Imaging prices at Licking Memorial Hospital
Newark, OH · every code in this section with a posted price and a Medicare benchmark.
266 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) | $548.05 | $548.05 | 6.5× |
| Abdomen 2 views (74019) | $720.45 | $720.45 | 7.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,311.75 | $2,311.75 | 6.0× |
| Angio pulmonary bilat (75743) | $10,026.80 | $10,026.80 | 3.3× |
| Angiography extremity bilateral rs&i (75716) | $8,165.65 | $8,165.65 | 2.7× |
| Angiography extremity unilateral rs&i (75710) | $8,165.65 | $8,165.65 | 2.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,052.65 | $5,052.65 | 1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,973.45 | $2,973.45 | 1.0× |
| Ankle 2 views (73600) | $657.95 | $657.95 | 7.8× |
| Aortography thoracic serialography rs&i (75605) | $6,465.70 | $6,465.70 | 1.2× |
| Artery X-Rays Abdomen (75726) | $8,165.65 | $8,165.65 | 1.5× |
| Arthrogram ankle (73615) | $1,250.80 | $1,250.80 | 3.7× |
| Arthrogram hip (73525) | $2,127.70 | $2,127.70 | 6.3× |
| Arthrogram Wrist (73115) | $2,127.70 | $2,127.70 | 6.3× |
| Bone age studies (77072) | $518.85 | $518.85 | 5.1× |
| Bone Imaging 3 Phase (78315) | $3,311 | $3,311 | 8.6× |
| Bone Imaging Limited Area (78300) | $2,492.15 | $2,492.15 | 6.5× |
| Bone Imaging Whole Body (78306) | $3,185.65 | $3,185.65 | 8.3× |
| Bone marrow imaging limited area (78102) | $1,594.70 | $1,594.70 | 4.1× |
| Bone survey infant (77076) | $777.95 | $777.95 | 7.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $3,218.85 | $3,218.85 | 6.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,501.95 | $5,501.95 | 4.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,631.35 | $1,631.35 | 3.1× |
| Cerebrospinal Fluid Scan (78630) | $2,935.20 | $2,935.20 | 5.6× |
| Chest 1 view (71045) | $418.50 | $418.50 | 5.0× |
| Chest 2 views (71046) | $589.35 | $589.35 | 7.0× |
| Chest 3 views (71047) | $717.25 | $717.25 | 8.5× |
| Chest 4 or more views (71048) | $717.25 | $717.25 | 7.1× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$657.95–$1,315.90 | $657.95–$1,315.90 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,013.85 | $1,013.85 | 10.1× |
| Contrast Exam Abdominl Aorta (75625) | $8,165.65 | $8,165.65 | 2.7× |
| Contrast X-Ray Bladder (74430) | $1,606.75 | $1,606.75 | 4.8× |
| Contrast X-Ray Of Elbow (73085) | $1,992.30 | $1,992.30 | 5.9× |
| Contrast X-Ray Of Knee Joint (73580) | $2,127.70 | $2,127.70 | 6.3× |
| CT abdomen and pelvis without and with contrast (74178) | $8,757.35 | $8,757.35 | 26.0× |
| CT abdomen and pelvis without contrast (74176) | $7,413.05 | $7,413.05 | 32.2× |
| CT abdomen w contrast (74160) | $4,489 | $4,489 | 26.5× |
| CT abdomen w wo contrast (74170) | $5,092 | $5,092 | 30.1× |
| CT abdomen w/o contrast (74150) | $3,929 | $3,929 | 39.0× |
| CT Angio Abdomen and Pelvis (74174) | $9,496.15 | $9,496.15 | 28.2× |
| CT Angio Chest (71275) | $5,775 | $5,775 | 34.1× |
| CT Angio Head (70496) | $4,458.65 | $4,458.65 | 26.4× |
| CT angio hrt w/3d image (75574) | $5,775 | $5,775 | 17.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,633.50–$3,267 | $1,633.50–$3,267 | varies |
| CT Angio Neck (70498) | $5,443.65 | $5,443.65 | 32.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $3,267 | $3,267 | 19.3× |
| CT cervical spine w/ contrast (72126) | $3,607.95 | $3,607.95 | 10.7× |
| CT cervical spine w/o contrast (72125) | $3,607.95 | $3,607.95 | 35.8× |
| CT cervical spine w/wo cont (72127) | $4,872.55 | $4,872.55 | 28.8× |
| CT chest w contrast (71260) | $3,523.10 | $3,523.10 | 20.8× |
| CT chest w/wo contrast (71270) | $5,775 | $5,775 | 34.1× |
| CT head/brain with contrast (70460) | $3,220.35 | $3,220.35 | 19.0× |
| CT head/brain without and with contrast (70470) | $4,168.90 | $4,168.90 | 24.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $533.45 | $533.45 | 6.4× |
| CT iac w contrast (70481) | $2,883.20 | $2,883.20 | 17.0× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$2,996.80–$5,993.60 | $2,996.80–$5,993.60 | varies |
| CT lower extremity w/contrast material (73701) | $2,996.80 | $2,996.80 | 17.7× |
| CT lumbar spine w contrast (72132) | $3,824.50 | $3,824.50 | 11.4× |
| CT lumbar spine w/o contrast (72131) | $3,834.25 | $3,834.25 | 38.0× |
| CT maxillofacial w contrast (70487) | $2,883.20 | $2,883.20 | 17.0× |
| CT maxillofacial wo contrast (70486) | $2,883.20 | $2,883.20 | 28.6× |
| CT neck tissue combo (70492) | $3,770.35 | $3,770.35 | 22.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,308.35 | $3,308.35 | 19.6× |
| CT orbits w/o contrast (70480) | $2,883.20 | $2,883.20 | 28.6× |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$2,927.80–$3,929 | $2,927.80–$3,929 | varies |
| CT scan of leg combo (73702) | $2,996.80 | $2,996.80 | 17.7× |
| CT soft tissue neck w contrast (70491) | $3,304.85 | $3,304.85 | 19.5× |
| CT soft tissue neck w/o contrast (70490) | $3,304.85 | $3,304.85 | 32.8× |
| CT thoracic spine w contrast (72129) | $3,524.80 | $3,524.80 | 20.8× |
| CT thoracic spine w/o contrast (72128) | $3,524.80 | $3,524.80 | 35.0× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$2,762.10–$3,523.10 | $2,762.10–$3,523.10 | varies |
| CT upper ext wo (73200) | $2,996.80 | $2,996.80 | 29.7× |
| CT upper extremity with contrast (73201) | $2,996.80 | $2,996.80 | 8.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $5,996.95 | $5,996.95 | 35.5× |
| Cta Abdomen (74175) | $5,775 | $5,775 | 34.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $9,902.30 | $9,902.30 | 29.4× |
| CTA pelvis (72191) | $5,775 | $5,775 | 34.1× |
| Dxa Bone Density Axial (77080) | $1,079.85 | $1,079.85 | 10.7× |
| Dxa bone density study (77085) | $1,271.40 | $1,271.40 | 12.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $254.95 | $254.95 | 3.0× |
| Echo exam uterus (76831) | $1,379.50 | $1,379.50 | 6.0× |
| Echo Guide For Artery Repair (76936) | $983.50 | $983.50 | 4.7× |
| Esophagram (74220) | $1,142.75 | $1,142.75 | 6.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,224.30 | $1,224.30 | 12.1× |
| Fluoroscopy up to 1 hr (76000) | $827.40 | $827.40 | 3.6× |
| Follow-Up Angiography (75898) | $2,484.60 | $2,484.60 | 0.8× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$657.95–$1,315.90 | $657.95–$1,315.90 | varies |
| Forearm 2 views (73090) | $687.30 | $687.30 | 8.2× |
| Gastric emptying imaging study (78264) | $2,311.75 | $2,311.75 | 6.0× |
| Gated Heart Planar Single (78472) | $3,903.55 | $3,903.55 | 10.1× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$657.95–$1,315.90 | $657.95–$1,315.90 | varies |
| Hepatobil Syst Image W/Drug (78227) | $3,295.30 | $3,295.30 | 6.3× |
| Hepatobiliary System Imaging (78226) | $2,605.10 | $2,605.10 | 6.8× |
| Ht Muscle Image Spect Sing (78451) | $7,436.30 | $7,436.30 | 6.0× |
| Hysterosalpingogram (74740) | $1,763 | $1,763 | 7.7× |
| Infant hip ultrasound, limited static exam (76886) | $960.45 | $960.45 | 11.4× |
| K Flow/Funct Image Multiple (78709) | $2,639.40 | $2,639.40 | 5.0× |
| K Flow/Funct Image W/Drug (78708) | $3,025.50 | $3,025.50 | 5.8× |
| K Flow/Funct Image W/O Drug (78707) | $3,024.40 | $3,024.40 | 5.8× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$758.90–$1,517.80 | $758.90–$1,517.80 | varies |
| Liver & Spleen Imaging Static Only (78215) | $2,606.10 | $2,606.10 | 6.8× |
| Lung Perf&Ventilat Diferentl (78598) | $3,257.90 | $3,257.90 | 6.2× |
| Lung perfusion differential (78597) | $2,883.60 | $2,883.60 | 7.5× |
| Lung Ventilat&Perfus Imaging (78582) | $3,257.90 | $3,257.90 | 6.2× |
| Lymph System Imaging (78195) | $2,566.20 | $2,566.20 | 4.9× |
| Magnetic Image Jaw Joint (70336) | $4,414.20 | $4,414.20 | 19.2× |
| Meckels Divert Exam (78290) | $2,311.75 | $2,311.75 | 6.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $49.85 | $49.85 | 1.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $139.10 | $139.10 | 1.5× |
| MRA head w/o contrast (70544) | $4,414.20 | $4,414.20 | 19.2× |
| MRA neck w contrast (70548) | $4,414.20 | $4,414.20 | 13.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,795.75 | $5,795.75 | 17.2× |
| MRA neck w/o contrast (70547) | $4,414.20 | $4,414.20 | 19.2× |
| MRI abdomen w/o contrast (74181) | $4,414.20 | $4,414.20 | 19.2× |
| MRI any jt lower extrem w/contrast material (73722) | $4,414.20 | $4,414.20 | 5.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $5,795.75 | $5,795.75 | 17.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $4,414.20 | $4,414.20 | 5.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $6,618.10 | $6,618.10 | 28.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $4,414.20 | $4,414.20 | 19.2× |
| MRI cervical spine w contrast (72142) | $4,414.20 | $4,414.20 | 13.1× |
| MRI cervical spine w/o cont (72141) | $4,414.20 | $4,414.20 | 19.2× |
| MRI chest w/o contrast (71550) | $4,414.20 | $4,414.20 | 19.2× |
| MRI chest wo w contrast (71552) | $5,795.75 | $5,795.75 | 17.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $5,795.75 | $5,795.75 | 17.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$4,414.20–$8,828.40 | $4,414.20–$8,828.40 | varies |
| MRI lumbar spine w contrast (72149) | $4,414.20 | $4,414.20 | 13.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,795.75 | $5,795.75 | 17.2× |
| MRI orbit face &/neck w/o contrast (70540) | $4,414.20 | $4,414.20 | 19.2× |
| MRI orbit face neck w contrast (70542) | $4,414.20 | $4,414.20 | 13.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,795.75 | $5,795.75 | 17.2× |
| MRI pelvis w contrast (72196) | $4,414.20 | $4,414.20 | 13.1× |
| MRI pelvis w/o & w contrast (72197) | $5,795.75 | $5,795.75 | 17.2× |
| MRI pelvis w/o contrast (72195) | $4,414.20 | $4,414.20 | 19.2× |
| MRI thoracic spine w/o contrast (72146) | $4,414.20 | $4,414.20 | 19.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $4,414.20 | $4,414.20 | 19.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $4,414.20 | $4,414.20 | 13.1× |
| MRI, abdomen, combo (74183) | $5,795.75 | $5,795.75 | 17.2× |
| MRI, dorsal spine combo (72157) | $5,795.75 | $5,795.75 | 17.2× |
| MRI, dorsal spine contrast (72147) | $4,414.20 | $4,414.20 | 13.1× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$4,414.20–$8,828.40 | $4,414.20–$8,828.40 | varies |
| MRI, joint upper extrem combo (73223) | $5,795.75 | $5,795.75 | 17.2× |
| MRI, lumbar spine combo (72158) | $5,795.75 | $5,795.75 | 17.2× |
| Myocardial Spect Multiple Studies (78452) | $9,868.15 | $9,868.15 | 7.9× |
| Neck soft tissue (70360) | $589 | $589 | 7.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $1,082.40 | $1,082.40 | 2.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $336.80 | $336.80 | 3.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,191.65 | $2,191.65 | 4.2× |
| Pelvis 1 or 2 views (72170) | $508.35 | $508.35 | 5.0× |
| PET image w/CT, full body (78816) | $12,080.75 | $12,080.75 | 8.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $12,080.75 | $12,080.75 | 8.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,883.60 | $2,883.60 | 7.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,047.90 | $1,047.90 | 10.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $780.30 | $780.30 | 1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$668.30–$1,336.60 | $668.30–$1,336.60 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$687.30–$1,374.60 | $687.30–$1,374.60 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$687.30–$1,374.60 | $687.30–$1,374.60 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $740.10 | $740.10 | 7.3× |
| Radex fingr minimum 2 views (73140) | $610.45 | $610.45 | 7.3× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$701.60–$1,403.20 | $701.60–$1,403.20 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$701.60–$1,403.20 | $701.60–$1,403.20 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $657.95 | $657.95 | 7.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $554.25 | $554.25 | 5.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $668.25 | $668.25 | 8.0× |
| Radex Ribs Unilateral 2 Views (71100) | $864.60 | $864.60 | 10.3× |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$657.95–$1,603.80 | $657.95–$1,603.80 | varies |
| Radex Spine 1 View Specify Level (72020) | $537.95 | $537.95 | 6.4× |
| Radex Sternum Minimum 2 Views (71120) | $1,037.30 | $1,037.30 | 12.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $792.70 | $792.70 | 9.4× |
| Radex Toe Minimum 2 Views (73660) | $610.45 | $610.45 | 7.3× |
| Radex upper extremity infant minimum 2 views (73092) | $657.95 | $657.95 | 6.5× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$701.60–$1,403.20 | $701.60–$1,403.20 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $583 | $583 | 5.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $720.45 | $720.45 | 7.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $893 | $893 | 8.9× |
| Radiologic exam colon double contrast study (74280) | $2,509.95 | $2,509.95 | 14.8× |
| Radiologic exam colon single contrast study (74270) | $1,606.55 | $1,606.55 | 9.5× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$830.75–$1,661.50 | $830.75–$1,661.50 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,142.75 | $1,142.75 | 6.8× |
| Radiologic exam swallow function contrast study (74230) | $1,662.90 | $1,662.90 | 9.8× |
| Radiologic exam upr gi trc double contrast study (74246) range across 4 matching MRF lines |
$1,756.70–$2,899.45 | $1,756.70–$2,899.45 | varies |
| Radiologic examination femur 1 view (73551) | $610.45 | $610.45 | 7.3× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$657.95–$1,315.90 | $657.95–$1,315.90 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$735.10–$1,470.20 | $735.10–$1,470.20 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$657.95–$1,315.90 | $657.95–$1,315.90 | varies |
| Ribs bilateral 3 views (71110) | $1,162.05 | $1,162.05 | 11.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,791.40 | $2,791.40 | 7.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,856.60 | $5,856.60 | 11.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $5,173.55 | $5,173.55 | 9.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $4,164.30 | $4,164.30 | 8.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $7,181.05 | $7,181.05 | 5.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,952.60 | $2,952.60 | 2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $4,164.30 | $4,164.30 | 3.3× |
| Scapula (73010) | $657.95 | $657.95 | 6.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $60.25 | $60.25 | 2.6× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$610.45–$1,220.90 | $610.45–$1,220.90 | varies |
| Shoulder Arthrography (73040) | $2,127.70 | $2,127.70 | 6.3× |
| Sialogram (70390) | $1,763 | $1,763 | 7.7× |
| Skull less than 4 views (70250) | $682.20 | $682.20 | 6.8× |
| Sternoclavicular joints (71130) | $543.45 | $543.45 | 6.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,606.55 | $1,606.55 | 9.5× |
| Thoracic spine 2 views (72070) | $610.45 | $610.45 | 6.1× |
| Thoracic spine 3 views (72072) | $864.55 | $864.55 | 8.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,634 | $2,634 | 6.8× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$691.25–$1,382.50 | $691.25–$1,382.50 | varies |
| Ultrasound elastography first target lesion (76982) | $1,351.70 | $1,351.70 | 13.4× |
| Ultrasound Elastography Parenchyma (76981) | $1,351.75 | $1,351.75 | 13.4× |
| Ultrasound Exam Aaa Screen (76706) | $439.15 | $439.15 | 4.4× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$879–$1,464.25 | $879–$1,464.25 | varies |
| Umbilical-artery Doppler (OB) (76820) | $464.75 | $464.75 | 4.6× |
| Unlisted fluoroscopic procedure (76496) | $273.55 | $273.55 | 3.3× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$1,756.70–$2,899.45 | $1,756.70–$2,899.45 | varies |
| Urethrocystogram voiding (74455) | $1,606.75 | $1,606.75 | 7.0× |
| Urethrocystography retrograde (74450) | $1,606.75 | $1,606.75 | 7.0× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$1,036.95–$2,073.90 | $1,036.95–$2,073.90 | varies |
| Us chest (76604) | $910.25 | $910.25 | 9.0× |
| Us complete joint (76881) | $54 | $54 | 0.5× |
| Us exam, pelvic, limited (76857) | $1,104.25 | $1,104.25 | 11.0× |
| Us head (76506) | $960.45 | $960.45 | 9.5× |
| Us kidney transplant (76776) | $1,570.15 | $1,570.15 | 15.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 6 matching MRF lines |
$337.10–$1,964.80 | $337.10–$1,964.80 | varies |
| Us ob detailed single fetus (76811) | $1,440.05 | $1,440.05 | 6.3× |
| Us ob limited 1 or more fetuses (76815) | $1,318.90 | $1,318.90 | 13.1× |
| Us ob transvaginal (76817) | $953.60 | $953.60 | 9.5× |
| Us pelvic non ob complete (76856) | $1,492.95 | $1,492.95 | 14.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,440.05 | $1,440.05 | 14.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,318.90 | $1,318.90 | 13.1× |
| Us retroperitoneal complete (76770) | $1,037.30 | $1,037.30 | 10.3× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$953.60–$965.15 | $953.60–$965.15 | varies |
| Us scrotum and contents (76870) | $1,152.55 | $1,152.55 | 11.4× |
| Us thyroid (76536) range across 2 matching MRF lines |
$910.25–$1,152.55 | $910.25–$1,152.55 | varies |
| Us transrectal (76872) | $1,152.55 | $1,152.55 | 11.4× |
| Vein X-Ray Chest (75827) | $5,787.60 | $5,787.60 | 3.8× |
| Venography caval inferior serialography rs&i (75825) | $5,052.65 | $5,052.65 | 1.7× |
| Venography extremity bilateral rs&i (75822) | $5,889.50 | $5,889.50 | 3.9× |
| Venography extremity unilateral rs&i (75820) | $3,926.30 | $3,926.30 | 2.6× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$657.95–$1,315.90 | $657.95–$1,315.90 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $578.85 | $578.85 | 6.9× |
| X-ray antegrade pyelogram tube (74425) | $1,236.05 | $1,236.05 | 3.7× |
| X-Ray Aorta Leg Arteries (75630) | $8,165.65 | $8,165.65 | 2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$687.30–$1,374.60 | $687.30–$1,374.60 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$1,151.55–$1,352.90 | $1,151.55–$1,352.90 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $493.30 | $493.30 | 5.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $610.45 | $610.45 | 7.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $657.95 | $657.95 | 7.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $797.65 | $797.65 | 7.9× |
| X-Ray Exam L-S Spine Bending (72114) | $1,099.60 | $1,099.60 | 10.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $816.45 | $816.45 | 9.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,123.70 | $1,123.70 | 11.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,162.05 | $1,162.05 | 11.5× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$687.30–$1,374.60 | $687.30–$1,374.60 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,617.45 | $1,617.45 | 9.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $840.60 | $840.60 | 10.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,009.35 | $1,009.35 | 10.0× |
| X-ray nose-rectum child f.b. (76010) | $405.25 | $405.25 | 4.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,162.05 | $1,162.05 | 11.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $753.90 | $753.90 | 7.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $753.90 | $753.90 | 9.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $787.60 | $787.60 | 9.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $912.60 | $912.60 | 9.1× |
| X-ray thoracic spine 4 vw (72074) | $864.55 | $864.55 | 8.6× |
| X-Ray Tmj Unilat (70328) | $396.35 | $396.35 | 4.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,284.85 | $1,284.85 | 3.8× |
| X-Rays Bone Length Studies (77073) | $766.15 | $766.15 | 7.6× |
| X-Rays Bone Survey Complete (77075) | $3,252.10 | $3,252.10 | 32.3× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$903.05–$945.75 | $903.05–$945.75 | varies |
| Xr orbits complete 4 views (70200) | $749.45 | $749.45 | 7.4× |
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.