Imaging prices at Kapiʻolani Medical Center for Women & Children
Honolulu, HI · every code in this section with a posted price and a Medicare benchmark.
345 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) | $219 | $365 | 2.1× |
| Abdomen 2 views (74019) | $225 | $375 | 1.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $739.80 | $1,233 | 1.6× |
| Angio internal mammary (75756) | $2,913 | $4,855 | 0.8× |
| Angio pulmonary bilat (75743) | $2,968.20 | $4,947 | 0.8× |
| Angiography extremity bilateral rs&i (75716) | $3,617.40 | $6,029 | 1.0× |
| Angiography extremity unilateral rs&i (75710) | $2,941.20 | $4,902 | 0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,274.80 | $5,458 | 0.9× |
| Ankle 2 views (73600) | $187.80 | $313 | 1.8× |
| Artery X-Rays Abdomen (75726) | $5,431.20 | $9,052 | 0.8× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,908.20 | $4,847 | 0.4× |
| Arthrogram ankle (73615) | $624 | $1,040 | 1.5× |
| Arthrogram hip (73525) | $544.80 | $908 | 1.3× |
| Arthrogram Wrist (73115) | $535.80 | $893 | 1.3× |
| Bone age studies (77072) | $225 | $375 | 1.8× |
| Bone Imaging 3 Phase (78315) | $1,000.80 | $1,668 | 2.1× |
| Bone Imaging Limited Area (78300) | $739.80 | $1,233 | 1.6× |
| Bone Imaging Multiple Areas (78305) | $757.20 | $1,262 | 1.6× |
| Bone Imaging Whole Body (78306) | $951.60 | $1,586 | 2.0× |
| Bone marrow imaging limited area (78102) | $721.80 | $1,203 | 1.5× |
| Bone marrow imaging; multiple areas (78103) | $739.80 | $1,233 | 1.6× |
| Bone survey infant (77076) | $320.40 | $534 | 2.6× |
| Brain Flow Imaging Only (78610) | $969 | $1,615 | 1.5× |
| Brain imaging < 4 static views (78600) | $739.80 | $1,233 | 1.6× |
| Brain Imaging Minimum 4 Static Views (78605) | $969 | $1,615 | 1.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,134.20 | $3,557 | 5.2× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,653 | $2,755 | 1.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $969 | $1,615 | 1.5× |
| Chest 1 view (71045) | $219 | $365 | 2.1× |
| Chest 2 views (71046) | $254.40 | $424 | 2.5× |
| Chest 3 views (71047) | $289.80 | $483 | 2.8× |
| Chest 4 or more views (71048) | $344.40 | $574 | 2.8× |
| Clavicle complete (73000) | $225 | $375 | 2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $370.80 | $618 | 3.0× |
| Contrast Exam Abdominl Aorta (75625) | $3,138 | $5,230 | 0.8× |
| Contrast X-Ray Bladder (74430) | $454.20 | $757 | 1.1× |
| Contrast X-Ray Of Elbow (73085) | $544.80 | $908 | 1.3× |
| Contrast X-Ray Of Knee Joint (73580) | $535.80 | $893 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) range across 4 matching MRF lines |
$2,763–$3,250.20 | $4,605–$5,417 | varies |
| CT abdomen and pelvis without contrast (74176) range across 5 matching MRF lines |
$1,355.40–$2,411.40 | $2,259–$4,019 | varies |
| CT abdomen w contrast (74160) | $1,589.40 | $2,649 | 7.7× |
| CT abdomen w wo contrast (74170) | $1,585.20 | $2,642 | 7.7× |
| CT abdomen w/o contrast (74150) | $1,291.20 | $2,152 | 10.5× |
| CT Angio Abdomen and Pelvis (74174) | $2,842.20 | $4,737 | 6.9× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,697.40–$1,782 | $2,829–$2,970 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$1,583.40–$2,094 | $2,639–$3,490 | varies |
| CT angio hrt w/3d image (75574) | $1,438.20 | $2,397 | 3.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,506–$1,697.40 | $2,510–$2,829 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$1,704–$2,211 | $2,840–$3,685 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,300.20–$1,361.40 | $2,167–$2,269 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,399.20 | $2,332 | 6.8× |
| CT cervical spine w/ contrast (72126) | $1,465.80 | $2,443 | 3.6× |
| CT cervical spine w/o contrast (72125) | $1,382.40 | $2,304 | 11.2× |
| CT chest w contrast (71260) | $1,570.20 | $2,617 | 7.6× |
| CT chest w/wo contrast (71270) | $2,028 | $3,380 | 9.8× |
| CT head/brain with contrast (70460) | $1,408.20 | $2,347 | 6.8× |
| CT head/brain without and with contrast (70470) | $1,509 | $2,515 | 7.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $642.60 | $1,071 | 1.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $142.80 | $238 | 1.4× |
| CT hrt w/3d image congen (75573) | $651.60 | $1,086 | 1.6× |
| CT iac w contrast (70481) | $1,368 | $2,280 | 6.6× |
| CT l-spine w&w/o contrast (72133) | $1,541.40 | $2,569 | 7.4× |
| CT lower ext w/o (73700) | $1,194.60 | $1,991 | 9.7× |
| CT lower extremity w/contrast material (73701) range across 5 matching MRF lines |
$1,401–$1,450.80 | $2,335–$2,418 | varies |
| CT lumbar spine w contrast (72132) | $1,657.80 | $2,763 | 4.0× |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,021.80–$1,389 | $1,703–$2,315 | varies |
| CT maxillofacial w contrast (70487) | $1,279.80 | $2,133 | 6.2× |
| CT maxillofacial wo contrast (70486) | $1,159.20 | $1,932 | 9.4× |
| CT neck tissue combo (70492) | $1,564.80 | $2,608 | 7.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,471.20 | $2,452 | 7.1× |
| CT orbits w/o contrast (70480) | $1,194.60 | $1,991 | 9.7× |
| CT pelvis w&w/o contrast (72194) | $1,571.40 | $2,619 | 7.6× |
| CT pelvis w/o contrast (72192) | $1,194.60 | $1,991 | 9.7× |
| CT scan of leg combo (73702) | $1,571.40 | $2,619 | 7.6× |
| CT scans face/jaw combo (70488) | $1,530 | $2,550 | 7.4× |
| CT soft tissue neck w contrast (70491) | $1,381.20 | $2,302 | 6.7× |
| CT soft tissue neck w/o contrast (70490) | $1,312.20 | $2,187 | 10.6× |
| CT thoracic spine w contrast (72129) | $1,448.40 | $2,414 | 7.0× |
| CT thoracic spine w/o contrast (72128) | $1,320.60 | $2,201 | 10.7× |
| CT thorax w/o contrast (71250) range across 4 matching MRF lines |
$1,134–$1,486.80 | $1,890–$2,478 | varies |
| CT upper ext wo (73200) | $1,194.60 | $1,991 | 9.7× |
| CT upper extremity w/o & w/contrast material (73202) | $1,541.40 | $2,569 | 7.4× |
| CT upper extremity with contrast (73201) | $1,450.80 | $2,418 | 3.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,697.40 | $2,829 | 8.2× |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,721.40–$1,801.20 | $2,869–$3,002 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,399.20 | $2,332 | 3.4× |
| CTA pelvis (72191) range across 2 matching MRF lines |
$1,740.60–$1,822.80 | $2,901–$3,038 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 3 matching MRF lines |
$378–$522 | $630–$870 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 3 matching MRF lines |
$378–$522 | $630–$870 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$336–$400.80 | $560–$668 | varies |
| Dxa Bone Density Axial (77080) | $249.60 | $416 | 2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $146.40 | $244 | 1.4× |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$454.20–$567.60 | $757–$946 | varies |
| Echo exam uterus (76831) | $516 | $860 | 1.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 3 matching MRF lines |
$358.20–$473.40 | $597–$789 | varies |
| Esophagram (74220) | $252 | $420 | 1.2× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$367.20–$455.40 | $612–$759 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$296.40–$371.40 | $494–$619 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,285.80 | $2,143 | 4.6× |
| Fluoroscopy up to 1 hr (76000) | $435 | $725 | 1.5× |
| Follow-Up Angiography (75898) | $1,316.40 | $2,194 | 0.4× |
| Foot 2 views (73620) | $204.60 | $341 | 2.0× |
| Forearm 2 views (73090) | $225 | $375 | 2.2× |
| Gastric emptying imaging study (78264) | $818.40 | $1,364 | 1.7× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $739.80 | $1,233 | 1.6× |
| Gastroesophageal Reflux Exam (78262) | $739.80 | $1,233 | 1.6× |
| Gated Heart Planar Single (78472) | $723 | $1,205 | 1.5× |
| Gated Heart, Multiple (78473) | $855.60 | $1,426 | 1.8× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $969 | $1,615 | 1.5× |
| Hand 2 views (73120) | $225 | $375 | 1.8× |
| Hepatobil Syst Image W/Drug (78227) | $969 | $1,615 | 1.5× |
| Hepatobiliary System Imaging (78226) | $723 | $1,205 | 1.5× |
| Ht Muscle Image Spect Sing (78451) | $2,349.60 | $3,916 | 1.5× |
| Hysterosalpingogram (74740) | $543.60 | $906 | 1.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $439.20 | $732 | 4.3× |
| Infant hip ultrasound, limited static exam (76886) | $407.40 | $679 | 4.0× |
| Infusion Ivp (74410) | $784.20 | $1,307 | 3.8× |
| Joint Survey Single View (77077) | $180.60 | $301 | 1.5× |
| K Flow/Funct Image Multiple (78709) | $1,294.80 | $2,158 | 2.0× |
| K Flow/Funct Image W/Drug (78708) | $1,167 | $1,945 | 1.8× |
| K Flow/Funct Image W/O Drug (78707) | $1,052.40 | $1,754 | 1.6× |
| Kidney Imaging Morphol (78700) | $749.40 | $1,249 | 1.6× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,357.20 | $2,262 | 2.9× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$288–$460.80 | $480–$768 | varies |
| Liver & Spleen Imaging Static Only (78215) | $739.80 | $1,233 | 1.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $855.60 | $1,426 | 1.8× |
| Lung Perf&Ventilat Diferentl (78598) | $1,052.40 | $1,754 | 1.6× |
| Lung perfusion differential (78597) | $749.40 | $1,249 | 1.6× |
| Lung Ventilat&Perfus Imaging (78582) | $969 | $1,615 | 1.5× |
| Lung Ventilation Imaging (78579) | $739.80 | $1,233 | 1.6× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$969–$999.60 | $1,615–$1,666 | varies |
| Magnetic Image Jaw Joint (70336) | $1,443.60 | $2,406 | 5.1× |
| Mammary ductogram or galactogram multiple (77054) | $427.20 | $712 | 1.5× |
| Mammary ductogram or galactogram single (77053) | $340.80 | $568 | 1.2× |
| Meckels Divert Exam (78290) | $828.60 | $1,381 | 1.8× |
| Mr safety determination physician/other qhp (76016) | $231 | $385 | 2.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $64.20 | $107 | 1.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $240 | $400 | 2.1× |
| Mr safety implt pos&/immoblj (76019) | $172.80 | $288 | 2.5× |
| Mr safety med physics xm customization plng&mntr (76017) | $632.40 | $1,054 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) | $2,188.80 | $3,648 | 5.3× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,743.60–$1,755.60 | $2,906–$2,926 | varies |
| MRA head with contrast (70545) | $1,962 | $3,270 | 4.8× |
| MRA neck w contrast (70548) | $1,854.60 | $3,091 | 4.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,188.80 | $3,648 | 5.3× |
| MRA neck w/o contrast (70547) | $1,812 | $3,020 | 6.4× |
| MRI abdomen w contrast (74182) | $1,953.60 | $3,256 | 4.7× |
| MRI abdomen w/o contrast (74181) | $1,947 | $3,245 | 6.9× |
| MRI any jt lower extrem w/contrast material (73722) | $1,627.80 | $2,713 | 1.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,956 | $3,260 | 4.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,753.80 | $2,923 | 1.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,031.60 | $3,386 | 7.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,410 | $2,350 | 5.0× |
| MRI cardiac w/o cont stress (75559) | $1,443.60 | $2,406 | 2.2× |
| MRI cardiac w/o contrast (75557) | $1,620.60 | $2,701 | 5.7× |
| MRI cervical spine w contrast (72142) | $1,512.60 | $2,521 | 3.7× |
| MRI cervical spine w/o cont (72141) | $1,509.60 | $2,516 | 5.4× |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$1,643.40–$1,790.40 | $2,739–$2,984 | varies |
| MRI chest with contrast (71551) | $1,704.60 | $2,841 | 1.8× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$1,864.80–$2,048.40 | $3,108–$3,414 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,627.80 | $2,713 | 3.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,856.40 | $3,094 | 4.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,237.20–$1,708.20 | $2,062–$2,847 | varies |
| MRI lumbar spine w contrast (72149) | $1,816.80 | $3,028 | 4.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,786.20 | $2,977 | 4.3× |
| MRI orbit face &/neck w/o contrast (70540) | $1,620.60 | $2,701 | 5.7× |
| MRI orbit face neck w contrast (70542) | $1,539.60 | $2,566 | 3.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,851.60 | $3,086 | 4.5× |
| MRI pelvis w contrast (72196) | $1,906.80 | $3,178 | 4.6× |
| MRI pelvis w/o & w contrast (72197) | $2,347.20 | $3,912 | 5.7× |
| MRI pelvis w/o contrast (72195) | $1,992 | $3,320 | 7.1× |
| MRI spectroscopy (76390) | $1,412.40 | $2,354 | 13.7× |
| MRI thoracic spine w/o contrast (72146) | $1,578 | $2,630 | 5.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,509.60 | $2,516 | 3.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,150.20–$1,590 | $1,917–$2,650 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,818.60 | $3,031 | 4.4× |
| MRI, abdomen, combo (74183) | $2,316 | $3,860 | 5.6× |
| MRI, dorsal spine combo (72157) | $1,875.60 | $3,126 | 4.6× |
| MRI, dorsal spine contrast (72147) | $1,560 | $2,600 | 3.8× |
| MRI, joint upper extrem (73221) | $1,808.40 | $3,014 | 6.4× |
| MRI, joint upper extrem combo (73223) | $1,909.80 | $3,183 | 4.6× |
| MRI, lumbar spine combo (72158) | $2,123.40 | $3,539 | 5.2× |
| Myocardial Spect Multiple Studies (78452) | $2,442.60 | $4,071 | 1.6× |
| Neck soft tissue (70360) | $220.80 | $368 | 2.1× |
| Nm csf leak detection (78650) | $2,527.20 | $4,212 | 1.7× |
| Nonvascular Shunt X-Ray (75809) | $495.60 | $826 | 4.0× |
| Nuclear Rx Oral Admin (79005) | $500.40 | $834 | 1.8× |
| Ob us nuchal meas 1 gest (76813) | $153.60 | $256 | 1.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $218.40 | $364 | 1.8× |
| Parathyroid Planar Imaging (78070) | $818.40 | $1,364 | 1.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $739.80 | $1,233 | 1.6× |
| Pelvis 1 or 2 views (72170) | $185.40 | $309 | 1.5× |
| Perineogram (74775) | $506.40 | $844 | 1.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $749.40 | $1,249 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $432 | $720 | 3.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $516 | $860 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$277.20–$444 | $462–$740 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $171 | $285 | 1.7× |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$280.20–$451.20 | $467–$752 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $301.80 | $503 | 2.4× |
| Radex fingr minimum 2 views (73140) | $162.60 | $271 | 1.6× |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$258–$412.80 | $430–$688 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$294–$470.40 | $490–$784 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $225 | $375 | 2.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $337.80 | $563 | 2.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $282.60 | $471 | 2.7× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $202.20 | $337 | 2.0× |
| Radex Ribs Unilateral 2 Views (71100) | $234.60 | $391 | 2.3× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$250.80–$315.60 | $418–$526 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $216.60 | $361 | 2.1× |
| Radex Spine 1 View Specify Level (72020) | $199.20 | $332 | 1.9× |
| Radex Sternum Minimum 2 Views (71120) | $233.40 | $389 | 2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $513.60 | $856 | 5.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$172.80–$176.40 | $288–$294 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $282 | $470 | 2.3× |
| Radex Wrist Complete Minimum 3 Views (73110) | $276 | $460 | 2.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $526.80 | $878 | 4.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $476.40 | $794 | 3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $252 | $420 | 2.0× |
| Radiologic exam colon double contrast study (74280) | $504.60 | $841 | 2.4× |
| Radiologic exam colon single contrast study (74270) | $512.40 | $854 | 2.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $336.60 | $561 | 1.6× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$335.40–$344.40 | $559–$574 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $301.20 | $502 | 2.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $537 | $895 | 2.6× |
| Radiologic exam swallow function contrast study (74230) | $440.40 | $734 | 2.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $336.60 | $561 | 1.6× |
| Radiologic examination femur 1 view (73551) | $219 | $365 | 2.1× |
| Radiologic examination femur minimum 2 views (73552) | $249 | $415 | 2.4× |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$216–$280.80 | $360–$468 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $294 | $490 | 2.4× |
| Radiologic Examination Salivary Gland Calculus (70380) | $177.60 | $296 | 1.7× |
| Radiologic examination tibia & fibula 2 views (73590) | $225 | $375 | 2.2× |
| Ribs bilateral 3 views (71110) | $356.40 | $594 | 2.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $739.80 | $1,233 | 1.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $855.60 | $1,426 | 1.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,329.20 | $3,882 | 3.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,263.80 | $3,773 | 3.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,893.60 | $3,156 | 3.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,584.20 | $4,307 | 1.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,665.80 | $4,443 | 1.7× |
| Salivary Gland Imaging (78230) | $739.80 | $1,233 | 1.6× |
| Scapula (73010) | $222 | $370 | 1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$45–$72 | $75–$120 | varies |
| Sella turcica (70240) | $410.40 | $684 | 4.0× |
| Shoulder 1 view (73020) | $180.60 | $301 | 1.8× |
| Shoulder Arthrography (73040) | $675.60 | $1,126 | 1.6× |
| Sialogram (70390) | $289.80 | $483 | 1.0× |
| Skull less than 4 views (70250) | $308.40 | $514 | 2.5× |
| Spleen Imaging (78185) | $756 | $1,260 | 1.6× |
| Sternoclavicular joints (71130) | $101.40 | $169 | 1.0× |
| Testicular Imaging W/Flow (78761) | $739.80 | $1,233 | 1.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $627.60 | $1,046 | 3.0× |
| Thoracic spine 2 views (72070) | $233.40 | $389 | 1.9× |
| Thoracic spine 3 views (72072) | $303 | $505 | 2.5× |
| Thoracolumbar 2 views (72080) | $240.60 | $401 | 2.3× |
| Thyroid Imaging With Vascular Flow (78013) | $723 | $1,205 | 1.5× |
| Thyroid Met Imaging Body (78018) | $1,052.40 | $1,754 | 1.6× |
| Thyroid Uptake Measurement (78012) | $739.80 | $1,233 | 1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,027.20 | $1,712 | 2.2× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$273.60–$538.80 | $456–$898 | varies |
| Ultrasound elastography first target lesion (76982) | $311.40 | $519 | 2.5× |
| Ultrasound Elastography Parenchyma (76981) | $247.20 | $412 | 2.0× |
| Ultrasound Exam Aaa Screen (76706) | $191.40 | $319 | 1.5× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$246.60–$412.20 | $411–$687 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$336–$420 | $560–$700 | varies |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$1,365–$6,724.20 | $2,275–$11,207 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $739.80 | $1,233 | 1.6× |
| Unlisted us procedure (76999) | $407.40 | $679 | 4.0× |
| Upper gi w/o kub (74240) | $252 | $420 | 1.2× |
| Ureteral Reflux Study (78740) | $739.80 | $1,233 | 1.6× |
| Urethrocystogram voiding (74455) | $549 | $915 | 1.9× |
| Urethrocystography retrograde (74450) | $610.80 | $1,018 | 2.2× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$326.40–$643.20 | $544–$1,072 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$285–$388.20 | $475–$647 | varies |
| Us complete joint (76881) | $391.80 | $653 | 3.2× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$169.80–$366 | $283–$610 | varies |
| Us head (76506) | $407.40 | $679 | 3.3× |
| Us kidney transplant (76776) | $291 | $485 | 2.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$226.80–$295.20 | $378–$492 | varies |
| Us ob detailed single fetus (76811) | $562.80 | $938 | 2.0× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$265.20–$403.80 | $442–$673 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$220.20–$403.80 | $367–$673 | varies |
| Us pelvic non ob complete (76856) | $487.20 | $812 | 3.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $445.20 | $742 | 3.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$264–$403.80 | $440–$673 | varies |
| Us retroperitoneal complete (76770) | $473.40 | $789 | 3.8× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$238.20–$418.80 | $397–$698 | varies |
| Us scrotum and contents (76870) | $357.60 | $596 | 2.9× |
| Us spinal canal and contents (76800) | $407.40 | $679 | 3.3× |
| Us thyroid (76536) range across 2 matching MRF lines |
$374.40–$445.80 | $624–$743 | varies |
| Us transrectal (76872) | $298.20 | $497 | 2.4× |
| Vascular Flow Imaging (78445) | $739.80 | $1,233 | 1.6× |
| Vein X-Ray Chest (75827) | $948 | $1,580 | 0.5× |
| Venography caval inferior serialography rs&i (75825) | $3,173.40 | $5,289 | 0.9× |
| Venography extremity bilateral rs&i (75822) | $931.20 | $1,552 | 0.5× |
| Venography extremity unilateral rs&i (75820) | $809.40 | $1,349 | 0.4× |
| Venography Renal Bilateral (75833) | $3,274.80 | $5,458 | 0.9× |
| Venography Renal Unilateral (75831) | $3,274.80 | $5,458 | 0.9× |
| Venous sampling by catheter (75893) | $5,437.20 | $9,062 | 0.8× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,847.40 | $3,079 | 3.9× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$181.20–$226.80 | $302–$378 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $467.40 | $779 | 4.5× |
| X-ray antegrade pyelogram tube (74425) | $561 | $935 | 1.4× |
| X-Ray Aorta Leg Arteries (75630) | $3,117.60 | $5,196 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $207.60 | $346 | 1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$187.20–$197.40 | $312–$329 | varies |
| X-Ray Exam Breast Specimen (76098) | $589.80 | $983 | 0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $233.40 | $389 | 2.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $358.20 | $597 | 2.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $465 | $775 | 3.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $198.60 | $331 | 1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $282 | $470 | 2.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $312 | $520 | 2.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $300 | $500 | 2.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $491.40 | $819 | 4.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $592.80 | $988 | 4.8× |
| X-Ray Exam L-S Spine Bending (72114) | $388.80 | $648 | 3.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $283.80 | $473 | 2.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $342.60 | $571 | 2.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $265.20 | $442 | 2.1× |
| X-ray eye for foreign body (70030) | $212.40 | $354 | 2.1× |
| X-ray humerus (73060) range across 6 matching MRF lines |
$155.40–$257.40 | $259–$429 | varies |
| X-ray IV pyelogram (ivp) (74400) | $627.60 | $1,046 | 3.0× |
| X-ray IV pyelogram+tomography (74415) | $675.60 | $1,126 | 3.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $294 | $490 | 2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $225 | $375 | 2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $210 | $350 | 1.7× |
| X-ray nose-rectum child f.b. (76010) | $225 | $375 | 2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $442.20 | $737 | 3.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $241.20 | $402 | 2.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $231.60 | $386 | 1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $232.20 | $387 | 2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $294 | $490 | 2.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $495.60 | $826 | 4.0× |
| X-ray thoracic spine 4 vw (72074) | $486 | $810 | 3.9× |
| X-Ray Tmj Unilat (70328) | $255.60 | $426 | 2.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $727.80 | $1,213 | 1.8× |
| X-Rays Bone Length Studies (77073) | $330 | $550 | 2.7× |
| X-Rays Bone Survey Complete (77075) | $542.40 | $904 | 4.4× |
| Xr c-spine 4 or 5 views (72050) | $321.60 | $536 | 2.6× |
| Xr facial bones less than 3 views (70140) | $231.60 | $386 | 2.3× |
| XR Mastoids < 3 Views Bilateral (70120) | $169.20 | $282 | 1.4× |
| Xr orbits complete 4 views (70200) | $405 | $675 | 3.3× |
| Xr Tomogram Single Plane (76100) | $352.20 | $587 | 2.9× |
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.