Imaging prices at Memorial Hospital Biloxi

Biloxi, MS · every code in this section with a posted price and a Medicare benchmark.

386 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) $9,718.45 $13,883.50 8.0×
Abdomen 1 View (74018) $566.74 $809.63 7.4×
Abdomen 2 views (74019) $696.50 $995 7.6×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,813.32 $2,590.46 5.2×
Acute venous thrombosis imaging, peptide Non-Facility (78456) $1,463.32 $2,090.45 1.3×
Adrenal Cortex & Medulla Img (78075) $2,106.58 $3,009.40 1.9×
Angio internal mammary (75756) $3,304.88 $4,721.25 1.2×
Angio pulmonary bilat (75743) $5,875.66 $8,393.80 2.1×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $3,755.96 $5,365.65 1.4×
Angiography extremity bilateral rs&i (75716) $3,322.91 $4,747.02 1.2×
Angiography extremity unilateral rs&i (75710) $3,304.88 $4,721.25 1.2×
Angiography pulmonary unilateral slctv rs&i (75741) $4,652.06 $6,645.80 1.7×
Ankle 2 views (73600) $430.65 $615.22 5.7×
Aortography thoracic serialography rs&i (75605) $5,675.99 $8,108.55 1.2×
Aortography thoracic w/o serialography rs&i (75600) $3,304.88 $4,721.25 1.2×
Artery X-Rays Abdomen (75726) $5,705.13 $8,150.19 1.2×
Artery X-Rays Adrenal Gland (75731) $3,304.88 $4,721.25 1.2×
Artery X-Rays Pelvis (75736) $5,675.99 $8,108.55 1.2×
Artery X-Rays Spine (75705) $5,675.99 $8,108.55 1.2×
Arthrogram ankle (73615) $1,459.08 $2,084.40 4.8×
Arthrogram hip (73525) $816.59 $1,166.55 2.7×
Arthrogram Wrist (73115) $925.40 $1,322 3.0×
Basic radiation dosimetry calculation (77300)
range across 2 matching MRF lines
$971.32–$974.33 $1,387.60–$1,391.90 varies
Bone age studies (77072) $403.76 $576.80 4.4×
Bone Imaging 3 Phase (78315) $2,827.03 $4,038.61 8.1×
Bone Imaging Limited Area (78300) $1,926.23 $2,751.75 5.5×
Bone Imaging Multiple Areas (78305) $1,926.23 $2,751.75 5.5×
Bone Imaging Whole Body (78306) $2,566.03 $3,665.76 7.3×
Bone marrow imaging limited area (78102) $4,099.20 $5,856 11.7×
Bone marrow imaging; multiple areas (78103) $4,900 $7,000 14.0×
Bone marrow imaging; whole body (78104) $5,658 $8,082.85 16.2×
Bone survey infant (77076) $429.77 $613.96 4.7×
Brachytx isodose complex (77318) $4,385.26 $6,264.65 13.4×
Brachytx isodose intermed (77317) $3,319.96 $4,742.80 10.1×
Brachytx Isodose Plan Simple (77316) $2,349.62 $3,356.60 7.2×
Brain Flow Imaging Only (78610) $1,162.63 $1,660.90 2.4×
Brain Image W/Flow < 4 Views (78601) $772.72 $1,103.88 2.2×
Brain imaging < 4 static views (78600) $428.52 $612.17 1.2×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $3,956.19 $5,651.70 8.3×
Brain Imaging Minimum 4 Static Views (78605) $772.72 $1,103.88 1.6×
Cardiac Shunt Detection (78428) $1,592.75 $2,275.35 4.6×
Cat Scan Follow-Up Study (76380) $1,203.09 $1,718.70 15.8×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $2,395.44 $3,422.05 5.0×
Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) $772.72 $1,103.88 1.6×
Cerebrospinal Fluid Scan (78630) $4,142.88 $5,918.40 8.7×
Chest 1 view (71045) $647.50 $925 8.5×
Chest 2 views (71046) $665 $950 8.7×
Chest 3 views (71047) $682.50 $975 9.0×
Chest 4 or more views (71048) $713.09 $1,018.70 7.8×
Clavicle complete (73000) $411.43 $587.76 5.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $2,943.22 $4,204.60 32.2×
Continuing medical physics consltj pr wk (77336) $1,295.07 $1,850.10 11.0×
Contrast Exam Abdominl Aorta (75625) $3,304.88 $4,721.25 1.2×
Contrast X-Ray Bladder (74430) $382.40 $546.29 1.3×
Contrast X-Ray Of Elbow (73085)
range across 4 matching MRF lines
$1,057.70–$1,459.08 $1,511–$2,084.40 varies
Contrast X-Ray Of Knee Joint (73580) $1,189.09 $1,698.70 3.9×
Corpora cavernosography (74445) $729.75 $1,042.50 8.0×
CT abdomen and pelvis without and with contrast (74178)
range across 3 matching MRF lines
$7,046.51–$7,070 $10,066.44–$10,100 varies
CT abdomen and pelvis without contrast (74176) $6,670.88 $9,529.83 32.0×
CT abdomen w contrast (74160) $3,037.50 $4,339.29 19.8×
CT abdomen w wo contrast (74170) $3,462.48 $4,946.40 22.6×
CT abdomen w/o contrast (74150) $2,940 $4,200 32.1×
CT Angio Abdomen and Pelvis (74174) $8,050.06 $11,500.08 26.4×
CT Angio Chest (71275) $4,481.68 $6,402.40 29.2×
CT Angio Head (70496) $3,913.74 $5,591.06 25.5×
CT angio hrt w/3d image (75574) $531.92 $759.88 1.7×
Ct Angio Lwr Extr W/O&W/Dye (73706) $4,091.13 $5,844.47 26.7×
CT Angio Neck (70498) $3,727.81 $5,325.44 24.3×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,865.94 $4,094.20 18.7×
CT cervical spine w/ contrast (72126) $4,620 $6,600 15.1×
CT cervical spine w/o contrast (72125)
range across 2 matching MRF lines
$1,050–$4,604.04 $1,500–$6,577.20 varies
CT cervical spine w/wo cont (72127) $4,690 $6,700 30.6×
CT chest w contrast (71260) $3,510.05 $5,014.36 22.9×
CT chest w/wo contrast (71270) $4,182.63 $5,975.18 27.3×
CT head/brain with contrast (70460) $3,552.50 $5,075 23.1×
CT head/brain without and with contrast (70470)
range across 3 matching MRF lines
$3,552.50–$3,587.50 $5,075–$5,125 varies
CT heart contrast eval cardiac structure&morph (75572) $506.42 $723.45 1.7×
CT heart no contrast quant eval coronry calcium (75571) $112.07 $160.10 1.5×
CT hrt w/3d image congen (75573) $489.86 $699.80 1.6×
CT iac w contrast (70481) $3,150 $4,500 20.5×
CT l-spine w&w/o contrast (72133) $4,628.14 $6,611.63 30.2×
CT lower ext w/o (73700)
range across 19 matching MRF lines
$1,050–$2,966.12 $1,500–$4,237.31 varies
CT lower extremity w/contrast material (73701) $3,150 $4,500 20.5×
CT lumbar spine w contrast (72132) $4,550 $6,500 14.9×
CT lumbar spine w/o contrast (72131)
range across 2 matching MRF lines
$1,050–$4,491.87 $1,500–$6,416.95 varies
CT maxillofacial w contrast (70487) $3,850 $5,500 25.1×
CT maxillofacial wo contrast (70486) $1,869.03 $2,670.04 20.4×
CT neck tissue combo (70492) $4,060 $5,800 26.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $3,335.85 $4,765.50 21.7×
CT orbits w/o contrast (70480) $2,836.84 $4,052.63 31.0×
CT pelvis w&w/o contrast (72194) $4,200 $6,000 27.4×
CT pelvis w/o contrast (72192) $3,960.61 $5,658.02 43.3×
CT scan of leg combo (73702) $3,220 $4,600 21.0×
CT scans face/jaw combo (70488) $3,920 $5,600 25.5×
CT soft tissue neck w contrast (70491) $4,009.11 $5,727.30 26.1×
CT soft tissue neck w/o contrast (70490) $3,660.43 $5,229.19 40.0×
CT thoracic spine w contrast (72129) $5,401.21 $7,716.01 35.2×
CT thoracic spine w/o contrast (72128)
range across 2 matching MRF lines
$1,050–$4,904.16 $1,500–$7,005.94 varies
CT thoracic spine w/wo cont (72130) $5,744.41 $8,206.30 37.4×
CT thorax w/o contrast (71250)
range across 5 matching MRF lines
$1,050–$3,486.54 $1,500–$4,980.77 varies
CT upper ext wo (73200) $3,201.14 $4,573.06 35.0×
CT upper extremity w/o & w/contrast material (73202) $3,290 $4,700 21.4×
CT upper extremity with contrast (73201)
range across 14 matching MRF lines
$2,865.94–$3,227 $4,094.20–$4,610 varies
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $4,078.49 $5,826.42 26.6×
Cta Abdomen (74175) $3,760.26 $5,371.80 24.5×
CTA pelvis (72191) $4,504.71 $6,435.30 29.4×
Discography Cerv/Thor Spine (72285) $2,662.10 $3,803 1.6×
Diskography lumbar (72295) $2,662.10 $3,803 1.6×
Dxa Bone Density Axial (77080)
range across 2 matching MRF lines
$70–$542.18 $100–$774.54 varies
Dxa bone density study (77085)
range across 2 matching MRF lines
$50.40–$604.03 $72–$862.90 varies
Dxa bone density study 1/>sites appendiclr skel (77081)
range across 2 matching MRF lines
$70–$203.14 $100–$290.20 varies
Echo exam of fetal heart (76825) $668.96 $955.65 1.4×
Echo Guide For Artery Repair (76936) $2,149.87 $3,071.24 11.4×
Esophageal Motility Study (78258) $2,408.25 $3,440.35 6.9×
Esophagram (74220) $1,153.22 $1,647.46 7.5×
Fetal Biophys Profile W/Nst (76818) $2,048.59 $2,926.56 22.4×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $2,051.55 $2,930.78 22.4×
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $5,781.58 $8,259.40 27.7×
Fluoroscopy up to 1 hr (76000)
range across 6 matching MRF lines
$1,684.73–$1,918.74 $2,406.75–$2,741.05 varies
Follow-Up Angiography (75898) $3,304.88 $4,721.25 1.2×
Foot 2 views (73620) $464.66 $663.80 6.1×
Forearm 2 views (73090) $440.02 $628.60 5.8×
Gastric emptying imaging study (78264)
range across 2 matching MRF lines
$1,833.93–$1,871.61 $2,619.90–$2,673.73 varies
Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) $2,320.54 $3,315.05 6.6×
Gastric Mucosa Imaging (78261) $2,531.03 $3,615.75 7.2×
Gastroesophageal Reflux Exam (78262) $2,408.25 $3,440.35 6.9×
Gated Heart Planar Single (78472) $3,693.45 $5,276.35 10.6×
Gated Heart, Multiple (78473) $4,091.05 $5,844.35 11.7×
Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) $2,320.54 $3,315.05 4.9×
Hand 2 views (73120) $406 $580 4.4×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $3,051.23 $4,358.90 5.0×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $3,051.30 $4,359 5.0×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $3,345.58 $4,779.40 5.5×
Heart Image (Pet) Multiple (78492) $12,658.80 $18,084 10.1×
Hepatobil Syst Image W/Drug (78227) $2,782.79 $3,975.42 5.9×
Hepatobiliary System Imaging (78226) $2,625 $3,750 7.5×
Ht Musc Image Planar Mult (78454) $4,688.25 $6,697.50 4.1×
Ht Muscle Image Spect Sing (78451) $4,284 $6,120 3.8×
Hysterosalpingogram (74740) $502.60 $718 2.4×
Infant hip ultrasound with hip movement (dynamic) (76885) $1,374.12 $1,963.03 18.0×
Infant hip ultrasound, limited static exam (76886) $907.94 $1,297.05 11.9×
K Flow/Funct Image Multiple (78709) $3,505.78 $5,008.26 7.4×
K Flow/Funct Image W/O Drug (78707) $2,820.16 $4,028.80 5.9×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $1,744.17 $2,491.67 5.0×
Knee 3 Views (73562) $645.37 $921.95 8.5×
Leveen/Shunt Patency Exam (78291) $2,568.20 $3,668.85 7.3×
Liver & Spleen Imaging Static Only (78215) $2,517.69 $3,596.70 7.2×
Liver & Spleen Imaging W/Vascular Flow (78216) $3,628.45 $5,183.50 10.4×
Liver imaging static only (78201) $2,177.49 $3,110.70 4.6×
Liver imaging w/vascular flow (78202) $2,177.49 $3,110.70 4.6×
Lung Perf&Ventilat Diferentl (78598) $6,396.46 $9,137.80 13.5×
Lung perfusion differential (78597) $3,050.92 $4,358.45 8.7×
Lung Ventilat&Perfus Imaging (78582) $6,083.45 $8,690.64 12.8×
Lung Ventilation Imaging (78579) $3,345.58 $4,779.40 9.6×
Lymph System Imaging (78195) $2,476.11 $3,537.30 5.2×
Magnetic Image Jaw Joint (70336) $4,154.22 $5,934.60 19.9×
Mammary ductogram or galactogram multiple (77054) $1,050.28 $1,500.40 5.0×
Mammary ductogram or galactogram single (77053) $700.63 $1,000.90 3.4×
Meckels Divert Exam (78290) $3,275.51 $4,679.30 9.4×
Mlc imrt design & construction per imrt plan (77338) $2,496.45 $3,566.35 7.6×
Mra Head W/O & W/Contrast Material (70546) $2,695 $3,850 8.8×
MRA head w/o contrast (70544) $2,348.78 $3,355.40 11.3×
MRA head with contrast (70545) $2,663.15 $3,804.50 8.7×
MRA neck w contrast (70548) $2,418.50 $3,455 7.9×
Mra Neck W/O &W/Contrast Material (70549) $2,614.50 $3,735 8.6×
MRA neck w/o contrast (70547) $2,223.20 $3,176 10.7×
MRI abdomen w contrast (74182)
range across 3 matching MRF lines
$1,050–$5,264.01 $1,500–$7,520.02 varies
MRI abdomen w/o contrast (74181)
range across 4 matching MRF lines
$1,050–$6,511.13 $1,500–$9,301.62 varies
MRI any jt lower extrem w/contrast material (73722) $4,620 $6,600 6.7×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $4,690 $6,700 15.4×
MRI any jt upper extremity w/contrast matrl (73222) $4,697 $6,710 6.8×
MRI Breast W/O Contrast Bilateral (77047) $5,301.87 $7,574.10 25.4×
MRI Breast Without Contrast Material Unilateral (77046) $4,569.60 $6,528 21.9×
MRI cervical spine w contrast (72142)
range across 2 matching MRF lines
$1,050–$4,830 $1,500–$6,900 varies
MRI cervical spine w/o cont (72141)
range across 3 matching MRF lines
$1,050–$4,816.55 $1,500–$6,880.78 varies
MRI chest w/o contrast (71550)
range across 4 matching MRF lines
$1,050–$4,569.25 $1,500–$6,527.50 varies
MRI chest with contrast (71551)
range across 3 matching MRF lines
$1,009.54–$4,620 $1,442.20–$6,600 varies
MRI chest wo w contrast (71552)
range across 3 matching MRF lines
$1,050–$4,690 $1,500–$6,700 varies
MRI lower extrem oth/thn jt w/contrast matrl (73719)
range across 9 matching MRF lines
$5,250–$6,306.16 $7,500–$9,008.80 varies
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $5,320 $7,600 17.4×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $5,080.99 $7,258.55 24.3×
MRI lumbar spine w contrast (72149)
range across 2 matching MRF lines
$1,050–$4,760 $1,500–$6,800 varies
Mri Neck Spine W/O & W/Dye (72156)
range across 3 matching MRF lines
$1,050–$5,832.22 $1,500–$8,331.74 varies
MRI orbit face &/neck w/o contrast (70540) $4,612.30 $6,589 22.1×
MRI orbit face neck w contrast (70542) $4,620 $6,600 15.1×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $4,745.46 $6,779.23 15.5×
MRI pelvis w contrast (72196)
range across 4 matching MRF lines
$1,050–$4,970 $1,500–$7,100 varies
MRI pelvis w/o & w contrast (72197)
range across 5 matching MRF lines
$1,050–$5,040 $1,500–$7,200 varies
MRI pelvis w/o contrast (72195)
range across 7 matching MRF lines
$1,050–$4,916.63 $1,500–$7,023.76 varies
MRI spectroscopy (76390) $421.96 $602.80 5.5×
MRI thoracic spine w/o contrast (72146)
range across 4 matching MRF lines
$1,050–$5,200.94 $1,500–$7,429.91 varies
MRI upper extremity oth than jt w/contr matrl (73219) $4,410 $6,300 14.4×
MRI upper extremity oth than jt w/o contr matrl (73218) $4,357.61 $6,225.16 20.9×
Mri Uppr Extremity W/O&W/Dye (73220) $4,574.50 $6,535 15.0×
MRI, abdomen, combo (74183)
range across 4 matching MRF lines
$1,050–$5,285 $1,500–$7,550 varies
MRI, dorsal spine combo (72157)
range across 4 matching MRF lines
$1,050–$6,364.01 $1,500–$9,091.44 varies
MRI, dorsal spine contrast (72147)
range across 2 matching MRF lines
$1,050–$5,250 $1,500–$7,500 varies
MRI, joint upper extrem (73221) $4,630.26 $6,614.66 22.2×
MRI, joint upper extrem combo (73223) $4,955.31 $7,079.01 16.2×
MRI, lumbar spine combo (72158)
range across 3 matching MRF lines
$1,050–$5,791.42 $1,500–$8,273.46 varies
Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) $2,716.32 $3,880.45 7.8×
Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) $2,716.32 $3,880.45 5.7×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $3,622.05 $5,174.35 3.2×
Myocardial Spect Multiple Studies (78452) $4,713.87 $6,734.10 4.2×
N-invas est c ffr sw aly CTA (75580) $1,031.21 $1,473.15 1.4×
Neck soft tissue (70360) $262.80 $375.43 3.5×
Nm csf leak detection (78650) $3,474.21 $4,963.15 3.1×
Nm myocard infarct spect (78469) $673.75 $962.50 1.4×
Ntsty modul radthx pln dose-vol histos (77301) $15,723.82 $22,462.60 13.0×
Nuclear Rx Oral Admin (79005) $4,187.98 $5,982.83 20.5×
Ophthalmic Ultrasonic Foreign Body Localization (76529) $555.59 $793.70 7.3×
Parathyroid imaging w/tomographic spect & CT (78072) $3,092.46 $4,417.80 6.5×
Parathyroid Planar Imaging (78070) $2,673.97 $3,819.95 7.6×
Parathyroid planar imaging w/wo subtraction (78071) $3,736.64 $5,338.05 10.7×
Pelvis 1 or 2 views (72170) $520.46 $743.51 5.7×
Peritoneogram Rs&I (74190) $1,396.43 $1,994.90 2.9×
Pet Image Skull-Thigh (78812) $12,658.80 $18,084 10.1×
PET image w/CT, full body (78816) $9,172.24 $13,103.20 7.3×
PET imaging CT attenuation skull base mid-thigh (78815) $9,211.12 $13,158.74 7.4×
Pet Imaging Limited Area Chest Head/Neck (78811) $12,778.12 $18,254.45 11.3×
Pet Myocardial Sngl Study (78491) $11,249.95 $16,071.35 9.0×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $3,304.88 $4,721.25 1.2×
Pulmonary Perfusion Imaging Particulate (78580) $2,684.29 $3,834.70 7.7×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $937.69 $1,339.55 10.3×
Radex abscess/fistula/sinus tract rs&i (76080) $1,094.87 $1,564.10 2.3×
Radex Ankle Complete Minimum 3 Views (73610) $458.13 $654.47 6.0×
Radex Calcaneus Minimum 2 Views (73650) $403.76 $576.80 5.3×
Radex elbow complete minimum 3 views (73080) $446.31 $637.59 5.9×
Radex Facial Bones Complete Minimum 3 Views (70150) $541.52 $773.60 5.9×
Radex fingr minimum 2 views (73140) $292.43 $417.76 3.8×
Radex foot complete minimum 3 views (73630) $466.80 $666.86 6.1×
Radex Hand Minimum 3 Views (73130) $414.10 $591.57 5.4×
Radex lower extremity infant minimum 2 views (73592) $506.10 $723 6.6×
Radex Nasal Bones Complete Minimum 3 Views (70160) $467.81 $668.30 6.1×
Radex Ribs Unilateral 2 Views (71100) $136.73 $195.33 1.8×
Radex shoulder complete minimum 2 views (73030) $488.25 $697.50 6.4×
Radex Sinuses Paransl < 3 Views (70210) $226.52 $323.60 3.0×
Radex Spine 1 View Specify Level (72020) $485.70 $693.86 6.4×
Radex Sternum Minimum 2 Views (71120) $403.76 $576.80 5.3×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $526.89 $752.70 6.9×
Radex Toe Minimum 2 Views (73660) $310.14 $443.06 4.1×
Radex upper extremity infant minimum 2 views (73092) $403.76 $576.80 4.4×
Radex Wrist Complete Minimum 3 Views (73110) $427 $610 5.6×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $2,692.98 $3,847.12 29.4×
Radiation Delivery Stereotactic Cranial Linear (77372)
range across 2 matching MRF lines
$18,864.86–$19,921.37 $26,949.80–$28,459.10 varies
Radiation treatment delivery level 1 (77402) $908.43 $1,297.75 10.2×
Radiation treatment delivery level 2 (77407) $1,202.74 $1,718.20 3.6×
Radiation treatment delivery level 3 (77412) $1,445.47 $2,064.95 3.0×
Radiolog exam mandible compl minimum 4 views (70110) $483.97 $691.39 5.3×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $693.67 $990.95 7.6×
Radiologic exam colon double contrast study (74280) $1,564.36 $2,234.80 10.2×
Radiologic exam colon single contrast study (74270) $1,313.05 $1,875.79 8.6×
Radiologic Exam Esophagus Double Contrast Study (74221) $1,066.88 $1,524.11 7.0×
Radiologic exam knee complete 4/more views (73564)
range across 2 matching MRF lines
$623.80–$661.50 $891.14–$945 varies
Radiologic exam pelvis compl minimum 3 views (72190) $675.70 $965.28 7.4×
Radiologic Exam Small Int Single Contrast Study (74250) $1,612.71 $2,303.87 10.5×
Radiologic exam upr gi trc double contrast study (74246) $1,787.07 $2,552.96 11.6×
Radiologic examination femur minimum 2 views (73552) $505.25 $721.79 6.6×
Radiologic examination knee 1/2 views (73560) $623.80 $891.14 8.2×
Radiologic Examination Osseous Survey Limited (77074) $1,239.63 $1,770.90 13.6×
Radiologic examination tibia & fibula 2 views (73590) $462.81 $661.15 6.1×
Radiopharm Dacryocystography (78660) $863.03 $1,232.90 2.5×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) $1,176 $1,680 3.5×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) $1,554.53 $2,220.75 4.6×
Renal Cyst Study (74470) $1,116.99 $1,595.70 2.3×
Ribs bilateral 3 views (71110) $235.10 $335.86 2.6×
Rp loclzj tum plnr 1 area single day imaging (78800) $3,211.39 $4,587.70 9.2×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $3,211.39 $4,587.70 9.2×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $4,529.73 $6,471.04 9.5×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $6,078.56 $8,683.65 12.8×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $4,146.10 $5,923 8.7×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $2,992.43 $4,274.90 2.6×
Rp Therapy Intravenous Administration (79101)
range across 5 matching MRF lines
$1,390.41–$1,511.16 $1,986.30–$2,158.80 varies
Salivary Gland Imaging (78230) $469.13 $670.19 1.3×
Scapula (73010) $403.76 $576.80 4.4×
Screening Digital Breast Tomosynthesis Bi (77063)
range across 2 matching MRF lines
$35.77–$39.34 $51.10–$56.20 varies
Shoulder 1 view (73020) $411.84 $588.34 5.4×
Shoulder Arthrography (73040) $1,057.21 $1,510.30 3.5×
Sialogram (70390) $1,175.37 $1,679.10 5.6×
Skull less than 4 views (70250) $581.52 $830.74 6.4×
Special dosimetry (77331) $971.32 $1,387.60 8.3×
Special Physics Consult (77370) $1,455.62 $2,079.45 12.4×
Special teletherapy port plan (77321) $1,443.51 $2,062.15 4.4×
Special treatment procedure (77470) $3,628.73 $5,183.90 7.5×
Spleen Imaging (78185) $1,695.40 $2,422 4.8×
Stereotactic Body Radiation Delivery (77373)
range across 4 matching MRF lines
$10,517.96–$15,019.48 $15,025.65–$21,456.40 varies
Sternoclavicular joints (71130) $427.38 $610.54 5.6×
Telethx isodose pln cplx w/basic dosimetry (77307) $3,152.80 $4,504 9.6×
Telethx isodose pln smpl w/dosimetry calculation (77306) $2,182.67 $3,118.10 6.7×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $3,560.03 $5,085.75 10.9×
Ther rad simulaj-aided field setting simple (77280) $1,794.21 $2,563.15 15.3×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $1,929.69 $2,756.70 12.6×
Thoracic spine 2 views (72070) $492.49 $703.56 5.4×
Thoracic spine 3 views (72072) $500.50 $715 5.5×
Thoracolumbar 2 views (72080) $467.81 $668.30 6.1×
Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) $554.67 $792.38 1.6×
Thyroid Carcinoma Metastases Img Lmtd Area (78015) $2,049.11 $2,927.30 5.9×
Thyroid Imaging With Vascular Flow (78013) $1,875.34 $2,679.05 5.4×
Thyroid Met Imaging Body (78018) $2,557.59 $3,653.70 5.4×
Thyroid Uptake Measurement (78012) $816.59 $1,166.55 2.3×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $2,015.02 $2,878.60 5.8×
Tx Devices Design & Construction Complex (77334) $1,496.46 $2,137.80 4.6×
Tx devices design & construction intermediate (77333) $1,196.72 $1,709.60 10.2×
Tx devices design & construction simple (77332) $898.03 $1,282.90 7.6×
Ultrasound Breast Limited (76642)
range across 7 matching MRF lines
$105–$728.78 $150–$1,041.12 varies
Ultrasound Elastography Parenchyma (76981)
range across 14 matching MRF lines
$120.99–$1,227.98 $172.84–$1,754.25 varies
Ultrasound Exam Aaa Screen (76706) $810.32 $1,157.60 8.9×
Ultrasound, abdomen limited (76705) $1,086.91 $1,552.73 11.9×
Umbilical-artery Doppler (OB) (76820) $166.11 $237.30 1.8×
Upper gi w/o kub (74240) $1,149.09 $1,641.55 7.5×
Ureteral Reflux Study (78740) $1,090.92 $1,558.45 3.1×
Urethrocystogram voiding (74455) $666.37 $951.96 3.2×
Urethrocystography retrograde (74450) $1,240.09 $1,771.55 5.9×
Us breast unilateral complete (76641)
range across 6 matching MRF lines
$111.66–$2,393.27 $159.51–$3,418.95 varies
Us chest (76604) $1,155.58 $1,650.83 12.6×
Us complete joint (76881)
range across 4 matching MRF lines
$829.92–$1,145.41 $1,185.60–$1,636.30 varies
Us exam, pelvic, limited (76857) $445.24 $636.06 4.9×
Us head (76506) $1,692.62 $2,418.03 18.5×
Us kidney transplant (76776) $836.19 $1,194.55 9.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $801.47 $1,144.95 8.8×
Us ob detailed single fetus (76811) $1,176.50 $1,680.72 5.6×
Us ob limited 1 or more fetuses (76815) $1,077.42 $1,539.17 11.8×
Us ob transvaginal (76817) $1,041.45 $1,487.78 11.4×
Us pelvic non ob complete (76856) $1,337.52 $1,910.74 14.6×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801)
range across 4 matching MRF lines
$1,179.72–$1,584.98 $1,685.32–$2,264.25 varies
Us preg uterus real time f/u trnsabdl per fetus (76816) $1,393.90 $1,991.28 15.2×
Us retroperitoneal complete (76770) $1,179.33 $1,684.76 12.9×
Us retroperitoneal limited (76775)
range across 2 matching MRF lines
$525–$958.32 $750–$1,369.03 varies
Us scrotum and contents (76870) $1,126.35 $1,609.07 12.3×
Us spinal canal and contents (76800) $1,070.27 $1,528.95 11.7×
Us thyroid (76536)
range across 4 matching MRF lines
$897.99–$1,113.81 $1,282.84–$1,591.15 varies
Us transrectal (76872) $401.63 $573.75 4.4×
Vascular Flow Imaging (78445) $1,342.74 $1,918.20 3.8×
Vasogram (74440) $729.75 $1,042.50 3.5×
Vein X-Ray Chest (75827) $3,153.05 $4,504.35 2.3×
Vein X-Ray Spleen/Liver (75810) $3,304.88 $4,721.25 1.2×
Venogram Sinus/Jugular (75860) $3,304.88 $4,721.25 1.2×
Venography caval inferior serialography rs&i (75825) $3,981.39 $5,687.70 1.4×
Venography extremity bilateral rs&i (75822) $1,715 $2,450 1.2×
Venography extremity unilateral rs&i (75820) $1,679.41 $2,399.16 1.2×
Venography Renal Bilateral (75833) $3,325 $4,750 1.2×
Venography Renal Unilateral (75831) $3,304.88 $4,721.25 1.2×
Venous sampling by catheter (75893) $5,675.99 $8,108.55 1.2×
Venous thrombosis imaging (78457) $2,054.78 $2,935.40 4.3×
Venous Thrombosis Imaging Venogram Bilateral (78458) $2,370.76 $3,386.80 6.8×
Vertebral fracture assessment via dxa (77086) $153.86 $219.80 2.0×
Wrist 2 views (73100) $422.56 $603.65 5.5×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $403.76 $576.80 5.3×
X-ray antegrade pyelogram tube (74425) $397.11 $567.30 1.3×
X-Ray Aorta Leg Arteries (75630) $3,889 $5,555.71 1.4×
X-Ray Bend Only L-S Spine (72120) $687.59 $982.27 7.5×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $447.89 $639.84 5.9×
X-Ray Exam Breast Specimen (76098) $757.61 $1,082.30 1.6×
X-Ray Exam Entire Spi 1 Vw (72081) $591.92 $845.60 7.8×
X-Ray Exam Entire Spi 2/3 Vw (72082) $1,575.56 $2,250.80 17.2×
X-Ray Exam Entire Spi 4/5 Vw (72083) $2,166.92 $3,095.60 23.7×
X-Ray Exam Hip Uni 1 View (73501) $462.89 $661.27 6.1×
X-Ray Exam Hip Uni 2-3 Views (73502) $594.66 $849.51 7.8×
X-Ray Exam Hips Bi 3-4 Views (73522) $853.84 $1,219.77 9.3×
X-Ray Exam Hips Bi 5/> Views (73523) $643.90 $919.86 7.0×
X-Ray Exam L-S Spine Bending (72114) $671.01 $958.58 7.3×
X-Ray Exam Neck Spine 2-3 Vw (72040) $556.21 $794.59 7.3×
X-Ray Exam Neck Spine 6/>Vws (72052) $666.19 $951.70 7.3×
X-Ray Exam Unilat Ribs/Chest (71101) $593.24 $847.48 6.5×
X-ray eye for foreign body (70030) $583.42 $833.45 7.7×
X-ray humerus (73060) $446.64 $638.06 5.9×
X-ray IV pyelogram (ivp) (74400) $1,691.62 $2,416.60 11.0×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $421.96 $602.80 5.5×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $403.76 $576.80 5.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $583.63 $833.76 6.4×
X-ray nose-rectum child f.b. (76010) $277.48 $396.40 3.6×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $663.41 $947.73 7.3×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $467.81 $668.30 5.1×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $403.76 $576.80 4.4×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $420.27 $600.38 5.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $478.58 $683.69 6.3×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $736.17 $1,051.67 8.0×
X-Ray Stress View (77071) $557.27 $796.10 7.3×
X-ray thoracic spine 4 vw (72074) $575.32 $821.89 6.3×
X-Ray Tmj Unilat (70328) $526.89 $752.70 6.9×
X-Ray Urinary Tract Exam With Contrast Material (74420) $1,048.55 $1,497.93 3.4×
X-Rays Bone Length Studies (77073) $929.60 $1,328 10.2×
X-Rays Bone Survey Complete (77075) $2,110.25 $3,014.64 23.1×
Xr c-spine 4 or 5 views (72050) $578.57 $826.53 6.3×
Xr facial bones less than 3 views (70140) $462.49 $660.70 6.1×
Xr orbits complete 4 views (70200) $403.76 $576.80 4.4×

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.