Imaging prices at Mercy Hospital Ada
Ada, OK · every code in this section with a posted price and a Medicare benchmark.
290 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) range across 2 matching MRF lines |
$6,789.90–$38,569.70 | $10,446–$59,338 | varies |
| Abdomen 1 View (74018) | $299 | $460 | 3.6× |
| Abdomen 2 views (74019) | $338 | $520 | 3.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$457.60–$637 | $704–$980 | varies |
| Angiography extremity bilateral rs&i (75716) | $10,080.85 | $15,509 | 3.3× |
| Angiography extremity unilateral rs&i (75710) | $3,923.40 | $6,036 | 1.3× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$200.85–$375.70 | $309–$578 | varies |
| Aortography thoracic serialography rs&i (75605) | $3,518.45 | $5,413 | 0.7× |
| Artery X-Rays Abdomen (75726) | $5,274.10 | $8,114 | 1.0× |
| Artery X-Rays Pelvis (75736) | $4,108.65 | $6,321 | 0.8× |
| Arthrogram hip (73525) | $573.95 | $883 | 1.7× |
| Arthrogram Wrist (73115) | $644.15 | $991 | 1.9× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$786.50–$44,857.15 | $1,210–$69,011 | varies |
| Bone age studies (77072) | $209.95 | $323 | 2.1× |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$739.70–$780.65 | $1,138–$1,201 | varies |
| Bone Imaging Limited Area (78300) | $1,058.20 | $1,628 | 2.8× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,146.60–$1,187.55 | $1,764–$1,827 | varies |
| Bone survey infant (77076) | $304.85 | $469 | 3.0× |
| Brachytx isodose complex (77318) | $2,219.75 | $3,415 | 6.2× |
| Brachytx isodose intermed (77317) | $1,435.20 | $2,208 | 4.0× |
| Brachytx Isodose Plan Simple (77316) | $780 | $1,200 | 2.2× |
| Brain Flow Imaging Only (78610) range across 2 matching MRF lines |
$1,550.90–$1,860.95 | $2,386–$2,863 | varies |
| Cat Scan Follow-Up Study (76380) | $780.65 | $1,201 | 9.3× |
| Chest 1 view (71045) | $236.60 | $364 | 2.8× |
| Chest 2 views (71046) | $359.45 | $553 | 4.3× |
| Chest 3 views (71047) | $462.80 | $712 | 5.5× |
| Chest 4 or more views (71048) | $573.95 | $883 | 5.7× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$210.60–$315.90 | $324–$486 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $367.90 | $566 | 3.7× |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$926.90–$38,569.70 | $1,426–$59,338 | varies |
| Contrast Exam Abdominl Aorta (75625) | $6,778.20 | $10,428 | 2.2× |
| Contrast X-Ray Bladder (74430) | $1,071.85 | $1,649 | 3.2× |
| Contrast X-Ray Of Knee Joint (73580) | $641.55 | $987 | 1.9× |
| CT abdomen and pelvis without and with contrast (74178) | $5,225.35 | $8,039 | 15.6× |
| CT abdomen and pelvis without contrast (74176) | $3,292.25 | $5,065 | 14.3× |
| CT abdomen w contrast (74160) | $2,039.05 | $3,137 | 12.1× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$2,216.50–$2,327.65 | $3,410–$3,581 | varies |
| CT abdomen w/o contrast (74150) | $1,741.35 | $2,679 | 17.3× |
| CT Angio Abdomen and Pelvis (74174) | $4,106.70 | $6,318 | 12.2× |
| CT Angio Chest (71275) | $1,128.40 | $1,736 | 6.7× |
| CT Angio Head (70496) | $1,009.45 | $1,553 | 6.0× |
| CT angio hrt w/3d image (75574) | $2,134.60 | $3,284 | 6.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$1,265.55–$1,898.65 | $1,947–$2,921 | varies |
| CT Angio Neck (70498) | $980.20 | $1,508 | 5.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,619.80–$2,340.65 | $2,492–$3,601 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $861.25 | $1,325 | 5.1× |
| CT cervical spine w/ contrast (72126) | $2,505.10 | $3,854 | 7.5× |
| CT cervical spine w/o contrast (72125) | $1,676.35 | $2,579 | 16.7× |
| CT cervical spine w/wo cont (72127) | $2,777.45 | $4,273 | 16.5× |
| CT chest w contrast (71260) | $1,795.30 | $2,762 | 10.6× |
| CT chest w/wo contrast (71270) | $2,762.50 | $4,250 | 16.4× |
| CT head/brain with contrast (70460) | $1,688.70 | $2,598 | 10.0× |
| CT head/brain without and with contrast (70470) | $1,966.90 | $3,026 | 11.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $32.50 | $50 | 0.4× |
| CT iac w contrast (70481) | $1,650.35 | $2,539 | 9.8× |
| CT l-spine w&w/o contrast (72133) | $2,670.20 | $4,108 | 15.8× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,719.90–$2,580.50 | $2,646–$3,970 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,608.10–$1,930.50 | $2,474–$2,970 | varies |
| CT lumbar spine w contrast (72132) | $2,036.45 | $3,133 | 6.1× |
| CT lumbar spine w/o contrast (72131) | $1,851.20 | $2,848 | 18.4× |
| CT maxillofacial w contrast (70487) | $1,275.30 | $1,962 | 7.6× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,252.55–$1,307.80 | $1,927–$2,012 | varies |
| CT neck tissue combo (70492) | $1,662.05 | $2,557 | 9.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,011.10 | $3,094 | 11.9× |
| CT orbits w/o contrast (70480) | $1,551.55 | $2,387 | 15.4× |
| CT pelvis w&w/o contrast (72194) | $2,031.90 | $3,126 | 12.0× |
| CT pelvis w/o contrast (72192) | $1,670.50 | $2,570 | 16.6× |
| CT scan of leg combo (73702) | $2,403.70 | $3,698 | 14.2× |
| CT scans face/jaw combo (70488) | $2,147.60 | $3,304 | 12.7× |
| CT soft tissue neck w contrast (70491) | $1,275.30 | $1,962 | 7.6× |
| CT soft tissue neck w/o contrast (70490) | $1,006.20 | $1,548 | 10.0× |
| CT thoracic spine w contrast (72129) | $1,969.50 | $3,030 | 11.7× |
| CT thoracic spine w/o contrast (72128) | $1,816.75 | $2,795 | 18.1× |
| CT thoracic spine w/wo cont (72130) | $2,590.90 | $3,986 | 15.4× |
| CT thorax w/o contrast (71250) | $1,040 | $1,600 | 10.3× |
| CT upper ext wo (73200) | $1,105.65 | $1,701 | 11.0× |
| CT upper extremity w/o & w/contrast material (73202) | $2,826.20 | $4,348 | 16.8× |
| CT upper extremity with contrast (73201) | $1,340.95 | $2,063 | 4.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,080.30 | $1,662 | 6.4× |
| Cta Abdomen (74175) | $2,509.65 | $3,861 | 14.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,498.95 | $5,383 | 10.4× |
| Dilation ureters/urethra rs&i (74485) | $2,847 | $4,380 | 1.4× |
| Diskography lumbar (72295) | $3,303.30 | $5,082 | 1.8× |
| Dxa Bone Density Axial (77080) | $335.40 | $516 | 3.3× |
| Dxa bone density study (77085) | $464.10 | $714 | 4.6× |
| Esophagram (74220) | $317.85 | $489 | 1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $718.25 | $1,105 | 7.1× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $3,209.05 | $4,937 | 14.0× |
| Fluoroscopy up to 1 hr (76000) | $2,484.30 | $3,822 | 10.8× |
| Foot 2 views (73620) range across 5 matching MRF lines |
$153.40–$265.85 | $236–$409 | varies |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$154.05–$287.95 | $237–$443 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$2,022.80–$2,652.65 | $3,112–$4,081 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,049.10 | $1,614 | 2.7× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$1,518.40–$1,704.95 | $2,336–$2,623 | varies |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $4,037.80 | $6,212 | 7.7× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$199.55–$343.20 | $307–$528 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,466.45 | $5,333 | 1.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,852.50 | $2,850 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,261–$1,826.12 | $1,940–$2,809.42 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$1,422.85–$1,718.60 | $2,189–$2,644 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$1,236.30–$4,898.40 | $1,902–$7,536 | varies |
| Hysterosalpingogram (74740) | $1,074.45 | $1,653 | 4.7× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$2,004.60–$2,168.40 | $3,084–$3,336 | varies |
| K Flow/Funct Image W/O Drug (78707) | $1,006.85 | $1,549 | 1.9× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$264.55–$397.15 | $407–$611 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,236.30 | $1,902 | 3.2× |
| Lung Ventilat&Perfus Imaging (78582) | $1,134.25 | $1,745 | 2.2× |
| Lung Ventilation Imaging (78579) | $1,118.65 | $1,721 | 2.9× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,201.85–$29,478.94 | $1,849–$45,352.22 | varies |
| Mammary ductogram or galactogram single (77053) | $597.35 | $919 | 2.6× |
| Meckels Divert Exam (78290) | $1,679.60 | $2,584 | 4.4× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$2,942.55–$46,450.30 | $4,527–$71,462 | varies |
| Mra Head W/O & W/Contrast Material (70546) | $3,288.35 | $5,059 | 9.8× |
| MRA head w/o contrast (70544) | $1,943.50 | $2,990 | 8.5× |
| MRA head with contrast (70545) | $2,901.60 | $4,464 | 8.6× |
| MRA neck w contrast (70548) | $2,190.50 | $3,370 | 6.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,350.75 | $5,155 | 10.0× |
| MRA neck w/o contrast (70547) | $2,834.65 | $4,361 | 12.4× |
| MRI abdomen w/o contrast (74181) | $2,028 | $3,120 | 8.8× |
| MRI any jt lower extrem w/contrast material (73722) | $2,120.95 | $3,263 | 2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,518.10 | $3,874 | 7.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,356.25 | $3,625 | 3.1× |
| MRI cervical spine w contrast (72142) | $3,021.85 | $4,649 | 9.0× |
| MRI cervical spine w/o cont (72141) | $2,692.30 | $4,142 | 11.7× |
| MRI chest w/o contrast (71550) | $1,561.30 | $2,402 | 6.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,571.05 | $2,417 | 4.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,358.50 | $2,090 | 5.9× |
| MRI lumbar spine w contrast (72149) | $2,943.20 | $4,528 | 8.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,966.95 | $6,103 | 11.8× |
| MRI orbit face &/neck w/o contrast (70540) | $1,805.05 | $2,777 | 7.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$3,152.50–$3,746.60 | $4,850–$5,764 | varies |
| MRI pelvis w/o & w contrast (72197) | $2,622.10 | $4,034 | 7.8× |
| MRI pelvis w/o contrast (72195) | $2,494.05 | $3,837 | 10.9× |
| MRI thoracic spine w/o contrast (72146) | $2,391.35 | $3,679 | 10.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,330.25 | $3,585 | 10.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,696.85 | $4,149 | 8.0× |
| MRI, abdomen, combo (74183) | $3,696.55 | $5,687 | 11.0× |
| MRI, dorsal spine combo (72157) | $3,216.20 | $4,948 | 9.6× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$1,716.65–$2,288 | $2,641–$3,520 | varies |
| MRI, joint upper extrem combo (73223) | $3,194.75 | $4,915 | 9.5× |
| MRI, lumbar spine combo (72158) | $3,901.30 | $6,002 | 11.6× |
| Myelogram Lumbar (72265) | $2,316.60 | $3,564 | 3.1× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$3,548.35–$6,302.37 | $5,459–$9,695.95 | varies |
| Neck soft tissue (70360) | $209.95 | $323 | 2.5× |
| Nonvascular Shunt X-Ray (75809) | $315.90 | $486 | 3.1× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$7,742.15–$40,174.55 | $11,911–$61,807 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$1,072.50–$2,033.20 | $1,650–$3,128 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$655.85–$1,383.85 | $1,009–$2,129 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$1,625.65–$2,353.65 | $2,501–$3,621 | varies |
| Pelvis 1 or 2 views (72170) | $137.80 | $212 | 1.4× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$4,091.75–$5,517.85 | $6,295–$8,489 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$5,198.70–$6,624.80 | $7,998–$10,192 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,946.75 | $2,995 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$689.65–$1,023.75 | $1,061–$1,575 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $300.30 | $462 | 3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,036.10 | $1,594 | 2.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$330.20–$494.65 | $508–$761 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$165.10–$247.65 | $254–$381 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$287.30–$429.65 | $442–$661 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $164.45 | $253 | 1.6× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$309.40–$463.45 | $476–$713 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$192.40–$287.95 | $296–$443 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$332.80–$499.20 | $512–$768 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$273.65–$410.15 | $421–$631 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $129.35 | $199 | 1.5× |
| Radex Ribs Unilateral 2 Views (71100) | $254.15 | $391 | 3.0× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$315.25–$473.20 | $485–$728 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $158.60 | $244 | 1.9× |
| Radex Spine 1 View Specify Level (72020) | $159.90 | $246 | 1.9× |
| Radex Sternum Minimum 2 Views (71120) | $355.55 | $547 | 4.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $264.55 | $407 | 3.2× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$309.40–$462.15 | $476–$711 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$195.65–$559 | $301–$860 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$295.10–$420.55 | $454–$647 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $961.35 | $1,479 | 9.6× |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$284.05–$6,283.55 | $437–$9,667 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$2,835.30–$40,039.35 | $4,362–$61,599 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$3,341–$25,827.10 | $5,140–$39,734 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $232.70 | $358 | 2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $526.50 | $810 | 5.2× |
| Radiologic exam colon double contrast study (74280) | $1,669.85 | $2,569 | 9.9× |
| Radiologic exam colon single contrast study (74270) | $400.40 | $616 | 2.4× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$345.80–$519.35 | $532–$799 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $358.80 | $552 | 3.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $464.10 | $714 | 2.8× |
| Radiologic exam swallow function contrast study (74230) | $332.80 | $512 | 2.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $551.20 | $848 | 3.3× |
| Radiologic examination femur 1 view (73551) | $230.75 | $355 | 2.8× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$243.75–$364.65 | $375–$561 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$193.70–$290.55 | $298–$447 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $518.05 | $797 | 5.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$187.20–$349.70 | $288–$538 | varies |
| Ribs bilateral 3 views (71110) | $423.80 | $652 | 4.2× |
| Scapula (73010) range across 3 matching MRF lines |
$189.80–$378.30 | $292–$582 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$75.40–$107.90 | $116–$166 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$164.45–$247 | $253–$380 | varies |
| Shoulder Arthrography (73040) | $507.65 | $781 | 1.5× |
| Skull less than 4 views (70250) | $209.95 | $323 | 2.1× |
| Special dosimetry (77331) | $708.50 | $1,090 | 5.5× |
| Special Physics Consult (77370) | $557.70 | $858 | 4.3× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$807.95–$27,949.35 | $1,243–$42,999 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$2,780.70–$28,351.05 | $4,278–$43,617 | varies |
| Sternoclavicular joints (71130) | $208 | $320 | 2.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$1,774.50–$22,915.10 | $2,730–$35,254 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,452.10 | $2,234 | 4.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$2,824.90–$40,174.55 | $4,346–$61,807 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,387.75 | $2,135 | 3.9× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$1,156.35–$40,090.70 | $1,779–$61,678 | varies |
| Thoracic spine 2 views (72070) | $267.15 | $411 | 2.7× |
| Thoracic spine 3 views (72072) | $330.20 | $508 | 3.3× |
| Thoracolumbar 2 views (72080) | $222.95 | $343 | 2.7× |
| Thyroid Imaging With Vascular Flow (78013) | $516.10 | $794 | 1.3× |
| Thyroid Uptake Measurement (78012) | $850.85 | $1,309 | 2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$1,084.85–$1,344.20 | $1,669–$2,068 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$1,984.45–$38,569.70 | $3,053–$59,338 | varies |
| Tx devices design & construction intermediate (77333) | $1,062.75 | $1,635 | 8.2× |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$577.20–$26,085.80 | $888–$40,132 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$193.05–$289.25 | $297–$445 | varies |
| Ultrasound Exam Aaa Screen (76706) | $417.95 | $643 | 4.2× |
| Ultrasound, abdomen limited (76705) | $573.95 | $883 | 5.7× |
| Umbilical-artery Doppler (OB) (76820) | $778.70 | $1,198 | 7.7× |
| Unlisted magnetic resonance procedure (76498) | $4,151.55 | $6,387 | 49.6× |
| Unlisted us procedure (76999) | $237.90 | $366 | 2.8× |
| Upper gi w/o kub (74240) | $1,005.55 | $1,547 | 6.0× |
| Urethrocystogram voiding (74455) | $1,140.75 | $1,755 | 5.0× |
| Urethrocystography retrograde (74450) | $706.55 | $1,087 | 3.1× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$689–$1,033.50 | $1,060–$1,590 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$322.40–$606.45 | $496–$933 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$355.55–$533.65 | $547–$821 | varies |
| Us exam, pelvic, limited (76857) | $335.40 | $516 | 3.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$502.45–$752.70 | $773–$1,158 | varies |
| Us ob limited 1 or more fetuses (76815) | $440.05 | $677 | 4.4× |
| Us ob transvaginal (76817) | $270.40 | $416 | 2.7× |
| Us pelvic non ob complete (76856) | $611 | $940 | 6.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $310.05 | $477 | 3.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $410.80 | $632 | 4.1× |
| Us retroperitoneal complete (76770) | $1,173.90 | $1,806 | 11.7× |
| Us retroperitoneal limited (76775) | $516.75 | $795 | 5.1× |
| Us scrotum and contents (76870) | $516.75 | $795 | 5.1× |
| Us spinal canal and contents (76800) | $749.45 | $1,153 | 7.5× |
| Us thyroid (76536) | $507.65 | $781 | 5.0× |
| Vein X-Ray Chest (75827) | $2,166.45 | $3,333 | 1.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,553.50 | $2,390 | 0.5× |
| Vein X-Ray Spleen/Liver (75810) | $4,716.40 | $7,256 | 1.6× |
| Venogram Sinus/Jugular (75860) | $3,022.50 | $4,650 | 1.0× |
| Venography Adrenal Unilateral (75840) | $4,181.45 | $6,433 | 1.4× |
| Venography caval inferior serialography rs&i (75825) | $3,783.65 | $5,821 | 1.2× |
| Venography extremity bilateral rs&i (75822) | $1,586.65 | $2,441 | 1.0× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$995.80–$1,194.70 | $1,532–$1,838 | varies |
| Venography Renal Unilateral (75831) | $2,022.80 | $3,112 | 0.7× |
| Venous sampling by catheter (75893) | $7,471.10 | $11,494 | 1.4× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$122.85–$184.60 | $189–$284 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $193.70 | $298 | 2.3× |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$998.40–$1,445.60 | $1,536–$2,224 | varies |
| X-Ray Aorta Leg Arteries (75630) | $3,889.60 | $5,984 | 1.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$210.60–$394.55 | $324–$607 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$421.85–$866.45 | $649–$1,333 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $402.35 | $619 | 4.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $468 | $720 | 4.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $791.05 | $1,217 | 7.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $145.60 | $224 | 1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $286 | $440 | 3.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $581.10 | $894 | 5.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $394.55 | $607 | 3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $458.90 | $706 | 4.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $746.20 | $1,148 | 7.4× |
| X-Ray Exam L-S Spine Bending (72114) | $855.40 | $1,316 | 8.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $277.55 | $427 | 3.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $616.20 | $948 | 6.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $237.90 | $366 | 2.4× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$144.30–$204.75 | $222–$315 | varies |
| X-ray humerus (73060) range across 5 matching MRF lines |
$195.65–$367.90 | $301–$566 | varies |
| X-ray IV pyelogram (ivp) (74400) | $987.35 | $1,519 | 5.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $191.10 | $294 | 2.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $210.60 | $324 | 2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $367.90 | $566 | 3.7× |
| X-ray nose-rectum child f.b. (76010) | $224.25 | $345 | 2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,098.50 | $1,690 | 10.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $400.40 | $616 | 4.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $217.10 | $334 | 2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $400.40 | $616 | 4.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $303.55 | $467 | 3.0× |
| X-ray thoracic spine 4 vw (72074) | $380.90 | $586 | 3.8× |
| X-Ray Tmj Unilat (70328) | $178.10 | $274 | 2.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $916.50 | $1,410 | 2.7× |
| X-Rays Bone Length Studies (77073) | $271.05 | $417 | 2.7× |
| X-Rays Bone Survey Complete (77075) | $590.20 | $908 | 5.9× |
| Xr c-spine 4 or 5 views (72050) | $391.95 | $603 | 3.9× |
| Xr facial bones less than 3 views (70140) | $143 | $220 | 1.7× |
| Xr orbits complete 4 views (70200) | $370.50 | $570 | 3.7× |
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.