Imaging prices at King’s Daughters Medical Center
Brookhaven, MS · every code in this section with a posted price and a Medicare benchmark.
280 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 |
$9.90–$72 | $33–$240 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$12.30–$80.70 | $41–$269 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $456.30 | $1,521 | 1.3× |
| Angiography extremity bilateral rs&i (75716) | $2,253.30 | $7,511 | 0.8× |
| Angiography extremity unilateral rs&i (75710) | $1,203.90 | $4,013 | 0.4× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$27.60–$58.20 | $92–$194 | varies |
| Artery X-Rays Abdomen (75726) | $2,151.90 | $7,173 | 0.4× |
| Artery X-Rays Pelvis (75736) | $2,253.30 | $7,511 | 0.5× |
| Arthrogram ankle (73615) | $324.30 | $1,081 | 1.1× |
| Arthrogram hip (73525) | $265.80 | $886 | 0.9× |
| Arthrogram Wrist (73115) | $255.60 | $852 | 0.8× |
| Bone age studies (77072) range across 2 matching MRF lines |
$37.50–$97.80 | $125–$326 | varies |
| Bone Imaging 3 Phase (78315) | $435.90 | $1,453 | 1.3× |
| Bone Imaging Limited Area (78300) | $339 | $1,130 | 1.0× |
| Bone Imaging Whole Body (78306) | $393.90 | $1,313 | 1.1× |
| Bone marrow imaging limited area (78102) | $353.70 | $1,179 | 1.0× |
| Bone survey infant (77076) | $86.10 | $287 | 1.0× |
| Cat Scan Follow-Up Study (76380) | $761.10 | $2,537 | 10.1× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$9.60–$174 | $32–$580 | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$11.40–$99.90 | $38–$333 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$106.80–$113.10 | $356–$377 | varies |
| Chest 4 or more views (71048) | $101.40 | $338 | 1.1× |
| Clavicle complete (73000) | $55.80 | $186 | 0.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$31.50–$59.70 | $105–$199 | varies |
| Contrast X-Ray Bladder (74430) | $189.60 | $632 | 0.6× |
| Contrast X-Ray Of Elbow (73085) | $262.80 | $876 | 0.9× |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$346.50–$414.60 | $1,155–$1,382 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $879 | $2,930 | 2.9× |
| CT abdomen and pelvis without contrast (74176) | $654 | $2,180 | 3.2× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$845.40–$879 | $2,818–$2,930 | varies |
| CT abdomen w wo contrast (74170) | $1,028.40 | $3,428 | 6.8× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$304.50–$761.40 | $1,015–$2,538 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$328.50–$480 | $1,095–$1,600 | varies |
| CT Angio Chest (71275) | $1,444.50 | $4,815 | 9.6× |
| CT Angio Head (70496) | $653.70 | $2,179 | 4.3× |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$182.70–$288.60 | $609–$962 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$366.60–$720 | $1,222–$2,400 | varies |
| CT Angio Neck (70498) | $653.70 | $2,179 | 4.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$365.10–$480 | $1,217–$1,600 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$299.40–$480 | $998–$1,600 | varies |
| CT cervical spine w/o contrast (72125) | $777.60 | $2,592 | 8.6× |
| CT cervical spine w/wo cont (72127) | $495.30 | $1,651 | 3.3× |
| CT chest w contrast (71260) | $777.60 | $2,592 | 5.1× |
| CT chest w/wo contrast (71270) | $1,053 | $3,510 | 7.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $282 | $940 | 3.1× |
| CT head/brain with contrast (70460) | $322.80 | $1,076 | 2.1× |
| CT head/brain without and with contrast (70470) | $890.70 | $2,969 | 5.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $37.50 | $125 | 0.5× |
| CT iac w contrast (70481) | $785.70 | $2,619 | 5.2× |
| CT l-spine w&w/o contrast (72133) | $366.60 | $1,222 | 2.4× |
| CT lower ext w/o (73700) | $656.40 | $2,188 | 7.3× |
| CT lower extremity w/contrast material (73701) | $777.60 | $2,592 | 5.1× |
| CT lumbar spine w contrast (72132) | $459.60 | $1,532 | 1.5× |
| CT lumbar spine w/o contrast (72131) | $777.60 | $2,592 | 8.6× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$591.30–$785.70 | $1,971–$2,619 | varies |
| CT maxillofacial wo contrast (70486) | $559.80 | $1,866 | 6.2× |
| CT neck tissue combo (70492) | $915.30 | $3,051 | 6.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $915.30 | $3,051 | 6.1× |
| CT orbits w/o contrast (70480) | $697.20 | $2,324 | 7.7× |
| CT pelvis w&w/o contrast (72194) | $1,004.40 | $3,348 | 6.6× |
| CT pelvis w/o contrast (72192) | $761.10 | $2,537 | 8.4× |
| CT scan of leg combo (73702) | $909.60 | $3,032 | 6.0× |
| CT scans face/jaw combo (70488) | $856.80 | $2,856 | 5.7× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$591.30–$785.70 | $1,971–$2,619 | varies |
| CT soft tissue neck w/o contrast (70490) | $697.20 | $2,324 | 7.7× |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$320.70–$780 | $1,069–$2,600 | varies |
| CT thoracic spine w/o contrast (72128) | $777.60 | $2,592 | 8.6× |
| CT thoracic spine w/wo cont (72130) | $500.40 | $1,668 | 3.3× |
| CT thorax w/o contrast (71250) | $777.60 | $2,592 | 8.6× |
| CT upper ext wo (73200) | $656.40 | $2,188 | 7.3× |
| CT upper extremity w/o & w/contrast material (73202) | $915.30 | $3,051 | 6.1× |
| CT upper extremity with contrast (73201) | $777.60 | $2,592 | 2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,953.60 | $6,512 | 12.9× |
| Cta Abdomen (74175) | $1,210.80 | $4,036 | 8.0× |
| CTA pelvis (72191) | $461.10 | $1,537 | 3.0× |
| Dilation ureters/urethra rs&i (74485) | $991.80 | $3,306 | 0.6× |
| Discography Cerv/Thor Spine (72285) | $1,797.90 | $5,993 | 1.1× |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$1,797.90–$2,321.10 | $5,993–$7,737 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) | $31.50 | $105 | 0.3× |
| Dxa Bone Density Axial (77080) | $319.80 | $1,066 | 3.5× |
| Dxa bone density study (77085) | $95.10 | $317 | 1.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $68.10 | $227 | 0.9× |
| Echo exam of fetal heart (76825) | $616.80 | $2,056 | 1.3× |
| Esophagram (74220) | $155.10 | $517 | 1.0× |
| Fetal Biophys Profile W/Nst (76818) | $289.50 | $965 | 3.2× |
| Fluoroscopy up to 1 hr (76000) | $132.30 | $441 | 0.6× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$29.10–$59.70 | $97–$199 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$11.10–$106.80 | $37–$356 | varies |
| Gastric emptying imaging study (78264) | $377.70 | $1,259 | 1.1× |
| Gastroesophageal Reflux Exam (78262) | $279.30 | $931 | 0.8× |
| Gated Heart Planar Single (78472) | $496.20 | $1,654 | 1.4× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$37.50–$53.70 | $125–$179 | varies |
| Hepatobil Syst Image W/Drug (78227) | $356.70 | $1,189 | 0.8× |
| Hepatobiliary System Imaging (78226) | $356.70 | $1,189 | 1.0× |
| Ht Muscle Image Spect Sing (78451) | $817.20 | $2,724 | 0.7× |
| Hysterosalpingogram (74740) | $247.50 | $825 | 1.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $183.90 | $613 | 2.5× |
| Infusion Ivp (74410) | $189.60 | $632 | 1.3× |
| Joint Survey Single View (77077) | $95.70 | $319 | 1.1× |
| K Flow/Funct Image Multiple (78709) | $345.60 | $1,152 | 0.7× |
| K Flow/Funct Image W/Drug (78708) | $345.60 | $1,152 | 0.7× |
| K Flow/Funct Image W/O Drug (78707) | $430.80 | $1,436 | 0.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $345.60 | $1,152 | 1.0× |
| Liver & Spleen Imaging Static Only (78215) | $285.30 | $951 | 0.8× |
| Lung perfusion differential (78597) | $119.10 | $397 | 0.3× |
| Lung Ventilat&Perfus Imaging (78582) | $470.70 | $1,569 | 1.0× |
| Lung Ventilation Imaging (78579) | $327 | $1,090 | 0.9× |
| Lymph System Imaging (78195) | $276.30 | $921 | 0.6× |
| Magnetic Image Jaw Joint (70336) | $813.60 | $2,712 | 4.0× |
| Mammary ductogram or galactogram multiple (77054) | $247.50 | $825 | 1.2× |
| Mammary ductogram or galactogram single (77053) | $247.50 | $825 | 1.2× |
| Meckels Divert Exam (78290) | $293.10 | $977 | 0.9× |
| Mra Head W/O & W/Contrast Material (70546) | $1,039.50 | $3,465 | 3.5× |
| MRA head w/o contrast (70544) | $1,002.30 | $3,341 | 4.9× |
| MRA neck w contrast (70548) | $1,020 | $3,400 | 3.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,020 | $3,400 | 3.4× |
| MRA neck w/o contrast (70547) | $1,002.30 | $3,341 | 4.9× |
| MRI abdomen w contrast (74182) | $782.70 | $2,609 | 2.6× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$680.40–$861.30 | $2,268–$2,871 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $603.90 | $2,013 | 0.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $849 | $2,830 | 2.8× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$603.90–$750 | $2,013–$2,500 | varies |
| MRI cervical spine w contrast (72142) | $1,182.60 | $3,942 | 3.9× |
| MRI cervical spine w/o cont (72141) | $861.30 | $2,871 | 4.2× |
| MRI chest w/o contrast (71550) | $680.40 | $2,268 | 3.3× |
| MRI chest wo w contrast (71552) | $850.50 | $2,835 | 2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $849 | $2,830 | 2.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$849–$1,698 | $2,830–$5,660 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $742.20 | $2,474 | 3.6× |
| MRI lumbar spine w contrast (72149) | $1,182.60 | $3,942 | 3.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,612.80 | $5,376 | 5.4× |
| MRI orbit face &/neck w/o contrast (70540) | $849 | $2,830 | 4.1× |
| MRI orbit face neck w contrast (70542) | $1,182.60 | $3,942 | 3.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $761.70 | $2,539 | 2.5× |
| MRI pelvis w contrast (72196) | $850.20 | $2,834 | 2.8× |
| MRI pelvis w/o & w contrast (72197) | $850.20 | $2,834 | 2.8× |
| MRI pelvis w/o contrast (72195) | $833.70 | $2,779 | 4.1× |
| MRI thoracic spine w/o contrast (72146) | $849 | $2,830 | 4.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $309.90 | $1,033 | 1.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $849 | $2,830 | 4.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $849 | $2,830 | 2.8× |
| MRI, abdomen, combo (74183) | $850.50 | $2,835 | 2.8× |
| MRI, dorsal spine combo (72157) | $1,606.50 | $5,355 | 5.3× |
| MRI, dorsal spine contrast (72147) | $1,182.60 | $3,942 | 3.9× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$690–$849 | $2,300–$2,830 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$487.80–$849 | $1,626–$2,830 | varies |
| MRI, lumbar spine combo (72158) | $1,614.90 | $5,383 | 5.4× |
| Myelogram cervical (72240) | $489.90 | $1,633 | 0.7× |
| Myelogram Lumbar (72265) | $621.60 | $2,072 | 0.9× |
| Myelography thoracic (72255) | $486 | $1,620 | 0.7× |
| Myelograpy 2/more regions rs&i (72270) | $522.60 | $1,742 | 0.8× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$817.20–$978.60 | $2,724–$3,262 | varies |
| Neck soft tissue (70360) | $50.40 | $168 | 0.7× |
| Nm unlisted gi procedure (78299) | $317.70 | $1,059 | 0.9× |
| Nonvascular Shunt X-Ray (75809) | $127.50 | $425 | 1.4× |
| Nuclear Rx Oral Admin (79005) | $402.90 | $1,343 | 2.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $91.20 | $304 | 1.0× |
| Optic foramina (70190) | $74.70 | $249 | 1.0× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$231.90–$510 | $773–$1,700 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) | $298.50 | $995 | 0.9× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$12.60–$97.80 | $42–$326 | varies |
| Peritoneogram Rs&I (74190) | $251.70 | $839 | 0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $327 | $1,090 | 0.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$19.50–$162.90 | $65–$543 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $247.50 | $825 | 0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$9–$108.60 | $30–$362 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$27.60–$55.80 | $92–$186 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$11.70–$108.60 | $39–$362 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $106.80 | $356 | 1.2× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$13.50–$48.60 | $45–$162 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$12–$118.20 | $40–$394 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$10.80–$108.60 | $36–$362 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $98.10 | $327 | 1.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $59.70 | $199 | 0.8× |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$15.60–$120.60 | $52–$402 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$17.10–$66.60 | $57–$222 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $155.10 | $517 | 1.0× |
| Radex Spine 1 View Specify Level (72020) | $76.80 | $256 | 1.0× |
| Radex Sternum Minimum 2 Views (71120) | $72 | $240 | 1.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $89.10 | $297 | 1.2× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$9.90–$48.60 | $33–$162 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$12.60–$117.30 | $42–$391 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $74.70 | $249 | 0.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $101.40 | $338 | 1.1× |
| Radiologic exam colon double contrast study (74280) | $279.30 | $931 | 1.8× |
| Radiologic exam colon single contrast study (74270) | $206.10 | $687 | 1.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $155.10 | $517 | 1.0× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$15.60–$124.80 | $52–$416 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $76.20 | $254 | 0.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $155.10 | $517 | 1.0× |
| Radiologic exam swallow function contrast study (74230) | $205.50 | $685 | 1.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $260.40 | $868 | 1.7× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$29.10–$120.60 | $97–$402 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$12–$58.20 | $40–$194 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $125.40 | $418 | 1.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$13.20–$106.80 | $44–$356 | varies |
| Renal Cyst Study (74470) | $316.20 | $1,054 | 0.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$313.50–$448.80 | $1,045–$1,496 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$313.50–$510.90 | $1,045–$1,703 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,082.40 | $3,608 | 2.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$510.90–$1,082.40 | $1,703–$3,608 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$510.90–$1,082.40 | $1,703–$3,608 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,082.40 | $3,608 | 1.0× |
| Scapula (73010) | $59.70 | $199 | 0.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $17.70 | $59 | 0.8× |
| Shoulder 1 view (73020) | $52.80 | $176 | 0.7× |
| Shoulder Arthrography (73040) | $295.80 | $986 | 1.0× |
| Skull less than 4 views (70250) | $74.70 | $249 | 0.8× |
| Sternoclavicular joints (71130) | $76.80 | $256 | 1.0× |
| Testicular Imaging W/Flow (78761) | $345.60 | $1,152 | 1.0× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$37.50–$72.90 | $125–$243 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$15.90–$97.80 | $53–$326 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$11.70–$74.70 | $39–$249 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$172.80–$510 | $576–$1,700 | varies |
| Thyroid Met Imaging Body (78018) | $680.10 | $2,267 | 1.5× |
| Thyroid Uptake Measurement (78012) | $119.10 | $397 | 0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $202.20 | $674 | 0.6× |
| Ultrasound Breast Limited (76642) | $76.80 | $256 | 1.0× |
| Ultrasound Exam Aaa Screen (76706) | $84 | $280 | 0.9× |
| Ultrasound, abdomen limited (76705) | $174.90 | $583 | 1.9× |
| Unlisted Dx Radiographic Procedure (76499) | $28.20 | $94 | 0.4× |
| Unlisted us procedure (76999) | $141.30 | $471 | 1.9× |
| Upper gi w/o kub (74240) | $191.10 | $637 | 1.3× |
| Urethrocystogram voiding (74455) | $189.60 | $632 | 0.9× |
| Urethrocystography retrograde (74450) | $189.60 | $632 | 0.9× |
| Us breast unilateral complete (76641) | $141.30 | $471 | 1.6× |
| Us chest (76604) | $198 | $660 | 2.2× |
| Us complete joint (76881) range across 4 matching MRF lines |
$95.70–$177 | $319–$590 | varies |
| Us exam, pelvic, limited (76857) | $85.80 | $286 | 1.0× |
| Us head (76506) | $180 | $600 | 2.0× |
| Us kidney transplant (76776) | $115.20 | $384 | 1.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $85.80 | $286 | 1.0× |
| Us ob limited 1 or more fetuses (76815) | $163.80 | $546 | 1.8× |
| Us ob transvaginal (76817) | $86.40 | $288 | 1.0× |
| Us pelvic non ob complete (76856) | $194.10 | $647 | 2.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $199.80 | $666 | 2.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $182.10 | $607 | 2.0× |
| Us retroperitoneal complete (76770) | $228.60 | $762 | 2.5× |
| Us retroperitoneal limited (76775) | $228.60 | $762 | 2.5× |
| Us scrotum and contents (76870) | $186.90 | $623 | 2.1× |
| Us thyroid (76536) | $169.80 | $566 | 1.9× |
| Us transrectal (76872) | $127.80 | $426 | 1.4× |
| Vein X-Ray Chest (75827) | $915.30 | $3,051 | 0.7× |
| Venography caval inferior serialography rs&i (75825) | $2,550.60 | $8,502 | 0.9× |
| Venography extremity bilateral rs&i (75822) | $772.80 | $2,576 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $772.80 | $2,576 | 0.6× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$27.60–$174.60 | $92–$582 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $74.70 | $249 | 1.0× |
| X-ray antegrade pyelogram tube (74425) | $189.60 | $632 | 0.6× |
| X-Ray Aorta Leg Arteries (75630) | $2,151.90 | $7,173 | 0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$27.60–$116.40 | $92–$388 | varies |
| X-Ray Exam Breast Specimen (76098) | $325.20 | $1,084 | 0.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 3 matching MRF lines |
$18.90–$163.50 | $63–$545 | varies |
| X-Ray Exam Hip Uni 1 View (73501) | $58.20 | $194 | 0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$13.20–$71.10 | $44–$237 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$12.30–$80.70 | $41–$269 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$15.30–$76.20 | $51–$254 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$12.30–$163.50 | $41–$545 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $126 | $420 | 1.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$21.30–$69.90 | $71–$233 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$28.50–$124.20 | $95–$414 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$16.80–$141.30 | $56–$471 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$11.10–$114.90 | $37–$383 | varies |
| X-ray IV pyelogram (ivp) (74400) | $189.60 | $632 | 1.3× |
| X-ray IV pyelogram+tomography (74415) | $282 | $940 | 1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $62.10 | $207 | 0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$29.10–$87.60 | $97–$292 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$13.20–$89.70 | $44–$299 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$21.30–$172.80 | $71–$576 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $71.10 | $237 | 0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$11.70–$62.70 | $39–$209 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$15.30–$87 | $51–$290 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $106.80 | $356 | 1.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $209.40 | $698 | 0.7× |
| X-Rays Bone Length Studies (77073) | $79.20 | $264 | 0.9× |
| X-Rays Bone Survey Complete (77075) | $170.10 | $567 | 1.9× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$18.30–$106.80 | $61–$356 | varies |
| Xr facial bones less than 3 views (70140) | $81.90 | $273 | 1.1× |
| Xr orbits complete 4 views (70200) | $93 | $310 | 1.0× |
| Xr Tomogram Single Plane (76100) | $162.90 | $543 | 1.8× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.