Imaging prices at Madison Memorial Hospital
Rexburg, ID · every code in this section with a posted price and a Medicare benchmark.
274 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 3 matching MRF lines |
$143.25–$154.50 | $191–$206 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$185.25–$192.75 | $247–$257 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,185.75 | $1,581 | 3.0× |
| Angiography extremity unilateral rs&i (75710) | $1,914.75 | $2,553 | 0.6× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$145.50–$225.75 | $194–$301 | varies |
| Arthrogram ankle (73615) | $675.75 | $901 | 2.0× |
| Arthrogram hip (73525) | $675.75 | $901 | 2.0× |
| Arthrogram Wrist (73115) | $434.25 | $579 | 1.3× |
| Bone age studies (77072) | $203.25 | $271 | 2.0× |
| Bone Imaging 3 Phase (78315) | $1,272 | $1,696 | 3.2× |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$1,229.25–$1,279.50 | $1,639–$1,706 | varies |
| Bone Imaging Multiple Areas (78305) | $996.75 | $1,329 | 2.5× |
| Bone Imaging Whole Body (78306) range across 3 matching MRF lines |
$1,222.50–$1,506 | $1,630–$2,008 | varies |
| Bone survey infant (77076) | $203.25 | $271 | 2.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $816 | $1,088 | 2.1× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $1,342.50 | $1,790 | 2.5× |
| Cat Scan Follow-Up Study (76380) | $546.75 | $729 | 6.4× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$182.25–$196.50 | $243–$262 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$182.25–$196.50 | $243–$262 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$236.25–$245.25 | $315–$327 | varies |
| Clavicle complete (73000) range across 4 matching MRF lines |
$39–$225.75 | $52–$301 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$156–$162 | $208–$216 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$534–$555.75 | $712–$741 | varies |
| Contrast X-Ray Of Elbow (73085) | $411.75 | $549 | 1.2× |
| Contrast X-Ray Of Knee Joint (73580) | $465.75 | $621 | 1.4× |
| Contrast Xray Throat/Cerv Esopha (74210) | $258 | $344 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$1,926–$2,004.75 | $2,568–$2,673 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$1,419–$1,482 | $1,892–$1,976 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,180.50–$1,228.50 | $1,574–$1,638 | varies |
| CT abdomen w wo contrast (74170) range across 3 matching MRF lines |
$912–$1,228.50 | $1,216–$1,638 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$927.75–$965.25 | $1,237–$1,287 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$1,940.25–$2,019.75 | $2,587–$2,693 | varies |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$1,120.50–$1,210.50 | $1,494–$1,614 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$825.75–$859.50 | $1,101–$1,146 | varies |
| CT angio hrt w/3d image (75574) | $527.25 | $703 | 1.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,180.50–$1,228.50 | $1,574–$1,638 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$938.25–$1,428.75 | $1,251–$1,905 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,772.25–$1,844.25 | $2,363–$2,459 | varies |
| CT cervical spine w/ contrast (72126) | $2,645.25 | $3,527 | 7.7× |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$879.75–$950.25 | $1,173–$1,267 | varies |
| CT cervical spine w/wo cont (72127) | $1,228.50 | $1,638 | 7.1× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,120.50–$1,166.25 | $1,494–$1,555 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$1,180.50–$1,228.50 | $1,574–$1,638 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$869.25–$904.50 | $1,159–$1,206 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$869.25–$904.50 | $1,159–$1,206 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $527.25 | $703 | 1.5× |
| CT heart no contrast quant eval coronry calcium (75571) range across 3 matching MRF lines |
$78.75–$95.25 | $105–$127 | varies |
| CT hrt w/3d image congen (75573) | $527.25 | $703 | 1.5× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$869.25–$904.50 | $1,159–$1,206 | varies |
| CT l-spine w&w/o contrast (72133) | $1,228.50 | $1,638 | 7.1× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$312–$1,448.25 | $416–$1,931 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,180.50–$1,228.50 | $1,574–$1,638 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$2,541.75–$2,645.25 | $3,389–$3,527 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$927.75–$965.25 | $1,237–$1,287 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$869.25–$904.50 | $1,159–$1,206 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$648.75–$675 | $865–$900 | varies |
| CT neck tissue combo (70492) range across 3 matching MRF lines |
$1,181.25–$1,229.25 | $1,575–$1,639 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $904.50 | $1,206 | 5.2× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$683.25–$711 | $911–$948 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,180.50–$1,228.50 | $1,574–$1,638 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$927.75–$965.25 | $1,237–$1,287 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,180.50–$1,228.50 | $1,574–$1,638 | varies |
| CT scans face/jaw combo (70488) | $904.50 | $1,206 | 5.2× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$855–$889.50 | $1,140–$1,186 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$927.75–$965.25 | $1,237–$1,287 | varies |
| CT thoracic spine w contrast (72129) | $1,228.50 | $1,638 | 7.1× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$927.75–$965.25 | $1,237–$1,287 | varies |
| CT thoracic spine w/wo cont (72130) | $1,228.50 | $1,638 | 7.1× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$879.75–$915.75 | $1,173–$1,221 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$927.75–$965.25 | $1,237–$1,287 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,180.50–$1,228.50 | $1,574–$1,638 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$2,541.75–$2,645.25 | $3,389–$3,527 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$901.50–$938.25 | $1,202–$1,251 | varies |
| Cta Abdomen (74175) range across 3 matching MRF lines |
$1,125–$1,228.50 | $1,500–$1,638 | varies |
| CTA pelvis (72191) | $1,228.50 | $1,638 | 7.1× |
| Dxa Bone Density Axial (77080) | $203.25 | $271 | 2.0× |
| Echo exam uterus (76831) | $534.75 | $713 | 2.3× |
| Esophageal Motility Study (78258) | $519 | $692 | 1.3× |
| Esophagram (74220) range across 3 matching MRF lines |
$248.25–$343.50 | $331–$458 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$203.25–$243.75 | $271–$325 | varies |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$405.75–$427.50 | $541–$570 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$145.50–$225.75 | $194–$301 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$145.50–$225.75 | $194–$301 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,222.50–$1,272 | $1,630–$1,696 | varies |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$877.50–$912.75 | $1,170–$1,217 | varies |
| Gated Heart, Multiple (78473) | $1,360.50 | $1,814 | 3.4× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$195.75–$303.75 | $261–$405 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,503.75–$1,565.25 | $2,005–$2,087 | varies |
| Hepatobiliary System Imaging (78226) range across 3 matching MRF lines |
$1,252.50–$1,303.50 | $1,670–$1,738 | varies |
| Ht Musc Image Planar Mult (78454) | $1,198.50 | $1,598 | 0.9× |
| Ht Muscle Image Spect Sing (78451) | $2,895.75 | $3,861 | 2.3× |
| Hysterosalpingogram (74740) | $427.50 | $570 | 1.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $187.50 | $250 | 2.2× |
| Infant hip ultrasound, limited static exam (76886) | $187.50 | $250 | 2.2× |
| K Flow/Funct Image Multiple (78709) | $1,566.75 | $2,089 | 2.9× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,343.25–$1,398 | $1,791–$1,864 | varies |
| Kidney Imaging Morphol (78700) | $424.50 | $566 | 1.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $468.75 | $625 | 1.2× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$137.25–$214.50 | $183–$286 | varies |
| Lung Perf&Ventilat Diferentl (78598) | $1,140 | $1,520 | 2.1× |
| Lung perfusion differential (78597) | $388.50 | $518 | 1.0× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$1,585.50–$1,650 | $2,114–$2,200 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$982.50–$1,022.25 | $1,310–$1,363 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,235.25–$1,285.50 | $1,647–$1,714 | varies |
| Meckels Divert Exam (78290) | $683.25 | $911 | 1.7× |
| Mra Head W/O & W/Contrast Material (70546) | $1,670.25 | $2,227 | 4.8× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,169.25–$1,216.50 | $1,559–$1,622 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$2,150.25–$2,238 | $2,867–$2,984 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$1,605–$1,670.25 | $2,140–$2,227 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$2,005.50–$2,087.25 | $2,674–$2,783 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$1,169.25–$1,216.50 | $1,559–$1,622 | varies |
| MRI abdomen w contrast (74182) | $1,670.25 | $2,227 | 4.8× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,235.25–$1,285.50 | $1,647–$1,714 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$3,225–$3,357 | $4,300–$4,476 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$1,605–$1,670.25 | $2,140–$2,227 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 5 matching MRF lines |
$1,561.50–$7,553.25 | $2,082–$10,071 | varies |
| MRI cervical spine w contrast (72142) | $1,532.25 | $2,043 | 4.4× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,131.75–$1,177.50 | $1,509–$1,570 | varies |
| MRI chest w/o contrast (71550) | $1,285.50 | $1,714 | 5.5× |
| MRI chest with contrast (71551) | $3,357 | $4,476 | 4.3× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$1,605–$1,670.25 | $2,140–$2,227 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,670.25 | $2,227 | 4.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,605–$1,670.25 | $2,140–$2,227 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,235.25–$1,285.50 | $1,647–$1,714 | varies |
| MRI lumbar spine w contrast (72149) | $1,532.25 | $2,043 | 4.4× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$1,472.25–$1,532.25 | $1,963–$2,043 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $1,285.50 | $1,714 | 5.5× |
| MRI orbit face neck w contrast (70542) | $1,670.25 | $2,227 | 4.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$1,605–$2,084.25 | $2,140–$2,779 | varies |
| MRI pelvis w contrast (72196) | $1,670.25 | $2,227 | 4.8× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,605–$1,670.25 | $2,140–$2,227 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,235.25–$1,285.50 | $1,647–$1,714 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,131.75–$1,177.50 | $1,509–$1,570 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$1,670.25–$2,505.75 | $2,227–$3,341 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$1,235.25–$2,505.75 | $1,647–$3,341 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,605–$1,670.25 | $2,140–$2,227 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,605–$1,670.25 | $2,140–$2,227 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,472.25–$1,532.25 | $1,963–$2,043 | varies |
| MRI, dorsal spine contrast (72147) | $1,532.25 | $2,043 | 4.4× |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$1,235.25–$1,929 | $1,647–$2,572 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,605–$1,670.25 | $2,140–$2,227 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,472.25–$1,532.25 | $1,963–$2,043 | varies |
| Myelogram cervical (72240) | $1,118.25 | $1,491 | 1.4× |
| Myelograpy 2/more regions rs&i (72270) | $1,118.25 | $1,491 | 1.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $668.25 | $891 | 1.7× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $621.75 | $829 | 1.2× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $670.50 | $894 | 0.5× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$4,160.25–$4,330.50 | $5,547–$5,774 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$145.50–$150.75 | $194–$201 | varies |
| Nm myocard infarct spect (78469) | $2,162.25 | $2,883 | 4.0× |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$153.75–$159.75 | $205–$213 | varies |
| Nuclear Rx Oral Admin (79005) | $315.75 | $421 | 1.4× |
| Ob us nuchal meas 1 gest (76813) | $253.50 | $338 | 2.5× |
| Optic foramina (70190) | $150.75 | $201 | 1.8× |
| Parathyroid Planar Imaging (78070) | $1,219.50 | $1,626 | 3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$1,224–$1,273.50 | $1,632–$1,698 | varies |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$185.25–$192.75 | $247–$257 | varies |
| Peritoneogram Rs&I (74190) | $897 | $1,196 | 1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$185.25–$192.75 | $247–$257 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $615.75 | $821 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$143.25–$214.50 | $191–$286 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$145.50–$225.75 | $194–$301 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$137.25–$214.50 | $183–$286 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $203.25 | $271 | 2.0× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$137.25–$214.50 | $183–$286 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$143.25–$214.50 | $191–$286 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$137.25–$214.50 | $183–$286 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$145.50–$225.75 | $194–$301 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $203.25 | $271 | 2.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$145.50–$150.75 | $194–$201 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$191.25–$198.75 | $255–$265 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$137.25–$214.50 | $183–$286 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$145.50–$150.75 | $194–$201 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $258 | $344 | 1.5× |
| Radex Spine 1 View Specify Level (72020) | $150.75 | $201 | 1.8× |
| Radex Sternum Minimum 2 Views (71120) | $198.75 | $265 | 2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $225.75 | $301 | 2.6× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$145.50–$225.75 | $194–$301 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$203.25–$391.50 | $271–$522 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$137.25–$214.50 | $183–$286 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$195.75–$203.25 | $261–$271 | varies |
| Radiologic exam colon double contrast study (74280) | $258 | $344 | 1.5× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$248.25–$258 | $331–$344 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$185.25–$288.75 | $247–$385 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$195.75–$203.25 | $261–$271 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $258 | $344 | 1.5× |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$248.25–$258 | $331–$344 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$258–$329.25 | $344–$439 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$137.25–$214.50 | $183–$286 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$137.25–$214.50 | $183–$286 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $203.25 | $271 | 2.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$137.25–$334.50 | $183–$446 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$387.75–$403.50 | $517–$538 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $648.75 | $865 | 1.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $553.50 | $738 | 1.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,149 | $5,532 | 7.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $4,133.25 | $5,511 | 7.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$791.25–$1,218.75 | $1,055–$1,625 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$195.75–$203.25 | $261–$271 | varies |
| Sella turcica (70240) | $150.75 | $201 | 1.8× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$145.50–$225.75 | $194–$301 | varies |
| Shoulder Arthrography (73040) | $1,227 | $1,636 | 3.6× |
| Skull less than 4 views (70250) | $203.25 | $271 | 2.0× |
| Sternoclavicular joints (71130) | $198.75 | $265 | 2.3× |
| Temporomandble Jt Arthrography Rs&I (70332) | $427.50 | $570 | 1.8× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $258 | $344 | 1.5× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$195.75–$203.25 | $261–$271 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$195.75–$203.25 | $261–$271 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$145.50–$150.75 | $194–$201 | varies |
| Thyroid Met Imaging Body (78018) | $897.75 | $1,197 | 1.7× |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$567–$590.25 | $756–$787 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,219.50 | $1,626 | 3.1× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$231–$240 | $308–$320 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$243.75–$253.50 | $325–$338 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$248.25–$258 | $331–$344 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$411–$427.50 | $548–$570 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$411–$427.50 | $548–$570 | varies |
| Us breast unilateral complete (76641) | $253.50 | $338 | 2.5× |
| Us chest (76604) range across 2 matching MRF lines |
$243.75–$253.50 | $325–$338 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$253.50–$381 | $338–$508 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$243.75–$253.50 | $325–$338 | varies |
| Us head (76506) range across 2 matching MRF lines |
$243.75–$253.50 | $325–$338 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$240.75–$253.50 | $321–$338 | varies |
| Us ob detailed single fetus (76811) | $429 | $572 | 1.8× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$243.75–$253.50 | $325–$338 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$203.25–$253.50 | $271–$338 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$435.75–$453 | $581–$604 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$243.75–$255.75 | $325–$341 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$203.25–$243.75 | $271–$325 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$231–$240 | $308–$320 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$243.75–$253.50 | $325–$338 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$266.25–$276.75 | $355–$369 | varies |
| Us spinal canal and contents (76800) | $253.50 | $338 | 2.5× |
| Us thyroid (76536) range across 2 matching MRF lines |
$231–$240 | $308–$320 | varies |
| Venography extremity unilateral rs&i (75820) | $2,152.50 | $2,870 | 1.4× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$137.25–$214.50 | $183–$286 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $225.75 | $301 | 2.6× |
| X-ray antegrade pyelogram tube (74425) | $555.75 | $741 | 1.6× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$195.75–$203.25 | $261–$271 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$145.50–$225.75 | $194–$301 | varies |
| X-Ray Exam Breast Specimen (76098) range across 4 matching MRF lines |
$855–$1,185 | $1,140–$1,580 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines |
$195.75–$217.50 | $261–$290 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$145.50–$150.75 | $194–$201 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$137.25–$165.75 | $183–$221 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$203.25–$303.75 | $271–$405 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$203.25–$303.75 | $271–$405 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$292.50–$303.75 | $390–$405 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$195.75–$216.75 | $261–$289 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$137.25–$165.75 | $183–$221 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $203.25 | $271 | 2.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$245.25–$255 | $327–$340 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$145.50–$150.75 | $194–$201 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$137.25–$214.50 | $183–$286 | varies |
| X-ray IV pyelogram (ivp) (74400) | $258 | $344 | 1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $150.75 | $201 | 1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$217.50–$225.75 | $290–$301 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$185.25–$192.75 | $247–$257 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$145.50–$150.75 | $194–$201 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $403.50 | $538 | 3.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$195.75–$203.25 | $261–$271 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $203.25 | $271 | 2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$145.50–$150.75 | $194–$201 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $150.75 | $201 | 1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $203.25 | $271 | 2.0× |
| X-Ray Stress View (77071) | $150.75 | $201 | 1.8× |
| X-ray thoracic spine 4 vw (72074) | $203.25 | $271 | 2.0× |
| X-Ray Tmj Unilat (70328) | $150.75 | $201 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $555.75 | $741 | 1.6× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$195.75–$203.25 | $261–$271 | varies |
| X-Rays Bone Survey Complete (77075) | $203.25 | $271 | 2.0× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$195.75–$203.25 | $261–$271 | varies |
| Xr facial bones less than 3 views (70140) | $150.75 | $201 | 1.8× |
| XR Mastoids < 3 Views Bilateral (70120) | $203.25 | $271 | 2.0× |
| Xr orbits complete 4 views (70200) | $203.25 | $271 | 2.0× |
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.