Imaging prices at Lucile Salter Packard Children's Hsp at Stanford
Palo Alto, CA · every code in this section with a posted price and a Medicare benchmark.
370 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) | $11,420.50 | $22,841 | 5.6× |
| Abdomen 1 View (74018) | $1,186.50 | $2,373 | 9.3× |
| Abdomen 2 views (74019) | $1,362 | $2,724 | 8.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $4,365 | $8,730 | 7.4× |
| Angio internal mammary (75756) | $13,151.50 | $26,303 | 2.8× |
| Angio pulmonary bilat (75743) | $6,223.50 | $12,447 | 1.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $6,430 | $12,860 | 1.4× |
| Angiography extremity bilateral rs&i (75716) | $10,728.50 | $21,457 | 2.3× |
| Angiography extremity unilateral rs&i (75710) | $17,325.50 | $34,651 | 3.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $17,325.50 | $34,651 | 3.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,472.50 | $6,945 | 0.7× |
| Ankle 2 views (73600) | $741.50 | $1,483 | 5.8× |
| Aortography thoracic serialography rs&i (75605) | $5,106 | $10,212 | 0.6× |
| Aortography thoracic w/o serialography rs&i (75600) | $17,325.50 | $34,651 | 3.7× |
| Artery X-Rays Abdomen (75726) | $17,325.50 | $34,651 | 2.1× |
| Artery X-Rays Adrenal Gland (75731) | $6,430 | $12,860 | 1.4× |
| Artery X-Rays Pelvis (75736) | $6,430 | $12,860 | 0.8× |
| Artery X-Rays Spine (75705) | $17,325.50 | $34,651 | 2.1× |
| Arthrogram ankle (73615) | $968.50 | $1,937 | 1.9× |
| Arthrogram hip (73525) | $968.50 | $1,937 | 1.9× |
| Arthrogram Wrist (73115) | $982.50 | $1,965 | 1.9× |
| Basic radiation dosimetry calculation (77300) | $120 | $240 | 0.6× |
| Bone age studies (77072) | $741.50 | $1,483 | 4.8× |
| Bone Imaging 3 Phase (78315) | $4,211 | $8,422 | 7.2× |
| Bone Imaging Limited Area (78300) | $3,333.50 | $6,667 | 5.7× |
| Bone Imaging Multiple Areas (78305) | $2,970.50 | $5,941 | 5.1× |
| Bone Imaging Whole Body (78306) | $3,799.50 | $7,599 | 6.5× |
| Bone marrow imaging; whole body (78104) | $3,719 | $7,438 | 6.3× |
| Bone survey infant (77076) | $1,779.50 | $3,559 | 11.6× |
| Brain imaging < 4 static views (78600) | $3,353 | $6,706 | 5.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $8,559 | $17,118 | 4.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $7,069.50 | $14,139 | 13.8× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $7,683 | $15,366 | 6.7× |
| Cardiac Shunt Detection (78428) | $3,587.50 | $7,175 | 6.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,564 | $5,128 | 3.2× |
| Chest 1 view (71045) | $1,036.50 | $2,073 | 8.1× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$1,036.50–$1,186.50 | $2,073–$2,373 | varies |
| Chest 3 views (71047) | $1,273 | $2,546 | 9.9× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$1,465–$1,567.50 | $2,930–$3,135 | varies |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $1,061 | $2,122 | 6.9× |
| Clavicle complete (73000) | $818 | $1,636 | 6.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $5,690 | $11,380 | 37.0× |
| Contrast Exam Abdominl Aorta (75625) | $17,325.50 | $34,651 | 3.7× |
| Contrast X-Ray Bladder (74430) | $1,445.50 | $2,891 | 2.8× |
| Contrast X-Ray Of Elbow (73085) | $968.50 | $1,937 | 1.9× |
| Contrast X-Ray Of Knee Joint (73580) | $968.50 | $1,937 | 1.9× |
| CT abdomen and pelvis without and with contrast (74178) | $8,841.50 | $17,683 | 17.2× |
| CT abdomen and pelvis without contrast (74176) | $7,687 | $15,374 | 21.9× |
| CT abdomen w contrast (74160) | $6,341 | $12,682 | 24.6× |
| CT abdomen w wo contrast (74170) | $6,196 | $12,392 | 24.0× |
| CT abdomen w/o contrast (74150) | $5,765 | $11,530 | 37.5× |
| CT Angio Abdomen and Pelvis (74174) range across 3 matching MRF lines |
$6,629.50–$9,987 | $13,259–$19,974 | varies |
| CT Angio Chest (71275) | $6,375.50 | $12,751 | 24.7× |
| CT Angio Head (70496) | $6,988.50 | $13,977 | 27.1× |
| CT angio hrt w/3d image (75574) | $4,304 | $8,608 | 8.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $7,919.50 | $15,839 | 30.7× |
| CT Angio Neck (70498) | $6,988.50 | $13,977 | 27.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $8,208.50 | $16,417 | 31.8× |
| CT cervical spine w/ contrast (72126) | $4,755 | $9,510 | 9.3× |
| CT cervical spine w/o contrast (72125) | $4,323 | $8,646 | 28.1× |
| CT cervical spine w/wo cont (72127) | $4,973 | $9,946 | 19.3× |
| CT chest w contrast (71260) | $6,341 | $12,682 | 24.6× |
| CT chest w/wo contrast (71270) | $6,629.50 | $13,259 | 25.7× |
| CT head/brain with contrast (70460) | $4,756 | $9,512 | 18.4× |
| CT head/brain without and with contrast (70470) | $4,973 | $9,946 | 19.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $4,218.50 | $8,437 | 8.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $3,429 | $6,858 | 26.8× |
| CT hrt w/3d image congen (75573) | $4,304 | $8,608 | 8.4× |
| CT iac w contrast (70481) | $5,284 | $10,568 | 20.5× |
| CT l-spine w&w/o contrast (72133) | $4,647.50 | $9,295 | 18.0× |
| CT lower ext w/o (73700) | $4,805.50 | $9,611 | 31.3× |
| CT lower extremity w/contrast material (73701) | $5,284 | $10,568 | 20.5× |
| CT lumbar spine w contrast (72132) | $4,755 | $9,510 | 9.3× |
| CT lumbar spine w/o contrast (72131) | $4,323 | $8,646 | 28.1× |
| CT maxillofacial w contrast (70487) | $3,700 | $7,400 | 14.3× |
| CT maxillofacial wo contrast (70486) | $3,365 | $6,730 | 21.9× |
| CT neck tissue combo (70492) | $6,629.50 | $13,259 | 25.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $5,526 | $11,052 | 21.4× |
| CT orbits w/o contrast (70480) | $4,805.50 | $9,611 | 31.3× |
| CT pelvis w&w/o contrast (72194) | $6,196 | $12,392 | 24.0× |
| CT pelvis w/o contrast (72192) | $5,765 | $11,530 | 37.5× |
| CT scan of leg combo (73702) | $5,526 | $11,052 | 21.4× |
| CT scans face/jaw combo (70488) | $3,869 | $7,738 | 15.0× |
| CT soft tissue neck w contrast (70491) | $6,341 | $12,682 | 24.6× |
| CT soft tissue neck w/o contrast (70490) | $5,765 | $11,530 | 37.5× |
| CT thoracic spine w contrast (72129) | $4,755 | $9,510 | 18.4× |
| CT thoracic spine w/o contrast (72128) | $4,323 | $8,646 | 28.1× |
| CT thoracic spine w/wo cont (72130) | $4,973 | $9,946 | 19.3× |
| CT thorax w/o contrast (71250) | $5,765 | $11,530 | 37.5× |
| CT unlisted procedure (76497) | $554 | $1,108 | 4.3× |
| CT upper ext wo (73200) | $4,805.50 | $9,611 | 31.3× |
| CT upper extremity w/o & w/contrast material (73202) | $5,164 | $10,328 | 20.0× |
| CT upper extremity with contrast (73201) | $5,284 | $10,568 | 10.3× |
| Cta Abdomen (74175) | $7,509.50 | $15,019 | 29.1× |
| CTA pelvis (72191) | $7,018.50 | $14,037 | 27.2× |
| Dilation ureters/urethra rs&i (74485) | $4,197.50 | $8,395 | 1.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 2 matching MRF lines |
$826–$831.50 | $1,652–$1,663 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$1,084.50–$1,092 | $2,169–$2,184 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) | $864.50 | $1,729 | 5.6× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$323.50–$589.50 | $647–$1,179 | varies |
| Dxa bone density study (77085) | $323.50 | $647 | 2.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $192.50 | $385 | 1.5× |
| Echo exam of fetal heart (76825) | $2,117 | $4,234 | 2.6× |
| Echo Guide For Artery Repair (76936) | $2,408 | $4,816 | 7.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,970.50 | $3,941 | 5.6× |
| Esophageal Motility Study (78258) | $4,812 | $9,624 | 8.2× |
| Esophagram (74220) | $1,751 | $3,502 | 6.8× |
| Fetal Biophys Profile W/Nst (76818) | $1,079.50 | $2,159 | 7.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $935.50 | $1,871 | 6.1× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $6,147 | $12,294 | 17.5× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$1,781.50–$2,199.50 | $3,563–$4,399 | varies |
| Follow-Up Angiography (75898) | $2,172.50 | $4,345 | 0.5× |
| Foot 2 views (73620) | $741.50 | $1,483 | 5.8× |
| Forearm 2 views (73090) | $781.50 | $1,563 | 6.1× |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$3,602.50–$4,876.50 | $7,205–$9,753 | varies |
| Gastroesophageal Reflux Exam (78262) | $2,991.50 | $5,983 | 5.1× |
| Gated Heart Planar Single (78472) | $2,214.50 | $4,429 | 3.8× |
| Gated Heart, Multiple (78473) | $5,134 | $10,268 | 8.7× |
| Hand 2 views (73120) | $741.50 | $1,483 | 4.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $11,760 | $23,520 | 2.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,072.50 | $6,145 | 0.7× |
| Hepatobil Syst Image W/Drug (78227) | $3,751 | $7,502 | 4.7× |
| Hepatobiliary System Imaging (78226) | $4,170.50 | $8,341 | 7.1× |
| Ht Muscle Image Spect Sing (78451) range across 3 matching MRF lines |
$2,220–$5,210.50 | $4,440–$10,421 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,596 | $3,192 | 12.5× |
| Infant hip ultrasound, limited static exam (76886) | $1,205.50 | $2,411 | 9.4× |
| Joint Survey Single View (77077) | $1,663 | $3,326 | 10.8× |
| K Flow/Funct Image W/Drug (78708) | $3,528 | $7,056 | 4.4× |
| K Flow/Funct Image W/O Drug (78707) | $4,404 | $8,808 | 5.5× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $3,330 | $6,660 | 5.7× |
| Knee 3 Views (73562) | $980 | $1,960 | 7.7× |
| Liver & Spleen Imaging Static Only (78215) | $2,644 | $5,288 | 4.5× |
| Liver imaging static only (78201) | $2,238.50 | $4,477 | 2.8× |
| Liver imaging w/vascular flow (78202) | $3,587.50 | $7,175 | 4.5× |
| Lung perfusion differential (78597) | $4,596.50 | $9,193 | 7.8× |
| Lung Ventilat&Perfus Imaging (78582) | $4,349 | $8,698 | 5.4× |
| Lung Ventilation Imaging (78579) | $3,683 | $7,366 | 6.3× |
| Lymph System Imaging (78195) | $4,878.50 | $9,757 | 6.1× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $3,123.50 | $6,247 | 1.3× |
| Lymphangiography extremity only unilateral rs&i (75801) | $2,812 | $5,624 | 3.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,123.50 | $6,247 | 0.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $3,123.50 | $6,247 | 0.7× |
| Magnetic Image Jaw Joint (70336) | $4,958 | $9,916 | 14.1× |
| Magnetic Resonance Elastography (76391) | $3,276.50 | $6,553 | 9.3× |
| Meckels Divert Exam (78290) | $3,456.50 | $6,913 | 5.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $314.50 | $629 | 7.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $1,128.50 | $2,257 | 8.1× |
| Mr safety implt pos&/immoblj (76019) | $727.50 | $1,455 | 8.4× |
| Mr safety med physics xm customization plng&mntr (76017) | $2,959.50 | $5,919 | 8.4× |
| Mra Head W/O & W/Contrast Material (70546) | $7,683 | $15,366 | 15.0× |
| MRA head w/o contrast (70544) | $6,147 | $12,294 | 17.5× |
| MRA head with contrast (70545) | $7,069.50 | $14,139 | 13.8× |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$1,604.50–$7,069.50 | $3,209–$14,139 | varies |
| Mra Neck W/O &W/Contrast Material (70549) | $7,683 | $15,366 | 15.0× |
| MRA neck w/o contrast (70547) | $6,147 | $12,294 | 17.5× |
| MRI abdomen w contrast (74182) | $7,069.50 | $14,139 | 13.8× |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$1,604.50–$6,862.50 | $3,209–$13,725 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $7,069.50 | $14,139 | 6.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $7,683 | $15,366 | 15.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $6,607 | $13,214 | 5.7× |
| MRI bone marrow blood supply (77084) | $7,683 | $15,366 | 21.9× |
| MRI brain functional w/o physician admnistration (70554) | $3,380 | $6,760 | 9.6× |
| MRI brain functional w/physician admnistration (70555) | $3,380 | $6,760 | 9.6× |
| MRI cardiac w/o cont stress (75559) | $6,147 | $12,294 | 7.6× |
| MRI cardiac w/o contrast (75557) | $6,147 | $12,294 | 17.5× |
| MRI cervical spine w contrast (72142) | $7,069.50 | $14,139 | 13.8× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$4,119–$6,147 | $8,238–$12,294 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$1,604.50–$6,147 | $3,209–$12,294 | varies |
| MRI chest with contrast (71551) | $7,069.50 | $14,139 | 6.1× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$2,004.50–$7,683 | $4,009–$15,366 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $7,069.50 | $14,139 | 13.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,004.50–$7,683 | $4,009–$15,366 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,604.50–$6,147 | $3,209–$12,294 | varies |
| MRI lumbar spine w contrast (72149) | $7,069.50 | $14,139 | 13.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $7,683 | $15,366 | 15.0× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$5,745–$6,147 | $11,490–$12,294 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$6,607–$7,069.50 | $13,214–$14,139 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$7,180.50–$7,683 | $14,361–$15,366 | varies |
| MRI pelvis w contrast (72196) | $7,069.50 | $14,139 | 13.8× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$2,004.50–$7,683 | $4,009–$15,366 | varies |
| MRI pelvis w/o contrast (72195) range across 4 matching MRF lines |
$1,604.50–$6,147 | $3,209–$12,294 | varies |
| MRI spectroscopy (76390) | $3,276.50 | $6,553 | 25.6× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$4,119–$6,147 | $8,238–$12,294 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $7,069.50 | $14,139 | 13.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $6,147 | $12,294 | 17.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $7,683 | $15,366 | 15.0× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$2,004.50–$7,683 | $4,009–$15,366 | varies |
| MRI, dorsal spine combo (72157) | $7,683 | $15,366 | 15.0× |
| MRI, dorsal spine contrast (72147) | $7,069.50 | $14,139 | 13.8× |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$2,049.50–$6,147 | $4,099–$12,294 | varies |
| MRI, joint upper extrem combo (73223) | $7,683 | $15,366 | 15.0× |
| MRI, lumbar spine combo (72158) | $7,683 | $15,366 | 15.0× |
| Myelogram cervical (72240) | $2,372.50 | $4,745 | 2.1× |
| Myelogram Lumbar (72265) | $2,372.50 | $4,745 | 2.1× |
| Myelography thoracic (72255) | $2,372.50 | $4,745 | 2.1× |
| Myelograpy 2/more regions rs&i (72270) | $3,872 | $7,744 | 3.4× |
| Myocardial Spect Multiple Studies (78452) range across 4 matching MRF lines |
$5,153.50–$8,696 | $10,307–$17,392 | varies |
| Neck soft tissue (70360) | $727.50 | $1,455 | 5.7× |
| Nm csf leak detection (78650) | $3,119 | $6,238 | 1.6× |
| Nonvascular Shunt X-Ray (75809) | $667.50 | $1,335 | 4.3× |
| Nuclear Rx Intra-Arterial (79445) | $17,738 | $35,476 | 51.7× |
| Nuclear Rx Oral Admin (79005) | $3,583 | $7,166 | 10.4× |
| Ob us nuchal meas 1 gest (76813) | $754 | $1,508 | 4.9× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $718 | $1,436 | 4.7× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $1,136 | $2,272 | 5.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $718 | $1,436 | 4.7× |
| Ophthalmic us dx quantitative a-scan only (76511) | $718 | $1,436 | 4.7× |
| Panoramic X-ray of jaws (70355) | $772 | $1,544 | 6.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $4,211.50 | $8,423 | 5.3× |
| Parathyroid Planar Imaging (78070) | $3,587.50 | $7,175 | 6.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $3,246.50 | $6,493 | 5.5× |
| Pelvis 1 or 2 views (72170) | $1,036.50 | $2,073 | 6.7× |
| Peritoneogram Rs&I (74190) | $741 | $1,482 | 0.9× |
| Pet Image Skull-Thigh (78812) | $8,954 | $17,908 | 4.3× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $5,919 | $11,838 | 3.1× |
| PET whole body (78813) | $9,136 | $18,272 | 4.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $6,881 | $13,762 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $3,587.50 | $7,175 | 6.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,567.50 | $3,135 | 10.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$1,551.50–$3,254.50 | $3,103–$6,509 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $817.50 | $1,635 | 6.4× |
| Radex Calcaneus Minimum 2 Views (73650) | $890.50 | $1,781 | 7.0× |
| Radex elbow complete minimum 3 views (73080) | $817.50 | $1,635 | 6.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $877.50 | $1,755 | 5.7× |
| Radex fingr minimum 2 views (73140) | $595 | $1,190 | 4.6× |
| Radex foot complete minimum 3 views (73630) | $817.50 | $1,635 | 6.4× |
| Radex Hand Minimum 3 Views (73130) | $817.50 | $1,635 | 6.4× |
| Radex lower extremity infant minimum 2 views (73592) | $670 | $1,340 | 5.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $1,034 | $2,068 | 8.1× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $772 | $1,544 | 6.0× |
| Radex Ribs Unilateral 2 Views (71100) | $1,254 | $2,508 | 9.8× |
| Radex shoulder complete minimum 2 views (73030) | $1,023.50 | $2,047 | 8.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $660 | $1,320 | 5.2× |
| Radex Spine 1 View Specify Level (72020) | $741.50 | $1,483 | 5.8× |
| Radex Sternum Minimum 2 Views (71120) | $837 | $1,674 | 6.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $904.50 | $1,809 | 7.1× |
| Radex Toe Minimum 2 Views (73660) | $595 | $1,190 | 4.6× |
| Radex upper extremity infant minimum 2 views (73092) | $781.50 | $1,563 | 5.1× |
| Radex Wrist Complete Minimum 3 Views (73110) | $817.50 | $1,635 | 6.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $917.50 | $1,835 | 6.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,362 | $2,724 | 8.9× |
| Radiologic exam colon double contrast study (74280) | $2,154.50 | $4,309 | 8.4× |
| Radiologic exam colon single contrast study (74270) | $1,781.50 | $3,563 | 6.9× |
| Radiologic exam knee complete 4/more views (73564) | $1,184.50 | $2,369 | 7.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $1,195.50 | $2,391 | 7.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,694.50 | $3,389 | 6.6× |
| Radiologic exam swallow function contrast study (74230) | $2,197.50 | $4,395 | 8.5× |
| Radiologic exam teeth complete full mouth (70320) | $772 | $1,544 | 2.2× |
| Radiologic examination femur 1 view (73551) | $893 | $1,786 | 7.0× |
| Radiologic examination femur minimum 2 views (73552) | $893 | $1,786 | 7.0× |
| Radiologic examination knee 1/2 views (73560) | $890.50 | $1,781 | 7.0× |
| Radiologic Examination Osseous Survey Limited (77074) | $1,663 | $3,326 | 10.8× |
| Radiologic examination tibia & fibula 2 views (73590) | $893 | $1,786 | 7.0× |
| Renal Cyst Study (74470) | $697.50 | $1,395 | 0.9× |
| Ribs bilateral 3 views (71110) | $1,379.50 | $2,759 | 9.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$3,231.50–$3,984.50 | $6,463–$7,969 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $6,338 | $12,676 | 7.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 3 matching MRF lines |
$3,217.50–$5,063.50 | $6,435–$10,127 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 8 matching MRF lines |
$430–$6,073.50 | $860–$12,147 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $6,579.50 | $13,159 | 3.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $6,833 | $13,666 | 3.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $711.50 | $1,423 | 0.4× |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$1,413.50–$4,018 | $2,827–$8,036 | varies |
| Salivary Gland Imaging Serial Images (78231) | $2,809 | $5,618 | 4.8× |
| Scapula (73010) | $876 | $1,752 | 5.7× |
| Shoulder 1 view (73020) | $890.50 | $1,781 | 7.0× |
| Shoulder Arthrography (73040) | $968.50 | $1,937 | 1.9× |
| Skull less than 4 views (70250) | $909 | $1,818 | 5.9× |
| Special Physics Consult (77370) | $4,808.50 | $9,617 | 24.3× |
| Special treatment procedure (77470) | $6,010.50 | $12,021 | 7.4× |
| Speech evaluation, complex (70371) | $1,235 | $2,470 | 3.5× |
| Spleen Imaging (78185) | $5,919 | $11,838 | 10.1× |
| Sternoclavicular joints (71130) | $877 | $1,754 | 6.9× |
| Superior sagittal sinus venogram (75870) | $2,812 | $5,624 | 0.6× |
| Temporomandble Jt Arthrography Rs&I (70332) | $968.50 | $1,937 | 2.8× |
| Testicular Imaging W/Flow (78761) | $2,858.50 | $5,717 | 4.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $2,075.50 | $4,151 | 8.0× |
| Thoracic spine 2 views (72070) | $853 | $1,706 | 5.5× |
| Thoracolumbar 2 views (72080) | $853 | $1,706 | 6.7× |
| Thyroid Imaging With Vascular Flow (78013) | $1,318 | $2,636 | 2.2× |
| Thyroid Met Imaging Body (78018) | $3,913 | $7,826 | 4.9× |
| Thyroid Uptake Measurement (78012) | $1,922.50 | $3,845 | 3.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $3,123 | $6,246 | 5.3× |
| Tx Devices Design & Construction Complex (77334) | $2,404.50 | $4,809 | 4.4× |
| Ultrasound Breast Limited (76642) | $903 | $1,806 | 7.1× |
| Ultrasound elastography first target lesion (76982) | $2,600 | $5,200 | 16.9× |
| Ultrasound Elastography Parenchyma (76981) | $2,600 | $5,200 | 16.9× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $2,136.50 | $4,273 | 4.2× |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$1,061–$1,596 | $2,122–$3,192 | varies |
| Umbilical-artery Doppler (OB) (76820) | $864.50 | $1,729 | 5.6× |
| Unlisted Dx Radiographic Procedure (76499) | $11,760 | $23,520 | 91.9× |
| Unlisted fluoroscopic procedure (76496) | $11,760 | $23,520 | 91.9× |
| Unlisted magnetic resonance procedure (76498) | $936 | $1,872 | 7.3× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $936 | $1,872 | 1.6× |
| Unlisted us procedure (76999) range across 3 matching MRF lines |
$1,205.50–$3,491.50 | $2,411–$6,983 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$1,570–$1,779.50 | $3,140–$3,559 | varies |
| Ureteral Reflux Study (78740) | $1,975 | $3,950 | 3.4× |
| Urethrocystogram voiding (74455) | $2,011.50 | $4,023 | 5.7× |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$1,531–$1,612 | $3,062–$3,224 | varies |
| Us breast unilateral complete (76641) | $1,126.50 | $2,253 | 7.3× |
| Us chest (76604) | $1,424.50 | $2,849 | 9.3× |
| Us complete joint (76881) | $1,915.50 | $3,831 | 12.5× |
| Us exam, pelvic, limited (76857) | $1,205.50 | $2,411 | 7.8× |
| Us head (76506) | $1,499 | $2,998 | 9.7× |
| Us kidney transplant (76776) | $2,433.50 | $4,867 | 15.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$1,061–$1,596 | $2,122–$3,192 | varies |
| Us ob detailed single fetus (76811) | $1,627 | $3,254 | 4.6× |
| Us ob limited 1 or more fetuses (76815) | $884.50 | $1,769 | 5.8× |
| Us ob transvaginal (76817) | $930 | $1,860 | 6.0× |
| Us pelvic non ob complete (76856) | $1,596 | $3,192 | 10.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,283.50 | $2,567 | 8.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $648.50 | $1,297 | 4.2× |
| Us retroperitoneal complete (76770) | $1,593 | $3,186 | 10.4× |
| Us retroperitoneal limited (76775) | $1,661.50 | $3,323 | 10.8× |
| Us scrotum and contents (76870) | $1,596 | $3,192 | 10.4× |
| Us spinal canal and contents (76800) | $1,205.50 | $2,411 | 7.8× |
| Us thyroid (76536) | $1,596 | $3,192 | 10.4× |
| Us transrectal (76872) | $1,009 | $2,018 | 6.6× |
| Vein X-Ray Chest (75827) | $5,688.50 | $11,377 | 2.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,083 | $4,166 | 0.4× |
| Vein X-Ray Skull Epidural (75872) | $2,276 | $4,552 | 2.5× |
| Vein X-Ray Spleen/Liver (75810) | $2,812 | $5,624 | 0.6× |
| Venogram Sinus/Jugular (75860) | $17,325.50 | $34,651 | 3.7× |
| Venography Adrenal Unilateral (75840) | $3,072.50 | $6,145 | 0.7× |
| Venography caval inferior serialography rs&i (75825) | $4,766 | $9,532 | 1.0× |
| Venography extremity bilateral rs&i (75822) | $3,205 | $6,410 | 1.4× |
| Venography extremity unilateral rs&i (75820) | $2,512 | $5,024 | 1.1× |
| Venography Orbital Rs&I (75880) | $3,472.50 | $6,945 | 3.8× |
| Venography Renal Bilateral (75833) | $3,072.50 | $6,145 | 0.7× |
| Venography Renal Unilateral (75831) | $3,072.50 | $6,145 | 0.7× |
| Venous sampling by catheter (75893) | $5,106 | $10,212 | 0.6× |
| Vertebral fracture assessment via dxa (77086) | $192.50 | $385 | 1.5× |
| Wrist 2 views (73100) | $741.50 | $1,483 | 5.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $862 | $1,724 | 6.7× |
| X-ray antegrade pyelogram tube (74425) | $2,464 | $4,928 | 4.8× |
| X-Ray Aorta Leg Arteries (75630) | $6,430 | $12,860 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $797.50 | $1,595 | 5.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $741.50 | $1,483 | 5.8× |
| X-Ray Exam Breast Specimen (76098) | $1,004 | $2,008 | 1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $1,036.50 | $2,073 | 8.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$1,195.50–$1,966 | $2,391–$3,932 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,333 | $2,666 | 8.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $890.50 | $1,781 | 7.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $1,023.50 | $2,047 | 8.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $1,188 | $2,376 | 7.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,188 | $2,376 | 7.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,304.50 | $2,609 | 8.5× |
| X-Ray Exam L-S Spine Bending (72114) | $1,490 | $2,980 | 9.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $853 | $1,706 | 6.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,297 | $2,594 | 8.4× |
| X-ray eye for foreign body (70030) | $527 | $1,054 | 4.1× |
| X-ray head for orthodontia (70350) | $772 | $1,544 | 6.0× |
| X-ray humerus (73060) | $781.50 | $1,563 | 6.1× |
| X-ray IV pyelogram (ivp) (74400) | $972.50 | $1,945 | 3.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $758.50 | $1,517 | 5.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $1,080.50 | $2,161 | 8.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $853 | $1,706 | 5.5× |
| X-ray nose-rectum child f.b. (76010) | $1,297.50 | $2,595 | 10.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,077 | $2,154 | 7.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $980 | $1,960 | 6.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $933.50 | $1,867 | 7.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $800 | $1,600 | 6.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,098.50 | $2,197 | 7.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,879.50 | $3,759 | 3.7× |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$800.50–$811.50 | $1,601–$1,623 | varies |
| X-Rays Bone Survey Complete (77075) | $1,779.50 | $3,559 | 11.6× |
| Xr c-spine 4 or 5 views (72050) | $1,127.50 | $2,255 | 7.3× |
| Xr facial bones less than 3 views (70140) | $776.50 | $1,553 | 6.1× |
| Xr orbits complete 4 views (70200) | $1,075.50 | $2,151 | 7.0× |
| Xr Tomogram Single Plane (76100) | $890.50 | $1,781 | 5.8× |
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.