Imaging prices at Lake Charles Memorial Hospital
Lake Charles, LA · every code in this section with a posted price and a Medicare benchmark.
294 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) | $2,163.87 | $3,606.45 | 1.7× |
| Abdomen 1 View (74018) | $129.60 | $216 | 1.6× |
| Abdomen 2 views (74019) | $181.80 | $303 | 1.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $440.10 | $733.50 | 1.2× |
| Angio pulmonary bilat (75743) | $2,435.10 | $4,058.50 | 0.8× |
| Angiography extremity bilateral rs&i (75716) | $4,500.60 | $7,501 | 1.5× |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$1,303.02–$4,500.60 | $2,171.70–$7,501 | varies |
| Ankle 2 views (73600) | $131.04 | $218.40 | 1.6× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,640.36 | $2,733.93 | 0.3× |
| Artery X-Rays Abdomen (75726) | $2,782.50 | $4,637.50 | 0.5× |
| Arthrogram ankle (73615) | $210.37 | $350.61 | 0.6× |
| Arthrogram hip (73525) | $222.16 | $370.26 | 0.7× |
| Arthrogram Wrist (73115) | $225.69 | $376.15 | 0.7× |
| Basic radiation dosimetry calculation (77300) | $222.68 | $371.13 | 1.8× |
| Bone age studies (77072) | $181.80 | $303 | 1.9× |
| Bone Imaging 3 Phase (78315) | $1,347.06 | $2,245.10 | 3.6× |
| Bone Imaging Limited Area (78300) | $864.27 | $1,440.45 | 2.3× |
| Bone Imaging Whole Body (78306) | $1,211.43 | $2,019.05 | 3.3× |
| Bone survey infant (77076) | $181.80 | $303 | 1.9× |
| Brachytx isodose complex (77318) | $544.20 | $907 | 1.6× |
| Brachytx isodose intermed (77317) | $475.80 | $793 | 1.4× |
| Brachytx Isodose Plan Simple (77316) | $544.20 | $907 | 1.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $616.41 | $1,027.35 | 1.2× |
| Cat Scan Follow-Up Study (76380) | $338.58 | $564.30 | 4.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 2 matching MRF lines |
$294.28–$766.80 | $490.47–$1,278 | varies |
| Cerebrospinal Fluid Scan (78630) | $732 | $1,220 | 1.5× |
| Chest 1 view (71045) | $129.60 | $216 | 1.6× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$144–$225.96 | $240–$376.60 | varies |
| Chest 3 views (71047) | $123.55 | $205.92 | 1.5× |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$120–$181.80 | $200–$303 | varies |
| Clavicle complete (73000) | $169.22 | $282.04 | 2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,276.20 | $2,127 | 13.1× |
| Continuing medical physics consltj pr wk (77336) | $253.30 | $422.17 | 2.0× |
| Contrast Exam Abdominl Aorta (75625) | $4,500.60 | $7,501 | 1.5× |
| Contrast X-Ray Bladder (74430) | $620.40 | $1,034 | 1.9× |
| Contrast X-Ray Of Elbow (73085) | $219.52 | $365.86 | 0.7× |
| Contrast X-Ray Of Knee Joint (73580) | $315.60 | $526 | 1.0× |
| CT abdomen and pelvis without and with contrast (74178) | $2,904 | $4,840 | 9.0× |
| CT abdomen and pelvis without contrast (74176) | $2,904 | $4,840 | 13.1× |
| CT abdomen w contrast (74160) | $1,257.43 | $2,095.72 | 7.7× |
| CT abdomen w wo contrast (74170) | $1,431.94 | $2,386.56 | 8.8× |
| CT abdomen w/o contrast (74150) | $1,133.88 | $1,889.80 | 11.7× |
| CT Angio Abdomen and Pelvis (74174) | $1,680 | $2,800 | 5.2× |
| CT Angio Chest (71275) | $1,567.45 | $2,612.42 | 9.6× |
| CT Angio Head (70496) | $1,102.76 | $1,837.94 | 6.8× |
| CT angio hrt w/3d image (75574) | $471.24 | $785.40 | 1.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,052.40 | $1,754 | 6.5× |
| CT Angio Neck (70498) | $1,212.79 | $2,021.31 | 7.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,052.40 | $1,754 | 6.5× |
| CT cervical spine w/ contrast (72126) | $1,257.43 | $2,095.72 | 3.9× |
| CT cervical spine w/o contrast (72125) | $1,728.97 | $2,881.62 | 17.8× |
| CT cervical spine w/wo cont (72127) | $1,143.12 | $1,905.20 | 7.0× |
| CT chest w contrast (71260) | $1,693.76 | $2,822.93 | 10.4× |
| CT chest w/wo contrast (71270) | $1,875.26 | $3,125.43 | 11.5× |
| CT head/brain with contrast (70460) | $790.91 | $1,318.19 | 4.9× |
| CT head/brain without and with contrast (70470) | $1,728.97 | $2,881.62 | 10.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $471.24 | $785.40 | 1.5× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$129.60–$333.50 | $216–$555.84 | varies |
| CT hrt w/3d image congen (75573) | $471.24 | $785.40 | 1.5× |
| CT iac w contrast (70481) | $1,332.58 | $2,220.96 | 8.2× |
| CT l-spine w&w/o contrast (72133) | $879.55 | $1,465.92 | 5.4× |
| CT lower ext w/o (73700) | $1,004.52 | $1,674.20 | 10.3× |
| CT lower extremity w/contrast material (73701) | $984.19 | $1,640.32 | 6.0× |
| CT lumbar spine w contrast (72132) | $1,075.01 | $1,791.68 | 3.3× |
| CT lumbar spine w/o contrast (72131) | $1,281.72 | $2,136.20 | 13.2× |
| CT maxillofacial w contrast (70487) | $1,211.33 | $2,018.89 | 7.4× |
| CT maxillofacial wo contrast (70486) | $1,211.33 | $2,018.89 | 12.5× |
| CT neck tissue combo (70492) | $1,650 | $2,750 | 10.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $911.13 | $1,518.55 | 5.6× |
| CT orbits w/o contrast (70480) | $1,211.33 | $2,018.89 | 12.5× |
| CT pelvis w&w/o contrast (72194) | $1,428.77 | $2,381.28 | 8.8× |
| CT pelvis w/o contrast (72192) | $928.15 | $1,546.92 | 9.6× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,005.95–$1,050 | $1,676.58–$1,750 | varies |
| CT scans face/jaw combo (70488) | $1,211.33 | $2,018.89 | 7.4× |
| CT soft tissue neck w contrast (70491) | $1,555.09 | $2,591.82 | 9.5× |
| CT soft tissue neck w/o contrast (70490) | $1,381.22 | $2,302.03 | 14.2× |
| CT thoracic spine w contrast (72129) | $1,028.81 | $1,714.68 | 6.3× |
| CT thoracic spine w/o contrast (72128) | $1,257.43 | $2,095.72 | 13.0× |
| CT thoracic spine w/wo cont (72130) | $1,143.12 | $1,905.20 | 7.0× |
| CT thorax w/o contrast (71250) | $1,276.21 | $2,127.02 | 13.1× |
| CT upper ext wo (73200) | $1,004.52 | $1,674.20 | 10.3× |
| CT upper extremity w/o & w/contrast material (73202) | $1,200 | $2,000 | 7.4× |
| CT upper extremity with contrast (73201) | $1,143.12 | $1,905.20 | 3.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,408.18 | $2,346.96 | 8.6× |
| Cta Abdomen (74175) | $1,402.63 | $2,337.72 | 8.6× |
| CTA pelvis (72191) | $1,004.40 | $1,674 | 6.2× |
| Dilation ureters/urethra rs&i (74485) | $1,200 | $2,000 | 0.6× |
| Doppler Fetal Mid Cerebral Artery (76821) | $166.80 | $278 | 1.7× |
| Dxa Bone Density Axial (77080) | $181.80 | $303 | 1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $86.13 | $143.55 | 1.1× |
| Echo Guide For Artery Repair (76936) | $167.95 | $279.92 | 0.8× |
| Echograp Trans R Pros Study (76873) | $241.82 | $403.04 | 2.5× |
| Esophagram (74220) | $295.80 | $493 | 1.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $193.75 | $322.92 | 2.0× |
| Fluoroscopy up to 1 hr (76000) | $500.26 | $833.76 | 2.3× |
| Follow-Up Angiography (75898) | $960.34 | $1,600.56 | 0.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$100.80–$129.60 | $168–$216 | varies |
| Forearm 2 views (73090) | $169.22 | $282.04 | 2.1× |
| Gastric emptying imaging study (78264) | $878.79 | $1,464.65 | 2.4× |
| Gated Heart Planar Single (78472) | $660.33 | $1,100.55 | 1.8× |
| Hand 2 views (73120) | $181.80 | $303 | 1.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,025.40 | $1,709 | 1.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,202.40 | $2,004 | 1.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,350.40 | $5,584 | 1.1× |
| Hepatobil Syst Image W/Drug (78227) | $1,080 | $1,800 | 2.1× |
| Hepatobiliary System Imaging (78226) | $944.46 | $1,574.10 | 2.5× |
| Ht Muscle Image Spect Sing (78451) | $672.03 | $1,120.05 | 0.6× |
| Hysterosalpingogram (74740) | $378.60 | $631 | 1.7× |
| Interstitial radiation source applic complex (77778) | $1,658.58 | $2,764.30 | 2.6× |
| Joint Survey Single View (77077) | $181.80 | $303 | 1.9× |
| K Flow/Funct Image Multiple (78709) | $665.40 | $1,109 | 1.3× |
| K Flow/Funct Image W/Drug (78708) | $1,135.86 | $1,893.10 | 2.3× |
| K Flow/Funct Image W/O Drug (78707) | $766.80 | $1,278 | 1.5× |
| Kidney Imaging Morphol (78700) | $435 | $725 | 1.2× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$140.71–$175.89 | $234.52–$293.15 | varies |
| Leveen/Shunt Patency Exam (78291) | $309.87 | $516.45 | 0.8× |
| Liver & Spleen Imaging Static Only (78215) | $835.65 | $1,392.75 | 2.3× |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$597.60–$1,175.85 | $996–$1,959.75 | varies |
| Lung Ventilat&Perfus Imaging (78582) | $1,175.85 | $1,959.75 | 2.3× |
| Lung Ventilation Imaging (78579) | $600 | $1,000 | 1.6× |
| Lymph System Imaging (78195) | $355.41 | $592.35 | 0.7× |
| Mammary ductogram or galactogram multiple (77054) | $439.44 | $732.40 | 2.0× |
| Mammary ductogram or galactogram single (77053) | $527.74 | $879.56 | 2.4× |
| Meckels Divert Exam (78290) | $650.43 | $1,084.05 | 1.8× |
| Mlc imrt design & construction per imrt plan (77338) | $1,774.47 | $2,957.45 | 5.1× |
| MRA head w/o contrast (70544) | $882.60 | $1,471 | 4.0× |
| MRA neck w contrast (70548) | $1,024.50 | $1,707.50 | 3.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,159.20 | $1,932 | 3.6× |
| MRA neck w/o contrast (70547) | $882.60 | $1,471 | 4.0× |
| MRI abdomen w/o contrast (74181) | $882.60 | $1,471 | 4.0× |
| MRI any jt lower extrem w/contrast material (73722) | $1,024.20 | $1,707 | 1.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,024.50 | $1,707.50 | 3.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,200 | $2,000 | 5.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,200 | $2,000 | 5.4× |
| MRI cervical spine w contrast (72142) | $1,216.50 | $2,027.50 | 3.8× |
| MRI cervical spine w/o cont (72141) | $1,047.60 | $1,746 | 4.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,024.20 | $1,707 | 3.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,024.50 | $1,707.50 | 3.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $882.60 | $1,471 | 4.0× |
| MRI lumbar spine w contrast (72149) | $1,216.50 | $2,027.50 | 3.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,216.50 | $2,027.50 | 3.8× |
| MRI orbit face &/neck w/o contrast (70540) | $882.60 | $1,471 | 4.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,024.50 | $1,707.50 | 3.2× |
| MRI pelvis w/o & w contrast (72197) | $1,024.50 | $1,707.50 | 3.2× |
| MRI pelvis w/o contrast (72195) | $882.60 | $1,471 | 4.0× |
| MRI thoracic spine w/o contrast (72146) | $1,047.60 | $1,746 | 4.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $882.60 | $1,471 | 4.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,024.50 | $1,707.50 | 3.2× |
| MRI, abdomen, combo (74183) | $1,275.12 | $2,125.20 | 3.9× |
| MRI, dorsal spine combo (72157) | $1,216.50 | $2,027.50 | 3.8× |
| MRI, joint upper extrem (73221) | $882.60 | $1,471 | 4.0× |
| MRI, joint upper extrem combo (73223) | $1,024.50 | $1,707.50 | 3.2× |
| MRI, lumbar spine combo (72158) | $1,216.50 | $2,027.50 | 3.8× |
| Myelogram cervical (72240) | $525.60 | $876 | 0.7× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$1,794.30–$2,065.80 | $2,990.50–$3,443 | varies |
| Neck soft tissue (70360) | $175.89 | $293.15 | 2.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $600 | $1,000 | 1.6× |
| Nm csf leak detection (78650) | $706.20 | $1,177 | 0.6× |
| Nonvascular Shunt X-Ray (75809) | $181.80 | $303 | 1.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,022.60 | $3,371 | 1.6× |
| Nuclear Rx Oral Admin (79005) | $389.14 | $648.56 | 1.8× |
| Parathyroid Planar Imaging (78070) | $362.34 | $603.90 | 1.0× |
| Parathyroid planar imaging w/wo subtraction (78071) | $859.98 | $1,433.30 | 2.3× |
| Pelvis 1 or 2 views (72170) | $181.80 | $303 | 1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $181.80 | $303 | 1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $213.46 | $355.76 | 0.4× |
| Radex Ankle Complete Minimum 3 Views (73610) | $169.22 | $282.04 | 2.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $140.71 | $234.52 | 1.7× |
| Radex elbow complete minimum 3 views (73080) | $169.22 | $282.04 | 2.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $251.59 | $419.32 | 2.6× |
| Radex fingr minimum 2 views (73140) | $140.71 | $234.52 | 1.7× |
| Radex foot complete minimum 3 views (73630) | $140.71 | $234.52 | 1.7× |
| Radex Hand Minimum 3 Views (73130) | $140.71 | $234.52 | 1.7× |
| Radex lower extremity infant minimum 2 views (73592) | $89.86 | $149.76 | 1.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $157.20 | $262 | 1.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $169.22 | $282.04 | 2.1× |
| Radex Ribs Unilateral 2 Views (71100) | $169.22 | $282.04 | 2.1× |
| Radex shoulder complete minimum 2 views (73030) | $169.22 | $282.04 | 2.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $169.22 | $282.04 | 2.1× |
| Radex Spine 1 View Specify Level (72020) | $129.60 | $216 | 1.6× |
| Radex Sternum Minimum 2 Views (71120) | $169.22 | $282.04 | 2.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $272.91 | $454.85 | 3.4× |
| Radex Toe Minimum 2 Views (73660) | $140.71 | $234.52 | 1.7× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$100.80–$181.80 | $168–$303 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) | $169.22 | $282.04 | 2.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $5,229 | $8,715 | 0.8× |
| Radiation treatment delivery level 1 (77402) | $199.20 | $332 | 2.1× |
| Radiation treatment delivery level 2 (77407) | $160.80 | $268 | 0.4× |
| Radiation treatment delivery level 3 (77412) | $383.07 | $638.45 | 0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $251.59 | $419.32 | 2.6× |
| Radiologic exam colon double contrast study (74280) | $295.80 | $493 | 1.8× |
| Radiologic exam colon single contrast study (74270) | $158.14 | $263.56 | 1.0× |
| Radiologic exam knee complete 4/more views (73564) | $181.80 | $303 | 1.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $157.03 | $261.72 | 1.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $295.80 | $493 | 1.8× |
| Radiologic exam swallow function contrast study (74230) | $295.80 | $493 | 1.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $295.80 | $493 | 1.8× |
| Radiologic examination femur minimum 2 views (73552) | $140.71 | $234.52 | 1.7× |
| Radiologic examination knee 1/2 views (73560) | $167.09 | $278.49 | 2.1× |
| Radiologic Examination Osseous Survey Limited (77074) | $270.24 | $450.40 | 2.8× |
| Radiologic examination tibia & fibula 2 views (73590) | $169.22 | $282.04 | 2.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $306.60 | $511 | 0.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $255.60 | $426 | 0.7× |
| Ribs bilateral 3 views (71110) | $221.76 | $369.60 | 2.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,020 | $1,700 | 2.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $504.60 | $841 | 1.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,092.80 | $3,488 | 4.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$1,328.94–$2,065.80 | $2,214.90–$3,443 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$914.10–$2,065.80 | $1,523.50–$3,443 | varies |
| Rp Therapy Intravenous Administration (79101) | $385.80 | $643 | 1.8× |
| Scapula (73010) | $138.46 | $230.76 | 1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $40.20 | $67 | 1.7× |
| Shoulder 1 view (73020) | $129.60 | $216 | 1.6× |
| Shoulder Arthrography (73040) | $300.96 | $501.60 | 0.9× |
| Skull less than 4 views (70250) | $199.53 | $332.55 | 2.1× |
| Special dosimetry (77331) | $171.72 | $286.20 | 1.4× |
| Special Physics Consult (77370) | $413.82 | $689.70 | 3.3× |
| Special treatment procedure (77470) | $1,134.54 | $1,890.90 | 2.2× |
| Stereotactic Body Radiation Delivery (77373) | $2,872.20 | $4,787 | 1.7× |
| Sternoclavicular joints (71130) | $147.05 | $245.08 | 1.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $544.20 | $907 | 1.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $544.20 | $907 | 1.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $767.71 | $1,279.51 | 2.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $544.20 | $907 | 1.6× |
| Ther rad simulaj-aided field setting simple (77280) | $397.05 | $661.75 | 3.2× |
| Thoracic spine 2 views (72070) | $181.80 | $303 | 1.9× |
| Thoracic spine 3 views (72072) | $181.80 | $303 | 1.9× |
| Thyroid Imaging With Vascular Flow (78013) | $402.60 | $671 | 1.1× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$766.80–$897 | $1,278–$1,495 | varies |
| Thyroid Uptake Measurement (78012) | $381.90 | $636.50 | 1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $859.98 | $1,433.30 | 2.3× |
| Tx Devices Design & Construction Complex (77334) | $544.20 | $907 | 1.6× |
| Tx devices design & construction simple (77332) | $327.75 | $546.25 | 2.6× |
| Ultrasound Breast Limited (76642) | $249.48 | $415.80 | 3.1× |
| Ultrasound Exam Aaa Screen (76706) | $181.80 | $303 | 1.9× |
| Ultrasound, abdomen limited (76705) | $184.40 | $307.34 | 1.9× |
| Umbilical-artery Doppler (OB) (76820) | $332.11 | $553.52 | 3.4× |
| Upper gi w/o kub (74240) | $295.80 | $493 | 1.8× |
| Urethrocystogram voiding (74455) | $378.60 | $631 | 1.7× |
| Urethrocystography retrograde (74450) | $155.28 | $258.80 | 0.7× |
| Us breast unilateral complete (76641) | $249.48 | $415.80 | 2.6× |
| Us chest (76604) range across 2 matching MRF lines |
$181.80–$294.84 | $303–$491.40 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$255.55–$319.44 | $425.92–$532.40 | varies |
| Us exam, pelvic, limited (76857) | $238.92 | $398.20 | 2.5× |
| Us head (76506) | $315.90 | $526.50 | 3.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $181.80 | $303 | 1.9× |
| Us ob detailed single fetus (76811) | $352.80 | $588 | 1.6× |
| Us ob limited 1 or more fetuses (76815) | $186.84 | $311.40 | 1.9× |
| Us ob transvaginal (76817) | $181.80 | $303 | 1.9× |
| Us pelvic non ob complete (76856) | $462.23 | $770.39 | 4.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $248.94 | $414.90 | 2.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $162.86 | $271.44 | 1.7× |
| Us retroperitoneal complete (76770) | $388.78 | $647.96 | 4.0× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$201.75–$343.20 | $336.25–$572 | varies |
| Us thyroid (76536) | $343.20 | $572 | 3.5× |
| Us transrectal (76872) | $264.53 | $440.88 | 2.7× |
| Vein X-Ray Chest (75827) | $1,064.23 | $1,773.72 | 0.7× |
| Venogram Sinus/Jugular (75860) | $840.48 | $1,400.80 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $1,663.70 | $2,772.83 | 0.6× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$691.20–$960 | $1,152–$1,600 | varies |
| Venography extremity unilateral rs&i (75820) range across 6 matching MRF lines |
$633.60–$768 | $1,056–$1,280 | varies |
| Wrist 2 views (73100) | $138.25 | $230.42 | 1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $221.76 | $369.60 | 2.7× |
| X-ray antegrade pyelogram tube (74425) | $159.94 | $266.56 | 0.5× |
| X-Ray Aorta Leg Arteries (75630) | $4,500.60 | $7,501 | 1.5× |
| X-Ray Bend Only L-S Spine (72120) | $181.80 | $303 | 1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $140.71 | $234.52 | 1.7× |
| X-Ray Exam Breast Specimen (76098) | $782.40 | $1,304 | 1.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $248.62 | $414.36 | 3.1× |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$129.60–$284.33 | $216–$473.88 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$153.84–$169.22 | $256.40–$282.04 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $181.80 | $303 | 1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $162.36 | $270.60 | 1.7× |
| X-Ray Exam L-S Spine Bending (72114) | $365.38 | $608.96 | 3.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $175.89 | $293.15 | 2.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $303.86 | $506.44 | 3.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$168–$210 | $280–$350 | varies |
| X-ray humerus (73060) | $169.22 | $282.04 | 2.1× |
| X-ray IV pyelogram (ivp) (74400) | $365.38 | $608.96 | 2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $169.22 | $282.04 | 2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $78.14 | $130.24 | 1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $197.80 | $329.67 | 2.0× |
| X-ray nose-rectum child f.b. (76010) | $60.21 | $100.35 | 0.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $240 | $400 | 2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $181.80 | $303 | 1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $169.22 | $282.04 | 2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $314.49 | $524.15 | 3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $277.20 | $462 | 2.9× |
| X-Ray Stress View (77071) | $57.36 | $95.60 | 0.7× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$127.92–$181.80 | $213.20–$303 | varies |
| X-Rays Bone Survey Complete (77075) | $310.82 | $518.04 | 3.2× |
| Xr c-spine 4 or 5 views (72050) | $251.59 | $419.32 | 2.6× |
| Xr facial bones less than 3 views (70140) | $240 | $400 | 3.0× |
| Xr orbits complete 4 views (70200) | $221.76 | $369.60 | 2.3× |
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.