Imaging prices at Madison St. Joseph Health Center
Madisonville, TX · every code in this section with a posted price and a Medicare benchmark.
279 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) | $2,140.60 | $12,232 | 1.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $476.18 | $2,721 | 1.2× |
| Adrenal Cortex & Medulla Img (78075) | $282.98 | $1,617 | 0.2× |
| Angio internal mammary (75756) | $580.65 | $3,318 | 0.2× |
| Angio pulmonary bilat (75743) | $917.53 | $5,243 | 0.3× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,525.43 | $14,431 | 0.8× |
| Angiography extremity bilateral rs&i (75716) | $1,625.23 | $9,287 | 0.5× |
| Angiography extremity unilateral rs&i (75710) | $1,491.18 | $8,521 | 0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $668.15 | $3,818 | 0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $515.73 | $2,947 | 0.2× |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$851.20 | $4,864 | 0.2× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$1,694.88 | $9,685 | 0.3× |
| Artery X-Rays Adrenal Gland (75731) | $591.68 | $3,381 | 0.2× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,531.90 | $14,468 | 0.5× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$1,087.10 | $6,212 | 0.2× |
| Basic radiation dosimetry calculation (77300) | $621.78 | $3,553 | 4.6× |
| Bone age studies (77072) | $144.38 | $825 | 1.4× |
| Bone Imaging 3 Phase (78315) | $1,006.95 | $5,754 | 2.5× |
| Bone Imaging Limited Area (78300) | $657.13 | $3,755 | 1.6× |
| Bone Imaging Multiple Areas (78305) | $793.63 | $4,535 | 2.0× |
| Bone Imaging Whole Body (78306) | $853.48 | $4,877 | 2.1× |
| Bone survey infant (77076) | $315.35 | $1,802 | 3.0× |
| Brachytx isodose complex (77318) | $812 | $4,640 | 2.2× |
| Brachytx isodose intermed (77317) | $677.43 | $3,871 | 1.8× |
| Brachytx Isodose Plan Simple (77316) | $634.03 | $3,623 | 1.7× |
| Brain Flow Imaging Only (78610) | $180.08 | $1,029 | 0.3× |
| Brain Image W/Flow < 4 Views (78601) | $341.08 | $1,949 | 0.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $906.68 | $5,181 | 1.7× |
| Cat Scan Follow-Up Study (76380) | $294.53 | $1,683 | 3.4× |
| Cerebrospinal Fluid Scan (78630) | $510.83 | $2,919 | 0.9× |
| Chest 4 or more views (71048) | $169.23 | $967 | 1.6× |
| Cholecystography Oral Contrast (74290) | $178.85 | $1,022 | 1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$55.30–$114.10 | $316–$652 | varies |
| Continuing medical physics consltj pr wk (77336) | $233.63 | $1,335 | 1.7× |
| Contrast Exam Abdominl Aorta (75625) | $1,543.15 | $8,818 | 0.5× |
| Contrast X-Ray Bladder (74430) | $199.50 | $1,140 | 0.6× |
| CT abdomen and pelvis without and with contrast (74178) | $1,489.25 | $8,510 | 4.2× |
| CT abdomen and pelvis without contrast (74176) | $1,400.70 | $8,004 | 5.8× |
| CT abdomen w contrast (74160) | $746.20 | $4,264 | 4.2× |
| CT abdomen w wo contrast (74170) | $793.80 | $4,536 | 4.5× |
| CT abdomen w/o contrast (74150) | $666.93 | $3,811 | 6.4× |
| CT Angio Abdomen and Pelvis (74174) | $1,050.35 | $6,002 | 3.0× |
| CT Angio Chest (71275) | $670.60 | $3,832 | 3.8× |
| CT Angio Head (70496) | $587.83 | $3,359 | 3.3× |
| CT angio hrt w/3d image (75574) | $711.03 | $4,063 | 2.0× |
| CT Angio Neck (70498) | $617.75 | $3,530 | 3.5× |
| CT cervical spine w/ contrast (72126) | $625.45 | $3,574 | 1.8× |
| CT cervical spine w/o contrast (72125) | $568.58 | $3,249 | 5.4× |
| CT cervical spine w/wo cont (72127) | $693.53 | $3,963 | 3.9× |
| CT chest w contrast (71260) | $645.58 | $3,689 | 3.7× |
| CT chest w/wo contrast (71270) | $761.78 | $4,353 | 4.3× |
| CT head/brain with contrast (70460) | $745.33 | $4,259 | 4.2× |
| CT head/brain without and with contrast (70470) | $837.38 | $4,785 | 4.8× |
| CT heart contrast eval cardiac structure&morph (75572) | $147.70 | $844 | 0.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $76.13 | $435 | 0.9× |
| CT hrt w/3d image congen (75573) | $147.70 | $844 | 0.4× |
| CT iac w contrast (70481) | $518 | $2,960 | 2.9× |
| CT l-spine w&w/o contrast (72133) | $813.23 | $4,647 | 4.6× |
| CT lumbar spine w contrast (72132) | $691.78 | $3,953 | 2.0× |
| CT lumbar spine w/o contrast (72131) | $527.98 | $3,017 | 5.0× |
| CT maxillofacial w contrast (70487) | $734.48 | $4,197 | 4.2× |
| CT maxillofacial wo contrast (70486) | $550.73 | $3,147 | 5.2× |
| CT neck tissue combo (70492) | $745.85 | $4,262 | 4.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $604.63 | $3,455 | 3.4× |
| CT orbits w/o contrast (70480) | $454.48 | $2,597 | 4.3× |
| CT pelvis w&w/o contrast (72194) | $692.30 | $3,956 | 3.9× |
| CT pelvis w/o contrast (72192) | $484.23 | $2,767 | 4.6× |
| CT scans face/jaw combo (70488) | $793.10 | $4,532 | 4.5× |
| CT soft tissue neck w contrast (70491) | $611.28 | $3,493 | 3.5× |
| CT soft tissue neck w/o contrast (70490) | $85.75 | $490 | 0.8× |
| CT thoracic spine w contrast (72129) | $524.30 | $2,996 | 3.0× |
| CT thoracic spine w/o contrast (72128) | $468.13 | $2,675 | 4.5× |
| CT thoracic spine w/wo cont (72130) | $613.38 | $3,505 | 3.5× |
| CT thorax w/o contrast (71250) | $565.43 | $3,231 | 5.4× |
| CT unlisted procedure (76497) | $39.03 | $223 | 0.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $657.65 | $3,758 | 3.7× |
| Cta Abdomen (74175) | $766.85 | $4,382 | 4.4× |
| CTA pelvis (72191) | $499.28 | $2,853 | 2.8× |
| Dilation ureters/urethra rs&i (74485) | $889.70 | $5,084 | 0.4× |
| Diskography lumbar (72295) | $525.88 | $3,005 | 0.3× |
| Echo exam uterus (76831) | $331.10 | $1,892 | 1.4× |
| Echo Guide For Artery Repair (76936) | $360.68 | $2,061 | 1.7× |
| Echograp Trans R Pros Study (76873) | $85.58 | $489 | 0.8× |
| Esophagram (74220) | $191.80 | $1,096 | 1.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $301.53 | $1,723 | 2.9× |
| Fluoroscopy up to 1 hr (76000) | $237.48 | $1,357 | 1.0× |
| Follow-Up Angiography (75898) | $493.85 | $2,822 | 0.2× |
| Gastric emptying imaging study (78264) | $786.80 | $4,496 | 2.0× |
| Gastroesophageal Reflux Exam (78262) | $509.60 | $2,912 | 1.3× |
| Gated Heart Planar Single (78472) | $591.33 | $3,379 | 1.5× |
| Gated Heart, Multiple (78473) | $614.60 | $3,512 | 1.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,491.18 | $8,521 | 2.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,432.90 | $8,188 | 2.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,233.75 | $7,050 | 1.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $575.23 | $3,287 | 0.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $575.23 | $3,287 | 0.2× |
| Hepatobil Syst Image W/Drug (78227) | $621.95 | $3,554 | 1.1× |
| Hepatobiliary System Imaging (78226) | $584.68 | $3,341 | 1.5× |
| Ht Muscle Image Spect Sing (78451) | $1,351.88 | $7,725 | 1.0× |
| Hysterosalpingogram (74740) | $310.10 | $1,772 | 1.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $183.93 | $1,051 | 2.1× |
| Infusion Ivp (74410) | $191.98 | $1,097 | 1.1× |
| Interstitial radiation source applic complex (77778) | $1,121.93 | $6,411 | 1.6× |
| Intracavitary Radiation Source Applic Complex (77763) | $892.15 | $5,098 | 1.3× |
| Intracavitary Radiation Source Applic Intermed (77762) range across 2 matching MRF lines |
$686.53–$686.70 | $3,923–$3,924 | varies |
| Intracavitary radiation source applic simple (77761) | $468.65 | $2,678 | 0.8× |
| K Flow/Funct Image Multiple (78709) | $1,203.30 | $6,876 | 2.2× |
| K Flow/Funct Image W/Drug (78708) | $620.20 | $3,544 | 1.1× |
| K Flow/Funct Image W/O Drug (78707) | $763 | $4,360 | 1.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $738.15 | $4,218 | 1.8× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $512.58 | $2,929 | 1.3× |
| Liver & Spleen Imaging Static Only (78215) | $404.60 | $2,312 | 1.0× |
| Lung Perf&Ventilat Diferentl (78598) | $338.80 | $1,936 | 0.6× |
| Lung perfusion differential (78597) | $258.65 | $1,478 | 0.6× |
| Lung Ventilat&Perfus Imaging (78582) | $421.40 | $2,408 | 0.8× |
| Lung Ventilation Imaging (78579) | $248.15 | $1,418 | 0.6× |
| Lymph System Imaging (78195) | $606.73 | $3,467 | 1.1× |
| Magnetic Image Jaw Joint (70336) | $485.45 | $2,774 | 2.0× |
| Meckels Divert Exam (78290) | $467.08 | $2,669 | 1.2× |
| Mlc imrt design & construction per imrt plan (77338) | $2,325.93 | $13,291 | 6.2× |
| Mr safety determination physician/other qhp (76016) | $39.03 | $223 | 0.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $11.03 | $63 | 0.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $40.78 | $233 | 0.4× |
| Mr safety implt pos&/immoblj (76019) | $26.25 | $150 | 0.4× |
| Mr safety med physics xm customization plng&mntr (76017) | $106.93 | $611 | 0.4× |
| Mra Head W/O & W/Contrast Material (70546) | $931.53 | $5,323 | 2.7× |
| MRA head w/o contrast (70544) | $608.83 | $3,479 | 2.5× |
| MRA head with contrast (70545) | $639.28 | $3,653 | 1.8× |
| MRA neck w contrast (70548) | $1,017.63 | $5,815 | 2.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,433.25 | $8,190 | 4.1× |
| MRA neck w/o contrast (70547) | $888.65 | $5,078 | 3.7× |
| MRI abdomen w contrast (74182) | $1,160.43 | $6,631 | 3.3× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$105.88–$747.78 | $605–$4,273 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $226.80 | $1,296 | 0.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $226.80 | $1,296 | 0.9× |
| MRI cervical spine w contrast (72142) | $1,260.18 | $7,201 | 3.6× |
| MRI cervical spine w/o cont (72141) | $869.05 | $4,966 | 3.6× |
| MRI chest w/o contrast (71550) | $787.50 | $4,500 | 3.3× |
| MRI chest with contrast (71551) | $962.50 | $5,500 | 1.2× |
| MRI chest wo w contrast (71552) | $1,137.50 | $6,500 | 3.2× |
| MRI lumbar spine w contrast (72149) | $1,051.40 | $6,008 | 3.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,460.03 | $8,343 | 4.2× |
| MRI orbit face &/neck w/o contrast (70540) | $674.63 | $3,855 | 2.8× |
| MRI orbit face neck w contrast (70542) | $795.38 | $4,545 | 2.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,006.78 | $5,753 | 2.9× |
| MRI pelvis w contrast (72196) | $880.78 | $5,033 | 2.5× |
| MRI pelvis w/o & w contrast (72197) | $1,100.93 | $6,291 | 3.1× |
| MRI pelvis w/o contrast (72195) | $649.60 | $3,712 | 2.7× |
| MRI thoracic spine w/o contrast (72146) | $827.75 | $4,730 | 3.5× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$147.70–$1,289.23 | $844–$7,367 | varies |
| MRI, dorsal spine combo (72157) | $1,250.03 | $7,143 | 3.6× |
| MRI, dorsal spine contrast (72147) | $910.53 | $5,203 | 2.6× |
| MRI, lumbar spine combo (72158) | $1,250.03 | $7,143 | 3.6× |
| Myelogram cervical (72240) | $492.98 | $2,817 | 0.6× |
| Myelogram Lumbar (72265) | $518.70 | $2,964 | 0.7× |
| Myelography thoracic (72255) | $280 | $1,600 | 0.4× |
| Myelograpy 2/more regions rs&i (72270) | $303.98 | $1,737 | 0.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $573.65 | $3,278 | 1.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $1,875.48 | $10,717 | 1.4× |
| Myocardial Spect Multiple Studies (78452) | $1,755.78 | $10,033 | 1.4× |
| Neck soft tissue (70360) | $126.88 | $725 | 1.5× |
| Nonvascular Shunt X-Ray (75809) | $110.95 | $634 | 1.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,802.28 | $16,013 | 2.0× |
| Nuclear Rx Oral Admin (79005) | $590.63 | $3,375 | 2.5× |
| Optic foramina (70190) | $123.90 | $708 | 1.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $587.65 | $3,358 | 1.1× |
| Parathyroid Planar Imaging (78070) | $380.45 | $2,174 | 0.9× |
| PET image w/CT, full body (78816) | $2,315.60 | $13,232 | 1.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,270.10 | $12,972 | 1.6× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,327.55 | $7,586 | 1.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $970.73 | $5,547 | 0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $312.73 | $1,787 | 0.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $219.80 | $1,256 | 0.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $34.13 | $195 | 0.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $124.43 | $711 | 1.4× |
| Radex Sinuses Paransl < 3 Views (70210) | $148.05 | $846 | 1.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $72.80 | $416 | 0.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,794.80 | $10,256 | 17.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $7,263.90 | $41,508 | 1.0× |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$46.38–$136.85 | $265–$782 | varies |
| Radiation treatment delivery level 2 (77407) | $104.13 | $595 | 0.3× |
| Radiation treatment delivery level 3 (77412) | $507.50 | $2,900 | 0.9× |
| Radiolog exam mandible compl minimum 4 views (70110) | $148.05 | $846 | 1.4× |
| Radiologic exam colon double contrast study (74280) | $404.25 | $2,310 | 2.3× |
| Radiologic exam colon single contrast study (74270) | $343.53 | $1,963 | 1.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $249.55 | $1,426 | 1.4× |
| Radiologic exam swallow function contrast study (74230) | $178.33 | $1,019 | 1.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $492.10 | $2,812 | 2.8× |
| Radiologic Examination Osseous Survey Limited (77074) | $192.68 | $1,101 | 1.8× |
| Renal Cyst Study (74470) | $166.25 | $950 | 0.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$405.65–$405.83 | $2,318–$2,319 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $807.10 | $4,612 | 1.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,027.78–$2,718.45 | $5,873–$15,534 | varies |
| Rp Therapy Intravenous Administration (79101) | $354.20 | $2,024 | 1.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $34.83 | $199 | 1.5× |
| Sella turcica (70240) | $35.88 | $205 | 0.4× |
| Sialogram (70390) | $198.28 | $1,133 | 0.8× |
| Skull less than 4 views (70250) | $133.70 | $764 | 1.3× |
| Special dosimetry (77331) | $153.30 | $876 | 1.1× |
| Special Physics Consult (77370) | $394.98 | $2,257 | 2.9× |
| Special teletherapy port plan (77321) | $588.35 | $3,362 | 1.6× |
| Special treatment procedure (77470) | $690.38 | $3,945 | 1.2× |
| Speech evaluation, complex (70371) | $99.58 | $569 | 0.4× |
| Srs Multisource (77371) | $15,441.30 | $88,236 | 2.1× |
| Stereotactic Body Radiation Delivery (77373) | $4,166.75 | $23,810 | 2.3× |
| Superior sagittal sinus venogram (75870) | $493.85 | $2,822 | 0.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $305.90 | $1,748 | 0.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $247.80 | $1,416 | 0.7× |
| Testicular Imaging W/Flow (78761) | $500.15 | $2,858 | 1.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,798.13 | $10,275 | 4.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,137.50 | $6,500 | 3.0× |
| Ther rad simulaj-aided field setting simple (77280) | $787.50 | $4,500 | 5.8× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,409.28 | $8,053 | 8.0× |
| Thoracolumbar 2 views (72080) | $104.65 | $598 | 1.2× |
| Thyroid Imaging With Vascular Flow (78013) | $216.48 | $1,237 | 0.5× |
| Thyroid Met Imaging Body (78018) | $809.03 | $4,623 | 1.5× |
| Thyroid Uptake Measurement (78012) | $145.78 | $833 | 0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $415.98 | $2,377 | 1.0× |
| Tx Devices Design & Construction Complex (77334) | $773.33 | $4,419 | 2.1× |
| Tx devices design & construction intermediate (77333) | $665 | $3,800 | 4.9× |
| Tx devices design & construction simple (77332) | $371 | $2,120 | 2.7× |
| Ultrasound Breast Limited (76642) | $221.20 | $1,264 | 2.5× |
| Ultrasound Exam Aaa Screen (76706) | $176.58 | $1,009 | 1.7× |
| Ultrasound, abdomen limited (76705) | $231.70 | $1,324 | 2.2× |
| Unlisted Dx Radiographic Procedure (76499) | $35 | $200 | 0.4× |
| Unlisted magnetic resonance procedure (76498) | $35.18 | $201 | 0.4× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $564.90 | $3,228 | 5.5× |
| Unlisted respiratory px dx nuclear medicine (78599) | $389.03 | $2,223 | 1.0× |
| Unlisted us procedure (76999) | $164.68 | $941 | 1.9× |
| Upper gi w/o kub (74240) | $287.53 | $1,643 | 1.6× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $25.38 | $145 | 2.3× |
| Urea breath test c-14 isotopic analysis (78268) | $57.40 | $328 | 0.6× |
| Ureteral Reflux Study (78740) | $351.05 | $2,006 | 0.9× |
| Urethrocystogram voiding (74455) | $364.88 | $2,085 | 1.5× |
| Urethrocystography retrograde (74450) | $364.88 | $2,085 | 1.5× |
| Us chest (76604) | $180.08 | $1,029 | 1.7× |
| Us complete joint (76881) | $203.53 | $1,163 | 1.9× |
| Us exam, pelvic, limited (76857) | $138.95 | $794 | 1.3× |
| Us head (76506) | $177.28 | $1,013 | 1.7× |
| Us ob limited 1 or more fetuses (76815) | $249.73 | $1,427 | 2.4× |
| Us ob transvaginal (76817) | $284.73 | $1,627 | 2.7× |
| Us pelvic non ob complete (76856) | $295.40 | $1,688 | 2.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $282.98 | $1,617 | 2.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $339.68 | $1,941 | 3.2× |
| Us retroperitoneal complete (76770) | $274.58 | $1,569 | 2.6× |
| Us retroperitoneal limited (76775) | $266.35 | $1,522 | 2.5× |
| Us spinal canal and contents (76800) | $103.25 | $590 | 1.0× |
| Vascular Flow Imaging (78445) | $315.35 | $1,802 | 0.8× |
| Vein X-Ray Chest (75827) | $536.90 | $3,068 | 0.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $515.73 | $2,947 | 0.2× |
| Vein X-Ray Skull Epidural (75872) | $258.13 | $1,475 | 0.4× |
| Venogram Sinus/Jugular (75860) | $580.65 | $3,318 | 0.2× |
| Venography Adrenal Unilateral (75840) | $493.85 | $2,822 | 0.2× |
| Venography caval inferior serialography rs&i (75825) | $945.53 | $5,403 | 0.3× |
| Venography extremity bilateral rs&i (75822) | $356.65 | $2,038 | 0.2× |
| Venography extremity unilateral rs&i (75820) | $639.45 | $3,654 | 0.4× |
| Venography Renal Bilateral (75833) | $899.68 | $5,141 | 0.3× |
| Venography Renal Unilateral (75831) | $1,052.28 | $6,013 | 0.3× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$851.20 | $4,864 | 0.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $156.28 | $893 | 1.8× |
| X-ray antegrade pyelogram tube (74425) | $383.95 | $2,194 | 1.1× |
| X-Ray Aorta Leg Arteries (75630) | $1,913.63 | $10,935 | 0.6× |
| X-Ray Bend Only L-S Spine (72120) | $176.93 | $1,011 | 1.7× |
| X-Ray Exam Breast Specimen (76098) | $287.88 | $1,645 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $341.25 | $1,950 | 3.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $597.28 | $3,413 | 5.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,194.38 | $6,825 | 11.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $166.25 | $950 | 1.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $236.95 | $1,354 | 2.3× |
| X-ray IV pyelogram (ivp) (74400) | $191.98 | $1,097 | 1.1× |
| X-ray nose-rectum child f.b. (76010) | $160.65 | $918 | 1.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $188.30 | $1,076 | 1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $164.50 | $940 | 1.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $383.95 | $2,194 | 1.1× |
| X-Rays Bone Length Studies (77073) | $61.95 | $354 | 0.6× |
| X-Rays Bone Survey Complete (77075) | $291.90 | $1,668 | 2.8× |
| Xr facial bones less than 3 views (70140) | $124.95 | $714 | 1.4× |
| Xr orbits complete 4 views (70200) | $102.73 | $587 | 1.0× |
| Xr Tomogram Single Plane (76100) | $54.08 | $309 | 0.5× |
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.