Imaging prices at Lewis County General Hospital
Lowville, NY · every code in this section with a posted price and a Medicare benchmark.
287 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) | $333 | $405 | 3.1× |
| Abdomen 2 views (74019) | $485.11 | $590 | 3.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,722.56 | $2,095 | 3.5× |
| Ankle 2 views (73600) | $261.47 | $318 | 2.4× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$326.42–$1,381.34 | $397–$1,680 | varies |
| Bone age studies (77072) | $411.93 | $501 | 3.2× |
| Bone Imaging 3 Phase (78315) | $1,969.23 | $2,395 | 3.9× |
| Bone Imaging Limited Area (78300) | $1,577.85 | $1,919 | 3.2× |
| Bone Imaging Whole Body (78306) | $1,900.16 | $2,311 | 3.8× |
| Bone marrow imaging; whole body (78104) | $1,267.87 | $1,542 | 2.5× |
| Bone survey infant (77076) | $461.27 | $561 | 3.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,034.18 | $2,474 | 3.0× |
| Chest 1 view (71045) | $218.71 | $266 | 2.0× |
| Chest 2 views (71046) | $326.42 | $397 | 3.0× |
| Chest 3 views (71047) | $357.67 | $435 | 3.3× |
| Chest 4 or more views (71048) | $424.27 | $516 | 3.3× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$297.65–$299.29 | $362–$364 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,856.58 | $2,258 | 14.2× |
| Contrast X-Ray Bladder (74430) | $962 | $1,170 | 2.2× |
| Contrast X-Ray Of Elbow (73085) | $1,381.34 | $1,680 | 3.2× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$2,192.05–$2,698.54 | $2,666–$3,282 | varies |
| CT abdomen and pelvis without contrast (74176) | $2,400.90 | $2,920 | 8.1× |
| CT abdomen w contrast (74160) | $2,717.45 | $3,305 | 12.4× |
| CT abdomen w wo contrast (74170) | $3,365.37 | $4,093 | 15.4× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$2,192.05–$3,365.37 | $2,666–$4,093 | varies |
| CT Angio Abdomen and Pelvis (74174) | $2,172.32 | $2,642 | 5.0× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,828.63–$2,539.03 | $2,224–$3,088 | varies |
| CT Angio Head (70496) | $3,195.99 | $3,887 | 14.6× |
| CT angio hrt w/3d image (75574) | $2,537.39 | $3,086 | 5.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$1,655.96–$2,225.76 | $2,014–$2,707 | varies |
| CT Angio Neck (70498) | $3,195.99 | $3,887 | 14.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,655.96–$2,225.76 | $2,014–$2,707 | varies |
| CT bone density (77078) | $368.36 | $448 | 3.4× |
| CT cervical spine w/ contrast (72126) | $2,537.39 | $3,086 | 5.8× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$1,914.14–$2,096.67 | $2,328–$2,550 | varies |
| CT cervical spine w/wo cont (72127) | $2,886.01 | $3,510 | 13.2× |
| CT chest w contrast (71260) | $2,975.63 | $3,619 | 13.6× |
| CT chest w/wo contrast (71270) | $3,195.99 | $3,887 | 14.6× |
| CT colonography screening (74263) | $3,634.23 | $4,420 | 12.2× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $3,861.17 | $4,696 | 17.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $3,634.23 | $4,420 | 27.8× |
| CT head/brain with contrast (70460) | $2,582.61 | $3,141 | 11.8× |
| CT head/brain without and with contrast (70470) | $3,195.99 | $3,887 | 14.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $3,195.99 | $3,887 | 7.3× |
| CT heart no contrast quant eval coronry calcium (75571) | $200 | $243.24 | 1.8× |
| CT hrt w/3d image congen (75573) | $3,195.99 | $3,887 | 7.3× |
| CT iac w contrast (70481) | $2,428.03 | $2,953 | 11.1× |
| CT l-spine w&w/o contrast (72133) | $3,195.99 | $3,887 | 14.6× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,736.54–$1,914.96 | $2,112–$2,329 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$2,300.59–$2,537.39 | $2,798–$3,086 | varies |
| CT lumbar spine w contrast (72132) | $2,695.25 | $3,278 | 6.2× |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$2,079.41–$2,270.16 | $2,529–$2,761 | varies |
| CT maxillofacial w contrast (70487) | $2,830.10 | $3,442 | 12.9× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$2,128.74–$2,129.56 | $2,589–$2,590 | varies |
| CT neck tissue combo (70492) | $2,642.63 | $3,214 | 12.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,775.01 | $3,375 | 12.7× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,748.87–$2,192.87 | $2,127–$2,667 | varies |
| CT pelvis w&w/o contrast (72194) | $2,778.30 | $3,379 | 12.7× |
| CT pelvis w/o contrast (72192) | $2,192.05 | $2,666 | 16.8× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,063.78–$3,205.86 | $2,510–$3,899 | varies |
| CT scans face/jaw combo (70488) | $2,918.08 | $3,549 | 13.3× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$2,365.54–$2,386.10 | $2,877–$2,902 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,748.87–$2,164.10 | $2,127–$2,632 | varies |
| CT thoracic spine w contrast (72129) | $2,830.10 | $3,442 | 12.9× |
| CT thoracic spine w/o contrast (72128) | $2,131.21 | $2,592 | 16.3× |
| CT thoracic spine w/wo cont (72130) | $3,195.99 | $3,887 | 14.6× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$2,079.41–$2,080.23 | $2,529–$2,530 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,655.96–$1,965.12 | $2,014–$2,390 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,617.14–$2,886.01 | $3,183–$3,510 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$2,300.59–$2,537.39 | $2,798–$3,086 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,192.05 | $2,666 | 10.0× |
| Cta Abdomen (74175) | $2,935.34 | $3,570 | 13.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,042.23 | $3,700 | 7.0× |
| CTA pelvis (72191) | $2,975.63 | $3,619 | 13.6× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$892.94–$893.76 | $1,086–$1,087 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $443.18 | $539 | 4.1× |
| Echo exam uterus (76831) | $803.31 | $977 | 2.7× |
| Esophagram (74220) | $527.87 | $642 | 2.4× |
| Fetal Biophys Profile W/Nst (76818) | $324.78 | $395 | 2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $592.82 | $721 | 4.5× |
| Fluoroscopy up to 1 hr (76000) | $547.60 | $666 | 1.8× |
| Foot 2 views (73620) | $258.18 | $314 | 2.4× |
| Forearm 2 views (73090) | $261.47 | $318 | 2.4× |
| Gastric emptying imaging study (78264) | $1,373.94 | $1,671 | 2.8× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,245.67 | $1,515 | 2.5× |
| Gastroesophageal Reflux Exam (78262) | $1,312.27 | $1,596 | 2.6× |
| Gated Heart Planar Single (78472) | $1,803.14 | $2,193 | 3.6× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,504.67 | $1,830 | 2.2× |
| Hand 2 views (73120) | $261.47 | $318 | 2.0× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,838.50–$1,840.14 | $2,236–$2,238 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$416.87–$1,706.94 | $507–$2,076 | varies |
| Ht Muscle Image Spect Sing (78451) | $4,865.93 | $5,918 | 3.0× |
| Hysterosalpingogram (74740) | $1,425.74 | $1,734 | 4.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$470.31–$494.98 | $572–$602 | varies |
| Infusion Ivp (74410) | $1,132.20 | $1,377 | 5.2× |
| K Flow/Funct Image Multiple (78709) | $1,896.05 | $2,306 | 2.8× |
| K Flow/Funct Image W/Drug (78708) | $2,072.83 | $2,521 | 3.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,877.96 | $2,284 | 2.8× |
| Kidney Imaging Morphol (78700) | $1,654.32 | $2,012 | 3.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,778.47 | $2,163 | 3.6× |
| Knee 3 Views (73562) | $346.16 | $421 | 3.2× |
| Liver & Spleen Imaging Static Only (78215) | $1,543.32 | $1,877 | 3.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $2,038.30 | $2,479 | 4.1× |
| Lung Perf&Ventilat Diferentl (78598) | $1,873.03 | $2,278 | 2.8× |
| Lung Ventilat&Perfus Imaging (78582) | $1,655.14 | $2,013 | 2.4× |
| Lung Ventilation Imaging (78579) | $502.38 | $611 | 1.0× |
| Lymph System Imaging (78195) | $1,580.32 | $1,922 | 2.3× |
| Magnetic Image Jaw Joint (70336) | $3,527.35 | $4,290 | 11.8× |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$1,448.76–$1,469.32 | $1,762–$1,787 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$623.25–$1,165.09 | $758–$1,417 | varies |
| Meckels Divert Exam (78290) | $1,527.69 | $1,858 | 3.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $82.22 | $100 | 2.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $205.56 | $250 | 1.7× |
| Mra Head W/O & W/Contrast Material (70546) | $5,073.95 | $6,171 | 11.7× |
| MRA head w/o contrast (70544) | $3,712.35 | $4,515 | 12.5× |
| MRA head with contrast (70545) | $3,949.97 | $4,804 | 9.1× |
| MRA neck w contrast (70548) | $3,949.97 | $4,804 | 9.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,816.77 | $4,642 | 8.8× |
| MRA neck w/o contrast (70547) | $4,111.95 | $5,001 | 13.8× |
| MRI abdomen w contrast (74182) | $3,949.97 | $4,804 | 9.1× |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$2,900.81–$3,527.35 | $3,528–$4,290 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $3,609.57 | $4,390 | 3.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $5,073.95 | $6,171 | 11.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,949.97 | $4,804 | 4.0× |
| MRI bone marrow blood supply (77084) | $3,527.35 | $4,290 | 11.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,974.98 | $2,402 | 6.6× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,131.38 | $1,376 | 3.8× |
| MRI cervical spine w contrast (72142) | $4,495.10 | $5,467 | 10.3× |
| MRI cervical spine w/o cont (72141) | $3,823.35 | $4,650 | 12.8× |
| MRI chest w/o contrast (71550) | $3,527.35 | $4,290 | 11.8× |
| MRI chest with contrast (71551) | $3,949.97 | $4,804 | 4.0× |
| MRI chest wo w contrast (71552) | $5,073.95 | $6,171 | 11.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,949.97 | $4,804 | 9.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $5,073.95 | $6,171 | 11.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,527.35 | $4,290 | 11.8× |
| MRI lumbar spine w contrast (72149) | $3,949.97 | $4,804 | 9.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,073.95 | $6,171 | 11.7× |
| MRI orbit face &/neck w/o contrast (70540) | $4,034.66 | $4,907 | 13.5× |
| MRI orbit face neck w contrast (70542) | $3,949.97 | $4,804 | 9.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,925.13 | $5,990 | 11.3× |
| MRI pelvis w contrast (72196) | $3,949.97 | $4,804 | 9.1× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$4,172.79–$5,073.95 | $5,075–$6,171 | varies |
| MRI pelvis w/o contrast (72195) | $3,527.35 | $4,290 | 11.8× |
| MRI spectroscopy (76390) | $3,679.46 | $4,475 | 33.9× |
| MRI thoracic spine w/o contrast (72146) | $3,527.35 | $4,290 | 11.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,949.97 | $4,804 | 9.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,527.35 | $4,290 | 11.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $5,073.95 | $6,171 | 11.7× |
| MRI, abdomen, combo (74183) | $5,073.95 | $6,171 | 11.7× |
| MRI, dorsal spine combo (72157) | $5,073.95 | $6,171 | 11.7× |
| MRI, dorsal spine contrast (72147) | $3,949.97 | $4,804 | 9.1× |
| MRI, joint upper extrem (73221) | $3,712.35 | $4,515 | 12.5× |
| MRI, joint upper extrem combo (73223) | $5,073.95 | $6,171 | 11.7× |
| MRI, lumbar spine combo (72158) | $5,339.53 | $6,494 | 12.3× |
| Myelogram cervical (72240) | $1,854.12 | $2,255 | 1.9× |
| Myelogram Lumbar (72265) | $1,866.45 | $2,270 | 1.9× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$4,535.39–$5,424.22 | $5,516–$6,597 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$271.33–$272.16 | $330–$331 | varies |
| Optic foramina (70190) | $406.18 | $494 | 3.7× |
| Parathyroid Planar Imaging (78070) | $1,143.71 | $1,391 | 2.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,580.32 | $1,922 | 3.2× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$279.56–$288.60 | $340–$351 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$426.73–$560.76 | $519–$682 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,438.07 | $1,749 | 2.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$365.89–$406.18 | $445–$494 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $251.60 | $306 | 2.3× |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$362.60–$363.42 | $441–$442 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $474.42 | $577 | 3.6× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$240.09–$258.18 | $292–$314 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$342.05–$343.69 | $416–$418 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$368.36–$369.18 | $448–$449 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $406.18 | $494 | 3.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $514.71 | $626 | 3.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $365.89 | $445 | 3.4× |
| Radex Ribs Unilateral 2 Views (71100) | $370.82 | $451 | 3.4× |
| Radex shoulder complete minimum 2 views (73030) | $405.36 | $493 | 3.7× |
| Radex Sinuses Paransl < 3 Views (70210) | $292.71 | $356 | 2.7× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,181.54 | $1,437 | 5.4× |
| Radex Spine 1 View Specify Level (72020) | $283.67 | $345 | 2.6× |
| Radex Sternum Minimum 2 Views (71120) | $319.85 | $389 | 2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$459.62–$460.45 | $559–$560 | varies |
| Radex Toe Minimum 2 Views (73660) | $240.09 | $292 | 2.2× |
| Radex upper extremity infant minimum 2 views (73092) | $406.18 | $494 | 3.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $382.33 | $465 | 3.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $504.02 | $613 | 3.9× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$381.51–$485.11 | $464–$590 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $510.60 | $621 | 3.9× |
| Radiologic exam colon double contrast study (74280) | $945.56 | $1,150 | 4.3× |
| Radiologic exam colon single contrast study (74270) | $724.38 | $881 | 3.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $457.98 | $557 | 2.1× |
| Radiologic exam knee complete 4/more views (73564) | $346.16 | $421 | 2.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $389.73 | $474 | 3.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $485.93 | $591 | 2.2× |
| Radiologic exam swallow function contrast study (74230) | $564.87 | $687 | 2.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $864.16 | $1,051 | 3.9× |
| Radiologic examination femur 1 view (73551) | $153.76 | $187 | 1.4× |
| Radiologic examination femur minimum 2 views (73552) | $286.96 | $349 | 2.6× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$259.82–$269.69 | $316–$328 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $660.25 | $803 | 5.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$297.65–$299.29 | $362–$364 | varies |
| Ribs bilateral 3 views (71110) | $517.18 | $629 | 4.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,008.70 | $2,443 | 4.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,708.41 | $3,294 | 4.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 8 matching MRF lines |
$1,637.05–$5,164.40 | $1,991–$6,281 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$316.56–$317.38 | $385–$386 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $87.98 | $107 | 3.8× |
| Sella turcica (70240) | $264.76 | $322 | 2.4× |
| Shoulder 1 view (73020) | $261.47 | $318 | 2.4× |
| Shoulder Arthrography (73040) | $1,381.34 | $1,680 | 3.2× |
| Skull less than 4 views (70250) | $317.38 | $386 | 2.4× |
| Sternoclavicular joints (71130) | $277.91 | $338 | 2.6× |
| Tbs technical calculation only (77091) | $246.67 | $300 | 2.3× |
| Testicular Imaging W/Flow (78761) | $1,803.96 | $2,194 | 3.6× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$368.36–$369.18 | $448–$449 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$350.27–$406.18 | $426–$494 | varies |
| Thoracolumbar 2 views (72080) | $369.18 | $449 | 3.4× |
| Thyroid Imaging With Vascular Flow (78013) | $965.29 | $1,174 | 1.9× |
| Thyroid Uptake Measurement (78012) | $799.20 | $972 | 1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,189.76 | $1,447 | 2.4× |
| Ultrasound Breast Limited (76642) | $591.18 | $719 | 5.4× |
| Ultrasound Elastography Parenchyma (76981) | $351.09 | $427 | 2.7× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$591.18–$595.29 | $719–$724 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$651.20–$652.85 | $792–$794 | varies |
| Umbilical-artery Doppler (OB) (76820) | $392.20 | $477 | 3.0× |
| Unlisted Dx Radiographic Procedure (76499) | $388.09 | $472 | 3.6× |
| Unlisted us procedure (76999) | $521.29 | $634 | 4.8× |
| Upper gi w/o kub (74240) | $672.58 | $818 | 3.1× |
| Ureteral Reflux Study (78740) | $1,778.47 | $2,163 | 3.6× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$818.94–$962 | $996–$1,170 | varies |
| Urethrocystography retrograde (74450) | $1,123.16 | $1,366 | 3.8× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$250.78–$343.69 | $305–$418 | varies |
| Us chest (76604) | $685.74 | $834 | 5.3× |
| Us complete joint (76881) | $762.20 | $927 | 5.8× |
| Us exam, pelvic, limited (76857) | $430.85 | $524 | 3.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $670.94 | $816 | 5.1× |
| Us ob detailed single fetus (76811) | $800.85 | $974 | 2.7× |
| Us ob limited 1 or more fetuses (76815) | $572.27 | $696 | 4.4× |
| Us ob transvaginal (76817) | $787.69 | $958 | 6.0× |
| Us pelvic non ob complete (76856) | $686.56 | $835 | 5.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $747.40 | $909 | 5.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$430.02–$561.58 | $523–$683 | varies |
| Us retroperitoneal complete (76770) | $812.36 | $988 | 6.2× |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$685.74–$827.98 | $834–$1,007 | varies |
| Us scrotum and contents (76870) | $685.74 | $834 | 5.3× |
| Us spinal canal and contents (76800) | $718.62 | $874 | 5.5× |
| Us thyroid (76536) range across 2 matching MRF lines |
$696.42–$697.25 | $847–$848 | varies |
| Venography extremity bilateral rs&i (75822) | $3,337.41 | $4,059 | 1.7× |
| Venography extremity unilateral rs&i (75820) | $2,468.32 | $3,002 | 1.3× |
| Wrist 2 views (73100) | $251.60 | $306 | 2.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$359.31–$430.85 | $437–$524 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $274.62 | $334 | 2.5× |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$252.42–$439.07 | $307–$534 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$152.93–$153.76 | $186–$187 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $254.07 | $309 | 1.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $485.93 | $591 | 3.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $153.76 | $187 | 1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 5 matching MRF lines |
$227.76–$228.58 | $277–$278 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$441.53–$442.36 | $537–$538 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $472.78 | $575 | 3.6× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$482.65–$483.47 | $587–$588 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $405.36 | $493 | 3.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $566.51 | $689 | 4.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $421.80 | $513 | 3.2× |
| X-ray eye for foreign body (70030) | $343.69 | $418 | 3.2× |
| X-ray humerus (73060) | $299.29 | $364 | 2.8× |
| X-ray IV pyelogram (ivp) (74400) | $962 | $1,170 | 4.4× |
| X-ray IV pyelogram+tomography (74415) | $1,825.34 | $2,220 | 8.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $288.60 | $351 | 2.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $287.78 | $350 | 2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $421.80 | $513 | 3.2× |
| X-ray nose-rectum child f.b. (76010) | $279.56 | $340 | 2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $633.94 | $771 | 4.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $403.71 | $491 | 3.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $490.87 | $597 | 3.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$358.49–$406.18 | $436–$494 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$407.82–$541.02 | $496–$658 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$397.96–$572.27 | $484–$696 | varies |
| X-Ray Stress View (77071) | $255.71 | $311 | 2.4× |
| X-Ray Tmj Unilat (70328) | $426.73 | $519 | 3.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $962 | $1,170 | 2.2× |
| X-Rays Bone Length Studies (77073) | $464.56 | $565 | 3.6× |
| X-Rays Bone Survey Complete (77075) | $1,498.09 | $1,822 | 11.5× |
| Xr c-spine 4 or 5 views (72050) | $397.96 | $484 | 3.0× |
| Xr facial bones less than 3 views (70140) | $409.47 | $498 | 3.8× |
| XR Mastoids < 3 Views Bilateral (70120) | $273.80 | $333 | 2.1× |
| Xr orbits complete 4 views (70200) | $430.85 | $524 | 3.3× |
| Xr Tomogram Single Plane (76100) | $605.16 | $736 | 4.6× |
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.