Imaging prices at Mercy Hospital Lebanon
Lebanon, MO · every code in this section with a posted price and a Medicare benchmark.
275 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) | $278.20 | $428 | 3.2× |
| Abdomen 2 views (74019) | $376.35 | $579 | 3.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,026.35 | $1,579 | 2.6× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$200.85–$410.80 | $309–$632 | varies |
| Arthrogram hip (73525) | $1,380.60 | $2,124 | 4.0× |
| Arthrogram Wrist (73115) | $1,525.55 | $2,347 | 4.4× |
| Bone age studies (77072) | $209.95 | $323 | 2.0× |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,695.85–$1,884.35 | $2,609–$2,899 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$893.75–$1,082.25 | $1,375–$1,665 | varies |
| Bone Imaging Multiple Areas (78305) | $1,181.05 | $1,817 | 2.9× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,605.50–$1,820.65 | $2,470–$2,801 | varies |
| Bone marrow imaging limited area (78102) | $399.10 | $614 | 1.0× |
| Bone marrow imaging; multiple areas (78103) | $1,380.60 | $2,124 | 3.4× |
| Bone marrow imaging; whole body (78104) | $1,249.95 | $1,923 | 3.1× |
| Bone survey infant (77076) | $362.05 | $557 | 3.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,170.35 | $3,339 | 4.0× |
| Cat Scan Follow-Up Study (76380) | $618.80 | $952 | 7.1× |
| Chest 1 view (71045) | $244.40 | $376 | 2.8× |
| Chest 2 views (71046) | $304.85 | $469 | 3.5× |
| Chest 3 views (71047) | $352.30 | $542 | 4.0× |
| Chest 4 or more views (71048) | $494.65 | $761 | 4.7× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$358.15–$537.55 | $551–$827 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $995.15 | $1,531 | 9.5× |
| Contrast X-Ray Bladder (74430) | $685.75 | $1,055 | 2.0× |
| CT abdomen and pelvis without and with contrast (74178) | $3,630.90 | $5,586 | 10.4× |
| CT abdomen and pelvis without contrast (74176) | $2,429.70 | $3,738 | 10.2× |
| CT abdomen w contrast (74160) | $2,225.60 | $3,424 | 12.7× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$2,262–$2,511.60 | $3,480–$3,864 | varies |
| CT abdomen w/o contrast (74150) | $1,856.40 | $2,856 | 17.7× |
| CT Angio Abdomen and Pelvis (74174) | $2,754.05 | $4,237 | 7.9× |
| CT Angio Chest (71275) | $1,195.35 | $1,839 | 6.8× |
| CT Angio Head (70496) | $1,180.40 | $1,816 | 6.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,336.10–$3,504.80 | $3,594–$5,392 | varies |
| CT Angio Neck (70498) | $1,157 | $1,780 | 6.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,714.70–$2,572.05 | $2,638–$3,957 | varies |
| CT cervical spine w/ contrast (72126) | $1,724.45 | $2,653 | 4.9× |
| CT cervical spine w/o contrast (72125) | $921.05 | $1,417 | 8.8× |
| CT cervical spine w/wo cont (72127) | $2,048.15 | $3,151 | 11.7× |
| CT chest w contrast (71260) | $1,806.35 | $2,779 | 10.3× |
| CT chest w/wo contrast (71270) | $1,975.35 | $3,039 | 11.2× |
| CT head/brain with contrast (70460) | $1,184.95 | $1,823 | 6.7× |
| CT head/brain without and with contrast (70470) | $1,619.15 | $2,491 | 9.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $35.75 | $55 | 0.4× |
| CT iac w contrast (70481) | $1,617.85 | $2,489 | 9.2× |
| CT l-spine w&w/o contrast (72133) | $1,964.30 | $3,022 | 11.2× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,086.15–$1,372.15 | $1,671–$2,111 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,171.95–$1,546.35 | $1,803–$2,379 | varies |
| CT lumbar spine w contrast (72132) | $1,591.85 | $2,449 | 4.6× |
| CT lumbar spine w/o contrast (72131) | $1,458.60 | $2,244 | 13.9× |
| CT maxillofacial w contrast (70487) | $1,860.95 | $2,863 | 10.6× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$815.75–$1,710.80 | $1,255–$2,632 | varies |
| CT neck tissue combo (70492) | $1,871.35 | $2,879 | 10.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,768 | $2,720 | 10.1× |
| CT orbits w/o contrast (70480) | $1,495.65 | $2,301 | 14.3× |
| CT pelvis w&w/o contrast (72194) | $2,068.30 | $3,182 | 11.8× |
| CT pelvis w/o contrast (72192) | $1,328.60 | $2,044 | 12.7× |
| CT scan of leg combo (73702) | $1,287.65 | $1,981 | 7.3× |
| CT scans face/jaw combo (70488) | $2,048.15 | $3,151 | 11.7× |
| CT soft tissue neck w contrast (70491) | $1,459.90 | $2,246 | 8.3× |
| CT soft tissue neck w/o contrast (70490) | $1,248 | $1,920 | 11.9× |
| CT thoracic spine w contrast (72129) | $1,738.10 | $2,674 | 9.9× |
| CT thoracic spine w/o contrast (72128) | $991.25 | $1,525 | 9.5× |
| CT thoracic spine w/wo cont (72130) | $2,455.70 | $3,778 | 14.0× |
| CT thorax w/o contrast (71250) | $900.90 | $1,386 | 8.6× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,077.05–$1,615.90 | $1,657–$2,486 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,415.70 | $2,178 | 8.1× |
| CT upper extremity with contrast (73201) | $1,175.85 | $1,809 | 3.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,216.50 | $3,410 | 12.6× |
| Cta Abdomen (74175) | $2,524.60 | $3,884 | 14.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,967.90 | $4,566 | 8.5× |
| CTA pelvis (72191) | $2,340.65 | $3,601 | 13.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $466.70 | $718 | 4.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $742.30 | $1,142 | 7.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $380.25 | $585 | 3.6× |
| Dxa Bone Density Axial (77080) | $233.35 | $359 | 2.2× |
| Dxa bone density study (77085) | $649.35 | $999 | 6.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $162.50 | $250 | 1.9× |
| Echo exam of fetal heart (76825) | $1,426.10 | $2,194 | 2.6× |
| Echo exam uterus (76831) | $481 | $740 | 2.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $926.90 | $1,426 | 3.9× |
| Esophagram (74220) | $592.15 | $911 | 3.4× |
| Fetal Biophys Profile W/Nst (76818) | $777.40 | $1,196 | 7.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $571.35 | $879 | 5.5× |
| Fluoroscopy up to 1 hr (76000) | $290.55 | $447 | 1.2× |
| Foot 2 views (73620) range across 6 matching MRF lines |
$230.10–$431.60 | $354–$664 | varies |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$170.30–$460.20 | $262–$708 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$937.30–$1,225.25 | $1,442–$1,885 | varies |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$784.55–$1,140.75 | $1,207–$1,755 | varies |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $4,037.80 | $6,212 | 7.4× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$196.30–$410.15 | $302–$631 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,553.50–$2,214.98 | $2,390–$3,407.66 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$1,592.50–$1,860.30 | $2,450–$2,862 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$2,853.50–$3,973.45 | $4,390–$6,113 | varies |
| Hysterosalpingogram (74740) | $609.70 | $938 | 2.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $616.85 | $949 | 7.1× |
| Infant hip ultrasound, limited static exam (76886) | $387.40 | $596 | 4.4× |
| Infusion Ivp (74410) | $976.30 | $1,502 | 5.6× |
| K Flow/Funct Image Multiple (78709) | $1,683.50 | $2,590 | 3.1× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,262.30–$1,708.13 | $1,942–$2,627.90 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$1,574.95–$1,994.85 | $2,423–$3,069 | varies |
| Kidney Imaging Morphol (78700) | $553.80 | $852 | 1.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,774.50 | $2,730 | 4.4× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$334.10–$501.15 | $514–$771 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$1,415.05–$2,617.55 | $2,177–$4,027 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $2,045.55 | $3,147 | 5.1× |
| Lung Perf&Ventilat Diferentl (78598) | $1,550.25 | $2,385 | 2.9× |
| Lung perfusion differential (78597) | $1,198.60 | $1,844 | 3.0× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$1,238.90–$1,574.95 | $1,906–$2,423 | varies |
| Lymph System Imaging (78195) | $819.65 | $1,261 | 1.5× |
| Meckels Divert Exam (78290) | $1,073.15 | $1,651 | 2.7× |
| Mra Head W/O & W/Contrast Material (70546) | $3,070.60 | $4,724 | 8.8× |
| MRA head w/o contrast (70544) | $1,514.50 | $2,330 | 6.3× |
| MRA head with contrast (70545) | $2,765.75 | $4,255 | 7.9× |
| MRA neck w contrast (70548) | $2,518.10 | $3,874 | 7.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,558.40 | $3,936 | 7.3× |
| MRA neck w/o contrast (70547) | $2,325.05 | $3,577 | 9.7× |
| MRI abdomen w contrast (74182) | $2,193.10 | $3,374 | 6.3× |
| MRI abdomen w/o contrast (74181) | $1,913.60 | $2,944 | 8.0× |
| MRI any jt lower extrem w/contrast material (73722) | $2,737.80 | $4,212 | 3.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,218.80–$4,828.20 | $4,952–$7,428 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,034.20 | $4,668 | 3.9× |
| MRI cervical spine w contrast (72142) | $2,672.80 | $4,112 | 7.6× |
| MRI cervical spine w/o cont (72141) | $2,535.65 | $3,901 | 10.6× |
| MRI chest w/o contrast (71550) | $1,381.90 | $2,126 | 5.8× |
| MRI chest wo w contrast (71552) | $3,355.30 | $5,162 | 9.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,731.95 | $4,203 | 7.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,023.15 | $4,651 | 8.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,499.25–$3,749.20 | $3,845–$5,768 | varies |
| MRI lumbar spine w contrast (72149) | $2,461.55 | $3,787 | 7.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,800.20 | $4,308 | 8.0× |
| MRI orbit face &/neck w/o contrast (70540) | $1,682.20 | $2,588 | 7.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$3,288.35–$4,325.10 | $5,059–$6,654 | varies |
| MRI pelvis w contrast (72196) | $2,496.65 | $3,841 | 7.1× |
| MRI pelvis w/o & w contrast (72197) | $2,635.75 | $4,055 | 7.5× |
| MRI pelvis w/o contrast (72195) | $2,259.40 | $3,476 | 9.5× |
| MRI thoracic spine w/o contrast (72146) | $2,527.85 | $3,889 | 10.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,213.25 | $3,405 | 6.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,653.60 | $2,544 | 6.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,807.35 | $4,319 | 8.0× |
| MRI, abdomen, combo (74183) | $2,550.60 | $3,924 | 7.3× |
| MRI, dorsal spine combo (72157) | $2,672.80 | $4,112 | 7.6× |
| MRI, dorsal spine contrast (72147) | $2,632.50 | $4,050 | 7.5× |
| MRI, joint upper extrem (73221) | $2,613 | $4,020 | 10.9× |
| MRI, joint upper extrem combo (73223) | $3,185.65 | $4,901 | 9.1× |
| MRI, lumbar spine combo (72158) | $2,632.50 | $4,050 | 7.5× |
| Myelogram Lumbar (72265) | $1,145.30 | $1,762 | 1.5× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,901.90 | $2,926 | 4.7× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$3,480.10–$5,361.85 | $5,354–$8,249 | varies |
| Neck soft tissue (70360) | $209.30 | $322 | 2.4× |
| Ob us nuchal meas 1 gest (76813) | $471.90 | $726 | 4.5× |
| Panoramic X-ray of jaws (70355) | $235.30 | $362 | 2.7× |
| Parathyroid Planar Imaging (78070) | $911.95 | $1,403 | 2.3× |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$1,224.60–$1,661.40 | $1,884–$2,556 | varies |
| Pelvis 1 or 2 views (72170) | $313.95 | $483 | 3.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $689.65 | $1,061 | 1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $527.15 | $811 | 5.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$378.95–$568.10 | $583–$874 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$263.90–$395.20 | $406–$608 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$384.15–$576.55 | $591–$887 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $270.40 | $416 | 2.6× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$255.45–$383.50 | $393–$590 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$351–$527.15 | $540–$811 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$334.75–$476.45 | $515–$733 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$180.05–$270.40 | $277–$416 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $250.25 | $385 | 2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $334.75 | $515 | 3.8× |
| Radex Ribs Unilateral 2 Views (71100) | $327.60 | $504 | 3.8× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$333.45–$500.50 | $513–$770 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $220.35 | $339 | 2.5× |
| Radex Spine 1 View Specify Level (72020) | $164.45 | $253 | 1.9× |
| Radex Sternum Minimum 2 Views (71120) | $334.10 | $514 | 3.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $371.80 | $572 | 4.3× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$281.45–$422.50 | $433–$650 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$222.95–$387.40 | $343–$596 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$345.80–$518.70 | $532–$798 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $731.90 | $1,126 | 7.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $611 | $940 | 5.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $519.35 | $799 | 5.0× |
| Radiologic exam colon double contrast study (74280) | $1,260.35 | $1,939 | 7.2× |
| Radiologic exam colon single contrast study (74270) | $794.30 | $1,222 | 4.5× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$367.25–$551.85 | $565–$849 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $370.50 | $570 | 3.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $431.60 | $664 | 2.5× |
| Radiologic exam swallow function contrast study (74230) | $659.10 | $1,014 | 3.8× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$499.85–$980.85 | $769–$1,509 | varies |
| Radiologic examination femur 1 view (73551) | $262.60 | $404 | 3.0× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$356.85–$534.95 | $549–$823 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$261.30–$391.95 | $402–$603 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$274.30–$420.55 | $422–$647 | varies |
| Ribs bilateral 3 views (71110) | $291.20 | $448 | 2.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $601.90 | $926 | 1.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,057.90 | $3,166 | 3.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,346.50 | $3,610 | 4.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,418.30–$3,030.95 | $2,182–$4,663 | varies |
| Scapula (73010) range across 3 matching MRF lines |
$378.95–$443.30 | $583–$682 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$66.30–$99.45 | $102–$153 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$260–$390 | $400–$600 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$1,318.20–$1,613.95 | $2,028–$2,483 | varies |
| Skull less than 4 views (70250) | $200.20 | $308 | 1.9× |
| Sternoclavicular joints (71130) | $398.45 | $613 | 4.6× |
| Testicular Imaging W/Flow (78761) | $815.10 | $1,254 | 2.0× |
| Thoracic spine 2 views (72070) | $365.30 | $562 | 3.5× |
| Thoracic spine 3 views (72072) | $462.15 | $711 | 4.4× |
| Thoracolumbar 2 views (72080) | $349.05 | $537 | 4.0× |
| Thyroid Imaging With Vascular Flow (78013) | $626.60 | $964 | 1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$878.15–$1,042.60 | $1,351–$1,604 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$434.20–$650.65 | $668–$1,001 | varies |
| Ultrasound Elastography Parenchyma (76981) | $367.90 | $566 | 3.5× |
| Ultrasound Exam Aaa Screen (76706) | $245.70 | $378 | 2.3× |
| Ultrasound, abdomen limited (76705) | $700.70 | $1,078 | 6.7× |
| Umbilical-artery Doppler (OB) (76820) | $215.15 | $331 | 2.1× |
| Upper gi w/o kub (74240) | $527.80 | $812 | 3.0× |
| Urethrocystogram voiding (74455) | $680.55 | $1,047 | 2.8× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$547.30–$821.60 | $842–$1,264 | varies |
| Us chest (76604) | $631.15 | $971 | 6.0× |
| Us complete joint (76881) | $703.30 | $1,082 | 6.7× |
| Us exam, pelvic, limited (76857) | $551.85 | $849 | 5.3× |
| Us head (76506) | $586.95 | $903 | 5.6× |
| Us kidney transplant (76776) | $683.80 | $1,052 | 6.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$501.80–$753.35 | $772–$1,159 | varies |
| Us ob detailed single fetus (76811) | $848.25 | $1,305 | 3.5× |
| Us ob limited 1 or more fetuses (76815) | $419.90 | $646 | 4.0× |
| Us ob transvaginal (76817) | $376.35 | $579 | 3.6× |
| Us pelvic non ob complete (76856) | $874.90 | $1,346 | 8.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $733.20 | $1,128 | 7.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $365.30 | $562 | 3.5× |
| Us retroperitoneal complete (76770) | $945.10 | $1,454 | 9.0× |
| Us retroperitoneal limited (76775) | $469.30 | $722 | 4.5× |
| Us scrotum and contents (76870) | $763.10 | $1,174 | 7.3× |
| Us spinal canal and contents (76800) | $824.20 | $1,268 | 7.9× |
| Us thyroid (76536) | $785.20 | $1,208 | 7.5× |
| Us transrectal (76872) | $1,070.55 | $1,647 | 10.2× |
| Venography extremity bilateral rs&i (75822) | $2,558.40 | $3,936 | 1.6× |
| Venography extremity unilateral rs&i (75820) | $2,200.90 | $3,386 | 1.4× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$191.75–$421.85 | $295–$649 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $276.90 | $426 | 3.2× |
| X-Ray Bend Only L-S Spine (72120) | $281.45 | $433 | 2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$180.70–$428.35 | $278–$659 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$211.90–$317.20 | $326–$488 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $388.70 | $598 | 4.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $434.20 | $668 | 4.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $555.75 | $855 | 5.3× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$214.50–$226.20 | $330–$348 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $285.35 | $439 | 3.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $341.25 | $525 | 3.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $412.75 | $635 | 3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $447.85 | $689 | 4.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $757.90 | $1,166 | 7.2× |
| X-Ray Exam L-S Spine Bending (72114) | $751.40 | $1,156 | 7.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $356.20 | $548 | 4.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $555.10 | $854 | 5.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $385.45 | $593 | 3.7× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$241.15–$301.60 | $371–$464 | varies |
| X-ray humerus (73060) range across 5 matching MRF lines |
$253.50–$438.75 | $390–$675 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,002.95 | $1,543 | 5.7× |
| X-ray IV pyelogram+tomography (74415) | $1,068.60 | $1,644 | 6.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $241.15 | $371 | 2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $205.40 | $316 | 2.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $387.40 | $596 | 3.7× |
| X-ray nose-rectum child f.b. (76010) | $286 | $440 | 3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $436.80 | $672 | 4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $380.90 | $586 | 3.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $284.70 | $438 | 2.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $365.95 | $563 | 4.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $337.35 | $519 | 3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $364.65 | $561 | 3.5× |
| X-ray thoracic spine 4 vw (72074) | $858 | $1,320 | 8.2× |
| X-Ray Tmj Unilat (70328) | $202.15 | $311 | 2.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $637 | $980 | 1.8× |
| X-Rays Bone Length Studies (77073) | $314.60 | $484 | 3.0× |
| X-Rays Bone Survey Complete (77075) | $720.20 | $1,108 | 6.9× |
| Xr c-spine 4 or 5 views (72050) | $458.90 | $706 | 4.4× |
| Xr facial bones less than 3 views (70140) | $222.95 | $343 | 2.6× |
| Xr orbits complete 4 views (70200) | $296.40 | $456 | 2.8× |
| Xr Tomogram Single Plane (76100) | $1,240.20 | $1,908 | 11.8× |
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.