Imaging prices at MercyOne North Iowa Medical Center
Mason City, IA · 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 |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $6,149.65 | $9,461 | 4.4× |
| Abdomen 1 View (74018) | $241.80 | $372 | 2.8× |
| Abdomen 2 views (74019) | $330.85 | $509 | 3.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $887.25 | $1,365 | 2.2× |
| Angio internal mammary (75756) | $8.45 | $13 | 0.0× |
| Angiography extremity bilateral rs&i (75716) | $46,702.83 | — | 14.7× |
| Angiography extremity unilateral rs&i (75710) | $43,858.67 | — | 13.8× |
| Ankle 2 views (73600) | $574 | — | 6.6× |
| Artery X-Rays Abdomen (75726) | $79,948.84 | — | 14.3× |
| Artery X-Rays Pelvis (75736) | $6,287.45 | $9,673 | 1.1× |
| Artery X-Rays Spine (75705) | $10,348.65 | $15,921 | 1.8× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$817.05–$1,225.90 | $1,257–$1,886 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$988–$1,482 | $1,520–$2,280 | varies |
| Basic radiation dosimetry calculation (77300) | $523.90 | $806 | 3.9× |
| Bone age studies (77072) | $293.80 | $452 | 2.8× |
| Bone Imaging 3 Phase (78315) | $1,855.10 | $2,854 | 4.6× |
| Bone Imaging Limited Area (78300) | $845 | $1,300 | 2.1× |
| Bone Imaging Whole Body (78306) | $1,739.40 | $2,676 | 4.3× |
| Bone survey infant (77076) | $242.45 | $373 | 2.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,222 | $1,880 | 2.2× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $2,382.90 | $3,666 | 5.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,643.20 | $2,528 | 4.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,643.20 | $2,528 | 2.1× |
| Cat Scan Follow-Up Study (76380) | $689.65 | $1,061 | 7.9× |
| Cerebrospinal Fluid Scan (78630) | $1,009.45 | $1,553 | 1.8× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$6,676.04–$16,131.14 | — | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$747–$896 | — | varies |
| Chest 3 views (71047) | $63.05 | $97 | 0.7× |
| Clavicle complete (73000) range across 6 matching MRF lines |
$181.35–$272.35 | $279–$419 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $207.35 | $319 | 2.0× |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$38,653–$58,471.50 | — | varies |
| Contrast Exam Abdominl Aorta (75625) | $6,602.05 | $10,157 | 2.1× |
| Contrast X-Ray Bladder (74430) | $619.45 | $953 | 1.8× |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$748.15–$1,122.55 | $1,151–$1,727 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $7,542 | — | 21.5× |
| CT abdomen and pelvis without contrast (74176) | $4,993 | — | 20.8× |
| CT abdomen w contrast (74160) | $1,569.10 | $2,414 | 8.9× |
| CT abdomen w wo contrast (74170) | $1,976 | $3,040 | 11.2× |
| CT abdomen w/o contrast (74150) | $1,027.65 | $1,581 | 9.8× |
| CT Angio Abdomen and Pelvis (74174) | $4,272.45 | $6,573 | 12.2× |
| CT Angio Chest (71275) | $2,944.50 | $4,530 | 16.7× |
| CT Angio Head (70496) | $7,849.50 | — | 44.5× |
| CT angio hrt w/3d image (75574) | $938.60 | $1,444 | 2.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 6 matching MRF lines |
$1,310.40–$1,965.60 | $2,016–$3,024 | varies |
| CT Angio Neck (70498) | $2,690.35 | $4,139 | 15.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $471.25 | $725 | 2.7× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $349.70 | $538 | 2.0× |
| CT cervical spine w/ contrast (72126) | $2,022.15 | $3,111 | 5.8× |
| CT cervical spine w/o contrast (72125) | $1,929.85 | $2,969 | 18.3× |
| CT cervical spine w/wo cont (72127) | $2,432.30 | $3,742 | 13.8× |
| CT chest w contrast (71260) | $2,235.35 | $3,439 | 12.7× |
| CT chest w/wo contrast (71270) | $3,938 | — | 22.3× |
| CT head/brain with contrast (70460) | $2,188.55 | $3,367 | 12.4× |
| CT head/brain without and with contrast (70470) | $2,247.05 | $3,457 | 12.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,544.40 | $2,376 | 4.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $68.25 | $105 | 0.8× |
| CT iac w contrast (70481) | $1,209.65 | $1,861 | 6.9× |
| CT lower ext w/o (73700) range across 6 matching MRF lines |
$1,200.55–$1,801.15 | $1,847–$2,771 | varies |
| CT lower extremity w/contrast material (73701) range across 6 matching MRF lines |
$1,441.05–$2,161.25 | $2,217–$3,325 | varies |
| CT lumbar spine w contrast (72132) | $1,798.55 | $2,767 | 5.1× |
| CT lumbar spine w/o contrast (72131) | $1,571.05 | $2,417 | 14.9× |
| CT maxillofacial w contrast (70487) | $1,760.85 | $2,709 | 10.0× |
| CT maxillofacial wo contrast (70486) | $1,597.70 | $2,458 | 15.2× |
| CT neck tissue combo (70492) | $1,858.35 | $2,859 | 10.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,337.70 | $2,058 | 7.6× |
| CT orbits w/o contrast (70480) | $1,661 | — | 15.8× |
| CT pelvis w&w/o contrast (72194) | $1,844.70 | $2,838 | 10.5× |
| CT pelvis w/o contrast (72192) | $1,157.65 | $1,781 | 11.0× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,495.65–$2,243.80 | $2,301–$3,452 | varies |
| CT scans face/jaw combo (70488) | $1,295.45 | $1,993 | 7.3× |
| CT soft tissue neck w contrast (70491) | $1,763.45 | $2,713 | 10.0× |
| CT soft tissue neck w/o contrast (70490) | $1,025.05 | $1,577 | 9.7× |
| CT thoracic spine w contrast (72129) | $1,733.55 | $2,667 | 9.8× |
| CT thoracic spine w/o contrast (72128) | $1,542.45 | $2,373 | 14.7× |
| CT thoracic spine w/wo cont (72130) | $1,646.45 | $2,533 | 9.3× |
| CT thorax w/o contrast (71250) | $1,578.20 | $2,428 | 15.0× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,313–$1,969.50 | $2,020–$3,030 | varies |
| CT upper extremity with contrast (73201) | $4,612.90 | — | 13.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,488.85 | $3,829 | 14.1× |
| Cta Abdomen (74175) | $1,727.70 | $2,658 | 9.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,914.25 | $2,945 | 5.5× |
| CTA pelvis (72191) | $2,483 | $3,820 | 14.1× |
| Diskography lumbar (72295) | $6,646.90 | $10,226 | 3.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $260.65 | $401 | 2.5× |
| Dxa Bone Density Axial (77080) | $1,371 | — | 13.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $180.70 | $278 | 2.1× |
| Echo exam uterus (76831) | $491.40 | $756 | 2.0× |
| Esophagram (74220) | $369.20 | $568 | 2.1× |
| Fetal Biophys Profile W/Nst (76818) | $202.80 | $312 | 1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,608 | — | 15.3× |
| Fluoroscopy up to 1 hr (76000) | $910 | — | 3.8× |
| Follow-Up Angiography (75898) | $5,853.25 | $9,005 | 1.8× |
| Foot 2 views (73620) | $29,020 | — | 331.4× |
| Forearm 2 views (73090) | $599 | — | 6.8× |
| Gastric emptying imaging study (78264) | $1,120.60 | $1,724 | 2.8× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$152.75–$229.45 | $235–$353 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,059.20 | $3,168 | 3.8× |
| Hepatobiliary System Imaging (78226) | $1,222.65 | $1,881 | 3.0× |
| Ht Muscle Image Spect Sing (78451) | $2,776.15 | $4,271 | 2.1× |
| Hysterosalpingogram (74740) | $992.55 | $1,527 | 4.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $740.35 | $1,139 | 8.5× |
| K Flow/Funct Image W/Drug (78708) | $1,508.65 | $2,321 | 2.8× |
| K Flow/Funct Image W/O Drug (78707) | $1,398.15 | $2,151 | 2.6× |
| Knee 3 Views (73562) range across 6 matching MRF lines |
$150.15–$225.55 | $231–$347 | varies |
| Lung Ventilat&Perfus Imaging (78582) | $1,256.45 | $1,933 | 2.3× |
| Lymph System Imaging (78195) | $1,763.45 | $2,713 | 3.2× |
| Mlc imrt design & construction per imrt plan (77338) | $30,903 | — | 82.0× |
| Mra Head W/O & W/Contrast Material (70546) range across 3 matching MRF lines |
$3,226.10–$3,447.80 | — | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,590–$2,528 | — | varies |
| MRA head with contrast (70545) | $1,453.40 | $2,236 | 4.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,643.20 | $2,528 | 4.7× |
| MRA neck w/o contrast (70547) | $1,788.80 | $2,752 | 7.4× |
| MRI abdomen w/o contrast (74181) | $1,033.50 | $1,590 | 4.3× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$2,031.90–$3,047.85 | $3,126–$4,689 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$1,643.20–$2,465.45 | $2,528–$3,793 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$2,143.05–$3,214.90 | $3,297–$4,946 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,879.15 | $2,891 | 7.8× |
| MRI cardiac w/o contrast (75557) | $1,917.50 | $2,950 | 8.0× |
| MRI cervical spine w/o cont (72141) | $1,033.50 | $1,590 | 4.3× |
| MRI chest w/o contrast (71550) | $1,492.40 | $2,296 | 6.2× |
| MRI chest wo w contrast (71552) | $724.10 | $1,114 | 2.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$1,643.20–$2,465.45 | $2,528–$3,793 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 6 matching MRF lines |
$1,033.50–$1,550.25 | $1,590–$2,385 | varies |
| Mri Neck Spine W/O & W/Dye (72156) | $1,643.20 | $2,528 | 4.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,987.90 | — | 8.5× |
| MRI pelvis w/o & w contrast (72197) | $1,643.20 | $2,528 | 4.7× |
| MRI pelvis w/o contrast (72195) | $984.10 | $1,514 | 4.1× |
| MRI thoracic spine w/o contrast (72146) | $1,033.50 | $1,590 | 4.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,068.95–$3,103.10 | $3,183–$4,774 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$1,643.20–$2,465.45 | $2,528–$3,793 | varies |
| MRI, abdomen, combo (74183) | $1,643.20 | $2,528 | 4.7× |
| MRI, dorsal spine combo (72157) | $1,643.20 | $2,528 | 4.7× |
| MRI, joint upper extrem (73221) range across 6 matching MRF lines |
$1,033.50–$1,550.25 | $1,590–$2,385 | varies |
| MRI, joint upper extrem combo (73223) range across 6 matching MRF lines |
$1,643.20–$2,465.45 | $2,528–$3,793 | varies |
| MRI, lumbar spine combo (72158) | $1,643.20 | $2,528 | 4.7× |
| Myelograpy 2/more regions rs&i (72270) | $1,540.50 | $2,370 | 2.0× |
| Myocardial Spect Multiple Studies (78452) | $3,892.85 | $5,989 | 3.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $3,218.80 | $4,952 | 2.2× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $5,811 | $8,940 | 2.6× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $3,656.90 | $5,626 | 1.6× |
| Neck soft tissue (70360) | $231.40 | $356 | 2.6× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,748.25 | $7,305 | 3.4× |
| Nuclear Rx Oral Admin (79005) | $859.30 | $1,322 | 3.7× |
| Ob us nuchal meas 1 gest (76813) | $465.40 | $716 | 4.4× |
| Panoramic X-ray of jaws (70355) | $209.95 | $323 | 2.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,434.90 | $3,746 | 4.5× |
| Pelvis 1 or 2 views (72170) | $1,114 | — | 10.6× |
| PET image w/CT, full body (78816) | $5,768.10 | $8,874 | 4.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,685.55 | $8,747 | 4.0× |
| Pet Myocardial Sngl Study (78491) | $3,891.55 | $5,987 | 2.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $805.35 | $1,239 | 2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $308.75 | $475 | 2.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$2,062.90–$4,125.80 | — | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$307–$2,983 | — | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 6 matching MRF lines |
$123.50–$185.90 | $190–$286 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$751–$1,813 | — | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $317.85 | $489 | 3.0× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$422–$842 | — | varies |
| Radex foot complete minimum 3 views (73630) range across 9 matching MRF lines |
$191.10–$286.65 | $294–$441 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$504–$1,491 | — | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 6 matching MRF lines |
$216.45–$325 | $333–$500 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $273 | $420 | 3.1× |
| Radex Ribs Unilateral 2 Views (71100) | $186.55 | $287 | 2.1× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$514–$782 | — | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$3,868–$60,206.23 | — | varies |
| Radex Sternum Minimum 2 Views (71120) | $66.30 | $102 | 0.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $227.50 | $350 | 2.6× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$195–$292.50 | $300–$450 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$207.35–$311.35 | $319–$479 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$508–$818 | — | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $490.75 | $755 | 4.7× |
| Radiation treatment delivery level 1 (77402) | $2,027.35 | $3,119 | 19.7× |
| Radiation treatment delivery level 2 (77407) | $2,128.10 | $3,274 | 5.5× |
| Radiation treatment delivery level 3 (77412) | $2,228.20 | $3,428 | 4.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $330.85 | $509 | 3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $184.60 | $284 | 1.8× |
| Radiologic exam colon single contrast study (74270) | $436.80 | $672 | 2.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $471.25 | $725 | 2.7× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$144.30–$216.45 | $222–$333 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $217.10 | $334 | 2.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $365.95 | $563 | 2.1× |
| Radiologic exam swallow function contrast study (74230) | $421.85 | $649 | 2.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $619.45 | $953 | 3.5× |
| Radiologic examination femur 1 view (73551) range across 6 matching MRF lines |
$161.20–$241.80 | $248–$372 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$217.10–$325.65 | $334–$501 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$608–$2,413 | — | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $360.75 | $555 | 3.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$650–$1,327 | — | varies |
| Ribs bilateral 3 views (71110) | $356.20 | $548 | 3.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,098.20 | $3,228 | 3.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,285.10 | $5,054 | 2.5× |
| Scapula (73010) range across 3 matching MRF lines |
$177.45–$266.50 | $273–$410 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$39–$59.15 | $60–$91 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$228.80–$343.20 | $352–$528 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$817.05–$1,225.90 | $1,257–$1,886 | varies |
| Skull less than 4 views (70250) | $182 | $280 | 1.7× |
| Special dosimetry (77331) | $415.35 | $639 | 3.1× |
| Special teletherapy port plan (77321) | $1,037.40 | $1,596 | 2.8× |
| Special treatment procedure (77470) | $1,960.40 | $3,016 | 3.5× |
| Stereotactic Body Radiation Delivery (77373) | $2,842.45 | $4,373 | 1.6× |
| Sternoclavicular joints (71130) | $174.85 | $269 | 2.0× |
| Tbs technical calculation only (77091) | $203.45 | $313 | 2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $982.80 | $1,512 | 2.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,823.90 | $2,806 | 4.8× |
| Ther rad simulaj-aided field setting simple (77280) | $835.25 | $1,285 | 6.2× |
| Thoracic spine 2 views (72070) | $248.95 | $383 | 2.4× |
| Thoracic spine 3 views (72072) | $89.70 | $138 | 0.9× |
| Thoracolumbar 2 views (72080) | $268.45 | $413 | 3.1× |
| Thyroid Met Imaging Body (78018) | $1,066 | $1,640 | 2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,069.25 | $1,645 | 2.7× |
| Tx Devices Design & Construction Complex (77334) | $28,212 | — | 74.9× |
| Tx devices design & construction simple (77332) | $635.70 | $978 | 4.7× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$460.85–$691.60 | $709–$1,064 | varies |
| Ultrasound Elastography Parenchyma (76981) | $1,625 | — | 15.4× |
| Ultrasound Exam Aaa Screen (76706) | $303.55 | $467 | 2.9× |
| Ultrasound, abdomen limited (76705) | $825 | — | 7.8× |
| Umbilical-artery Doppler (OB) (76820) | $260.65 | $401 | 2.5× |
| Upper gi w/o kub (74240) | $447.85 | $689 | 2.5× |
| Urethrocystogram voiding (74455) | $619.45 | $953 | 2.6× |
| Urethrocystography retrograde (74450) | $596.05 | $917 | 2.5× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$507–$760.50 | $780–$1,170 | varies |
| Us chest (76604) | $382.85 | $589 | 3.6× |
| Us complete joint (76881) | $425.75 | $655 | 4.0× |
| Us exam, pelvic, limited (76857) | $604 | — | 5.7× |
| Us head (76506) | $451.10 | $694 | 4.3× |
| Us kidney transplant (76776) | $936 | $1,440 | 8.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $638 | — | 6.1× |
| Us ob detailed single fetus (76811) | $1,131.65 | $1,741 | 4.7× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$1,016–$1,455 | — | varies |
| Us ob transvaginal (76817) | $481.65 | $741 | 4.6× |
| Us pelvic non ob complete (76856) | $2,194 | — | 20.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $592.15 | $911 | 5.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $429 | $660 | 4.1× |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$1,075–$1,860 | — | varies |
| Us retroperitoneal limited (76775) | $87.10 | $134 | 0.8× |
| Us scrotum and contents (76870) | $544.05 | $837 | 5.2× |
| Us spinal canal and contents (76800) | $396.50 | $610 | 3.8× |
| Us thyroid (76536) | $492.70 | $758 | 4.7× |
| Us transrectal (76872) | $87.10 | $134 | 0.8× |
| Vein X-Ray Chest (75827) | $1,990.95 | $3,063 | 1.3× |
| Venogram Sinus/Jugular (75860) | $3,081 | $4,740 | 1.0× |
| Venography caval inferior serialography rs&i (75825) | $6,602.05 | $10,157 | 2.1× |
| Venography extremity unilateral rs&i (75820) | $1,990.30 | $3,062 | 1.3× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$170–$255 | — | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $225.55 | $347 | 2.6× |
| X-Ray Aorta Leg Arteries (75630) | $6,602.05 | $10,157 | 2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$647–$4,508 | — | varies |
| X-Ray Exam Breast Specimen (76098) | $34,942.15 | — | 63.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $163.15 | $251 | 1.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $312 | $480 | 3.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $707.20 | $1,088 | 6.7× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$78,982.35–$80,674.55 | — | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $160.55 | $247 | 1.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $260 | $400 | 2.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $276.90 | $426 | 2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $248.30 | $382 | 2.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $162.50 | $250 | 1.5× |
| X-Ray Exam L-S Spine Bending (72114) | $374.40 | $576 | 3.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $257.40 | $396 | 2.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $457.60 | $704 | 4.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $339.30 | $522 | 3.2× |
| X-ray eye for foreign body (70030) range across 6 matching MRF lines |
$224.25–$336.70 | $345–$518 | varies |
| X-ray humerus (73060) | $761 | — | 8.7× |
| X-ray IV pyelogram (ivp) (74400) | $619.45 | $953 | 3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$863–$900 | — | varies |
| X-ray nose-rectum child f.b. (76010) | $488.15 | $751 | 5.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $408.20 | $628 | 3.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $199.55 | $307 | 1.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $263.25 | $405 | 2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $244.40 | $376 | 2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $214.50 | $330 | 2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $338 | $520 | 3.2× |
| X-Rays Bone Length Studies (77073) | $202.80 | $312 | 1.9× |
| X-Rays Bone Survey Complete (77075) | $293.80 | $452 | 2.8× |
| Xr c-spine 4 or 5 views (72050) | $282.75 | $435 | 2.7× |
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.