Imaging prices at Kenmare Community Hospital
Kenmare, ND · every code in this section with a posted price and a Medicare benchmark.
392 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) | $2,000 | $2,500 | 1.4× |
| Abdomen 1 View (74018) | $155.20 | $194 | 1.7× |
| Abdomen 2 views (74019) | $252 | $315 | 2.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $936 | $1,170 | 2.3× |
| Adrenal Cortex & Medulla Img (78075) | $1,950.40 | $2,438 | 1.5× |
| Angio pulmonary bilat (75743) | $5,368.80 | $6,711 | 1.7× |
| Angiography extremity bilateral rs&i (75716) | $5,368.80 | $6,711 | 1.7× |
| Angiography extremity unilateral rs&i (75710) | $5,368.80 | $6,711 | 1.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,368.80 | $6,711 | 1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $5,368.80 | $6,711 | 1.7× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$186.40–$372.80 | $233–$466 | varies |
| Aortography thoracic serialography rs&i (75605) | $9,255.20 | $11,569 | 1.6× |
| Artery X-Rays Abdomen (75726) | $9,255.20 | $11,569 | 1.6× |
| Artery X-Rays Pelvis (75736) | $9,255.20 | $11,569 | 1.6× |
| Artery X-Rays Spine (75705) | $9,255.20 | $11,569 | 1.6× |
| Arthrogram ankle (73615) | $640 | $800 | 1.8× |
| Arthrogram hip (73525) | $864 | $1,080 | 2.4× |
| Arthrogram Wrist (73115) | $798.40 | $998 | 2.2× |
| Basic radiation dosimetry calculation (77300) | $280 | $350 | 2.0× |
| Bone age studies (77072) | $264.80 | $331 | 2.5× |
| Bone Imaging 3 Phase (78315) | $672 | $840 | 1.6× |
| Bone Imaging Limited Area (78300) | $672 | $840 | 1.6× |
| Bone Imaging Multiple Areas (78305) | $672 | $840 | 1.6× |
| Bone Imaging Whole Body (78306) | $672 | $840 | 1.6× |
| Bone marrow imaging limited area (78102) | $566.40 | $708 | 1.4× |
| Bone survey infant (77076) | $264.80 | $331 | 2.5× |
| Brachytx isodose complex (77318) | $376 | $470 | 1.0× |
| Brachytx Isodose Plan Simple (77316) | $558.40 | $698 | 1.5× |
| Brain Image W/Flow < 4 Views (78601) | $566.40 | $708 | 1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $742.40 | $928 | 1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,148.80 | $2,686 | 1.5× |
| Cardiac Shunt Detection (78428) | $566.40 | $708 | 1.4× |
| Cat Scan Follow-Up Study (76380) | $1,012 | $1,265 | 11.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $866.40 | $1,083 | 1.6× |
| Cerebrospinal Fluid Scan (78630) | $866.40 | $1,083 | 1.6× |
| Chest 1 view (71045) | $232.80 | $291 | 2.6× |
| Chest 2 views (71046) | $232.80 | $291 | 2.6× |
| Chest 3 views (71047) | $232.80 | $291 | 2.6× |
| Chest 4 or more views (71048) | $332.80 | $416 | 3.1× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$186.40–$289.60 | $233–$362 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,018.40 | $1,273 | 9.5× |
| Continuing medical physics consltj pr wk (77336) | $400 | $500 | 2.9× |
| Contrast Exam Abdominl Aorta (75625) | $5,368.80 | $6,711 | 1.7× |
| Contrast X-Ray Bladder (74430) | $946.40 | $1,183 | 2.7× |
| Contrast X-Ray Of Elbow (73085) | $1,059.20 | $1,324 | 3.0× |
| Contrast X-Ray Of Knee Joint (73580) | $1,083.20 | $1,354 | 3.0× |
| CT abdomen and pelvis without and with contrast (74178) | $3,060.80 | $3,826 | 8.6× |
| CT abdomen and pelvis without contrast (74176) | $2,314.40 | $2,893 | 9.5× |
| CT abdomen w contrast (74160) | $2,076.80 | $2,596 | 11.6× |
| CT abdomen w wo contrast (74170) | $2,388 | $2,985 | 13.3× |
| CT abdomen w/o contrast (74150) | $1,805.60 | $2,257 | 16.9× |
| CT Angio Abdomen and Pelvis (74174) | $2,758.40 | $3,448 | 7.7× |
| CT Angio Chest (71275) | $2,314.40 | $2,893 | 12.9× |
| CT Angio Head (70496) | $2,254.40 | $2,818 | 12.6× |
| CT angio hrt w/3d image (75574) | $2,693.60 | $3,367 | 7.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,012–$4,024 | $2,515–$5,030 | varies |
| CT Angio Neck (70498) | $2,259.20 | $2,824 | 12.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$2,314.40–$4,628.80 | $2,893–$5,786 | varies |
| CT bone density (77078) | $834.40 | $1,043 | 9.4× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $383.20 | $479 | 2.1× |
| CT cervical spine w/ contrast (72126) | $1,454.40 | $1,818 | 4.1× |
| CT cervical spine w/o contrast (72125) | $1,264.80 | $1,581 | 11.8× |
| CT cervical spine w/wo cont (72127) | $1,672 | $2,090 | 9.3× |
| CT chest w contrast (71260) | $1,444.80 | $1,806 | 8.1× |
| CT chest w/wo contrast (71270) | $1,662.40 | $2,078 | 9.3× |
| CT head/brain with contrast (70460) | $1,280 | $1,600 | 7.1× |
| CT head/brain without and with contrast (70470) | $1,472 | $1,840 | 8.2× |
| CT heart no contrast quant eval coronry calcium (75571) range across 3 matching MRF lines |
$36–$781.60 | $45–$977 | varies |
| CT iac w contrast (70481) | $1,584.80 | $1,981 | 8.8× |
| CT l-spine w&w/o contrast (72133) | $1,720 | $2,150 | 9.6× |
| CT lower ext w/o (73700) range across 23 matching MRF lines |
$1,260–$2,520 | $1,575–$3,150 | varies |
| CT lower extremity w/contrast material (73701) range across 21 matching MRF lines |
$1,449.60–$2,898.40 | $1,812–$3,623 | varies |
| CT lumbar spine w contrast (72132) | $1,496 | $1,870 | 4.2× |
| CT lumbar spine w/o contrast (72131) | $1,300.80 | $1,626 | 12.2× |
| CT maxillofacial w contrast (70487) | $1,444.80 | $1,806 | 8.1× |
| CT maxillofacial wo contrast (70486) | $1,256.80 | $1,571 | 11.8× |
| CT neck tissue combo (70492) | $1,662.40 | $2,078 | 9.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,822.40 | $2,278 | 10.2× |
| CT orbits w/o contrast (70480) | $1,378.40 | $1,723 | 12.9× |
| CT pelvis w&w/o contrast (72194) | $1,779.20 | $2,224 | 9.9× |
| CT pelvis w/o contrast (72192) | $1,345.60 | $1,682 | 12.6× |
| CT scan of leg combo (73702) range across 21 matching MRF lines |
$1,666.40–$3,333.60 | $2,083–$4,167 | varies |
| CT scans face/jaw combo (70488) | $1,662.40 | $2,078 | 9.3× |
| CT soft tissue neck w contrast (70491) | $1,444.80 | $1,806 | 8.1× |
| CT soft tissue neck w/o contrast (70490) | $1,256.80 | $1,571 | 11.8× |
| CT thoracic spine w contrast (72129) | $1,471.20 | $1,839 | 8.2× |
| CT thoracic spine w/o contrast (72128) | $1,279.20 | $1,599 | 12.0× |
| CT thoracic spine w/wo cont (72130) | $1,692 | $2,115 | 9.4× |
| CT thorax w/o contrast (71250) | $1,256.80 | $1,571 | 11.8× |
| CT upper ext wo (73200) range across 21 matching MRF lines |
$1,256.80–$2,513.60 | $1,571–$3,142 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 21 matching MRF lines |
$1,662.40–$3,324.80 | $2,078–$4,156 | varies |
| CT upper extremity with contrast (73201) range across 21 matching MRF lines |
$1,444.80–$2,889.60 | $1,806–$3,612 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,487.20 | $3,109 | 13.9× |
| Cta Abdomen (74175) | $2,314.40 | $2,893 | 12.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $763.20 | $954 | 2.1× |
| CTA pelvis (72191) | $2,314.40 | $2,893 | 12.9× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $577.60 | $722 | 2.4× |
| Dilation ureters/urethra rs&i (74485) | $3,744 | $4,680 | 1.8× |
| Discography Cerv/Thor Spine (72285) | $3,746.40 | $4,683 | 1.9× |
| Diskography lumbar (72295) | $3,746.40 | $4,683 | 1.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $453.60 | $567 | 4.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $453.60 | $567 | 4.2× |
| Doppler Fetal Mid Cerebral Artery (76821) | $216.80 | $271 | 2.0× |
| Dxa Bone Density Axial (77080) | $264.80 | $331 | 2.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$20–$163.20 | $25–$204 | varies |
| Echo exam of fetal heart (76825) | $1,928.80 | $2,411 | 3.5× |
| Echo exam uterus (76831) | $920 | $1,150 | 3.8× |
| Echo Guide For Artery Repair (76936) | $528.80 | $661 | 2.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $920 | $1,150 | 3.8× |
| Echograp Trans R Pros Study (76873) | $653.60 | $817 | 6.1× |
| Esophagram (74220) | $557.60 | $697 | 3.1× |
| Fetal Biophys Profile W/Nst (76818) | $109.60 | $137 | 1.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $453.60 | $567 | 4.2× |
| Fluoroscopy up to 1 hr (76000) | $513.60 | $642 | 2.1× |
| Follow-Up Angiography (75898) | $5,368.80 | $6,711 | 1.7× |
| Foot 2 views (73620) range across 6 matching MRF lines |
$186.40–$289.60 | $233–$362 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$186.40–$289.60 | $233–$362 | varies |
| Gastric emptying imaging study (78264) | $566.40 | $708 | 1.4× |
| Gated Heart Planar Single (78472) | $566.40 | $708 | 1.4× |
| Gated Heart, Multiple (78473) | $566.40 | $708 | 1.4× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$186.40–$372.80 | $233–$466 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,745.60 | $7,182 | 1.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $5,474.40 | $6,843 | 1.7× |
| Hepatobil Syst Image W/Drug (78227) | $742.40 | $928 | 1.3× |
| Hepatobiliary System Imaging (78226) | $566.40 | $708 | 1.4× |
| Ht Muscle Image Spect Sing (78451) | $1,950.40 | $2,438 | 1.5× |
| Hyperthermia external generated superficial (77600) | $400 | $500 | 1.0× |
| Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators Non-Facility (77610) | $594.40 | $743 | 1.1× |
| Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators Non-Facility (77615) | $800 | $1,000 | 1.4× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) | $594.40 | $743 | 1.1× |
| Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm) Non-Facility (77605) | $713.60 | $892 | 1.0× |
| Hysterosalpingogram (74740) | $577.60 | $722 | 2.4× |
| Infant hip ultrasound, limited static exam (76886) | $471.20 | $589 | 5.3× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,240 | $1,550 | 1.7× |
| Intracavitary radiation source applic simple (77761) | $828 | $1,035 | 1.5× |
| Joint Survey Single View (77077) | $264.80 | $331 | 2.5× |
| K Flow/Funct Image Multiple (78709) | $742.40 | $928 | 1.3× |
| K Flow/Funct Image W/Drug (78708) | $742.40 | $928 | 1.3× |
| K Flow/Funct Image W/O Drug (78707) | $742.40 | $928 | 1.3× |
| Kidney Imaging Morphol (78700) | $566.40 | $708 | 1.4× |
| Knee 3 Views (73562) range across 6 matching MRF lines |
$204.80–$289.60 | $256–$362 | varies |
| Leveen/Shunt Patency Exam (78291) | $566.40 | $708 | 1.4× |
| Liver & Spleen Imaging Static Only (78215) | $866.40 | $1,083 | 2.1× |
| Lung perfusion differential (78597) | $925.60 | $1,157 | 2.3× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$866.40–$936 | $1,083–$1,170 | varies |
| Lymph System Imaging (78195) | $936 | $1,170 | 1.7× |
| Magnetic Image Jaw Joint (70336) | $2,440 | $3,050 | 10.0× |
| Mammary ductogram or galactogram multiple (77054) | $760 | $950 | 3.1× |
| Mammary ductogram or galactogram single (77053) | $685.60 | $857 | 2.8× |
| Meckels Divert Exam (78290) | $566.40 | $708 | 1.4× |
| Mlc imrt design & construction per imrt plan (77338) | $1,200 | $1,500 | 3.1× |
| Mr safety determination physician/other qhp (76016) | $188.80 | $236 | 2.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $52.80 | $66 | 1.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $196.80 | $246 | 2.0× |
| Mr safety implt pos&/immoblj (76019) | $127.20 | $159 | 2.1× |
| Mra Head W/O & W/Contrast Material (70546) | $3,221.60 | $4,027 | 9.0× |
| MRA head w/o contrast (70544) | $1,584 | $1,980 | 6.5× |
| MRA neck w contrast (70548) | $2,757.60 | $3,447 | 7.7× |
| MRA neck w/o contrast (70547) | $2,707.20 | $3,384 | 11.1× |
| MRI abdomen w contrast (74182) | $2,320 | $2,900 | 6.5× |
| MRI abdomen w/o contrast (74181) | $1,932.80 | $2,416 | 7.9× |
| MRI any jt lower extrem w/contrast material (73722) range across 12 matching MRF lines |
$2,320–$4,638.40 | $2,900–$5,798 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 12 matching MRF lines |
$2,680.80–$5,357.60 | $3,351–$6,697 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 12 matching MRF lines |
$2,320–$4,638.40 | $2,900–$5,798 | varies |
| MRI bone marrow blood supply (77084) | $2,440 | $3,050 | 10.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,932.80 | $2,416 | 7.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,126.40 | $2,658 | 8.7× |
| MRI cardiac w/o contrast (75557) | $1,932.80 | $2,416 | 7.9× |
| MRI cervical spine w contrast (72142) | $3,221.60 | $4,027 | 9.0× |
| MRI cervical spine w/o cont (72141) | $2,440 | $3,050 | 10.0× |
| MRI chest w/o contrast (71550) | $2,527.20 | $3,159 | 10.4× |
| MRI chest wo w contrast (71552) | $3,446.40 | $4,308 | 9.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 12 matching MRF lines |
$2,320–$4,638.40 | $2,900–$5,798 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 12 matching MRF lines |
$2,576.80–$5,153.60 | $3,221–$6,442 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 12 matching MRF lines |
$1,932.80–$3,864.80 | $2,416–$4,831 | varies |
| MRI lumbar spine w contrast (72149) | $3,221.60 | $4,027 | 9.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,608 | $4,510 | 10.1× |
| MRI orbit face &/neck w/o contrast (70540) | $2,074.40 | $2,593 | 8.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,221.60 | $4,027 | 9.0× |
| MRI pelvis w contrast (72196) | $2,625.60 | $3,282 | 7.4× |
| MRI pelvis w/o & w contrast (72197) | $3,221.60 | $4,027 | 9.0× |
| MRI pelvis w/o contrast (72195) | $2,440 | $3,050 | 10.0× |
| MRI thoracic spine w/o contrast (72146) | $2,440 | $3,050 | 10.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 12 matching MRF lines |
$2,378.40–$4,756.80 | $2,973–$5,946 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 12 matching MRF lines |
$2,208.80–$4,417.60 | $2,761–$5,522 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 12 matching MRF lines |
$2,897.60–$5,796.80 | $3,622–$7,246 | varies |
| MRI, abdomen, combo (74183) | $3,221.60 | $4,027 | 9.0× |
| MRI, dorsal spine combo (72157) | $3,608 | $4,510 | 10.1× |
| MRI, dorsal spine contrast (72147) | $3,221.60 | $4,027 | 9.0× |
| MRI, joint upper extrem (73221) range across 12 matching MRF lines |
$1,932.80–$3,864.80 | $2,416–$4,831 | varies |
| MRI, joint upper extrem combo (73223) range across 12 matching MRF lines |
$2,682.40–$5,363.20 | $3,353–$6,704 | varies |
| MRI, lumbar spine combo (72158) | $3,608 | $4,510 | 10.1× |
| Musculoskeletal Nuclear Exam (78399) | $566.40 | $708 | 1.4× |
| Myelogram cervical (72240) | $1,349.60 | $1,687 | 1.7× |
| Myelogram Lumbar (72265) | $1,349.60 | $1,687 | 1.7× |
| Myelography thoracic (72255) | $1,349.60 | $1,687 | 1.7× |
| Myelograpy 2/more regions rs&i (72270) | $1,349.60 | $1,687 | 1.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $566.40 | $708 | 1.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,950.40 | $2,438 | 1.5× |
| Myocardial Spect Multiple Studies (78452) | $1,950.40 | $2,438 | 1.5× |
| Neck soft tissue (70360) | $176.80 | $221 | 2.0× |
| Nervous system nuclear exam (78699) | $566.40 | $708 | 1.4× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $388.80 | $486 | 1.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $566.40 | $708 | 1.4× |
| Nm csf leak detection (78650) | $1,950.40 | $2,438 | 1.5× |
| Nm myocard infarct spect (78469) | $1,817.60 | $2,272 | 3.3× |
| Nm unlisted gi procedure (78299) | $566.40 | $708 | 1.4× |
| Nm whole blood volume (78122) | $866.40 | $1,083 | 1.6× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,680 | $5,850 | 3.3× |
| Nuclear Rx Oral Admin (79005) | $532.80 | $666 | 2.2× |
| Ob us nuchal meas 1 gest (76813) | $453.60 | $567 | 4.2× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$109.60–$404.80 | $137–$506 | varies |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $109.60 | $137 | 1.0× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $132.80 | $166 | 1.0× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $109.60 | $137 | 1.0× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $90.40 | $113 | 1.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $229.60 | $287 | 2.1× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $100 | $125 | 3.4× |
| Ophthalmic us dx quantitative a-scan only (76511) | $109.60 | $137 | 1.0× |
| Panoramic X-ray of jaws (70355) | $186.40 | $233 | 2.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $866.40 | $1,083 | 1.6× |
| Parathyroid Planar Imaging (78070) | $866.40 | $1,083 | 2.1× |
| Pelvis 1 or 2 views (72170) | $264.80 | $331 | 2.5× |
| Pet Image Skull-Thigh (78812) | $2,308 | $2,885 | 1.6× |
| Pet Image W/Ct Lmtd (78814) | $2,374.40 | $2,968 | 1.6× |
| PET image w/CT, full body (78816) | $2,374.40 | $2,968 | 1.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,374.40 | $2,968 | 1.6× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $2,020 | $2,525 | 1.5× |
| PET whole body (78813) | $2,308 | $2,885 | 1.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $6,062.40 | $7,578 | 1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $936 | $1,170 | 2.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $252 | $315 | 2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,220.80 | $1,526 | 2.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$214.40–$428.80 | $268–$536 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$186.40–$289.60 | $233–$362 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$204.80–$312 | $256–$390 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $264.80 | $331 | 2.5× |
| Radex fingr minimum 2 views (73140) | $163.20 | $204 | 1.8× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$192–$289.60 | $240–$362 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$214.40–$428.80 | $268–$536 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$186.40–$289.60 | $233–$362 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $533.60 | $667 | 5.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $186.40 | $233 | 2.1× |
| Radex Ribs Unilateral 2 Views (71100) | $186.40 | $233 | 2.1× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$186.40–$289.60 | $233–$362 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $186.40 | $233 | 2.1× |
| Radex Spine 1 View Specify Level (72020) | $163.20 | $204 | 1.8× |
| Radex Sternum Minimum 2 Views (71120) | $163.20 | $204 | 1.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $186.40 | $233 | 2.1× |
| Radex Toe Minimum 2 Views (73660) | $163.20 | $204 | 1.8× |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$264.80–$289.60 | $331–$362 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$186.40–$289.60 | $233–$362 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $11,088 | $13,860 | 1.5× |
| Radiation treatment delivery level 1 (77402) | $1,440 | $1,800 | 13.8× |
| Radiation treatment delivery level 2 (77407) | $1,760 | $2,200 | 4.5× |
| Radiation treatment delivery level 3 (77412) | $2,160 | $2,700 | 3.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $264.80 | $331 | 2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $252 | $315 | 2.4× |
| Radiologic exam colon double contrast study (74280) | $577.60 | $722 | 3.2× |
| Radiologic exam colon single contrast study (74270) | $577.60 | $722 | 3.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $557.60 | $697 | 3.1× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$264.80–$529.60 | $331–$662 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $264.80 | $331 | 2.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $412 | $515 | 2.3× |
| Radiologic exam swallow function contrast study (74230) | $494.40 | $618 | 2.8× |
| Radiologic exam teeth complete full mouth (70320) | $540.80 | $676 | 2.2× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $540.80 | $676 | 2.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $607.20 | $759 | 3.4× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$163.20–$289.60 | $204–$362 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$186.40–$289.60 | $233–$362 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$186.40–$289.60 | $233–$362 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $220 | $275 | 2.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$186.40–$289.60 | $233–$362 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) | $186.40 | $233 | 2.1× |
| Ribs bilateral 3 views (71110) | $264.80 | $331 | 2.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $936 | $1,170 | 2.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $936 | $1,170 | 2.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,217.60 | $2,772 | 4.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,016 | $2,520 | 3.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,328.80 | $2,911 | 4.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,856 | $3,570 | 2.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,444.80 | $3,056 | 1.8× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $367.20 | $459 | 1.5× |
| Rp Therapy Intravenous Administration (79101) | $360.80 | $451 | 1.5× |
| Salivary Gland Function Study (78232) | $566.40 | $708 | 1.4× |
| Salivary Gland Imaging Serial Images (78231) | $566.40 | $708 | 1.4× |
| Scapula (73010) range across 3 matching MRF lines |
$186.40–$289.60 | $233–$362 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $103.20 | $129 | 4.4× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$163.20–$289.60 | $204–$362 | varies |
| Shoulder Arthrography (73040) | $864 | $1,080 | 2.4× |
| Sialogram (70390) | $577.60 | $722 | 2.4× |
| Skull less than 4 views (70250) | $264.80 | $331 | 2.5× |
| Special dosimetry (77331) | $194.40 | $243 | 1.4× |
| Special Physics Consult (77370) | $480 | $600 | 3.5× |
| Special teletherapy port plan (77321) | $521.60 | $652 | 1.4× |
| Special treatment procedure (77470) | $1,588 | $1,985 | 2.8× |
| Stereotactic Body Radiation Delivery (77373) | $4,400 | $5,500 | 2.4× |
| Sternoclavicular joints (71130) | $186.40 | $233 | 2.1× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) | $1,105.60 | $1,382 | 10.6× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $1,515.20 | $1,894 | 39.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $532.80 | $666 | 1.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $521.60 | $652 | 1.4× |
| Testicular Imaging W/Flow (78761) | $566.40 | $708 | 1.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,515.20 | $1,894 | 4.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,199.20 | $1,499 | 3.1× |
| Ther rad simulaj-aided field setting simple (77280) | $720 | $900 | 5.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $494.40 | $618 | 2.8× |
| Thoracic spine 2 views (72070) | $264.80 | $331 | 2.5× |
| Thoracic spine 3 views (72072) | $264.80 | $331 | 2.5× |
| Thoracolumbar 2 views (72080) | $186.40 | $233 | 2.1× |
| Thyroid Imaging With Vascular Flow (78013) | $566.40 | $708 | 1.4× |
| Thyroid Met Imaging Body (78018) | $742.40 | $928 | 1.3× |
| Thyroid Uptake Measurement (78012) | $566.40 | $708 | 1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $566.40 | $708 | 1.4× |
| Tx Devices Design & Construction Complex (77334) | $768 | $960 | 2.0× |
| Tx devices design & construction intermediate (77333) | $580 | $725 | 4.2× |
| Tx devices design & construction simple (77332) | $400 | $500 | 2.9× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$333.60–$667.20 | $417–$834 | varies |
| Ultrasound Elastography Parenchyma (76981) | $576 | $720 | 5.4× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$28–$453.60 | $35–$567 | varies |
| Ultrasound, abdomen limited (76705) | $453.60 | $567 | 4.2× |
| Umbilical-artery Doppler (OB) (76820) | $216.80 | $271 | 2.0× |
| Upper gi w/o kub (74240) | $577.60 | $722 | 3.2× |
| Ureteral Reflux Study (78740) | $566.40 | $708 | 1.4× |
| Urethrocystogram voiding (74455) | $513.60 | $642 | 2.1× |
| Urethrocystography retrograde (74450) | $513.60 | $642 | 2.1× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$453.60–$904 | $567–$1,130 | varies |
| Us chest (76604) | $453.60 | $567 | 4.2× |
| Us exam, pelvic, limited (76857) | $453.60 | $567 | 4.2× |
| Us head (76506) | $538.40 | $673 | 5.0× |
| Us kidney transplant (76776) | $485.60 | $607 | 4.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$109.60–$453.60 | $137–$567 | varies |
| Us ob detailed single fetus (76811) | $781.60 | $977 | 3.2× |
| Us ob limited 1 or more fetuses (76815) range across 5 matching MRF lines |
$52–$1,104 | $65–$1,380 | varies |
| Us ob transvaginal (76817) | $453.60 | $567 | 4.2× |
| Us pelvic non ob complete (76856) | $479.20 | $599 | 4.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $476 | $595 | 4.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $454.40 | $568 | 4.3× |
| Us retroperitoneal complete (76770) | $485.60 | $607 | 4.5× |
| Us retroperitoneal limited (76775) | $453.60 | $567 | 4.2× |
| Us scrotum and contents (76870) | $585.60 | $732 | 5.5× |
| Us spinal canal and contents (76800) | $543.20 | $679 | 5.1× |
| Us thyroid (76536) | $560 | $700 | 5.2× |
| Us transrectal (76872) | $585.60 | $732 | 5.5× |
| Vascular Flow Imaging (78445) | $566.40 | $708 | 1.4× |
| Vasogram (74440) | $513.60 | $642 | 2.1× |
| Vein X-Ray Chest (75827) | $2,696.80 | $3,371 | 1.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $5,474.40 | $6,843 | 1.7× |
| Venogram Sinus/Jugular (75860) | $5,368.80 | $6,711 | 1.7× |
| Venography caval inferior serialography rs&i (75825) | $5,368.80 | $6,711 | 1.7× |
| Venography extremity bilateral rs&i (75822) | $2,696.80 | $3,371 | 1.7× |
| Venography extremity unilateral rs&i (75820) | $2,696.80 | $3,371 | 1.7× |
| Venography Renal Bilateral (75833) | $5,368.80 | $6,711 | 1.7× |
| Venography Renal Unilateral (75831) | $5,368.80 | $6,711 | 1.7× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$186.40–$289.60 | $233–$362 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$163.20–$326.40 | $204–$408 | varies |
| X-ray antegrade pyelogram tube (74425) | $946.40 | $1,183 | 2.7× |
| X-Ray Aorta Leg Arteries (75630) | $5,368.80 | $6,711 | 1.7× |
| X-Ray Bend Only L-S Spine (72120) | $264.80 | $331 | 2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$186.40–$289.60 | $233–$362 | varies |
| X-Ray Exam Breast Specimen (76098) | $960 | $1,200 | 1.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $186.40 | $233 | 2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $264.80 | $331 | 2.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $264.80 | $331 | 2.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $186.40 | $233 | 2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $204.80 | $256 | 2.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $264.80 | $331 | 2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $264.80 | $331 | 2.5× |
| X-Ray Exam L-S Spine Bending (72114) | $264.80 | $331 | 2.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $163.20 | $204 | 1.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $264.80 | $331 | 2.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $264.80 | $331 | 2.5× |
| X-ray eye for foreign body (70030) | $176.80 | $221 | 2.0× |
| X-ray humerus (73060) range across 6 matching MRF lines |
$186.40–$289.60 | $233–$362 | varies |
| X-ray IV pyelogram (ivp) (74400) | $607.20 | $759 | 3.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $186.40 | $233 | 2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $163.20 | $204 | 1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $264.80 | $331 | 2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $264.80 | $331 | 2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $264.80 | $331 | 2.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $264.80 | $331 | 2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $186.40 | $233 | 2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $186.40 | $233 | 2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $264.80 | $331 | 2.5× |
| X-Ray Tmj Unilat (70328) | $163.20 | $204 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,008 | $1,260 | 2.8× |
| X-Rays Bone Length Studies (77073) | $264.80 | $331 | 2.5× |
| X-Rays Bone Survey Complete (77075) | $264.80 | $331 | 2.5× |
| Xr c-spine 4 or 5 views (72050) | $264.80 | $331 | 2.5× |
| Xr facial bones less than 3 views (70140) | $186.40 | $233 | 2.1× |
| Xr orbits complete 4 views (70200) | $264.80 | $331 | 2.5× |
| Xr Tomogram Single Plane (76100) | $252 | $315 | 2.4× |
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.