta (75625)
range across 2 matching MRF lines		 $10,139 $249–$17,148 3.1×
Contrast X-Ray Bladder (74430)
range across 3 matching MRF lines		 $92–$882 $154–$1,624 varies
Contrast X-Ray Of Elbow (73085) $882 $1,470 2.4×
Contrast X-Ray Of Knee Joint (73580)
range across 3 matching MRF lines		 $102–$1,323 $170–$2,375 varies
Corpora cavernosography (74445) $128 $213 1.2×
CT abdomen and pelvis without and with contrast (74178)
range across 2 matching MRF lines		 $211–$3,351 $352–$5,937 varies
CT abdomen and pelvis without contrast (74176)
range across 2 matching MRF lines		 $183–$2,750 $305–$4,888 varies
CT abdomen w contrast (74160)
range across 2 matching MRF lines		 $134–$1,618 $223–$2,919 varies
CT abdomen w wo contrast (74170)
range across 2 matching MRF lines		 $146–$2,144 $244–$3,817 varies
CT abdomen w/o contrast (74150)
range across 2 matching MRF lines		 $125–$1,378 $208–$2,504 varies
CT Angio Abdomen and Pelvis (74174)
range across 2 matching MRF lines		 $232–$3,478 $386–$6,183 varies
CT Angio Chest (71275)
range across 2 matching MRF lines		 $192–$1,681 $320–$3,122 varies
CT Angio Head (70496)
range across 2 matching MRF lines		 $184–$1,825 $306–$3,347 varies
CT angio hrt w/3d image (75574)
range across 2 matching MRF lines		 $252–$3,351 $420–$6,005 varies
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 3 matching MRF lines		 $298–$2,426 $497–$4,541 varies
CT Angio Neck (70498)
range across 2 matching MRF lines		 $184–$1,897 $306–$3,468 varies
Ct Angio Upr Extrm W/O&W/Dye (73206)
range across 2 matching MRF lines		 $189–$1,618 $315–$3,011 varies
CT bone density (77078)
range across 2 matching MRF lines		 $26–$1,003 $44–$1,715 varies
CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473)
range across 2 matching MRF lines		 $62–$1,631 $104–$2,823 varies
CT cervical spine w/ contrast (72126)
range across 2 matching MRF lines		 $128–$3,351 $213–$5,798 varies
CT cervical spine w/o contrast (72125)
range across 2 matching MRF lines		 $104–$1,274 $174–$2,298 varies
CT cervical spine w/wo cont (72127)
range across 2 matching MRF lines		 $133–$1,618 $222–$2,918 varies
CT chest w contrast (71260)
range across 2 matching MRF lines		 $122–$1,618 $204–$2,900 varies
CT chest w/wo contrast (71270)
range across 2 matching MRF lines		 $131–$1,711 $219–$3,070 varies
CT colonography screening (74263) $2,877 $4,795 11.6×
CT colonogrphy dx image postprocess w/o contrast (74261)
range across 2 matching MRF lines		 $254–$1,837 $423–$3,484 varies
CT head/brain with contrast (70460)
range across 2 matching MRF lines		 $119–$1,618 $198–$2,894 varies
CT head/brain without and with contrast (70470)
range across 2 matching MRF lines		 $134–$1,618 $223–$2,919 varies
CT heart contrast eval cardiac structure&morph (75572)
range across 2 matching MRF lines		 $182–$3,351 $304–$5,889 varies
CT heart no contrast quant eval coronry calcium (75571)
range across 2 matching MRF lines		 $61–$1,003 $102–$1,773 varies
CT hrt w/3d image congen (75573)
range across 2 matching MRF lines		 $268–$3,351 $447–$6,032 varies
CT iac w contrast (70481)
range across 2 matching MRF lines		 $119–$1,618 $198–$2,894 varies
CT l-spine w&w/o contrast (72133)
range across 2 matching MRF lines		 $133–$1,618 $222–$2,918 varies
CT lower ext w/o (73700)
range across 3 matching MRF lines		 $157–$1,818 $261–$3,291 varies
CT lower extremity w/contrast material (73701)
range across 3 matching MRF lines		 $183–$2,426 $305–$4,349 varies
CT lumbar spine w contrast (72132)
range across 2 matching MRF lines		 $128–$3,351 $213–$5,798 varies
CT lumbar spine w/o contrast (72131)
range across 2 matching MRF lines		 $104–$1,375 $174–$2,465 varies
CT maxillofacial w contrast (70487)
range across 2 matching MRF lines		 $119–$1,618 $198–$2,894 varies
CT maxillofacial wo contrast (70486)
range across 2 matching MRF lines		 $91–$1,212 $151–$2,171 varies
CT neck tissue combo (70492)
range across 2 matching MRF lines		 $170–$1,618 $283–$2,979 varies
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,618 $2,696 8.9×
CT orbits w/o contrast (70480)
range across 2 matching MRF lines		 $135–$1,383 $225–$2,530 varies
CT pelvis w&w/o contrast (72194)
range across 2 matching MRF lines		 $128–$1,979 $213–$3,511 varies
CT pelvis w/o contrast (72192)
range across 2 matching MRF lines		 $115–$1,263 $191–$2,296 varies
CT scan of leg combo (73702)
range across 3 matching MRF lines		 $202–$2,426 $337–$4,381 varies
CT scans face/jaw combo (70488)
range across 2 matching MRF lines		 $133–$1,618 $222–$2,918 varies
CT soft tissue neck w contrast (70491)
range across 2 matching MRF lines		 $145–$1,618 $242–$2,938 varies
CT soft tissue neck w/o contrast (70490)
range across 2 matching MRF lines		 $135–$1,212 $225–$2,245 varies
CT thoracic spine w contrast (72129)
range across 2 matching MRF lines		 $128–$1,618 $214–$2,910 varies
CT thoracic spine w/o contrast (72128)
range across 2 matching MRF lines		 $104–$1,358 $174–$2,437 varies
CT thoracic spine w/wo cont (72130) $1,618 $2,696 8.9×
CT thorax w/o contrast (71250)
range across 2 matching MRF lines		 $113–$1,328 $189–$2,402 varies
CT unlisted procedure (76497)
range across 2 matching MRF lines		 $28–$1,003 $47–$1,718 varies
CT upper ext wo (73200)
range across 3 matching MRF lines		 $157–$1,818 $261–$3,291 varies
CT upper extremity w/o & w/contrast material (73202)
range across 3 matching MRF lines		 $191–$2,426 $318–$4,362 varies
CT upper extremity with contrast (73201)
range across 3 matching MRF lines		 $183–$5,027 $305–$8,683 varies
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635)
range across 2 matching MRF lines		 $250–$2,220 $416–$4,116 varies
Cta Abdomen (74175)
range across 2 matching MRF lines		 $191–$1,929 $319–$3,534 varies
CTA head&neck c+ w/noncontrast img&post-pxessing (70471)
range across 2 matching MRF lines		 $156–$3,345 $260–$5,835 varies
CTA pelvis (72191)
range across 2 matching MRF lines		 $189–$1,618 $315–$3,011 varies
Dilation ureters/urethra rs&i (74485)
range across 2 matching MRF lines		 $5,683 $144–$9,615 2.6×
Discography Cerv/Thor Spine (72285)
range across 2 matching MRF lines		 $124–$5,768 $207–$9,820 varies
Diskography lumbar (72295)
range across 2 matching MRF lines		 $248–$5,768 $413–$10,026 varies
Dxa Bone Density Axial (77080)
range across 2 matching MRF lines		 $21–$347 $35–$613 varies
Dxa bone density study (77085) $319 $532 2.9×
Dxa bone density study 1/>sites appendiclr skel (77081)
range across 2 matching MRF lines		 $21–$264 $35–$475 varies
Echograp Trans R Pros Study (76873)
range across 2 matching MRF lines		 $392–$542 $653–$1,557 varies
Esophagram (74220)
range across 2 matching MRF lines		 $64–$426 $106–$816 varies
Fetal Biophys Profile W/Nst (76818)
range across 2 matching MRF lines		 $110–$510 $184–$1,034 varies
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 2 matching MRF lines		 $80–$510 $134–$984 varies
Fluoroscopy up to 1 hr (76000)
range across 4 matching MRF lines		 $97–$724 $161–$1,367 varies
Follow-Up Angiography (75898)
range across 2 matching MRF lines		 $202–$7,799 $337–$13,336 varies
Foot 2 views (73620)
range across 5 matching MRF lines		 $64–$396 $106–$819 varies
Forearm 2 views (73090)
range across 4 matching MRF lines		 $65–$396 $109–$824 varies
Gastric emptying imaging study (78264)
range across 2 matching MRF lines		 $82–$1,220 $137–$2,171 varies
Gastroesophageal Reflux Exam (78262) $1,082 $1,803 2.6×
Gated Heart Planar Single (78472)
range across 2 matching MRF lines		 $463–$1,082 $771–$2,574 varies
Hand 2 views (73120)
range across 5 matching MRF lines		 $70–$478 $117–$973 varies
Hepatobil Syst Image W/Drug (78227)
range across 2 matching MRF lines		 $94–$1,337 $156–$2,384 varies
Hepatobiliary System Imaging (78226)
range across 2 matching MRF lines		 $77–$1,503 $128–$2,633 varies
Ht Muscle Image Spect Sing (78451)
range across 2 matching MRF lines		 $141–$3,242 $235–$5,638 varies
Hysterosalpingogram (74740)
range across 2 matching MRF lines		 $40–$724 $67–$1,273 varies
Infant hip ultrasound with hip movement (dynamic) (76885)
range across 2 matching MRF lines		 $79–$500 $131–$965 varies
Interstitial radiation source applic complex (77778)
range across 3 matching MRF lines		 $1,042–$2,185 $1,737–$5,378 varies
K Flow/Funct Image Multiple (78709)
range across 3 matching MRF lines		 $143–$1,342 $239–$2,475 varies
K Flow/Funct Image W/Drug (78708)
range across 2 matching MRF lines		 $124–$1,337 $207–$2,435 varies
K Flow/Funct Image W/O Drug (78707)
range across 2 matching MRF lines		 $98–$1,337 $163–$2,391 varies
Kidney Imaging Morphol (78700) $1,082 $1,803 2.6×
Knee 3 Views (73562)
range across 4 matching MRF lines		 $91–$396 $152–$888 varies
Liver & Spleen Imaging Static Only (78215) $1,082 $1,803 2.6×
Lung Perf&Ventilat Diferentl (78598)
range across 2 matching MRF lines		 $85–$1,337 $142–$2,370 varies
Lung perfusion differential (78597)
range across 2 matching MRF lines		 $75–$1,082 $125–$1,928 varies
Lung Ventilat&Perfus Imaging (78582)
range across 2 matching MRF lines		 $110–$1,447 $183–$2,594 varies
Lung Ventilation Imaging (78579)
range across 2 matching MRF lines		 $50–$1,082 $83–$1,886 varies
Lymph System Imaging (78195)
range across 2 matching MRF lines		 $122–$1,337 $204–$2,432 varies
Lymphangiography extremity only unilateral rs&i (75801)
range across 2 matching MRF lines		 $1,012–$1,791 $1,687–$4,672 varies
Magnetic Image Jaw Joint (70336)
range across 6 matching MRF lines		 $29–$2,171 $258–$3,876 varies
Mammary ductogram or galactogram single (77053) $724 $1,206 2.9×
Meckels Divert Exam (78290) $1,082 $1,803 2.6×
Mlc imrt design & construction per imrt plan (77338)
range across 2 matching MRF lines		 $509–$1,862 $848–$3,951 varies
Mra Head W/O & W/Contrast Material (70546)
range across 2 matching MRF lines		 $155–$2,966 $259–$5,203 varies
MRA head w/o contrast (70544)
range across 3 matching MRF lines		 $125–$2,171 $209–$3,827 varies
MRA head with contrast (70545) $2,645 $4,409 7.3×
MRA neck w contrast (70548)
range across 2 matching MRF lines		 $158–$2,645 $263–$4,672 varies
Mra Neck W/O &W/Contrast Material (70549)
range across 2 matching MRF lines		 $189–$2,666 $315–$4,759 varies
MRA neck w/o contrast (70547)
range across 2 matching MRF lines		 $126–$2,171 $210–$3,828 varies
MRI abdomen w contrast (74182)
range across 2 matching MRF lines		 $182–$2,645 $303–$4,712 varies
MRI abdomen w/o contrast (74181)
range across 2 matching MRF lines		 $153–$2,171 $255–$3,873 varies
MRI any jt lower extrem w/contrast material (73722)
range across 3 matching MRF lines		 $257–$9,020 $428–$15,461 varies
MRI any jt lower extrem w/o & w/contrast matrl (73723)
range across 4 matching MRF lines		 $342–$3,968 $570–$7,184 varies
MRI any jt upper extremity w/contrast matrl (73222)
range across 3 matching MRF lines		 $257–$9,020 $428–$15,461 varies
MRI Breast W/O Contrast Bilateral (77047)
range across 2 matching MRF lines		 $168–$2,171 $280–$3,898 varies
MRI Breast Without Contrast Material Unilateral (77046)
range across 2 matching MRF lines		 $152–$2,171 $253–$3,871 varies
MRI cervical spine w contrast (72142)
range across 2 matching MRF lines		 $190–$2,645 $316–$4,725 varies
MRI cervical spine w/o cont (72141)
range across 2 matching MRF lines		 $156–$2,171 $260–$3,878 varies
MRI chest w/o contrast (71550)
range across 2 matching MRF lines		 $154–$2,171 $257–$3,875 varies
MRI chest with contrast (71551)
range across 2 matching MRF lines		 $182–$6,013 $303–$10,325 varies
MRI chest wo w contrast (71552)
range across 2 matching MRF lines		 $239–$2,645 $399–$4,808 varies
MRI lower extrem oth/thn jt w/contrast matrl (73719)
range across 3 matching MRF lines		 $269–$3,968 $448–$7,062 varies
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 3 matching MRF lines		 $342–$3,968 $570–$7,184 varies
MRI lower extrem oth/thn jt w/o contr matrl (73718)
range across 4 matching MRF lines		 $506–$3,256 $843–$6,692 varies
MRI lumbar spine w contrast (72149) $2,645 $4,409 7.3×
Mri Neck Spine W/O & W/Dye (72156)
range across 2 matching MRF lines		 $243–$2,645 $405–$4,814 varies
MRI orbit face &/neck w/o contrast (70540)
range across 2 matching MRF lines		 $141–$2,171 $235–$3,853 varies
MRI orbit face neck w contrast (70542) $2,645 $4,409 7.3×
Mri Orbt/Fac/Nck W/O &W/Dye (70543)
range across 2 matching MRF lines		 $227–$2,803 $379–$5,051 varies
MRI pelvis w contrast (72196) $2,645 $4,409 7.3×
MRI pelvis w/o & w contrast (72197)
range across 3 matching MRF lines		 $232–$2,645 $387–$4,796 varies
MRI pelvis w/o contrast (72195)
range across 3 matching MRF lines		 $154–$2,171 $257–$3,875 varies
MRI thoracic spine w/o contrast (72146)
range across 2 matching MRF lines		 $156–$2,171 $260–$3,878 varies
MRI upper extremity oth than jt w/contr matrl (73219)
range across 4 matching MRF lines		 $749–$3,968 $1,249–$8,488 varies
MRI upper extremity oth than jt w/o contr matrl (73218)
range across 4 matching MRF lines		 $685–$3,256 $1,141–$7,138 varies
Mri Uppr Extremity W/O&W/Dye (73220)
range across 3 matching MRF lines		 $342–$3,968 $570–$7,184 varies
MRI, abdomen, combo (74183)
range across 3 matching MRF lines		 $232–$2,645 $387–$4,796 varies
MRI, dorsal spine combo (72157)
range across 2 matching MRF lines		 $243–$2,663 $405–$4,843 varies
MRI, dorsal spine contrast (72147)
range across 2 matching MRF lines		 $188–$2,645 $313–$4,722 varies
MRI, joint upper extrem (73221)
range across 4 matching MRF lines		 $463–$3,256 $772–$6,585 varies
MRI, joint upper extrem combo (73223)
range across 3 matching MRF lines		 $342–$3,968 $570–$7,184 varies
MRI, lumbar spine combo (72158)
range across 2 matching MRF lines		 $243–$2,659 $405–$4,836 varies
Myelogram cervical (72240) $2,005 $3,341 2.5×
Myelogram Lumbar (72265) $2,005 $3,341 2.5×
Myelography thoracic (72255) $2,005 $3,341 2.5×
Myelograpy 2/more regions rs&i (72270) $2,005 $3,341 2.5×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $3,242 $5,403 2.4×
Myocardial Spect Multiple Studies (78452)
range across 2 matching MRF lines		 $167–$3,242 $278–$5,681 varies
Neck soft tissue (70360)
range across 2 matching MRF lines		 $19–$264 $32–$472 varies
Nm red cell survival study (78130) $319 $532 0.8×
Nm whole blood volume (78122) $525 $875 0.9×
Nonvascular Shunt X-Ray (75809)
range across 4 matching MRF lines		 $160–$319 $303–$835 varies
Ntsty modul radthx pln dose-vol histos (77301)
range across 2 matching MRF lines		 $950–$6,938 $1,583–$13,147 varies
Nuclear Rx Oral Admin (79005)
range across 2 matching MRF lines		 $186–$1,068 $310–$2,090 varies
Oph bmtry us echograpy a-scan io lens pwr cal (76519)
range across 2 matching MRF lines		 $67–$510 $112–$962 varies
Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510)
range across 3 matching MRF lines		 $136–$926 $226–$1,770 varies
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512)
range across 3 matching MRF lines		 $106–$766 $177–$1,453 varies
Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514)
range across 2 matching MRF lines		 $17–$118 $29–$225 varies
Ophthalmic us dx quantitative a-scan only (76511)
range across 3 matching MRF lines		 $123–$766 $205–$1,481 varies
Parathyroid imaging w/tomographic spect & CT (78072) $808 $1,347 1.4×
Parathyroid Planar Imaging (78070)
range across 2 matching MRF lines		 $83–$1,157 $139–$2,068 varies
Pelvis 1 or 2 views (72170)
range across 2 matching MRF lines		 $63–$319 $105–$637 varies
Peritoneogram Rs&I (74190) $1,637 $2,729 2.9×
Pet Image W/Ct Lmtd (78814)
range across 2 matching MRF lines		 $225–$6,164 $375–$10,649 varies
PET image w/CT, full body (78816)
range across 2 matching MRF lines		 $253–$6,562 $422–$11,358 varies
PET imaging CT attenuation skull base mid-thigh (78815)
range across 2 matching MRF lines		 $252–$6,164 $420–$10,694 varies
Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110)
range across 2 matching MRF lines		 $224–$295 $373–$492 varies
Pulmonary Perfusion Imaging Particulate (78580)
range across 2 matching MRF lines		 $77–$1,082 $128–$1,931 varies
Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577)
range across 2 matching MRF lines		 $55–$10,836 $91–$18,151 varies
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022)
range across 2 matching MRF lines		 $34–$320 $57–$591 varies
Radex abscess/fistula/sinus tract rs&i (76080)
range across 2 matching MRF lines		 $55–$1,637 $92–$2,821 varies
Radex Ankle Complete Minimum 3 Views (73610)
range across 4 matching MRF lines		 $82–$396 $136–$864 varies
Radex Calcaneus Minimum 2 Views (73650)
range across 4 matching MRF lines		 $64–$396 $106–$819 varies
Radex elbow complete minimum 3 views (73080)
range across 4 matching MRF lines		 $73–$396 $122–$843 varies
Radex Facial Bones Complete Minimum 3 Views (70150)
range across 2 matching MRF lines		 $28–$351 $46–$631 varies
Radex fingr minimum 2 views (73140)
range across 4 matching MRF lines		 $86–$396 $143–$875 varies
Radex foot complete minimum 3 views (73630)
range across 6 matching MRF lines		 $76–$396 $127–$851 varies
Radex Hand Minimum 3 Views (73130)
range across 5 matching MRF lines		 $83–$396 $139–$869 varies
Radex lower extremity infant minimum 2 views (73592)
range across 4 matching MRF lines		 $70–$396 $117–$836 varies
Radex Nasal Bones Complete Minimum 3 Views (70160)
range across 2 matching MRF lines		 $85–$264 $141–$581 varies
Radex Ribs Unilateral 2 Views (71100)
range across 2 matching MRF lines		 $82–$264 $137–$577 varies
Radex shoulder complete minimum 2 views (73030)
range across 4 matching MRF lines		 $77–$396 $129–$854 varies
Radex Sinuses Paransl < 3 Views (70210)
range across 2 matching MRF lines		 $73–$264 $121–$561 varies
Radex Spine 1 View Specify Level (72020)
range across 3 matching MRF lines		 $55–$264 $91–$531 varies
Radex Sternum Minimum 2 Views (71120)
range across 2 matching MRF lines		 $75–$264 $125–$565 varies
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $264 $440 2.9×
Radex Toe Minimum 2 Views (73660)
range across 4 matching MRF lines		 $65–$396 $109–$823 varies
Radex upper extremity infant minimum 2 views (73092)
range across 3 matching MRF lines		 $26–$479 $44–$842 varies
Radex Wrist Complete Minimum 3 Views (73110)
range across 4 matching MRF lines		 $93–$396 $155–$892 varies
Radiation Delivery Stereotactic Cranial Linear (77372) $38,757 $64,595 5.1×
Radiation treatment delivery level 1 (77402) $532 $886 5.0×
Radiation treatment delivery level 2 (77407) $2,009 $3,349 5.0×
Radiation treatment delivery level 3 (77412) $2,879 $4,798 5.0×
Radiolog exam mandible compl minimum 4 views (70110)
range across 2 matching MRF lines		 $98–$319 $163–$695 varies
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021)
range across 2 matching MRF lines		 $95–$319 $159–$691 varies
Radiologic exam colon double contrast study (74280) $426 $710 2.3×
Radiologic exam colon single contrast study (74270)
range across 2 matching MRF lines		 $109–$426 $181–$891 varies
Radiologic Exam Esophagus Double Contrast Study (74221)
range across 2 matching MRF lines		 $74–$426 $123–$833 varies
Radiologic exam knee complete 4/more views (73564)
range across 4 matching MRF lines		 $106–$479 $177–$1,064 varies
Radiologic exam pelvis compl minimum 3 views (72190)
range across 2 matching MRF lines		 $94–$319 $157–$689 varies
Radiologic Exam Small Int Single Contrast Study (74250)
range across 2 matching MRF lines		 $85–$447 $142–$887 varies
Radiologic exam swallow function contrast study (74230)
range across 2 matching MRF lines		 $56–$426 $93–$803 varies
Radiologic exam upr gi trc double contrast study (74246)
range across 2 matching MRF lines		 $94–$426 $157–$867 varies
Radiologic examination femur 1 view (73551)
range across 4 matching MRF lines		 $67–$396 $111–$826 varies
Radiologic examination femur minimum 2 views (73552)
range across 4 matching MRF lines		 $80–$450 $133–$950 varies
Radiologic examination knee 1/2 views (73560)
range across 5 matching MRF lines		 $76–$396 $127–$851 varies
Radiologic Examination Osseous Survey Limited (77074) $319 $532 2.9×
Radiologic examination tibia & fibula 2 views (73590)
range across 4 matching MRF lines		 $71–$396 $118–$837 varies
Red Cell Volume Determination Spx 1 Sampling (78120)
range across 2 matching MRF lines		 $52–$377 $87–$629 varies
Red Cell Volume Determination Spx Mult Samplings (78121) $113 $189 0.2×
Ribs bilateral 3 views (71110)
range across 2 matching MRF lines		 $31–$319 $51–$583 varies
Rp loclzj tum plnr 1 area single day imaging (78800)
range across 2 matching MRF lines		 $68–$1,082 $113–$1,916 varies
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,082 $1,803 2.6×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $3,242 $5,403 5.8×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $3,242 $5,403 5.8×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 2 matching MRF lines		 $110–$3,242 $184–$5,587 varies
Rp loclzj tum spect 2 area/sep acquisj img (78831) $3,242 $5,403 2.4×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $4,046 $6,743 2.7×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $3,242 $5,403 2.4×
Rp Therapy Intravenous Administration (79101)
range across 2 matching MRF lines		 $205–$697 $342–$1,504 varies
Scapula (73010)
range across 4 matching MRF lines		 $54–$479 $90–$933 varies
Screening Digital Breast Tomosynthesis Bi (77063)
range across 2 matching MRF lines		 $64–$175 $106–$398 varies
Shoulder 1 view (73020)
range across 4 matching MRF lines		 $49–$396 $81–$781 varies
Shoulder Arthrography (73040)
range across 3 matching MRF lines		 $90–$1,323 $150–$2,355 varies
Sialogram (70390) $724 $1,206 2.9×
Skull less than 4 views (70250)
range across 3 matching MRF lines		 $80–$319 $134–$666 varies
Special dosimetry (77331) $677 $1,128 4.9×
Special Physics Consult (77370)
range across 2 matching MRF lines		 $305–$677 $509–$1,637 varies
Stereotactic Body Radiation Delivery (77373) $8,955 $14,925 4.8×
Sternoclavicular joints (71130)
range across 4 matching MRF lines		 $92–$395 $153–$889 varies
Telethx isodose pln cplx w/basic dosimetry (77307)
range across 2 matching MRF lines		 $345–$1,862 $575–$3,678 varies
Telethx isodose pln smpl w/dosimetry calculation (77306)
range across 2 matching MRF lines		 $166–$1,862 $276–$3,379 varies
Temporomandble Jt Arthrography Rs&I (70332) $336 $560 1.4×
Ther Rad Simulaj-Aided Field Setting Complex (77290)
range across 2 matching MRF lines		 $185–$1,862 $309–$3,412 varies
Ther Rad Simulaj-Aided Field Setting Intermed (77285)
range across 2 matching MRF lines		 $127–$1,862 $212–$3,315 varies
Ther rad simulaj-aided field setting simple (77280)
range across 2 matching MRF lines		 $85–$677 $141–$1,269 varies
Thoracic spine 2 views (72070)
range across 2 matching MRF lines		 $74–$319 $123–$655 varies
Thoracic spine 3 views (72072)
range across 2 matching MRF lines		 $24–$319 $40–$572 varies
Thoracolumbar 2 views (72080)
range across 2 matching MRF lines		 $78–$264 $130–$570 varies
Thyroid Imaging With Vascular Flow (78013) $1,082 $1,803 2.6×
Thyroid Met Imaging Body (78018)
range across 4 matching MRF lines		 $86–$1,337 $143–$2,371 varies
Thyroid Uptake Measurement (78012)
range across 2 matching MRF lines		 $1,082 $32–$1,835 2.6×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014)
range across 2 matching MRF lines		 $52–$1,082 $86–$1,889 varies
Tx Devices Design & Construction Complex (77334)
range across 2 matching MRF lines		 $136–$1,862 $227–$3,330 varies
Tx devices design & construction intermediate (77333)
range across 2 matching MRF lines		 $89–$677 $149–$1,277 varies
Tx devices design & construction simple (77332)
range across 2 matching MRF lines		 $54–$677 $90–$1,218 varies
Ultrasound Breast Limited (76642)
range across 4 matching MRF lines		 $190–$633 $316–$1,529 varies
Ultrasound elastography first target lesion (76982) $510 $850 4.7×
Ultrasound Elastography Parenchyma (76981)
range across 2 matching MRF lines		 $64–$510 $106–$956 varies
Ultrasound Exam Aaa Screen (76706)
range across 2 matching MRF lines		 $239–$510 $399–$1,249 varies
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines		 $194–$510 $324–$1,174 varies
Unlisted us procedure (76999)
range across 2 matching MRF lines		 $123–$422 $205–$908 varies
Upper gi w/o kub (74240) $459 $765 2.5×
Urethrocystogram voiding (74455)
range across 2 matching MRF lines		 $34–$724 $57–$1,263 varies
Urethrocystography retrograde (74450)
range across 2 matching MRF lines		 $34–$724 $57–$1,263 varies
Us breast unilateral complete (76641)
range across 2 matching MRF lines		 $229–$510 $381–$1,231 varies
Us chest (76604)
range across 2 matching MRF lines		 $130–$510 $217–$1,067 varies
Us complete joint (76881)
range across 2 matching MRF lines		 $95–$510 $159–$1,009 varies
Us exam, pelvic, limited (76857)
range across 2 matching MRF lines		 $52–$510 $87–$937 varies
Us head (76506)
range across 2 matching MRF lines		 $67–$510 $112–$962 varies
Us kidney transplant (76776)
range across 2 matching MRF lines		 $80–$510 $133–$983 varies
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 3 matching MRF lines		 $73–$510 $122–$972 varies
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines		 $181–$510 $301–$1,151 varies
Us ob transvaginal (76817)
range across 2 matching MRF lines		 $79–$510 $132–$982 varies
Us pelvic non ob complete (76856)
range across 2 matching MRF lines		 $73–$510 $121–$971 varies
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801)
range across 2 matching MRF lines		 $104–$510 $174–$1,024 varies
Us preg uterus real time f/u trnsabdl per fetus (76816)
range across 2 matching MRF lines		 $89–$510 $149–$999 varies
Us retroperitoneal complete (76770)
range across 2 matching MRF lines		 $241–$510 $402–$1,252 varies
Us retroperitoneal limited (76775)
range across 2 matching MRF lines		 $136–$510 $227–$1,077 varies
Us scrotum and contents (76870)
range across 2 matching MRF lines		 $223–$510 $372–$1,222 varies
Us spinal canal and contents (76800)
range across 2 matching MRF lines		 $138–$510 $230–$1,080 varies
Us thyroid (76536)
range across 2 matching MRF lines		 $60–$510 $100–$950 varies
Us transrectal (76872)
range across 3 matching MRF lines		 $317–$510 $528–$1,378 varies
Vein X-Ray Chest (75827) $3,796 $6,326 2.3×
Venography caval inferior serialography rs&i (75825)
range across 2 matching MRF lines		 $7,799 $198–$13,197 2.4×
Venography extremity bilateral rs&i (75822)
range across 2 matching MRF lines		 $298–$4,934 $496–$8,719 varies
Venography extremity unilateral rs&i (75820)
range across 2 matching MRF lines		 $107–$4,934 $179–$8,402 varies
Venography Renal Bilateral (75833)
range across 2 matching MRF lines		 $7,799 $257–$13,256 2.4×
Venography Renal Unilateral (75831)
range across 2 matching MRF lines		 $7,799 $189–$13,188 2.4×
Wrist 2 views (73100)
range across 4 matching MRF lines		 $76–$396 $126–$849 varies
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050)
range across 2 matching MRF lines		 $65–$264 $108–$548 varies
X-ray antegrade pyelogram tube (74425)
range across 2 matching MRF lines		 $54–$882 $90–$1,560 varies
X-Ray Aorta Leg Arteries (75630)
range across 2 matching MRF lines		 $207–$10,139 $345–$17,244 varies
X-Ray Bend Only L-S Spine (72120)
range across 2 matching MRF lines		 $91–$328 $152–$698 varies
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 4 matching MRF lines		 $65–$396 $109–$824 varies
X-Ray Exam Breast Specimen (76098)
range across 3 matching MRF lines		 $97–$1,637 $161–$2,890 varies
X-Ray Exam Entire Spi 1 Vw (72081)
range across 2 matching MRF lines		 $28–$264 $46–$486 varies
X-Ray Exam Entire Spi 2/3 Vw (72082)
range across 2 matching MRF lines		 $34–$319 $56–$588 varies
X-Ray Exam Entire Spi 4/5 Vw (72083)
range across 2 matching MRF lines		 $38–$512 $64–$917 varies
X-Ray Exam Hip Uni 1 View (73501)
range across 3 matching MRF lines		 $75–$264 $125–$565 varies
X-Ray Exam Hip Uni 2-3 Views (73502)
range across 6 matching MRF lines		 $107–$396 $178–$927 varies
X-Ray Exam Hip Uni 4/> Views (73503)
range across 5 matching MRF lines		 $45–$479 $75–$873 varies
X-Ray Exam Hips Bi 2 Views (73521)
range across 3 matching MRF lines		 $92–$319 $154–$686 varies
X-Ray Exam Hips Bi 3-4 Views (73522)
range across 3 matching MRF lines		 $121–$319 $202–$734 varies
X-Ray Exam Hips Bi 5/> Views (73523)
range across 2 matching MRF lines		 $139–$553 $232–$1,153 varies
X-Ray Exam L-S Spine Bending (72114)
range across 2 matching MRF lines		 $33–$452 $55–$809 varies
X-Ray Exam Neck Spine 2-3 Vw (72040)
range across 2 matching MRF lines		 $89–$264 $148–$588 varies
X-Ray Exam Neck Spine 6/>Vws (72052)
range across 2 matching MRF lines		 $139–$484 $232–$1,039 varies
X-Ray Exam Unilat Ribs/Chest (71101)
range across 3 matching MRF lines		 $28–$2,955 $47–$4,972 varies
X-ray eye for foreign body (70030)
range across 2 matching MRF lines		 $74–$264 $123–$563 varies
X-ray head for orthodontia (70350)
range across 2 matching MRF lines		 $39–$264 $65–$505 varies
X-ray humerus (73060)
range across 4 matching MRF lines		 $71–$396 $119–$839 varies
X-ray IV pyelogram (ivp) (74400) $426 $710 2.3×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565)
range across 2 matching MRF lines		 $89–$264 $149–$589 varies
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100)
range across 2 matching MRF lines		 $89–$319 $148–$680 varies
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111)
range across 2 matching MRF lines		 $118–$319 $196–$728 varies
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202)
range across 2 matching MRF lines		 $24–$319 $40–$572 varies
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200)
range across 2 matching MRF lines		 $19–$319 $31–$563 varies
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220)
range across 2 matching MRF lines		 $73–$264 $122–$562 varies
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220)
range across 2 matching MRF lines		 $23–$305 $39–$548 varies
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260)
range across 2 matching MRF lines		 $100–$319 $167–$699 varies
X-Ray Tmj Unilat (70328)
range across 2 matching MRF lines		 $19–$264 $32–$472 varies
X-Ray Urinary Tract Exam With Contrast Material (74420)
range across 2 matching MRF lines		 $175–$882 $291–$1,761 varies
X-Rays Bone Length Studies (77073)
range across 2 matching MRF lines		 $101–$319 $169–$701 varies
X-Rays Bone Survey Complete (77075)
range across 2 matching MRF lines		 $58–$554 $97–$1,021 varies
Xr c-spine 4 or 5 views (72050)
range across 2 matching MRF lines		 $121–$325 $202–$744 varies
Xr facial bones less than 3 views (70140)
range across 2 matching MRF lines		 $22–$264 $36–$476 varies
Xr orbits complete 4 views (70200)
range across 2 matching MRF lines		 $107–$319 $178–$710 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.