Imaging prices at Lindsborg Community Hospital

Lindsborg, KS · every code in this section with a posted price and a Medicare benchmark.

390 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $5,659.50 $8,085 4.4×
Abdomen 1 View (74018) $313.39 $447.70 3.9×
Abdomen 2 views (74019) $420.42 $600.60 4.4×
Acute Gastrointestinal Blood Loss Imaging (78278) $801.78 $1,145.40 2.2×
Adrenal Cortex & Medulla Img (78075) $985.18 $1,407.40 0.8×
Angio internal mammary (75756) $5,196.87 $7,424.10 1.8×
Angio pulmonary bilat (75743) $4,572.54 $6,532.20 1.6×
Angiography extremity bilateral rs&i (75716) $4,572.54 $6,532.20 1.6×
Angiography extremity unilateral rs&i (75710) $4,572.54 $6,532.20 1.6×
Angiography pulmonary unilateral slctv rs&i (75741) $4,572.54 $6,532.20 1.6×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $1,850.45 $2,643.50 0.6×
Ankle 2 views (73600) $383.25 $547.50 4.8×
Aortography thoracic serialography rs&i (75605) $4,572.54 $6,532.20 0.9×
Aortography thoracic w/o serialography rs&i (75600) $4,572.54 $6,532.20 1.6×
Artery X-Rays Abdomen (75726) $4,572.54 $6,532.20 0.9×
Artery X-Rays Pelvis (75736) $4,572.54 $6,532.20 0.9×
Arthrogram ankle (73615) $475.86 $679.80 1.5×
Arthrogram hip (73525) $497.14 $710.20 1.5×
Arthrogram Wrist (73115) $569.73 $813.90 1.8×
Basic radiation dosimetry calculation (77300) $487.20 $696 3.9×
Bone age studies (77072) $383.25 $547.50 4.0×
Bone Imaging 3 Phase (78315) $573.93 $819.90 1.6×
Bone Imaging Limited Area (78300) $1,036.49 $1,480.70 2.8×
Bone Imaging Multiple Areas (78305) $1,221.43 $1,744.90 3.3×
Bone Imaging Whole Body (78306) $1,887.34 $2,696.20 5.1×
Bone survey infant (77076)
range across 2 matching MRF lines
$337.40–$386.40 $482–$552 varies
Brachytx isodose complex (77318) $1,255.52 $1,793.60 3.6×
Brachytx isodose intermed (77317) $867.09 $1,238.70 2.5×
Brachytx Isodose Plan Simple (77316) $726.18 $1,037.40 2.1×
Brain Flow Imaging Only (78610) $400.40 $572 0.8×
Brain Image W/Flow < 4 Views (78601) $719.39 $1,027.70 2.0×
Brain imaging < 4 static views (78600) $596.82 $852.60 1.6×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $1,192.87 $1,704.10 2.4×
Brain Imaging Minimum 4 Static Views (78605) $1,104.74 $1,578.20 2.2×
Brain Imaging Pet Metabolic Evaluation (78608) $4,965.87 $7,094.10 3.8×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $1,670.90 $2,387 4.5×
Cat Scan Follow-Up Study (76380)
range across 3 matching MRF lines
$160.30–$678.02 $229–$968.60 varies
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $686.42 $980.60 1.4×
Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) $806.05 $1,151.50 1.6×
Cerebrospinal Fluid Scan (78630) $1,005.13 $1,435.90 2.0×
Chest 1 view (71045) $259.63 $370.90 3.2×
Chest 2 views (71046) $394.80 $564 4.9×
Chest 3 views (71047) $480.20 $686 6.0×
Chest 4 or more views (71048) $548.45 $783.50 5.7×
Cholecystography Oral Contrast (74290) $458.64 $655.20 2.8×
Clavicle complete (73000) $407.54 $582.20 5.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $285.53 $407.90 3.0×
Continuing medical physics consltj pr wk (77336) $1,079.05 $1,541.50 8.7×
Contrast Exam Abdominl Aorta (75625) $4,572.54 $6,532.20 1.6×
Contrast X-Ray Bladder (74430) $736.05 $1,051.50 2.3×
Contrast X-Ray Of Elbow (73085)
range across 2 matching MRF lines
$362.25–$905.52 $517.50–$1,293.60 varies
Contrast X-Ray Of Knee Joint (73580) $749.14 $1,070.20 2.3×
Contrast Xray Throat/Cerv Esopha (74210) $509.95 $728.50 3.2×
CT abdomen and pelvis without and with contrast (74178) $2,277.24 $3,253.20 7.1×
CT abdomen and pelvis without contrast (74176)
range across 2 matching MRF lines
$595.56–$1,891.75 $850.80–$2,702.50 varies
CT abdomen w contrast (74160) $1,891.75 $2,702.50 11.7×
CT abdomen w wo contrast (74170) $2,277.24 $3,253.20 14.1×
CT abdomen w/o contrast (74150) $1,891.75 $2,702.50 19.7×
CT Angio Abdomen and Pelvis (74174) $974.61 $1,392.30 3.0×
CT Angio Chest (71275) $2,277.24 $3,253.20 14.1×
CT Angio Head (70496) $2,277.24 $3,253.20 14.1×
CT angio hrt w/3d image (75574) $626.92 $895.60 2.0×
Ct Angio Lwr Extr W/O&W/Dye (73706) $2,277.24 $3,253.20 14.1×
CT Angio Neck (70498) $2,277.24 $3,253.20 14.1×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,277.24 $3,253.20 14.1×
CT bone density (77078) $1,281.21 $1,830.30 16.0×
CT cervical spine w/ contrast (72126) $1,891.75 $2,702.50 5.9×
CT cervical spine w/o contrast (72125) $1,891.75 $2,702.50 19.7×
CT cervical spine w/wo cont (72127) $2,277.24 $3,253.20 14.1×
CT chest w contrast (71260) $1,891.75 $2,702.50 11.7×
CT chest w/wo contrast (71270) $2,277.24 $3,253.20 14.1×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $1,774.92 $2,535.60 11.0×
CT colonogrphy dx image postprocess w/o contrast (74261) $1,774.92 $2,535.60 18.5×
CT head/brain with contrast (70460) $1,891.75 $2,702.50 11.7×
CT head/brain without and with contrast (70470) $2,277.24 $3,253.20 14.1×
CT heart contrast eval cardiac structure&morph (75572) $626.92 $895.60 2.0×
CT heart no contrast quant eval coronry calcium (75571) $210 $300 2.6×
CT hrt w/3d image congen (75573) $626.92 $895.60 2.0×
CT iac w contrast (70481) $1,891.75 $2,702.50 11.7×
CT l-spine w&w/o contrast (72133) $2,277.24 $3,253.20 14.1×
CT lower ext w/o (73700) $1,891.75 $2,702.50 19.7×
CT lower extremity w/contrast material (73701) $1,891.75 $2,702.50 11.7×
CT lumbar spine w contrast (72132) $1,891.75 $2,702.50 5.9×
CT lumbar spine w/o contrast (72131) $1,891.75 $2,702.50 19.7×
CT maxillofacial w contrast (70487) $1,891.75 $2,702.50 11.7×
CT maxillofacial wo contrast (70486) $1,891.75 $2,702.50 19.7×
CT neck tissue combo (70492) $2,277.24 $3,253.20 14.1×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $2,277.24 $3,253.20 14.1×
CT orbits w/o contrast (70480) $1,891.75 $2,702.50 19.7×
CT pelvis w&w/o contrast (72194) $2,277.24 $3,253.20 14.1×
CT pelvis w/o contrast (72192) $1,891.75 $2,702.50 19.7×
CT scan of leg combo (73702) $2,277.24 $3,253.20 14.1×
CT scans face/jaw combo (70488) $2,277.24 $3,253.20 14.1×
CT soft tissue neck w contrast (70491) $1,891.75 $2,702.50 11.7×
CT soft tissue neck w/o contrast (70490) $1,891.75 $2,702.50 19.7×
CT thoracic spine w contrast (72129) $1,891.75 $2,702.50 11.7×
CT thoracic spine w/o contrast (72128) $1,891.75 $2,702.50 19.7×
CT thoracic spine w/wo cont (72130) $2,277.24 $3,253.20 14.1×
CT thorax w/o contrast (71250) $1,891.75 $2,702.50 19.7×
CT unlisted procedure (76497) $400.75 $572.50 5.0×
CT upper ext wo (73200) $1,891.75 $2,702.50 19.7×
CT upper extremity w/o & w/contrast material (73202) $2,277.24 $3,253.20 14.1×
CT upper extremity with contrast (73201) $1,891.75 $2,702.50 5.9×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $4,623.64 $6,605.20 28.7×
Cta Abdomen (74175) $2,277.24 $3,253.20 14.1×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $2,277.24 $3,253.20 7.1×
CTA pelvis (72191) $2,277.24 $3,253.20 14.1×
Discography Cerv/Thor Spine (72285) $2,345.56 $3,350.80 1.3×
Diskography lumbar (72295)
range across 2 matching MRF lines
$2,345.56–$2,443.63 $3,350.80–$3,490.90 varies
Doppler Fetal Mid Cerebral Artery (76821) $223.65 $319.50 2.3×
Dxa Bone Density Axial (77080)
range across 2 matching MRF lines
$161.07–$392.07 $230.10–$560.10 varies
Dxa bone density study 1/>sites appendiclr skel (77081) $154.35 $220.50 1.9×
Echo exam uterus (76831) $1,409.31 $2,013.30 6.4×
Echo Guide For Artery Repair (76936) $1,093.54 $1,562.20 5.5×
Echograp Trans R Pros Study (76873) $1,323.77 $1,891.10 13.8×
Esophagram (74220) $369.18 $527.40 2.3×
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 2 matching MRF lines
$201.39–$1,237.11 $287.70–$1,767.30 varies
Fluoroscopy up to 1 hr (76000) $475.86 $679.80 2.2×
Foot 2 views (73620) $383.25 $547.50 4.8×
Forearm 2 views (73090) $374.92 $535.60 4.7×
Gastric emptying imaging study (78264) $1,944.46 $2,777.80 5.3×
Gastroesophageal Reflux Exam (78262) $1,018.08 $1,454.40 2.8×
Gated Heart Planar Single (78472) $1,706.25 $2,437.50 4.6×
Hand 2 views (73120) $383.25 $547.50 4.0×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $4,227.93 $6,039.90 6.6×
Heart first pass single,planar (78481) $1,706.25 $2,437.50 3.4×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $4,572.54 $6,532.20 1.6×
Hepatobil Syst Image W/Drug (78227) $1,550.15 $2,214.50 3.1×
Hepatobiliary System Imaging (78226) $1,550.15 $2,214.50 4.2×
Ht Muscle Image Spect Sing (78451) $3,876.60 $5,538 3.3×
Hysterosalpingogram (74740) $651 $930 3.0×
Infant hip ultrasound with hip movement (dynamic) (76885) $1,409.31 $2,013.30 17.6×
Infant hip ultrasound, limited static exam (76886) $154 $220 1.9×
Infusion Ivp (74410) $1,089.06 $1,555.80 6.8×
Interstitial radiation source applic complex (77778) $3,528.07 $5,040.10 5.5×
Intracavitary Radiation Source Applic Complex (77763) $1,109.08 $1,584.40 1.7×
Intracavitary Radiation Source Applic Intermed (77762) $824.53 $1,177.90 1.6×
Intracavitary radiation source applic simple (77761) $694.89 $992.70 1.4×
Joint Survey Single View (77077) $366.17 $523.10 3.8×
K Flow/Funct Image Multiple (78709) $1,999.76 $2,856.80 4.0×
K Flow/Funct Image W/Drug (78708)
range across 2 matching MRF lines
$385.49–$1,999.76 $550.70–$2,856.80 varies
K Flow/Funct Image W/O Drug (78707) $1,504.72 $2,149.60 3.0×
Kidney Funcj Study Non-Img Radioisotopic Study (78725) $969.64 $1,385.20 2.6×
Kidney Imaging Morphol (78700) $1,045.31 $1,493.30 2.8×
Knee 3 Views (73562)
range across 3 matching MRF lines
$138.46–$454.51 $197.80–$649.30 varies
Leveen/Shunt Patency Exam (78291) $740.60 $1,058 2.0×
Liver & Spleen Imaging Static Only (78215) $1,070.51 $1,529.30 2.9×
Liver & Spleen Imaging W/Vascular Flow (78216) $1,541.75 $2,202.50 4.2×
Liver imaging static only (78201) $797.37 $1,139.10 1.6×
Liver imaging w/vascular flow (78202) $1,018.08 $1,454.40 2.0×
Lung Perf&Ventilat Diferentl (78598) $2,574.04 $3,677.20 5.2×
Lung perfusion differential (78597) $1,073.73 $1,533.90 2.9×
Lung Ventilat&Perfus Imaging (78582) $1,886.01 $2,694.30 3.8×
Lung Ventilation Imaging (78579) $1,074.92 $1,535.60 2.9×
Lymph System Imaging (78195) $841.47 $1,202.10 1.7×
Magnetic Image Jaw Joint (70336) $814.24 $1,163.20 3.7×
Mammary ductogram or galactogram multiple (77054) $521.29 $744.70 2.4×
Mammary ductogram or galactogram single (77053) $557.13 $795.90 2.5×
Meckels Divert Exam (78290) $1,109.08 $1,584.40 3.0×
Mlc imrt design & construction per imrt plan (77338) $1,773.03 $2,532.90 5.1×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $43.75 $62.50 1.6×
Mra Head W/O & W/Contrast Material (70546) $3,960.39 $5,657.70 12.3×
MRA head w/o contrast (70544) $2,988.72 $4,269.60 13.6×
MRA head with contrast (70545) $2,988.72 $4,269.60 9.3×
MRA neck w contrast (70548) $2,988.72 $4,269.60 9.3×
Mra Neck W/O &W/Contrast Material (70549) $3,960.39 $5,657.70 12.3×
MRA neck w/o contrast (70547) $2,988.72 $4,269.60 13.6×
MRI abdomen w contrast (74182) $2,988.72 $4,269.60 9.3×
MRI abdomen w/o contrast (74181) $2,988.72 $4,269.60 13.6×
MRI any jt lower extrem w/contrast material (73722) $2,741.90 $3,917 3.8×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,185.07 $4,550.10 9.9×
MRI any jt upper extremity w/contrast matrl (73222) $2,741.90 $3,917 3.8×
MRI Breast W/O Contrast Bilateral (77047) $2,988.72 $4,269.60 13.6×
MRI Breast Without Contrast Material Unilateral (77046) $2,988.72 $4,269.60 13.6×
MRI cervical spine w contrast (72142) $2,988.72 $4,269.60 9.3×
MRI cervical spine w/o cont (72141)
range across 2 matching MRF lines
$710.50–$2,988.72 $1,015–$4,269.60 varies
MRI chest w/o contrast (71550) $2,988.72 $4,269.60 13.6×
MRI chest with contrast (71551) $2,988.72 $4,269.60 4.1×
MRI chest wo w contrast (71552) $3,960.39 $5,657.70 12.3×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,741.90 $3,917 8.5×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $3,185.07 $4,550.10 9.9×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,741.90 $3,917 12.5×
MRI lumbar spine w contrast (72149) $2,988.72 $4,269.60 9.3×
Mri Neck Spine W/O & W/Dye (72156) $3,960.39 $5,657.70 12.3×
MRI orbit face &/neck w/o contrast (70540) $2,741.90 $3,917 12.5×
MRI orbit face neck w contrast (70542) $2,988.72 $4,269.60 9.3×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,960.39 $5,657.70 12.3×
MRI pelvis w contrast (72196) $2,988.72 $4,269.60 9.3×
MRI pelvis w/o & w contrast (72197) $3,960.39 $5,657.70 12.3×
MRI pelvis w/o contrast (72195) $2,988.72 $4,269.60 13.6×
MRI thoracic spine w/o contrast (72146)
range across 2 matching MRF lines
$710.50–$2,988.72 $1,015–$4,269.60 varies
MRI upper extremity oth than jt w/contr matrl (73219) $2,741.90 $3,917 8.5×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,741.90 $3,917 12.5×
Mri Uppr Extremity W/O&W/Dye (73220) $3,185.07 $4,550.10 9.9×
MRI, abdomen, combo (74183) $3,960.39 $5,657.70 12.3×
MRI, dorsal spine combo (72157) $3,960.39 $5,657.70 12.3×
MRI, dorsal spine contrast (72147) $2,988.72 $4,269.60 9.3×
MRI, joint upper extrem (73221) $2,741.90 $3,917 12.5×
MRI, joint upper extrem combo (73223) $3,185.07 $4,550.10 9.9×
MRI, lumbar spine combo (72158) $3,960.39 $5,657.70 12.3×
Myelogram Lumbar (72265)
range across 2 matching MRF lines
$4,202.94–$4,773.02 $6,004.20–$6,818.60 varies
Myelography thoracic (72255) $4,773.02 $6,818.60 6.6×
Myelograpy 2/more regions rs&i (72270) $5,039.16 $7,198.80 7.0×
Myocardial Imaging Pet Metabolic Evaluation (78459) $4,965.87 $7,094.10 4.2×
Myocardial Spect Multiple Studies (78452) $4,194.40 $5,992 3.5×
Neck soft tissue (70360) $349.16 $498.80 4.4×
Ntsty modul radthx pln dose-vol histos (77301) $5,813.15 $8,304.50 4.6×
Nuclear Rx Intra-Arterial (79445) $613.97 $877.10 2.9×
Nuclear Rx Oral Admin (79005) $467.46 $667.80 2.2×
Optic foramina (70190) $467.46 $667.80 5.8×
Parathyroid Planar Imaging (78070) $985.18 $1,407.40 2.7×
Parathyroid planar imaging w/wo subtraction (78071)
range across 2 matching MRF lines
$523.46–$900.48 $747.80–$1,286.40 varies
Pelvis 1 or 2 views (72170) $411.95 $588.50 4.3×
PET image w/CT, full body (78816)
range across 2 matching MRF lines
$4,965.87–$9,115.75 $7,094.10–$13,022.50 varies
PET imaging CT attenuation skull base mid-thigh (78815) $4,965.87 $7,094.10 3.8×
PET whole body (78813) $4,965.87 $7,094.10 3.8×
Pulmonary Perfusion Imaging Particulate (78580) $703.57 $1,005.10 1.9×
Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) $1,662.50 $2,375 1.9×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $823.06 $1,175.80 8.6×
Radex abscess/fistula/sinus tract rs&i (76080)
range across 2 matching MRF lines
$507.43–$735.91 $724.90–$1,051.30 varies
Radex Ankle Complete Minimum 3 Views (73610) $501.41 $716.30 6.3×
Radex Calcaneus Minimum 2 Views (73650) $383.25 $547.50 4.8×
Radex elbow complete minimum 3 views (73080) $451.71 $645.30 5.6×
Radex Facial Bones Complete Minimum 3 Views (70150) $548.45 $783.50 5.7×
Radex fingr minimum 2 views (73140) $181.79 $259.70 2.3×
Radex foot complete minimum 3 views (73630) $411.95 $588.50 5.1×
Radex Hand Minimum 3 Views (73130) $426.16 $608.80 5.3×
Radex lower extremity infant minimum 2 views (73592)
range across 2 matching MRF lines
$43.33–$279.30 $61.90–$399 varies
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $582.68 $832.40 6.1×
Radex Nasal Bones Complete Minimum 3 Views (70160) $370.51 $529.30 4.6×
Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) $366.24 $523.20 4.6×
Radex Ribs Unilateral 2 Views (71100) $319.41 $456.30 4.0×
Radex shoulder complete minimum 2 views (73030)
range across 2 matching MRF lines
$55.09–$431.83 $78.70–$616.90 varies
Radex Sinuses Paransl < 3 Views (70210) $399 $570 5.0×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $1,611.33 $2,301.90 10.0×
Radex Spine 1 View Specify Level (72020) $400.40 $572 5.0×
Radex Sternum Minimum 2 Views (71120)
range across 2 matching MRF lines
$45.64–$514.29 $65.20–$734.70 varies
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $394.80 $564 4.9×
Radex Toe Minimum 2 Views (73660) $181.79 $259.70 2.3×
Radex upper extremity infant minimum 2 views (73092) $243.74 $348.20 2.5×
Radex Wrist Complete Minimum 3 Views (73110) $426.16 $608.80 5.3×
Radiation Delivery Stereotactic Cranial Linear (77372) $8,324.26 $11,891.80 1.2×
Radiation treatment delivery level 1 (77402) $185.50 $265 2.0×
Radiation treatment delivery level 2 (77407) $689.50 $985 1.9×
Radiation treatment delivery level 3 (77412) $990.50 $1,415 1.9×
Radiolog exam mandible compl minimum 4 views (70110) $573.93 $819.90 6.0×
Radiologic exam colon double contrast study (74280) $1,188.95 $1,698.50 7.4×
Radiologic exam colon single contrast study (74270) $938.28 $1,340.40 5.8×
Radiologic Exam Esophagus Double Contrast Study (74221) $472.78 $675.40 2.9×
Radiologic exam knee complete 4/more views (73564)
range across 4 matching MRF lines
$94.43–$481.39 $134.90–$687.70 varies
Radiologic exam pelvis compl minimum 3 views (72190) $433.02 $618.60 4.5×
Radiologic Exam Small Int Single Contrast Study (74250) $823.06 $1,175.80 5.1×
Radiologic exam swallow function contrast study (74230) $665.07 $950.10 4.1×
Radiologic exam teeth complete full mouth (70320) $312.13 $445.90 1.4×
Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) $245.42 $350.60 1.1×
Radiologic exam upr gi trc double contrast study (74246) $986.72 $1,409.60 6.1×
Radiologic examination femur 1 view (73551) $108.08 $154.40 1.4×
Radiologic examination femur minimum 2 views (73552) $431.83 $616.90 5.4×
Radiologic examination knee 1/2 views (73560) $263.97 $377.10 3.3×
Radiologic Examination Osseous Survey Limited (77074) $657.86 $939.80 6.8×
Radiologic Examination Salivary Gland Calculus (70380) $352.17 $503.10 4.4×
Radiologic examination tibia & fibula 2 views (73590) $420.42 $600.60 5.3×
Radiologic examination, teeth; single view Non-Facility (70300) $191.38 $273.40 2.4×
Ribs bilateral 3 views (71110) $362.25 $517.50 3.8×
Rp loclzj tum plnr 1 area single day imaging (78800) $362.25 $517.50 1.0×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801)
range across 2 matching MRF lines
$435.89–$1,315.37 $622.70–$1,879.10 varies
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804)
range across 3 matching MRF lines
$2,379.72–$3,943.45 $3,399.60–$5,633.50 varies
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $2,630.18 $3,757.40 5.3×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 3 matching MRF lines
$1,887.34–$2,284.31 $2,696.20–$3,263.30 varies
Rp Therapy Intravenous Administration (79101) $613.97 $877.10 2.9×
Salivary Gland Imaging (78230) $695.80 $994 1.9×
Scapula (73010) $426.16 $608.80 4.4×
Screening Digital Breast Tomosynthesis Bi (77063) $59.92 $85.60 2.6×
Sella turcica (70240) $312.13 $445.90 3.9×
Shoulder 1 view (73020) $294.98 $421.40 3.7×
Shoulder Arthrography (73040) $878.71 $1,255.30 2.7×
Sialogram (70390) $407.54 $582.20 1.9×
Skull less than 4 views (70250) $455.98 $651.40 4.7×
Special dosimetry (77331) $249.62 $356.60 2.0×
Special Physics Consult (77370) $1,114.68 $1,592.40 9.0×
Special teletherapy port plan (77321) $1,254.26 $1,791.80 3.6×
Special treatment procedure (77470) $1,675.38 $2,393.40 3.3×
Spleen Imaging (78185) $841.47 $1,202.10 2.3×
Stereotactic Body Radiation Delivery (77373) $4,814.53 $6,877.90 2.9×
Sternoclavicular joints (71130) $383.25 $547.50 4.8×
Superior sagittal sinus venogram (75870) $4,572.54 $6,532.20 1.6×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,214.43 $1,734.90 3.5×
Telethx isodose pln smpl w/dosimetry calculation (77306) $717.71 $1,025.30 2.1×
Temporomandble Jt Arthrography Rs&I (70332) $571.13 $815.90 2.6×
Testicular Imaging W/Flow (78761) $1,074.92 $1,535.60 2.9×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $2,913.26 $4,161.80 8.5×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $2,123.52 $3,033.60 6.2×
Ther rad simulaj-aided field setting simple (77280) $1,547.49 $2,210.70 12.5×
Thoracic spine 2 views (72070) $611.24 $873.20 6.4×
Thoracic spine 3 views (72072) $649.32 $927.60 6.8×
Thoracolumbar 2 views (72080) $564.06 $805.80 7.0×
Thyroid Imaging With Vascular Flow (78013) $793.80 $1,134 2.2×
Thyroid Met Imaging Body (78018) $1,419.39 $2,027.70 2.8×
Thyroid Uptake Measurement (78012) $481.39 $687.70 1.3×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,101.87 $1,574.10 3.0×
Tx Devices Design & Construction Complex (77334) $1,168.79 $1,669.70 3.4×
Tx devices design & construction intermediate (77333) $505.68 $722.40 4.1×
Tx devices design & construction simple (77332) $443.10 $633 3.6×
Ultrasound Breast Limited (76642) $426.37 $609.10 5.3×
Ultrasound Elastography Parenchyma (76981) $279.09 $398.70 2.9×
Ultrasound Exam Aaa Screen (76706) $284.41 $406.30 3.0×
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines
$116.27–$389.20 $166.10–$556 varies
Umbilical-artery Doppler (OB) (76820) $287.56 $410.80 3.0×
Unlisted Dx Radiographic Procedure (76499) $579.74 $828.20 7.2×
Unlisted respiratory px dx nuclear medicine (78599) $861.63 $1,230.90 2.3×
Unlisted us procedure (76999) $220.15 $314.50 2.8×
Upper gi w/o kub (74240) $965.02 $1,378.60 6.0×
Urethrocystogram voiding (74455) $679.42 $970.60 3.1×
Urethrocystography retrograde (74450) $679.42 $970.60 3.1×
Us breast unilateral complete (76641) $639.38 $913.40 6.6×
Us chest (76604) $1,237.11 $1,767.30 12.9×
Us complete joint (76881) $1,237.11 $1,767.30 12.9×
Us exam, pelvic, limited (76857) $971.04 $1,387.20 10.1×
Us head (76506) $1,237.11 $1,767.30 12.9×
Us kidney transplant (76776) $1,237.11 $1,767.30 12.9×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $761.74 $1,088.20 7.9×
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines
$392.07–$411.95 $560.10–$588.50 varies
Us ob transvaginal (76817) $392.07 $560.10 4.1×
Us pelvic non ob complete (76856) $1,386.42 $1,980.60 14.4×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801)
range across 2 matching MRF lines
$203.70–$480.27 $291–$686.10 varies
Us preg uterus real time f/u trnsabdl per fetus (76816)
range across 2 matching MRF lines
$188.72–$392.07 $269.60–$560.10 varies
Us retroperitoneal complete (76770) $1,237.11 $1,767.30 12.9×
Us retroperitoneal limited (76775)
range across 2 matching MRF lines
$128.24–$389.20 $183.20–$556 varies
Us scrotum and contents (76870) $1,237.11 $1,767.30 12.9×
Us spinal canal and contents (76800) $1,261.33 $1,801.90 13.1×
Us thyroid (76536) $1,237.11 $1,767.30 12.9×
Us transrectal (76872) $1,323.77 $1,891.10 13.8×
Vasogram (74440) $501.41 $716.30 2.3×
Vein X-Ray Chest (75827) $1,850.45 $2,643.50 1.3×
Vein X-Ray Skull Epidural (75872) $1,850.45 $2,643.50 3.2×
Vein X-Ray Spleen/Liver (75810) $564.06 $805.80 0.2×
Venography Adrenal Unilateral (75840) $4,572.54 $6,532.20 1.6×
Venography caval inferior serialography rs&i (75825) $4,572.54 $6,532.20 1.6×
Venography extremity bilateral rs&i (75822) $1,850.45 $2,643.50 1.3×
Venography extremity unilateral rs&i (75820) $1,850.45 $2,643.50 1.3×
Venography Renal Bilateral (75833) $4,572.54 $6,532.20 1.6×
Venography Renal Unilateral (75831) $4,572.54 $6,532.20 1.6×
Venous sampling by catheter (75893) $4,572.54 $6,532.20 0.9×
Venous thrombosis imaging (78457) $955.50 $1,365 1.9×
Venous Thrombosis Imaging Venogram Bilateral (78458) $1,235.71 $1,765.30 3.4×
Wrist 2 views (73100) $383.25 $547.50 4.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $455.98 $651.40 5.7×
X-ray antegrade pyelogram tube (74425) $643.79 $919.70 2.0×
X-Ray Aorta Leg Arteries (75630) $4,572.54 $6,532.20 1.6×
X-Ray Bend Only L-S Spine (72120) $521.29 $744.70 5.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $411.95 $588.50 5.1×
X-Ray Exam Breast Specimen (76098) $515.55 $736.50 1.0×
X-Ray Exam Entire Spi 1 Vw (72081) $108.08 $154.40 1.4×
X-Ray Exam Entire Spi 2/3 Vw (72082)
range across 2 matching MRF lines
$180.60–$1,342.46 $258–$1,917.80 varies
X-Ray Exam Hip Uni 1 View (73501)
range across 2 matching MRF lines
$145.53–$263.97 $207.90–$377.10 varies
X-Ray Exam Hip Uni 2-3 Views (73502)
range across 2 matching MRF lines
$145.53–$434.63 $207.90–$620.90 varies
X-Ray Exam Hip Uni 4/> Views (73503) $215.11 $307.30 2.2×
X-Ray Exam Hips Bi 2 Views (73521) $713.58 $1,019.40 7.4×
X-Ray Exam Hips Bi 3-4 Views (73522) $298.69 $426.70 3.1×
X-Ray Exam Hips Bi 5/> Views (73523) $334.39 $477.70 3.5×
X-Ray Exam L-S Spine Bending (72114) $760.48 $1,086.40 7.9×
X-Ray Exam Neck Spine 2-3 Vw (72040) $455.98 $651.40 5.7×
X-Ray Exam Neck Spine 6/>Vws (72052) $713.58 $1,019.40 7.4×
X-Ray Exam Unilat Ribs/Chest (71101) $557.13 $795.90 5.8×
X-ray eye for foreign body (70030) $366.17 $523.10 4.6×
X-ray head for orthodontia (70350) $98.07 $140.10 1.2×
X-ray humerus (73060) $335.23 $478.90 4.2×
X-ray IV pyelogram (ivp) (74400) $894.04 $1,277.20 5.5×
X-ray IV pyelogram+tomography (74415) $1,406.44 $2,009.20 8.7×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $504.28 $720.40 6.3×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $267.68 $382.40 3.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $557.13 $795.90 5.8×
X-ray nose-rectum child f.b. (76010) $389.20 $556 4.9×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $512.82 $732.60 5.3×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $428.68 $612.40 4.5×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $363.37 $519.10 3.8×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $428.68 $612.40 5.4×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $565.46 $807.80 7.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $536.97 $767.10 5.6×
X-ray thoracic spine 4 vw (72074) $429.94 $614.20 4.5×
X-Ray Tmj Unilat (70328) $265.30 $379 3.3×
X-Ray Urinary Tract Exam With Contrast Material (74420) $894.04 $1,277.20 2.8×
X-Rays Bone Length Studies (77073)
range across 2 matching MRF lines
$431.97–$820.19 $617.10–$1,171.70 varies
X-Rays Bone Survey Complete (77075) $1,261.33 $1,801.90 13.1×
Xr c-spine 4 or 5 views (72050) $635.18 $907.40 6.6×
Xr facial bones less than 3 views (70140) $333.55 $476.50 4.2×
XR Mastoids < 3 Views Bilateral (70120) $435.89 $622.70 4.5×
Xr myelogram posterior fossa (70010) $1,025.22 $1,464.60 3.2×
Xr orbits complete 4 views (70200) $521.29 $744.70 5.4×
Xr Tomogram Single Plane (76100) $871.22 $1,244.60 9.1×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.