Imaging prices at Jefferson Davis Community Hospital
Prentiss, MS · every code in this section with a posted price and a Medicare benchmark.
373 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) | $1,134 | $3,240 | 1.0× |
| Abdomen 1 View (74018) | $149.50 | $427.13 | 2.0× |
| Abdomen 2 views (74019) | $188.89 | $539.66 | 2.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $584.86 | $1,671.01 | 1.7× |
| Angio pulmonary bilat (75743) | $1,232.81 | $3,522.31 | 0.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $1,173.52 | $3,352.91 | 0.4× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$1,801.15–$1,801.57 | $5,146.13–$5,147.34 | varies |
| Angiography extremity unilateral rs&i (75710) | $1,576.27 | $4,503.62 | 0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,436.52 | $4,104.32 | 0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,093.91 | $3,125.43 | 0.4× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$120.70–$160.93 | $344.85–$459.80 | varies |
| Aortography thoracic serialography rs&i (75605) | $1,528.42 | $4,366.89 | 0.3× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$1,801.15–$1,801.57 | $5,146.13–$5,147.34 | varies |
| Artery X-Rays Adrenal Gland (75731) | $1,173.52 | $3,352.91 | 0.4× |
| Artery X-Rays Pelvis (75736) | $1,530.96 | $4,374.15 | 0.3× |
| Artery X-Rays Spine (75705) | $1,496.23 | $4,274.93 | 0.3× |
| Arthrogram ankle (73615) | $141.45 | $404.14 | 0.5× |
| Arthrogram hip (73525) | $147.38 | $421.08 | 0.5× |
| Arthrogram Wrist (73115) | $205.40 | $586.85 | 0.7× |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$138.25–$162.05 | $395–$463 | varies |
| Bone age studies (77072) | $76.66 | $219.01 | 0.9× |
| Bone Imaging 3 Phase (78315) | $743.25 | $2,123.55 | 2.2× |
| Bone Imaging Limited Area (78300) | $470.09 | $1,343.10 | 1.4× |
| Bone Imaging Multiple Areas (78305) | $514.56 | $1,470.15 | 1.5× |
| Bone Imaging Whole Body (78306) | $705.13 | $2,014.65 | 2.0× |
| Bone survey infant (77076) | $177.87 | $508.20 | 2.0× |
| Brachytx isodose complex (77318) | $527.45 | $1,507 | 1.6× |
| Brachytx isodose intermed (77317) | $413 | $1,180 | 1.3× |
| Brachytx Isodose Plan Simple (77316) | $297.50 | $850 | 0.9× |
| Brain Flow Imaging Only (78610) | $365.91 | $1,045.44 | 0.8× |
| Brain Image W/Flow < 4 Views (78601) | $385.81 | $1,102.31 | 1.1× |
| Brain imaging < 4 static views (78600) | $320.17 | $914.76 | 0.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $815.67 | $2,330.46 | 1.7× |
| Brain Imaging Minimum 4 Static Views (78605) | $354.90 | $1,013.98 | 0.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,905.75 | $5,445 | 6.3× |
| Cat Scan Follow-Up Study (76380) | $356.59 | $1,018.82 | 4.8× |
| Cerebrospinal Fluid Scan (78630) | $631.44 | $1,804.11 | 1.3× |
| Chest 1 view (71045) | $124.51 | $355.74 | 1.7× |
| Chest 2 views (71046) | $137.64 | $393.25 | 1.8× |
| Chest 3 views (71047) | $158.82 | $453.75 | 2.1× |
| Chest 4 or more views (71048) | $169.40 | $484 | 1.9× |
| Clavicle complete (73000) | $158.82 | $453.75 | 2.1× |
| Continuing medical physics consltj pr wk (77336) | $273.35 | $781 | 2.4× |
| Contrast Exam Abdominl Aorta (75625) | $1,870.60 | $5,344.57 | 0.7× |
| Contrast X-Ray Bladder (74430) | $168.13 | $480.37 | 0.6× |
| Contrast X-Ray Of Elbow (73085) | $180.42 | $515.46 | 0.6× |
| Contrast X-Ray Of Knee Joint (73580) | $154.58 | $441.65 | 0.5× |
| Contrast Xray Throat/Cerv Esopha (74210) | $140.18 | $400.51 | 0.9× |
| CT abdomen and pelvis without and with contrast (74178) | $1,985.37 | $5,672.48 | 6.6× |
| CT abdomen and pelvis without contrast (74176) | $1,411.11 | $4,031.72 | 6.9× |
| CT abdomen w contrast (74160) | $994.81 | $2,842.29 | 6.6× |
| CT abdomen w wo contrast (74170) | $1,176.49 | $3,361.38 | 7.8× |
| CT abdomen w/o contrast (74150) | $812.70 | $2,321.99 | 9.0× |
| CT Angio Abdomen and Pelvis (74174) | $1,167.17 | $3,334.76 | 3.9× |
| CT Angio Chest (71275) | $773.74 | $2,210.67 | 5.1× |
| CT Angio Head (70496) | $773.74 | $2,210.67 | 5.1× |
| CT angio hrt w/3d image (75574) | $880.04 | $2,514.38 | 2.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$830.49–$1,660.97 | $2,372.81–$4,745.62 | varies |
| CT Angio Neck (70498) | $1,060.03 | $3,028.63 | 7.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$773.74–$1,547.47 | $2,210.67–$4,421.34 | varies |
| CT cervical spine w/ contrast (72126) | $975.33 | $2,786.63 | 3.2× |
| CT cervical spine w/o contrast (72125) | $899.10 | $2,568.83 | 10.0× |
| CT cervical spine w/wo cont (72127) | $1,189.19 | $3,397.68 | 7.9× |
| CT chest w contrast (71260) | $917.73 | $2,622.07 | 6.1× |
| CT chest w/wo contrast (71270) | $1,110.42 | $3,172.62 | 7.3× |
| CT colonography screening (74263) | $606.88 | $1,733.93 | 3.0× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $703.01 | $2,008.60 | 4.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $467.13 | $1,334.63 | 5.2× |
| CT head/brain with contrast (70460) | $813.97 | $2,325.62 | 5.4× |
| CT head/brain without and with contrast (70470) | $990.57 | $2,830.19 | 6.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $814.40 | $2,326.83 | 2.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $37.70 | $107.69 | 0.5× |
| CT hrt w/3d image congen (75573) | $830.49 | $2,372.81 | 2.8× |
| CT iac w contrast (70481) | $814.82 | $2,328.04 | 5.4× |
| CT l-spine w&w/o contrast (72133) | $1,171.41 | $3,346.86 | 7.7× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$736.89–$1,473.78 | $2,105.40–$4,210.80 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$789.41–$1,578.81 | $2,255.44–$4,510.88 | varies |
| CT lumbar spine w contrast (72132) | $997.35 | $2,849.55 | 3.3× |
| CT lumbar spine w/o contrast (72131) | $888.93 | $2,539.79 | 9.9× |
| CT maxillofacial w contrast (70487) | $825.41 | $2,358.29 | 5.5× |
| CT maxillofacial wo contrast (70486) | $741.55 | $2,118.71 | 8.2× |
| CT neck tissue combo (70492) | $1,046.47 | $2,989.91 | 6.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $951.19 | $2,717.66 | 6.3× |
| CT orbits w/o contrast (70480) | $769.50 | $2,198.57 | 8.5× |
| CT pelvis w&w/o contrast (72194) | $1,127.36 | $3,221.02 | 7.5× |
| CT pelvis w/o contrast (72192) | $802.54 | $2,292.95 | 8.9× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$994.81–$1,989.61 | $2,842.29–$5,684.58 | varies |
| CT scans face/jaw combo (70488) | $992.69 | $2,836.24 | 6.6× |
| CT soft tissue neck w contrast (70491) | $878.77 | $2,510.75 | 5.8× |
| CT soft tissue neck w/o contrast (70490) | $761.88 | $2,176.79 | 8.5× |
| CT thoracic spine w contrast (72129) | $844.46 | $2,412.74 | 5.6× |
| CT thoracic spine w/o contrast (72128) | $844.46 | $2,412.74 | 9.4× |
| CT thoracic spine w/wo cont (72130) | $844.46 | $2,412.74 | 5.6× |
| CT thorax w/o contrast (71250) | $769.50 | $2,198.57 | 8.5× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$722.50–$1,444.99 | $2,064.26–$4,128.52 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$956.27–$1,912.53 | $2,732.18–$5,464.36 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$815.24–$1,630.48 | $2,329.25–$4,658.50 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,148.54 | $3,281.52 | 7.6× |
| Cta Abdomen (74175) | $1,412.80 | $4,036.56 | 9.3× |
| CTA pelvis (72191) | $758.49 | $2,167.11 | 5.0× |
| Dilation ureters/urethra rs&i (74485) | $1,348.85 | $3,853.85 | 0.7× |
| Discography Cerv/Thor Spine (72285) | $1,093.91 | $3,125.43 | 0.6× |
| Diskography lumbar (72295) | $1,116.77 | $3,190.77 | 0.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $216.84 | $619.52 | 2.4× |
| Dxa Bone Density Axial (77080) | $177.87 | $508.20 | 2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $146.11 | $417.45 | 1.9× |
| Echo exam of fetal heart (76825) | $615.35 | $1,758.13 | 1.3× |
| Echo Guide For Artery Repair (76936) | $408.68 | $1,167.65 | 2.2× |
| Echograp Trans R Pros Study (76873) | $224.46 | $641.30 | 2.5× |
| Esophagram (74220) | $232.51 | $664.29 | 1.5× |
| Fetal Biophys Profile W/Nst (76818) | $218.11 | $623.15 | 2.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $166.02 | $474.32 | 1.8× |
| Fluoroscopy up to 1 hr (76000) | $203.28 | $580.80 | 1.0× |
| Follow-Up Angiography (75898) | $268.93 | $768.35 | 0.1× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$78.35–$104.61 | $223.85–$298.87 | varies |
| Forearm 2 views (73090) | $156.70 | $447.70 | 2.1× |
| Gastric emptying imaging study (78264) | $668.71 | $1,910.59 | 1.9× |
| Gastroesophageal Reflux Exam (78262) | $297.73 | $850.63 | 0.9× |
| Gated Heart Planar Single (78472) | $696.24 | $1,989.24 | 2.0× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$120.70–$160.93 | $344.85–$459.80 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $2,361.45 | $6,747 | 3.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,967.35 | $5,621 | 3.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,615.60 | $4,616 | 2.7× |
| Heart Image (Pet) Multiple (78492) | $1,748.64 | $4,996.09 | 1.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,571.19 | $4,489.10 | 0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,196.82 | $3,419.46 | 0.4× |
| Hepatobil Syst Image W/Drug (78227) | $700.05 | $2,000.13 | 1.5× |
| Hepatobiliary System Imaging (78226) | $463.31 | $1,323.74 | 1.3× |
| Ht Muscle Image Spect Sing (78451) | $1,300.15 | $3,714.70 | 1.2× |
| Hysterosalpingogram (74740) | $226.15 | $646.14 | 1.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $188.04 | $537.24 | 2.5× |
| Interstitial radiation source applic complex (77778) | $1,020.95 | $2,917 | 1.7× |
| Joint Survey Single View (77077) | $108.84 | $310.97 | 1.2× |
| K Flow/Funct Image Multiple (78709) | $450.61 | $1,287.44 | 1.0× |
| K Flow/Funct Image W/Drug (78708) | $685.23 | $1,957.78 | 1.5× |
| K Flow/Funct Image W/O Drug (78707) | $669.13 | $1,911.80 | 1.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $222.34 | $635.25 | 0.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$143.57–$191.43 | $410.19–$546.92 | varies |
| Leveen/Shunt Patency Exam (78291) | $252.83 | $722.37 | 0.7× |
| Liver & Spleen Imaging Static Only (78215) | $564.11 | $1,611.72 | 1.6× |
| Lung Perf&Ventilat Diferentl (78598) | $563.26 | $1,609.30 | 1.2× |
| Lung perfusion differential (78597) | $534.89 | $1,528.23 | 1.6× |
| Lung Ventilat&Perfus Imaging (78582) | $753.41 | $2,152.59 | 1.6× |
| Lung Ventilation Imaging (78579) | $429.43 | $1,226.94 | 1.2× |
| Lymph System Imaging (78195) | $343.46 | $981.31 | 0.7× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $268.93 | $768.35 | 0.2× |
| Lymphangiography extremity only unilateral rs&i (75801) | $177.03 | $505.78 | 0.3× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,093.91 | $3,125.43 | 0.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $268.93 | $768.35 | 0.1× |
| Magnetic Image Jaw Joint (70336) | $1,046.47 | $2,989.91 | 5.1× |
| Meckels Divert Exam (78290) | $539.12 | $1,540.33 | 1.6× |
| Mlc imrt design & construction per imrt plan (77338) | $218.05 | $623 | 0.7× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$1,078.66–$1,450.07 | $3,081.87–$4,143.04 | varies |
| MRA head w/o contrast (70544) | $987.61 | $2,821.72 | 4.8× |
| MRA head with contrast (70545) | $1,044.36 | $2,983.86 | 3.5× |
| MRA neck w contrast (70548) | $827.95 | $2,365.55 | 2.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,004.97 | $2,871.33 | 3.3× |
| MRA neck w/o contrast (70547) | $689.46 | $1,969.88 | 3.4× |
| MRI abdomen w contrast (74182) | $1,503.43 | $4,295.50 | 5.0× |
| MRI abdomen w/o contrast (74181) | $1,334.03 | $3,811.50 | 6.5× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$1,439.90–$1,863.40 | $4,114–$5,324 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$1,907.87–$2,576.58 | $5,451.05–$7,361.64 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$1,403.91–$1,827.41 | $4,011.15–$5,221.15 | varies |
| MRI cardiac w/o contrast (75557) | $1,286.60 | $3,675.98 | 6.3× |
| MRI cervical spine w contrast (72142) | $1,416.19 | $4,046.24 | 4.7× |
| MRI cervical spine w/o cont (72141) | $1,323.44 | $3,781.25 | 6.4× |
| MRI chest w/o contrast (71550) | $1,308.20 | $3,737.69 | 6.4× |
| MRI chest with contrast (71551) | $865.22 | $2,472.03 | 1.3× |
| MRI chest wo w contrast (71552) | $1,680.88 | $4,802.49 | 5.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$1,445.41–$2,044.24 | $4,129.73–$5,840.67 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,745.67–$1,994.69 | $4,987.62–$5,699.10 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$1,234.51–$1,868.91 | $3,527.15–$5,339.73 | varies |
| MRI lumbar spine w contrast (72149) | $1,378.50 | $3,938.55 | 4.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,683.84 | $4,810.96 | 5.6× |
| MRI orbit face &/neck w/o contrast (70540) | $1,227.73 | $3,507.79 | 6.0× |
| MRI orbit face neck w contrast (70542) | $1,301.42 | $3,718.33 | 4.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,746.10 | $4,988.83 | 5.8× |
| MRI pelvis w contrast (72196) | $1,431.43 | $4,089.80 | 4.8× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,678.34–$1,680.88 | $4,795.23–$4,802.49 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$869.03–$1,334.03 | $2,482.92–$3,811.50 | varies |
| MRI spectroscopy (76390) | $867.33 | $2,478.08 | 11.6× |
| MRI thoracic spine w/o contrast (72146) | $1,323.87 | $3,782.46 | 6.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$1,347.58–$1,771.08 | $3,850.22–$5,060.22 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,163.36–$1,586.86 | $3,323.87–$4,533.87 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$1,668.17–$2,134.87 | $4,766.19–$6,099.61 | varies |
| MRI, abdomen, combo (74183) | $1,680.88 | $4,802.49 | 5.6× |
| MRI, dorsal spine combo (72157) | $1,685.11 | $4,814.59 | 5.6× |
| MRI, dorsal spine contrast (72147) | $1,383.16 | $3,951.86 | 4.6× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$1,334.03–$1,779.98 | $3,811.50–$5,085.63 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$1,680.88–$2,104.38 | $4,802.49–$6,012.49 | varies |
| MRI, lumbar spine combo (72158) | $1,678.76 | $4,796.44 | 5.6× |
| Myelogram cervical (72240) | $665.75 | $1,902.12 | 1.0× |
| Myocardial Spect Multiple Studies (78452) | $1,544.51 | $4,412.87 | 1.4× |
| Neck soft tissue (70360) | $125.78 | $359.37 | 1.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $254.10 | $726 | 0.7× |
| Nm csf leak detection (78650) | $584.01 | $1,668.59 | 0.5× |
| Nonvascular Shunt X-Ray (75809) | $352.36 | $1,006.72 | 3.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,111.25 | $3,175 | 0.9× |
| Nuclear Rx Oral Admin (79005) | $425.20 | $1,214.84 | 2.1× |
| Panoramic X-ray of jaws (70355) | $68.61 | $196.02 | 0.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $425.20 | $1,214.84 | 0.9× |
| Parathyroid Planar Imaging (78070) | $531.50 | $1,518.55 | 1.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $425.20 | $1,214.84 | 1.2× |
| Pelvis 1 or 2 views (72170) | $127.90 | $365.42 | 1.4× |
| Peritoneogram Rs&I (74190) | $229.12 | $654.61 | 0.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,626.55 | $7,504.42 | 2.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,436.52 | $4,104.32 | 0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $538.70 | $1,539.12 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $247.75 | $707.85 | 2.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $164.75 | $470.69 | 0.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$141.03–$188.04 | $402.93–$537.24 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$114.77–$152.89 | $327.91–$436.81 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$124.51–$194.39 | $355.74–$555.39 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $190.16 | $543.29 | 2.1× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$131.29–$137.64 | $375.10–$393.25 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$139.76–$186.34 | $399.30–$532.40 | varies |
| Radex Hand Minimum 3 Views (73130) | $167.29 | $477.95 | 2.2× |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$120.70–$160.93 | $344.85–$459.80 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $116.47 | $332.75 | 1.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $151.19 | $431.97 | 2.0× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $190.58 | $544.50 | 2.5× |
| Radex Ribs Unilateral 2 Views (71100) | $94.87 | $271.04 | 1.3× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$177.87–$237.16 | $508.20–$677.60 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $94.02 | $268.62 | 1.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $141.88 | $405.35 | 0.9× |
| Radex Spine 1 View Specify Level (72020) | $95.29 | $272.25 | 1.3× |
| Radex Sternum Minimum 2 Views (71120) | $146.11 | $417.45 | 1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $167.29 | $477.95 | 2.2× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$120.70–$127.05 | $344.85–$363 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$116.47–$201.17 | $332.75–$574.75 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$118.16–$157.55 | $337.59–$450.12 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $247.75 | $707.85 | 2.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $6,602.05 | $18,863 | 1.0× |
| Radiation treatment delivery level 1 (77402) | $227.50 | $650 | 2.6× |
| Radiation treatment delivery level 2 (77407) | $332.50 | $950 | 1.0× |
| Radiation treatment delivery level 3 (77412) | $369.25 | $1,055 | 0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $185.50 | $529.98 | 2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $200.32 | $572.33 | 2.2× |
| Radiologic exam colon double contrast study (74280) | $413.34 | $1,180.96 | 2.7× |
| Radiologic exam colon single contrast study (74270) | $329.06 | $940.17 | 2.2× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$158.39–$210.91 | $452.54–$602.58 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $156.28 | $446.49 | 1.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $282.06 | $805.86 | 1.9× |
| Radiologic exam swallow function contrast study (74230) | $108 | $308.55 | 0.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $314.24 | $897.82 | 2.1× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$125.78–$167.71 | $359.37–$479.16 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$167.29–$223.19 | $477.95–$637.67 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$78.35–$104.61 | $223.85–$298.87 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $250.72 | $716.32 | 2.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$137.22–$182.96 | $392.04–$522.72 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $352.80 | $1,008 | 1.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $294 | $840 | 0.9× |
| Renal Cyst Study (74470) | $177.03 | $505.78 | 0.4× |
| Ribs bilateral 3 views (71110) | $185.50 | $529.98 | 2.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $344.31 | $983.73 | 1.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $411.22 | $1,174.91 | 1.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,228.15 | $3,509 | 2.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $865.22 | $2,472.03 | 1.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $958.81 | $2,739.44 | 2.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $958.81 | $2,739.44 | 0.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,219.68 | $3,484.80 | 1.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $958.81 | $2,739.44 | 0.9× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $543.78 | $1,553.64 | 2.7× |
| Rp Therapy Intravenous Administration (79101) | $408.26 | $1,166.44 | 2.0× |
| Scapula (73010) range across 3 matching MRF lines |
$133.83–$169.40 | $382.36–$484 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$25.41–$38.12 | $72.60–$108.90 | varies |
| Shoulder 1 view (73020) | $63.95 | $182.71 | 0.9× |
| Sialogram (70390) | $177.87 | $508.20 | 0.9× |
| Skull less than 4 views (70250) | $88.94 | $254.10 | 1.0× |
| Special dosimetry (77331) range across 2 matching MRF lines |
$121.80–$129.50 | $348–$370 | varies |
| Special Physics Consult (77370) | $224.70 | $642 | 1.9× |
| Special teletherapy port plan (77321) | $357 | $1,020 | 1.1× |
| Special treatment procedure (77470) | $436.80 | $1,248 | 0.9× |
| Stereotactic Body Radiation Delivery (77373) | $4,559.10 | $13,026 | 3.0× |
| Sternoclavicular joints (71130) | $88.94 | $254.10 | 1.2× |
| Superior sagittal sinus venogram (75870) | $369.72 | $1,056.33 | 0.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $326.20 | $932 | 1.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $208.60 | $596 | 0.6× |
| Testicular Imaging W/Flow (78761) | $240.98 | $688.49 | 0.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $576.10 | $1,646 | 1.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $371.70 | $1,062 | 1.2× |
| Ther rad simulaj-aided field setting simple (77280) | $295.40 | $844 | 2.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $412.92 | $1,179.75 | 2.7× |
| Thoracic spine 2 views (72070) | $156.28 | $446.49 | 1.7× |
| Thoracic spine 3 views (72072) | $156.28 | $446.49 | 1.7× |
| Thoracolumbar 2 views (72080) | $154.58 | $441.65 | 2.1× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $545.05 | $1,557.27 | 1.6× |
| Thyroid Imaging With Vascular Flow (78013) | $317.63 | $907.50 | 0.9× |
| Thyroid Met Imaging Body (78018) | $681.42 | $1,946.89 | 1.5× |
| Thyroid Uptake Measurement (78012) | $317.63 | $907.50 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $529.38 | $1,512.50 | 1.5× |
| Tx Devices Design & Construction Complex (77334) range across 10 matching MRF lines |
$146.65–$342.30 | $419–$978 | varies |
| Tx devices design & construction intermediate (77333) | $204.05 | $583 | 1.8× |
| Tx devices design & construction simple (77332) range across 3 matching MRF lines |
$146.65–$272.30 | $419–$778 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$121.13–$211.75 | $346.06–$605 | varies |
| Ultrasound Exam Aaa Screen (76706) | $210.91 | $602.58 | 2.3× |
| Ultrasound, abdomen limited (76705) | $349.39 | $998.25 | 3.9× |
| Umbilical-artery Doppler (OB) (76820) | $213.03 | $608.63 | 2.4× |
| Unlisted magnetic resonance procedure (76498) | $611.96 | $1,748.45 | 8.2× |
| Upper gi w/o kub (74240) | $289.26 | $826.43 | 1.9× |
| Urethrocystogram voiding (74455) | $317.63 | $907.50 | 1.5× |
| Urethrocystography retrograde (74450) | $212.18 | $606.21 | 1.0× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$182.11–$275.28 | $520.30–$786.50 | varies |
| Us chest (76604) | $206.25 | $589.27 | 2.3× |
| Us complete joint (76881) range across 4 matching MRF lines |
$127.05–$224.46 | $363–$641.30 | varies |
| Us exam, pelvic, limited (76857) | $203.28 | $580.80 | 2.3× |
| Us head (76506) | $138.49 | $395.67 | 1.5× |
| Us kidney transplant (76776) | $233.78 | $667.92 | 2.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$127.05–$224.46 | $363–$641.30 | varies |
| Us ob detailed single fetus (76811) | $334.57 | $955.90 | 1.6× |
| Us ob limited 1 or more fetuses (76815) | $188.04 | $537.24 | 2.1× |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$188.04–$219.38 | $537.24–$626.78 | varies |
| Us pelvic non ob complete (76856) | $329.91 | $942.59 | 3.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $297.30 | $849.42 | 3.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $177.87 | $508.20 | 2.0× |
| Us retroperitoneal complete (76770) | $380.31 | $1,086.58 | 4.2× |
| Us retroperitoneal limited (76775) | $380.31 | $1,086.58 | 4.2× |
| Us scrotum and contents (76870) | $297.30 | $849.42 | 3.3× |
| Us spinal canal and contents (76800) | $201.17 | $574.75 | 2.2× |
| Us thyroid (76536) | $279.51 | $798.60 | 3.1× |
| Vein X-Ray Chest (75827) | $841.08 | $2,403.06 | 0.6× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,408.14 | $4,023.25 | 0.5× |
| Vein X-Ray Skull Epidural (75872) | $1,093.91 | $3,125.43 | 2.0× |
| Venogram Sinus/Jugular (75860) | $1,093.91 | $3,125.43 | 0.4× |
| Venography Adrenal Unilateral (75840) | $1,173.52 | $3,352.91 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $1,774.47 | $5,069.90 | 0.7× |
| Venography extremity bilateral rs&i (75822) | $952.03 | $2,720.08 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $739.44 | $2,112.66 | 0.5× |
| Venography Orbital Rs&I (75880) | $1,093.91 | $3,125.43 | 2.0× |
| Venography Renal Bilateral (75833) | $1,369.18 | $3,911.93 | 0.5× |
| Venography Renal Unilateral (75831) | $1,256.95 | $3,591.28 | 0.5× |
| Venous sampling by catheter (75893) | $1,173.52 | $3,352.91 | 0.2× |
| Vertebral fracture assessment via dxa (77086) | $116.47 | $332.75 | 1.6× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$118.16–$143.99 | $337.59–$411.40 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $86.82 | $248.05 | 1.2× |
| X-ray antegrade pyelogram tube (74425) | $205.40 | $586.85 | 0.7× |
| X-Ray Aorta Leg Arteries (75630) | $1,732.12 | $4,948.90 | 0.6× |
| X-Ray Bend Only L-S Spine (72120) | $212.18 | $606.21 | 2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$124.51–$146.11 | $355.74–$417.45 | varies |
| X-Ray Exam Breast Specimen (76098) | $228.69 | $653.40 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $120.70 | $344.85 | 1.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $163.05 | $465.85 | 1.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $205.40 | $586.85 | 2.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $78.35 | $223.85 | 1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $142.30 | $406.56 | 1.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $203.28 | $580.80 | 2.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $194.39 | $555.39 | 2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $272.32 | $778.03 | 3.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $310.01 | $885.72 | 3.4× |
| X-Ray Exam L-S Spine Bending (72114) | $250.29 | $715.11 | 2.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $152.46 | $435.60 | 2.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $152.46 | $435.60 | 1.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $185.50 | $529.98 | 2.1× |
| X-ray humerus (73060) | $154.58 | $441.65 | 2.1× |
| X-ray IV pyelogram (ivp) (74400) | $397.25 | $1,134.98 | 2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $94.02 | $268.62 | 1.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $120.70 | $344.85 | 1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $169.83 | $485.21 | 1.9× |
| X-ray nose-rectum child f.b. (76010) | $77.08 | $220.22 | 1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $244.79 | $699.38 | 2.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $124.94 | $356.95 | 1.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $116.04 | $331.54 | 1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $149.08 | $425.92 | 2.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $185.50 | $529.98 | 2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $222.77 | $636.46 | 2.5× |
| X-ray thoracic spine 4 vw (72074) | $156.28 | $446.49 | 1.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $227 | $648.56 | 0.8× |
| X-Rays Bone Length Studies (77073) | $109.27 | $312.18 | 1.2× |
| X-Rays Bone Survey Complete (77075) | $322.71 | $922.02 | 3.6× |
| Xr c-spine 4 or 5 views (72050) | $225.73 | $644.93 | 2.5× |
| Xr facial bones less than 3 views (70140) | $167.71 | $479.16 | 2.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $94.02 | $268.62 | 1.0× |
| Xr orbits complete 4 views (70200) | $95.29 | $272.25 | 1.1× |
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.