Imaging prices at Jackson Hospital
Montgomery, AL · every code in this section with a posted price and a Medicare benchmark.
286 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) range across 3 matching MRF lines |
$17.29–$67.64 | $91–$356 | varies |
| Abdomen 2 views (74019) | $23.18 | $122 | 0.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $324.52 | $1,708 | 0.9× |
| Angio internal mammary (75756) | $562.21 | $2,959 | 0.2× |
| Angio pulmonary bilat (75743) | $2,018.18 | $10,622 | 0.7× |
| Angiography extremity bilateral rs&i (75716) | $1,999.75 | $10,525 | 0.7× |
| Angiography extremity unilateral rs&i (75710) range across 4 matching MRF lines |
$1,922.80–$2,352.39 | $10,120–$12,381 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 4 matching MRF lines |
$1,966.88–$2,045.54 | $10,352–$10,766 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $762.66 | $4,014 | 0.3× |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$17.29–$68.40 | $91–$360 | varies |
| Aortography thoracic serialography rs&i (75605) | $2,317.24 | $12,196 | 0.5× |
| Aortography thoracic w/o serialography rs&i (75600) | $2,646.70 | $13,930 | 0.9× |
| Artery X-Rays Abdomen (75726) | $4,156.25 | $21,875 | 0.8× |
| Artery X-Rays Pelvis (75736) | $2,458.41 | $12,939 | 0.5× |
| Arthrogram ankle (73615) | $308.37 | $1,623 | 1.0× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$316.16–$330.03 | $1,664–$1,737 | varies |
| Arthrogram Wrist (73115) | $308.37 | $1,623 | 1.0× |
| Bone age studies (77072) | $41.80 | $220 | 0.4× |
| Bone Imaging 3 Phase (78315) | $308.18 | $1,622 | 0.9× |
| Bone Imaging Limited Area (78300) | $369.55 | $1,945 | 1.0× |
| Bone Imaging Whole Body (78306) | $289.56 | $1,524 | 0.8× |
| Bone marrow imaging; multiple areas (78103) | $334.40 | $1,760 | 0.9× |
| Bone survey infant (77076) | $53.20 | $280 | 0.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $553.09 | $2,911 | 1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $869.06 | $4,574 | 0.7× |
| Cat Scan Follow-Up Study (76380) | $76 | $400 | 1.0× |
| Cerebrospinal Fluid Scan (78630) | $553.09 | $2,911 | 1.1× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$17.29–$46.74 | $91–$246 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$17.29–$56.05 | $91–$295 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$12.35–$53.58 | $65–$282 | varies |
| Chest 4 or more views (71048) | $93.29 | $491 | 1.0× |
| Cholecystography Oral Contrast (74290) | $52.63 | $277 | 0.3× |
| Clavicle complete (73000) range across 5 matching MRF lines |
$17.29–$70.11 | $91–$369 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $270.94 | $1,426 | 2.9× |
| Contrast Exam Abdominl Aorta (75625) | $2,352.39 | $12,381 | 0.8× |
| Contrast X-Ray Bladder (74430) | $247.57 | $1,303 | 0.8× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$308.37–$316.16 | $1,623–$1,664 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $347.70 | $1,830 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) | $662.72 | $3,488 | 2.1× |
| CT abdomen and pelvis without contrast (74176) | $574.18 | $3,022 | 2.7× |
| CT abdomen w contrast (74160) | $365.56 | $1,924 | 2.3× |
| CT abdomen w wo contrast (74170) | $432.63 | $2,277 | 2.8× |
| CT abdomen w/o contrast (74150) | $325.09 | $1,711 | 3.5× |
| CT Angio Abdomen and Pelvis (74174) | $660.06 | $3,474 | 2.1× |
| CT Angio Chest (71275) | $390.64 | $2,056 | 2.5× |
| CT Angio Head (70496) | $181.07 | $953 | 1.2× |
| CT angio hrt w/3d image (75574) | $372.97 | $1,963 | 1.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$335.16–$419.14 | $1,764–$2,206 | varies |
| CT Angio Neck (70498) | $390.64 | $2,056 | 2.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$335.16–$490.20 | $1,764–$2,580 | varies |
| CT cervical spine w/o contrast (72125) | $290.51 | $1,529 | 3.1× |
| CT chest w contrast (71260) | $345.04 | $1,816 | 2.2× |
| CT chest w/wo contrast (71270) | $365.56 | $1,924 | 2.3× |
| CT head/brain with contrast (70460) | $327.37 | $1,723 | 2.1× |
| CT head/brain without and with contrast (70470) | $417.24 | $2,196 | 2.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $226.67 | $1,193 | 0.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $56.05 | $295 | 0.7× |
| CT iac w contrast (70481) | $387.03 | $2,037 | 2.5× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$101.65–$153.14 | $535–$806 | varies |
| CT lower extremity w/contrast material (73701) | $335.16 | $1,764 | 2.1× |
| CT lumbar spine w/o contrast (72131) | $344.66 | $1,814 | 3.7× |
| CT maxillofacial wo contrast (70486) | $305.90 | $1,610 | 3.3× |
| CT neck tissue combo (70492) | $339.53 | $1,787 | 2.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $150.86 | $794 | 1.0× |
| CT orbits w/o contrast (70480) | $101.65 | $535 | 1.1× |
| CT pelvis w&w/o contrast (72194) | $181.07 | $953 | 1.2× |
| CT pelvis w/o contrast (72192) | $292.41 | $1,539 | 3.1× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$298.11–$319.01 | $1,569–$1,679 | varies |
| CT soft tissue neck w contrast (70491) | $308.37 | $1,623 | 2.0× |
| CT soft tissue neck w/o contrast (70490) | $305.52 | $1,608 | 3.3× |
| CT thoracic spine w/o contrast (72128) | $366.89 | $1,931 | 3.9× |
| CT thorax w/o contrast (71250) | $270.94 | $1,426 | 2.9× |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$484.50–$708.70 | $2,550–$3,730 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$290.89–$319.96 | $1,531–$1,684 | varies |
| CT upper extremity with contrast (73201) | $345.80 | $1,820 | 1.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $702.24 | $3,696 | 4.5× |
| Cta Abdomen (74175) | $468.92 | $2,468 | 3.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $129.50 | $681.60 | 0.4× |
| CTA pelvis (72191) | $649.99 | $3,421 | 4.1× |
| Dilation ureters/urethra rs&i (74485) | $1,008.33 | $5,307 | 0.5× |
| Discography Cerv/Thor Spine (72285) | $3,014.92 | $15,868 | 1.7× |
| Diskography lumbar (72295) | $3,226.01 | $16,979 | 1.8× |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$20.90–$83.79 | $110–$441 | varies |
| Dxa bone density study (77085) | $88.54 | $466 | 0.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $33.82 | $178 | 0.4× |
| Echo Guide For Artery Repair (76936) | $206.91 | $1,089 | 1.1× |
| Esophagram (74220) | $188.86 | $994 | 1.2× |
| Fetal Biophys Profile W/Nst (76818) range across 3 matching MRF lines |
$23.75–$79.04 | $125–$416 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $23.75 | $125 | 0.3× |
| Follow-Up Angiography (75898) | $780.14 | $4,106 | 0.3× |
| Foot 2 views (73620) range across 5 matching MRF lines |
$17.29–$68.40 | $91–$360 | varies |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$17.29–$68.40 | $91–$360 | varies |
| Gastric emptying imaging study (78264) | $218.69 | $1,151 | 0.6× |
| Gastroesophageal Reflux Exam (78262) | $295.07 | $1,553 | 0.8× |
| Gated Heart Planar Single (78472) | $206.72 | $1,088 | 0.6× |
| Gated Heart, Multiple (78473) | $68.40 | $360 | 0.2× |
| Hand 2 views (73120) range across 5 matching MRF lines |
$23.18–$125.59 | $122–$661 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,317.24 | $12,196 | 0.8× |
| Hepatobil Syst Image W/Drug (78227) | $290.70 | $1,530 | 0.6× |
| Hepatobiliary System Imaging (78226) | $242.25 | $1,275 | 0.7× |
| Ht Muscle Image Spect Sing (78451) | $1,057.16 | $5,564 | 0.9× |
| Hysterosalpingogram (74740) | $313.88 | $1,652 | 1.5× |
| Infant hip ultrasound, limited static exam (76886) | $54.15 | $285 | 0.7× |
| Joint Survey Single View (77077) | $200.45 | $1,055 | 2.1× |
| K Flow/Funct Image W/Drug (78708) | $390.26 | $2,054 | 0.8× |
| K Flow/Funct Image W/O Drug (78707) | $380.76 | $2,004 | 0.8× |
| Knee 3 Views (73562) range across 5 matching MRF lines |
$17.29–$70.11 | $91–$369 | varies |
| Leveen/Shunt Patency Exam (78291) | $183.16 | $964 | 0.5× |
| Liver & Spleen Imaging Static Only (78215) | $212.04 | $1,116 | 0.6× |
| Lung Perf&Ventilat Diferentl (78598) | $255.93 | $1,347 | 0.5× |
| Lung Ventilat&Perfus Imaging (78582) | $314.64 | $1,656 | 0.6× |
| Lymph System Imaging (78195) | $359.29 | $1,891 | 0.7× |
| Meckels Divert Exam (78290) | $189.24 | $996 | 0.5× |
| MRA head w/o contrast (70544) | $206.91 | $1,089 | 1.0× |
| MRA head with contrast (70545) | $330.98 | $1,742 | 1.1× |
| MRA neck w contrast (70548) | $493.05 | $2,595 | 1.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $345.80 | $1,820 | 1.1× |
| MRA neck w/o contrast (70547) | $206.91 | $1,089 | 1.0× |
| MRI abdomen w/o contrast (74181) | $538.65 | $2,835 | 2.5× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$503.50–$552.33 | $2,650–$2,907 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$788.69–$961.40 | $4,151–$5,060 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $619.40 | $3,260 | 0.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $581.59 | $3,061 | 2.7× |
| MRI Breast Without Contrast Material Unilateral (77046) | $472.72 | $2,488 | 2.2× |
| MRI cervical spine w contrast (72142) | $597.17 | $3,143 | 1.9× |
| MRI cervical spine w/o cont (72141) | $206.91 | $1,089 | 1.0× |
| MRI chest w/o contrast (71550) | $484.50 | $2,550 | 2.3× |
| MRI chest wo w contrast (71552) | $434.15 | $2,285 | 1.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$475–$486.97 | $2,500–$2,563 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 4 matching MRF lines |
$657.21–$961.40 | $3,459–$5,060 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$474.43–$600.78 | $2,497–$3,162 | varies |
| MRI lumbar spine w contrast (72149) | $345.80 | $1,820 | 1.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $345.80 | $1,820 | 1.1× |
| MRI orbit face &/neck w/o contrast (70540) | $206.91 | $1,089 | 1.0× |
| MRI orbit face neck w contrast (70542) | $288.23 | $1,517 | 0.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $345.80 | $1,820 | 1.1× |
| MRI pelvis w/o & w contrast (72197) | $345.80 | $1,820 | 1.1× |
| MRI pelvis w/o contrast (72195) | $206.91 | $1,089 | 1.0× |
| MRI thoracic spine w/o contrast (72146) | $206.91 | $1,089 | 1.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $486.97 | $2,563 | 1.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$206.91–$258.97 | $1,089–$1,363 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$345.80–$506.16 | $1,820–$2,664 | varies |
| MRI, abdomen, combo (74183) | $538.65 | $2,835 | 1.7× |
| MRI, dorsal spine combo (72157) | $345.80 | $1,820 | 1.1× |
| MRI, dorsal spine contrast (72147) | $587.29 | $3,091 | 1.9× |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$206.91–$310.84 | $1,089–$1,636 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$345.80–$421.80 | $1,820–$2,220 | varies |
| MRI, lumbar spine combo (72158) | $345.80 | $1,820 | 1.1× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $338.01 | $1,779 | 0.9× |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$235.60–$1,057.16 | $1,240–$5,564 | varies |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$17.29–$37.05 | $91–$195 | varies |
| Nm csf leak detection (78650) | $504.26 | $2,654 | 0.4× |
| Nuclear Rx Intra-Arterial (79445) | $190.95 | $1,005 | 0.9× |
| Nuclear Rx Oral Admin (79005) | $287.28 | $1,512 | 1.4× |
| Optic foramina (70190) | $53.58 | $282 | 0.7× |
| Parathyroid Planar Imaging (78070) | $242.25 | $1,275 | 0.7× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$23.18–$44.46 | $122–$234 | varies |
| PET image w/CT, full body (78816) | $1,042.72 | $5,488 | 0.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 3 matching MRF lines |
$1,042.72–$1,077.87 | $5,488–$5,673 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,161.06 | $11,374 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $351.50 | $1,850 | 1.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$23.18–$93.10 | $122–$490 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $371.07 | $1,953 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$17.29–$70.11 | $91–$369 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 5 matching MRF lines |
$17.29–$75.43 | $91–$397 | varies |
| Radex elbow complete minimum 3 views (73080) range across 5 matching MRF lines |
$17.29–$70.11 | $91–$369 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$23.18–$76.76 | $122–$404 | varies |
| Radex fingr minimum 2 views (73140) range across 5 matching MRF lines |
$17.29–$70.11 | $91–$369 | varies |
| Radex foot complete minimum 3 views (73630) range across 5 matching MRF lines |
$17.29–$70.11 | $91–$369 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$17.29–$70.11 | $91–$369 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$51.49–$70.11 | $271–$369 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $82.65 | $435 | 0.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$17.29–$49.40 | $91–$260 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$17.29–$60.80 | $91–$320 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$17.29–$70.11 | $91–$369 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$17.29–$46.55 | $91–$245 | varies |
| Radex Spine 1 View Specify Level (72020) | $49.02 | $258 | 0.6× |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$17.29–$54.53 | $91–$287 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $50.73 | $267 | 0.6× |
| Radex Toe Minimum 2 Views (73660) range across 5 matching MRF lines |
$17.29–$70.11 | $91–$369 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 4 matching MRF lines |
$92.15–$122.55 | $485–$645 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 5 matching MRF lines |
$17.29–$70.11 | $91–$369 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$23.18–$59.66 | $122–$314 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$23.18–$73.53 | $122–$387 | varies |
| Radiologic exam colon double contrast study (74280) | $122.93 | $647 | 0.8× |
| Radiologic exam colon single contrast study (74270) | $107.54 | $566 | 0.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $163.02 | $858 | 1.0× |
| Radiologic exam knee complete 4/more views (73564) range across 5 matching MRF lines |
$23.18–$125.59 | $122–$661 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $72.20 | $380 | 0.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $149.15 | $785 | 0.9× |
| Radiologic examination femur minimum 2 views (73552) range across 5 matching MRF lines |
$23.18–$70.11 | $122–$369 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$17.29–$70.11 | $91–$369 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $73.72 | $388 | 0.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$17.29–$70.11 | $91–$369 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $53.58 | $282 | 0.1× |
| Ribs bilateral 3 views (71110) | $73.53 | $387 | 0.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,101.81 | $5,799 | 2.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,101.81 | $5,799 | 2.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,075.02 | $5,658 | 2.2× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $601.16 | $3,164 | 2.9× |
| Salivary Gland Imaging Serial Images (78231) | $295.07 | $1,553 | 0.8× |
| Scapula (73010) range across 5 matching MRF lines |
$82.65–$127.49 | $435–$671 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $23.37 | $123 | 1.0× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$52.82–$70.11 | $278–$369 | varies |
| Shoulder Arthrography (73040) | $288.23 | $1,517 | 0.9× |
| Sialogram (70390) | $327.75 | $1,725 | 1.5× |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$23.18–$52.25 | $122–$275 | varies |
| Sternoclavicular joints (71130) | $53.20 | $280 | 0.7× |
| Testicular Imaging W/Flow (78761) | $407.36 | $2,144 | 1.1× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$23.18–$64.60 | $122–$340 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$23.18–$73.53 | $122–$387 | varies |
| Thoracolumbar 2 views (72080) | $64.60 | $340 | 0.8× |
| Thyroid Imaging With Vascular Flow (78013) | $188.48 | $992 | 0.5× |
| Thyroid Met Imaging Body (78018) | $319.96 | $1,684 | 0.7× |
| Thyroid Uptake Measurement (78012) | $171.19 | $901 | 0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $313.88 | $1,652 | 0.9× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$56.05–$81.13 | $295–$427 | varies |
| Ultrasound Elastography Parenchyma (76981) | $101.65 | $535 | 1.1× |
| Ultrasound Exam Aaa Screen (76706) | $84.55 | $445 | 0.9× |
| Ultrasound, abdomen limited (76705) | $102.41 | $539 | 1.1× |
| Upper gi w/o kub (74240) | $140.22 | $738 | 0.9× |
| Ureteral Reflux Study (78740) | $380.76 | $2,004 | 1.1× |
| Urethrocystogram voiding (74455) | $247.57 | $1,303 | 1.2× |
| Urethrocystography retrograde (74450) | $241.49 | $1,271 | 1.1× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$20.52–$125.59 | $108–$661 | varies |
| Us chest (76604) | $90.25 | $475 | 1.0× |
| Us exam, pelvic, limited (76857) | $23.75 | $125 | 0.3× |
| Us head (76506) | $81.13 | $427 | 0.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $91.20 | $480 | 1.0× |
| Us ob detailed single fetus (76811) | $23.75 | $125 | 0.1× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$23.75–$149.91 | $125–$789 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$23.75–$149.91 | $125–$789 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$23.75–$110.77 | $125–$583 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$23.75–$92.34 | $125–$486 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$23.75–$85.12 | $125–$448 | varies |
| Us retroperitoneal complete (76770) | $107.54 | $566 | 1.1× |
| Us retroperitoneal limited (76775) | $89.68 | $472 | 1.0× |
| Us scrotum and contents (76870) | $97.85 | $515 | 1.0× |
| Us spinal canal and contents (76800) | $87.02 | $458 | 0.9× |
| Us thyroid (76536) | $114.19 | $601 | 1.2× |
| Us transrectal (76872) range across 3 matching MRF lines |
$23.75–$100.89 | $125–$531 | varies |
| Vascular Flow Imaging (78445) | $304.95 | $1,605 | 0.9× |
| Vein X-Ray Chest (75827) | $768.93 | $4,047 | 0.5× |
| Venogram Sinus/Jugular (75860) | $750.12 | $3,948 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $2,409.96 | $12,684 | 0.9× |
| Venography extremity bilateral rs&i (75822) | $897.56 | $4,724 | 0.6× |
| Venography extremity unilateral rs&i (75820) range across 4 matching MRF lines |
$451.25–$469.30 | $2,375–$2,470 | varies |
| Venous sampling by catheter (75893) | $2,315.34 | $12,186 | 0.5× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $181.07 | $953 | 0.5× |
| Vertebral fracture assessment via dxa (77086) | $54.72 | $288 | 0.7× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$17.29–$70.11 | $91–$369 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $47.31 | $249 | 0.6× |
| X-ray antegrade pyelogram tube (74425) | $232.56 | $1,224 | 0.7× |
| X-Ray Aorta Leg Arteries (75630) | $2,409.96 | $12,684 | 0.9× |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$23.18–$65.74 | $122–$346 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$17.29–$70.11 | $91–$369 | varies |
| X-Ray Exam Breast Specimen (76098) | $271.32 | $1,428 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $65.74 | $346 | 0.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $23.18 | $122 | 0.2× |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$17.29–$46.74 | $91–$246 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$17.29–$54.15 | $91–$285 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$23.18–$75.05 | $122–$395 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $129.20 | $680 | 1.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$17.29–$54.53 | $91–$287 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $106.02 | $558 | 1.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 4 matching MRF lines |
$23.18–$63.27 | $122–$333 | varies |
| X-ray eye for foreign body (70030) | $79.42 | $418 | 1.0× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$17.29–$54.53 | $91–$287 | varies |
| X-ray IV pyelogram (ivp) (74400) | $141.17 | $743 | 0.9× |
| X-ray IV pyelogram+tomography (74415) | $239.97 | $1,263 | 1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $17.29 | $91 | 0.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$17.29–$54.53 | $91–$287 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$23.18–$64.60 | $122–$340 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $23.75 | $125 | 0.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $59.66 | $314 | 0.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $23.18 | $122 | 0.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$17.29–$54.53 | $91–$287 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$17.29–$60.80 | $91–$320 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $64.60 | $340 | 0.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$78.66–$171.95 | $414–$905 | varies |
| X-Rays Bone Length Studies (77073) | $86.45 | $455 | 0.9× |
| X-Rays Bone Survey Complete (77075) | $200.26 | $1,054 | 2.1× |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$23.18–$82.84 | $122–$436 | varies |
| Xr facial bones less than 3 views (70140) range across 3 matching MRF lines |
$17.29–$49.78 | $91–$262 | varies |
| Xr orbits complete 4 views (70200) | $53.20 | $280 | 0.6× |
| Xr Tomogram Single Plane (76100) | $114.38 | $602 | 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.