Imaging prices at Hillcrest Hospital South
Tulsa, OK · every code in this section with a posted price and a Medicare benchmark.
291 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) | $203.70 | $679 | 2.4× |
| Abdomen 2 views (74019) | $257.10 | $857 | 2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $564.90 | $1,883 | 1.5× |
| Adrenal Cortex & Medulla Img (78075) | $1,504.50 | $5,015 | 1.2× |
| Angio internal mammary (75756) | $1,270.80 | $4,236 | 0.4× |
| Angio pulmonary bilat (75743) | $2,416.50 | $8,055 | 0.8× |
| Angiography extremity bilateral rs&i (75716) | $1,184.40 | $3,948 | 0.4× |
| Angiography extremity unilateral rs&i (75710) | $1,176.30 | $3,921 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,111.80 | $3,706 | 0.4× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$232.80–$349.20 | $776–$1,164 | varies |
| Aortography thoracic serialography rs&i (75605) | $5,116.50 | $17,055 | 1.0× |
| Artery X-Rays Abdomen (75726) | $5,058.90 | $16,863 | 0.9× |
| Artery X-Rays Pelvis (75736) | $4,698.60 | $15,662 | 0.9× |
| Arthrogram hip (73525) | $403.50 | $1,345 | 1.2× |
| Arthrogram Wrist (73115) | $425.10 | $1,417 | 1.3× |
| Bone age studies (77072) | $230.10 | $767 | 2.3× |
| Bone Imaging 3 Phase (78315) | $1,019.40 | $3,398 | 2.7× |
| Bone Imaging Limited Area (78300) | $454.50 | $1,515 | 1.2× |
| Bone Imaging Multiple Areas (78305) | $574.20 | $1,914 | 1.5× |
| Bone Imaging Whole Body (78306) | $693.90 | $2,313 | 1.8× |
| Bone survey infant (77076) | $213.30 | $711 | 2.1× |
| Brain Flow Imaging Only (78610) | $781.80 | $2,606 | 1.5× |
| Brain Image W/Flow < 4 Views (78601) | $407.70 | $1,359 | 1.1× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $407.70 | $1,359 | 1.1× |
| Cat Scan Follow-Up Study (76380) | $83.40 | $278 | 1.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $565.80 | $1,886 | 1.1× |
| Cerebrospinal Fluid Scan (78630) | $537.30 | $1,791 | 1.0× |
| Chest 1 view (71045) | $204.60 | $682 | 2.4× |
| Chest 2 views (71046) | $225 | $750 | 2.7× |
| Chest 3 views (71047) | $236.10 | $787 | 2.8× |
| Chest 4 or more views (71048) | $247.50 | $825 | 2.5× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$242.70–$364.05 | $809–$1,213.50 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $878.10 | $2,927 | 8.7× |
| Contrast Exam Abdominl Aorta (75625) | $1,249.20 | $4,164 | 0.4× |
| Contrast X-Ray Bladder (74430) | $510 | $1,700 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) | $2,695.80 | $8,986 | 8.0× |
| CT abdomen and pelvis without contrast (74176) | $1,969.80 | $6,566 | 8.6× |
| CT abdomen w contrast (74160) | $1,081.20 | $3,604 | 6.4× |
| CT abdomen w wo contrast (74170) | $1,424.70 | $4,749 | 8.4× |
| CT abdomen w/o contrast (74150) | $979.20 | $3,264 | 9.7× |
| CT Angio Abdomen and Pelvis (74174) | $2,172.90 | $7,243 | 6.5× |
| CT Angio Chest (71275) | $1,581.60 | $5,272 | 9.4× |
| CT Angio Head (70496) | $1,210.50 | $4,035 | 7.2× |
| CT angio hrt w/3d image (75574) | $1,191.90 | $3,973 | 3.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,685.70–$2,528.55 | $5,619–$8,428.50 | varies |
| CT Angio Neck (70498) | $1,243.80 | $4,146 | 7.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,329.30 | $4,431 | 7.9× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $161.40 | $538 | 1.0× |
| CT cervical spine w/ contrast (72126) | $868.20 | $2,894 | 2.6× |
| CT cervical spine w/o contrast (72125) | $1,096.50 | $3,655 | 10.9× |
| CT cervical spine w/wo cont (72127) | $1,529.70 | $5,099 | 9.1× |
| CT chest w contrast (71260) | $1,178.40 | $3,928 | 7.0× |
| CT chest w/wo contrast (71270) | $963 | $3,210 | 5.7× |
| CT head/brain with contrast (70460) | $1,423.20 | $4,744 | 8.4× |
| CT head/brain without and with contrast (70470) | $1,711.80 | $5,706 | 10.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $207.30 | $691 | 0.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $59.40 | $198 | 0.7× |
| CT hrt w/3d image congen (75573) | $338.40 | $1,128 | 1.0× |
| CT iac w contrast (70481) | $1,220.70 | $4,069 | 7.2× |
| CT l-spine w&w/o contrast (72133) | $2,627.40 | $8,758 | 15.6× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$902.40–$1,353.60 | $3,008–$4,512 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,035.30–$1,552.95 | $3,451–$5,176.50 | varies |
| CT lumbar spine w contrast (72132) | $891.30 | $2,971 | 2.7× |
| CT lumbar spine w/o contrast (72131) | $1,115.70 | $3,719 | 11.1× |
| CT maxillofacial w contrast (70487) | $1,125 | $3,750 | 6.7× |
| CT maxillofacial wo contrast (70486) | $989.10 | $3,297 | 9.8× |
| CT neck tissue combo (70492) | $1,165.50 | $3,885 | 6.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,342.50 | $4,475 | 8.0× |
| CT orbits w/o contrast (70480) | $1,109.40 | $3,698 | 11.0× |
| CT pelvis w&w/o contrast (72194) | $1,271.40 | $4,238 | 7.5× |
| CT pelvis w/o contrast (72192) | $743.70 | $2,479 | 7.4× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,089–$1,633.50 | $3,630–$5,445 | varies |
| CT scans face/jaw combo (70488) | $1,182.90 | $3,943 | 7.0× |
| CT soft tissue neck w contrast (70491) | $1,132.20 | $3,774 | 6.7× |
| CT soft tissue neck w/o contrast (70490) | $848.70 | $2,829 | 8.4× |
| CT thoracic spine w contrast (72129) | $920.70 | $3,069 | 5.5× |
| CT thoracic spine w/o contrast (72128) | $1,121.40 | $3,738 | 11.2× |
| CT thoracic spine w/wo cont (72130) | $1,519.80 | $5,066 | 9.0× |
| CT thorax w/o contrast (71250) | $907.20 | $3,024 | 9.0× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$617.40–$926.10 | $2,058–$3,087 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,297.20 | $4,324 | 7.7× |
| CT upper extremity with contrast (73201) | $773.70 | $2,579 | 2.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,370.40 | $4,568 | 8.1× |
| Cta Abdomen (74175) | $1,376.40 | $4,588 | 8.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,400 | $8,000 | 7.2× |
| CTA pelvis (72191) | $1,526.10 | $5,087 | 9.0× |
| Dxa Bone Density Axial (77080) | $198.90 | $663 | 2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $67.20 | $224 | 0.8× |
| Echo exam uterus (76831) | $402.30 | $1,341 | 1.8× |
| Echo Guide For Artery Repair (76936) | $267 | $890 | 1.3× |
| Esophagram (74220) | $330.30 | $1,101 | 2.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,708.50 | $5,695 | 17.0× |
| Fluoroscopy up to 1 hr (76000) | $228.30 | $761 | 1.0× |
| Follow-Up Angiography (75898) | $2,970 | $9,900 | 1.0× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$178.50–$267.75 | $595–$892.50 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$247.80–$371.70 | $826–$1,239 | varies |
| Gastric emptying imaging study (78264) | $843.90 | $2,813 | 2.2× |
| Gated Heart Planar Single (78472) | $753 | $2,510 | 2.0× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$253.80–$380.70 | $846–$1,269 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,023.30 | $3,411 | 2.0× |
| Hepatobiliary System Imaging (78226) | $956.40 | $3,188 | 2.5× |
| Ht Muscle Image Spect Sing (78451) | $1,491.30 | $4,971 | 1.2× |
| Hysterosalpingogram (74740) | $677.40 | $2,258 | 3.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $222.60 | $742 | 2.7× |
| Infant hip ultrasound, limited static exam (76886) | $202.20 | $674 | 2.4× |
| K Flow/Funct Image W/Drug (78708) | $943.20 | $3,144 | 1.8× |
| K Flow/Funct Image W/O Drug (78707) | $836.70 | $2,789 | 1.6× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$280.20–$420.30 | $934–$1,401 | varies |
| Liver & Spleen Imaging Static Only (78215) | $445.80 | $1,486 | 1.2× |
| Lung Perf&Ventilat Diferentl (78598) | $550.80 | $1,836 | 1.1× |
| Lung perfusion differential (78597) | $1,075.50 | $3,585 | 2.8× |
| Lung Ventilat&Perfus Imaging (78582) | $694.80 | $2,316 | 1.3× |
| Lymph System Imaging (78195) | $805.20 | $2,684 | 1.5× |
| Magnetic Image Jaw Joint (70336) | $564.30 | $1,881 | 2.5× |
| Mammary ductogram or galactogram single (77053) | $435 | $1,450 | 1.9× |
| Meckels Divert Exam (78290) | $435.60 | $1,452 | 1.1× |
| Mr safety determination physician/other qhp (76016) | $86.10 | $287 | 1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $24.60 | $82 | 0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $89.70 | $299 | 1.0× |
| Mr safety implt pos&/immoblj (76019) | $58.20 | $194 | 1.0× |
| Mr safety med physics xm customization plng&mntr (76017) | $235.80 | $786 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $1,073.10 | $3,577 | 3.2× |
| MRA head w/o contrast (70544) | $665.10 | $2,217 | 2.9× |
| MRA head with contrast (70545) | $975.60 | $3,252 | 2.9× |
| MRA neck w contrast (70548) | $1,192.50 | $3,975 | 3.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,379.70 | $4,599 | 4.1× |
| MRA neck w/o contrast (70547) | $886.80 | $2,956 | 3.9× |
| MRI abdomen w contrast (74182) | $1,188.60 | $3,962 | 3.5× |
| MRI abdomen w/o contrast (74181) | $1,080.60 | $3,602 | 4.7× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,052.30–$3,078.45 | $6,841–$10,261.50 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,602.30 | $5,341 | 4.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,522.80 | $5,076 | 2.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $239.40 | $798 | 1.0× |
| MRI cervical spine w contrast (72142) | $1,608.60 | $5,362 | 4.8× |
| MRI cervical spine w/o cont (72141) | $1,107.60 | $3,692 | 4.8× |
| MRI chest w/o contrast (71550) | $239.40 | $798 | 1.0× |
| MRI chest wo w contrast (71552) | $1,512 | $5,040 | 4.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,217.10 | $4,057 | 3.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,338.90 | $4,463 | 4.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,106.40–$1,659.60 | $3,688–$5,532 | varies |
| MRI lumbar spine w contrast (72149) | $1,474.50 | $4,915 | 4.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,671.90 | $5,573 | 5.0× |
| MRI orbit face &/neck w/o contrast (70540) | $1,193.40 | $3,978 | 5.2× |
| MRI orbit face neck w contrast (70542) | $1,342.20 | $4,474 | 4.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,899 | $6,330 | 5.7× |
| MRI pelvis w contrast (72196) | $1,173.30 | $3,911 | 3.5× |
| MRI pelvis w/o & w contrast (72197) | $1,233.60 | $4,112 | 3.7× |
| MRI pelvis w/o contrast (72195) | $678.30 | $2,261 | 3.0× |
| MRI thoracic spine w/o contrast (72146) | $1,092.30 | $3,641 | 4.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,233.60 | $4,112 | 3.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,457.70 | $4,859 | 6.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,418.70 | $4,729 | 4.2× |
| MRI, abdomen, combo (74183) | $2,091 | $6,970 | 6.2× |
| MRI, dorsal spine combo (72157) | $1,514.10 | $5,047 | 4.5× |
| MRI, dorsal spine contrast (72147) | $1,096.20 | $3,654 | 3.3× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,115.40–$1,673.10 | $3,718–$5,577 | varies |
| MRI, joint upper extrem combo (73223) | $1,205.10 | $4,017 | 3.6× |
| MRI, lumbar spine combo (72158) | $1,756.50 | $5,855 | 5.2× |
| Myocardial Spect Multiple Studies (78452) | $2,725.50 | $9,085 | 2.2× |
| N-invas est c ffr sw aly CTA (75580) | $1,070.10 | $3,567 | 1.3× |
| Neck soft tissue (70360) | $197.10 | $657 | 2.4× |
| Parathyroid Planar Imaging (78070) | $1,275.90 | $4,253 | 3.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,079.40 | $3,598 | 2.8× |
| Pelvis 1 or 2 views (72170) | $259.50 | $865 | 2.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $546.30 | $1,821 | 1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $452.70 | $1,509 | 4.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $544.20 | $1,814 | 1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$283.20–$424.80 | $944–$1,416 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$228.90–$343.35 | $763–$1,144.50 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$266.10–$399.15 | $887–$1,330.50 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $321.60 | $1,072 | 3.2× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$269.70–$404.55 | $899–$1,348.50 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$288–$432 | $960–$1,440 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$290.10–$435.15 | $967–$1,450.50 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$306–$459 | $1,020–$1,530 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $258.30 | $861 | 3.1× |
| Radex Ribs Unilateral 2 Views (71100) | $294.60 | $982 | 3.5× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$238.20–$357.30 | $794–$1,191 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $221.10 | $737 | 2.6× |
| Radex Spine 1 View Specify Level (72020) | $269.40 | $898 | 3.2× |
| Radex Sternum Minimum 2 Views (71120) | $203.70 | $679 | 2.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $370.50 | $1,235 | 4.4× |
| Radex Toe Minimum 2 Views (73660) | $203.70 | $679 | 2.4× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$306–$459 | $1,020–$1,530 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$278.70–$418.05 | $929–$1,393.50 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $607.50 | $2,025 | 6.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $283.20 | $944 | 2.8× |
| Radiologic exam colon double contrast study (74280) | $726 | $2,420 | 4.3× |
| Radiologic exam colon single contrast study (74270) | $396.90 | $1,323 | 2.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $336.90 | $1,123 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$303.60–$455.40 | $1,012–$1,518 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $372.60 | $1,242 | 3.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $416.40 | $1,388 | 2.5× |
| Radiologic exam swallow function contrast study (74230) | $342.60 | $1,142 | 2.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $464.40 | $1,548 | 2.8× |
| Radiologic examination femur 1 view (73551) | $94.50 | $315 | 1.1× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$267–$400.50 | $890–$1,335 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$245.10–$367.65 | $817–$1,225.50 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$247.80–$371.70 | $826–$1,239 | varies |
| Ribs bilateral 3 views (71110) | $428.40 | $1,428 | 4.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $705.90 | $2,353 | 1.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $824.10 | $2,747 | 2.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,485.60 | $4,952 | 2.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,130.10 | $3,767 | 2.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,633.80 | $5,446 | 3.1× |
| Salivary Gland Function Study (78232) | $407.70 | $1,359 | 1.1× |
| Scapula (73010) | $232.20 | $774 | 2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $27.60 | $92 | 1.2× |
| Shoulder 1 view (73020) | $174 | $580 | 2.1× |
| Shoulder Arthrography (73040) | $426 | $1,420 | 1.3× |
| Skull less than 4 views (70250) | $202.20 | $674 | 2.0× |
| Speech evaluation, complex (70371) | $260.70 | $869 | 1.1× |
| Sternoclavicular joints (71130) | $247.20 | $824 | 3.0× |
| Thoracic spine 2 views (72070) | $277.80 | $926 | 2.8× |
| Thoracic spine 3 views (72072) | $319.20 | $1,064 | 3.2× |
| Thoracolumbar 2 views (72080) | $351.30 | $1,171 | 4.2× |
| Thyroid Uptake Measurement (78012) | $536.10 | $1,787 | 1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $696.60 | $2,322 | 1.8× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$402.30–$603.45 | $1,341–$2,011.50 | varies |
| Ultrasound Elastography Parenchyma (76981) | $298.50 | $995 | 3.0× |
| Ultrasound Exam Aaa Screen (76706) | $149.40 | $498 | 1.5× |
| Ultrasound, abdomen limited (76705) | $368.10 | $1,227 | 3.7× |
| Umbilical-artery Doppler (OB) (76820) | $193.20 | $644 | 1.9× |
| Unlisted fluoroscopic procedure (76496) | $59.70 | $199 | 0.7× |
| Upper gi w/o kub (74240) | $339.60 | $1,132 | 2.0× |
| Urethrocystogram voiding (74455) | $643.50 | $2,145 | 2.8× |
| Urethrocystography retrograde (74450) | $462.60 | $1,542 | 2.0× |
| Us breast unilateral complete (76641) | $463.20 | $1,544 | 4.6× |
| Us chest (76604) | $247.80 | $826 | 2.5× |
| Us complete joint (76881) | $356.10 | $1,187 | 3.5× |
| Us exam, pelvic, limited (76857) | $216 | $720 | 2.1× |
| Us head (76506) | $539.40 | $1,798 | 5.4× |
| Us kidney transplant (76776) | $343.20 | $1,144 | 3.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$249–$373.50 | $830–$1,245 | varies |
| Us ob detailed single fetus (76811) | $131.10 | $437 | 0.6× |
| Us ob limited 1 or more fetuses (76815) | $261.60 | $872 | 2.6× |
| Us ob transvaginal (76817) | $323.10 | $1,077 | 3.2× |
| Us pelvic non ob complete (76856) | $550.50 | $1,835 | 5.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $342.30 | $1,141 | 3.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $351.90 | $1,173 | 3.5× |
| Us retroperitoneal complete (76770) | $461.70 | $1,539 | 4.6× |
| Us retroperitoneal limited (76775) | $339.60 | $1,132 | 3.4× |
| Us scrotum and contents (76870) | $362.70 | $1,209 | 3.6× |
| Us spinal canal and contents (76800) | $290.40 | $968 | 2.9× |
| Us thyroid (76536) | $356.10 | $1,187 | 3.5× |
| Vein X-Ray Chest (75827) | $999.30 | $3,331 | 0.7× |
| Venography caval inferior serialography rs&i (75825) | $1,269 | $4,230 | 0.4× |
| Venography extremity bilateral rs&i (75822) | $781.80 | $2,606 | 0.5× |
| Venography extremity unilateral rs&i (75820) | $436.20 | $1,454 | 0.3× |
| Venography Renal Bilateral (75833) | $1,371.30 | $4,571 | 0.5× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$234.90–$352.35 | $783–$1,174.50 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $247.50 | $825 | 3.0× |
| X-ray antegrade pyelogram tube (74425) | $503.40 | $1,678 | 1.5× |
| X-Ray Aorta Leg Arteries (75630) | $1,378.20 | $4,594 | 0.5× |
| X-Ray Bend Only L-S Spine (72120) | $164.10 | $547 | 1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$244.20–$366.30 | $814–$1,221 | varies |
| X-Ray Exam Breast Specimen (76098) | $463.50 | $1,545 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $490.20 | $1,634 | 5.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $700.80 | $2,336 | 7.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $558.30 | $1,861 | 5.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $155.10 | $517 | 1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $189.90 | $633 | 2.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $208.80 | $696 | 2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $208.80 | $696 | 2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $330 | $1,100 | 3.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $296.40 | $988 | 2.9× |
| X-Ray Exam L-S Spine Bending (72114) | $504.30 | $1,681 | 5.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $249.90 | $833 | 3.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $352.80 | $1,176 | 3.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $345.60 | $1,152 | 3.4× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$266.10–$399.15 | $887–$1,330.50 | varies |
| X-ray IV pyelogram (ivp) (74400) | $561 | $1,870 | 3.3× |
| X-ray IV pyelogram+tomography (74415) | $714.90 | $2,383 | 4.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $552 | $1,840 | 6.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $190.20 | $634 | 2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $273.30 | $911 | 2.7× |
| X-ray nose-rectum child f.b. (76010) | $71.40 | $238 | 0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $455.10 | $1,517 | 4.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $237.60 | $792 | 2.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $213.60 | $712 | 2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $219.30 | $731 | 2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $347.40 | $1,158 | 4.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $417 | $1,390 | 4.1× |
| X-ray thoracic spine 4 vw (72074) | $366.30 | $1,221 | 3.6× |
| X-Ray Tmj Unilat (70328) | $87.90 | $293 | 1.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $384 | $1,280 | 1.1× |
| X-Rays Bone Length Studies (77073) | $252 | $840 | 2.5× |
| X-Rays Bone Survey Complete (77075) | $585 | $1,950 | 5.8× |
| Xr c-spine 4 or 5 views (72050) | $333.30 | $1,111 | 3.3× |
| Xr facial bones less than 3 views (70140) | $194.70 | $649 | 2.3× |
| Xr orbits complete 4 views (70200) | $124.20 | $414 | 1.2× |
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.