Imaging prices at Memorial Hospital
Dumas, TX · every code in this section with a posted price and a Medicare benchmark.
259 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) | $260.80 | $326 | 3.0× |
| Abdomen 2 views (74019) | $372.80 | $466 | 3.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,056 | $1,320 | 2.6× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$36.80–$270.40 | $46–$338 | varies |
| Arthrogram ankle (73615) | $874.40 | $1,093 | 2.5× |
| Arthrogram hip (73525) | $874.40 | $1,093 | 2.5× |
| Arthrogram Wrist (73115) | $848.80 | $1,061 | 2.4× |
| Bone age studies (77072) | $278.40 | $348 | 2.7× |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$107.20–$1,780.80 | $134–$2,226 | varies |
| Bone Imaging Limited Area (78300) | $1,140.80 | $1,426 | 2.8× |
| Bone Imaging Multiple Areas (78305) | $1,100 | $1,375 | 2.7× |
| Bone Imaging Whole Body (78306) range across 3 matching MRF lines |
$107.20–$1,200.80 | $134–$1,501 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$44.80–$484 | $56–$605 | varies |
| Cat Scan Follow-Up Study (76380) | $640.80 | $801 | 7.3× |
| Chest 1 view (71045) | $266.40 | $333 | 3.0× |
| Chest 2 views (71046) | $310.40 | $388 | 3.6× |
| Chest 3 views (71047) | $355.20 | $444 | 4.1× |
| Chest 4 or more views (71048) | $400 | $500 | 3.8× |
| Cholecystography Oral Contrast (74290) | $381.60 | $477 | 2.2× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$44.80–$266.40 | $56–$333 | varies |
| Contrast X-Ray Bladder (74430) | $685.60 | $857 | 2.0× |
| Contrast X-Ray Of Elbow (73085) | $874.40 | $1,093 | 2.5× |
| Contrast X-Ray Of Knee Joint (73580) | $874.40 | $1,093 | 2.5× |
| CT abdomen and pelvis without and with contrast (74178) range across 4 matching MRF lines |
$152.80–$5,598.40 | $191–$6,998 | varies |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$193.60–$3,803.20 | $242–$4,754 | varies |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$145.60–$2,839.20 | $182–$3,549 | varies |
| CT abdomen w wo contrast (74170) range across 3 matching MRF lines |
$172–$3,552.80 | $215–$4,441 | varies |
| CT abdomen w/o contrast (74150) range across 5 matching MRF lines |
$152.80–$2,539.20 | $191–$3,174 | varies |
| CT Angio Chest (71275) range across 4 matching MRF lines |
$214.40–$2,899.20 | $268–$3,624 | varies |
| CT Angio Head (70496) | $2,755.20 | $3,444 | 15.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$1,603.20–$2,675.20 | $2,004–$3,344 | varies |
| CT Angio Neck (70498) | $3,192 | $3,990 | 18.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,840 | $3,550 | 16.1× |
| CT cervical spine w/ contrast (72126) | $2,277.60 | $2,847 | 6.5× |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$152.80–$1,968.80 | $191–$2,461 | varies |
| CT cervical spine w/wo cont (72127) | $2,496.80 | $3,121 | 14.2× |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$141.60–$2,540 | $177–$3,175 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$154.40–$2,786.40 | $193–$3,483 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,848.80 | $2,311 | 10.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,848.80 | $2,311 | 17.6× |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$152.80–$1,844 | $191–$2,305 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$152.80–$2,496.80 | $191–$3,121 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$175.20–$181.60 | $219–$227 | varies |
| CT iac w contrast (70481) | $1,828.80 | $2,286 | 10.4× |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$303.20–$2,496.80 | $379–$3,121 | varies |
| CT lower ext w/o (73700) range across 16 matching MRF lines |
$152.80–$1,434.40 | $191–$1,793 | varies |
| CT lower extremity w/contrast material (73701) range across 15 matching MRF lines |
$164.80–$1,568.80 | $206–$1,961 | varies |
| CT lumbar spine w contrast (72132) | $2,277.60 | $2,847 | 6.5× |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$115.20–$1,968.80 | $144–$2,461 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,757.60–$1,828.80 | $2,197–$2,286 | varies |
| CT maxillofacial wo contrast (70486) range across 5 matching MRF lines |
$152.80–$1,724.80 | $191–$2,156 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$372–$2,560 | $465–$3,200 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,496.80 | $3,121 | 14.2× |
| CT orbits w/o contrast (70480) range across 6 matching MRF lines |
$152.80–$1,890.40 | $191–$2,363 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$372–$2,786.40 | $465–$3,483 | varies |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$152.80–$1,834.40 | $191–$2,293 | varies |
| CT scan of leg combo (73702) range across 15 matching MRF lines |
$184.80–$2,194.40 | $231–$2,743 | varies |
| CT scans face/jaw combo (70488) | $2,496.80 | $3,121 | 14.2× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$264.80–$1,858.40 | $331–$2,323 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$245.60–$1,724.80 | $307–$2,156 | varies |
| CT thoracic spine w contrast (72129) | $2,277.60 | $2,847 | 12.9× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$262.40–$1,968.80 | $328–$2,461 | varies |
| CT thoracic spine w/wo cont (72130) | $2,496.80 | $3,121 | 14.2× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$116.80–$2,180 | $146–$2,725 | varies |
| CT upper ext wo (73200) range across 16 matching MRF lines |
$152.80–$1,434.40 | $191–$1,793 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 13 matching MRF lines |
$184.80–$2,194.40 | $231–$2,743 | varies |
| CT upper extremity with contrast (73201) range across 13 matching MRF lines |
$164.80–$1,568.80 | $206–$1,961 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,652 | $5,815 | 26.4× |
| Cta Abdomen (74175) range across 4 matching MRF lines |
$372–$3,045.60 | $465–$3,807 | varies |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$44.80–$336.80 | $56–$421 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $266.40 | $333 | 3.0× |
| Echo exam uterus (76831) | $444.80 | $556 | 1.9× |
| Esophageal Motility Study (78258) | $1,056 | $1,320 | 2.6× |
| Esophagram (74220) | $472.80 | $591 | 2.7× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$107.20–$124 | $134–$155 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$420–$680.80 | $525–$851 | varies |
| Fluoroscopy up to 1 hr (76000) | $430.40 | $538 | 1.8× |
| Foot 2 views (73620) range across 5 matching MRF lines |
$36.80–$266.40 | $46–$333 | varies |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$25.60–$285.60 | $32–$357 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$152.80–$1,961.60 | $191–$2,452 | varies |
| Gated Heart Planar Single (78472) | $1,521.60 | $1,902 | 3.8× |
| Gated Heart, Multiple (78473) | $1,560 | $1,950 | 3.9× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$44.80–$266.40 | $56–$333 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 3 matching MRF lines |
$152.80–$1,509.60 | $191–$1,887 | varies |
| Hysterosalpingogram (74740) | $860.80 | $1,076 | 3.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $568.80 | $711 | 6.5× |
| K Flow/Funct Image W/Drug (78708) | $1,831.20 | $2,289 | 3.4× |
| K Flow/Funct Image W/O Drug (78707) range across 3 matching MRF lines |
$152.80–$1,748 | $191–$2,185 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,067.20 | $1,334 | 2.7× |
| Kidney Imaging Morphol (78700) | $1,044.80 | $1,306 | 2.6× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$36.80–$378.40 | $46–$473 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,184 | $1,480 | 2.9× |
| Liver imaging w/vascular flow (78202) | $1,184 | $1,480 | 2.2× |
| Lung Ventilat&Perfus Imaging (78582) | $1,869.60 | $2,337 | 3.4× |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$152.80–$728.80 | $191–$911 | varies |
| Magnetic Image Jaw Joint (70336) | $2,083.20 | $2,604 | 8.7× |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$606.40–$644.80 | $758–$806 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$484.80–$516.80 | $606–$646 | varies |
| Meckels Divert Exam (78290) | $1,056 | $1,320 | 2.6× |
| Mra Head W/O & W/Contrast Material (70546) | $3,227.20 | $4,034 | 9.2× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$197.60–$2,139.20 | $247–$2,674 | varies |
| MRA head with contrast (70545) | $2,352.80 | $2,941 | 6.7× |
| MRA neck w contrast (70548) | $2,352.80 | $2,941 | 6.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,227.20 | $4,034 | 9.2× |
| MRA neck w/o contrast (70547) | $2,139.20 | $2,674 | 8.9× |
| MRI abdomen w contrast (74182) range across 4 matching MRF lines |
$2,139.20–$2,352.80 | $2,674–$2,941 | varies |
| MRI abdomen w/o contrast (74181) range across 4 matching MRF lines |
$1,976–$2,139.20 | $2,470–$2,674 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $2,071.20 | $2,589 | 2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,854.40 | $3,568 | 8.1× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 6 matching MRF lines |
$1,976–$2,071.20 | $2,470–$2,589 | varies |
| MRI cervical spine w contrast (72142) | $2,352.80 | $2,941 | 6.7× |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$184.80–$2,704.80 | $231–$3,381 | varies |
| MRI chest w/o contrast (71550) | $2,139.20 | $2,674 | 8.9× |
| MRI chest with contrast (71551) | $2,499.20 | $3,124 | 3.2× |
| MRI chest wo w contrast (71552) | $3,227.20 | $4,034 | 9.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,071.20 | $2,589 | 5.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,854.40 | $3,568 | 8.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 6 matching MRF lines |
$138.40–$2,212.80 | $173–$2,766 | varies |
| MRI lumbar spine w contrast (72149) | $2,226.40 | $2,783 | 6.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,242.40 | $4,053 | 9.3× |
| MRI orbit face &/neck w/o contrast (70540) | $2,139.20 | $2,674 | 8.9× |
| MRI orbit face neck w contrast (70542) | $2,352.80 | $2,941 | 6.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$2,363.20–$3,227.20 | $2,954–$4,034 | varies |
| MRI pelvis w contrast (72196) | $2,352.80 | $2,941 | 6.7× |
| MRI pelvis w/o & w contrast (72197) | $3,071.20 | $3,839 | 8.8× |
| MRI pelvis w/o contrast (72195) | $2,139.20 | $2,674 | 8.9× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$184.80–$2,704.80 | $231–$3,381 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,071.20 | $2,589 | 5.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 7 matching MRF lines |
$138.40–$1,872.80 | $173–$2,341 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 6 matching MRF lines |
$2,843.20–$2,854.40 | $3,554–$3,568 | varies |
| MRI, abdomen, combo (74183) range across 4 matching MRF lines |
$3,071.20–$3,227.20 | $3,839–$4,034 | varies |
| MRI, dorsal spine combo (72157) | $3,242.40 | $4,053 | 9.3× |
| MRI, dorsal spine contrast (72147) | $2,352.80 | $2,941 | 6.7× |
| MRI, joint upper extrem (73221) range across 10 matching MRF lines |
$154.40–$2,212.80 | $193–$2,766 | varies |
| MRI, joint upper extrem combo (73223) | $2,854.40 | $3,568 | 8.1× |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$172–$3,242.40 | $215–$4,053 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$1,732.80–$2,054.40 | $2,166–$2,568 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$1,732.80–$2,054.40 | $2,166–$2,568 | varies |
| Myelography thoracic (72255) | $1,690.40 | $2,113 | 2.1× |
| Myelograpy 2/more regions rs&i (72270) | $1,732.80 | $2,166 | 2.2× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $1,174.40 | $1,468 | 2.2× |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$179.20–$2,778.40 | $224–$3,473 | varies |
| Neck soft tissue (70360) range across 4 matching MRF lines |
$22.40–$266.40 | $28–$333 | varies |
| Nm unlisted gi procedure (78299) | $667.20 | $834 | 1.7× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$1,016–$1,132 | $1,270–$1,415 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,132 | $1,415 | 2.8× |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$36.80–$266.40 | $46–$333 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$152.80–$937.60 | $191–$1,172 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$47.20–$446.40 | $59–$558 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $530.40 | $663 | 1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$44.80–$288 | $56–$360 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $266.40 | $333 | 3.0× |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$25.60–$266.40 | $32–$333 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 4 matching MRF lines |
$44.80–$266.40 | $56–$333 | varies |
| Radex fingr minimum 2 views (73140) range across 15 matching MRF lines |
$25.60–$266.40 | $32–$333 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$25.60–$334.40 | $32–$418 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$36.80–$281.60 | $46–$352 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $266.40 | $333 | 3.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $266.40 | $333 | 2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 4 matching MRF lines |
$44.80–$296.80 | $56–$371 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 5 matching MRF lines |
$43.20–$300 | $54–$375 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$25.60–$296.80 | $32–$371 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$52.80–$296.80 | $66–$371 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$25.60–$40 | $32–$50 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$49.60–$296.80 | $62–$371 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $310.40 | $388 | 3.6× |
| Radex Toe Minimum 2 Views (73660) range across 15 matching MRF lines |
$22.40–$266.40 | $28–$333 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) | $274.40 | $343 | 3.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $527.20 | $659 | 5.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $337.60 | $422 | 3.2× |
| Radiologic exam colon double contrast study (74280) | $644.80 | $806 | 3.7× |
| Radiologic exam colon single contrast study (74270) | $527.20 | $659 | 3.0× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$44.80–$388 | $56–$485 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $296.80 | $371 | 2.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$356–$472.80 | $445–$591 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$244.80–$472.80 | $306–$591 | varies |
| Radiologic exam upr gi trc double contrast study (74246) | $502.40 | $628 | 2.9× |
| Radiologic examination femur minimum 2 views (73552) | $300.80 | $376 | 3.4× |
| Radiologic examination knee 1/2 views (73560) range across 7 matching MRF lines |
$36.80–$334.40 | $46–$418 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$25.60–$266.40 | $32–$333 | varies |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$44.80–$388.80 | $56–$486 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,841.60 | $2,302 | 3.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,728.80 | $2,161 | 3.2× |
| Scapula (73010) range across 4 matching MRF lines |
$21.60–$266.40 | $27–$333 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $154.40 | $193 | 6.6× |
| Sella turcica (70240) | $266.40 | $333 | 3.0× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$42.40–$266.40 | $53–$333 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$179.20–$874.40 | $224–$1,093 | varies |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$36.80–$266.40 | $46–$333 | varies |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$63.20–$296.80 | $79–$371 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$44.80–$296.80 | $56–$371 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$43.20–$405.60 | $54–$507 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$50.40–$310.40 | $63–$388 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $820 | $1,025 | 2.0× |
| Thyroid Uptake Measurement (78012) | $580 | $725 | 1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $820 | $1,025 | 2.0× |
| Ultrasound Breast Limited (76642) | $276.80 | $346 | 3.2× |
| Ultrasound Exam Aaa Screen (76706) | $504 | $630 | 4.8× |
| Ultrasound, abdomen limited (76705) range across 6 matching MRF lines |
$76.80–$592 | $96–$740 | varies |
| Umbilical-artery Doppler (OB) (76820) | $105.60 | $132 | 1.0× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$107.20–$394.40 | $134–$493 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$381.60–$789.60 | $477–$987 | varies |
| Ureteral Reflux Study (78740) | $945.60 | $1,182 | 2.4× |
| Urethrocystogram voiding (74455) | $685.60 | $857 | 2.9× |
| Urethrocystography retrograde (74450) | $685.60 | $857 | 2.9× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$393.60–$452.80 | $492–$566 | varies |
| Us chest (76604) | $506.40 | $633 | 4.8× |
| Us complete joint (76881) | $540 | $675 | 5.1× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$107.20–$394.40 | $134–$493 | varies |
| Us head (76506) | $695.20 | $869 | 6.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$340–$343.20 | $425–$429 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$107.20–$420 | $134–$525 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$107.20–$471.20 | $134–$589 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$84.80–$653.60 | $106–$817 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$115.20–$420 | $144–$525 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$280–$446.40 | $350–$558 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$107.20–$504 | $134–$630 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$54.40–$568.80 | $68–$711 | varies |
| Us spinal canal and contents (76800) | $570.40 | $713 | 5.4× |
| Us thyroid (76536) range across 4 matching MRF lines |
$107.20–$597.60 | $134–$747 | varies |
| Venography extremity bilateral rs&i (75822) | $3,450.40 | $4,313 | 2.2× |
| Venography extremity unilateral rs&i (75820) | $1,728.80 | $2,161 | 1.1× |
| Vertebral fracture assessment via dxa (77086) | $197.60 | $247 | 2.3× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$43.20–$266.40 | $54–$333 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$63.20–$266.40 | $79–$333 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$75.20–$310.40 | $94–$388 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$36.80–$266.40 | $46–$333 | varies |
| X-Ray Exam Breast Specimen (76098) | $291.20 | $364 | 0.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $337.60 | $422 | 3.2× |
| X-Ray Exam Hip Uni 1 View (73501) | $266.40 | $333 | 3.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$293.60–$324 | $367–$405 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $418.40 | $523 | 4.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $532.80 | $666 | 5.1× |
| X-Ray Exam L-S Spine Bending (72114) | $527.20 | $659 | 5.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 5 matching MRF lines |
$44.80–$296.80 | $56–$371 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$94.40–$444 | $118–$555 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 5 matching MRF lines |
$35.20–$310.40 | $44–$388 | varies |
| X-ray eye for foreign body (70030) | $49.60 | $62 | 0.6× |
| X-ray humerus (73060) range across 5 matching MRF lines |
$25.60–$300 | $32–$375 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 3 matching MRF lines |
$65.60–$748.80 | $82–$936 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 3 matching MRF lines |
$59.20–$310.40 | $74–$388 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $266.40 | $333 | 3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 4 matching MRF lines |
$43.20–$405.60 | $54–$507 | varies |
| X-ray nose-rectum child f.b. (76010) | $266.40 | $333 | 3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $496 | $620 | 4.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$44.80–$296.80 | $56–$371 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$44.80–$296.80 | $56–$371 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$36.80–$310.40 | $46–$388 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$44.80–$324.80 | $56–$406 | varies |
| X-Ray Stress View (77071) | $288 | $360 | 3.3× |
| X-Ray Tmj Unilat (70328) | $53.60 | $67 | 0.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $685.60 | $857 | 2.0× |
| X-Rays Bone Length Studies (77073) | $317.60 | $397 | 3.0× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$668.80–$806.40 | $836–$1,008 | varies |
| Xr c-spine 4 or 5 views (72050) range across 4 matching MRF lines |
$47.20–$420 | $59–$525 | varies |
| Xr facial bones less than 3 views (70140) range across 5 matching MRF lines |
$49.60–$266.40 | $62–$333 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $63.20 | $79 | 0.6× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$71.20–$296.80 | $89–$371 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$370.40–$551.20 | $463–$689 | 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.