Imaging prices at Methodist Fremont Health
Fremont, NE · every code in this section with a posted price and a Medicare benchmark.
324 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) | $4,082.21 | $11,033 | 2.8× |
| Abdomen 1 View (74018) | $185.37 | $501 | 2.1× |
| Abdomen 2 views (74019) | $259.74 | $702 | 2.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $903.91 | $2,443 | 2.2× |
| Angiography extremity bilateral rs&i (75716) | $1,192.14 | $3,222 | 0.4× |
| Angiography extremity unilateral rs&i (75710) | $2,259.59 | $6,107 | 0.7× |
| Ankle 2 views (73600) | $152.07 | $411 | 1.7× |
| Arthrogram ankle (73615) | $313.76 | $848 | 0.9× |
| Arthrogram hip (73525) | $370.37 | $1,001 | 1.0× |
| Arthrogram Wrist (73115) | $313.76 | $848 | 0.9× |
| Basic radiation dosimetry calculation (77300) | $427.35 | $1,155 | 3.1× |
| Bone age studies (77072) | $125.80 | $340 | 1.2× |
| Bone Imaging 3 Phase (78315) | $1,706.07 | $4,611 | 4.1× |
| Bone Imaging Limited Area (78300) | $768.49 | $2,077 | 1.9× |
| Bone Imaging Multiple Areas (78305) | $1,226.55 | $3,315 | 3.0× |
| Bone Imaging Whole Body (78306) | $1,279.46 | $3,458 | 3.1× |
| Bone survey infant (77076) | $157.25 | $425 | 1.4× |
| Brain Imaging Minimum 4 Static Views (78605) | $487.66 | $1,318 | 0.9× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,468.16 | $3,968 | 3.5× |
| Cat Scan Follow-Up Study (76380) | $462.87 | $1,251 | 5.1× |
| Chest 1 view (71045) | $141.34 | $382 | 1.6× |
| Chest 2 views (71046) | $219.41 | $593 | 2.4× |
| Chest 3 views (71047) | $254.93 | $689 | 2.8× |
| Chest 4 or more views (71048) | $281.20 | $760 | 2.6× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $131.35 | $355 | 1.2× |
| Clavicle complete (73000) | $218.67 | $591 | 2.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$1,459.65–$1,503.68 | $3,945–$4,064 | varies |
| Continuing medical physics consltj pr wk (77336) | $617.16 | $1,668 | 4.4× |
| Contrast Exam Abdominl Aorta (75625) | $2,259.59 | $6,107 | 0.7× |
| Contrast X-Ray Bladder (74430) | $251.97 | $681 | 0.7× |
| Contrast X-Ray Of Elbow (73085) | $313.76 | $848 | 0.9× |
| Contrast X-Ray Of Knee Joint (73580) | $313.76 | $848 | 0.9× |
| CT abdomen and pelvis without and with contrast (74178) | $3,016.24 | $8,152 | 8.3× |
| CT abdomen and pelvis without contrast (74176) | $2,461.98 | $6,654 | 9.9× |
| CT abdomen w contrast (74160) | $1,830.39 | $4,947 | 10.0× |
| CT abdomen w wo contrast (74170) | $2,244.42 | $6,066 | 12.3× |
| CT abdomen w/o contrast (74150) | $1,743.81 | $4,713 | 16.1× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$2,579.64–$2,682.87 | $6,972–$7,251 | varies |
| CT Angio Chest (71275) | $1,768.97 | $4,781 | 9.7× |
| CT Angio Head (70496) | $1,017.87 | $2,751 | 5.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,323.49 | $3,577 | 7.3× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,393.05–$1,448.55 | $3,765–$3,915 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,214.34 | $3,282 | 6.7× |
| CT cervical spine w/ contrast (72126) | $1,183.26 | $3,198 | 3.3× |
| CT cervical spine w/o contrast (72125) | $1,309.43 | $3,539 | 12.1× |
| CT cervical spine w/wo cont (72127) | $1,768.60 | $4,780 | 9.7× |
| CT chest w contrast (71260) | $1,595.81 | $4,313 | 8.8× |
| CT chest w/wo contrast (71270) | $2,244.42 | $6,066 | 12.3× |
| CT head/brain with contrast (70460) | $1,402.67 | $3,791 | 7.7× |
| CT head/brain without and with contrast (70470) | $1,685.35 | $4,555 | 9.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,094.83 | $2,959 | 3.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $113.22 | $306 | 1.3× |
| CT iac w contrast (70481) | $1,424.50 | $3,850 | 7.8× |
| CT l-spine w&w/o contrast (72133) | $1,517.37 | $4,101 | 8.3× |
| CT lower ext w/o (73700) | $1,625.41 | $4,393 | 15.0× |
| CT lower extremity w/contrast material (73701) | $1,574.72 | $4,256 | 8.6× |
| CT lumbar spine w contrast (72132) | $1,402.30 | $3,790 | 3.9× |
| CT lumbar spine w/o contrast (72131) | $1,421.54 | $3,842 | 13.1× |
| CT maxillofacial w contrast (70487) | $1,319.42 | $3,566 | 7.2× |
| CT maxillofacial wo contrast (70486) | $1,214.34 | $3,282 | 11.2× |
| CT neck tissue combo (70492) | $1,559.92 | $4,216 | 8.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,528.47 | $4,131 | 8.4× |
| CT orbits w/o contrast (70480) | $1,402.67 | $3,791 | 12.9× |
| CT pelvis w&w/o contrast (72194) | $1,674.99 | $4,527 | 9.2× |
| CT pelvis w/o contrast (72192) | $1,539.20 | $4,160 | 14.2× |
| CT scan of leg combo (73702) | $1,697.93 | $4,589 | 9.3× |
| CT scans face/jaw combo (70488) | $1,529.21 | $4,133 | 8.4× |
| CT soft tissue neck w contrast (70491) | $1,427.46 | $3,858 | 7.8× |
| CT soft tissue neck w/o contrast (70490) | $1,364.56 | $3,688 | 12.6× |
| CT thoracic spine w contrast (72129) | $1,386.76 | $3,748 | 7.6× |
| CT thoracic spine w/o contrast (72128) | $1,485.55 | $4,015 | 13.7× |
| CT thoracic spine w/wo cont (72130) | $1,517.37 | $4,101 | 8.3× |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$1,459.65–$1,503.68 | $3,945–$4,064 | varies |
| CT upper ext wo (73200) | $1,359.75 | $3,675 | 12.5× |
| CT upper extremity w/o & w/contrast material (73202) | $1,361.60 | $3,680 | 7.5× |
| CT upper extremity with contrast (73201) | $1,104.08 | $2,984 | 3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,935.47 | $5,231 | 10.6× |
| Cta Abdomen (74175) | $1,989.49 | $5,377 | 10.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,134.05 | $3,065 | 3.1× |
| CTA pelvis (72191) | $1,454.84 | $3,932 | 8.0× |
| Discography Cerv/Thor Spine (72285) | $799.57 | $2,161 | 0.4× |
| Diskography lumbar (72295) | $994.56 | $2,688 | 0.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $112.11 | $303 | 1.0× |
| Dxa Bone Density Axial (77080) | $321.53 | $869 | 3.0× |
| Echo exam uterus (76831) | $369.26 | $998 | 1.5× |
| Esophagram (74220) | $350.39 | $947 | 1.9× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$120.25–$543.90 | $325–$1,470 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $518 | $1,400 | 4.8× |
| Fluoroscopy up to 1 hr (76000) | $399.97 | $1,081 | 1.6× |
| Follow-Up Angiography (75898) range across 3 matching MRF lines |
$1,575.46–$3,151.29 | $4,258–$8,517 | varies |
| Foot 2 views (73620) | $185 | $500 | 2.0× |
| Forearm 2 views (73090) | $190.92 | $516 | 2.1× |
| Gastric emptying imaging study (78264) | $1,230.25 | $3,325 | 3.0× |
| Gated Heart Planar Single (78472) | $1,362.71 | $3,683 | 3.3× |
| Gated Heart, Multiple (78473) | $1,468.16 | $3,968 | 3.5× |
| Hand 2 views (73120) | $172.42 | $466 | 1.6× |
| Hepatobil Syst Image W/Drug (78227) | $1,278.72 | $3,456 | 2.3× |
| Hepatobiliary System Imaging (78226) | $963.48 | $2,604 | 2.3× |
| Ht Muscle Image Spect Sing (78451) | $1,689.42 | $4,566 | 1.3× |
| Hysterosalpingogram (74740) | $325.97 | $881 | 1.3× |
| Image fusion (77399) | $277.13 | $749 | 2.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $172.42 | $466 | 1.9× |
| Interstitial radiation source applic complex (77778) | $4,690.12 | $12,676 | 6.5× |
| K Flow/Funct Image W/Drug (78708) | $1,322.75 | $3,575 | 2.3× |
| K Flow/Funct Image W/O Drug (78707) | $1,095.94 | $2,962 | 1.9× |
| Knee 3 Views (73562) | $252.34 | $682 | 2.8× |
| Liver & Spleen Imaging Static Only (78215) | $744.81 | $2,013 | 1.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $783.29 | $2,117 | 1.9× |
| Liver imaging static only (78201) | $358.53 | $969 | 0.6× |
| Lung perfusion differential (78597) | $912.05 | $2,465 | 2.2× |
| Lymph System Imaging (78195) | $854.70 | $2,310 | 1.5× |
| Magnetic Image Jaw Joint (70336) | $1,674.62 | $4,526 | 6.8× |
| Mlc imrt design & construction per imrt plan (77338) | $6,164.94 | $16,662 | 15.9× |
| Mr safety determination physician/other qhp (76016) | $280.83 | $759 | 3.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $78.44 | $212 | 2.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $292.67 | $791 | 3.0× |
| Mr safety implt pos&/immoblj (76019) | $189.44 | $512 | 3.1× |
| Mr safety med physics xm customization plng&mntr (76017) | $770.71 | $2,083 | 3.1× |
| Mra Head W/O & W/Contrast Material (70546) | $1,880.34 | $5,082 | 5.2× |
| MRA head w/o contrast (70544) | $1,841.12 | $4,976 | 7.4× |
| MRA head with contrast (70545) | $1,889.22 | $5,106 | 5.2× |
| MRA neck w contrast (70548) | $1,676.47 | $4,531 | 4.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,810.41 | $4,893 | 5.0× |
| MRA neck w/o contrast (70547) | $1,576.20 | $4,260 | 6.4× |
| MRI abdomen w contrast (74182) | $1,738.63 | $4,699 | 4.8× |
| MRI abdomen w/o contrast (74181) | $1,768.97 | $4,781 | 7.1× |
| MRI any jt lower extrem w/contrast material (73722) | $2,455.32 | $6,636 | 3.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,990.71 | $8,083 | 8.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,732.34 | $4,682 | 2.1× |
| MRI bone marrow blood supply (77084) | $1,484.81 | $4,013 | 6.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,919.56 | $5,188 | 7.7× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,282.42 | $3,466 | 5.2× |
| MRI cervical spine w contrast (72142) | $2,625.89 | $7,097 | 7.2× |
| MRI cervical spine w/o cont (72141) | $2,474.93 | $6,689 | 10.0× |
| MRI chest w/o contrast (71550) | $1,877.01 | $5,073 | 7.6× |
| MRI chest with contrast (71551) | $1,794.87 | $4,851 | 2.2× |
| MRI chest wo w contrast (71552) | $2,282.53 | $6,169 | 6.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,496.65 | $4,045 | 4.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,852.59 | $5,007 | 5.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,562.14 | $4,222 | 6.3× |
| MRI lumbar spine w contrast (72149) | $2,663.26 | $7,198 | 7.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,070.63 | $8,299 | 8.5× |
| MRI orbit face &/neck w/o contrast (70540) | $2,126.76 | $5,748 | 8.6× |
| MRI orbit face neck w contrast (70542) | $2,238.13 | $6,049 | 6.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,660.30 | $7,190 | 7.3× |
| MRI pelvis w contrast (72196) | $1,963.96 | $5,308 | 5.4× |
| MRI pelvis w/o & w contrast (72197) | $2,163.76 | $5,848 | 6.0× |
| MRI pelvis w/o contrast (72195) | $1,803.38 | $4,874 | 7.3× |
| MRI thoracic spine w/o contrast (72146) | $2,506.38 | $6,774 | 10.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,454.47 | $3,931 | 4.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,412.66 | $3,818 | 5.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,958.41 | $5,293 | 5.4× |
| MRI, abdomen, combo (74183) | $2,459.76 | $6,648 | 6.8× |
| MRI, dorsal spine combo (72157) | $2,955.19 | $7,987 | 8.2× |
| MRI, dorsal spine contrast (72147) | $2,663.26 | $7,198 | 7.4× |
| MRI, joint upper extrem (73221) | $1,648.72 | $4,456 | 6.7× |
| MRI, joint upper extrem combo (73223) | $1,606.54 | $4,342 | 4.4× |
| MRI, lumbar spine combo (72158) | $3,074.70 | $8,310 | 8.5× |
| Myelogram cervical (72240) | $497.28 | $1,344 | 0.6× |
| Myelogram Lumbar (72265) | $522.07 | $1,411 | 0.6× |
| Myelography thoracic (72255) | $497.28 | $1,344 | 0.6× |
| Myelograpy 2/more regions rs&i (72270) | $576.09 | $1,557 | 0.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $447.70 | $1,210 | 1.1× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $447.70 | $1,210 | 0.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $987.53 | $2,669 | 0.7× |
| Myocardial Spect Multiple Studies (78452) | $2,831.61 | $7,653 | 2.1× |
| N-invas est c ffr sw aly CTA (75580) | $1,629.85 | $4,405 | 1.8× |
| Neck soft tissue (70360) | $183.89 | $497 | 2.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $185 | $500 | 0.4× |
| Nm myocard infarct spect (78469) | $1,313.87 | $3,551 | 2.3× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,492.65 | $14,845 | 3.8× |
| Nuclear Rx Oral Admin (79005) | $1,253.93 | $3,389 | 5.2× |
| Ophthalmic us dx quantitative a-scan only (76511) | $119.88 | $324 | 1.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,006.03 | $2,719 | 1.8× |
| Parathyroid Planar Imaging (78070) | $723.35 | $1,955 | 1.7× |
| Pelvis 1 or 2 views (72170) | $182.78 | $494 | 1.7× |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$3,721.83–$4,586.89 | $10,059–$12,397 | varies |
| PET image w/CT, full body (78816) | $3,721.83 | $10,059 | 2.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$3,228.99–$3,721.83 | $8,727–$10,059 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $832.13 | $2,249 | 2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $318.94 | $862 | 2.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $320.05 | $865 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) | $239.76 | $648 | 2.7× |
| Radex Calcaneus Minimum 2 Views (73650) | $163.54 | $442 | 1.8× |
| Radex elbow complete minimum 3 views (73080) | $234.95 | $635 | 2.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $325.60 | $880 | 3.0× |
| Radex fingr minimum 2 views (73140) | $160.95 | $435 | 1.8× |
| Radex foot complete minimum 3 views (73630) | $268.25 | $725 | 3.0× |
| Radex Hand Minimum 3 Views (73130) | $270.10 | $730 | 3.0× |
| Radex lower extremity infant minimum 2 views (73592) | $158.36 | $428 | 1.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $290.08 | $784 | 2.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $243.46 | $658 | 2.7× |
| Radex Ribs Unilateral 2 Views (71100) | $225.70 | $610 | 2.5× |
| Radex shoulder complete minimum 2 views (73030) | $166.13 | $449 | 1.8× |
| Radex Sinuses Paransl < 3 Views (70210) | $178.34 | $482 | 2.0× |
| Radex Spine 1 View Specify Level (72020) | $171.31 | $463 | 1.9× |
| Radex Sternum Minimum 2 Views (71120) | $214.23 | $579 | 2.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $258.63 | $699 | 2.9× |
| Radex Toe Minimum 2 Views (73660) | $190.92 | $516 | 2.1× |
| Radex upper extremity infant minimum 2 views (73092) | $158.36 | $428 | 1.5× |
| Radex Wrist Complete Minimum 3 Views (73110) | $239.76 | $648 | 2.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $478.78 | $1,294 | 4.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $16,425.41 | $44,393 | 2.1× |
| Radiation treatment delivery level 1 (77402) | $524.29 | $1,417 | 4.9× |
| Radiation treatment delivery level 2 (77407) | $629 | $1,700 | 1.6× |
| Radiation treatment delivery level 3 (77412) | $770.71 | $2,083 | 1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $297.48 | $804 | 2.7× |
| Radiologic exam colon double contrast study (74280) | $586.82 | $1,586 | 3.2× |
| Radiologic exam colon single contrast study (74270) | $362.60 | $980 | 2.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $522.81 | $1,413 | 2.9× |
| Radiologic exam knee complete 4/more views (73564) | $266.40 | $720 | 2.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $189.44 | $512 | 1.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $365.56 | $988 | 2.0× |
| Radiologic exam swallow function contrast study (74230) | $320.42 | $866 | 1.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $525.03 | $1,419 | 2.9× |
| Radiologic examination femur 1 view (73551) | $97.31 | $263 | 1.1× |
| Radiologic examination femur minimum 2 views (73552) | $253.08 | $684 | 2.8× |
| Radiologic examination knee 1/2 views (73560) | $212.38 | $574 | 2.4× |
| Radiologic Examination Osseous Survey Limited (77074) | $558.70 | $1,510 | 5.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $224.59 | $607 | 2.5× |
| Renal Cyst Study (74470) | $475.45 | $1,285 | 0.8× |
| Ribs bilateral 3 views (71110) | $313.02 | $846 | 2.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $564.25 | $1,525 | 1.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $876.53 | $2,369 | 2.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,220.26 | $3,298 | 2.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,199.54 | $3,242 | 2.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,077.44 | $2,912 | 1.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,820.62 | $10,326 | 2.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,569.02 | $9,646 | 2.7× |
| Rp Therapy Intravenous Administration (79101) | $1,770.08 | $4,784 | 7.3× |
| Scapula (73010) | $201.65 | $545 | 1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $28.86 | $78 | 1.2× |
| Sella turcica (70240) | $181.67 | $491 | 2.0× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$120.25–$158.36 | $325–$428 | varies |
| Shoulder Arthrography (73040) | $392.94 | $1,062 | 1.1× |
| Sialogram (70390) | $318.20 | $860 | 1.3× |
| Skull less than 4 views (70250) | $236.43 | $639 | 2.2× |
| Special dosimetry (77331) | $642.32 | $1,736 | 4.6× |
| Special Physics Consult (77370) | $487.29 | $1,317 | 3.5× |
| Special teletherapy port plan (77321) | $1,233.21 | $3,333 | 3.2× |
| Special treatment procedure (77470) | $1,802.64 | $4,872 | 3.1× |
| Stereotactic Body Radiation Delivery (77373) | $4,625.74 | $12,502 | 2.5× |
| Sternoclavicular joints (71130) | $189.07 | $511 | 2.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,869.72 | $7,756 | 7.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,418.21 | $3,833 | 3.6× |
| Ther rad simulaj-aided field setting simple (77280) | $1,017.50 | $2,750 | 7.3× |
| Thoracic spine 2 views (72070) | $314.13 | $849 | 2.9× |
| Thoracic spine 3 views (72072) | $345.95 | $935 | 3.2× |
| Thoracolumbar 2 views (72080) | $314.13 | $849 | 3.5× |
| Thyroid Met Imaging Body (78018) | $1,175.12 | $3,176 | 2.1× |
| Thyroid Uptake Measurement (78012) | $377.40 | $1,020 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $919.08 | $2,484 | 2.2× |
| Tx Devices Design & Construction Complex (77334) | $863.58 | $2,334 | 2.2× |
| Tx devices design & construction intermediate (77333) | $617.16 | $1,668 | 4.4× |
| Tx devices design & construction simple (77332) | $404.78 | $1,094 | 2.9× |
| Ultrasound Breast Limited (76642) range across 5 matching MRF lines |
$138.75–$277.50 | $375–$750 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$147.63–$319.31 | $399–$863 | varies |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$185.74–$365.56 | $502–$988 | varies |
| Umbilical-artery Doppler (OB) (76820) | $129.50 | $350 | 1.2× |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$61.05–$71.41 | $165–$193 | varies |
| Unlisted magnetic resonance procedure (76498) range across 3 matching MRF lines |
$1,841.12–$2,638.47 | $4,976–$7,131 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $332.63 | $899 | 0.8× |
| Upper gi w/o kub (74240) | $287.86 | $778 | 1.6× |
| Urethrocystogram voiding (74455) | $257.52 | $696 | 1.0× |
| Urethrocystography retrograde (74450) | $257.52 | $696 | 1.0× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$155.40–$278.24 | $420–$752 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$119.88–$325.97 | $324–$881 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$77.70–$200.17 | $210–$541 | varies |
| Us head (76506) | $216.45 | $585 | 2.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$119.88–$321.53 | $324–$869 | varies |
| Us ob detailed single fetus (76811) | $398.86 | $1,078 | 1.6× |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$189.44–$284.90 | $512–$770 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$156.14–$405.52 | $422–$1,096 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$319.31–$531.69 | $863–$1,437 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$133.20–$448.07 | $360–$1,211 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $243.46 | $658 | 2.2× |
| Us retroperitoneal complete (76770) | $344.10 | $930 | 3.2× |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$132.46–$418.84 | $358–$1,132 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$319.31–$400.34 | $863–$1,082 | varies |
| Us spinal canal and contents (76800) | $344.10 | $930 | 3.2× |
| Us thyroid (76536) range across 2 matching MRF lines |
$119.88–$374.81 | $324–$1,013 | varies |
| Us transrectal (76872) range across 4 matching MRF lines |
$212.38–$2,518.96 | $574–$6,808 | varies |
| Vascular Flow Imaging (78445) | $358.53 | $969 | 0.9× |
| Venography caval inferior serialography rs&i (75825) | $2,259.59 | $6,107 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $2,551.15 | $6,895 | 1.6× |
| Wrist 2 views (73100) | $159.84 | $432 | 1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $229.03 | $619 | 2.5× |
| X-ray antegrade pyelogram tube (74425) | $263.44 | $712 | 0.7× |
| X-Ray Aorta Leg Arteries (75630) | $2,259.59 | $6,107 | 0.7× |
| X-Ray Bend Only L-S Spine (72120) | $411.07 | $1,111 | 3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $181.30 | $490 | 2.0× |
| X-Ray Exam Breast Specimen (76098) | $116.92 | $316 | 0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $505.79 | $1,367 | 5.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $234.95 | $635 | 2.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $229.40 | $620 | 2.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $97.31 | $263 | 1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $202.02 | $546 | 2.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $252.34 | $682 | 2.3× |
| X-Ray Exam L-S Spine Bending (72114) | $452.14 | $1,222 | 4.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $250.12 | $676 | 2.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $455.84 | $1,232 | 4.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $271.58 | $734 | 2.5× |
| X-ray eye for foreign body (70030) | $159.84 | $432 | 1.8× |
| X-ray humerus (73060) | $229.03 | $619 | 2.5× |
| X-ray IV pyelogram (ivp) (74400) | $519.11 | $1,403 | 2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $181.67 | $491 | 2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $176.49 | $477 | 2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $310.06 | $838 | 2.9× |
| X-ray nose-rectum child f.b. (76010) | $264.18 | $714 | 2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $329.67 | $891 | 3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $205.35 | $555 | 1.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $246.79 | $667 | 2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $167.24 | $452 | 1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $317.09 | $857 | 3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $342.25 | $925 | 3.2× |
| X-Ray Tmj Unilat (70328) | $181.67 | $491 | 2.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $293.78 | $794 | 0.8× |
| X-Rays Bone Length Studies (77073) | $162.43 | $439 | 1.5× |
| X-Rays Bone Survey Complete (77075) | $558.70 | $1,510 | 5.1× |
| Xr c-spine 4 or 5 views (72050) | $408.11 | $1,103 | 3.8× |
| Xr facial bones less than 3 views (70140) | $181.67 | $491 | 2.0× |
| XR Mastoids < 3 Views Bilateral (70120) | $181.67 | $491 | 1.7× |
| Xr orbits complete 4 views (70200) | $256.41 | $693 | 2.4× |
| Xr Tomogram Single Plane (76100) | $431.05 | $1,165 | 4.0× |
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.