Imaging prices at Memorial Health University Medical Center
Savannah, GA · every code in this section with a posted price and a Medicare benchmark.
361 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) | $7,654 | $7,654 | 6.2× |
| Abdomen 1 View (74018) | $780 | $780 | 10.1× |
| Abdomen 2 views (74019) | $899 | $899 | 9.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $5,091 | $5,091 | 14.3× |
| Angio internal mammary (75756) | $3,488 | $3,488 | 1.2× |
| Angio pulmonary bilat (75743) | $7,955 | $7,955 | 2.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $8,896 | $8,896 | 3.2× |
| Angiography extremity bilateral rs&i (75716) | $8,821 | $8,821 | 3.1× |
| Angiography extremity unilateral rs&i (75710) | $8,821 | $8,821 | 3.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $7,241 | $7,241 | 2.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $7,849 | $7,849 | 2.8× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$697–$970 | $697–$970 | varies |
| Aortography thoracic serialography rs&i (75605) | $6,644 | $6,644 | 1.3× |
| Artery X-Rays Abdomen (75726) | $7,524 | $7,524 | 1.5× |
| Artery X-Rays Adrenal Gland (75731) | $8,896 | $8,896 | 3.2× |
| Artery X-Rays Pelvis (75736) | $7,598 | $7,598 | 1.5× |
| Artery X-Rays Spine (75705) | $6,421 | $6,421 | 1.3× |
| Arthrogram ankle (73615) | $2,481 | $2,481 | 8.0× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$1,386–$1,928 | $1,386–$1,928 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$1,539–$2,142 | $1,539–$2,142 | varies |
| Basic radiation dosimetry calculation (77300) | $947 | $947 | 7.9× |
| Bone age studies (77072) | $559 | $559 | 6.0× |
| Bone Imaging 3 Phase (78315) | $5,175 | $5,175 | 14.5× |
| Bone Imaging Limited Area (78300) | $5,175 | $5,175 | 14.5× |
| Bone Imaging Multiple Areas (78305) | $1,736 | $1,736 | 4.9× |
| Bone Imaging Whole Body (78306) | $5,175 | $5,175 | 14.5× |
| Bone marrow imaging limited area (78102) | $5,757 | $5,757 | 16.2× |
| Bone survey infant (77076) | $584 | $584 | 6.3× |
| Brachytx isodose complex (77318) | $2,616 | $2,616 | 7.8× |
| Brachytx isodose intermed (77317) | $1,645 | $1,645 | 4.9× |
| Brachytx Isodose Plan Simple (77316) | $1,582 | $1,582 | 4.7× |
| Brain Image W/Flow < 4 Views (78601) | $8,678 | $8,678 | 24.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,916 | $2,916 | 6.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $18,041 | $18,041 | 14.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $7,734 | $7,734 | 24.9× |
| Cat Scan Follow-Up Study (76380) | $384 | $384 | 5.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $8,678 | $8,678 | 17.9× |
| Cerebrospinal Fluid Scan (78630) | $8,678 | $8,678 | 17.9× |
| Chest 1 view (71045) | $701 | $701 | 9.0× |
| Chest 2 views (71046) | $837 | $837 | 10.8× |
| Chest 3 views (71047) | $408 | $408 | 5.3× |
| Chest 4 or more views (71048) | $768 | $768 | 8.2× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $539 | $539 | 5.8× |
| Cisternography Positive Contrast Rs&I (70015) | $1,874 | $1,874 | 2.7× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$568–$789 | $568–$789 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,587 | $1,587 | 17.0× |
| Continuing medical physics consltj pr wk (77336) | $1,456 | $1,456 | 12.2× |
| Contrast Exam Abdominl Aorta (75625) | $8,821 | $8,821 | 3.1× |
| Contrast X-Ray Bladder (74430) | $1,723 | $1,723 | 5.5× |
| Contrast X-Ray Of Elbow (73085) | $3,399 | $3,399 | 10.9× |
| Contrast X-Ray Of Knee Joint (73580) | $3,399 | $3,399 | 10.9× |
| CT abdomen and pelvis without and with contrast (74178) | $5,959 | $5,959 | 19.2× |
| CT abdomen and pelvis without contrast (74176) | $3,757 | $3,757 | 17.7× |
| CT abdomen w contrast (74160) | $3,822 | $3,822 | 24.5× |
| CT abdomen w wo contrast (74170) | $4,280 | $4,280 | 27.4× |
| CT abdomen w/o contrast (74150) | $1,904 | $1,904 | 20.5× |
| CT Angio Abdomen and Pelvis (74174) | $5,959 | $5,959 | 19.2× |
| CT Angio Chest (71275) | $7,949 | $7,949 | 50.9× |
| CT Angio Head (70496) | $4,473 | $4,473 | 28.6× |
| CT angio hrt w/3d image (75574) | $3,428 | $3,428 | 11.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$4,473–$6,224 | $4,473–$6,224 | varies |
| CT Angio Neck (70498) | $4,473 | $4,473 | 28.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $4,473 | $4,473 | 28.6× |
| CT cervical spine w/ contrast (72126) | $3,822 | $3,822 | 12.3× |
| CT cervical spine w/o contrast (72125) | $1,904 | $1,904 | 20.5× |
| CT cervical spine w/wo cont (72127) | $4,280 | $4,280 | 27.4× |
| CT chest w contrast (71260) | $3,822 | $3,822 | 24.5× |
| CT chest w/wo contrast (71270) | $4,280 | $4,280 | 27.4× |
| CT colonography screening (74263) | $1,487 | $1,487 | 7.0× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,251 | $1,251 | 8.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,718 | $1,718 | 18.5× |
| CT head/brain with contrast (70460) | $3,822 | $3,822 | 24.5× |
| CT head/brain without and with contrast (70470) | $4,280 | $4,280 | 27.4× |
| CT heart contrast eval cardiac structure&morph (75572) | $3,428 | $3,428 | 11.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $262 | $262 | 3.4× |
| CT hrt w/3d image congen (75573) | $3,428 | $3,428 | 11.0× |
| CT iac w contrast (70481) | $3,822 | $3,822 | 24.5× |
| CT l-spine w&w/o contrast (72133) | $4,280 | $4,280 | 27.4× |
| CT lower ext w/o (73700) | $1,904 | $1,904 | 20.5× |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$3,822–$5,319 | $3,822–$5,319 | varies |
| CT lumbar spine w contrast (72132) | $3,822 | $3,822 | 12.3× |
| CT lumbar spine w/o contrast (72131) | $6,020 | $6,020 | 64.7× |
| CT maxillofacial w contrast (70487) | $5,936 | $5,936 | 38.0× |
| CT maxillofacial wo contrast (70486) | $5,870 | $5,870 | 63.1× |
| CT neck tissue combo (70492) | $4,280 | $4,280 | 27.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $4,280 | $4,280 | 27.4× |
| CT orbits w/o contrast (70480) | $1,904 | $1,904 | 20.5× |
| CT pelvis w&w/o contrast (72194) | $4,280 | $4,280 | 27.4× |
| CT pelvis w/o contrast (72192) | $1,904 | $1,904 | 20.5× |
| CT scan of leg combo (73702) | $4,280 | $4,280 | 27.4× |
| CT scans face/jaw combo (70488) | $6,302 | $6,302 | 40.3× |
| CT soft tissue neck w contrast (70491) | $3,822 | $3,822 | 24.5× |
| CT soft tissue neck w/o contrast (70490) | $1,904 | $1,904 | 20.5× |
| CT thoracic spine w contrast (72129) | $3,822 | $3,822 | 24.5× |
| CT thoracic spine w/o contrast (72128) | $5,520 | $5,520 | 59.3× |
| CT thoracic spine w/wo cont (72130) | $4,280 | $4,280 | 27.4× |
| CT thorax w/o contrast (71250) | $1,904 | $1,904 | 20.5× |
| CT upper ext wo (73200) | $1,904 | $1,904 | 20.5× |
| CT upper extremity w/o & w/contrast material (73202) | $4,280 | $4,280 | 27.4× |
| CT upper extremity with contrast (73201) | $3,822 | $3,822 | 12.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,473 | $4,473 | 28.6× |
| Cta Abdomen (74175) | $4,473 | $4,473 | 28.6× |
| CTA pelvis (72191) | $4,473 | $4,473 | 28.6× |
| Dilation ureters/urethra rs&i (74485) | $3,886 | $3,886 | 2.1× |
| Diskography lumbar (72295) | $5,742 | $5,742 | 3.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $969 | $969 | 10.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $1,661 | $1,661 | 17.8× |
| Dxa Bone Density Axial (77080) | $1,293 | $1,293 | 13.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $1,311 | $1,311 | 16.9× |
| Echo exam of fetal heart (76825) | $860 | $860 | 1.8× |
| Echo Guide For Artery Repair (76936) | $4,503 | $4,503 | 23.4× |
| Echograp Trans R Pros Study (76873) | $1,015 | $1,015 | 10.9× |
| Esophagram (74220) | $1,241 | $1,241 | 7.9× |
| Fetal Biophys Profile W/Nst (76818) | $1,819 | $1,819 | 19.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,012 | $1,012 | 10.9× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,817 | $1,817 | 8.6× |
| Fluoroscopy up to 1 hr (76000) | $1,081 | $1,081 | 5.1× |
| Follow-Up Angiography (75898) | $2,352 | $2,352 | 0.8× |
| Foot 2 views (73620) range across 6 matching MRF lines |
$633–$881 | $633–$881 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$899–$1,247 | $899–$1,247 | varies |
| Gastric emptying imaging study (78264) | $5,091 | $5,091 | 14.3× |
| Gated Heart Planar Single (78472) | $5,819 | $5,819 | 16.3× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$534–$740 | $534–$740 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $11,386 | $11,386 | 18.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $11,386 | $11,386 | 18.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $11,386 | $11,386 | 18.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $6,572 | $6,572 | 2.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $6,335 | $6,335 | 2.3× |
| Hepatobil Syst Image W/Drug (78227) | $5,811 | $5,811 | 12.0× |
| Hepatobiliary System Imaging (78226) | $5,811 | $5,811 | 16.3× |
| Ht Muscle Image Spect Sing (78451) | $17,763 | $17,763 | 15.4× |
| Hysterosalpingogram (74740) | $1,849 | $1,849 | 8.7× |
| Image fusion (77399) | $1,095 | $1,095 | 9.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $2,067 | $2,067 | 26.7× |
| Interstitial radiation source applic complex (77778) | $5,935 | $5,935 | 9.6× |
| Intracavitary Radiation Source Applic Complex (77763) | $5,935 | $5,935 | 9.6× |
| Intracavitary Radiation Source Applic Intermed (77762) | $4,341 | $4,341 | 8.8× |
| Intracavitary radiation source applic simple (77761) | $4,341 | $4,341 | 8.8× |
| Intraop radiaj tx deliver xray single tx session (77424) unusually low: confirm this is the full procedure |
$3,105 | $3,105 | 0.5× |
| K Flow/Funct Image Multiple (78709) | $6,550 | $6,550 | 13.5× |
| K Flow/Funct Image W/Drug (78708) | $6,550 | $6,550 | 13.5× |
| K Flow/Funct Image W/O Drug (78707) | $6,550 | $6,550 | 13.5× |
| Knee 3 Views (73562) | $973 | $973 | 12.6× |
| Liver & Spleen Imaging Static Only (78215) | $5,811 | $5,811 | 16.3× |
| Liver imaging static only (78201) | $5,811 | $5,811 | 12.0× |
| Lung Perf&Ventilat Diferentl (78598) | $6,858 | $6,858 | 14.2× |
| Lung perfusion differential (78597) | $4,922 | $4,922 | 13.8× |
| Lung Ventilat&Perfus Imaging (78582) | $6,858 | $6,858 | 14.2× |
| Lymph System Imaging (78195) | $5,757 | $5,757 | 11.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $15,290 | $15,290 | 5.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $17,684 | $17,684 | 6.3× |
| Magnetic Image Jaw Joint (70336) | $4,587 | $4,587 | 21.6× |
| Magnetic Resonance Elastography (76391) | $1,648 | $1,648 | 7.8× |
| Mammary ductogram or galactogram multiple (77054) | $1,482 | $1,482 | 7.0× |
| Mammary ductogram or galactogram single (77053) | $1,111 | $1,111 | 5.2× |
| Meckels Divert Exam (78290) | $5,091 | $5,091 | 14.3× |
| Mlc imrt design & construction per imrt plan (77338) | $2,587 | $2,587 | 7.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $106 | $106 | 4.1× |
| Mra Head W/O & W/Contrast Material (70546) | $7,734 | $7,734 | 24.9× |
| MRA head w/o contrast (70544) | $4,587 | $4,587 | 21.6× |
| MRA head with contrast (70545) | $6,836 | $6,836 | 22.0× |
| MRA neck w contrast (70548) | $6,836 | $6,836 | 22.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $7,734 | $7,734 | 24.9× |
| MRA neck w/o contrast (70547) | $4,587 | $4,587 | 21.6× |
| MRI abdomen w contrast (74182) | $6,836 | $6,836 | 22.0× |
| MRI abdomen w/o contrast (74181) | $4,587 | $4,587 | 21.6× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$6,836–$9,513 | $6,836–$9,513 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$7,734–$10,760 | $7,734–$10,760 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$6,836–$9,513 | $6,836–$9,513 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $6,836 | $6,836 | 32.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $7,734 | $7,734 | 36.4× |
| MRI cardiac w/o contrast (75557) | $4,587 | $4,587 | 21.6× |
| MRI cervical spine w contrast (72142) | $6,836 | $6,836 | 22.0× |
| MRI cervical spine w/o cont (72141) | $4,587 | $4,587 | 21.6× |
| MRI chest w/o contrast (71550) | $4,587 | $4,587 | 21.6× |
| MRI chest with contrast (71551) | $4,324 | $4,324 | 6.2× |
| MRI chest wo w contrast (71552) | $7,734 | $7,734 | 24.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$6,836–$9,513 | $6,836–$9,513 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$7,734–$10,760 | $7,734–$10,760 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$4,587–$6,381 | $4,587–$6,381 | varies |
| MRI lumbar spine w contrast (72149) | $6,836 | $6,836 | 22.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $7,734 | $7,734 | 24.9× |
| MRI orbit face &/neck w/o contrast (70540) | $4,587 | $4,587 | 21.6× |
| MRI orbit face neck w contrast (70542) | $6,836 | $6,836 | 22.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $9,151 | $9,151 | 29.5× |
| MRI pelvis w contrast (72196) | $6,836 | $6,836 | 22.0× |
| MRI pelvis w/o & w contrast (72197) | $7,734 | $7,734 | 24.9× |
| MRI pelvis w/o contrast (72195) | $4,587 | $4,587 | 21.6× |
| MRI spectroscopy (76390) | $1,150 | $1,150 | 14.8× |
| MRI thoracic spine w/o contrast (72146) | $3,950 | $3,950 | 18.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$6,836–$9,513 | $6,836–$9,513 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$4,587–$6,381 | $4,587–$6,381 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$7,734–$10,760 | $7,734–$10,760 | varies |
| MRI, abdomen, combo (74183) | $7,734 | $7,734 | 24.9× |
| MRI, dorsal spine combo (72157) | $7,734 | $7,734 | 24.9× |
| MRI, dorsal spine contrast (72147) | $6,836 | $6,836 | 22.0× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$4,587–$6,381 | $4,587–$6,381 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$7,734–$10,760 | $7,734–$10,760 | varies |
| MRI, lumbar spine combo (72158) | $7,734 | $7,734 | 24.9× |
| Myocardial Spect Multiple Studies (78452) | $17,763 | $17,763 | 15.4× |
| Neck soft tissue (70360) | $732 | $732 | 9.4× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $1,826 | $1,826 | 5.3× |
| Nonvascular Shunt X-Ray (75809) | $1,247 | $1,247 | 13.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,603 | $5,603 | 4.5× |
| Nuclear Rx Intra-Arterial (79445) | $1,851 | $1,851 | 8.9× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$1,711–$4,312 | $1,711–$4,312 | varies |
| Ob us nuchal meas 1 gest (76813) | $831 | $831 | 8.9× |
| Parathyroid Planar Imaging (78070) | $4,391 | $4,391 | 12.3× |
| Pelvis 1 or 2 views (72170) | $885 | $885 | 9.5× |
| Pet Image W/Ct Lmtd (78814) | $20,591 | $20,591 | 16.2× |
| PET image w/CT, full body (78816) | $13,261 | $13,261 | 10.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $20,591 | $20,591 | 16.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $6,421 | $6,421 | 2.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $4,922 | $4,922 | 13.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,369 | $1,369 | 14.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,311 | $1,311 | 2.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$1,055–$1,467 | $1,055–$1,467 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$741–$1,030 | $741–$1,030 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$842–$1,173 | $842–$1,173 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,227 | $1,227 | 13.2× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$724–$1,008 | $724–$1,008 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$969–$1,347 | $969–$1,347 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$892–$1,241 | $892–$1,241 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$707–$985 | $707–$985 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $873 | $873 | 11.3× |
| Radex Ribs Unilateral 2 Views (71100) | $962 | $962 | 12.4× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$780–$1,084 | $780–$1,084 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $773 | $773 | 10.0× |
| Radex Spine 1 View Specify Level (72020) | $397 | $397 | 5.1× |
| Radex Sternum Minimum 2 Views (71120) | $1,067 | $1,067 | 13.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $538 | $538 | 6.9× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$544–$755 | $544–$755 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$639–$889 | $639–$889 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$878–$1,221 | $878–$1,221 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $58,625 | $58,625 | 8.9× |
| Radiation treatment delivery level 3 (77412) | $1,529 | $1,529 | 3.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,239 | $1,239 | 13.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $453 | $453 | 4.9× |
| Radiologic exam colon double contrast study (74280) | $2,851 | $2,851 | 18.3× |
| Radiologic exam colon single contrast study (74270) | $2,006 | $2,006 | 12.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,241 | $1,241 | 7.9× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$1,686–$2,345 | $1,686–$2,345 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $1,305 | $1,305 | 14.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,539 | $1,539 | 9.9× |
| Radiologic exam swallow function contrast study (74230) | $1,372 | $1,372 | 8.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,296 | $1,296 | 8.3× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$1,035–$1,440 | $1,035–$1,440 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$658–$916 | $658–$916 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $2,499 | $2,499 | 26.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$873–$1,214 | $873–$1,214 | varies |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $1,982 | $1,982 | 9.5× |
| Ribs bilateral 3 views (71110) | $693 | $693 | 7.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,149 | $2,149 | 6.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,990 | $1,990 | 5.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $18,516 | $18,516 | 38.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,149 | $2,149 | 4.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $11,006 | $11,006 | 22.8× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $1,982 | $1,982 | 9.5× |
| Rp Therapy Intravenous Administration (79101) | $3,075 | $3,075 | 14.8× |
| Scapula (73010) | $816 | $816 | 8.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $194 | $194 | 8.3× |
| Shoulder 1 view (73020) | $697 | $697 | 9.0× |
| Shoulder Arthrography (73040) range across 4 matching MRF lines |
$2,062–$2,867 | $2,062–$2,867 | varies |
| Sialogram (70390) | $1,163 | $1,163 | 5.5× |
| Skull less than 4 views (70250) | $1,003 | $1,003 | 10.8× |
| Special dosimetry (77331) | $6,960 | $6,960 | 58.1× |
| Special Physics Consult (77370) | $5,043 | $5,043 | 42.1× |
| Special teletherapy port plan (77321) | $1,678 | $1,678 | 5.0× |
| Special treatment procedure (77470) | $2,061 | $2,061 | 4.2× |
| Srs Multisource (77371) | $34,653 | $34,653 | 5.3× |
| Stereotactic Body Radiation Delivery (77373) | $21,638 | $21,638 | 13.6× |
| Sternoclavicular joints (71130) | $1,227 | $1,227 | 15.8× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $1,037 | $1,037 | 11.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,682 | $2,682 | 8.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $2,682 | $2,682 | 8.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,854 | $2,854 | 8.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,944 | $1,944 | 5.8× |
| Ther rad simulaj-aided field setting simple (77280) | $1,523 | $1,523 | 12.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,595 | $1,595 | 10.2× |
| Thoracic spine 2 views (72070) | $962 | $962 | 10.3× |
| Thoracic spine 3 views (72072) | $701 | $701 | 7.5× |
| Thoracolumbar 2 views (72080) | $980 | $980 | 12.6× |
| Thyroid Met Imaging Body (78018) | $5,876 | $5,876 | 12.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $4,391 | $4,391 | 12.3× |
| Tx Devices Design & Construction Complex (77334) | $1,404 | $1,404 | 4.2× |
| Tx devices design & construction intermediate (77333) | $1,165 | $1,165 | 9.7× |
| Tx devices design & construction simple (77332) | $933 | $933 | 7.8× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$1,066–$1,482 | $1,066–$1,482 | varies |
| Ultrasound Elastography Parenchyma (76981) | $611 | $611 | 6.6× |
| Ultrasound Exam Aaa Screen (76706) | $772 | $772 | 8.3× |
| Ultrasound, abdomen limited (76705) | $2,159 | $2,159 | 23.2× |
| Umbilical-artery Doppler (OB) (76820) | $1,661 | $1,661 | 17.8× |
| Unlisted fluoroscopic procedure (76496) | $474 | $474 | 6.1× |
| Unlisted magnetic resonance procedure (76498) | $486 | $486 | 6.3× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $5,386 | $5,386 | 59.3× |
| Upper gi w/o kub (74240) | $1,031 | $1,031 | 6.6× |
| Urethrocystogram voiding (74455) | $2,171 | $2,171 | 10.2× |
| Urethrocystography retrograde (74450) | $1,538 | $1,538 | 7.2× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$1,468–$2,043 | $1,468–$2,043 | varies |
| Us chest (76604) | $688 | $688 | 7.4× |
| Us complete joint (76881) | $1,353 | $1,353 | 14.5× |
| Us exam, pelvic, limited (76857) | $1,468 | $1,468 | 15.8× |
| Us head (76506) | $1,482 | $1,482 | 15.9× |
| Us kidney transplant (76776) | $2,095 | $2,095 | 22.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $876 | $876 | 9.4× |
| Us ob detailed single fetus (76811) | $2,385 | $2,385 | 11.2× |
| Us ob limited 1 or more fetuses (76815) | $1,191 | $1,191 | 12.8× |
| Us ob transvaginal (76817) | $1,823 | $1,823 | 19.6× |
| Us pelvic non ob complete (76856) | $2,191 | $2,191 | 23.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $718 | $718 | 7.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $946 | $946 | 10.2× |
| Us retroperitoneal complete (76770) | $2,159 | $2,159 | 23.2× |
| Us retroperitoneal limited (76775) | $772 | $772 | 8.3× |
| Us scrotum and contents (76870) | $1,782 | $1,782 | 19.1× |
| Us spinal canal and contents (76800) | $1,548 | $1,548 | 16.6× |
| Us thyroid (76536) | $1,781 | $1,781 | 19.1× |
| Vein X-Ray Chest (75827) | $5,152 | $5,152 | 3.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $6,335 | $6,335 | 2.3× |
| Venogram Sinus/Jugular (75860) | $3,203 | $3,203 | 1.1× |
| Venography Adrenal Unilateral (75840) | $7,428 | $7,428 | 2.6× |
| Venography caval inferior serialography rs&i (75825) | $12,283 | $12,283 | 4.4× |
| Venography extremity bilateral rs&i (75822) | $2,475 | $2,475 | 1.8× |
| Venography extremity unilateral rs&i (75820) | $2,475 | $2,475 | 1.8× |
| Venography Renal Bilateral (75833) | $8,461 | $8,461 | 3.0× |
| Venography Renal Unilateral (75831) | $8,461 | $8,461 | 3.0× |
| Venous sampling by catheter (75893) | $6,421 | $6,421 | 1.3× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$773–$1,077 | $773–$1,077 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $568 | $568 | 7.3× |
| X-ray antegrade pyelogram tube (74425) | $1,378 | $1,378 | 4.4× |
| X-Ray Aorta Leg Arteries (75630) | $10,123 | $10,123 | 3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$767–$1,064 | $767–$1,064 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,193 | $1,193 | 2.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $1,874 | $1,874 | 24.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $2,499 | $2,499 | 26.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $835 | $835 | 10.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $835 | $835 | 10.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $723 | $723 | 7.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $1,071 | $1,071 | 11.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,382 | $1,382 | 14.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $627 | $627 | 6.7× |
| X-Ray Exam L-S Spine Bending (72114) | $1,128 | $1,128 | 12.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $973 | $973 | 12.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,597 | $1,597 | 17.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $768 | $768 | 8.2× |
| X-ray humerus (73060) range across 6 matching MRF lines |
$1,003–$1,398 | $1,003–$1,398 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $593 | $593 | 7.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $842 | $842 | 10.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,227 | $1,227 | 13.2× |
| X-ray nose-rectum child f.b. (76010) | $460 | $460 | 5.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $707 | $707 | 7.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,175 | $1,175 | 12.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $1,026 | $1,026 | 13.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,247 | $1,247 | 16.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,502 | $1,502 | 16.1× |
| X-Ray Stress View (77071) | $402 | $402 | 5.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $4,459 | $4,459 | 14.4× |
| X-Rays Bone Length Studies (77073) | $927 | $927 | 10.0× |
| X-Rays Bone Survey Complete (77075) | $2,499 | $2,499 | 26.8× |
| Xr c-spine 4 or 5 views (72050) | $1,765 | $1,765 | 19.0× |
| Xr facial bones less than 3 views (70140) | $693 | $693 | 8.9× |
| Xr orbits complete 4 views (70200) | $1,220 | $1,220 | 13.1× |
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.