Imaging prices at Holland Hospital
Holland, MI · every code in this section with a posted price and a Medicare benchmark.
321 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) | $102.60 | $171 | 1.2× |
| Abdomen 2 views (74019) | $133.80 | $223 | 1.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $478.20 | $797 | 1.2× |
| Angio pulmonary bilat (75743) | $2,533.80 | $4,223 | 0.8× |
| Angiography extremity bilateral rs&i (75716) | $1,584 | $2,640 | 0.5× |
| Angiography extremity unilateral rs&i (75710) | $2,143.20 | $3,572 | 0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,651.20 | $2,752 | 0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,276.20 | $2,127 | 0.4× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$102.60–$154.20 | $171–$257 | varies |
| Aortography thoracic serialography rs&i (75605) | $2,953.80 | $4,923 | 0.5× |
| Artery X-Rays Abdomen (75726) | $2,953.80 | $4,923 | 0.5× |
| Artery X-Rays Pelvis (75736) | $2,953.80 | $4,923 | 0.5× |
| Artery X-Rays Spine (75705) | $2,953.80 | $4,923 | 0.5× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$661.80–$1,323 | $1,103–$2,205 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$759.60–$1,519.20 | $1,266–$2,532 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$759.60–$1,521 | $1,266–$2,535 | varies |
| Bone age studies (77072) | $181.20 | $302 | 1.7× |
| Bone Imaging 3 Phase (78315) | $720 | $1,200 | 1.8× |
| Bone Imaging Limited Area (78300) | $390 | $650 | 1.0× |
| Bone Imaging Multiple Areas (78305) | $480 | $800 | 1.2× |
| Bone Imaging Whole Body (78306) | $739.80 | $1,233 | 1.9× |
| Bone survey infant (77076) | $202.80 | $338 | 1.9× |
| Brain Image W/Flow < 4 Views (78601) | $845.40 | $1,409 | 2.1× |
| Brain imaging < 4 static views (78600) | $487.20 | $812 | 1.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $670.80 | $1,118 | 1.2× |
| Brain Imaging Minimum 4 Static Views (78605) | $487.20 | $812 | 0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,998.20 | $4,997 | 2.1× |
| Cat Scan Follow-Up Study (76380) | $315 | $525 | 3.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $480 | $800 | 0.9× |
| Cerebrospinal Fluid Scan (78630) | $605.40 | $1,009 | 1.1× |
| Chest 1 view (71045) | $102.60 | $171 | 1.2× |
| Chest 2 views (71046) | $102.60 | $171 | 1.2× |
| Chest 3 views (71047) | $133.80 | $223 | 1.5× |
| Chest 4 or more views (71048) | $159 | $265 | 1.5× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$78.60–$154.20 | $131–$257 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $210 | $350 | 2.0× |
| Contrast Exam Abdominl Aorta (75625) | $1,584 | $2,640 | 0.5× |
| Contrast X-Ray Bladder (74430) | $228 | $380 | 0.7× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$602.40–$1,204.80 | $1,004–$2,008 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$594–$1,188.60 | $990–$1,981 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $157.80 | $263 | 0.9× |
| CT abdomen and pelvis without and with contrast (74178) | $1,855.20 | $3,092 | 5.3× |
| CT abdomen and pelvis without contrast (74176) | $1,436.40 | $2,394 | 6.0× |
| CT abdomen w contrast (74160) | $718.20 | $1,197 | 4.1× |
| CT abdomen w wo contrast (74170) | $838.20 | $1,397 | 4.8× |
| CT abdomen w/o contrast (74150) | $598.80 | $998 | 5.7× |
| CT Angio Abdomen and Pelvis (74174) | $1,855.20 | $3,092 | 5.3× |
| CT Angio Chest (71275) | $1,107 | $1,845 | 6.3× |
| CT Angio Head (70496) | $897.60 | $1,496 | 5.1× |
| CT angio hrt w/3d image (75574) | $420 | $700 | 1.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,137–$1,705.80 | $1,895–$2,843 | varies |
| CT Angio Neck (70498) | $897.60 | $1,496 | 5.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$585–$1,137 | $975–$1,895 | varies |
| CT cervical spine w/ contrast (72126) | $808.20 | $1,347 | 2.3× |
| CT cervical spine w/o contrast (72125) | $598.80 | $998 | 5.7× |
| CT cervical spine w/wo cont (72127) | $897.60 | $1,496 | 5.1× |
| CT chest w contrast (71260) | $808.20 | $1,347 | 4.6× |
| CT chest w/wo contrast (71270) | $897.60 | $1,496 | 5.1× |
| CT head/brain with contrast (70460) | $808.20 | $1,347 | 4.6× |
| CT head/brain without and with contrast (70470) | $897.60 | $1,496 | 5.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $90 | $150 | 1.0× |
| CT iac w contrast (70481) | $808.20 | $1,347 | 4.6× |
| CT l-spine w&w/o contrast (72133) | $897.60 | $1,496 | 5.1× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$598.80–$658.20 | $998–$1,097 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$718.20–$808.20 | $1,197–$1,347 | varies |
| CT lumbar spine w contrast (72132) | $808.20 | $1,347 | 2.3× |
| CT lumbar spine w/o contrast (72131) | $598.80 | $998 | 5.7× |
| CT maxillofacial w contrast (70487) | $808.20 | $1,347 | 4.6× |
| CT maxillofacial wo contrast (70486) | $598.80 | $998 | 5.7× |
| CT neck tissue combo (70492) | $897.60 | $1,496 | 5.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $897.60 | $1,496 | 5.1× |
| CT orbits w/o contrast (70480) | $598.80 | $998 | 5.7× |
| CT pelvis w&w/o contrast (72194) | $838.20 | $1,397 | 4.8× |
| CT pelvis w/o contrast (72192) | $598.80 | $998 | 5.7× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$838.20–$867.60 | $1,397–$1,446 | varies |
| CT scans face/jaw combo (70488) | $897.60 | $1,496 | 5.1× |
| CT soft tissue neck w contrast (70491) | $808.20 | $1,347 | 4.6× |
| CT soft tissue neck w/o contrast (70490) | $598.80 | $998 | 5.7× |
| CT thoracic spine w contrast (72129) | $808.20 | $1,347 | 4.6× |
| CT thoracic spine w/o contrast (72128) | $598.80 | $998 | 5.7× |
| CT thoracic spine w/wo cont (72130) | $897.60 | $1,496 | 5.1× |
| CT thorax w/o contrast (71250) | $598.80 | $998 | 5.7× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$598.80–$658.20 | $998–$1,097 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$838.20–$867.60 | $1,397–$1,446 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$718.20–$808.20 | $1,197–$1,347 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,167 | $1,945 | 6.7× |
| Cta Abdomen (74175) | $1,137 | $1,895 | 6.5× |
| CTA pelvis (72191) | $897.60 | $1,496 | 5.1× |
| Dilation ureters/urethra rs&i (74485) | $1,078.20 | $1,797 | 0.5× |
| Dxa Bone Density Axial (77080) | $222.60 | $371 | 2.1× |
| Dxa bone density study (77085) | $329.40 | $549 | 3.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $45 | $75 | 0.5× |
| Esophagram (74220) | $135 | $225 | 0.8× |
| Fetal Biophys Profile W/Nst (76818) | $177.60 | $296 | 1.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $151.20 | $252 | 1.5× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$90.60–$160.80 | $151–$268 | varies |
| Follow-Up Angiography (75898) | $514.80 | $858 | 0.2× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$102.60–$154.20 | $171–$257 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$78.60–$154.20 | $131–$257 | varies |
| Gastric emptying imaging study (78264) | $840 | $1,400 | 2.1× |
| Gastroesophageal Reflux Exam (78262) | $449.40 | $749 | 1.1× |
| Gated Heart Planar Single (78472) | $720 | $1,200 | 1.8× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$78.60–$118.20 | $131–$197 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,862.60 | $4,771 | 0.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,776.60 | $2,961 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $684.60 | $1,141 | 1.3× |
| Hepatobiliary System Imaging (78226) | $591 | $985 | 1.5× |
| Ht Muscle Image Spect Sing (78451) | $1,092.60 | $1,821 | 0.8× |
| Hysterosalpingogram (74740) | $588 | $980 | 2.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $281.40 | $469 | 3.2× |
| K Flow/Funct Image Multiple (78709) | $805.80 | $1,343 | 1.5× |
| K Flow/Funct Image W/Drug (78708) | $570.60 | $951 | 1.1× |
| K Flow/Funct Image W/O Drug (78707) | $900 | $1,500 | 1.7× |
| Kidney Imaging Morphol (78700) | $463.80 | $773 | 1.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $910.20 | $1,517 | 2.3× |
| Knee 3 Views (73562) range across 5 matching MRF lines |
$15–$200.40 | $25–$334 | varies |
| Leveen/Shunt Patency Exam (78291) range across 2 matching MRF lines |
$412.80–$1,200 | $688–$2,000 | varies |
| Liver & Spleen Imaging Static Only (78215) | $480 | $800 | 1.2× |
| Liver imaging static only (78201) | $857.40 | $1,429 | 1.6× |
| Lung Perf&Ventilat Diferentl (78598) | $432 | $720 | 0.8× |
| Lung perfusion differential (78597) | $480 | $800 | 1.2× |
| Lung Ventilat&Perfus Imaging (78582) | $717 | $1,195 | 1.3× |
| Lung Ventilation Imaging (78579) | $555 | $925 | 1.4× |
| Lymph System Imaging (78195) | $563.40 | $939 | 1.0× |
| Magnetic Image Jaw Joint (70336) | $1,036.20 | $1,727 | 4.4× |
| Mammary ductogram or galactogram multiple (77054) | $169.80 | $283 | 0.7× |
| Mammary ductogram or galactogram single (77053) | $234 | $390 | 1.0× |
| Meckels Divert Exam (78290) | $427.80 | $713 | 1.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $30 | $50 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $1,480.80 | $2,468 | 4.3× |
| MRA head w/o contrast (70544) | $1,102.80 | $1,838 | 4.6× |
| MRA head with contrast (70545) | $1,386 | $2,310 | 4.0× |
| MRA neck w contrast (70548) | $1,386 | $2,310 | 4.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,480.80 | $2,468 | 4.3× |
| MRA neck w/o contrast (70547) | $1,102.80 | $1,838 | 4.6× |
| MRI abdomen w contrast (74182) | $1,386 | $2,310 | 4.0× |
| MRI abdomen w/o contrast (74181) | $1,102.80 | $1,838 | 4.6× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,386–$1,455.60 | $2,310–$2,426 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,480.80–$1,554.60 | $2,468–$2,591 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,386–$1,455.60 | $2,310–$2,426 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,158 | $1,930 | 4.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,102.80 | $1,838 | 4.6× |
| MRI cervical spine w contrast (72142) | $1,386 | $2,310 | 4.0× |
| MRI cervical spine w/o cont (72141) | $1,102.80 | $1,838 | 4.6× |
| MRI chest w/o contrast (71550) | $1,102.80 | $1,838 | 4.6× |
| MRI chest with contrast (71551) | $1,386 | $2,310 | 1.8× |
| MRI chest wo w contrast (71552) | $1,480.80 | $2,468 | 4.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$1,386–$1,455.60 | $2,310–$2,426 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,480.80–$1,554.60 | $2,468–$2,591 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,102.80–$1,158 | $1,838–$1,930 | varies |
| MRI lumbar spine w contrast (72149) | $1,386 | $2,310 | 4.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,480.80 | $2,468 | 4.3× |
| MRI orbit face &/neck w/o contrast (70540) | $1,102.80 | $1,838 | 4.6× |
| MRI orbit face neck w contrast (70542) | $1,386 | $2,310 | 4.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,480.80 | $2,468 | 4.3× |
| MRI pelvis w contrast (72196) | $1,386 | $2,310 | 4.0× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$720–$1,480.80 | $1,200–$2,468 | varies |
| MRI pelvis w/o contrast (72195) | $1,102.80 | $1,838 | 4.6× |
| MRI thoracic spine w/o contrast (72146) | $1,102.80 | $1,838 | 4.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$1,386–$1,455.60 | $2,310–$2,426 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,102.80–$1,158 | $1,838–$1,930 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,480.80–$1,554.60 | $2,468–$2,591 | varies |
| MRI, abdomen, combo (74183) | $1,480.80 | $2,468 | 4.3× |
| MRI, dorsal spine combo (72157) | $1,480.80 | $2,468 | 4.3× |
| MRI, dorsal spine contrast (72147) | $1,386 | $2,310 | 4.0× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,102.80–$1,158 | $1,838–$1,930 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,480.80–$1,554.60 | $2,468–$2,591 | varies |
| MRI, lumbar spine combo (72158) | $1,480.80 | $2,468 | 4.3× |
| Myelogram cervical (72240) | $1,601.40 | $2,669 | 2.1× |
| Myelogram Lumbar (72265) | $661.80 | $1,103 | 0.8× |
| Myelography thoracic (72255) | $514.80 | $858 | 0.7× |
| Myelograpy 2/more regions rs&i (72270) | $1,816.20 | $3,027 | 2.3× |
| Myocardial Spect Multiple Studies (78452) | $1,879.80 | $3,133 | 1.5× |
| N-invas est c ffr sw aly CTA (75580) | $2,700 | $4,500 | 3.2× |
| Neck soft tissue (70360) | $102.60 | $171 | 1.2× |
| Nuclear Rx Oral Admin (79005) | $480 | $800 | 2.1× |
| Panoramic X-ray of jaws (70355) | $102.60 | $171 | 1.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,200 | $2,000 | 2.2× |
| Parathyroid Planar Imaging (78070) | $301.80 | $503 | 0.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $330.60 | $551 | 0.8× |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$13.20–$110.40 | $22–$184 | varies |
| Peritoneogram Rs&I (74190) | $668.40 | $1,114 | 1.2× |
| Pet Image W/Ct Lmtd (78814) | $2,205 | $3,675 | 1.5× |
| PET image w/CT, full body (78816) | $3,261 | $5,435 | 2.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,261 | $5,435 | 2.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,862.60 | $4,771 | 0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $435 | $725 | 1.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $228.60 | $381 | 2.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $338.40 | $564 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$133.80–$200.40 | $223–$334 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$78.60–$118.20 | $131–$197 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$78.60–$154.20 | $131–$257 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $159 | $265 | 1.5× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$78.60–$118.20 | $131–$197 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$102.60–$200.40 | $171–$334 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$78.60–$154.20 | $131–$257 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$102.60–$200.40 | $171–$334 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $102.60 | $171 | 1.2× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $94.80 | $158 | 1.1× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$133.80–$200.40 | $223–$334 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $132.60 | $221 | 1.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$441–$496.80 | $735–$828 | varies |
| Radex Spine 1 View Specify Level (72020) | $110.40 | $184 | 1.3× |
| Radex Sternum Minimum 2 Views (71120) | $159 | $265 | 1.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $190.80 | $318 | 2.2× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$78.60–$118.20 | $131–$197 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$102.60–$154.20 | $171–$257 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$102.60–$200.40 | $171–$334 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $274.20 | $457 | 2.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $190.80 | $318 | 1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $133.80 | $223 | 1.3× |
| Radiologic exam colon double contrast study (74280) | $303 | $505 | 1.7× |
| Radiologic exam colon single contrast study (74270) | $250.80 | $418 | 1.4× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$15–$261 | $25–$435 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $159 | $265 | 1.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $166.20 | $277 | 1.0× |
| Radiologic exam swallow function contrast study (74230) | $205.20 | $342 | 1.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $186.60 | $311 | 1.1× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$102.60–$154.20 | $171–$257 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$44.40–$200.40 | $74–$334 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$21–$154.20 | $35–$257 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $147.60 | $246 | 1.4× |
| Radiologic Examination Salivary Gland Calculus (70380) | $159.60 | $266 | 1.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$102.60–$154.20 | $171–$257 | varies |
| Renal Cyst Study (74470) | $241.80 | $403 | 0.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $600 | $1,000 | 1.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,105.80 | $1,843 | 2.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,200 | $2,000 | 2.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$600–$900 | $1,000–$1,500 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $900 | $1,500 | 0.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,200 | $2,000 | 0.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$900–$1,200 | $1,500–$2,000 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$102.60–$154.20 | $171–$257 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$75.60–$84 | $126–$140 | varies |
| Sella turcica (70240) | $159 | $265 | 1.8× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$110.40–$190.80 | $184–$318 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$414–$609 | $690–$1,015 | varies |
| Sialogram (70390) | $159.60 | $266 | 0.7× |
| Skull less than 4 views (70250) | $132.60 | $221 | 1.3× |
| Sternoclavicular joints (71130) | $159 | $265 | 1.8× |
| Testicular Imaging W/Flow (78761) | $600 | $1,000 | 1.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $381 | $635 | 2.2× |
| Thoracic spine 2 views (72070) | $102.60 | $171 | 1.0× |
| Thoracic spine 3 views (72072) | $133.80 | $223 | 1.3× |
| Thoracolumbar 2 views (72080) | $133.80 | $223 | 1.5× |
| Thyroid Imaging With Vascular Flow (78013) | $300 | $500 | 0.8× |
| Thyroid Met Imaging Body (78018) | $480 | $800 | 0.9× |
| Thyroid Uptake Measurement (78012) | $223.20 | $372 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $411 | $685 | 1.0× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$82.20–$141.60 | $137–$236 | varies |
| Ultrasound elastography first target lesion (76982) | $48 | $80 | 0.5× |
| Ultrasound Elastography Parenchyma (76981) | $150 | $250 | 1.4× |
| Ultrasound Exam Aaa Screen (76706) | $217.20 | $362 | 2.1× |
| Ultrasound, abdomen limited (76705) | $247.20 | $412 | 2.4× |
| Umbilical-artery Doppler (OB) (76820) | $84.60 | $141 | 0.8× |
| Upper gi w/o kub (74240) | $207 | $345 | 1.2× |
| Ureteral Reflux Study (78740) | $600 | $1,000 | 1.5× |
| Urethrocystogram voiding (74455) | $248.40 | $414 | 1.0× |
| Urethrocystography retrograde (74450) | $283.20 | $472 | 1.2× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$166.80–$250.20 | $278–$417 | varies |
| Us chest (76604) | $150 | $250 | 1.4× |
| Us complete joint (76881) | $288.60 | $481 | 2.8× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$84–$136.80 | $140–$228 | varies |
| Us head (76506) | $336.60 | $561 | 3.2× |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$210–$267 | $350–$445 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $214.80 | $358 | 2.1× |
| Us ob limited 1 or more fetuses (76815) | $180 | $300 | 1.7× |
| Us ob transvaginal (76817) | $238.20 | $397 | 2.3× |
| Us pelvic non ob complete (76856) | $211.80 | $353 | 2.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $214.80 | $358 | 2.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $85.20 | $142 | 0.8× |
| Us retroperitoneal complete (76770) | $267 | $445 | 2.6× |
| Us retroperitoneal limited (76775) | $217.20 | $362 | 2.1× |
| Us scrotum and contents (76870) | $220.80 | $368 | 2.1× |
| Us thyroid (76536) range across 4 matching MRF lines |
$49.20–$183 | $82–$305 | varies |
| Us transrectal (76872) range across 3 matching MRF lines |
$60–$201 | $100–$335 | varies |
| Vein X-Ray Chest (75827) | $911.40 | $1,519 | 0.6× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,305.60 | $2,176 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $1,776.60 | $2,961 | 0.6× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$823.20–$1,500 | $1,372–$2,500 | varies |
| Venography extremity unilateral rs&i (75820) | $758.40 | $1,264 | 0.5× |
| Venography Renal Bilateral (75833) | $3,415.20 | $5,692 | 1.1× |
| Venography Renal Unilateral (75831) | $1,707.60 | $2,846 | 0.5× |
| Vertebral fracture assessment via dxa (77086) | $107.40 | $179 | 1.2× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$12–$154.20 | $20–$257 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $132.60 | $221 | 1.5× |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$57–$390 | $95–$650 | varies |
| X-Ray Aorta Leg Arteries (75630) | $1,584 | $2,640 | 0.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$78.60–$154.20 | $131–$257 | varies |
| X-Ray Exam Breast Specimen (76098) | $388.20 | $647 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $159 | $265 | 1.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $228.60 | $381 | 2.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $228.60 | $381 | 2.2× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$15.60–$132.60 | $26–$221 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 5 matching MRF lines |
$20.40–$102.60 | $34–$171 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 6 matching MRF lines |
$19.80–$154.20 | $33–$257 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$25.80–$118.20 | $43–$197 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $261 | $435 | 2.5× |
| X-Ray Exam L-S Spine Bending (72114) | $217.20 | $362 | 2.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $133.80 | $223 | 1.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $217.20 | $362 | 2.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $174 | $290 | 1.7× |
| X-ray eye for foreign body (70030) | $102.60 | $171 | 1.2× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$51.60–$154.20 | $86–$257 | varies |
| X-ray IV pyelogram (ivp) (74400) | $496.20 | $827 | 2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $132.60 | $221 | 1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$13.20–$133.80 | $22–$223 | varies |
| X-ray nose-rectum child f.b. (76010) | $147 | $245 | 1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $261 | $435 | 2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $102.60 | $171 | 1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $102.60 | $171 | 1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $159 | $265 | 1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $159 | $265 | 1.5× |
| X-ray thoracic spine 4 vw (72074) | $174 | $290 | 1.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$105.60–$353.40 | $176–$589 | varies |
| X-Rays Bone Length Studies (77073) | $186 | $310 | 1.8× |
| X-Rays Bone Survey Complete (77075) | $237.60 | $396 | 2.3× |
| Xr c-spine 4 or 5 views (72050) | $174 | $290 | 1.7× |
| Xr facial bones less than 3 views (70140) | $132.60 | $221 | 1.5× |
| Xr orbits complete 4 views (70200) | $159 | $265 | 1.5× |
| Xr Tomogram Single Plane (76100) | $189 | $315 | 1.8× |
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.