Imaging prices at Memorial Hospital

Abilene, KS · every code in this section with a posted price and a Medicare benchmark.

383 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $620.60 $620.60 0.5×
Abdomen 1 View (74018) $447.70 $447.70 5.6×
Abdomen 2 views (74019) $600.60 $600.60 6.2×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,145.40 $1,145.40 3.1×
Adrenal Cortex & Medulla Img (78075) $1,407.40 $1,407.40 1.2×
Angio internal mammary (75756) $7,424.10 $7,424.10 2.6×
Angio pulmonary bilat (75743)
range across 2 matching MRF lines
$198–$6,532.20 $198–$6,532.20 varies
Angiography extremity bilateral rs&i (75716)
range across 2 matching MRF lines
$209.30–$6,532.20 $209.30–$6,532.20 varies
Angiography extremity unilateral rs&i (75710)
range across 2 matching MRF lines
$725.90–$6,532.20 $725.90–$6,532.20 varies
Angiography pulmonary unilateral slctv rs&i (75741) $6,532.20 $6,532.20 2.2×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $2,643.50 $2,643.50 0.9×
Ankle 2 views (73600) $547.50 $547.50 6.8×
Aortography thoracic serialography rs&i (75605) $6,532.20 $6,532.20 1.3×
Aortography thoracic w/o serialography rs&i (75600) $6,532.20 $6,532.20 2.2×
Artery X-Rays Abdomen (75726) $6,532.20 $6,532.20 1.3×
Artery X-Rays Pelvis (75736) $6,532.20 $6,532.20 1.3×
Arthrogram ankle (73615) $679.80 $679.80 2.1×
Arthrogram hip (73525) $710.20 $710.20 2.2×
Arthrogram Wrist (73115) $813.90 $813.90 2.5×
Basic radiation dosimetry calculation (77300) $91.60 $91.60 0.7×
Bone age studies (77072) $547.50 $547.50 5.7×
Bone Imaging 3 Phase (78315) $819.90 $819.90 2.2×
Bone Imaging Limited Area (78300) $1,480.70 $1,480.70 4.0×
Bone Imaging Multiple Areas (78305) $1,744.90 $1,744.90 4.7×
Bone Imaging Whole Body (78306) $2,696.20 $2,696.20 7.3×
Bone survey infant (77076)
range across 2 matching MRF lines
$482–$552 $482–$552 varies
Brachytx isodose complex (77318) $486.70 $486.70 1.4×
Brachytx isodose intermed (77317) $303.50 $303.50 0.9×
Brachytx Isodose Plan Simple (77316) $287.40 $287.40 0.8×
Brain Flow Imaging Only (78610) $572 $572 1.1×
Brain Image W/Flow < 4 Views (78601) $1,027.70 $1,027.70 2.8×
Brain imaging < 4 static views (78600) $852.60 $852.60 2.3×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $1,704.10 $1,704.10 3.4×
Brain Imaging Minimum 4 Static Views (78605) $1,578.20 $1,578.20 3.2×
Brain Imaging Pet Metabolic Evaluation (78608) $7,094.10 $7,094.10 5.4×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $2,387 $2,387 6.5×
Cat Scan Follow-Up Study (76380)
range across 3 matching MRF lines
$229–$968.60 $229–$968.60 varies
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $980.60 $980.60 2.0×
Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) $1,151.50 $1,151.50 2.3×
Cerebrospinal Fluid Scan (78630) $1,435.90 $1,435.90 2.9×
Chest 1 view (71045) $370.90 $370.90 4.6×
Chest 2 views (71046) $564 $564 7.0×
Chest 3 views (71047) $686 $686 8.6×
Chest 4 or more views (71048) $783.50 $783.50 8.1×
Cholecystography Oral Contrast (74290) $655.20 $655.20 4.1×
Clavicle complete (73000) $582.20 $582.20 7.3×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $407.90 $407.90 4.2×
Contrast Exam Abdominl Aorta (75625)
range across 2 matching MRF lines
$174.50–$6,532.20 $174.50–$6,532.20 varies
Contrast X-Ray Bladder (74430) $1,051.50 $1,051.50 3.3×
Contrast X-Ray Of Elbow (73085)
range across 2 matching MRF lines
$517.50–$1,293.60 $517.50–$1,293.60 varies
Contrast X-Ray Of Knee Joint (73580) $1,070.20 $1,070.20 3.3×
Contrast Xray Throat/Cerv Esopha (74210) $728.50 $728.50 4.5×
CT abdomen and pelvis without and with contrast (74178) $3,253.20 $3,253.20 10.1×
CT abdomen and pelvis without contrast (74176)
range across 2 matching MRF lines
$850.80–$2,702.50 $850.80–$2,702.50 varies
CT abdomen w contrast (74160) $2,702.50 $2,702.50 16.8×
CT abdomen w wo contrast (74170) $3,253.20 $3,253.20 20.2×
CT abdomen w/o contrast (74150) $2,702.50 $2,702.50 28.1×
CT Angio Abdomen and Pelvis (74174)
range across 2 matching MRF lines
$1,392.30–$4,879.40 $1,392.30–$4,879.40 varies
CT Angio Chest (71275) $3,253.20 $3,253.20 20.2×
CT Angio Head (70496) $3,253.20 $3,253.20 20.2×
CT angio hrt w/3d image (75574) $895.60 $895.60 2.8×
Ct Angio Lwr Extr W/O&W/Dye (73706) $3,253.20 $3,253.20 20.2×
CT Angio Neck (70498) $3,253.20 $3,253.20 20.2×
Ct Angio Upr Extrm W/O&W/Dye (73206) $3,253.20 $3,253.20 20.2×
CT bone density (77078) $1,830.30 $1,830.30 22.9×
CT cervical spine w/ contrast (72126) $2,702.50 $2,702.50 8.4×
CT cervical spine w/o contrast (72125) $2,702.50 $2,702.50 28.1×
CT cervical spine w/wo cont (72127) $3,253.20 $3,253.20 20.2×
CT chest w contrast (71260) $2,702.50 $2,702.50 16.8×
CT chest w/wo contrast (71270) $3,253.20 $3,253.20 20.2×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $2,535.60 $2,535.60 15.7×
CT colonogrphy dx image postprocess w/o contrast (74261) $2,535.60 $2,535.60 26.4×
CT head/brain with contrast (70460) $2,702.50 $2,702.50 16.8×
CT head/brain without and with contrast (70470) $3,253.20 $3,253.20 20.2×
CT heart contrast eval cardiac structure&morph (75572) $895.60 $895.60 2.8×
CT heart no contrast quant eval coronry calcium (75571) $300 $300 3.7×
CT hrt w/3d image congen (75573) $895.60 $895.60 2.8×
CT iac w contrast (70481) $2,702.50 $2,702.50 16.8×
CT l-spine w&w/o contrast (72133) $3,253.20 $3,253.20 20.2×
CT lower ext w/o (73700) $2,702.50 $2,702.50 28.1×
CT lower extremity w/contrast material (73701) $2,702.50 $2,702.50 16.8×
CT lumbar spine w contrast (72132) $2,702.50 $2,702.50 8.4×
CT lumbar spine w/o contrast (72131) $2,702.50 $2,702.50 28.1×
CT maxillofacial w contrast (70487) $2,702.50 $2,702.50 16.8×
CT maxillofacial wo contrast (70486) $2,702.50 $2,702.50 28.1×
CT neck tissue combo (70492) $3,253.20 $3,253.20 20.2×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $3,253.20 $3,253.20 20.2×
CT orbits w/o contrast (70480) $2,702.50 $2,702.50 28.1×
CT pelvis w&w/o contrast (72194) $3,253.20 $3,253.20 20.2×
CT pelvis w/o contrast (72192) $2,702.50 $2,702.50 28.1×
CT scan of leg combo (73702) $3,253.20 $3,253.20 20.2×
CT scans face/jaw combo (70488) $3,253.20 $3,253.20 20.2×
CT soft tissue neck w contrast (70491) $2,702.50 $2,702.50 16.8×
CT soft tissue neck w/o contrast (70490) $2,702.50 $2,702.50 28.1×
CT thoracic spine w contrast (72129) $2,702.50 $2,702.50 16.8×
CT thoracic spine w/o contrast (72128) $2,702.50 $2,702.50 28.1×
CT thoracic spine w/wo cont (72130) $3,253.20 $3,253.20 20.2×
CT thorax w/o contrast (71250) $2,702.50 $2,702.50 28.1×
CT unlisted procedure (76497) $572.50 $572.50 7.2×
CT upper ext wo (73200) $2,702.50 $2,702.50 28.1×
CT upper extremity w/o & w/contrast material (73202) $3,253.20 $3,253.20 20.2×
CT upper extremity with contrast (73201) $2,702.50 $2,702.50 8.4×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $6,605.20 $6,605.20 40.9×
Cta Abdomen (74175) $3,253.20 $3,253.20 20.2×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $3,253.20 $3,253.20 10.1×
CTA pelvis (72191) $3,253.20 $3,253.20 20.2×
Discography Cerv/Thor Spine (72285) $3,350.80 $3,350.80 1.9×
Diskography lumbar (72295)
range across 2 matching MRF lines
$3,350.80–$3,490.90 $3,350.80–$3,490.90 varies
Doppler Fetal Mid Cerebral Artery (76821) $319.50 $319.50 3.3×
Dxa Bone Density Axial (77080)
range across 4 matching MRF lines
$56.20–$560.10 $56.20–$560.10 varies
Dxa bone density study 1/>sites appendiclr skel (77081)
range across 2 matching MRF lines
$31–$220.50 $31–$220.50 varies
Echo exam uterus (76831)
range across 2 matching MRF lines
$171.80–$2,013.30 $171.80–$2,013.30 varies
Echo Guide For Artery Repair (76936) $1,562.20 $1,562.20 7.9×
Echograp Trans R Pros Study (76873) $1,891.10 $1,891.10 19.7×
Esophagram (74220) $527.40 $527.40 3.3×
Fetal Biophys Profile W/Nst (76818) $286.30 $286.30 3.0×
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 3 matching MRF lines
$220.90–$1,767.30 $220.90–$1,767.30 varies
Fluoroscopy up to 1 hr (76000)
range across 2 matching MRF lines
$39–$679.80 $39–$679.80 varies
Foot 2 views (73620) $547.50 $547.50 6.8×
Forearm 2 views (73090) $535.60 $535.60 6.7×
Gastric emptying imaging study (78264) $2,777.80 $2,777.80 7.6×
Gastroesophageal Reflux Exam (78262) $1,454.40 $1,454.40 4.0×
Gated Heart Planar Single (78472)
range across 2 matching MRF lines
$104.90–$2,437.50 $104.90–$2,437.50 varies
Hand 2 views (73120) $547.50 $547.50 5.7×
Heart first pass single,planar (78481) $2,437.50 $2,437.50 4.9×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $6,532.20 $6,532.20 2.2×
Hepatobil Syst Image W/Drug (78227) $2,214.50 $2,214.50 4.4×
Hepatobiliary System Imaging (78226) $2,214.50 $2,214.50 6.0×
Ht Muscle Image Spect Sing (78451)
range across 2 matching MRF lines
$146.60–$5,538 $146.60–$5,538 varies
Hysterosalpingogram (74740) $930 $930 4.2×
Infant hip ultrasound with hip movement (dynamic) (76885) $2,013.30 $2,013.30 25.2×
Infant hip ultrasound, limited static exam (76886) $220 $220 2.7×
Infusion Ivp (74410) $1,555.80 $1,555.80 9.6×
Joint Survey Single View (77077) $523.10 $523.10 5.4×
K Flow/Funct Image Multiple (78709) $2,856.80 $2,856.80 5.7×
K Flow/Funct Image W/Drug (78708)
range across 2 matching MRF lines
$550.70–$2,856.80 $550.70–$2,856.80 varies
K Flow/Funct Image W/O Drug (78707) $2,149.60 $2,149.60 4.3×
Kidney Funcj Study Non-Img Radioisotopic Study (78725) $1,385.20 $1,385.20 3.8×
Kidney Imaging Morphol (78700) $1,493.30 $1,493.30 4.1×
Knee 3 Views (73562)
range across 3 matching MRF lines
$197.80–$649.30 $197.80–$649.30 varies
Leveen/Shunt Patency Exam (78291) $1,058 $1,058 2.9×
Liver & Spleen Imaging Static Only (78215) $1,529.30 $1,529.30 4.2×
Liver & Spleen Imaging W/Vascular Flow (78216) $2,202.50 $2,202.50 6.0×
Liver imaging static only (78201) $1,139.10 $1,139.10 2.3×
Liver imaging w/vascular flow (78202) $1,454.40 $1,454.40 2.9×
Lung Perf&Ventilat Diferentl (78598) $3,677.20 $3,677.20 7.4×
Lung perfusion differential (78597) $1,533.90 $1,533.90 4.2×
Lung Ventilat&Perfus Imaging (78582) $2,694.30 $2,694.30 5.4×
Lung Ventilation Imaging (78579) $1,535.60 $1,535.60 4.2×
Lymph System Imaging (78195)
range across 2 matching MRF lines
$146.60–$1,202.10 $146.60–$1,202.10 varies
Magnetic Image Jaw Joint (70336) $1,163.20 $1,163.20 5.3×
Mammary ductogram or galactogram multiple (77054) $744.70 $744.70 3.4×
Mammary ductogram or galactogram single (77053) $795.90 $795.90 3.6×
Meckels Divert Exam (78290) $1,584.40 $1,584.40 4.3×
Mlc imrt design & construction per imrt plan (77338) $643.50 $643.50 1.9×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $62.50 $62.50 2.3×
Mra Head W/O & W/Contrast Material (70546) $5,657.70 $5,657.70 17.6×
MRA head w/o contrast (70544) $4,269.60 $4,269.60 19.5×
MRA head with contrast (70545) $4,269.60 $4,269.60 13.3×
MRA neck w contrast (70548) $4,269.60 $4,269.60 13.3×
Mra Neck W/O &W/Contrast Material (70549) $5,657.70 $5,657.70 17.6×
MRA neck w/o contrast (70547) $4,269.60 $4,269.60 19.5×
MRI abdomen w contrast (74182) $4,269.60 $4,269.60 13.3×
MRI abdomen w/o contrast (74181) $4,269.60 $4,269.60 19.5×
MRI any jt lower extrem w/contrast material (73722) $3,917 $3,917 5.4×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $4,550.10 $4,550.10 14.2×
MRI any jt upper extremity w/contrast matrl (73222) $3,917 $3,917 5.4×
MRI Breast W/O Contrast Bilateral (77047) $4,269.60 $4,269.60 19.5×
MRI Breast Without Contrast Material Unilateral (77046) $4,269.60 $4,269.60 19.5×
MRI cervical spine w contrast (72142) $4,269.60 $4,269.60 13.3×
MRI cervical spine w/o cont (72141)
range across 2 matching MRF lines
$1,015–$4,269.60 $1,015–$4,269.60 varies
MRI chest w/o contrast (71550) $4,269.60 $4,269.60 19.5×
MRI chest with contrast (71551) $4,269.60 $4,269.60 5.9×
MRI chest wo w contrast (71552) $5,657.70 $5,657.70 17.6×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $3,917 $3,917 12.2×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $4,550.10 $4,550.10 14.2×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $3,917 $3,917 17.9×
MRI lumbar spine w contrast (72149) $4,269.60 $4,269.60 13.3×
Mri Neck Spine W/O & W/Dye (72156) $5,657.70 $5,657.70 17.6×
MRI orbit face &/neck w/o contrast (70540) $3,917 $3,917 17.9×
MRI orbit face neck w contrast (70542) $4,269.60 $4,269.60 13.3×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $5,657.70 $5,657.70 17.6×
MRI pelvis w contrast (72196) $4,269.60 $4,269.60 13.3×
MRI pelvis w/o & w contrast (72197) $5,657.70 $5,657.70 17.6×
MRI pelvis w/o contrast (72195) $4,269.60 $4,269.60 19.5×
MRI thoracic spine w/o contrast (72146)
range across 2 matching MRF lines
$1,015–$4,269.60 $1,015–$4,269.60 varies
MRI upper extremity oth than jt w/contr matrl (73219) $3,917 $3,917 12.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $3,917 $3,917 17.9×
Mri Uppr Extremity W/O&W/Dye (73220) $4,550.10 $4,550.10 14.2×
MRI, abdomen, combo (74183) $5,657.70 $5,657.70 17.6×
MRI, dorsal spine combo (72157) $5,657.70 $5,657.70 17.6×
MRI, dorsal spine contrast (72147) $4,269.60 $4,269.60 13.3×
MRI, joint upper extrem (73221) $3,917 $3,917 17.9×
MRI, joint upper extrem combo (73223) $4,550.10 $4,550.10 14.2×
MRI, lumbar spine combo (72158) $5,657.70 $5,657.70 17.6×
Myelogram Lumbar (72265)
range across 2 matching MRF lines
$6,004.20–$6,818.60 $6,004.20–$6,818.60 varies
Myelography thoracic (72255) $6,818.60 $6,818.60 9.5×
Myelograpy 2/more regions rs&i (72270) $7,198.80 $7,198.80 10.0×
Myocardial Imaging Pet Metabolic Evaluation (78459) $7,094.10 $7,094.10 6.0×
Myocardial Spect Multiple Studies (78452)
range across 2 matching MRF lines
$203.30–$5,992 $203.30–$5,992 varies
Neck soft tissue (70360) $498.80 $498.80 6.2×
Ntsty modul radthx pln dose-vol histos (77301) $1,157.60 $1,157.60 0.9×
Nuclear Rx Intra-Arterial (79445) $877.10 $877.10 4.1×
Nuclear Rx Oral Admin (79005) $667.80 $667.80 3.1×
Ob us nuchal meas 1 gest (76813) $246.30 $246.30 2.6×
Optic foramina (70190) $667.80 $667.80 8.3×
Parathyroid Planar Imaging (78070) $1,407.40 $1,407.40 3.8×
Parathyroid planar imaging w/wo subtraction (78071)
range across 2 matching MRF lines
$747.80–$1,286.40 $747.80–$1,286.40 varies
Pelvis 1 or 2 views (72170) $588.50 $588.50 6.1×
PET image w/CT, full body (78816)
range across 2 matching MRF lines
$7,094.10–$13,022.50 $7,094.10–$13,022.50 varies
PET imaging CT attenuation skull base mid-thigh (78815) $7,094.10 $7,094.10 5.4×
PET whole body (78813) $7,094.10 $7,094.10 5.4×
Pulmonary Perfusion Imaging Particulate (78580) $1,005.10 $1,005.10 2.7×
Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) $2,375 $2,375 2.8×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $1,175.80 $1,175.80 12.2×
Radex abscess/fistula/sinus tract rs&i (76080)
range across 2 matching MRF lines
$724.90–$1,051.30 $724.90–$1,051.30 varies
Radex Ankle Complete Minimum 3 Views (73610) $716.30 $716.30 9.0×
Radex Calcaneus Minimum 2 Views (73650) $547.50 $547.50 6.8×
Radex elbow complete minimum 3 views (73080) $645.30 $645.30 8.1×
Radex Facial Bones Complete Minimum 3 Views (70150) $783.50 $783.50 8.1×
Radex fingr minimum 2 views (73140) $259.70 $259.70 3.2×
Radex foot complete minimum 3 views (73630) $588.50 $588.50 7.4×
Radex Hand Minimum 3 Views (73130) $608.80 $608.80 7.6×
Radex lower extremity infant minimum 2 views (73592)
range across 2 matching MRF lines
$61.90–$399 $61.90–$399 varies
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $832.40 $832.40 8.7×
Radex Nasal Bones Complete Minimum 3 Views (70160) $529.30 $529.30 6.6×
Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) $523.20 $523.20 6.5×
Radex Ribs Unilateral 2 Views (71100) $456.30 $456.30 5.7×
Radex shoulder complete minimum 2 views (73030)
range across 2 matching MRF lines
$78.70–$616.90 $78.70–$616.90 varies
Radex Sinuses Paransl < 3 Views (70210) $570 $570 7.1×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $2,301.90 $2,301.90 14.3×
Radex Spine 1 View Specify Level (72020) $572 $572 7.1×
Radex Sternum Minimum 2 Views (71120)
range across 2 matching MRF lines
$65.20–$734.70 $65.20–$734.70 varies
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $564 $564 7.0×
Radex Toe Minimum 2 Views (73660) $259.70 $259.70 3.2×
Radex upper extremity infant minimum 2 views (73092) $348.20 $348.20 3.6×
Radex Wrist Complete Minimum 3 Views (73110) $608.80 $608.80 7.6×
Radiolog exam mandible compl minimum 4 views (70110) $819.90 $819.90 8.5×
Radiologic exam colon double contrast study (74280) $1,698.50 $1,698.50 10.5×
Radiologic exam colon single contrast study (74270) $1,340.40 $1,340.40 8.3×
Radiologic Exam Esophagus Double Contrast Study (74221) $675.40 $675.40 4.2×
Radiologic exam knee complete 4/more views (73564)
range across 4 matching MRF lines
$134.90–$687.70 $134.90–$687.70 varies
Radiologic exam pelvis compl minimum 3 views (72190) $618.60 $618.60 6.4×
Radiologic Exam Small Int Single Contrast Study (74250) $1,175.80 $1,175.80 7.3×
Radiologic exam swallow function contrast study (74230) $950.10 $950.10 5.9×
Radiologic exam teeth complete full mouth (70320) $445.90 $445.90 2.0×
Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) $350.60 $350.60 1.6×
Radiologic exam upr gi trc double contrast study (74246) $1,409.60 $1,409.60 8.7×
Radiologic examination femur 1 view (73551) $154.40 $154.40 1.9×
Radiologic examination femur minimum 2 views (73552) $616.90 $616.90 7.7×
Radiologic examination knee 1/2 views (73560) $377.10 $377.10 4.7×
Radiologic Examination Osseous Survey Limited (77074) $939.80 $939.80 9.8×
Radiologic Examination Salivary Gland Calculus (70380) $503.10 $503.10 6.3×
Radiologic examination tibia & fibula 2 views (73590) $600.60 $600.60 7.5×
Radiologic examination, teeth; single view Non-Facility (70300) $273.40 $273.40 3.4×
Ribs bilateral 3 views (71110) $517.50 $517.50 5.4×
Rp loclzj tum plnr 1 area single day imaging (78800) $517.50 $517.50 1.4×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801)
range across 2 matching MRF lines
$622.70–$1,879.10 $622.70–$1,879.10 varies
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804)
range across 3 matching MRF lines
$3,399.60–$5,633.50 $3,399.60–$5,633.50 varies
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $3,757.40 $3,757.40 7.5×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 4 matching MRF lines
$115–$3,263.30 $115–$3,263.30 varies
Rp Therapy Intravenous Administration (79101) $877.10 $877.10 4.1×
Salivary Gland Imaging (78230) $994 $994 2.7×
Scapula (73010) $608.80 $608.80 6.3×
Screening Digital Breast Tomosynthesis Bi (77063) $85.60 $85.60 3.7×
Sella turcica (70240) $445.90 $445.90 5.6×
Shoulder 1 view (73020) $421.40 $421.40 5.3×
Shoulder Arthrography (73040) $1,255.30 $1,255.30 3.9×
Sialogram (70390) $582.20 $582.20 2.7×
Skull less than 4 views (70250) $651.40 $651.40 6.8×
Special dosimetry (77331) $127.20 $127.20 1.0×
Special treatment procedure (77470) $295.50 $295.50 0.6×
Spleen Imaging (78185) $1,202.10 $1,202.10 3.3×
Sternoclavicular joints (71130) $547.50 $547.50 6.8×
Superior sagittal sinus venogram (75870) $6,532.20 $6,532.20 2.2×
Telethx isodose pln cplx w/basic dosimetry (77307) $421.40 $421.40 1.2×
Telethx isodose pln smpl w/dosimetry calculation (77306) $377.90 $377.90 1.1×
Temporomandble Jt Arthrography Rs&I (70332) $815.90 $815.90 3.7×
Testicular Imaging W/Flow (78761) $1,535.60 $1,535.60 4.2×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $226.80 $226.80 0.7×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $158.10 $158.10 0.5×
Ther rad simulaj-aided field setting simple (77280) $104.30 $104.30 0.8×
Thoracic spine 2 views (72070) $873.20 $873.20 9.1×
Thoracic spine 3 views (72072) $927.60 $927.60 9.6×
Thoracolumbar 2 views (72080) $805.80 $805.80 10.1×
Thyroid Imaging With Vascular Flow (78013) $1,134 $1,134 3.1×
Thyroid Met Imaging Body (78018) $2,027.70 $2,027.70 4.1×
Thyroid Uptake Measurement (78012) $687.70 $687.70 1.9×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,574.10 $1,574.10 4.3×
Tx Devices Design & Construction Complex (77334) $160.30 $160.30 0.5×
Tx devices design & construction intermediate (77333) $105.40 $105.40 0.9×
Tx devices design & construction simple (77332) $64.20 $64.20 0.5×
Ultrasound Breast Limited (76642) $609.10 $609.10 7.6×
Ultrasound Elastography Parenchyma (76981) $398.70 $398.70 4.1×
Ultrasound Exam Aaa Screen (76706) $406.30 $406.30 4.2×
Ultrasound, abdomen limited (76705)
range across 3 matching MRF lines
$166.10–$556 $166.10–$556 varies
Umbilical-artery Doppler (OB) (76820)
range across 2 matching MRF lines
$120.30–$410.80 $120.30–$410.80 varies
Unlisted Dx Radiographic Procedure (76499) $828.20 $828.20 10.3×
Unlisted respiratory px dx nuclear medicine (78599) $1,230.90 $1,230.90 3.3×
Unlisted us procedure (76999) $314.50 $314.50 3.9×
Upper gi w/o kub (74240) $1,378.60 $1,378.60 8.5×
Urethrocystogram voiding (74455) $970.60 $970.60 4.4×
Urethrocystography retrograde (74450) $970.60 $970.60 4.4×
Us breast unilateral complete (76641) $913.40 $913.40 9.5×
Us chest (76604)
range across 2 matching MRF lines
$80.20–$1,767.30 $80.20–$1,767.30 varies
Us complete joint (76881)
range across 2 matching MRF lines
$229–$1,767.30 $229–$1,767.30 varies
Us exam, pelvic, limited (76857)
range across 2 matching MRF lines
$456.90–$1,387.20 $456.90–$1,387.20 varies
Us head (76506) $1,767.30 $1,767.30 18.4×
Us kidney transplant (76776) $1,767.30 $1,767.30 18.4×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $1,088.20 $1,088.20 11.3×
Us ob detailed single fetus (76811) $343.50 $343.50 1.6×
Us ob limited 1 or more fetuses (76815)
range across 4 matching MRF lines
$244–$588.50 $244–$588.50 varies
Us ob transvaginal (76817)
range across 2 matching MRF lines
$229–$560.10 $229–$560.10 varies
Us pelvic non ob complete (76856)
range across 3 matching MRF lines
$342.40–$1,980.60 $342.40–$1,980.60 varies
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801)
range across 3 matching MRF lines
$291–$686.10 $291–$686.10 varies
Us preg uterus real time f/u trnsabdl per fetus (76816)
range across 4 matching MRF lines
$269.60–$560.10 $269.60–$560.10 varies
Us retroperitoneal complete (76770)
range across 2 matching MRF lines
$80.80–$1,767.30 $80.80–$1,767.30 varies
Us retroperitoneal limited (76775)
range across 3 matching MRF lines
$80.20–$556 $80.20–$556 varies
Us scrotum and contents (76870) $1,767.30 $1,767.30 18.4×
Us spinal canal and contents (76800) $1,801.90 $1,801.90 18.7×
Us thyroid (76536) $1,767.30 $1,767.30 18.4×
Us transrectal (76872) $1,891.10 $1,891.10 19.7×
Vascular Flow Imaging (78445) $260 $260 0.7×
Vasogram (74440) $716.30 $716.30 3.3×
Vein X-Ray Chest (75827)
range across 2 matching MRF lines
$139.10–$2,643.50 $139.10–$2,643.50 varies
Vein X-Ray Skull Epidural (75872) $2,643.50 $2,643.50 4.6×
Vein X-Ray Spleen/Liver (75810) $805.80 $805.80 0.3×
Venogram Sinus/Jugular (75860)
range across 3 matching MRF lines
$160.30–$369.90 $160.30–$369.90 varies
Venography Adrenal Unilateral (75840) $6,532.20 $6,532.20 2.2×
Venography caval inferior serialography rs&i (75825) $6,532.20 $6,532.20 2.2×
Venography extremity bilateral rs&i (75822) $2,643.50 $2,643.50 1.8×
Venography extremity unilateral rs&i (75820)
range across 2 matching MRF lines
$260–$2,643.50 $260–$2,643.50 varies
Venography Renal Bilateral (75833) $6,532.20 $6,532.20 2.2×
Venography Renal Unilateral (75831) $6,532.20 $6,532.20 2.2×
Venous sampling by catheter (75893) $6,532.20 $6,532.20 1.3×
Venous thrombosis imaging (78457) $1,365 $1,365 2.7×
Venous Thrombosis Imaging Venogram Bilateral (78458) $1,765.30 $1,765.30 4.8×
Wrist 2 views (73100) $547.50 $547.50 6.8×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $651.40 $651.40 8.1×
X-ray antegrade pyelogram tube (74425) $919.70 $919.70 2.9×
X-Ray Aorta Leg Arteries (75630)
range across 2 matching MRF lines
$214.20–$6,532.20 $214.20–$6,532.20 varies
X-Ray Bend Only L-S Spine (72120) $744.70 $744.70 7.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $588.50 $588.50 7.4×
X-Ray Exam Breast Specimen (76098) $736.50 $736.50 1.5×
X-Ray Exam Entire Spi 1 Vw (72081) $154.40 $154.40 1.9×
X-Ray Exam Entire Spi 2/3 Vw (72082)
range across 2 matching MRF lines
$258–$1,917.80 $258–$1,917.80 varies
X-Ray Exam Hip Uni 1 View (73501)
range across 2 matching MRF lines
$207.90–$377.10 $207.90–$377.10 varies
X-Ray Exam Hip Uni 2-3 Views (73502)
range across 2 matching MRF lines
$207.90–$620.90 $207.90–$620.90 varies
X-Ray Exam Hip Uni 4/> Views (73503) $307.30 $307.30 3.2×
X-Ray Exam Hips Bi 2 Views (73521) $1,019.40 $1,019.40 10.6×
X-Ray Exam Hips Bi 3-4 Views (73522) $426.70 $426.70 4.4×
X-Ray Exam Hips Bi 5/> Views (73523) $477.70 $477.70 5.0×
X-Ray Exam L-S Spine Bending (72114) $1,086.40 $1,086.40 11.3×
X-Ray Exam Neck Spine 2-3 Vw (72040) $651.40 $651.40 8.1×
X-Ray Exam Neck Spine 6/>Vws (72052) $1,019.40 $1,019.40 10.6×
X-Ray Exam Unilat Ribs/Chest (71101) $795.90 $795.90 8.3×
X-ray eye for foreign body (70030) $523.10 $523.10 6.5×
X-ray head for orthodontia (70350) $140.10 $140.10 1.8×
X-ray humerus (73060) $478.90 $478.90 6.0×
X-ray IV pyelogram (ivp) (74400) $1,277.20 $1,277.20 7.9×
X-ray IV pyelogram+tomography (74415) $2,009.20 $2,009.20 12.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $720.40 $720.40 9.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $382.40 $382.40 4.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $795.90 $795.90 8.3×
X-ray nose-rectum child f.b. (76010) $556 $556 6.9×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $732.60 $732.60 7.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $612.40 $612.40 6.4×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $519.10 $519.10 5.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $612.40 $612.40 7.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $807.80 $807.80 10.1×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $767.10 $767.10 8.0×
X-Ray Stress View (77071)
range across 2 matching MRF lines
$21.90–$142 $21.90–$142 varies
X-ray thoracic spine 4 vw (72074) $614.20 $614.20 6.4×
X-Ray Tmj Unilat (70328) $379 $379 4.7×
X-Ray Urinary Tract Exam With Contrast Material (74420) $1,277.20 $1,277.20 4.0×
X-Rays Bone Length Studies (77073)
range across 2 matching MRF lines
$617.10–$1,171.70 $617.10–$1,171.70 varies
X-Rays Bone Survey Complete (77075) $1,801.90 $1,801.90 18.7×
Xr c-spine 4 or 5 views (72050) $907.40 $907.40 9.4×
Xr facial bones less than 3 views (70140) $476.50 $476.50 6.0×
XR Mastoids < 3 Views Bilateral (70120) $622.70 $622.70 6.5×
Xr myelogram posterior fossa (70010) $1,464.60 $1,464.60 4.6×
Xr orbits complete 4 views (70200) $744.70 $744.70 7.7×
Xr Tomogram Single Plane (76100) $1,244.60 $1,244.60 12.9×

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.