Imaging prices at Liberty Hospital
Liberty, MO · every code in this section with a posted price and a Medicare benchmark.
373 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) | $2,736 | $9,807 | 2.0× |
| Abdomen 1 View (74018) | $167 | $601 | 1.9× |
| Abdomen 2 views (74019) | $149 | $535 | 1.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $581 | $2,086 | 1.5× |
| Angio internal mammary (75756) | $1,154 | $4,139 | 0.4× |
| Angio pulmonary bilat (75743) | $1,952 | $6,999 | 0.6× |
| Angiography extremity bilateral rs&i (75716) range across 9 matching MRF lines |
$2,646–$2,738 | $9,486–$9,816 | varies |
| Angiography extremity unilateral rs&i (75710) range across 16 matching MRF lines |
$1,306–$2,031 | $4,684–$7,280 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,356 | $4,861 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,154 | $4,139 | 0.4× |
| Ankle 2 views (73600) | $124 | $445 | 1.4× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,544 | $9,120 | 0.5× |
| Aortography thoracic w/o serialography rs&i (75600) | $1,254 | $4,498 | 0.4× |
| Artery X-Rays Abdomen (75726) | $3,755 | $13,461 | 0.7× |
| Artery X-Rays Adrenal Gland (75731) | $932 | $3,343 | 0.3× |
| Artery X-Rays Pelvis (75736) range across 5 matching MRF lines |
$2,196–$2,532 | $7,874–$9,078 | varies |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$1,985 | $7,118 | 0.4× |
| Arthrogram ankle (73615) | $246 | $882 | 0.7× |
| Arthrogram hip (73525) | $343 | $1,230 | 1.0× |
| Arthrogram Wrist (73115) | $268 | $964 | 0.8× |
| Basic radiation dosimetry calculation (77300) | $313 | $1,124 | 2.3× |
| Bone age studies (77072) | $102 | $366 | 1.0× |
| Bone Imaging 3 Phase (78315) | $703 | $2,521 | 1.8× |
| Bone Imaging Limited Area (78300) | $446 | $1,602 | 1.1× |
| Bone Imaging Whole Body (78306) | $638 | $2,290 | 1.6× |
| Bone survey infant (77076) | $116 | $419 | 1.1× |
| Brachytx isodose complex (77318) | $283 | $1,016 | 0.8× |
| Brain Flow Imaging Only (78610) | $444 | $1,592 | 0.8× |
| Brain Image W/Flow < 4 Views (78601) | $358 | $1,286 | 0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,598 | $5,729 | 1.1× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $552 | $1,981 | 1.0× |
| Cardiac Shunt Detection (78428) | $280 | $1,007 | 0.7× |
| Cat Scan Follow-Up Study (76380) | $303 | $1,089 | 3.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $392 | $1,408 | 0.7× |
| Cerebrospinal Fluid Scan (78630) range across 3 matching MRF lines |
$558–$675 | $2,003–$2,421 | varies |
| Chest 1 view (71045) | $127 | $457 | 1.5× |
| Chest 2 views (71046) range across 3 matching MRF lines |
$128–$1,026 | $460–$3,680 | varies |
| Chest 3 views (71047) | $116 | $416 | 1.3× |
| Chest 4 or more views (71048) | $130 | $469 | 1.2× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$112–$115 | $405–$415 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $295 | $1,059 | 2.8× |
| Continuing medical physics consltj pr wk (77336) | $339 | $1,218 | 2.5× |
| Contrast Exam Abdominl Aorta (75625) | $2,069 | $7,416 | 0.7× |
| Contrast X-Ray Bladder (74430) | $464 | $1,666 | 1.3× |
| Contrast X-Ray Of Elbow (73085) | $237 | $850 | 0.7× |
| Contrast X-Ray Of Knee Joint (73580) | $297 | $1,066 | 0.8× |
| CT abdomen and pelvis without and with contrast (74178) | $1,573 | $5,641 | 4.5× |
| CT abdomen and pelvis without contrast (74176) | $1,272 | $4,562 | 5.3× |
| CT abdomen w contrast (74160) | $771 | $2,765 | 4.4× |
| CT abdomen w wo contrast (74170) | $859 | $3,082 | 4.9× |
| CT abdomen w/o contrast (74150) | $609 | $2,183 | 5.8× |
| CT Angio Abdomen and Pelvis (74174) | $1,586 | $5,686 | 4.5× |
| CT Angio Chest (71275) | $1,037 | $3,719 | 5.9× |
| CT Angio Head (70496) | $969 | $3,474 | 5.5× |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$451–$623 | $1,619–$2,234 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $952 | $3,414 | 5.4× |
| CT Angio Neck (70498) | $1,080 | $3,871 | 6.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$814–$1,221 | $2,919–$4,379 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $135 | $484 | 0.8× |
| CT cervical spine w/ contrast (72126) | $881 | $3,158 | 2.5× |
| CT cervical spine w/o contrast (72125) | $836 | $2,998 | 8.0× |
| CT cervical spine w/wo cont (72127) | $969 | $3,474 | 5.5× |
| CT chest w contrast (71260) | $836 | $2,999 | 4.8× |
| CT chest w/wo contrast (71270) | $920 | $3,299 | 5.2× |
| CT head/brain with contrast (70460) | $797 | $2,858 | 4.5× |
| CT head/brain without and with contrast (70470) | $827 | $2,965 | 4.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $494 | $1,771 | 1.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $46 | $166 | 0.5× |
| CT iac w contrast (70481) | $794 | $2,849 | 4.5× |
| CT l-spine w&w/o contrast (72133) | $898 | $3,219 | 5.1× |
| CT lower ext w/o (73700) | $612 | $2,196 | 5.8× |
| CT lower extremity w/contrast material (73701) | $634 | $2,274 | 3.6× |
| CT lumbar spine w contrast (72132) | $881 | $3,160 | 2.5× |
| CT lumbar spine w/o contrast (72131) | $869 | $3,117 | 8.3× |
| CT maxillofacial w contrast (70487) | $716 | $2,569 | 4.1× |
| CT maxillofacial wo contrast (70486) | $659 | $2,365 | 6.3× |
| CT neck tissue combo (70492) | $789 | $2,829 | 4.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $874 | $3,134 | 5.0× |
| CT orbits w/o contrast (70480) | $516 | $1,853 | 4.9× |
| CT pelvis w&w/o contrast (72194) | $886 | $3,176 | 5.0× |
| CT pelvis w/o contrast (72192) | $670 | $2,402 | 6.4× |
| CT scan of leg combo (73702) | $763 | $2,735 | 4.3× |
| CT scans face/jaw combo (70488) | $832 | $2,984 | 4.7× |
| CT soft tissue neck w contrast (70491) | $704 | $2,524 | 4.0× |
| CT soft tissue neck w/o contrast (70490) | $607 | $2,177 | 5.8× |
| CT thoracic spine w contrast (72129) | $789 | $2,830 | 4.5× |
| CT thoracic spine w/o contrast (72128) | $828 | $2,970 | 7.9× |
| CT thoracic spine w/wo cont (72130) | $946 | $3,391 | 5.4× |
| CT thorax w/o contrast (71250) | $633 | $2,271 | 6.0× |
| CT unlisted procedure (76497) | $141 | $507 | 1.6× |
| CT upper ext wo (73200) | $556 | $1,994 | 5.3× |
| CT upper extremity w/o & w/contrast material (73202) | $680 | $2,440 | 3.9× |
| CT upper extremity with contrast (73201) | $648 | $2,324 | 1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $953 | $3,418 | 5.4× |
| Cta Abdomen (74175) | $1,027 | $3,683 | 5.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $268 | $961 | 0.8× |
| CTA pelvis (72191) | $1,933 | $6,931 | 11.0× |
| Dilation ureters/urethra rs&i (74485) | $649 | $2,328 | 0.3× |
| Discography Cerv/Thor Spine (72285) | $1,091 | $3,912 | 0.6× |
| Diskography lumbar (72295) | $1,337 | $4,795 | 0.7× |
| Dxa Bone Density Axial (77080) | $178 | $641 | 1.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $63 | $227 | 0.7× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$185–$195 | $666–$699 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$210–$219 | $754–$787 | varies |
| Echograp Trans R Pros Study (76873) | $291 | $1,045 | 2.8× |
| Esophagram (74220) range across 3 matching MRF lines |
$189–$227 | $678–$816 | varies |
| Fetal Biophys Profile W/Nst (76818) | $169 | $609 | 1.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $191 | $685 | 1.8× |
| Fluoroscopy up to 1 hr (76000) | $338 | $1,214 | 1.4× |
| Follow-Up Angiography (75898) | $953 | $3,418 | 0.3× |
| Foot 2 views (73620) | $115 | $415 | 1.3× |
| Forearm 2 views (73090) | $118 | $425 | 1.4× |
| Gastric emptying imaging study (78264) range across 3 matching MRF lines |
$500–$621 | $1,793–$2,227 | varies |
| Gastroesophageal Reflux Exam (78262) | $374 | $1,343 | 0.9× |
| Gated Heart Planar Single (78472) | $580 | $2,080 | 1.4× |
| Gated Heart, Multiple (78473) | $416 | $1,492 | 1.0× |
| Hand 2 views (73120) | $132 | $474 | 1.3× |
| Heart first pass single,planar (78481) | $303 | $1,088 | 0.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,739 | $6,234 | 0.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,172 | $4,201 | 0.4× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$606–$749 | $2,175–$2,688 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$494–$600 | $1,773–$2,151 | varies |
| Ht Musc Image Planar Mult (78454) | $1,172 | $4,201 | 0.9× |
| Ht Muscle Image Spect Sing (78451) range across 3 matching MRF lines |
$1,432–$1,777 | $5,135–$6,372 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$218–$243 | $784–$872 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $99 | $358 | 1.1× |
| Interstitial radiation source applic complex (77778) | $1,269 | $4,551 | 1.8× |
| Intracavitary Radiation Source Applic Complex (77763) | $321 | $1,154 | 0.5× |
| Intracavitary Radiation Source Applic Intermed (77762) | $305 | $1,096 | 0.6× |
| Intracavitary radiation source applic simple (77761) | $289 | $1,037 | 0.5× |
| Joint Survey Single View (77077) | $135 | $484 | 1.3× |
| K Flow/Funct Image Multiple (78709) | $602 | $2,158 | 1.1× |
| K Flow/Funct Image W/Drug (78708) | $636 | $2,281 | 1.2× |
| K Flow/Funct Image W/O Drug (78707) | $595 | $2,133 | 1.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 2 matching MRF lines |
$392–$423 | $1,407–$1,517 | varies |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$168–$252 | $603–$905 | varies |
| Leveen/Shunt Patency Exam (78291) | $346 | $1,241 | 0.9× |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$317–$347 | $1,137–$1,247 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $452 | $1,622 | 1.1× |
| Lung Perf&Ventilat Diferentl (78598) | $536 | $1,923 | 1.0× |
| Lung perfusion differential (78597) | $446 | $1,602 | 1.1× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$603–$679 | $2,162–$2,435 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$157–$218 | $564–$784 | varies |
| Lymph System Imaging (78195) | $595 | $2,136 | 1.1× |
| Magnetic Image Jaw Joint (70336) | $680 | $2,439 | 2.8× |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$180–$196 | $648–$703 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$131–$149 | $471–$537 | varies |
| Meckels Divert Exam (78290) | $390 | $1,401 | 1.0× |
| Mlc imrt design & construction per imrt plan (77338) | $518 | $1,858 | 1.4× |
| Mr safety determination physician/other qhp (76016) | $66 | $238 | 0.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $31 | $114 | 1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $66 | $238 | 0.7× |
| Mr safety med physics xm customization plng&mntr (76017) | $174 | $626 | 0.7× |
| Mra Head W/O & W/Contrast Material (70546) | $1,200 | $4,304 | 3.4× |
| MRA head w/o contrast (70544) | $1,105 | $3,964 | 4.6× |
| MRA head with contrast (70545) | $1,161 | $4,162 | 3.3× |
| MRA neck w contrast (70548) | $930 | $3,334 | 2.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,207 | $4,327 | 3.5× |
| MRA neck w/o contrast (70547) | $917 | $3,288 | 3.8× |
| MRI abdomen w contrast (74182) | $990 | $3,551 | 2.8× |
| MRI abdomen w/o contrast (74181) range across 4 matching MRF lines |
$770–$900 | $2,761–$3,228 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $1,062 | $3,808 | 1.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,330 | $4,770 | 3.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,224 | $4,390 | 1.6× |
| MRI Breast W/O Contrast Bilateral (77047) | $656 | $2,352 | 2.7× |
| MRI Breast Without Contrast Material Unilateral (77046) | $195 | $699 | 0.8× |
| MRI cervical spine w contrast (72142) | $1,118 | $4,008 | 3.2× |
| MRI cervical spine w/o cont (72141) | $997 | $3,574 | 4.2× |
| MRI chest w/o contrast (71550) | $961 | $3,446 | 4.0× |
| MRI chest wo w contrast (71552) | $1,146 | $4,108 | 3.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,176 | $4,216 | 3.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,383 | $4,958 | 4.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,069–$1,604 | $3,833–$5,750 | varies |
| MRI lumbar spine w contrast (72149) | $1,395 | $5,001 | 4.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,401 | $5,025 | 4.0× |
| MRI orbit face &/neck w/o contrast (70540) | $961 | $3,446 | 4.0× |
| MRI orbit face neck w contrast (70542) | $888 | $3,183 | 2.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,279 | $4,585 | 3.7× |
| MRI pelvis w contrast (72196) | $1,310 | $4,696 | 3.7× |
| MRI pelvis w/o & w contrast (72197) | $1,327 | $4,759 | 3.8× |
| MRI pelvis w/o contrast (72195) | $1,247 | $4,472 | 5.2× |
| MRI thoracic spine w/o contrast (72146) | $975 | $3,496 | 4.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $971 | $3,482 | 2.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$774–$925 | $2,776–$3,316 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,143 | $4,097 | 3.3× |
| MRI, abdomen, combo (74183) | $1,434 | $5,140 | 4.1× |
| MRI, dorsal spine combo (72157) | $1,479 | $5,303 | 4.2× |
| MRI, dorsal spine contrast (72147) | $1,119 | $4,012 | 3.2× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$742–$989 | $2,661–$3,548 | varies |
| MRI, joint upper extrem combo (73223) | $1,253 | $4,493 | 3.6× |
| MRI, lumbar spine combo (72158) | $1,465 | $5,251 | 4.2× |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$515–$577 | $1,849–$2,069 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$515–$576 | $1,848–$2,068 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$361–$422 | $1,295–$1,515 | varies |
| Myelograpy 2/more regions rs&i (72270) range across 2 matching MRF lines |
$676–$768 | $2,424–$2,754 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $312 | $1,119 | 0.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $521 | $1,869 | 0.4× |
| Myocardial Spect Multiple Studies (78452) range across 14 matching MRF lines |
$1,904–$2,446 | $6,827–$8,768 | varies |
| Neck soft tissue (70360) | $115 | $415 | 1.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $183 | $659 | 0.5× |
| Nonvascular Shunt X-Ray (75809) | $146 | $526 | 1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,764 | $13,493 | 2.7× |
| Nuclear Rx Oral Admin (79005) | $544 | $1,953 | 2.3× |
| Panoramic X-ray of jaws (70355) | $125 | $451 | 1.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $730 | $2,619 | 1.3× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$438–$537 | $1,571–$1,928 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) | $487 | $1,748 | 1.2× |
| Pelvis 1 or 2 views (72170) | $140 | $502 | 1.3× |
| Pet Image Skull-Thigh (78812) | $706 | $2,533 | 0.5× |
| Pet Image W/Ct Lmtd (78814) | $1,798 | $6,447 | 1.3× |
| PET image w/CT, full body (78816) | $2,132 | $7,644 | 1.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,342 | $8,395 | 1.6× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,712 | $6,138 | 1.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $958 | $3,435 | 0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$450–$521 | $1,615–$1,868 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $195 | $702 | 1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 4 matching MRF lines |
$305–$454 | $1,095–$1,628 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$150–$189 | $539–$679 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$112–$168 | $402–$603 | varies |
| Radex elbow complete minimum 3 views (73080) | $169 | $609 | 1.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $164 | $589 | 1.6× |
| Radex fingr minimum 2 views (73140) | $127 | $457 | 1.5× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$127–$191 | $457–$686 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$189–$283 | $678–$1,017 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $94 | $340 | 1.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $117 | $421 | 1.3× |
| Radex Ribs Unilateral 2 Views (71100) | $115 | $415 | 1.3× |
| Radex shoulder complete minimum 2 views (73030) | $210 | $756 | 2.4× |
| Radex Sinuses Paransl < 3 Views (70210) | $97 | $349 | 1.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $307 | $1,101 | 1.7× |
| Radex Spine 1 View Specify Level (72020) | $109 | $393 | 1.3× |
| Radex Sternum Minimum 2 Views (71120) | $103 | $370 | 1.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $126 | $453 | 1.4× |
| Radex Toe Minimum 2 Views (73660) | $120 | $432 | 1.4× |
| Radex upper extremity infant minimum 2 views (73092) | $90 | $325 | 0.9× |
| Radex Wrist Complete Minimum 3 Views (73110) | $157 | $563 | 1.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $3,736 | $13,391 | 0.5× |
| Radiation treatment delivery level 1 (77402) | $114 | $409 | 1.1× |
| Radiation treatment delivery level 2 (77407) | $379 | $1,359 | 1.0× |
| Radiation treatment delivery level 3 (77412) | $469 | $1,684 | 0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $150 | $540 | 1.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $147 | $527 | 1.4× |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$313–$397 | $1,125–$1,423 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$305–$361 | $1,094–$1,294 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $234 | $840 | 1.3× |
| Radiologic exam knee complete 4/more views (73564) | $185 | $664 | 1.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $143 | $513 | 1.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $279 | $1,001 | 1.6× |
| Radiologic exam swallow function contrast study (74230) | $296 | $1,062 | 1.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $425 | $1,524 | 2.4× |
| Radiologic examination femur 1 view (73551) | $91 | $329 | 1.0× |
| Radiologic examination femur minimum 2 views (73552) | $115 | $415 | 1.3× |
| Radiologic examination knee 1/2 views (73560) | $128 | $462 | 1.5× |
| Radiologic Examination Osseous Survey Limited (77074) | $170 | $611 | 1.6× |
| Radiologic examination tibia & fibula 2 views (73590) | $138 | $498 | 1.6× |
| Renal Cyst Study (74470) | $213 | $767 | 0.4× |
| Ribs bilateral 3 views (71110) | $169 | $609 | 1.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$313–$344 | $1,123–$1,233 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$276–$307 | $992–$1,102 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $872 | $3,127 | 1.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,194 | $7,867 | 4.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,171 | $4,200 | 2.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $967 | $3,466 | 0.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,691 | $6,061 | 1.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,192 | $4,274 | 0.9× |
| Rp Therapy Intravenous Administration (79101) | $313 | $1,124 | 1.3× |
| Salivary Gland Imaging (78230) | $269 | $967 | 0.7× |
| Salivary Gland Imaging Serial Images (78231) | $279 | $1,002 | 0.7× |
| Scapula (73010) | $144 | $518 | 1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$25–$29 | $92–$104 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$106–$159 | $381–$572 | varies |
| Shoulder Arthrography (73040) | $328 | $1,177 | 0.9× |
| Skull less than 4 views (70250) | $158 | $568 | 1.5× |
| Special dosimetry (77331) | $104 | $374 | 0.8× |
| Special Physics Consult (77370) | $502 | $1,802 | 3.7× |
| Special teletherapy port plan (77321) | $243 | $872 | 0.6× |
| Special treatment procedure (77470) | $980 | $3,513 | 1.8× |
| Speech evaluation, complex (70371) range across 2 matching MRF lines |
$97–$128 | $350–$460 | varies |
| Stereotactic Body Radiation Delivery (77373) | $1,511 | $5,419 | 0.8× |
| Sternoclavicular joints (71130) | $97 | $349 | 1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $283 | $1,016 | 0.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $148 | $531 | 0.4× |
| Temporomandble Jt Arthrography Rs&I (70332) range across 2 matching MRF lines |
$242–$275 | $868–$989 | varies |
| Testicular Imaging W/Flow (78761) | $288 | $1,033 | 0.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $955 | $3,425 | 2.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $479 | $1,719 | 1.3× |
| Ther rad simulaj-aided field setting simple (77280) | $591 | $2,121 | 4.4× |
| Thoracic spine 2 views (72070) | $140 | $502 | 1.3× |
| Thoracic spine 3 views (72072) | $145 | $520 | 1.4× |
| Thoracolumbar 2 views (72080) | $138 | $496 | 1.6× |
| Thyroid Imaging With Vascular Flow (78013) | $253 | $908 | 0.6× |
| Thyroid Met Imaging Body (78018) range across 3 matching MRF lines |
$450–$604 | $1,616–$2,166 | varies |
| Thyroid Uptake Measurement (78012) | $284 | $1,019 | 0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $361 | $1,294 | 0.9× |
| Tx Devices Design & Construction Complex (77334) | $673 | $2,413 | 1.8× |
| Tx devices design & construction intermediate (77333) | $174 | $624 | 1.3× |
| Tx devices design & construction simple (77332) | $138 | $498 | 1.0× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$114–$244 | $412–$878 | varies |
| Ultrasound Elastography Parenchyma (76981) | $135 | $487 | 1.3× |
| Ultrasound Exam Aaa Screen (76706) | $154 | $552 | 1.5× |
| Ultrasound, abdomen limited (76705) | $289 | $1,037 | 2.8× |
| Unlisted Dx Radiographic Procedure (76499) range across 3 matching MRF lines |
$102–$538 | $367–$1,931 | varies |
| Unlisted magnetic resonance procedure (76498) range across 3 matching MRF lines |
$258–$286 | $926–$1,026 | varies |
| Unlisted us procedure (76999) | $182 | $654 | 2.1× |
| Upper gi w/o kub (74240) | $386 | $1,385 | 2.2× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$223–$292 | $801–$1,050 | varies |
| Urethrocystography retrograde (74450) | $266 | $956 | 1.1× |
| Us breast unilateral complete (76641) range across 7 matching MRF lines |
$265–$397 | $950–$1,425 | varies |
| Us chest (76604) | $185 | $665 | 1.8× |
| Us exam, pelvic, limited (76857) | $207 | $743 | 2.0× |
| Us head (76506) | $151 | $544 | 1.4× |
| Us kidney transplant (76776) | $165 | $593 | 1.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$183–$275 | $659–$989 | varies |
| Us ob limited 1 or more fetuses (76815) | $181 | $649 | 1.7× |
| Us ob transvaginal (76817) | $195 | $700 | 1.9× |
| Us pelvic non ob complete (76856) | $359 | $1,290 | 3.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $263 | $946 | 2.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$155–$173 | $556–$623 | varies |
| Us retroperitoneal complete (76770) | $364 | $1,306 | 3.5× |
| Us retroperitoneal limited (76775) | $243 | $872 | 2.3× |
| Us scrotum and contents (76870) | $304 | $1,090 | 2.9× |
| Us spinal canal and contents (76800) | $140 | $502 | 1.3× |
| Us thyroid (76536) | $371 | $1,330 | 3.5× |
| Us transrectal (76872) | $177 | $635 | 1.7× |
| Vein X-Ray Chest (75827) | $1,059 | $3,798 | 0.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $909 | $3,259 | 0.3× |
| Venogram Sinus/Jugular (75860) range across 3 matching MRF lines |
$832–$1,249 | $2,985–$4,478 | varies |
| Venography caval inferior serialography rs&i (75825) | $1,861 | $6,672 | 0.6× |
| Venography extremity bilateral rs&i (75822) range across 8 matching MRF lines |
$662–$1,045 | $2,373–$3,747 | varies |
| Venography extremity unilateral rs&i (75820) range across 12 matching MRF lines |
$634–$988 | $2,275–$3,543 | varies |
| Venography Renal Bilateral (75833) | $956 | $3,428 | 0.3× |
| Venography Renal Unilateral (75831) | $1,221 | $4,379 | 0.4× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,455 | $5,218 | 0.3× |
| Vertebral fracture assessment via dxa (77086) | $68 | $244 | 0.8× |
| Wrist 2 views (73100) | $120 | $432 | 1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $97 | $351 | 1.1× |
| X-ray antegrade pyelogram tube (74425) range across 9 matching MRF lines |
$195–$430 | $699–$1,543 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 9 matching MRF lines |
$2,049–$2,353 | $7,346–$8,435 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$95–$115 | $344–$415 | varies |
| X-Ray Exam Breast Specimen (76098) | $211 | $757 | 0.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $160 | $575 | 1.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $152 | $548 | 1.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $102 | $366 | 1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $132 | $475 | 1.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $155 | $556 | 1.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $279 | $1,002 | 2.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $288 | $1,034 | 2.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $323 | $1,159 | 3.1× |
| X-Ray Exam L-S Spine Bending (72114) | $275 | $989 | 2.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $157 | $564 | 1.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $221 | $793 | 2.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $219 | $787 | 2.1× |
| X-ray humerus (73060) | $118 | $424 | 1.4× |
| X-ray IV pyelogram (ivp) (74400) | $313 | $1,123 | 1.8× |
| X-ray IV pyelogram+tomography (74415) | $286 | $1,028 | 1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $103 | $370 | 1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $127 | $457 | 1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $140 | $502 | 1.3× |
| X-ray nose-rectum child f.b. (76010) | $101 | $365 | 1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $181 | $649 | 1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $193 | $695 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $191 | $687 | 2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $150 | $539 | 1.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $183 | $657 | 1.7× |
| X-ray thoracic spine 4 vw (72074) | $152 | $547 | 1.5× |
| X-Ray Tmj Unilat (70328) | $85 | $306 | 1.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 4 matching MRF lines |
$854–$1,282 | $3,064–$4,596 | varies |
| X-Rays Bone Length Studies (77073) | $205 | $738 | 2.0× |
| X-Rays Bone Survey Complete (77075) | $341 | $1,225 | 3.3× |
| Xr c-spine 4 or 5 views (72050) | $194 | $697 | 1.9× |
| Xr facial bones less than 3 views (70140) | $107 | $385 | 1.2× |
| Xr orbits complete 4 views (70200) | $176 | $634 | 1.7× |
| Xr Tomogram Single Plane (76100) | $89 | $319 | 0.8× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.