Imaging prices at Legacy Salmon Creek Medical Center
Vancouver, WA · every code in this section with a posted price and a Medicare benchmark.
391 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) range across 2 matching MRF lines |
$8,104.85–$10,131.55 | $12,469–$15,587 | varies |
| Abdomen 1 View (74018) | $293.80 | $452 | 3.0× |
| Abdomen 2 views (74019) | $353.60 | $544 | 3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $942.50 | $1,450 | 2.1× |
| Angio internal mammary (75756) | $4,689.10 | $7,214 | 1.3× |
| Angio pulmonary bilat (75743) | $7,031.05 | $10,817 | 2.0× |
| Angiography extremity bilateral rs&i (75716) | $6,238.70 | $9,598 | 1.8× |
| Angiography extremity unilateral rs&i (75710) | $5,460 | $8,400 | 1.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $4,689.10 | $7,214 | 1.3× |
| Ankle 2 views (73600) | $198.90 | $306 | 2.1× |
| Aortography thoracic serialography rs&i (75605) | $6,081.40 | $9,356 | 1.0× |
| Artery X-Rays Abdomen (75726) | $9,313.85 | $14,329 | 1.5× |
| Artery X-Rays Pelvis (75736) | $6,081.40 | $9,356 | 1.0× |
| Artery X-Rays Spine (75705) | $9,313.85 | $14,329 | 1.5× |
| Arthrogram ankle (73615) | $433.55 | $667 | 1.1× |
| Arthrogram hip (73525) | $774.15 | $1,191 | 2.0× |
| Arthrogram Wrist (73115) | $429.65 | $661 | 1.1× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$424.45–$425.10 | $653–$654 | varies |
| Bone age studies (77072) | $160.55 | $247 | 1.4× |
| Bone Imaging 3 Phase (78315) | $857.35 | $1,319 | 1.9× |
| Bone Imaging Limited Area (78300) | $640.25 | $985 | 1.4× |
| Bone Imaging Multiple Areas (78305) | $703.95 | $1,083 | 1.6× |
| Bone Imaging Whole Body (78306) | $1,008.80 | $1,552 | 2.3× |
| Bone marrow imaging; whole body (78104) | $904.80 | $1,392 | 2.0× |
| Bone survey infant (77076) | $585 | $900 | 5.0× |
| Brachytx isodose complex (77318) | $1,283.75 | $1,975 | 3.1× |
| Brachytx isodose intermed (77317) | $1,229.80 | $1,892 | 2.9× |
| Brachytx Isodose Plan Simple (77316) | $1,176.50 | $1,810 | 2.8× |
| Brain Flow Imaging Only (78610) | $744.90 | $1,146 | 1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,969.20 | $4,568 | 1.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,480.70 | $2,278 | 3.8× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,194.40 | $3,376 | 2.5× |
| Cat Scan Follow-Up Study (76380) | $606.45 | $933 | 6.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,085.50 | $1,670 | 1.8× |
| Cerebrospinal Fluid Scan (78630) | $913.90 | $1,406 | 1.5× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$163.80–$272.35 | $252–$419 | varies |
| Chest 2 views (71046) | $172.90 | $266 | 1.8× |
| Chest 3 views (71047) range across 3 matching MRF lines |
$279.50–$280.15 | $430–$431 | varies |
| Chest 4 or more views (71048) | $291.85 | $449 | 2.5× |
| Clavicle complete (73000) | $170.30 | $262 | 1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $221.65 | $341 | 1.9× |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$473.85–$476.45 | $729–$733 | varies |
| Contrast Exam Abdominl Aorta (75625) | $5,397.60 | $8,304 | 1.5× |
| Contrast X-Ray Bladder (74430) | $430.30 | $662 | 1.1× |
| Contrast X-Ray Of Elbow (73085) | $751.40 | $1,156 | 1.9× |
| Contrast X-Ray Of Knee Joint (73580) | $433.55 | $667 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) | $2,510.95 | $3,863 | 6.5× |
| CT abdomen and pelvis without contrast (74176) | $1,843.40 | $2,836 | 6.9× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$605.80–$1,073.15 | $932–$1,651 | varies |
| CT abdomen w wo contrast (74170) | $1,233.70 | $1,898 | 6.3× |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$561.60–$995.15 | $864–$1,531 | varies |
| CT Angio Abdomen and Pelvis (74174) | $2,139.15 | $3,291 | 5.5× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,080.95–$1,104.35 | $1,663–$1,699 | varies |
| CT Angio Head (70496) | $1,560.65 | $2,401 | 8.0× |
| CT angio hrt w/3d image (75574) | $1,103.70 | $1,698 | 2.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$674.05–$1,441.70 | $1,037–$2,218 | varies |
| CT Angio Neck (70498) | $1,562.60 | $2,404 | 8.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $963.30 | $1,482 | 4.9× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,243.45 | $1,913 | 6.4× |
| CT cervical spine w/ contrast (72126) | $935.35 | $1,439 | 2.4× |
| CT cervical spine w/o contrast (72125) | $846.95 | $1,303 | 7.3× |
| CT cervical spine w/wo cont (72127) | $1,129.05 | $1,737 | 5.8× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$623.35–$1,064.70 | $959–$1,638 | varies |
| CT chest w/wo contrast (71270) | $1,388.40 | $2,136 | 7.1× |
| CT colonography screening (74263) | $649.35 | $999 | 2.4× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $827.45 | $1,273 | 4.2× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $566.15 | $871 | 4.9× |
| CT head/brain with contrast (70460) | $956.15 | $1,471 | 4.9× |
| CT head/brain without and with contrast (70470) | $1,183 | $1,820 | 6.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $65.65 | $101 | 0.7× |
| CT hrt w/3d image congen (75573) | $1,017.90 | $1,566 | 2.6× |
| CT iac w contrast (70481) | $812.50 | $1,250 | 4.2× |
| CT l-spine w&w/o contrast (72133) | $1,129.05 | $1,737 | 5.8× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$748.15–$890.50 | $1,151–$1,370 | varies |
| CT lower extremity w/contrast material (73701) | $1,113.45 | $1,713 | 5.7× |
| CT lumbar spine w contrast (72132) | $1,090.05 | $1,677 | 2.8× |
| CT lumbar spine w/o contrast (72131) | $1,051.70 | $1,618 | 9.0× |
| CT maxillofacial w contrast (70487) | $956.15 | $1,471 | 4.9× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$707.85–$941.85 | $1,089–$1,449 | varies |
| CT neck tissue combo (70492) | $1,195.35 | $1,839 | 6.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,270.75 | $1,955 | 6.5× |
| CT orbits w/o contrast (70480) | $733.85 | $1,129 | 6.3× |
| CT pelvis w&w/o contrast (72194) | $1,402.70 | $2,158 | 7.2× |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$588.25–$941.85 | $905–$1,449 | varies |
| CT scan of leg combo (73702) | $1,337.05 | $2,057 | 6.8× |
| CT scans face/jaw combo (70488) | $1,183 | $1,820 | 6.1× |
| CT soft tissue neck w contrast (70491) | $1,048.45 | $1,613 | 5.4× |
| CT soft tissue neck w/o contrast (70490) | $968.50 | $1,490 | 8.3× |
| CT thoracic spine w contrast (72129) | $1,093.95 | $1,683 | 5.6× |
| CT thoracic spine w/o contrast (72128) | $1,057.55 | $1,627 | 9.1× |
| CT thoracic spine w/wo cont (72130) | $1,129.05 | $1,737 | 5.8× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$588.25–$1,004.25 | $905–$1,545 | varies |
| CT unlisted procedure (76497) | $206.70 | $318 | 2.1× |
| CT upper ext wo (73200) | $890.50 | $1,370 | 7.6× |
| CT upper extremity w/o & w/contrast material (73202) | $1,419.60 | $2,184 | 7.3× |
| CT upper extremity with contrast (73201) | $1,155.05 | $1,777 | 3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,167.40 | $1,796 | 6.0× |
| Cta Abdomen (74175) | $1,069.90 | $1,646 | 5.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,285.75 | $5,055 | 8.5× |
| CTA pelvis (72191) | $1,069.90 | $1,646 | 5.5× |
| Diskography lumbar (72295) | $3,262.35 | $5,019 | 1.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $200.85 | $309 | 1.7× |
| Dxa Bone Density Axial (77080) | $433.55 | $667 | 3.7× |
| Dxa bone density study (77085) | $928.85 | $1,429 | 8.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $323.05 | $497 | 3.3× |
| Echo exam of fetal heart (76825) | $721.50 | $1,110 | 1.2× |
| Echo exam uterus (76831) | $364 | $560 | 1.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $517.40 | $796 | 1.9× |
| Esophagram (74220) | $529.10 | $814 | 2.7× |
| Fetal Biophys Profile W/Nst (76818) | $416 | $640 | 3.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $416 | $640 | 3.6× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,483.30 | $2,282 | 5.6× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$668.85–$1,070.55 | $1,029–$1,647 | varies |
| Follow-Up Angiography (75898) | $3,648.45 | $5,613 | 1.0× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$121.55–$196.30 | $187–$302 | varies |
| Forearm 2 views (73090) | $237.90 | $366 | 2.5× |
| Gastric emptying imaging study (78264) | $793 | $1,220 | 1.8× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,190.15 | $1,831 | 2.7× |
| Gastroesophageal Reflux Exam (78262) | $769.60 | $1,184 | 1.7× |
| Gated Heart Planar Single (78472) | $808.60 | $1,244 | 1.8× |
| Gated Heart, Multiple (78473) | $1,199.90 | $1,846 | 2.7× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,585.35 | $2,439 | 2.6× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$100.10–$178.10 | $154–$274 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $5,556.85 | $8,549 | 7.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $5,211.05 | $8,017 | 6.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $3,473.60 | $5,344 | 4.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,689.10 | $7,214 | 1.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $4,689.10 | $7,214 | 1.3× |
| Hepatobil Syst Image W/Drug (78227) | $942.50 | $1,450 | 1.6× |
| Hepatobiliary System Imaging (78226) | $942.50 | $1,450 | 2.1× |
| Ht Musc Image Planar Mult (78454) | $2,348.45 | $3,613 | 1.6× |
| Ht Muscle Image Spect Sing (78451) | $2,237.30 | $3,442 | 1.6× |
| Hysterosalpingogram (74740) | $434.20 | $668 | 1.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $349.70 | $538 | 3.6× |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$177.45–$217.10 | $273–$334 | varies |
| Interstitial radiation source applic complex (77778) | $2,941.90 | $4,526 | 3.8× |
| Intracavitary Radiation Source Applic Complex (77763) | $5,752.50 | $8,850 | 7.4× |
| Intracavitary Radiation Source Applic Intermed (77762) | $4,933.50 | $7,590 | 8.0× |
| Intracavitary radiation source applic simple (77761) | $4,109.95 | $6,323 | 6.7× |
| Joint Survey Single View (77077) | $105.95 | $163 | 0.9× |
| K Flow/Funct Image Multiple (78709) | $882.05 | $1,357 | 1.5× |
| K Flow/Funct Image W/Drug (78708) | $845.65 | $1,301 | 1.4× |
| K Flow/Funct Image W/O Drug (78707) | $810.55 | $1,247 | 1.3× |
| Kidney Imaging Morphol (78700) | $540.15 | $831 | 1.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $545.35 | $839 | 1.2× |
| Knee 3 Views (73562) | $230.10 | $354 | 2.4× |
| Leveen/Shunt Patency Exam (78291) | $808.60 | $1,244 | 1.8× |
| Liver & Spleen Imaging Static Only (78215) | $755.95 | $1,163 | 1.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $966.55 | $1,487 | 2.2× |
| Liver imaging static only (78201) | $885.30 | $1,362 | 1.5× |
| Lung Perf&Ventilat Diferentl (78598) | $2,122.25 | $3,265 | 3.5× |
| Lung perfusion differential (78597) | $1,562.60 | $2,404 | 3.5× |
| Lung Ventilat&Perfus Imaging (78582) | $1,147.25 | $1,765 | 1.9× |
| Lung Ventilation Imaging (78579) | $587.60 | $904 | 1.3× |
| Lymph System Imaging (78195) | $808.60 | $1,244 | 1.3× |
| Magnetic Image Jaw Joint (70336) | $1,162.20 | $1,788 | 4.4× |
| Mammary ductogram or galactogram single (77053) | $454.35 | $699 | 1.7× |
| Meckels Divert Exam (78290) | $769.60 | $1,184 | 1.7× |
| Mlc imrt design & construction per imrt plan (77338) | $989.30 | $1,522 | 2.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $19.50 | $30 | 0.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $74.10 | $114 | 0.7× |
| Mr safety implt pos&/immoblj (76019) | $48.10 | $74 | 0.7× |
| Mr safety med physics xm customization plng&mntr (76017) | $195.65 | $301 | 0.7× |
| Mra Head W/O & W/Contrast Material (70546) | $2,578.55 | $3,967 | 6.6× |
| MRA head w/o contrast (70544) | $1,192.75 | $1,835 | 4.5× |
| MRA head with contrast (70545) | $1,358.50 | $2,090 | 3.5× |
| MRA neck w contrast (70548) | $1,358.50 | $2,090 | 3.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,578.55 | $3,967 | 6.6× |
| MRA neck w/o contrast (70547) | $1,116.05 | $1,717 | 4.2× |
| MRI abdomen w contrast (74182) | $1,589.90 | $2,446 | 4.1× |
| MRI abdomen w/o contrast (74181) | $1,352 | $2,080 | 5.1× |
| MRI any jt lower extrem w/contrast material (73722) | $1,565.85 | $2,409 | 1.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,817.75 | $4,335 | 7.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,565.85 | $2,409 | 1.8× |
| MRI bone marrow blood supply (77084) | $924.95 | $1,423 | 3.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,343.25 | $3,605 | 8.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,612.65 | $2,481 | 6.1× |
| MRI cardiac w/o cont stress (75559) | $1,652.30 | $2,542 | 2.7× |
| MRI cardiac w/o contrast (75557) | $1,047.15 | $1,611 | 3.9× |
| MRI cervical spine w contrast (72142) | $2,037.10 | $3,134 | 5.2× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$408.85–$1,425.45 | $629–$2,193 | varies |
| MRI chest w/o contrast (71550) | $1,463.80 | $2,252 | 5.5× |
| MRI chest wo w contrast (71552) | $2,819.70 | $4,338 | 7.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,565.85 | $2,409 | 4.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,483.65 | $3,821 | 6.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,097.20 | $1,688 | 4.1× |
| MRI lumbar spine w contrast (72149) | $1,425.45 | $2,193 | 3.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,648.75 | $4,075 | 6.8× |
| MRI orbit face &/neck w/o contrast (70540) | $1,560.65 | $2,401 | 5.9× |
| MRI orbit face neck w contrast (70542) | $1,565.85 | $2,409 | 4.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,436.20 | $3,748 | 6.3× |
| MRI pelvis w contrast (72196) | $2,282.80 | $3,512 | 5.9× |
| MRI pelvis w/o & w contrast (72197) | $2,841.80 | $4,372 | 7.3× |
| MRI pelvis w/o contrast (72195) | $1,482 | $2,280 | 5.6× |
| MRI spectroscopy (76390) | $1,128.40 | $1,736 | 11.6× |
| MRI thoracic spine w/o contrast (72146) | $1,383.85 | $2,129 | 5.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,444.30 | $2,222 | 3.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,155.70 | $1,778 | 4.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 5 matching MRF lines |
$2,291.90–$2,484.30 | $3,526–$3,822 | varies |
| MRI, abdomen, combo (74183) | $2,620.15 | $4,031 | 6.7× |
| MRI, dorsal spine combo (72157) | $2,648.75 | $4,075 | 6.8× |
| MRI, dorsal spine contrast (72147) | $1,402.70 | $2,158 | 3.6× |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$1,118–$1,119.95 | $1,720–$1,723 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$2,789.15–$2,790.45 | $4,291–$4,293 | varies |
| MRI, lumbar spine combo (72158) | $2,648.75 | $4,075 | 6.8× |
| Myelogram cervical (72240) | $1,522.95 | $2,343 | 1.7× |
| Myelogram Lumbar (72265) | $1,250.60 | $1,924 | 1.4× |
| Myelography thoracic (72255) | $1,522.95 | $2,343 | 1.7× |
| Myelograpy 2/more regions rs&i (72270) | $1,535.30 | $2,362 | 1.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,251.60 | $3,464 | 1.6× |
| Myocardial Spect Multiple Studies (78452) | $2,863.90 | $4,406 | 2.0× |
| N-invas est c ffr sw aly CTA (75580) | $815.10 | $1,254 | 0.9× |
| Neck soft tissue (70360) | $189.15 | $291 | 2.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $286.65 | $441 | 0.6× |
| Nm csf leak detection (78650) | $966.55 | $1,487 | 0.7× |
| Nm myocard infarct spect (78469) | $914.55 | $1,407 | 1.5× |
| Nonvascular Shunt X-Ray (75809) | $255.45 | $393 | 2.2× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$8,711.30–$10,084.75 | $13,402–$15,515 | varies |
| Nuclear Rx Oral Admin (79005) | $371.15 | $571 | 1.4× |
| Ob us nuchal meas 1 gest (76813) | $263.90 | $406 | 2.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $198.25 | $305 | 1.7× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,751.75 | $2,695 | 2.9× |
| Parathyroid Planar Imaging (78070) | $618.80 | $952 | 1.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,593.15 | $2,451 | 3.6× |
| Pelvis 1 or 2 views (72170) | $206.05 | $317 | 1.8× |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$3,400.15–$3,571.75 | $5,231–$5,495 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$3,946.15–$4,147.65 | $6,071–$6,381 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,798.60 | $5,844 | 2.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,689.10 | $7,214 | 1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $757.90 | $1,166 | 1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $449.15 | $691 | 3.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $555.10 | $854 | 0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) | $230.10 | $354 | 2.4× |
| Radex Calcaneus Minimum 2 Views (73650) | $196.30 | $302 | 2.0× |
| Radex elbow complete minimum 3 views (73080) | $219.70 | $338 | 2.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $280.15 | $431 | 2.4× |
| Radex fingr minimum 2 views (73140) | $174.85 | $269 | 1.8× |
| Radex foot complete minimum 3 views (73630) | $224.25 | $345 | 2.3× |
| Radex Hand Minimum 3 Views (73130) | $191.10 | $294 | 2.0× |
| Radex lower extremity infant minimum 2 views (73592) | $237.90 | $366 | 2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $224.25 | $345 | 2.3× |
| Radex Ribs Unilateral 2 Views (71100) | $219.70 | $338 | 2.3× |
| Radex shoulder complete minimum 2 views (73030) | $254.80 | $392 | 2.6× |
| Radex Sinuses Paransl < 3 Views (70210) | $90.35 | $139 | 0.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $687.05 | $1,057 | 3.5× |
| Radex Spine 1 View Specify Level (72020) | $239.20 | $368 | 2.5× |
| Radex Sternum Minimum 2 Views (71120) | $248.30 | $382 | 2.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $304.85 | $469 | 3.1× |
| Radex Toe Minimum 2 Views (73660) | $170.95 | $263 | 1.8× |
| Radex upper extremity infant minimum 2 views (73092) | $237.90 | $366 | 2.0× |
| Radex Wrist Complete Minimum 3 Views (73110) | $239.20 | $368 | 2.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,112.80 | $1,712 | 9.6× |
| Radiation treatment delivery level 1 (77402) | $643.50 | $990 | 5.7× |
| Radiation treatment delivery level 2 (77407) | $1,930.50 | $2,970 | 4.5× |
| Radiation treatment delivery level 3 (77412) | $2,895.75 | $4,455 | 4.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $297.70 | $458 | 2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $462.80 | $712 | 4.0× |
| Radiologic exam colon double contrast study (74280) | $652.60 | $1,004 | 3.3× |
| Radiologic exam colon single contrast study (74270) | $516.10 | $794 | 2.6× |
| Radiologic exam knee complete 4/more views (73564) | $273.65 | $421 | 2.3× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $312 | $480 | 2.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $652.60 | $1,004 | 3.3× |
| Radiologic exam swallow function contrast study (74230) | $397.15 | $611 | 2.0× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$570.05–$635.70 | $877–$978 | varies |
| Radiologic examination femur 1 view (73551) | $209.95 | $323 | 2.2× |
| Radiologic examination femur minimum 2 views (73552) | $280.80 | $432 | 2.9× |
| Radiologic examination knee 1/2 views (73560) | $205.40 | $316 | 2.1× |
| Radiologic Examination Osseous Survey Limited (77074) | $566.15 | $871 | 4.9× |
| Radiologic examination tibia & fibula 2 views (73590) | $237.90 | $366 | 2.5× |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $561.60 | $864 | 0.9× |
| Ribs bilateral 3 views (71110) | $273.65 | $421 | 2.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $769.60 | $1,184 | 1.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $923 | $1,420 | 2.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $985.40 | $1,516 | 1.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $981.50 | $1,510 | 1.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 7 matching MRF lines |
$981.50–$1,222.65 | $1,510–$1,881 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) range across 2 matching MRF lines |
$1,028.95–$1,441.05 | $1,583–$2,217 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,084.20 | $1,668 | 0.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $981.50 | $1,510 | 0.7× |
| Rp Therapy Intravenous Administration (79101) | $429 | $660 | 1.6× |
| Scapula (73010) | $213.85 | $329 | 1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $51.35 | $79 | 2.2× |
| Shoulder 1 view (73020) | $153.40 | $236 | 1.6× |
| Shoulder Arthrography (73040) | $774.15 | $1,191 | 2.0× |
| Skull less than 4 views (70250) | $237.90 | $366 | 2.0× |
| Special dosimetry (77331) | $670.15 | $1,031 | 4.5× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$815.10–$815.75 | $1,254–$1,255 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$313.95–$735.80 | $483–$1,132 | varies |
| Special treatment procedure (77470) | $2,547.35 | $3,919 | 4.1× |
| Srs Multisource (77371) | $41,507.70 | $63,858 | 5.1× |
| Stereotactic Body Radiation Delivery (77373) | $8,589.10 | $13,214 | 4.3× |
| Sternoclavicular joints (71130) | $200.20 | $308 | 2.1× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $213.20 | $328 | 1.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,106 | $3,240 | 5.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,896.70 | $2,918 | 4.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,090.70 | $1,678 | 2.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $871.65 | $1,341 | 2.1× |
| Ther rad simulaj-aided field setting simple (77280) | $653.90 | $1,006 | 4.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $687.05 | $1,057 | 3.5× |
| Thoracic spine 2 views (72070) | $238.55 | $367 | 2.0× |
| Thoracic spine 3 views (72072) | $323.05 | $497 | 2.8× |
| Thoracolumbar 2 views (72080) | $293.80 | $452 | 3.0× |
| Thyroid Imaging With Vascular Flow (78013) | $690.95 | $1,063 | 1.6× |
| Thyroid Met Imaging Body (78018) | $1,013.35 | $1,559 | 1.7× |
| Thyroid Uptake Measurement (78012) | $385.45 | $593 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $607.10 | $934 | 1.4× |
| Tx Devices Design & Construction Complex (77334) | $917.80 | $1,412 | 2.2× |
| Tx devices design & construction intermediate (77333) | $772.20 | $1,188 | 5.2× |
| Tx devices design & construction simple (77332) | $585.65 | $901 | 3.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$350.35–$525.20 | $539–$808 | varies |
| Ultrasound elastography first target lesion (76982) | $328.25 | $505 | 2.8× |
| Ultrasound Elastography Parenchyma (76981) | $328.25 | $505 | 2.8× |
| Ultrasound Exam Aaa Screen (76706) | $335.40 | $516 | 2.9× |
| Ultrasound, abdomen limited (76705) | $347.10 | $534 | 3.0× |
| Umbilical-artery Doppler (OB) (76820) | $380.25 | $585 | 3.3× |
| Unlisted magnetic resonance procedure (76498) | $377 | $580 | 3.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $1,343.55 | $2,067 | 11.8× |
| Unlisted us procedure (76999) | $172.90 | $266 | 1.8× |
| Upper gi w/o kub (74240) | $570.05 | $877 | 2.9× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) range across 2 matching MRF lines |
$126.75–$130 | $195–$200 | varies |
| Urea breath test c-14 isotopic analysis (78268) range across 2 matching MRF lines |
$278.20–$299 | $428–$460 | varies |
| Urethrocystogram voiding (74455) | $434.20 | $668 | 1.6× |
| Urethrocystography retrograde (74450) | $403.65 | $621 | 1.5× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$350.35–$525.20 | $539–$808 | varies |
| Us chest (76604) | $431.60 | $664 | 3.7× |
| Us complete joint (76881) | $614.25 | $945 | 5.3× |
| Us exam, pelvic, limited (76857) | $286 | $440 | 2.5× |
| Us head (76506) | $438.10 | $674 | 3.8× |
| Us kidney transplant (76776) | $457.60 | $704 | 3.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $463.45 | $713 | 4.0× |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$345.80–$390.65 | $532–$601 | varies |
| Us ob transvaginal (76817) | $237.90 | $366 | 2.0× |
| Us pelvic non ob complete (76856) | $544.05 | $837 | 4.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $486.20 | $748 | 4.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$171.60–$308.10 | $264–$474 | varies |
| Us retroperitoneal complete (76770) | $419.90 | $646 | 3.6× |
| Us retroperitoneal limited (76775) | $373.75 | $575 | 3.2× |
| Us scrotum and contents (76870) | $463.45 | $713 | 4.0× |
| Us spinal canal and contents (76800) | $486.20 | $748 | 4.2× |
| Us thyroid (76536) | $463.45 | $713 | 4.0× |
| Us transrectal (76872) | $570.05 | $877 | 4.9× |
| Vein X-Ray Chest (75827) | $3,864.90 | $5,946 | 2.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,648.45 | $5,613 | 1.0× |
| Venogram Sinus/Jugular (75860) | $4,689.10 | $7,214 | 1.3× |
| Venography caval inferior serialography rs&i (75825) | $4,689.10 | $7,214 | 1.3× |
| Venography extremity bilateral rs&i (75822) | $1,793.35 | $2,759 | 1.0× |
| Venography extremity unilateral rs&i (75820) | $1,793.35 | $2,759 | 1.0× |
| Venography Renal Unilateral (75831) | $4,689.10 | $7,214 | 1.3× |
| Venous sampling by catheter (75893) | $6,081.40 | $9,356 | 1.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$133.25–$191.10 | $205–$294 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $290.55 | $447 | 3.0× |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$477.75–$518.70 | $735–$798 | varies |
| X-Ray Aorta Leg Arteries (75630) | $6,878.30 | $10,582 | 2.0× |
| X-Ray Bend Only L-S Spine (72120) | $310.05 | $477 | 2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $183.30 | $282 | 1.9× |
| X-Ray Exam Breast Specimen (76098) | $437.45 | $673 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $243.10 | $374 | 2.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $423.15 | $651 | 3.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $742.30 | $1,142 | 6.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $182.65 | $281 | 1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$442–$795.60 | $680–$1,224 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,036.75 | $1,595 | 8.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $508.95 | $783 | 4.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $890.50 | $1,370 | 7.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,558.70 | $2,398 | 13.4× |
| X-Ray Exam L-S Spine Bending (72114) | $341.90 | $526 | 2.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $267.80 | $412 | 2.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $403.65 | $621 | 3.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $264.55 | $407 | 2.3× |
| X-ray eye for foreign body (70030) | $198.25 | $305 | 2.0× |
| X-ray humerus (73060) | $230.75 | $355 | 2.4× |
| X-ray IV pyelogram (ivp) (74400) | $579.80 | $892 | 3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $191.10 | $294 | 2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $205.40 | $316 | 2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $293.80 | $452 | 2.5× |
| X-ray nose-rectum child f.b. (76010) | $237.25 | $365 | 2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $429.65 | $661 | 3.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $317.20 | $488 | 2.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $235.30 | $362 | 2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $248.30 | $382 | 2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $258.05 | $397 | 2.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $310.05 | $477 | 2.7× |
| X-Ray Stress View (77071) | $134.55 | $207 | 1.4× |
| X-ray thoracic spine 4 vw (72074) | $355.55 | $547 | 3.1× |
| X-Ray Tmj Unilat (70328) | $252.85 | $389 | 2.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $616.20 | $948 | 1.6× |
| X-Rays Bone Length Studies (77073) | $143.65 | $221 | 1.2× |
| X-Rays Bone Survey Complete (77075) | $566.15 | $871 | 4.9× |
| Xr c-spine 4 or 5 views (72050) | $335.40 | $516 | 2.9× |
| Xr facial bones less than 3 views (70140) | $243.10 | $374 | 2.5× |
| Xr orbits complete 4 views (70200) | $230.10 | $354 | 2.0× |
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.