Imaging prices at Mary Rutan Health
Bellefontaine, OH · every code in this section with a posted price and a Medicare benchmark.
261 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 |
$428.80–$536.80 | $536–$671 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$515.20–$656 | $644–$820 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,468 | $1,835 | 3.7× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$310.40–$6,969.60 | $388–$8,712 | varies |
| Angiography extremity bilateral rs&i (75716) | $5,830.40 | $7,288 | 1.9× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$280.80–$4,861.60 | $351–$6,077 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$248–$5,840.80 | $310–$7,301 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$220–$5,784.80 | $275–$7,231 | varies |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$489.60–$676 | $612–$845 | varies |
| Artery X-Rays Abdomen (75726) | $5,185.60 | $6,482 | 0.9× |
| Artery X-Rays Pelvis (75736) | $5,271.20 | $6,589 | 1.0× |
| Bone age studies (77072) range across 2 matching MRF lines |
$420.80–$525.60 | $526–$657 | varies |
| Bone Imaging 3 Phase (78315) | $1,994.40 | $2,493 | 5.1× |
| Bone Imaging Limited Area (78300) | $1,468 | $1,835 | 3.7× |
| Bone Imaging Whole Body (78306) | $1,616 | $2,020 | 4.1× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$241.60–$321.60 | $302–$402 | varies |
| Chest 1 view (71045) range across 4 matching MRF lines |
$131.60–$540 | $164.50–$675 | varies |
| Chest 2 views (71046) range across 6 matching MRF lines |
$64.80–$596 | $81–$745 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$458.40–$573.60 | $573–$717 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$590.40–$738.40 | $738–$923 | varies |
| Clavicle complete (73000) range across 6 matching MRF lines |
$489.60–$736 | $612–$920 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$93.60–$118.40 | $117–$148 | varies |
| Contrast Exam Abdominl Aorta (75625) | $6,708.80 | $8,386 | 2.2× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$662.40–$828 | $828–$1,035 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) range across 2 matching MRF lines |
$689.60–$862.40 | $862–$1,078 | varies |
| Corpora cavernosography (74445) range across 2 matching MRF lines |
$731.20–$914.40 | $914–$1,143 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$3,548–$4,434.40 | $4,435–$5,543 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$2,642.40–$3,304 | $3,303–$4,130 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$2,443.20–$3,053.60 | $3,054–$3,817 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$3,385.60–$4,232 | $4,232–$5,290 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,585.60–$1,981.60 | $1,982–$2,477 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$3,416–$4,269.60 | $4,270–$5,337 | varies |
| CT Angio Chest (71275) range across 4 matching MRF lines |
$2,081.60–$2,895.20 | $2,602–$3,619 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$3,385.60–$4,232 | $4,232–$5,290 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$3,385.60–$4,232 | $4,232–$5,290 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$2,734.40–$3,418.40 | $3,418–$4,273 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$3,197.60–$3,996.80 | $3,997–$4,996 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,744–$2,180 | $2,180–$2,725 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$1,440.80–$1,802.40 | $1,801–$2,253 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$3,385.60–$4,232 | $4,232–$5,290 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,734.40–$2,168 | $2,168–$2,710 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$2,993.60–$3,743.20 | $3,742–$4,679 | varies |
| CT colonography screening (74263) range across 2 matching MRF lines |
$1,624.80–$2,030.40 | $2,031–$2,538 | varies |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 2 matching MRF lines |
$1,440.80–$1,802.40 | $1,801–$2,253 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,569.60–$1,961.60 | $1,962–$2,452 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$2,092–$2,615.20 | $2,615–$3,269 | varies |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$1,585.60–$2,132.80 | $1,982–$2,666 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$3,385.60–$4,232 | $4,232–$5,290 | varies |
| CT lower ext w/o (73700) range across 32 matching MRF lines |
$1,440.80–$2,940.80 | $1,801–$3,676 | varies |
| CT lower extremity w/contrast material (73701) range across 16 matching MRF lines |
$3,113.60–$3,971.20 | $3,892–$4,964 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$2,610.40–$3,262.40 | $3,263–$4,078 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,585.60–$1,981.60 | $1,982–$2,477 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,585.60–$1,981.60 | $1,982–$2,477 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$615.20–$1,981.60 | $769–$2,477 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$3,385.60–$4,232 | $4,232–$5,290 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,965.60–$2,457.60 | $2,457–$3,072 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,205.60–$1,507.20 | $1,507–$1,884 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$3,193.60–$3,992 | $3,992–$4,990 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,485.60–$1,856.80 | $1,857–$2,321 | varies |
| CT scan of leg combo (73702) range across 12 matching MRF lines |
$3,176.80–$3,971.20 | $3,971–$4,964 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,448–$1,811.20 | $1,810–$2,264 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$2,236–$2,794.40 | $2,795–$3,493 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,585.60–$1,981.60 | $1,982–$2,477 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$2,401.60–$3,001.60 | $3,002–$3,752 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,649.60–$2,063.20 | $2,062–$2,579 | varies |
| CT thoracic spine w/wo cont (72130) | $1,668.80 | $2,086 | 9.7× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$1,485.60–$1,856.80 | $1,857–$2,321 | varies |
| CT upper ext wo (73200) range across 30 matching MRF lines |
$1,440.80–$2,940.80 | $1,801–$3,676 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 12 matching MRF lines |
$3,516.80–$4,396 | $4,396–$5,495 | varies |
| CT upper extremity with contrast (73201) range across 18 matching MRF lines |
$2,275.20–$2,844 | $2,844–$3,555 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$2,946.40–$3,684 | $3,683–$4,605 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$2,734.40–$3,418.40 | $3,418–$4,273 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$2,720–$3,400 | $3,400–$4,250 | varies |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$728.80–$911.20 | $911–$1,139 | varies |
| Dxa Bone Density Axial (77080) range across 4 matching MRF lines |
$653.60–$960 | $817–$1,200 | varies |
| Echo Guide For Artery Repair (76936) | $262.40 | $328 | 1.2× |
| Esophagram (74220) range across 2 matching MRF lines |
$804–$1,005.60 | $1,005–$1,257 | varies |
| Fetal Biophys Profile W/Nst (76818) | $341.60 | $427 | 3.3× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$193.60–$578.40 | $242–$723 | varies |
| Foot 2 views (73620) range across 6 matching MRF lines |
$489.60–$748 | $612–$935 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$443.20–$631.20 | $554–$789 | varies |
| Gastric emptying imaging study (78264) | $1,616 | $2,020 | 4.1× |
| Gated Heart Planar Single (78472) | $1,384 | $1,730 | 3.5× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$443.20–$748 | $554–$935 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,233.60 | $2,792 | 4.2× |
| Hepatobiliary System Imaging (78226) | $1,616 | $2,020 | 4.1× |
| Ht Muscle Image Spect Sing (78451) range across 3 matching MRF lines |
$187.20–$1,754.40 | $234–$2,193 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$1,609.60–$2,011.20 | $2,012–$2,514 | varies |
| Infant hip ultrasound, limited static exam (76886) | $634.40 | $793 | 7.4× |
| K Flow/Funct Image Multiple (78709) | $2,288 | $2,860 | 4.3× |
| K Flow/Funct Image W/Drug (78708) | $2,131.20 | $2,664 | 4.0× |
| Kidney Imaging Morphol (78700) | $1,468 | $1,835 | 3.7× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $2,414.40 | $3,018 | 6.1× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$489.60–$748.80 | $612–$936 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,468 | $1,835 | 3.7× |
| Lung Ventilat&Perfus Imaging (78582) | $1,948.80 | $2,436 | 3.6× |
| Lymph System Imaging (78195) | $1,784.80 | $2,231 | 3.3× |
| Magnetic Image Jaw Joint (70336) | $1,518.40 | $1,898 | 6.5× |
| Mammary ductogram or galactogram single (77053) | $864 | $1,080 | 3.7× |
| Mra Head W/O & W/Contrast Material (70546) | $2,752.80 | $3,441 | 8.0× |
| MRA head w/o contrast (70544) | $2,086.40 | $2,608 | 8.9× |
| MRA neck w contrast (70548) | $2,224 | $2,780 | 6.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,284 | $4,105 | 9.6× |
| MRA neck w/o contrast (70547) | $2,086.40 | $2,608 | 8.9× |
| MRI abdomen w contrast (74182) | $3,187.20 | $3,984 | 9.3× |
| MRI abdomen w/o contrast (74181) | $984.80 | $1,231 | 4.2× |
| MRI any jt lower extrem w/contrast material (73722) | $2,108.80 | $2,636 | 2.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,283.20 | $4,104 | 9.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,108.80 | $2,636 | 2.7× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,740.80 | $2,176 | 7.4× |
| MRI cervical spine w contrast (72142) | $3,309.60 | $4,137 | 9.6× |
| MRI cervical spine w/o cont (72141) | $2,086.40 | $2,608 | 8.9× |
| MRI chest w/o contrast (71550) | $2,108.80 | $2,636 | 9.0× |
| MRI chest wo w contrast (71552) | $3,376.80 | $4,221 | 9.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,224 | $2,780 | 6.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,579.20 | $4,474 | 10.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 7 matching MRF lines |
$2,086.40–$2,259.20 | $2,608–$2,824 | varies |
| MRI lumbar spine w contrast (72149) | $3,579.20 | $4,474 | 10.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,620 | $4,525 | 10.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,897.60 | $2,372 | 8.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,609.60 | $4,512 | 10.5× |
| MRI pelvis w contrast (72196) | $2,048.80 | $2,561 | 6.0× |
| MRI pelvis w/o & w contrast (72197) | $3,609.60 | $4,512 | 10.5× |
| MRI pelvis w/o contrast (72195) | $2,086.40 | $2,608 | 8.9× |
| MRI thoracic spine w/o contrast (72146) | $1,976.80 | $2,471 | 8.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,319.20 | $4,149 | 9.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 10 matching MRF lines |
$1,897.60–$2,706.40 | $2,372–$3,383 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 9 matching MRF lines |
$3,187.20–$3,579.20 | $3,984–$4,474 | varies |
| MRI, abdomen, combo (74183) | $3,609.60 | $4,512 | 10.5× |
| MRI, dorsal spine combo (72157) | $3,609.60 | $4,512 | 10.5× |
| MRI, joint upper extrem (73221) range across 8 matching MRF lines |
$1,948–$2,086.40 | $2,435–$2,608 | varies |
| MRI, joint upper extrem combo (73223) | $3,283.20 | $4,104 | 9.6× |
| MRI, lumbar spine combo (72158) | $3,934.40 | $4,918 | 11.4× |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$899.20–$1,124 | $1,124–$1,405 | varies |
| Myocardial Spect Multiple Studies (78452) range across 4 matching MRF lines |
$1,044–$6,027.20 | $1,305–$7,534 | varies |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$428.80–$536.80 | $536–$671 | varies |
| Nonvascular Shunt X-Ray (75809) | $530.40 | $663 | 5.1× |
| Parathyroid Planar Imaging (78070) | $1,616 | $2,020 | 4.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,009.60 | $2,512 | 5.1× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$240–$300.80 | $300–$376 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $5,457.60 | $6,822 | 1.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,269.60 | $1,587 | 3.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$804–$1,005.60 | $1,005–$1,257 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 3 matching MRF lines |
$516.80–$646.40 | $646–$808 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 6 matching MRF lines |
$489.60–$713.60 | $612–$892 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 5 matching MRF lines |
$489.60–$736 | $612–$920 | varies |
| Radex elbow complete minimum 3 views (73080) range across 6 matching MRF lines |
$489.60–$736 | $612–$920 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$917.60–$1,147.20 | $1,147–$1,434 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$489.60–$612 | $612–$765 | varies |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$489.60–$718.40 | $612–$898 | varies |
| Radex Hand Minimum 3 Views (73130) range across 6 matching MRF lines |
$489.60–$712.80 | $612–$891 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 6 matching MRF lines |
$412.80–$562.40 | $516–$703 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$549.60–$687.20 | $687–$859 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$443.20–$554.40 | $554–$693 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$489.60–$736 | $612–$920 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$443.20–$554.40 | $554–$693 | varies |
| Radex Spine 1 View Specify Level (72020) | $216 | $270 | 2.5× |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$489.60–$612 | $612–$765 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$489.60–$612 | $612–$765 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$489.60–$612 | $612–$765 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 5 matching MRF lines |
$440.80–$834.40 | $551–$1,043 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 9 matching MRF lines |
$489.60–$704 | $612–$880 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $975.20 | $1,219 | 9.5× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$641.60–$801.60 | $802–$1,002 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$359.20–$458.40 | $449–$573 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$1,125.60–$1,407.20 | $1,407–$1,759 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$973.60–$1,217.60 | $1,217–$1,522 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,000.80 | $1,251 | 5.8× |
| Radiologic exam knee complete 4/more views (73564) range across 7 matching MRF lines |
$824.80–$1,348 | $1,031–$1,685 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$731.20–$914.40 | $914–$1,143 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$731.20–$914.40 | $914–$1,143 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 4 matching MRF lines |
$804–$2,011.20 | $1,005–$2,514 | varies |
| Radiologic examination femur 1 view (73551) range across 5 matching MRF lines |
$430.40–$554.40 | $538–$693 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$443.20–$554.40 | $554–$693 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$443.20–$596.80 | $554–$746 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$489.60–$736 | $612–$920 | varies |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$693.60–$868 | $867–$1,085 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,384 | $1,730 | 3.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,032 | $2,540 | 3.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,717.60 | $3,397 | 5.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,819.20 | $4,774 | 2.7× |
| Scapula (73010) range across 2 matching MRF lines |
$489.60–$612 | $612–$765 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$79.20–$93.60 | $99–$117 | varies |
| Shoulder 1 view (73020) range across 6 matching MRF lines |
$52.80–$571.20 | $66–$714 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$458.40–$572 | $573–$715 | varies |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$384–$391.20 | $480–$489 | varies |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$417.60–$523.20 | $522–$654 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$672.80–$840.80 | $841–$1,051 | varies |
| Thyroid Met Imaging Body (78018) | $1,896 | $2,370 | 3.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$316.80–$1,616 | $396–$2,020 | varies |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$634.40–$1,103.20 | $793–$1,379 | varies |
| Ultrasound elastography first target lesion (76982) | $356 | $445 | 3.5× |
| Ultrasound Elastography Parenchyma (76981) | $488.80 | $611 | 4.7× |
| Ultrasound Exam Aaa Screen (76706) | $1,191.20 | $1,489 | 11.6× |
| Ultrasound, abdomen limited (76705) | $1,191.20 | $1,489 | 11.6× |
| Upper gi w/o kub (74240) range across 4 matching MRF lines |
$651.20–$2,011.20 | $814–$2,514 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$519.20–$649.60 | $649–$812 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$1,380–$1,725.60 | $1,725–$2,157 | varies |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$203.86–$1,414.40 | $254.83–$1,768 | varies |
| Us chest (76604) | $1,191.20 | $1,489 | 11.6× |
| Us exam, pelvic, limited (76857) | $690.40 | $863 | 6.7× |
| Us head (76506) | $1,084 | $1,355 | 10.5× |
| Us kidney transplant (76776) | $773.60 | $967 | 7.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $634.40 | $793 | 6.2× |
| Us ob limited 1 or more fetuses (76815) | $673.60 | $842 | 6.5× |
| Us ob transvaginal (76817) | $1,191.20 | $1,489 | 11.6× |
| Us pelvic non ob complete (76856) | $1,191.20 | $1,489 | 11.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,191.20 | $1,489 | 11.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,022.40 | $1,278 | 9.9× |
| Us retroperitoneal complete (76770) | $1,191.20 | $1,489 | 11.6× |
| Us retroperitoneal limited (76775) | $1,084 | $1,355 | 10.5× |
| Us scrotum and contents (76870) | $1,191.20 | $1,489 | 11.6× |
| Us spinal canal and contents (76800) | $576 | $720 | 5.6× |
| Us thyroid (76536) | $1,191.20 | $1,489 | 11.6× |
| Us transrectal (76872) range across 2 matching MRF lines |
$262.40–$1,084 | $328–$1,355 | varies |
| Vein X-Ray Chest (75827) | $4,944 | $6,180 | 3.2× |
| Venography caval inferior serialography rs&i (75825) | $2,112 | $2,640 | 0.7× |
| Venography extremity bilateral rs&i (75822) range across 4 matching MRF lines |
$160–$3,520 | $200–$4,400 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$96–$2,985.60 | $120–$3,732 | varies |
| Venous thrombosis imaging (78457) | $1,721.60 | $2,152 | 3.2× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,955.20 | $2,444 | 5.0× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$347.20–$434.40 | $434–$543 | varies |
| Wrist 2 views (73100) range across 10 matching MRF lines |
$417.60–$682.40 | $522–$853 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$443.20–$554.40 | $554–$693 | varies |
| X-Ray Aorta Leg Arteries (75630) | $7,105.60 | $8,882 | 2.3× |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$489.60–$612 | $612–$765 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$443.20–$630.40 | $554–$788 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$978.40–$1,224 | $1,223–$1,530 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 3 matching MRF lines |
$354.40–$489.60 | $443–$612 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 4 matching MRF lines |
$917.60–$1,147.20 | $1,147–$1,434 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $941.60 | $1,177 | 9.1× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$480–$600.80 | $600–$751 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$400.80–$612 | $501–$765 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $492 | $615 | 4.8× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 4 matching MRF lines |
$640.80–$1,044.80 | $801–$1,306 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 6 matching MRF lines |
$741.60–$1,147.20 | $927–$1,434 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 3 matching MRF lines |
$1,836.80–$2,296 | $2,296–$2,870 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$941.60–$1,178.40 | $1,177–$1,473 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 6 matching MRF lines |
$444.80–$612 | $556–$765 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$983.20–$1,228.80 | $1,229–$1,536 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) | $708 | $885 | 6.9× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$428.80–$536.80 | $536–$671 | varies |
| X-ray humerus (73060) | $443.20 | $554 | 5.2× |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$944.80–$1,180.80 | $1,181–$1,476 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$489.60–$612 | $612–$765 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$538.40–$673.60 | $673–$842 | varies |
| X-ray nose-rectum child f.b. (76010) range across 3 matching MRF lines |
$420.80–$536.80 | $526–$671 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,135.20 | $1,419 | 11.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$435.20–$544 | $544–$680 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $443.20 | $554 | 4.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$435.20–$554.40 | $544–$693 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$576–$720 | $720–$900 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$735.20–$918.40 | $919–$1,148 | varies |
| X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines |
$917.60–$1,147.20 | $1,147–$1,434 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$940.80–$1,176.80 | $1,176–$1,471 | varies |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$443.20–$554.40 | $554–$693 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$834.40–$1,044.80 | $1,043–$1,306 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$917.60–$1,147.20 | $1,147–$1,434 | varies |
| Xr facial bones less than 3 views (70140) | $393.60 | $492 | 4.6× |
| XR Mastoids < 3 Views Bilateral (70120) | $553.60 | $692 | 5.4× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$556–$694.40 | $695–$868 | varies |
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.