Imaging prices at Mercy Hospital Ardmore, Inc
Ardmore, OK · every code in this section with a posted price and a Medicare benchmark.
317 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 |
$4,598.10–$34,757.45 | $7,074–$53,473 | varies |
| Abdomen 1 View (74018) | $317.20 | $488 | 3.8× |
| Abdomen 2 views (74019) | $347.10 | $534 | 3.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $897 | $1,380 | 2.3× |
| Angio internal mammary (75756) | $4,507.75 | $6,935 | 1.5× |
| Angio pulmonary bilat (75743) | $3,673.15 | $5,651 | 1.2× |
| Angiography extremity bilateral rs&i (75716) | $2,620.80 | $4,032 | 0.9× |
| Angiography extremity unilateral rs&i (75710) | $2,346.50 | $3,610 | 0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,398.20 | $5,228 | 1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $4,894.50 | $7,530 | 1.6× |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$195–$244.40 | $300–$376 | varies |
| Aortography thoracic serialography rs&i (75605) | $4,841.20 | $7,448 | 0.9× |
| Artery X-Rays Abdomen (75726) | $4,817.80 | $7,412 | 0.9× |
| Artery X-Rays Pelvis (75736) | $3,402.10 | $5,234 | 0.6× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$573.95–$992.55 | $883–$1,527 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$560.30–$861.90 | $862–$1,326 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$707.20–$37,642.68 | $1,088–$57,911.82 | varies |
| Bone age studies (77072) | $359.45 | $553 | 3.6× |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,047.15–$1,439.75 | $1,611–$2,215 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$1,292.20–$1,684.80 | $1,988–$2,592 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,496.30–$6,211.27 | $2,302–$9,555.80 | varies |
| Bone marrow imaging limited area (78102) | $4,070.30 | $6,262 | 10.6× |
| Bone survey infant (77076) | $318.50 | $490 | 3.2× |
| Brain Flow Imaging Only (78610) | $1,860.95 | $2,863 | 3.6× |
| Brain Image W/Flow < 4 Views (78601) | $1,777.10 | $2,734 | 4.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,070.30 | $6,262 | 3.0× |
| Cat Scan Follow-Up Study (76380) | $1,752.40 | $2,696 | 20.9× |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$788.45–$2,386.75 | $1,213–$3,671.93 | varies |
| Chest 1 view (71045) | $218.40 | $336 | 2.6× |
| Chest 2 views (71046) | $338 | $520 | 4.0× |
| Chest 3 views (71047) | $444.60 | $684 | 5.3× |
| Chest 4 or more views (71048) | $457.60 | $704 | 4.6× |
| Cholecystography Oral Contrast (74290) | $657.80 | $1,012 | 3.9× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$360.10–$540.80 | $554–$832 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $431.60 | $664 | 4.3× |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$340.60–$32,631.95 | $524–$50,203 | varies |
| Contrast Exam Abdominl Aorta (75625) | $1,973.40 | $3,036 | 0.6× |
| Contrast X-Ray Bladder (74430) | $458.90 | $706 | 1.4× |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$753.35–$1,894.10 | $1,159–$2,914 | varies |
| Corpora cavernosography (74445) | $533.65 | $821 | 5.3× |
| CT abdomen and pelvis without and with contrast (74178) | $5,087.55 | $7,827 | 15.2× |
| CT abdomen and pelvis without contrast (74176) | $2,697.50 | $4,150 | 11.8× |
| CT abdomen w contrast (74160) | $2,596.10 | $3,994 | 15.4× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$2,866.50–$3,008.85 | $4,410–$4,629 | varies |
| CT abdomen w/o contrast (74150) | $1,994.85 | $3,069 | 19.8× |
| CT Angio Abdomen and Pelvis (74174) | $2,948.40 | $4,536 | 8.8× |
| CT Angio Chest (71275) | $2,195.05 | $3,377 | 13.0× |
| CT Angio Head (70496) | $3,498.95 | $5,383 | 20.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,065.05–$3,097.25 | $3,177–$4,765 | varies |
| CT Angio Neck (70498) | $3,065.40 | $4,716 | 18.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,385.15–$2,307.50 | $2,131–$3,550 | varies |
| CT bone density (77078) | $828.10 | $1,274 | 9.9× |
| CT cervical spine w/ contrast (72126) | $2,388.10 | $3,674 | 7.1× |
| CT cervical spine w/o contrast (72125) | $2,156.70 | $3,318 | 21.4× |
| CT cervical spine w/wo cont (72127) | $2,546.05 | $3,917 | 15.1× |
| CT chest w contrast (71260) | $1,919.45 | $2,953 | 11.4× |
| CT chest w/wo contrast (71270) | $2,280.20 | $3,508 | 13.5× |
| CT head/brain with contrast (70460) | $1,829.75 | $2,815 | 10.8× |
| CT head/brain without and with contrast (70470) | $2,145.65 | $3,301 | 12.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $32.50 | $50 | 0.4× |
| CT iac w contrast (70481) | $1,138.15 | $1,751 | 6.7× |
| CT l-spine w&w/o contrast (72133) | $2,031.25 | $3,125 | 12.0× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,060.15–$1,590.55 | $1,631–$2,447 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,835.60–$2,752.75 | $2,824–$4,235 | varies |
| CT lumbar spine w contrast (72132) | $1,907.10 | $2,934 | 5.7× |
| CT lumbar spine w/o contrast (72131) | $1,557.40 | $2,396 | 15.5× |
| CT maxillofacial w contrast (70487) | $2,395.90 | $3,686 | 14.2× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,755.65–$2,171 | $2,701–$3,340 | varies |
| CT neck tissue combo (70492) | $2,557.10 | $3,934 | 15.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,733.55 | $2,667 | 10.3× |
| CT orbits w/o contrast (70480) | $1,007.50 | $1,550 | 10.0× |
| CT pelvis w&w/o contrast (72194) | $1,918.15 | $2,951 | 11.4× |
| CT pelvis w/o contrast (72192) | $1,531.40 | $2,356 | 15.2× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,990.95–$3,537.30 | $3,063–$5,442 | varies |
| CT scans face/jaw combo (70488) | $2,614.95 | $4,023 | 15.5× |
| CT soft tissue neck w contrast (70491) | $2,335.45 | $3,593 | 13.8× |
| CT soft tissue neck w/o contrast (70490) | $1,946.10 | $2,994 | 19.4× |
| CT thoracic spine w contrast (72129) | $1,415.70 | $2,178 | 8.4× |
| CT thoracic spine w/o contrast (72128) | $1,212.90 | $1,866 | 12.1× |
| CT thoracic spine w/wo cont (72130) | $2,020.85 | $3,109 | 12.0× |
| CT thorax w/o contrast (71250) | $1,634.10 | $2,514 | 16.3× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,554.80–$2,137.85 | $2,392–$3,289 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,946.10–$2,826.20 | $2,994–$4,348 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,650.35–$2,667.60 | $2,539–$4,104 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,414.45 | $5,253 | 20.2× |
| Cta Abdomen (74175) | $2,614.30 | $4,022 | 15.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,498.95 | $5,383 | 10.4× |
| CTA pelvis (72191) | $2,367.95 | $3,643 | 14.0× |
| Discography Cerv/Thor Spine (72285) | $1,777.75 | $2,735 | 0.9× |
| Diskography lumbar (72295) | $2,872.35 | $4,419 | 1.5× |
| Dxa Bone Density Axial (77080) | $581.75 | $895 | 5.8× |
| Dxa bone density study (77085) | $464.10 | $714 | 4.6× |
| Echograp Trans R Pros Study (76873) | $1,186.90 | $1,826 | 11.8× |
| Esophagram (74220) | $536.90 | $826 | 3.2× |
| Fetal Biophys Profile W/Nst (76818) | $543.40 | $836 | 5.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $403 | $620 | 4.0× |
| Fluoroscopy up to 1 hr (76000) | $833.95 | $1,283 | 3.6× |
| Follow-Up Angiography (75898) | $1,488.50 | $2,290 | 0.5× |
| Foot 2 views (73620) range across 6 matching MRF lines |
$170.30–$307.45 | $262–$473 | varies |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$290.55–$544.70 | $447–$838 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$2,031.90–$2,741.70 | $3,126–$4,218 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,049.10 | $1,614 | 2.7× |
| Gated Heart Planar Single (78472) | $2,271.10 | $3,494 | 5.9× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$165.10–$371.80 | $254–$572 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,601.60–$2,253.17 | $2,464–$3,466.42 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$2,270.45–$2,715.05 | $3,493–$4,177 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$1,457.95–$2,576.60 | $2,243–$3,964 | varies |
| Hysterosalpingogram (74740) | $419.25 | $645 | 1.8× |
| Infant hip ultrasound, limited static exam (76886) | $404.95 | $623 | 4.8× |
| Interstitial radiation source applic complex (77778) | $5,769.40 | $8,876 | 8.6× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,511.90–$1,636.05 | $2,326–$2,517 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$1,207.05–$1,352 | $1,857–$2,080 | varies |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,751.75 | $2,695 | 4.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$401.05–$600.60 | $617–$924 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,236.30 | $1,902 | 3.2× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$856.05–$7,866.85 | $1,317–$12,102.84 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,244.75–$21,027.32 | $1,915–$32,349.72 | varies |
| Magnetic Image Jaw Joint (70336) | $2,457 | $3,780 | 10.7× |
| Mammary ductogram or galactogram multiple (77054) range across 3 matching MRF lines |
$750.75–$1,032.20 | $1,155–$1,588 | varies |
| Mammary ductogram or galactogram single (77053) range across 3 matching MRF lines |
$537.55–$600.60 | $827–$924 | varies |
| Meckels Divert Exam (78290) | $1,679.60 | $2,584 | 4.4× |
| Medical physics dose eval radiation expos w/rprt (76145) | $663 | $1,020 | 1.8× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$1,907.10–$39,068.25 | $2,934–$60,105 | varies |
| Mra Head W/O & W/Contrast Material (70546) | $3,029 | $4,660 | 9.0× |
| MRA head w/o contrast (70544) | $2,074.15 | $3,191 | 9.0× |
| MRA head with contrast (70545) | $2,578.55 | $3,967 | 7.7× |
| MRA neck w contrast (70548) | $2,421.25 | $3,725 | 7.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,715.70 | $4,178 | 8.1× |
| MRA neck w/o contrast (70547) | $2,198.30 | $3,382 | 9.6× |
| MRI abdomen w/o contrast (74181) | $3,546.40 | $5,456 | 15.5× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$3,088.15–$4,387.50 | $4,751–$6,750 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,677.70–$5,516.55 | $5,658–$8,487 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$3,053.70–$4,248.40 | $4,698–$6,536 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $2,181.40 | $3,356 | 9.5× |
| MRI cervical spine w contrast (72142) | $2,951.65 | $4,541 | 8.8× |
| MRI cervical spine w/o cont (72141) | $2,441.40 | $3,756 | 10.6× |
| MRI chest w/o contrast (71550) | $2,850.25 | $4,385 | 12.4× |
| MRI chest with contrast (71551) | $3,227.90 | $4,966 | 4.3× |
| MRI chest wo w contrast (71552) | $3,643.90 | $5,606 | 10.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$2,634.45–$3,330.60 | $4,053–$5,124 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,929.55–$4,737.85 | $4,507–$7,289 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,357.55–$3,442.40 | $3,627–$5,296 | varies |
| MRI lumbar spine w contrast (72149) | $3,129.75 | $4,815 | 9.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,255.20 | $5,008 | 9.7× |
| MRI orbit face &/neck w/o contrast (70540) | $1,829.10 | $2,814 | 8.0× |
| MRI orbit face neck w contrast (70542) | $1,909.05 | $2,937 | 5.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,682.25 | $5,665 | 11.0× |
| MRI pelvis w contrast (72196) | $3,120.65 | $4,801 | 9.3× |
| MRI pelvis w/o & w contrast (72197) | $3,732.30 | $5,742 | 11.1× |
| MRI pelvis w/o contrast (72195) | $2,653.30 | $4,082 | 11.6× |
| MRI thoracic spine w/o contrast (72146) | $2,796.95 | $4,303 | 12.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,468.40 | $5,336 | 10.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,215.55 | $4,947 | 14.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$3,818.10–$4,345.25 | $5,874–$6,685 | varies |
| MRI, abdomen, combo (74183) | $4,737.85 | $7,289 | 14.1× |
| MRI, dorsal spine combo (72157) | $3,978 | $6,120 | 11.9× |
| MRI, dorsal spine contrast (72147) | $3,215.55 | $4,947 | 9.6× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,962.05–$4,181.45 | $4,557–$6,433 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$3,228.55–$4,520.10 | $4,967–$6,954 | varies |
| MRI, lumbar spine combo (72158) | $5,022.55 | $7,727 | 15.0× |
| Myelogram cervical (72240) | $2,481.05 | $3,817 | 3.3× |
| Myelogram Lumbar (72265) | $2,316.60 | $3,564 | 3.1× |
| Myelography thoracic (72255) | $2,734.55 | $4,207 | 3.6× |
| Myelograpy 2/more regions rs&i (72270) | $4,443.40 | $6,836 | 5.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $3,073.85 | $4,729 | 2.5× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$3,045.90–$6,606.60 | $4,686–$10,164 | varies |
| Neck soft tissue (70360) | $294.45 | $453 | 3.5× |
| Nonvascular Shunt X-Ray (75809) | $274.95 | $423 | 2.7× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$5,354.70–$36,562.50 | $8,238–$56,250 | varies |
| Nuclear Rx Oral Admin (79005) | $1,662.70 | $2,558 | 7.4× |
| Panoramic X-ray of jaws (70355) | $304.20 | $468 | 3.6× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$1,056.25–$1,398.15 | $1,625–$2,151 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,374.75 | $2,115 | 3.6× |
| Pelvis 1 or 2 views (72170) | $154.70 | $238 | 1.5× |
| Pet Image Skull-Thigh (78812) | $5,842.85 | $8,989 | 4.2× |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$4,641.65–$8,648.25 | $7,141–$13,305 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$6,392.75–$7,709.65 | $9,835–$11,861 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$5,673.20–$6,990.10 | $8,728–$10,754 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$703.30–$839.15 | $1,082–$1,291 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $391.30 | $602 | 3.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $895.70 | $1,378 | 1.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$361.40–$542.10 | $556–$834 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$161.85–$243.10 | $249–$374 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$359.45–$539.50 | $553–$830 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $224.90 | $346 | 2.2× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$138.45–$460.20 | $213–$708 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$388.70–$582.40 | $598–$896 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$382.85–$573.95 | $589–$883 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$215.15–$323.05 | $331–$497 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $295.10 | $454 | 2.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $248.95 | $383 | 3.0× |
| Radex Ribs Unilateral 2 Views (71100) | $224.25 | $345 | 2.7× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$385.45–$577.85 | $593–$889 | varies |
| Radex Spine 1 View Specify Level (72020) | $245.70 | $378 | 2.9× |
| Radex Sternum Minimum 2 Views (71120) | $245.70 | $378 | 2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $254.80 | $392 | 3.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$197.60–$295.75 | $304–$455 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 5 matching MRF lines |
$170.30–$291.85 | $262–$449 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$392.60–$588.90 | $604–$906 | varies |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$284.05–$5,978.70 | $437–$9,198 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$2,220.40–$37,216.40 | $3,416–$57,256 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$2,886.65–$19,136 | $4,441–$29,440 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $229.45 | $353 | 2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $453.70 | $698 | 4.5× |
| Radiologic exam colon double contrast study (74280) | $564.85 | $869 | 3.3× |
| Radiologic exam colon single contrast study (74270) | $451.75 | $695 | 2.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $527.80 | $812 | 3.1× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$471.25–$707.20 | $725–$1,088 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $300.95 | $463 | 3.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $687.70 | $1,058 | 4.1× |
| Radiologic exam swallow function contrast study (74230) | $300.30 | $462 | 1.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $479.05 | $737 | 2.8× |
| Radiologic examination femur 1 view (73551) | $245.05 | $377 | 2.9× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$274.30–$411.45 | $422–$633 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$383.50–$574.60 | $590–$884 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$249.60–$419.25 | $384–$645 | varies |
| Ribs bilateral 3 views (71110) | $534.95 | $823 | 5.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,069.25 | $1,645 | 2.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,076.10 | $3,194 | 4.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,399.80 | $3,692 | 4.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,722.55 | $5,727 | 3.0× |
| Scapula (73010) range across 3 matching MRF lines |
$364.65–$473.85 | $561–$729 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$82.55–$117.65 | $127–$181 | varies |
| Sella turcica (70240) | $205.40 | $316 | 2.5× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$230.75–$271.70 | $355–$418 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$761.15–$1,238.25 | $1,171–$1,905 | varies |
| Sialogram (70390) | $583.70 | $898 | 2.5× |
| Skull less than 4 views (70250) | $325 | $500 | 3.2× |
| Special dosimetry (77331) | $906.75 | $1,395 | 7.0× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$1,349.40–$32,664.45 | $2,076–$50,253 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$494–$21,500.70 | $760–$33,078 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$3,134.30–$37,642.68 | $4,822–$57,911.82 | varies |
| Speech evaluation, complex (70371) | $642.85 | $989 | 2.8× |
| Sternoclavicular joints (71130) | $223.60 | $344 | 2.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$1,238.25–$39,087.10 | $1,905–$60,134 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,119.30 | $1,722 | 3.1× |
| Temporomandble Jt Arthrography Rs&I (70332) range across 3 matching MRF lines |
$991.25–$1,652.30 | $1,525–$2,542 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$1,939.60–$34,758.54 | $2,984–$53,474.68 | 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 |
$853.45–$34,757.45 | $1,313–$53,473 | varies |
| Thoracic spine 2 views (72070) | $365.30 | $562 | 3.6× |
| Thoracic spine 3 views (72072) | $403 | $620 | 4.0× |
| Thoracolumbar 2 views (72080) | $552.50 | $850 | 6.6× |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$412.75–$429.65 | $635–$661 | varies |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$1,322.75–$7,498.12 | $2,035–$11,535.57 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$822.25–$35,317.33 | $1,265–$54,334.36 | varies |
| Tx devices design & construction intermediate (77333) | $705.90 | $1,086 | 5.5× |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$625.30–$19,136 | $962–$29,440 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$397.80–$596.05 | $612–$917 | varies |
| Ultrasound Exam Aaa Screen (76706) | $501.80 | $772 | 5.0× |
| Ultrasound, abdomen limited (76705) | $947.05 | $1,457 | 9.4× |
| Umbilical-artery Doppler (OB) (76820) | $778.70 | $1,198 | 7.7× |
| Unlisted Dx Radiographic Procedure (76499) | $360.75 | $555 | 4.3× |
| Unlisted us procedure (76999) | $313.30 | $482 | 3.7× |
| Upper gi w/o kub (74240) | $874.25 | $1,345 | 5.2× |
| Ureteral Reflux Study (78740) | $940.55 | $1,447 | 2.4× |
| Urethrocystogram voiding (74455) | $525.20 | $808 | 2.3× |
| Urethrocystography retrograde (74450) | $985.40 | $1,516 | 4.3× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$607.10–$910.65 | $934–$1,401 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$291.20–$930.15 | $448–$1,431 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$464.75–$697.45 | $715–$1,073 | varies |
| Us exam, pelvic, limited (76857) | $479.70 | $738 | 4.8× |
| Us head (76506) | $613.60 | $944 | 6.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$744.25–$1,116.70 | $1,145–$1,718 | varies |
| Us ob detailed single fetus (76811) | $624 | $960 | 2.7× |
| Us ob limited 1 or more fetuses (76815) | $440.05 | $677 | 4.4× |
| Us ob transvaginal (76817) | $529.10 | $814 | 5.3× |
| Us pelvic non ob complete (76856) | $1,086.80 | $1,672 | 10.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $732.55 | $1,127 | 7.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $278.85 | $429 | 2.8× |
| Us retroperitoneal complete (76770) | $481.65 | $741 | 4.8× |
| Us retroperitoneal limited (76775) | $711.75 | $1,095 | 7.1× |
| Us scrotum and contents (76870) | $964.60 | $1,484 | 9.6× |
| Us spinal canal and contents (76800) | $861.90 | $1,326 | 8.6× |
| Us thyroid (76536) | $559.65 | $861 | 5.6× |
| Vein X-Ray Chest (75827) | $2,166.45 | $3,333 | 1.4× |
| Venogram Sinus/Jugular (75860) | $3,022.50 | $4,650 | 1.0× |
| 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) | $1,221.35 | $1,879 | 0.8× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$250.25–$487.50 | $385–$750 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $200.85 | $309 | 2.4× |
| X-ray antegrade pyelogram tube (74425) | $665.60 | $1,024 | 2.0× |
| X-Ray Aorta Leg Arteries (75630) | $4,012.45 | $6,173 | 1.3× |
| X-Ray Bend Only L-S Spine (72120) | $512.20 | $788 | 5.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$248.95–$497.25 | $383–$765 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$402.35–$697.45 | $619–$1,073 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $278.20 | $428 | 3.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $392.60 | $604 | 3.9× |
| X-Ray Exam Hip Uni 1 View (73501) | $140.40 | $216 | 1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $305.50 | $470 | 3.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $487.50 | $750 | 4.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $399.75 | $615 | 4.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $457.60 | $704 | 4.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $495.30 | $762 | 4.9× |
| X-Ray Exam L-S Spine Bending (72114) | $661.70 | $1,018 | 6.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $427.70 | $658 | 5.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $468.65 | $721 | 4.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $476.45 | $733 | 4.7× |
| X-ray eye for foreign body (70030) | $142.35 | $219 | 1.7× |
| X-ray humerus (73060) range across 5 matching MRF lines |
$250.90–$438.75 | $386–$675 | varies |
| X-ray IV pyelogram (ivp) (74400) | $858.65 | $1,321 | 5.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $234 | $360 | 2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $512.20 | $788 | 5.1× |
| X-ray nose-rectum child f.b. (76010) | $314.60 | $484 | 3.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $351.65 | $541 | 3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $300.95 | $463 | 3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $393.25 | $605 | 4.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $211.25 | $325 | 2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $552.50 | $850 | 5.5× |
| X-Ray Tmj Unilat (70328) | $154.70 | $238 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,593.80 | $2,452 | 4.7× |
| X-Rays Bone Length Studies (77073) | $249.60 | $384 | 2.5× |
| X-Rays Bone Survey Complete (77075) | $614.25 | $945 | 6.1× |
| Xr c-spine 4 or 5 views (72050) | $440.05 | $677 | 4.4× |
| Xr orbits complete 4 views (70200) | $201.50 | $310 | 2.0× |
| Xr Tomogram Single Plane (76100) | $811.20 | $1,248 | 8.1× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.