Imaging prices at Ira Davenport Memorial Hospital
Bath, NY · every code in this section with a posted price and a Medicare benchmark.
306 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) | $1,127.54 | $5,637.70 | 0.7× |
| Abdomen 1 View (74018) | $75.99 | $379.97 | 0.7× |
| Abdomen 2 views (74019) | $87.33 | $436.63 | 0.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $320.57 | $1,602.83 | 0.6× |
| Angio internal mammary (75756) | $2,643.90 | $13,219.50 | 0.7× |
| Angio pulmonary bilat (75743) | $1,867.56 | $9,337.81 | 0.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,643.90 | $13,219.50 | 0.7× |
| Angiography extremity bilateral rs&i (75716) | $1,371.78 | $6,858.88 | 0.3× |
| Angiography extremity unilateral rs&i (75710) | $845.76 | $4,228.81 | 0.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,493.98 | $7,469.92 | 0.4× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$75.37–$78.39 | $376.86–$391.97 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$616.34 | $3,081.69 | 0.1× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$3,106.79 | $15,533.95 | 0.4× |
| Artery X-Rays Adrenal Gland (75731) | $2,643.90 | $13,219.50 | 0.7× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$1,493.98 | $7,469.92 | 0.2× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$567.46 | $2,837.30 | 0.1× |
| Arthrogram hip (73525) | $247.14 | $1,235.72 | 0.6× |
| Arthrogram Wrist (73115) | $155.12 | $775.62 | 0.4× |
| Basic radiation dosimetry calculation (77300) | $122.54 | $612.69 | 0.7× |
| Bone age studies (77072) | $72.06 | $360.32 | 0.6× |
| Bone Imaging 3 Phase (78315) | $522.31 | $2,611.55 | 1.0× |
| Bone Imaging Limited Area (78300) | $234.96 | $1,174.79 | 0.5× |
| Bone Imaging Whole Body (78306) | $431.54 | $2,157.72 | 0.9× |
| Bone survey infant (77076) | $42.80 | $214.01 | 0.3× |
| Brain Image W/Flow < 4 Views (78601) | $158.39 | $791.96 | 0.3× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $497.37 | $2,486.87 | 1.0× |
| Chest 1 view (71045) | $72.12 | $360.62 | 0.7× |
| Chest 2 views (71046) | $89.54 | $447.69 | 0.8× |
| Chest 3 views (71047) | $87.33 | $436.63 | 0.8× |
| Chest 4 or more views (71048) | $104.46 | $522.29 | 0.8× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$74.98–$77.98 | $374.89–$389.89 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $483.94 | $2,419.71 | 3.7× |
| Continuing medical physics consltj pr wk (77336) | $199.68 | $998.39 | 1.2× |
| Contrast Exam Abdominl Aorta (75625) | $842.05 | $4,210.24 | 0.2× |
| Contrast X-Ray Bladder (74430) | $156.77 | $783.87 | 0.4× |
| Contrast Xray Throat/Cerv Esopha (74210) | $86.58 | $432.89 | 0.4× |
| CT abdomen and pelvis without and with contrast (74178) | $1,631.87 | $8,159.35 | 3.7× |
| CT abdomen and pelvis without contrast (74176) | $1,029.81 | $5,149.04 | 3.5× |
| CT abdomen w contrast (74160) | $671.74 | $3,358.72 | 3.1× |
| CT abdomen w wo contrast (74170) | $887.02 | $4,435.08 | 4.1× |
| CT abdomen w/o contrast (74150) | $503.75 | $2,518.73 | 3.9× |
| CT Angio Abdomen and Pelvis (74174) | $1,425.86 | $7,129.30 | 3.3× |
| CT Angio Chest (71275) | $738.58 | $3,692.90 | 3.4× |
| CT Angio Head (70496) | $738.58 | $3,692.90 | 3.4× |
| CT angio hrt w/3d image (75574) | $856.99 | $4,284.95 | 2.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $641.54 | $3,207.70 | 2.9× |
| CT Angio Neck (70498) | $596.24 | $2,981.21 | 2.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $493.43 | $2,467.15 | 2.3× |
| CT cervical spine w/ contrast (72126) | $577.59 | $2,887.94 | 1.3× |
| CT cervical spine w/o contrast (72125) | $532.63 | $2,663.13 | 4.1× |
| CT cervical spine w/wo cont (72127) | $680.73 | $3,403.64 | 3.1× |
| CT chest w contrast (71260) | $550.45 | $2,752.27 | 2.5× |
| CT chest w/wo contrast (71270) | $746.01 | $3,730.03 | 3.4× |
| CT colonography screening (74263) | $328.58 | $1,642.89 | 1.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $649.79 | $3,248.95 | 5.0× |
| CT head/brain with contrast (70460) | $552.43 | $2,762.14 | 2.5× |
| CT head/brain without and with contrast (70470) | $665.26 | $3,326.32 | 3.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $160.14 | $800.68 | 1.5× |
| CT iac w contrast (70481) | $760.36 | $3,801.78 | 3.5× |
| CT l-spine w&w/o contrast (72133) | $701.35 | $3,506.77 | 3.2× |
| CT lower ext w/o (73700) | $467.44 | $2,337.18 | 3.6× |
| CT lower extremity w/contrast material (73701) | $554.90 | $2,774.49 | 2.5× |
| CT lumbar spine w contrast (72132) | $608.53 | $3,042.66 | 1.4× |
| CT lumbar spine w/o contrast (72131) | $538.40 | $2,692.01 | 4.1× |
| CT maxillofacial w contrast (70487) | $656.82 | $3,284.12 | 3.0× |
| CT maxillofacial wo contrast (70486) | $510.34 | $2,551.70 | 3.9× |
| CT neck tissue combo (70492) | $825.22 | $4,126.11 | 3.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $800.38 | $4,001.91 | 3.7× |
| CT orbits w/o contrast (70480) | $565.22 | $2,826.09 | 4.3× |
| CT pelvis w&w/o contrast (72194) | $767.37 | $3,836.83 | 3.5× |
| CT pelvis w/o contrast (72192) | $556.96 | $2,784.80 | 4.3× |
| CT scan of leg combo (73702) | $623.90 | $3,119.52 | 2.8× |
| CT scans face/jaw combo (70488) | $701.35 | $3,506.77 | 3.2× |
| CT soft tissue neck w contrast (70491) | $730.74 | $3,653.69 | 3.3× |
| CT soft tissue neck w/o contrast (70490) | $528.91 | $2,644.54 | 4.1× |
| CT thoracic spine w contrast (72129) | $680.73 | $3,403.64 | 3.1× |
| CT thoracic spine w/o contrast (72128) | $635.77 | $3,178.83 | 4.9× |
| CT thoracic spine w/wo cont (72130) | $711.67 | $3,558.35 | 3.3× |
| CT thorax w/o contrast (71250) | $483.94 | $2,419.71 | 3.7× |
| CT upper ext wo (73200) | $435.26 | $2,176.28 | 3.3× |
| CT upper extremity w/o & w/contrast material (73202) | $699.29 | $3,496.47 | 3.2× |
| CT upper extremity with contrast (73201) | $640.71 | $3,203.56 | 1.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $780.57 | $3,902.86 | 3.6× |
| Cta Abdomen (74175) | $771.08 | $3,855.40 | 3.5× |
| CTA pelvis (72191) | $658.46 | $3,292.29 | 3.0× |
| Dxa Bone Density Axial (77080) | $182.80 | $914 | 1.4× |
| Dxa bone density study (77085) | $228.51 | $1,142.53 | 1.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $45.70 | $228.52 | 0.4× |
| Esophagram (74220) | $169.98 | $849.89 | 0.8× |
| Fetal Biophys Profile W/Nst (76818) | $178.87 | $894.33 | 1.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $147.98 | $739.90 | 1.1× |
| Fluoroscopy up to 1 hr (76000) | $146.46 | $732.30 | 0.5× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$80.53–$83.75 | $402.64–$418.75 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$71.81–$116.13 | $359.03–$580.65 | varies |
| Gastric emptying imaging study (78264) | $404.31 | $2,021.55 | 0.8× |
| Gated Heart Planar Single (78472) | $497.37 | $2,486.87 | 1.0× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$80.13–$166.96 | $400.67–$834.79 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,493.98 | $7,469.92 | 0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,493.98 | $7,469.92 | 0.4× |
| Hepatobil Syst Image W/Drug (78227) | $469.09 | $2,345.43 | 0.7× |
| Hepatobiliary System Imaging (78226) | $469.09 | $2,345.43 | 0.9× |
| Ht Muscle Image Spect Sing (78451) | $534.67 | $2,673.37 | 0.3× |
| Hysterosalpingogram (74740) | $222.78 | $1,113.91 | 0.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $147.92 | $739.61 | 1.4× |
| Infusion Ivp (74410) | $235.17 | $1,175.83 | 1.1× |
| K Flow/Funct Image W/Drug (78708) | $387.40 | $1,937.02 | 0.6× |
| K Flow/Funct Image W/O Drug (78707) | $389.05 | $1,945.23 | 0.6× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$101.56–$105.62 | $507.78–$528.09 | varies |
| Liver & Spleen Imaging Static Only (78215) | $354.80 | $1,774.02 | 0.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $106.95 | $534.73 | 0.2× |
| Lung perfusion differential (78597) | $397 | $1,984.98 | 0.8× |
| Lung Ventilat&Perfus Imaging (78582) | $706.31 | $3,531.53 | 1.0× |
| Lung Ventilation Imaging (78579) | $247.13 | $1,235.64 | 0.5× |
| Lymph System Imaging (78195) | $383.27 | $1,916.37 | 0.6× |
| Magnetic Image Jaw Joint (70336) | $805.33 | $4,026.63 | 2.7× |
| Mlc imrt design & construction per imrt plan (77338) | $142.75 | $713.74 | 0.3× |
| Mr safety determination physician/other qhp (76016) | $70.30 | $351.51 | 0.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $19.56 | $97.78 | 0.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $73.29 | $366.44 | 0.6× |
| Mr safety implt pos&/immoblj (76019) | $47.43 | $237.13 | 0.6× |
| Mr safety med physics xm customization plng&mntr (76017) | $257.33 | $1,286.67 | 0.9× |
| Mra Head W/O & W/Contrast Material (70546) | $1,278.95 | $6,394.77 | 2.9× |
| MRA head w/o contrast (70544) | $885.77 | $4,428.87 | 3.0× |
| MRA head with contrast (70545) | $1,211.70 | $6,058.50 | 2.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,340.84 | $6,704.18 | 3.1× |
| MRA neck w/o contrast (70547) | $645.25 | $3,226.26 | 2.2× |
| MRI abdomen w contrast (74182) | $682.50 | $3,412.50 | 1.6× |
| MRI abdomen w/o contrast (74181) | $724.47 | $3,622.33 | 2.4× |
| MRI any jt lower extrem w/contrast material (73722) | $1,297.44 | $6,487.22 | 1.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,585.90 | $7,929.48 | 3.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $799.75 | $3,998.73 | 0.8× |
| MRI cervical spine w/o cont (72141) | $950.97 | $4,754.83 | 3.2× |
| MRI chest w/o contrast (71550) | $758.61 | $3,793.07 | 2.5× |
| MRI chest wo w contrast (71552) | $1,588.37 | $7,941.87 | 3.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,682.02 | $8,410.12 | 3.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $922.50 | $4,612.49 | 3.1× |
| MRI lumbar spine w contrast (72149) | $760.29 | $3,801.44 | 1.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,526.90 | $7,634.51 | 3.5× |
| MRI orbit face &/neck w/o contrast (70540) | $870.93 | $4,354.64 | 2.9× |
| MRI orbit face neck w contrast (70542) | $78.20 | $390.98 | 0.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,614.37 | $8,071.84 | 3.7× |
| MRI pelvis w contrast (72196) | $682.54 | $3,412.68 | 1.6× |
| MRI pelvis w/o & w contrast (72197) | $1,465.43 | $7,327.16 | 3.4× |
| MRI pelvis w/o contrast (72195) | $885.77 | $4,428.87 | 3.0× |
| MRI thoracic spine w/o contrast (72146) | $1,000.06 | $5,000.29 | 3.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $920.02 | $4,600.12 | 3.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,515.77 | $7,578.83 | 3.5× |
| MRI, abdomen, combo (74183) | $1,650.26 | $8,251.31 | 3.8× |
| MRI, dorsal spine combo (72157) | $1,248.83 | $6,244.15 | 2.9× |
| MRI, joint upper extrem (73221) | $913.01 | $4,565.07 | 3.1× |
| MRI, joint upper extrem combo (73223) | $1,472.45 | $7,362.23 | 3.4× |
| MRI, lumbar spine combo (72158) | $1,402.72 | $7,013.61 | 3.2× |
| Myelograpy 2/more regions rs&i (72270) | $294.93 | $1,474.63 | 0.3× |
| Myocardial Spect Multiple Studies (78452) | $972.41 | $4,862.07 | 0.6× |
| Neck soft tissue (70360) | $77.57 | $387.83 | 0.7× |
| Nm csf leak detection (78650) | $236.35 | $1,181.75 | 0.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,437.37 | $7,186.85 | 0.8× |
| Nuclear Rx Oral Admin (79005) | $396.89 | $1,984.44 | 1.4× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $135.73 | $678.66 | 1.0× |
| Parathyroid Planar Imaging (78070) | $336.66 | $1,683.29 | 0.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $336.66 | $1,683.29 | 0.7× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$71.41–$74.26 | $357.04–$371.32 | varies |
| Pet Image W/Ct Lmtd (78814) | $2,114.56 | $10,572.78 | 1.2× |
| PET image w/CT, full body (78816) | $2,264.99 | $11,324.97 | 1.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,253.83 | $11,269.13 | 1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $279.31 | $1,396.56 | 0.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $151 | $754.99 | 1.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $245.88 | $1,229.39 | 0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$89.26–$92.83 | $446.28–$464.13 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $69.72 | $348.61 | 0.6× |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$75.77–$78.80 | $378.85–$394 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $138.21 | $691.05 | 1.1× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$63.08–$94.08 | $315.39–$470.40 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$93.23–$194.07 | $466.14–$970.37 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$83.70–$174.27 | $418.51–$871.35 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $58.46 | $292.31 | 0.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $97.78 | $488.88 | 0.9× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $115.42 | $577.09 | 1.1× |
| Radex Ribs Unilateral 2 Views (71100) | $82.51 | $412.56 | 0.8× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$96.40–$100.26 | $482.01–$501.29 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $82.10 | $410.50 | 0.8× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$62.42–$64.91 | $312.08–$324.57 | varies |
| Radex Sternum Minimum 2 Views (71120) | $89.53 | $447.64 | 0.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $103.14 | $515.71 | 0.9× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$50.78–$52.81 | $253.90–$264.05 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $57.15 | $285.74 | 0.4× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$79.73–$82.92 | $398.66–$414.61 | varies |
| Radiation treatment delivery level 2 (77407) | $309.38 | $1,546.92 | 0.6× |
| Radiation treatment delivery level 3 (77412) | $306.70 | $1,533.48 | 0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $134.09 | $670.45 | 1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $84.91 | $424.53 | 0.7× |
| Radiologic exam colon double contrast study (74280) | $253.73 | $1,268.64 | 1.2× |
| Radiologic exam colon single contrast study (74270) | $191.85 | $959.24 | 0.9× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$120.20–$250.14 | $600.99–$1,250.68 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $122.12 | $610.61 | 0.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $180.71 | $903.53 | 0.8× |
| Radiologic exam swallow function contrast study (74230) | $173.28 | $866.38 | 0.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $250.02 | $1,250.08 | 1.1× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$88.07–$91.59 | $440.35–$457.97 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$113.08–$117.60 | $565.39–$588.01 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$78.15–$81.27 | $390.73–$406.35 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $127.89 | $639.46 | 1.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$78.15–$102.53 | $390.73–$512.66 | varies |
| Ribs bilateral 3 views (71110) | $127.89 | $639.46 | 1.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $258.26 | $1,291.31 | 0.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,042.44 | $5,212.20 | 1.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $498.79 | $2,493.95 | 0.7× |
| Scapula (73010) | $82.92 | $414.61 | 0.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $21.76 | $108.82 | 0.9× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$59.11–$61.47 | $295.54–$307.37 | varies |
| Shoulder Arthrography (73040) | $190.19 | $950.95 | 0.4× |
| Skull less than 4 views (70250) | $90.35 | $451.77 | 0.7× |
| Special Physics Consult (77370) | $193.08 | $965.42 | 1.2× |
| Special treatment procedure (77470) | $588.03 | $2,940.13 | 0.9× |
| Stereotactic Body Radiation Delivery (77373) | $1,034.96 | $5,174.82 | 0.5× |
| Sternoclavicular joints (71130) | $97.78 | $488.88 | 0.9× |
| Superior sagittal sinus venogram (75870) | $2,643.90 | $13,219.50 | 0.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $217.67 | $1,088.33 | 0.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $568.52 | $2,842.59 | 1.2× |
| Ther rad simulaj-aided field setting simple (77280) | $273.25 | $1,366.24 | 1.6× |
| Thoracic spine 2 views (72070) | $67.52 | $337.60 | 0.5× |
| Thoracic spine 3 views (72072) | $99.02 | $495.08 | 0.8× |
| Thoracolumbar 2 views (72080) | $87.05 | $435.25 | 0.8× |
| Thyroid Met Imaging Body (78018) | $606.46 | $3,032.31 | 0.9× |
| Thyroid Uptake Measurement (78012) | $149.77 | $748.85 | 0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $353.98 | $1,769.91 | 0.7× |
| Tx Devices Design & Construction Complex (77334) | $404.72 | $2,023.62 | 0.9× |
| Tx devices design & construction simple (77332) | $150.59 | $752.94 | 0.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$50.81–$66.86 | $254.03–$334.28 | varies |
| Ultrasound elastography first target lesion (76982) | $61.91 | $309.54 | 0.5× |
| Ultrasound Elastography Parenchyma (76981) | $61.91 | $309.54 | 0.5× |
| Ultrasound Exam Aaa Screen (76706) | $60.93 | $304.67 | 0.5× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $106.80 | $533.99 | 0.2× |
| Ultrasound, abdomen limited (76705) | $231.04 | $1,155.18 | 1.8× |
| Unlisted Dx Radiographic Procedure (76499) | $155.35 | $776.74 | 1.4× |
| Unlisted us procedure (76999) | $99.84 | $499.19 | 0.9× |
| Upper gi w/o kub (74240) | $106.80 | $533.99 | 0.5× |
| Urethrocystogram voiding (74455) | $175.34 | $876.69 | 0.6× |
| Urethrocystography retrograde (74450) | $155.90 | $779.51 | 0.5× |
| Us breast unilateral complete (76641) | $152.09 | $760.45 | 1.2× |
| Us chest (76604) | $182.36 | $911.78 | 1.4× |
| Us complete joint (76881) | $322.91 | $1,614.55 | 2.5× |
| Us exam, pelvic, limited (76857) | $122.95 | $614.75 | 0.9× |
| Us head (76506) | $121.18 | $605.88 | 0.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $161.31 | $806.54 | 1.2× |
| Us ob detailed single fetus (76811) | $170.48 | $852.40 | 0.6× |
| Us ob limited 1 or more fetuses (76815) | $88.29 | $441.45 | 0.7× |
| Us ob transvaginal (76817) | $148.10 | $740.48 | 1.1× |
| Us pelvic non ob complete (76856) | $228.56 | $1,142.78 | 1.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$114.43–$150.59 | $572.17–$752.94 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $98.64 | $493.21 | 0.8× |
| Us retroperitoneal complete (76770) | $224.02 | $1,120.09 | 1.7× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$159.47–$165.86 | $797.37–$829.28 | varies |
| Us scrotum and contents (76870) | $206.29 | $1,031.43 | 1.6× |
| Us spinal canal and contents (76800) | $172.32 | $861.58 | 1.3× |
| Us thyroid (76536) range across 3 matching MRF lines |
$146.10–$192.26 | $730.50–$961.29 | varies |
| Us transrectal (76872) | $114.77 | $573.86 | 0.9× |
| Vein X-Ray Chest (75827) | $797.90 | $3,989.48 | 0.4× |
| Vein X-Ray Skull Epidural (75872) | $519.34 | $2,596.69 | 0.7× |
| Venogram Sinus/Jugular (75860) | $490.52 | $2,452.58 | 0.1× |
| Venography Adrenal Unilateral (75840) | $2,643.90 | $13,219.50 | 0.7× |
| Venography caval inferior serialography rs&i (75825) | $1,493.98 | $7,469.92 | 0.4× |
| Venography extremity bilateral rs&i (75822) | $288.80 | $1,443.98 | 0.1× |
| Venography extremity unilateral rs&i (75820) | $282.61 | $1,413.03 | 0.1× |
| Venography Orbital Rs&I (75880) | $519.34 | $2,596.69 | 0.7× |
| Venography Renal Bilateral (75833) | $2,240.82 | $11,204.09 | 0.6× |
| Venography Renal Unilateral (75831) | $1,493.98 | $7,469.92 | 0.4× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$68.23–$70.96 | $341.17–$354.82 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $108.92 | $544.60 | 1.0× |
| X-ray antegrade pyelogram tube (74425) | $165.44 | $827.18 | 0.4× |
| X-Ray Aorta Leg Arteries (75630) | $1,493.98 | $7,469.92 | 0.4× |
| X-Ray Bend Only L-S Spine (72120) | $133.26 | $666.31 | 1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$73.39–$76.32 | $366.93–$381.61 | varies |
| X-Ray Exam Breast Specimen (76098) | $245.83 | $1,229.16 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$14.91–$126.44 | $74.55–$632.19 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$23.73–$154.71 | $118.65–$773.57 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $182.80 | $914 | 1.4× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$64.67–$67.25 | $323.33–$336.26 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$100.37–$104.38 | $501.84–$521.91 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $156.60 | $783.02 | 1.2× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$165.81–$172.45 | $829.07–$862.23 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$185.63–$200.78 | $928.15–$1,003.88 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $254.40 | $1,272 | 1.9× |
| X-Ray Exam L-S Spine Bending (72114) | $234.75 | $1,173.74 | 1.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$88.87–$92.42 | $444.34–$462.12 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $174.93 | $874.65 | 1.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $111.80 | $559.02 | 0.9× |
| X-ray eye for foreign body (70030) | $86.82 | $434.10 | 0.8× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$74.18–$77.15 | $370.90–$385.74 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $118.82 | $594.12 | 1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $116.28 | $581.40 | 1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$103.14–$107.26 | $515.69–$536.32 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $154.71 | $773.57 | 1.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $90.35 | $451.77 | 0.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $10.26 | $51.32 | 0.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $97.78 | $488.88 | 0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $117.99 | $589.95 | 1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $138.05 | $690.26 | 1.1× |
| X-ray thoracic spine 4 vw (72074) | $82.51 | $412.56 | 0.6× |
| X-Ray Tmj Unilat (70328) | $44.12 | $220.61 | 0.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $242.59 | $1,212.94 | 0.6× |
| X-Rays Bone Length Studies (77073) | $110.98 | $554.88 | 0.9× |
| X-Rays Bone Survey Complete (77075) | $223.62 | $1,118.08 | 1.7× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$149.95–$155.95 | $749.76–$779.75 | varies |
| Xr facial bones less than 3 views (70140) | $77.57 | $387.83 | 0.7× |
| Xr orbits complete 4 views (70200) | $99.02 | $495.08 | 0.8× |
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.