Imaging prices at Mercy Hospital Southeast
Cape Girardeau, MO · every code in this section with a posted price and a Medicare benchmark.
350 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 |
$7,010.25–$31,252 | $10,785–$48,080 | varies |
| Abdomen 1 View (74018) | $308.75 | $475 | 3.5× |
| Abdomen 2 views (74019) | $501.80 | $772 | 4.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,348.75 | $2,075 | 3.4× |
| Adrenal Cortex & Medulla Img (78075) | $2,639.65 | $4,061 | 2.0× |
| Angio pulmonary bilat (75743) | $4,737.85 | $7,289 | 1.5× |
| Angiography extremity bilateral rs&i (75716) | $4,737.85 | $7,289 | 1.5× |
| Angiography extremity unilateral rs&i (75710) | $4,737.85 | $7,289 | 1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$4,716.40–$4,737.85 | $7,256–$7,289 | varies |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$295.75–$553.80 | $455–$852 | varies |
| Artery X-Rays Abdomen (75726) | $4,737.85 | $7,289 | 0.9× |
| Artery X-Rays Pelvis (75736) | $4,716.40 | $7,256 | 0.8× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$726.70–$1,091.35 | $1,118–$1,679 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$429–$642.85 | $660–$989 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$671.45–$34,808.15 | $1,033–$53,551 | varies |
| Bone age studies (77072) | $292.50 | $450 | 2.8× |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,760.20–$1,871.35 | $2,708–$2,879 | varies |
| Bone Imaging Limited Area (78300) | $950.95 | $1,463 | 2.4× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,863.55–$3,220.75 | $2,867–$4,955 | varies |
| Bone marrow imaging limited area (78102) | $783.90 | $1,206 | 2.0× |
| Bone marrow imaging; multiple areas (78103) | $783.90 | $1,206 | 2.0× |
| Bone marrow imaging; whole body (78104) | $783.90 | $1,206 | 2.0× |
| Bone survey infant (77076) | $499.85 | $769 | 4.8× |
| Brain Flow Imaging Only (78610) | $231.40 | $356 | 0.4× |
| Brain Image W/Flow < 4 Views (78601) | $780.65 | $1,201 | 1.9× |
| Brain imaging < 4 static views (78600) | $698.75 | $1,075 | 1.7× |
| Brain Imaging Minimum 4 Static Views (78605) | $999.05 | $1,537 | 1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,482.35 | $3,819 | 1.7× |
| Cerebrospinal Fluid Scan (78630) | $453.05 | $697 | 0.8× |
| Chest 1 view (71045) | $282.10 | $434 | 3.2× |
| Chest 2 views (71046) | $349.05 | $537 | 4.0× |
| Chest 4 or more views (71048) | $458.90 | $706 | 4.4× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$285.35–$469.30 | $439–$722 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $245.05 | $377 | 2.3× |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$855.40–$31,252 | $1,316–$48,080 | varies |
| Contrast Exam Abdominl Aorta (75625) | $4,737.85 | $7,289 | 1.5× |
| Contrast X-Ray Bladder (74430) | $644.80 | $992 | 1.8× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$209.95–$313.95 | $323–$483 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$774.15–$1,161.55 | $1,191–$1,787 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $1,185.60 | $1,824 | 3.4× |
| CT abdomen and pelvis without contrast (74176) | $1,080.95 | $1,663 | 4.5× |
| CT abdomen w contrast (74160) | $984.75 | $1,515 | 5.6× |
| CT abdomen w wo contrast (74170) | $1,080.95 | $1,663 | 6.2× |
| CT abdomen w/o contrast (74150) | $984.75 | $1,515 | 9.4× |
| CT Angio Abdomen and Pelvis (74174) | $1,225.25 | $1,885 | 3.5× |
| CT Angio Chest (71275) | $2,866.50 | $4,410 | 16.3× |
| CT Angio Head (70496) | $1,955.20 | $3,008 | 11.1× |
| CT angio hrt w/3d image (75574) | $2,146.95 | $3,303 | 6.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,501.85–$4,275.05 | $3,849–$6,577 | varies |
| CT Angio Neck (70498) | $2,555.80 | $3,932 | 14.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,177.80–$1,964.95 | $1,812–$3,023 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $585 | $900 | 3.3× |
| CT cervical spine w/ contrast (72126) | $1,795.30 | $2,762 | 5.1× |
| CT cervical spine w/o contrast (72125) | $1,821.95 | $2,803 | 17.4× |
| CT cervical spine w/wo cont (72127) | $2,031.90 | $3,126 | 11.6× |
| CT chest w contrast (71260) | $2,011.75 | $3,095 | 11.5× |
| CT chest w/wo contrast (71270) | $2,346.50 | $3,610 | 13.4× |
| CT head/brain with contrast (70460) | $1,633.45 | $2,513 | 9.3× |
| CT head/brain without and with contrast (70470) | $1,801.80 | $2,772 | 10.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,575.60 | $2,424 | 4.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $84.50 | $130 | 1.0× |
| CT hrt w/3d image congen (75573) | $1,850.55 | $2,847 | 5.3× |
| CT iac w contrast (70481) | $1,534 | $2,360 | 8.7× |
| CT l-spine w&w/o contrast (72133) | $2,093 | $3,220 | 11.9× |
| CT lower ext w/o (73700) | $1,864.85 | $2,869 | 17.8× |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,842.75–$1,864.85 | $2,835–$2,869 | varies |
| CT lumbar spine w contrast (72132) | $1,963 | $3,020 | 5.6× |
| CT lumbar spine w/o contrast (72131) | $1,834.30 | $2,822 | 17.5× |
| CT maxillofacial w contrast (70487) | $1,763.45 | $2,713 | 10.0× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,224.60–$1,246.05 | $1,884–$1,917 | varies |
| CT neck tissue combo (70492) | $1,976.65 | $3,041 | 11.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,834.30 | $2,822 | 10.4× |
| CT orbits w/o contrast (70480) | $1,409.20 | $2,168 | 13.5× |
| CT pelvis w&w/o contrast (72194) | $1,080.95 | $1,663 | 6.2× |
| CT pelvis w/o contrast (72192) | $984.75 | $1,515 | 9.4× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,942.85–$1,964.95 | $2,989–$3,023 | varies |
| CT scans face/jaw combo (70488) | $2,117.70 | $3,258 | 12.1× |
| CT soft tissue neck w contrast (70491) | $2,193.75 | $3,375 | 12.5× |
| CT soft tissue neck w/o contrast (70490) | $2,126.80 | $3,272 | 20.3× |
| CT thoracic spine w contrast (72129) | $1,832.35 | $2,819 | 10.4× |
| CT thoracic spine w/o contrast (72128) | $1,883.05 | $2,897 | 18.0× |
| CT thoracic spine w/wo cont (72130) | $2,059.85 | $3,169 | 11.7× |
| CT thorax w/o contrast (71250) | $2,011.75 | $3,095 | 19.2× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$874.25–$1,104.35 | $1,345–$1,699 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,287–$1,901.90 | $1,980–$2,926 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,114.75–$1,203.15 | $1,715–$1,851 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,225.25 | $1,885 | 7.0× |
| Cta Abdomen (74175) | $1,185.60 | $1,824 | 6.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,060.50 | $3,170 | 5.9× |
| CTA pelvis (72191) | $2,361.45 | $3,633 | 13.4× |
| Diskography lumbar (72295) | $1,786.85 | $2,749 | 0.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $906.75 | $1,395 | 8.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $1,021.80 | $1,572 | 9.8× |
| Doppler Fetal Mid Cerebral Artery (76821) | $564.20 | $868 | 5.4× |
| Dxa Bone Density Axial (77080) | $497.90 | $766 | 4.8× |
| Dxa bone density study (77085) | $224.25 | $345 | 2.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $310.05 | $477 | 3.6× |
| Echo exam of fetal heart (76825) | $1,326 | $2,040 | 2.4× |
| Echo Guide For Artery Repair (76936) | $668.85 | $1,029 | 3.1× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $906.75 | $1,395 | 3.8× |
| Esophagram (74220) | $611 | $940 | 3.5× |
| Fetal Biophys Profile W/Nst (76818) | $766.35 | $1,179 | 7.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $652.60 | $1,004 | 6.2× |
| Fluoroscopy up to 1 hr (76000) | $633.75 | $975 | 2.7× |
| Foot 2 views (73620) range across 6 matching MRF lines |
$271.05–$522.60 | $417–$804 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$249.60–$499.85 | $384–$769 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,477.45–$1,945.45 | $2,273–$2,993 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $744.90 | $1,146 | 1.9× |
| Gastroesophageal Reflux Exam (78262) | $1,549.60 | $2,384 | 3.9× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$1,696.50–$2,184 | $2,610–$3,360 | varies |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,029.60 | $1,584 | 1.9× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$284.05–$554.45 | $437–$853 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,930.55 | $6,047 | 1.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,684.50 | $4,130 | 0.8× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,881.75–$2,783.53 | $2,895–$4,282.36 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$1,550.90–$2,292.55 | $2,386–$3,527 | varies |
| Ht Muscle Image Spect Sing (78451) | $1,350.70 | $2,078 | 1.0× |
| Hysterosalpingogram (74740) | $744.90 | $1,146 | 3.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $665.60 | $1,024 | 7.6× |
| Infant hip ultrasound, limited static exam (76886) | $377.65 | $581 | 4.3× |
| K Flow/Funct Image Multiple (78709) | $4,008.55 | $6,167 | 7.4× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$2,808–$3,839.33 | $4,320–$5,906.66 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$2,003.95–$3,025.75 | $3,083–$4,655 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,082.90 | $1,666 | 2.7× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$332.80–$608.40 | $512–$936 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,214.85 | $1,869 | 3.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $934.05 | $1,437 | 2.3× |
| Liver imaging static only (78201) range across 2 matching MRF lines |
$2,674.75–$86,489.96 | $4,115–$133,061.48 | varies |
| Liver imaging w/vascular flow (78202) | $1,658.15 | $2,551 | 3.0× |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$2,466.10–$3,924.05 | $3,794–$6,037 | varies |
| Lung perfusion differential (78597) | $1,985.75 | $3,055 | 5.0× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$1,999.40–$5,469.10 | $3,076–$8,414 | varies |
| Lung Ventilation Imaging (78579) | $724.10 | $1,114 | 1.8× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,565.20–$28,053.83 | $2,408–$43,159.74 | varies |
| Magnetic Image Jaw Joint (70336) | $707.85 | $1,089 | 3.0× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$1,081.60–$1,138.15 | $1,664–$1,751 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$4,357.60–$36,631.40 | $6,704–$56,356 | varies |
| Mra Head W/O & W/Contrast Material (70546) | $2,595.45 | $3,993 | 7.4× |
| MRA head w/o contrast (70544) | $2,076.75 | $3,195 | 8.7× |
| MRA head with contrast (70545) | $1,612 | $2,480 | 4.6× |
| MRA neck w contrast (70548) | $1,318.20 | $2,028 | 3.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,122.90 | $3,266 | 6.1× |
| MRA neck w/o contrast (70547) | $1,964.95 | $3,023 | 8.2× |
| MRI abdomen w contrast (74182) | $3,268.20 | $5,028 | 9.4× |
| MRI abdomen w/o contrast (74181) | $2,797.60 | $4,304 | 11.7× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$2,496–$3,494.40 | $3,840–$5,376 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$2,923.05–$4,428.45 | $4,497–$6,813 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$2,681.25–$3,753.75 | $4,125–$5,775 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $2,449.20 | $3,768 | 10.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,833 | $2,820 | 7.7× |
| MRI cervical spine w contrast (72142) | $2,286.05 | $3,517 | 6.5× |
| MRI cervical spine w/o cont (72141) | $2,286.05 | $3,517 | 9.6× |
| MRI chest w/o contrast (71550) | $1,774.50 | $2,730 | 7.4× |
| MRI chest with contrast (71551) | $1,774.50 | $2,730 | 2.3× |
| MRI chest wo w contrast (71552) | $2,278.90 | $3,506 | 6.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$2,496–$3,177.85 | $3,840–$4,889 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,923.05–$4,428.45 | $4,497–$6,813 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,496–$3,494.40 | $3,840–$5,376 | varies |
| MRI lumbar spine w contrast (72149) | $2,332.20 | $3,588 | 6.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,038.10 | $4,674 | 8.7× |
| MRI orbit face &/neck w/o contrast (70540) | $2,752.10 | $4,234 | 11.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,186.30 | $4,902 | 9.1× |
| MRI pelvis w contrast (72196) | $2,579.85 | $3,969 | 7.4× |
| MRI pelvis w/o & w contrast (72197) | $3,313.05 | $5,097 | 9.5× |
| MRI pelvis w/o contrast (72195) | $2,579.85 | $3,969 | 10.8× |
| MRI thoracic spine w/o contrast (72146) | $2,189.20 | $3,368 | 9.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$2,646.15–$3,703.70 | $4,071–$5,698 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,646.15–$3,703.70 | $4,071–$5,698 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$3,216.20–$4,757.35 | $4,948–$7,319 | varies |
| MRI, abdomen, combo (74183) | $3,729.70 | $5,738 | 10.7× |
| MRI, dorsal spine combo (72157) | $3,146 | $4,840 | 9.0× |
| MRI, dorsal spine contrast (72147) | $2,392 | $3,680 | 6.8× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,537.60–$3,753.75 | $3,904–$5,775 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$3,216.20–$4,757.35 | $4,948–$7,319 | varies |
| MRI, lumbar spine combo (72158) | $3,075.80 | $4,732 | 8.8× |
| Myelogram cervical (72240) | $2,119 | $3,260 | 2.7× |
| Myelogram Lumbar (72265) | $2,119 | $3,260 | 2.7× |
| Myelography thoracic (72255) | $2,119 | $3,260 | 2.7× |
| Myelograpy 2/more regions rs&i (72270) | $2,736.50 | $4,210 | 3.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,703.70 | $5,698 | 2.9× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$5,017.35–$7,502.30 | $7,719–$11,542 | varies |
| Neck soft tissue (70360) | $290.55 | $447 | 3.3× |
| Nm csf leak detection (78650) | $2,358.85 | $3,629 | 1.8× |
| Nonvascular Shunt X-Ray (75809) | $248.30 | $382 | 2.4× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$6,730.75–$36,631.40 | $10,355–$56,356 | varies |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$542.10–$82,105.97 | $834–$126,316.88 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$1,682.85–$8,182.85 | $2,589–$12,589 | varies |
| Panoramic X-ray of jaws (70355) | $167.05 | $257 | 1.9× |
| Parathyroid Planar Imaging (78070) | $1,042.60 | $1,604 | 2.6× |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$822.25–$1,443.65 | $1,265–$2,221 | varies |
| Pelvis 1 or 2 views (72170) | $308.75 | $475 | 2.9× |
| Pet Image W/Ct Lmtd (78814) | $7,299.50 | $11,230 | 5.1× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$7,299.50–$9,007.05 | $11,230–$13,857 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$7,299.50–$9,107.15 | $11,230–$14,011 | varies |
| PET whole body (78813) | $6,882.85 | $10,589 | 4.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,030.25 | $1,585 | 2.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $549.25 | $845 | 5.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $859.30 | $1,322 | 1.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$333.45–$522.60 | $513–$804 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$275.60–$522.60 | $424–$804 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$273–$562.25 | $420–$865 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $508.30 | $782 | 4.9× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$290.55–$454.35 | $447–$699 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$331.50–$522.60 | $510–$804 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$321.75–$585 | $495–$900 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$287.30–$546.65 | $442–$841 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $542.75 | $835 | 5.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $377 | $580 | 4.3× |
| Radex Ribs Unilateral 2 Views (71100) | $450.45 | $693 | 5.2× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$334.75–$613.60 | $515–$944 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $287.95 | $443 | 3.3× |
| Radex Spine 1 View Specify Level (72020) | $312.65 | $481 | 3.6× |
| Radex Sternum Minimum 2 Views (71120) | $348.40 | $536 | 4.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $332.80 | $512 | 3.8× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$265.85–$412.10 | $409–$634 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 5 matching MRF lines |
$339.30–$635.05 | $522–$977 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$319.80–$582.40 | $492–$896 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 2 matching MRF lines |
$19,533.80–$36,631.40 | $30,052–$56,356 | varies |
| Radiation treatment delivery level 1 (77402) | $619.45 | $953 | 6.1× |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$1,476.15–$21,756.15 | $2,271–$33,471 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$2,865.85–$21,721.70 | $4,409–$33,418 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $334.10 | $514 | 3.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $485.55 | $747 | 4.6× |
| Radiologic exam colon double contrast study (74280) | $1,075.75 | $1,655 | 6.1× |
| Radiologic exam colon single contrast study (74270) | $737.75 | $1,135 | 4.2× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$438.10–$828.10 | $674–$1,274 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $273 | $420 | 2.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $850.20 | $1,308 | 4.8× |
| Radiologic exam swallow function contrast study (74230) | $523.25 | $805 | 3.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,525.55 | $2,347 | 8.7× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$273–$424.45 | $420–$653 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$322.40–$472.55 | $496–$727 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$328.25–$595.40 | $505–$916 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $217.10 | $334 | 2.5× |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$315.25–$613.60 | $485–$944 | varies |
| Ribs bilateral 3 views (71110) | $560.30 | $862 | 5.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$807.30–$7,293.65 | $1,242–$11,221 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $827.45 | $1,273 | 2.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,161.55 | $1,787 | 2.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,015.95 | $1,563 | 1.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$835.90–$29,489.78 | $1,286–$45,368.90 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,710.50 | $4,170 | 2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,074.50 | $4,730 | 2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,710.50 | $4,170 | 2.1× |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$885.95–$109,305.95 | $1,363–$168,163 | varies |
| Salivary Gland Function Study (78232) | $879.45 | $1,353 | 2.2× |
| Scapula (73010) range across 3 matching MRF lines |
$269.10–$503.75 | $414–$775 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$104.65–$163.15 | $161–$251 | varies |
| Sella turcica (70240) | $249.60 | $384 | 2.9× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$249.60–$499.85 | $384–$769 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$984.10–$1,444.95 | $1,514–$2,223 | varies |
| Sialogram (70390) | $456.30 | $702 | 1.9× |
| Skull less than 4 views (70250) | $360.75 | $555 | 3.4× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$1,410.50–$57,831.80 | $2,170–$88,972 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$4,002.05–$41,389.40 | $6,157–$63,676 | varies |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$7,187.05–$52,419.25 | $11,057–$80,645 | varies |
| Sternoclavicular joints (71130) | $249.60 | $384 | 2.9× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) | $521.30 | $802 | 5.1× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) range across 2 matching MRF lines |
$521.30–$4,178.85 | $802–$6,429 | varies |
| Surf radj ther supfc/orthvlt treatment planning (77436) range across 2 matching MRF lines |
$521.30–$4,178.85 | $802–$6,429 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$323.05–$14,041.30 | $497–$21,602 | varies |
| Temporomandble Jt Arthrography Rs&I (70332) range across 3 matching MRF lines |
$848.90–$1,274.65 | $1,306–$1,961 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$2,425.15–$31,109 | $3,731–$47,860 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$1,270.75–$26,517.40 | $1,955–$40,796 | varies |
| Thoracic spine 2 views (72070) | $415.35 | $639 | 4.0× |
| Thoracic spine 3 views (72072) | $419.90 | $646 | 4.0× |
| Thoracolumbar 2 views (72080) | $415.35 | $639 | 4.8× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $876.20 | $1,348 | 2.2× |
| Thyroid Imaging With Vascular Flow (78013) | $497.90 | $766 | 1.2× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$1,366.30–$1,561.95 | $2,102–$2,403 | varies |
| Thyroid Uptake Measurement (78012) | $767 | $1,180 | 1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$1,198.60–$1,532.05 | $1,844–$2,357 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$1,600.95–$32,559.80 | $2,463–$50,092 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$815.75–$28,679.95 | $1,255–$44,123 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$190.45–$285.35 | $293–$439 | varies |
| Ultrasound Exam Aaa Screen (76706) | $257.40 | $396 | 2.5× |
| Ultrasound, abdomen limited (76705) | $1,060.15 | $1,631 | 10.1× |
| Umbilical-artery Doppler (OB) (76820) | $564.20 | $868 | 5.4× |
| Unlisted magnetic resonance procedure (76498) | $2,579.85 | $3,969 | 29.6× |
| Upper gi w/o kub (74240) | $1,540.50 | $2,370 | 8.8× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $330.85 | $509 | 29.9× |
| Urea breath test c-14 isotopic analysis (78268) | $330.85 | $509 | 3.5× |
| Urethrocystogram voiding (74455) | $923.65 | $1,421 | 3.9× |
| Urethrocystography retrograde (74450) | $496.60 | $764 | 2.1× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$190.45–$285.35 | $293–$439 | varies |
| Us chest (76604) | $503.10 | $774 | 4.8× |
| Us exam, pelvic, limited (76857) | $347.75 | $535 | 3.3× |
| Us head (76506) | $584.35 | $899 | 5.6× |
| Us kidney transplant (76776) | $716.95 | $1,103 | 6.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$775.45–$1,318.85 | $1,193–$2,029 | varies |
| Us ob detailed single fetus (76811) | $1,190.15 | $1,831 | 5.0× |
| Us ob limited 1 or more fetuses (76815) | $627.25 | $965 | 6.0× |
| Us ob transvaginal (76817) | $342.55 | $527 | 3.3× |
| Us pelvic non ob complete (76856) | $830.70 | $1,278 | 7.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $342.55 | $527 | 3.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $220.35 | $339 | 2.1× |
| Us retroperitoneal complete (76770) | $1,043.25 | $1,605 | 10.0× |
| Us retroperitoneal limited (76775) | $873.60 | $1,344 | 8.3× |
| Us scrotum and contents (76870) | $949 | $1,460 | 9.1× |
| Us spinal canal and contents (76800) | $382.85 | $589 | 3.7× |
| Us thyroid (76536) range across 2 matching MRF lines |
$82.55–$791.70 | $127–$1,218 | varies |
| Us transrectal (76872) | $366.60 | $564 | 3.5× |
| Vein X-Ray Chest (75827) | $1,672.45 | $2,573 | 1.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,483 | $3,820 | 0.8× |
| Venography caval inferior serialography rs&i (75825) | $4,737.85 | $7,289 | 1.5× |
| Venography extremity bilateral rs&i (75822) | $1,672.45 | $2,573 | 1.1× |
| Venography extremity unilateral rs&i (75820) | $4,737.85 | $7,289 | 3.0× |
| Venography Renal Unilateral (75831) | $2,424.50 | $3,730 | 0.8× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$283.40–$552.50 | $436–$850 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $287.95 | $443 | 3.3× |
| X-ray antegrade pyelogram tube (74425) range across 4 matching MRF lines |
$416–$707.85 | $640–$1,089 | varies |
| X-Ray Aorta Leg Arteries (75630) | $2,503.15 | $3,851 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $286 | $440 | 2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$272.35–$533 | $419–$820 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$1,168.05–$1,941.55 | $1,797–$2,987 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $235.95 | $363 | 2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $447.85 | $689 | 4.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $273 | $420 | 3.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $314.60 | $484 | 3.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $291.85 | $449 | 2.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $529.10 | $814 | 5.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $529.10 | $814 | 5.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $583.05 | $897 | 5.6× |
| X-Ray Exam L-S Spine Bending (72114) | $586.95 | $903 | 5.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $403.65 | $621 | 4.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $512.20 | $788 | 4.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $356.20 | $548 | 3.4× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$248.30–$444.60 | $382–$684 | varies |
| X-ray humerus (73060) range across 6 matching MRF lines |
$278.20–$544.05 | $428–$837 | varies |
| X-ray IV pyelogram (ivp) (74400) | $759.85 | $1,169 | 4.3× |
| X-ray IV pyelogram+tomography (74415) | $1,194.05 | $1,837 | 6.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $271.05 | $417 | 3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $143 | $220 | 1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $328.25 | $505 | 3.1× |
| X-ray nose-rectum child f.b. (76010) | $248.30 | $382 | 2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $356.20 | $548 | 3.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $379.60 | $584 | 3.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $189.80 | $292 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $338 | $520 | 3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $515.45 | $793 | 5.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $423.80 | $652 | 4.0× |
| X-ray thoracic spine 4 vw (72074) | $451.75 | $695 | 4.3× |
| X-Ray Tmj Unilat (70328) | $249.60 | $384 | 2.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $702 | $1,080 | 2.0× |
| X-Rays Bone Length Studies (77073) | $249.60 | $384 | 2.4× |
| X-Rays Bone Survey Complete (77075) | $1,022.45 | $1,573 | 9.8× |
| Xr c-spine 4 or 5 views (72050) | $475.15 | $731 | 4.5× |
| Xr facial bones less than 3 views (70140) | $431.60 | $664 | 5.0× |
| XR Mastoids < 3 Views Bilateral (70120) | $149.50 | $230 | 1.4× |
| Xr orbits complete 4 views (70200) | $547.95 | $843 | 5.2× |
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.