Imaging prices at Logan Health - Shelby
Shelby, MT · every code in this section with a posted price and a Medicare benchmark.
357 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) range across 7 matching MRF lines |
$13.65–$181.51 | $21–$279.25 | varies |
| Abdomen 2 views (74019) range across 5 matching MRF lines |
$17.55–$331.82 | $27–$510.50 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $71.50 | $110 | 0.2× |
| Angio internal mammary (75756) | $83.20 | $128 | 0.0× |
| Angio pulmonary bilat (75743) | $117.65 | $181 | 0.0× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $93.60 | $144 | 0.0× |
| Angiography extremity bilateral rs&i (75716) | $142.35 | $219 | 0.0× |
| Angiography extremity unilateral rs&i (75710) | $127.40 | $196 | 0.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $92.95 | $143 | 0.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $80.60 | $124 | 0.0× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$13–$233.19 | $20–$358.75 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$81.90 | $126 | 0.0× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$143.65 | $221 | 0.0× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$80.60 | $124 | 0.0× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$174.85 | $269 | 0.0× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$44.20–$421.04 | $68–$647.75 | varies |
| Arthrogram Wrist (73115) | $42.25 | $65 | 0.1× |
| Bone age studies (77072) range across 2 matching MRF lines |
$14.30–$185.90 | $22–$286 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$73.45–$1,500.36 | $113–$2,308.25 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$46.15–$475.31 | $71–$731.25 | varies |
| Bone Imaging Multiple Areas (78305) | $59.80 | $92 | 0.1× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$62.40–$1,218.59 | $96–$1,874.75 | varies |
| Bone marrow imaging; whole body (78104) | $57.20 | $88 | 0.1× |
| Bone survey infant (77076) | $52 | $80 | 0.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $46.80 | $72 | 0.1× |
| Brain Imaging Minimum 4 Static Views (78605) | $39 | $60 | 0.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $105.30 | $162 | 0.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $189.15 | $291 | 0.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $216.45 | $333 | 0.3× |
| Cardiac Shunt Detection (78428) | $56.55 | $87 | 0.1× |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$70.20–$745.22 | $108–$1,146.50 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $40.30 | $62 | 0.1× |
| Cerebrospinal Fluid Scan (78630) | $49.40 | $76 | 0.1× |
| Chest 1 view (71045) range across 12 matching MRF lines |
$13.65–$181.51 | $21–$279.25 | varies |
| Chest 2 views (71046) range across 6 matching MRF lines |
$16.25–$241.15 | $25–$371 | varies |
| Chest 3 views (71047) | $20.80 | $32 | 0.2× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$23.40–$270.40 | $36–$416 | varies |
| Clavicle complete (73000) range across 6 matching MRF lines |
$13–$201.82 | $20–$310.50 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$79.30–$1,044.71 | $122–$1,607.25 | varies |
| Contrast Exam Abdominl Aorta (75625) | $104 | $160 | 0.0× |
| Contrast X-Ray Bladder (74430) | $23.40 | $36 | 0.1× |
| Contrast X-Ray Of Elbow (73085) | $42.90 | $66 | 0.1× |
| Contrast X-Ray Of Knee Joint (73580) | $42.90 | $66 | 0.1× |
| CT abdomen and pelvis without and with contrast (74178) range across 4 matching MRF lines |
$146.90–$2,088.78 | $226–$3,213.50 | varies |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$128.05–$1,305.52 | $197–$2,008.50 | varies |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$92.95–$1,421.88 | $143–$2,187.50 | varies |
| CT abdomen w wo contrast (74170) range across 4 matching MRF lines |
$102.05–$1,959.75 | $157–$3,015 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$87.10–$1,131.65 | $134–$1,741 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 3 matching MRF lines |
$159.90–$1,538.88 | $246–$2,367.50 | varies |
| CT Angio Chest (71275) range across 6 matching MRF lines |
$133.25–$2,175.71 | $205–$3,347.25 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$128.05–$2,030.76 | $197–$3,124.25 | varies |
| CT angio hrt w/3d image (75574) | $174.20 | $268 | 0.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$137.80–$1,549.28 | $212–$2,383.50 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$128.05–$2,030.76 | $197–$3,124.25 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $131.30 | $202 | 0.7× |
| CT bone density (77078) | $18.20 | $28 | 0.2× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$89.05–$1,304.06 | $137–$2,006.25 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$73.45–$1,392.62 | $113–$2,142.50 | varies |
| CT cervical spine w/wo cont (72127) | $92.30 | $142 | 0.5× |
| CT chest w contrast (71260) range across 6 matching MRF lines |
$85.80–$1,392.62 | $132–$2,142.50 | varies |
| CT chest w/wo contrast (71270) range across 5 matching MRF lines |
$91–$1,625.32 | $140–$2,500.50 | varies |
| CT colonography screening (74263) | $169.65 | $261 | 0.7× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $176.15 | $271 | 1.6× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$83.20–$967.36 | $128–$1,488.25 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$92.95–$1,092.98 | $143–$1,681.50 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $126.75 | $195 | 0.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $43.55 | $67 | 0.5× |
| CT iac w contrast (70481) range across 4 matching MRF lines |
$83.20–$1,388.40 | $128–$2,136 | varies |
| CT l-spine w&w/o contrast (72133) | $92.30 | $142 | 0.5× |
| CT lower ext w/o (73700) range across 17 matching MRF lines |
$73.45–$1,131.65 | $113–$1,741 | varies |
| CT lower extremity w/contrast material (73701) range across 21 matching MRF lines |
$85.15–$1,288.95 | $131–$1,983 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$89.05–$1,190.15 | $137–$1,831 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$73.45–$1,131.65 | $113–$1,741 | varies |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$82.55–$1,305.52 | $127–$2,008.50 | varies |
| CT maxillofacial wo contrast (70486) range across 6 matching MRF lines |
$62.40–$1,044.71 | $96–$1,607.25 | varies |
| CT neck tissue combo (70492) | $119.60 | $184 | 0.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$92.30–$1,637.02 | $142–$2,518.50 | varies |
| CT orbits w/o contrast (70480) range across 5 matching MRF lines |
$93.60–$1,305.52 | $144–$2,008.50 | varies |
| CT pelvis w&w/o contrast (72194) range across 3 matching MRF lines |
$89.05–$1,651.81 | $137–$2,541.25 | varies |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$79.95–$977.28 | $123–$1,503.50 | varies |
| CT scan of leg combo (73702) | $88.40 | $136 | 0.5× |
| CT scans face/jaw combo (70488) range across 4 matching MRF lines |
$92.95–$1,740.70 | $143–$2,678 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$100.75–$1,740.70 | $155–$2,678 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$93.60–$1,017.25 | $144–$1,565 | varies |
| CT thoracic spine w contrast (72129) | $89.05 | $137 | 0.5× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$73.45–$1,043.74 | $113–$1,605.75 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$92.30–$1,082.58 | $142–$1,665.50 | varies |
| CT thorax w/o contrast (71250) range across 9 matching MRF lines |
$79.30–$1,044.71 | $122–$1,607.25 | varies |
| CT upper ext wo (73200) range across 26 matching MRF lines |
$73.45–$957.45 | $113–$1,473 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $89.05 | $137 | 0.5× |
| CT upper extremity with contrast (73201) range across 27 matching MRF lines |
$85.15–$920.89 | $131–$1,416.75 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$174.20–$2,030.76 | $268–$3,124.25 | varies |
| Cta Abdomen (74175) range across 4 matching MRF lines |
$132.60–$1,132.30 | $204–$1,742 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $128.05 | $197 | 0.4× |
| CTA pelvis (72191) range across 2 matching MRF lines |
$131.95–$1,641.25 | $203–$2,525 | varies |
| Dilation ureters/urethra rs&i (74485) | $59.15 | $91 | 0.0× |
| Discography Cerv/Thor Spine (72285) | $86.45 | $133 | 0.0× |
| Diskography lumbar (72295) | $62.40 | $96 | 0.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $41.60 | $64 | 0.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $52 | $80 | 0.5× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$14.95–$344.18 | $23–$529.50 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$15.60–$150.48 | $24–$231.50 | varies |
| Echo exam of fetal heart (76825) | $122.20 | $188 | 0.2× |
| Echo exam uterus (76831) | $53.95 | $83 | 0.2× |
| Echo Guide For Artery Repair (76936) | $144.30 | $222 | 0.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $61.10 | $94 | 0.3× |
| Esophagram (74220) range across 4 matching MRF lines |
$44.85–$445.58 | $69–$685.50 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$78–$327.60 | $120–$504 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$57.20–$209.79 | $88–$322.75 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $220.35 | $339 | 0.9× |
| Fluoroscopy up to 1 hr (76000) range across 9 matching MRF lines |
$23.40–$362.21 | $36–$557.25 | varies |
| Follow-Up Angiography (75898) | $134.55 | $207 | 0.0× |
| Foot 2 views (73620) range across 10 matching MRF lines |
$11.70–$264.88 | $18–$407.50 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$12.35–$176.80 | $19–$272 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$57.20–$796.74 | $88–$1,225.75 | varies |
| Gastroesophageal Reflux Exam (78262) | $50.05 | $77 | 0.1× |
| Gated Heart Planar Single (78472) | $70.20 | $108 | 0.2× |
| Hand 2 views (73120) range across 8 matching MRF lines |
$13–$182.49 | $20–$280.75 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $78 | $120 | 0.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $79.30 | $122 | 0.0× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$65–$1,289.11 | $100–$1,983.25 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$53.95–$1,500.36 | $83–$2,308.25 | varies |
| Ht Muscle Image Spect Sing (78451) range across 4 matching MRF lines |
$98.80–$1,150.50 | $152–$1,770 | varies |
| Hysterosalpingogram (74740) | $28.60 | $44 | 0.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $54.60 | $84 | 0.6× |
| Infant hip ultrasound, limited static exam (76886) | $46.80 | $72 | 0.5× |
| Joint Survey Single View (77077) | $26 | $40 | 0.2× |
| K Flow/Funct Image W/Drug (78708) range across 3 matching MRF lines |
$86.45–$365.95 | $133–$563 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$68.25–$1,307.64 | $105–$2,011.75 | varies |
| Kidney Imaging Morphol (78700) | $32.50 | $50 | 0.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $35.75 | $55 | 0.1× |
| Knee 3 Views (73562) range across 9 matching MRF lines |
$14.30–$306.96 | $22–$472.25 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $38.35 | $59 | 0.1× |
| Leveen/Shunt Patency Exam (78291) | $62.40 | $96 | 0.2× |
| Liver & Spleen Imaging Static Only (78215) | $35.75 | $55 | 0.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $40.30 | $62 | 0.1× |
| Lung Perf&Ventilat Diferentl (78598) | $59.80 | $92 | 0.1× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$76.70–$1,235.98 | $118–$1,901.50 | varies |
| Lung Ventilation Imaging (78579) | $35.10 | $54 | 0.1× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$85.80–$947.70 | $132–$1,458 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $85.80 | $132 | 0.1× |
| Lymphangiography extremity only unilateral rs&i (75801) | $66.95 | $103 | 0.1× |
| Magnetic Image Jaw Joint (70336) | $107.90 | $166 | 0.4× |
| Mammary ductogram or galactogram single (77053) | $26.65 | $41 | 0.1× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$49.40–$952.41 | $76–$1,465.25 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$107.90–$2,559.21 | $166–$3,937.25 | varies |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$87.75–$1,720.06 | $135–$2,646.25 | varies |
| MRA head with contrast (70545) range across 3 matching MRF lines |
$87.75–$1,628.09 | $135–$2,504.75 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$109.20–$1,709.50 | $168–$2,630 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$132.60–$1,934.08 | $204–$2,975.50 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$88.40–$1,139.78 | $136–$1,753.50 | varies |
| MRI abdomen w contrast (74182) range across 4 matching MRF lines |
$127.40–$1,709.50 | $196–$2,630 | varies |
| MRI abdomen w/o contrast (74181) range across 5 matching MRF lines |
$106.60–$1,504.42 | $164–$2,314.50 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 17 matching MRF lines |
$120.25–$1,628.09 | $185–$2,504.75 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 11 matching MRF lines |
$157.95–$2,623.24 | $243–$4,035.75 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 17 matching MRF lines |
$120.25–$1,653.11 | $185–$2,543.25 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $117 | $180 | 0.5× |
| MRI cardiac w/o contrast (75557) | $170.30 | $262 | 0.7× |
| MRI cervical spine w contrast (72142) | $131.30 | $202 | 0.4× |
| MRI cervical spine w/o cont (72141) range across 5 matching MRF lines |
$108.55–$1,618.82 | $167–$2,490.50 | varies |
| MRI chest w/o contrast (71550) range across 6 matching MRF lines |
$106.60–$1,732.25 | $164–$2,665 | varies |
| MRI chest with contrast (71551) | $127.40 | $196 | 0.2× |
| MRI chest wo w contrast (71552) range across 5 matching MRF lines |
$165.10–$2,552.55 | $254–$3,927 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 11 matching MRF lines |
$119.60–$1,796.11 | $184–$2,763.25 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 11 matching MRF lines |
$157.95–$2,623.24 | $243–$4,035.75 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 11 matching MRF lines |
$98.80–$1,747.20 | $152–$2,688 | varies |
| MRI lumbar spine w contrast (72149) range across 4 matching MRF lines |
$131.30–$1,800.82 | $202–$2,770.50 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 5 matching MRF lines |
$168.35–$2,450.82 | $259–$3,770.50 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 3 matching MRF lines |
$98.15–$1,149.69 | $151–$1,768.75 | varies |
| MRI orbit face neck w contrast (70542) | $119.60 | $184 | 0.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$157.30–$2,562.14 | $242–$3,941.75 | varies |
| MRI pelvis w contrast (72196) range across 6 matching MRF lines |
$127.40–$1,977.30 | $196–$3,042 | varies |
| MRI pelvis w/o & w contrast (72197) range across 8 matching MRF lines |
$161.20–$2,602.92 | $248–$4,004.50 | varies |
| MRI pelvis w/o contrast (72195) range across 9 matching MRF lines |
$106.60–$1,750.94 | $164–$2,693.75 | varies |
| MRI spectroscopy (76390) | $104 | $160 | 1.2× |
| MRI thoracic spine w/o contrast (72146) range across 4 matching MRF lines |
$108.55–$1,655.88 | $167–$2,547.50 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $119.60 | $184 | 0.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 17 matching MRF lines |
$98.80–$1,296.42 | $152–$1,994.50 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 17 matching MRF lines |
$157.95–$2,237.30 | $243–$3,442 | varies |
| MRI, abdomen, combo (74183) range across 8 matching MRF lines |
$161.20–$1,934.08 | $248–$2,975.50 | varies |
| MRI, dorsal spine combo (72157) range across 4 matching MRF lines |
$168.35–$2,259.40 | $259–$3,476 | varies |
| MRI, dorsal spine contrast (72147) range across 4 matching MRF lines |
$131.30–$1,709.50 | $202–$2,630 | varies |
| MRI, joint upper extrem (73221) range across 11 matching MRF lines |
$100.10–$1,323.08 | $154–$2,035.50 | varies |
| MRI, joint upper extrem combo (73223) range across 11 matching MRF lines |
$158.60–$2,304.41 | $244–$3,545.25 | varies |
| MRI, lumbar spine combo (72158) range across 4 matching MRF lines |
$168.35–$2,237.14 | $259–$3,441.75 | varies |
| Myelogram cervical (72240) | $67.60 | $104 | 0.1× |
| Myelogram Lumbar (72265) | $60.45 | $93 | 0.1× |
| Myelography thoracic (72255) | $71.50 | $110 | 0.1× |
| Myelograpy 2/more regions rs&i (72270) | $99.45 | $153 | 0.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $111.80 | $172 | 0.1× |
| Myocardial Spect Multiple Studies (78452) range across 9 matching MRF lines |
$116.35–$1,649.38 | $179–$2,537.50 | varies |
| N-invas est c ffr sw aly CTA (75580) | $54.60 | $84 | 0.1× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$13.65–$201.82 | $21–$310.50 | varies |
| Nm csf leak detection (78650) | $38.35 | $59 | 0.0× |
| Nonvascular Shunt X-Ray (75809) | $36.40 | $56 | 0.3× |
| Nuclear Rx Intra-Arterial (79445) | $167.70 | $258 | 0.7× |
| Nuclear Rx Oral Admin (79005) | $128.70 | $198 | 0.5× |
| Ob us nuchal meas 1 gest (76813) | $87.10 | $134 | 0.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $46.80 | $72 | 0.4× |
| Optic foramina (70190) | $16.90 | $26 | 0.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $111.80 | $172 | 0.2× |
| Parathyroid Planar Imaging (78070) | $57.85 | $89 | 0.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $85.80 | $132 | 0.2× |
| Pelvis 1 or 2 views (72170) range across 7 matching MRF lines |
$13–$264.88 | $20–$407.50 | varies |
| Pet Image Skull-Thigh (78812) | $135.85 | $209 | 0.1× |
| Pet Image W/Ct Lmtd (78814) | $156 | $240 | 0.1× |
| PET image w/CT, full body (78816) | $175.50 | $270 | 0.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $174.20 | $268 | 0.1× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $14.30 | $22 | 0.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $99.45 | $153 | 0.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $53.95 | $83 | 0.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$23.40–$346.45 | $36–$533 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $39 | $60 | 0.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$13–$345.31 | $20–$531.25 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 6 matching MRF lines |
$12.35–$220.84 | $19–$339.75 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$13–$306.96 | $20–$472.25 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$19.50–$306.96 | $30–$472.25 | varies |
| Radex fingr minimum 2 views (73140) range across 6 matching MRF lines |
$10.40–$162.18 | $16–$249.50 | varies |
| Radex foot complete minimum 3 views (73630) range across 5 matching MRF lines |
$13–$345.31 | $20–$531.25 | varies |
| Radex Hand Minimum 3 Views (73130) range across 7 matching MRF lines |
$13–$246.84 | $20–$379.75 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$12.35–$185.90 | $19–$286 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $25.35 | $39 | 0.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$13–$258.05 | $20–$397 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$16.90–$264.88 | $26–$407.50 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 17 matching MRF lines |
$14.30–$192.72 | $22–$296.50 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $13 | $20 | 0.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $85.80 | $132 | 0.5× |
| Radex Spine 1 View Specify Level (72020) range across 8 matching MRF lines |
$12.35–$103.84 | $19–$159.75 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$14.95–$201.82 | $23–$310.50 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$18.20–$133.09 | $28–$204.75 | varies |
| Radex Toe Minimum 2 Views (73660) range across 6 matching MRF lines |
$10.40–$201.82 | $16–$310.50 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $12.35 | $19 | 0.1× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 17 matching MRF lines |
$13–$221.98 | $20–$341.50 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $31.20 | $48 | 0.3× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$18.20–$274.95 | $28–$423 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $20.15 | $31 | 0.2× |
| Radiologic exam colon double contrast study (74280) | $91.65 | $141 | 0.5× |
| Radiologic exam colon single contrast study (74270) | $76.05 | $117 | 0.4× |
| Radiologic exam knee complete 4/more views (73564) range across 7 matching MRF lines |
$16.90–$346.45 | $26–$533 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 4 matching MRF lines |
$18.85–$346.45 | $29–$533 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $59.80 | $92 | 0.3× |
| Radiologic exam swallow function contrast study (74230) range across 3 matching MRF lines |
$39.65–$527.31 | $61–$811.25 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 4 matching MRF lines |
$65.65–$363.02 | $101–$558.50 | varies |
| Radiologic examination femur 1 view (73551) range across 6 matching MRF lines |
$13–$185.90 | $20–$286 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$13.65–$264.88 | $21–$407.50 | varies |
| Radiologic examination knee 1/2 views (73560) range across 10 matching MRF lines |
$13–$264.88 | $20–$407.50 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $32.50 | $50 | 0.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$12.35–$264.88 | $19–$407.50 | varies |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $20.80 | $32 | 0.0× |
| Renal Cyst Study (74470) | $39 | $60 | 0.1× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$21.45–$276.25 | $33–$425 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $47.45 | $73 | 0.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $53.30 | $82 | 0.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $72.15 | $111 | 0.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $57.20 | $88 | 0.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $76.70 | $118 | 0.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $130 | $200 | 0.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $150.15 | $231 | 0.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $104.65 | $161 | 0.1× |
| Salivary Gland Imaging Serial Images (78231) | $32.50 | $50 | 0.1× |
| Scapula (73010) range across 3 matching MRF lines |
$13.65–$201.82 | $21–$310.50 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $73.29 | $112.75 | 3.1× |
| Sella turcica (70240) | $14.30 | $22 | 0.2× |
| Shoulder 1 view (73020) range across 14 matching MRF lines |
$11.70–$148.69 | $18–$228.75 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$41.60–$709.64 | $64–$1,091.75 | varies |
| Sialogram (70390) | $28.60 | $44 | 0.1× |
| Skull less than 4 views (70250) range across 5 matching MRF lines |
$13.65–$181.51 | $21–$279.25 | varies |
| Sternoclavicular joints (71130) | $16.25 | $25 | 0.2× |
| Testicular Imaging W/Flow (78761) | $52.65 | $81 | 0.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $153.40 | $236 | 0.9× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$15.60–$223.28 | $24–$343.50 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$16.90–$247.98 | $26–$381.50 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$15.60–$153.56 | $24–$236.25 | varies |
| Thyroid Met Imaging Body (78018) | $61.10 | $94 | 0.1× |
| Thyroid Uptake Measurement (78012) | $13.65 | $21 | 0.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $36.40 | $56 | 0.1× |
| Ultrasound Breast Limited (76642) range across 5 matching MRF lines |
$50.70–$260.65 | $78–$401 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$41.60–$565.99 | $64–$870.75 | varies |
| Ultrasound, abdomen limited (76705) range across 5 matching MRF lines |
$44.20–$470.92 | $68–$724.50 | varies |
| Umbilical-artery Doppler (OB) (76820) | $273.81 | $421.25 | 2.6× |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$59.48–$62.56 | $91.50–$96.25 | varies |
| Unlisted us procedure (76999) | $207.51 | $319.25 | 2.3× |
| Upper gi w/o kub (74240) range across 7 matching MRF lines |
$59.15–$433.88 | $91–$667.50 | varies |
| Ureteral Reflux Study (78740) | $40.95 | $63 | 0.1× |
| Urethrocystogram voiding (74455) range across 6 matching MRF lines |
$23.40–$392.92 | $36–$604.50 | varies |
| Urethrocystography retrograde (74450) | $24.05 | $37 | 0.1× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$53.95–$298.02 | $83–$458.50 | varies |
| Us chest (76604) range across 4 matching MRF lines |
$42.90–$393.90 | $66–$606 | varies |
| Us complete joint (76881) range across 5 matching MRF lines |
$46.80–$290.39 | $72–$446.75 | varies |
| Us exam, pelvic, limited (76857) range across 7 matching MRF lines |
$36.40–$487.82 | $56–$750.50 | varies |
| Us head (76506) | $47.45 | $73 | 0.4× |
| Us kidney transplant (76776) | $55.90 | $86 | 0.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 13 matching MRF lines |
$35.75–$160.39 | $55–$246.75 | varies |
| Us ob detailed single fetus (76811) | $139.75 | $215 | 0.6× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$48.75–$383.66 | $75–$590.25 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$55.90–$426.40 | $86–$656 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$51.35–$569.40 | $79–$876 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$72.80–$327.60 | $112–$504 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$63.05–$232.21 | $97–$357.25 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$54.60–$565.99 | $84–$870.75 | varies |
| Us retroperitoneal limited (76775) range across 6 matching MRF lines |
$43.55–$358.64 | $67–$551.75 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$47.45–$500.34 | $73–$769.75 | varies |
| Us spinal canal and contents (76800) | $88.40 | $136 | 0.8× |
| Us thyroid (76536) range across 4 matching MRF lines |
$42.25–$505.05 | $65–$777 | varies |
| Us transrectal (76872) | $49.40 | $76 | 0.5× |
| Vein X-Ray Chest (75827) | $83.20 | $128 | 0.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $100.75 | $155 | 0.0× |
| Venogram Sinus/Jugular (75860) | $83.20 | $128 | 0.0× |
| Venography Adrenal Unilateral (75840) | $83.20 | $128 | 0.0× |
| Venography caval inferior serialography rs&i (75825) | $82.55 | $127 | 0.0× |
| Venography extremity bilateral rs&i (75822) | $106.60 | $164 | 0.1× |
| Venography extremity unilateral rs&i (75820) | $77.35 | $119 | 0.0× |
| Venography Renal Bilateral (75833) | $106.60 | $164 | 0.0× |
| Venography Renal Unilateral (75831) | $79.30 | $122 | 0.0× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$39 | $60 | 0.0× |
| Wrist 2 views (73100) range across 10 matching MRF lines |
$13–$295.75 | $20–$455 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$14.30–$223.28 | $22–$343.50 | varies |
| X-ray antegrade pyelogram tube (74425) | $37.05 | $57 | 0.1× |
| X-Ray Aorta Leg Arteries (75630) | $144.95 | $223 | 0.0× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$16.90–$303.55 | $26–$467 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$13–$254.64 | $20–$391.75 | varies |
| X-Ray Exam Breast Specimen (76098) | $23.40 | $36 | 0.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$19.50–$264.88 | $30–$407.50 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $23.40 | $36 | 0.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$26.65–$181.84 | $41–$279.75 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 6 matching MRF lines |
$14.30–$210.60 | $22–$324 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 5 matching MRF lines |
$16.90–$264.88 | $26–$407.50 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $20.80 | $32 | 0.2× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$16.90–$220.19 | $26–$338.75 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$22.10–$181.84 | $34–$279.75 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$23.40–$264.88 | $36–$407.50 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$22.75–$282.10 | $35–$434 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 6 matching MRF lines |
$16.90–$258.05 | $26–$397 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$22.10–$327.60 | $34–$504 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$20.15–$137.15 | $31–$211 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$13.65–$136.99 | $21–$210.75 | varies |
| X-ray humerus (73060) range across 6 matching MRF lines |
$13–$233.19 | $20–$358.75 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$35.75–$523.09 | $55–$804.75 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $58.50 | $90 | 0.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$13–$195.49 | $20–$300.75 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 6 matching MRF lines |
$16.90–$264.88 | $26–$407.50 | varies |
| X-ray nose-rectum child f.b. (76010) | $13.65 | $21 | 0.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$23.40–$180.21 | $36–$277.25 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$16.90–$137.15 | $26–$211 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$13–$130.65 | $20–$201 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$13–$264.88 | $20–$407.50 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$16.25–$151.78 | $25–$233.50 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$20.80–$326.14 | $32–$501.75 | varies |
| X-ray thoracic spine 4 vw (72074) | $18.20 | $28 | 0.2× |
| X-Ray Tmj Unilat (70328) | $13.65 | $21 | 0.2× |
| X-Rays Bone Length Studies (77073) | $20.80 | $32 | 0.2× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$41.60–$357.01 | $64–$549.25 | varies |
| Xr c-spine 4 or 5 views (72050) range across 4 matching MRF lines |
$20.80–$319.80 | $32–$492 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$15.60–$264.88 | $24–$407.50 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 3 matching MRF lines |
$13.65–$247.98 | $21–$381.50 | varies |
| Xr orbits complete 4 views (70200) | $20.80 | $32 | 0.2× |
| Xr Tomogram Single Plane (76100) | $44.20 | $68 | 0.4× |
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.