Imaging prices at Lallie Kemp Regional Medical Center
Independence, LA · every code in this section with a posted price and a Medicare benchmark.
371 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) | $2,441.09 | $4,068.48 | 1.9× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$191.27–$198.92 | $318.78–$331.53 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $465.82 | $776.36 | 1.3× |
| Angio internal mammary (75756) | $1,179.68 | $1,966.13 | 0.4× |
| Angio pulmonary bilat (75743) | $2,429.04 | $4,048.40 | 0.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $1,476.46 | $2,460.76 | 0.5× |
| Angiography extremity bilateral rs&i (75716) | $2,429.04 | $4,048.40 | 0.8× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$1,108.92–$2,429.04 | $1,848.20–$4,048.40 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,108.92 | $1,848.20 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,108.92 | $1,848.20 | 0.4× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$72.70–$75.61 | $121.17–$126.02 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,429.04 | $4,048.40 | 0.5× |
| Aortography thoracic w/o serialography rs&i (75600) | $2,429.04 | $4,048.40 | 0.8× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,429.04 | $4,048.40 | 0.5× |
| Artery X-Rays Adrenal Gland (75731) | $1,845.57 | $3,075.95 | 0.6× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,429.04 | $4,048.40 | 0.5× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$997.82 | $1,663.04 | 0.2× |
| Arthrogram ankle (73615) | $320.70 | $534.50 | 1.0× |
| Arthrogram hip (73525) | $320.70 | $534.50 | 1.0× |
| Arthrogram Wrist (73115) | $320.70 | $534.50 | 1.0× |
| Basic radiation dosimetry calculation (77300) | $236.08 | $393.47 | 1.9× |
| Bone age studies (77072) | $80.30 | $133.83 | 0.8× |
| Bone Imaging 3 Phase (78315) | $640.70 | $1,067.84 | 1.8× |
| Bone Imaging Limited Area (78300) | $452.06 | $753.43 | 1.2× |
| Bone Imaging Multiple Areas (78305) | $390.32 | $650.54 | 1.1× |
| Bone Imaging Whole Body (78306) | $684.72 | $1,141.20 | 1.9× |
| Bone marrow imaging limited area (78102) | $498.92 | $831.53 | 1.4× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$122.79–$127.70 | $204.65–$212.84 | varies |
| Brain Flow Imaging Only (78610) | $503.81 | $839.68 | 1.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $503.81 | $839.68 | 1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,745.98 | $2,909.96 | 1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $631.92 | $1,053.20 | 2.0× |
| Cat Scan Follow-Up Study (76380) | $398.17 | $663.62 | 5.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $402.52 | $670.87 | 0.8× |
| Cerebrospinal Fluid Scan (78630) | $538.97 | $898.29 | 1.1× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Chest 3 views (71047) | $86.05 | $143.42 | 1.1× |
| Chest 4 or more views (71048) | $86.05 | $143.42 | 0.9× |
| Cholecystography Oral Contrast (74290) | $148.22 | $247.04 | 0.9× |
| Cisternography Positive Contrast Rs&I (70015) | $317.89 | $529.81 | 0.4× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 3 matching MRF lines |
$160.32–$166.73 | $267.20–$277.89 | varies |
| Continuing medical physics consltj pr wk (77336) | $295.30 | $492.16 | 2.4× |
| Contrast Exam Abdominl Aorta (75625) | $2,429.04 | $4,048.40 | 0.8× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$281.83–$293.10 | $469.71–$488.50 | varies |
| Contrast X-Ray Of Elbow (73085) | $320.70 | $534.50 | 1.0× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$1,417.28–$1,473.97 | $2,362.13–$2,456.62 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$1,127.29–$1,172.38 | $1,878.81–$1,953.96 | varies |
| CT abdomen w contrast (74160) | $832.12 | $1,386.87 | 5.2× |
| CT abdomen w wo contrast (74170) | $1,046.08 | $1,743.46 | 6.6× |
| CT abdomen w/o contrast (74150) | $810.80 | $1,351.33 | 8.6× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$442.67–$460.37 | $737.78–$767.29 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,148.78–$1,194.74 | $1,914.64–$1,991.23 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,100.92–$1,144.95 | $1,834.86–$1,908.25 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$273.65–$284.59 | $456.08–$474.32 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $967.13 | $1,611.88 | 6.1× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,077.95–$1,121.07 | $1,796.59–$1,868.45 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,120.36 | $1,867.26 | 7.1× |
| CT bone density (77078) range across 2 matching MRF lines |
$137.13–$142.61 | $228.55–$237.69 | varies |
| CT cervical spine w/ contrast (72126) | $1,009.36 | $1,682.27 | 3.2× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$872.35–$907.25 | $1,453.92–$1,512.08 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$1,147.03–$1,192.91 | $1,911.72–$1,988.19 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$904.49–$940.67 | $1,507.48–$1,567.78 | varies |
| CT chest w/wo contrast (71270) | $1,064.23 | $1,773.72 | 6.7× |
| CT head/brain with contrast (70460) | $687.64 | $1,146.07 | 4.3× |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$970.16–$1,008.97 | $1,616.93–$1,681.61 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$123.92–$128.87 | $206.53–$214.79 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$848.69–$882.64 | $1,414.49–$1,471.07 | varies |
| CT l-spine w&w/o contrast (72133) | $1,264.76 | $2,107.93 | 8.0× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$728–$1,456 | $1,213.33–$2,426.66 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$858.38–$892.72 | $1,430.63–$1,487.86 | varies |
| CT lumbar spine w contrast (72132) | $1,009.36 | $1,682.27 | 3.2× |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,053.66–$1,095.80 | $1,756.10–$1,826.34 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$498.70–$518.65 | $831.17–$864.42 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$572.38–$595.27 | $953.96–$992.12 | varies |
| CT neck tissue combo (70492) | $953.70 | $1,589.50 | 6.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $951.14 | $1,585.23 | 6.0× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$693.08–$720.81 | $1,155.14–$1,201.35 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,005.84–$1,046.08 | $1,676.40–$1,743.46 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$654.36–$680.53 | $1,090.60–$1,134.22 | varies |
| CT scan of leg combo (73702) | $805.27 | $1,342.12 | 5.1× |
| CT scans face/jaw combo (70488) | $873.17 | $1,455.28 | 5.5× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$786.59–$818.05 | $1,310.98–$1,363.42 | varies |
| CT soft tissue neck w/o contrast (70490) | $757.12 | $1,261.86 | 8.0× |
| CT thoracic spine w contrast (72129) | $841.59 | $1,402.65 | 5.3× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$948.14–$986.07 | $1,580.24–$1,643.45 | varies |
| CT thoracic spine w/wo cont (72130) | $525.70 | $876.17 | 3.3× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$778.87–$810.02 | $1,298.11–$1,350.03 | varies |
| CT unlisted procedure (76497) | $185.42 | $309.03 | 2.4× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$658.91–$685.27 | $1,098.19–$1,142.12 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,195.16 | $1,991.93 | 7.5× |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$837.73–$1,675.46 | $1,396.22–$2,792.44 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$1,252.55–$1,302.65 | $2,087.58–$2,171.08 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,158.10–$1,204.42 | $1,930.16–$2,007.37 | varies |
| CTA pelvis (72191) | $805.75 | $1,342.91 | 5.1× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $305.92 | $509.86 | 1.4× |
| Dilation ureters/urethra rs&i (74485) | $261.55 | $435.91 | 0.1× |
| Discography Cerv/Thor Spine (72285) | $1,100.38 | $1,833.96 | 0.6× |
| Diskography lumbar (72295) | $1,100.38 | $1,833.96 | 0.6× |
| Dxa Bone Density Axial (77080) | $161.70 | $269.50 | 1.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $80.18 | $133.64 | 1.0× |
| Echo exam of fetal heart (76825) | $186.32 | $310.53 | 0.4× |
| Echo exam uterus (76831) | $287.05 | $478.41 | 1.3× |
| Echo Guide For Artery Repair (76936) | $382.60 | $637.66 | 2.0× |
| Echograp Trans R Pros Study (76873) | $200.27 | $333.78 | 2.1× |
| Esophageal Motility Study (78258) | $368.44 | $614.07 | 1.0× |
| Esophagram (74220) | $200.52 | $334.20 | 1.3× |
| Fetal Biophys Profile W/Nst (76818) | $253.93 | $423.22 | 2.7× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$150.57–$156.59 | $250.95–$260.99 | varies |
| Follow-Up Angiography (75898) | $376.14 | $626.90 | 0.1× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$72.70–$75.61 | $121.17–$126.02 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Gastric emptying imaging study (78264) | $611.85 | $1,019.75 | 1.7× |
| Gastric Mucosa Imaging (78261) | $368.44 | $614.07 | 1.0× |
| Gated Heart Planar Single (78472) | $930.68 | $1,551.13 | 2.6× |
| Gated Heart, Multiple (78473) | $744.70 | $1,241.16 | 2.1× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$72.70–$75.61 | $121.17–$126.02 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,429.04 | $4,048.40 | 0.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $997.82 | $1,663.04 | 0.3× |
| Hepatobiliary System Imaging (78226) | $661.95 | $1,103.25 | 1.8× |
| Ht Muscle Image Spect Sing (78451) | $683.21 | $1,138.68 | 0.6× |
| Hysterosalpingogram (74740) | $345.13 | $575.22 | 1.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $150.20 | $250.34 | 1.9× |
| Infusion Ivp (74410) | $399.30 | $665.50 | 2.5× |
| Interstitial radiation source applic complex (77778) | $1,669.31 | $2,782.18 | 2.6× |
| Intracavitary Radiation Source Applic Complex (77763) | $4,292.12 | $7,153.53 | 6.8× |
| Intracavitary Radiation Source Applic Intermed (77762) | $4,292.12 | $7,153.53 | 8.6× |
| Joint Survey Single View (77077) | $88.56 | $147.60 | 0.9× |
| K Flow/Funct Image Multiple (78709) | $484.33 | $807.21 | 1.0× |
| K Flow/Funct Image W/Drug (78708) | $471.03 | $785.05 | 1.0× |
| K Flow/Funct Image W/O Drug (78707) | $697.15 | $1,161.92 | 1.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $623.99 | $1,039.99 | 1.7× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$72.70–$151.22 | $121.17–$252.04 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $434.01 | $723.35 | 1.2× |
| Liver & Spleen Imaging Static Only (78215) | $579.81 | $966.35 | 1.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $737.87 | $1,229.78 | 2.0× |
| Liver imaging static only (78201) | $407.38 | $678.96 | 0.8× |
| Liver imaging w/vascular flow (78202) | $407.38 | $678.96 | 0.8× |
| Lung Ventilat&Perfus Imaging (78582) | $662.71 | $1,104.52 | 1.3× |
| Lung Ventilation Imaging (78579) | $367.42 | $612.36 | 1.0× |
| Lymph System Imaging (78195) | $487.35 | $812.25 | 1.0× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $324.53 | $540.88 | 0.2× |
| Lymphangiography extremity only unilateral rs&i (75801) | $324.53 | $540.88 | 0.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $369.79 | $616.32 | 0.1× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $369.79 | $616.32 | 0.1× |
| Magnetic Image Jaw Joint (70336) | $377.51 | $629.19 | 1.7× |
| Mammary ductogram or galactogram multiple (77054) | $197.81 | $329.68 | 0.9× |
| Mammary ductogram or galactogram single (77053) | $197.81 | $329.68 | 0.9× |
| Meckels Divert Exam (78290) | $368.44 | $614.07 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $1,079.47 | $1,799.12 | 3.4× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$377.51–$392.62 | $629.19–$654.36 | varies |
| MRA head with contrast (70545) | $488.12 | $813.54 | 1.5× |
| MRA neck w contrast (70548) | $734.83 | $1,224.71 | 2.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,266.97 | $2,111.62 | 4.0× |
| MRA neck w/o contrast (70547) | $377.51 | $629.19 | 1.7× |
| MRI abdomen w contrast (74182) | $741.26 | $1,235.43 | 2.3× |
| MRI abdomen w/o contrast (74181) | $392.62 | $654.36 | 1.8× |
| MRI any jt lower extrem w/contrast material (73722) | $1,141.66 | $1,902.76 | 1.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $741.26 | $1,235.43 | 2.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,097.75 | $1,829.58 | 1.5× |
| MRI cardiac w/o contrast (75557) | $587.99 | $979.99 | 2.7× |
| MRI cervical spine w contrast (72142) | $741.26 | $1,235.43 | 2.3× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$377.51–$392.62 | $629.19–$654.36 | varies |
| MRI chest w/o contrast (71550) | $604.25 | $1,007.09 | 2.8× |
| MRI chest wo w contrast (71552) | $858.05 | $1,430.09 | 2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $442.87 | $738.12 | 1.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $741.26 | $1,235.43 | 2.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$377.51–$392.62 | $629.19–$654.36 | varies |
| MRI lumbar spine w contrast (72149) | $741.26 | $1,235.43 | 2.3× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$712.75–$741.26 | $1,187.91–$1,235.43 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $392.62 | $654.36 | 1.8× |
| MRI orbit face neck w contrast (70542) | $712.75 | $1,187.91 | 2.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $741.26 | $1,235.43 | 2.3× |
| MRI pelvis w contrast (72196) | $741.26 | $1,235.43 | 2.3× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$712.75–$741.26 | $1,187.91–$1,235.43 | varies |
| MRI pelvis w/o contrast (72195) | $392.62 | $654.36 | 1.8× |
| MRI spectroscopy (76390) | $797.14 | $1,328.56 | 10.1× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$377.51–$392.62 | $629.19–$654.36 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $712.75 | $1,187.91 | 2.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $392.62 | $654.36 | 1.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $741.26 | $1,235.43 | 2.3× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$712.75–$741.26 | $1,187.91–$1,235.43 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$712.75–$741.26 | $1,187.91–$1,235.43 | varies |
| MRI, dorsal spine contrast (72147) | $741.26 | $1,235.43 | 2.3× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$377.51–$392.62 | $629.19–$654.36 | varies |
| MRI, joint upper extrem combo (73223) | $741.26 | $1,235.43 | 2.3× |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$712.75–$741.26 | $1,187.91–$1,235.43 | varies |
| Myelogram cervical (72240) | $297.98 | $496.64 | 0.4× |
| Myelography thoracic (72255) | $2,429.04 | $4,048.40 | 3.4× |
| Myelograpy 2/more regions rs&i (72270) | $305.17 | $508.61 | 0.4× |
| Myocardial Spect Multiple Studies (78452) | $1,085.54 | $1,809.24 | 0.9× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Nm csf leak detection (78650) | $402.52 | $670.87 | 0.3× |
| Nonvascular Shunt X-Ray (75809) | $313.82 | $523.04 | 3.3× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $182.06 | $303.43 | 1.9× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $182.06 | $303.43 | 1.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $182.06 | $303.43 | 1.9× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $71.20 | $118.66 | 2.7× |
| Ophthalmic us dx quantitative a-scan only (76511) | $182.06 | $303.43 | 1.9× |
| Optic foramina (70190) | $82.74 | $137.90 | 1.1× |
| Panoramic X-ray of jaws (70355) | $72.70 | $121.17 | 0.9× |
| Parathyroid Planar Imaging (78070) | $387.14 | $645.23 | 1.1× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Peritoneogram Rs&I (74190) | $369.79 | $616.32 | 0.7× |
| Pet Image Skull-Thigh (78812) | $2,466.96 | $4,111.60 | 1.9× |
| PET image w/CT, full body (78816) | $3,427.44 | $5,712.40 | 2.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,519.53 | $4,199.21 | 1.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,429.04 | $4,048.40 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $651.37 | $1,085.62 | 1.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$192.06–$199.74 | $320.10–$332.90 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $403.72 | $672.87 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $86.05 | $143.42 | 0.9× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$82.74–$165.48 | $137.90–$275.80 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $75.61 | $126.02 | 1.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $72.70 | $121.17 | 0.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $86.05 | $143.42 | 1.1× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $132.02 | $220.03 | 1.7× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$82.74–$165.48 | $137.90–$275.80 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $75.61 | $126.02 | 1.0× |
| Radex Spine 1 View Specify Level (72020) | $72.70 | $121.17 | 0.9× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $82.74 | $137.90 | 1.1× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $75.61 | $126.02 | 0.8× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $86.05 | $143.42 | 0.9× |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$246.72–$256.59 | $411.20–$427.65 | varies |
| Radiologic exam colon single contrast study (74270) | $195.79 | $326.32 | 1.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$284.26–$295.63 | $473.77–$492.72 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$82.74–$172.10 | $137.90–$286.84 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $72.70 | $121.17 | 0.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $234.47 | $390.79 | 1.5× |
| Radiologic exam swallow function contrast study (74230) | $225.79 | $376.31 | 1.4× |
| Radiologic exam teeth complete full mouth (70320) | $76.41 | $127.35 | 0.4× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $76.41 | $127.35 | 0.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $213.95 | $356.58 | 1.3× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$105.66–$109.88 | $176.10–$183.14 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $208.42 | $347.37 | 2.2× |
| Radiologic Examination Salivary Gland Calculus (70380) | $72.70 | $121.17 | 0.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $122.79 | $204.65 | 0.2× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $76.41 | $127.35 | 1.0× |
| Renal Cyst Study (74470) | $197.81 | $329.68 | 0.4× |
| Ribs bilateral 3 views (71110) | $86.05 | $143.42 | 0.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $409.62 | $682.70 | 1.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $409.62 | $682.70 | 1.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,116.55 | $1,860.91 | 2.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $913.79 | $1,522.99 | 1.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $555.67 | $926.12 | 1.1× |
| Scapula (73010) | $86.05 | $143.42 | 0.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$40.67–$42.29 | $67.78–$70.49 | varies |
| Sella turcica (70240) | $72.70 | $121.17 | 0.9× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$72.70–$75.61 | $121.17–$126.02 | varies |
| Shoulder Arthrography (73040) | $305.44 | $509.06 | 1.0× |
| Sialogram (70390) | $282.25 | $470.42 | 1.3× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$72.70–$75.61 | $121.17–$126.02 | varies |
| Special dosimetry (77331) | $250.51 | $417.51 | 2.1× |
| Special teletherapy port plan (77321) | $607.37 | $1,012.29 | 1.8× |
| Special treatment procedure (77470) | $1,091.17 | $1,818.61 | 2.2× |
| Speech evaluation, complex (70371) | $132.02 | $220.03 | 0.6× |
| Sternoclavicular joints (71130) | $86.05 | $143.42 | 1.1× |
| Superior sagittal sinus venogram (75870) | $756.29 | $1,260.49 | 0.3× |
| Temporomandble Jt Arthrography Rs&I (70332) | $305.44 | $509.06 | 1.4× |
| Testicular Imaging W/Flow (78761) | $639.56 | $1,065.94 | 1.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $740.49 | $1,234.15 | 2.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $768.81 | $1,281.35 | 2.3× |
| Ther rad simulaj-aided field setting simple (77280) | $375.89 | $626.48 | 3.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $151.45 | $252.41 | 1.0× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$142.60–$148.31 | $237.67–$247.18 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$72.70–$75.61 | $121.17–$126.02 | varies |
| Thoracolumbar 2 views (72080) | $75.61 | $126.02 | 1.0× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $409.62 | $682.70 | 1.1× |
| Thyroid Met Imaging Body (78018) | $471.40 | $785.67 | 1.0× |
| Tx Devices Design & Construction Complex (77334) | $519.23 | $865.39 | 1.5× |
| Tx devices design & construction simple (77332) | $386.78 | $644.63 | 3.2× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$211.04–$438.96 | $351.73–$731.60 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$308.20–$320.53 | $513.67–$534.22 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$261.14–$271.59 | $435.24–$452.65 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $181.43 | $302.38 | 2.3× |
| Unlisted fluoroscopic procedure (76496) | $150.57 | $250.95 | 1.9× |
| Unlisted magnetic resonance procedure (76498) | $653.96 | $1,089.94 | 8.3× |
| Unlisted us procedure (76999) | $115.74 | $192.90 | 1.5× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$220.15–$228.95 | $366.91–$381.59 | varies |
| Urethrocystogram voiding (74455) | $281.83 | $469.71 | 1.3× |
| Urethrocystography retrograde (74450) | $293.10 | $488.50 | 1.4× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$211.04–$422.08 | $351.73–$703.46 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$233.63–$242.98 | $389.38–$404.96 | varies |
| Us complete joint (76881) | $182.72 | $304.53 | 1.9× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$177.64–$184.74 | $296.06–$307.90 | varies |
| Us head (76506) | $150.20 | $250.34 | 1.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$118.13–$122.86 | $196.89–$204.77 | varies |
| Us ob detailed single fetus (76811) | $414.29 | $690.49 | 1.9× |
| Us ob limited 1 or more fetuses (76815) | $120.37 | $200.62 | 1.3× |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$163.21–$169.74 | $272.02–$282.90 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$266.45–$277.10 | $444.08–$461.84 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$329.99–$343.19 | $549.99–$571.99 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $121.81 | $203.01 | 1.3× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$288.47–$300.01 | $480.78–$500.01 | varies |
| Us retroperitoneal limited (76775) | $262.10 | $436.84 | 2.8× |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$258.86–$269.21 | $431.43–$448.69 | varies |
| Us spinal canal and contents (76800) | $150.20 | $250.34 | 1.6× |
| Us thyroid (76536) range across 2 matching MRF lines |
$221.96–$230.84 | $369.94–$384.74 | varies |
| Us transrectal (76872) | $195.48 | $325.80 | 2.1× |
| Vascular Flow Imaging (78445) | $341.84 | $569.74 | 0.9× |
| Vein X-Ray Chest (75827) | $1,028.62 | $1,714.36 | 0.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,476.46 | $2,460.76 | 0.5× |
| Vein X-Ray Skull Epidural (75872) | $756.29 | $1,260.49 | 1.3× |
| Vein X-Ray Spleen/Liver (75810) | $1,108.92 | $1,848.20 | 0.4× |
| Venogram Sinus/Jugular (75860) | $728.66 | $1,214.43 | 0.3× |
| Venography Adrenal Unilateral (75840) | $756.29 | $1,260.49 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $997.82 | $1,663.04 | 0.3× |
| Venography extremity bilateral rs&i (75822) | $728.66 | $1,214.43 | 0.5× |
| Venography extremity unilateral rs&i (75820) | $728.66 | $1,214.43 | 0.5× |
| Venography Orbital Rs&I (75880) | $756.29 | $1,260.49 | 1.3× |
| Venography Renal Bilateral (75833) | $997.82 | $1,663.04 | 0.3× |
| Venography Renal Unilateral (75831) | $756.29 | $1,260.49 | 0.3× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$728.66 | $1,214.43 | 0.1× |
| Venous thrombosis imaging (78457) | $341.84 | $569.74 | 0.7× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $361.28 | $602.13 | 1.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$72.70–$75.61 | $121.17–$126.02 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $86.05 | $143.42 | 1.1× |
| X-ray antegrade pyelogram tube (74425) | $281.83 | $469.71 | 0.9× |
| X-Ray Aorta Leg Arteries (75630) | $2,429.04 | $4,048.40 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $148.31 | $247.18 | 1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$72.70–$75.61 | $121.17–$126.02 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$170–$176.80 | $283.33–$294.66 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$101.60–$105.66 | $169.33–$176.10 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$105.66–$109.88 | $176.10–$183.14 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $190.21 | $317.01 | 2.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$175–$182 | $291.66–$303.33 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $181.84 | $303.07 | 1.9× |
| X-Ray Exam L-S Spine Bending (72114) | $148.31 | $247.18 | 1.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$142.60–$148.31 | $237.67–$247.18 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$72.70–$75.61 | $121.17–$126.02 | varies |
| X-ray eye for foreign body (70030) | $86.05 | $143.42 | 1.1× |
| X-ray head for orthodontia (70350) | $72.70 | $121.17 | 0.9× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$277.08–$288.16 | $461.80–$480.27 | varies |
| X-ray IV pyelogram+tomography (74415) | $464.58 | $774.30 | 2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$72.70–$75.61 | $121.17–$126.02 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $86.05 | $143.42 | 1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| X-ray nose-rectum child f.b. (76010) | $75.61 | $126.02 | 1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$122.79–$127.70 | $204.65–$212.84 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$72.70–$75.61 | $121.17–$126.02 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $75.61 | $126.02 | 0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$72.70–$75.61 | $121.17–$126.02 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $86.05 | $143.42 | 1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $148.31 | $247.18 | 1.6× |
| X-Ray Stress View (77071) | $80.30 | $133.83 | 1.0× |
| X-ray thoracic spine 4 vw (72074) | $72.70 | $121.17 | 0.8× |
| X-Ray Tmj Unilat (70328) | $86.05 | $143.42 | 1.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $305.93 | $509.88 | 1.0× |
| X-Rays Bone Length Studies (77073) | $82.74 | $137.90 | 0.9× |
| X-Rays Bone Survey Complete (77075) | $222.63 | $371.05 | 2.4× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$142.60–$148.31 | $237.67–$247.18 | varies |
| Xr facial bones less than 3 views (70140) | $86.05 | $143.42 | 1.1× |
| XR Mastoids < 3 Views Bilateral (70120) | $72.70 | $121.17 | 0.8× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$82.74–$86.05 | $137.90–$143.42 | varies |
| Xr Tomogram Single Plane (76100) | $200.79 | $334.65 | 2.1× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.