Imaging prices at Methodist Jennie Edmundson
Council Bluffs, IA · every code in this section with a posted price and a Medicare benchmark.
395 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) | $1,753.20 | $5,844 | 1.2× |
| Abdomen 1 View (74018) | $92.70 | $309 | 1.0× |
| Abdomen 2 views (74019) | $134.70 | $449 | 1.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $613.80 | $2,046 | 1.5× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $280.50 | $935 | 0.2× |
| Angio internal mammary (75756) | $1,210.80 | $4,036 | 0.4× |
| Angio pulmonary bilat (75743) | $939 | $3,130 | 0.3× |
| Angiography extremity bilateral rs&i (75716) | $939 | $3,130 | 0.3× |
| Angiography extremity unilateral rs&i (75710) | $1,249.50 | $4,165 | 0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $939 | $3,130 | 0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $945.90 | $3,153 | 0.3× |
| Ankle 2 views (73600) | $75 | $250 | 0.8× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,722.60 | $5,742 | 0.3× |
| Aortography thoracic w/o serialography rs&i (75600) | $939 | $3,130 | 0.3× |
| Artery X-Rays Abdomen (75726) range across 3 matching MRF lines |
$1,857.60–$2,019.30 | $6,192–$6,731 | varies |
| Artery X-Rays Adrenal Gland (75731) | $1,813.50 | $6,045 | 0.6× |
| Artery X-Rays Pelvis (75736) range across 4 matching MRF lines |
$2,655.60–$5,470.50 | $8,852–$18,235 | varies |
| Artery X-Rays Spine (75705) | $4,242 | $14,140 | 0.7× |
| Arthrogram ankle (73615) | $166.50 | $555 | 0.5× |
| Arthrogram hip (73525) | $237.60 | $792 | 0.7× |
| Arthrogram Wrist (73115) | $198.90 | $663 | 0.6× |
| Basic radiation dosimetry calculation (77300) | $191.10 | $637 | 1.4× |
| Bone age studies (77072) | $96.90 | $323 | 0.9× |
| Bone Imaging 3 Phase (78315) | $612.90 | $2,043 | 1.5× |
| Bone Imaging Limited Area (78300) | $346.50 | $1,155 | 0.8× |
| Bone Imaging Multiple Areas (78305) | $383.70 | $1,279 | 0.9× |
| Bone Imaging Whole Body (78306) range across 3 matching MRF lines |
$575.10–$880.50 | $1,917–$2,935 | varies |
| Bone survey infant (77076) | $204.60 | $682 | 1.9× |
| Brachytx Isodose Plan Simple (77316) | $191.10 | $637 | 0.5× |
| Brain Image W/Flow < 4 Views (78601) | $282 | $940 | 0.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $553.50 | $1,845 | 1.0× |
| Brain Imaging Minimum 4 Static Views (78605) | $560.10 | $1,867 | 1.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $606.30 | $2,021 | 1.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $870.60 | $2,902 | 2.4× |
| Cardiac Shunt Detection (78428) | $326.10 | $1,087 | 0.8× |
| Cat Scan Follow-Up Study (76380) | $367.80 | $1,226 | 4.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $578.70 | $1,929 | 1.0× |
| Cerebrospinal Fluid Scan (78630) | $1,228.20 | $4,094 | 2.2× |
| Chest 1 view (71045) range across 7 matching MRF lines |
$76.50–$1,710.60 | $255–$5,702 | varies |
| Chest 2 views (71046) range across 7 matching MRF lines |
$15.30–$124.80 | $51–$416 | varies |
| Chest 3 views (71047) | $115.20 | $384 | 1.3× |
| Chest 4 or more views (71048) | $153.30 | $511 | 1.4× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $102.90 | $343 | 1.0× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$82.20–$164.40 | $274–$548 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $542.70 | $1,809 | 5.1× |
| Continuing medical physics consltj pr wk (77336) | $191.10 | $637 | 1.4× |
| Contrast Exam Abdominl Aorta (75625) range across 4 matching MRF lines |
$1,338–$2,019.30 | $4,460–$6,731 | varies |
| Contrast X-Ray Bladder (74430) | $159.90 | $533 | 0.4× |
| Contrast X-Ray Of Elbow (73085) | $155.10 | $517 | 0.4× |
| Contrast X-Ray Of Knee Joint (73580) | $215.10 | $717 | 0.6× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$1,641–$1,675.20 | $5,470–$5,584 | varies |
| CT abdomen and pelvis without contrast (74176) | $1,145.40 | $3,818 | 4.7× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$760.20–$794.70 | $2,534–$2,649 | varies |
| CT abdomen w wo contrast (74170) | $1,086.60 | $3,622 | 6.1× |
| CT abdomen w/o contrast (74150) | $652.80 | $2,176 | 6.1× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$1,684.80–$1,735.50 | $5,616–$5,785 | varies |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$957–$991.50 | $3,190–$3,305 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$964.80–$999.60 | $3,216–$3,332 | varies |
| CT angio hrt w/3d image (75574) | $826.50 | $2,755 | 2.3× |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$814.80–$964.80 | $2,716–$3,216 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $605.40 | $2,018 | 3.4× |
| CT cervical spine w/ contrast (72126) | $687.30 | $2,291 | 1.9× |
| CT cervical spine w/o contrast (72125) | $640.20 | $2,134 | 6.0× |
| CT cervical spine w/wo cont (72127) | $605.40 | $2,018 | 3.4× |
| CT chest w contrast (71260) | $884.10 | $2,947 | 4.9× |
| CT chest w/wo contrast (71270) | $892.20 | $2,974 | 5.0× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$730.20–$730.50 | $2,434–$2,435 | varies |
| CT head/brain without and with contrast (70470) | $806.10 | $2,687 | 4.5× |
| CT heart contrast eval cardiac structure&morph (75572) range across 5 matching MRF lines |
$802.20–$914.10 | $2,674–$3,047 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $84.90 | $283 | 1.0× |
| CT iac w contrast (70481) | $834.90 | $2,783 | 4.7× |
| CT l-spine w&w/o contrast (72133) | $605.40 | $2,018 | 3.4× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$608.10–$1,215 | $2,027–$4,050 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$576.60–$1,625.10 | $1,922–$5,417 | varies |
| CT lumbar spine w contrast (72132) | $697.20 | $2,324 | 2.0× |
| CT lumbar spine w/o contrast (72131) | $640.20 | $2,134 | 6.0× |
| CT maxillofacial w contrast (70487) | $780 | $2,600 | 4.3× |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$333.30–$537.60 | $1,111–$1,792 | varies |
| CT neck tissue combo (70492) | $735.90 | $2,453 | 4.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $912.30 | $3,041 | 5.1× |
| CT orbits w/o contrast (70480) | $676.50 | $2,255 | 6.3× |
| CT pelvis w&w/o contrast (72194) | $821.40 | $2,738 | 4.6× |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$354–$632.10 | $1,180–$2,107 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$891.90–$1,748.40 | $2,973–$5,828 | varies |
| CT scans face/jaw combo (70488) | $715.50 | $2,385 | 4.0× |
| CT soft tissue neck w contrast (70491) | $884.10 | $2,947 | 4.9× |
| CT soft tissue neck w/o contrast (70490) | $695.10 | $2,317 | 6.5× |
| CT thoracic spine w contrast (72129) | $605.40 | $2,018 | 3.4× |
| CT thoracic spine w/o contrast (72128) | $640.20 | $2,134 | 6.0× |
| CT thoracic spine w/wo cont (72130) | $605.40 | $2,018 | 3.4× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$542.70–$659.70 | $1,809–$2,199 | varies |
| CT unlisted procedure (76497) | $620.10 | $2,067 | 7.0× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$570.60–$1,140.60 | $1,902–$3,802 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $747.60 | $2,492 | 4.2× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$701.10–$830.40 | $2,337–$2,768 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$916.50–$951 | $3,055–$3,170 | varies |
| Cta Abdomen (74175) | $840 | $2,800 | 4.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $919.50 | $3,065 | 2.6× |
| CTA pelvis (72191) range across 3 matching MRF lines |
$605.40–$942.60 | $2,018–$3,142 | varies |
| Dilation ureters/urethra rs&i (74485) | $1,686.30 | $5,621 | 0.8× |
| Discography Cerv/Thor Spine (72285) | $781.20 | $2,604 | 0.4× |
| Diskography lumbar (72295) | $1,107 | $3,690 | 0.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $90.60 | $302 | 0.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $105 | $350 | 1.0× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$75.60–$90.90 | $252–$303 | varies |
| Dxa Bone Density Axial (77080) | $180.90 | $603 | 1.7× |
| Echo exam of fetal heart (76825) | $417 | $1,390 | 0.7× |
| Echo exam uterus (76831) | $221.40 | $738 | 0.9× |
| Echo Guide For Artery Repair (76936) | $40.50 | $135 | 0.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $417 | $1,390 | 1.7× |
| Echograp Trans R Pros Study (76873) | $256.20 | $854 | 2.4× |
| Esophagram (74220) | $192.90 | $643 | 1.1× |
| Fetal Biophys Profile W/Nst (76818) range across 4 matching MRF lines |
$93.60–$121.20 | $312–$404 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$81–$93.60 | $270–$312 | varies |
| Fluoroscopy up to 1 hr (76000) range across 7 matching MRF lines |
$198.60–$898.20 | $662–$2,994 | varies |
| Follow-Up Angiography (75898) range across 3 matching MRF lines |
$1,182–$2,363.70 | $3,940–$7,879 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$75–$149.10 | $250–$497 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$108.30–$215.70 | $361–$719 | varies |
| Gastric emptying imaging study (78264) | $532.20 | $1,774 | 1.3× |
| Gastroesophageal Reflux Exam (78262) | $331.20 | $1,104 | 0.8× |
| Gated Heart Planar Single (78472) | $544.80 | $1,816 | 1.3× |
| Gated Heart, Multiple (78473) | $574.80 | $1,916 | 1.4× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$92.10–$184.50 | $307–$615 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,138.20 | $3,794 | 1.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,138.20 | $3,794 | 1.6× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,138.20 | $3,794 | 1.6× |
| Heart first pass single,planar (78481) | $288.90 | $963 | 0.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $991.80 | $3,306 | 0.3× |
| Hepatobil Syst Image W/Drug (78227) | $289.80 | $966 | 0.5× |
| Hepatobiliary System Imaging (78226) | $683.10 | $2,277 | 1.7× |
| Ht Musc Image Planar Mult (78454) | $785.70 | $2,619 | 0.6× |
| Ht Muscle Image Spect Sing (78451) | $943.50 | $3,145 | 0.7× |
| Hysterosalpingogram (74740) range across 3 matching MRF lines |
$203.10–$332.70 | $677–$1,109 | varies |
| Image fusion (77399) | $207.90 | $693 | 1.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $129.30 | $431 | 1.5× |
| Interstitial radiation source applic complex (77778) range across 2 matching MRF lines |
$905.40–$1,608 | $3,018–$5,360 | varies |
| Intracavitary Radiation Source Applic Complex (77763) | $668.10 | $2,227 | 0.9× |
| Intracavitary Radiation Source Applic Intermed (77762) | $668.10 | $2,227 | 1.2× |
| Joint Survey Single View (77077) | $54.60 | $182 | 0.5× |
| K Flow/Funct Image W/Drug (78708) | $846.60 | $2,822 | 1.5× |
| K Flow/Funct Image W/O Drug (78707) | $518.70 | $1,729 | 0.9× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$132–$263.40 | $440–$878 | varies |
| Leveen/Shunt Patency Exam (78291) | $499.50 | $1,665 | 1.2× |
| Liver & Spleen Imaging Static Only (78215) | $403.80 | $1,346 | 1.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $353.10 | $1,177 | 0.9× |
| Liver imaging static only (78201) | $743.40 | $2,478 | 1.3× |
| Liver imaging w/vascular flow (78202) | $743.40 | $2,478 | 1.3× |
| Lung perfusion differential (78597) | $760.20 | $2,534 | 1.9× |
| Lymph System Imaging (78195) | $415.80 | $1,386 | 0.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,210.20 | $4,034 | 0.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $954.60 | $3,182 | 0.3× |
| Magnetic Image Jaw Joint (70336) | $569.10 | $1,897 | 2.3× |
| Mammary ductogram or galactogram multiple (77054) | $116.70 | $389 | 0.5× |
| Mammary ductogram or galactogram single (77053) | $116.70 | $389 | 0.5× |
| Meckels Divert Exam (78290) | $561.90 | $1,873 | 1.4× |
| Mlc imrt design & construction per imrt plan (77338) | $2,442.30 | $8,141 | 6.4× |
| Mr safety determination physician/other qhp (76016) | $225.30 | $751 | 2.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $63 | $210 | 2.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $234.90 | $783 | 2.4× |
| Mr safety implt pos&/immoblj (76019) | $152.10 | $507 | 2.5× |
| Mr safety med physics xm customization plng&mntr (76017) | $618.90 | $2,063 | 2.5× |
| Mra Head W/O & W/Contrast Material (70546) | $1,135.80 | $3,786 | 3.2× |
| MRA head w/o contrast (70544) | $1,116 | $3,720 | 4.6× |
| MRA head with contrast (70545) | $1,115.40 | $3,718 | 3.1× |
| MRA neck w contrast (70548) | $822 | $2,740 | 2.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $887.10 | $2,957 | 2.5× |
| MRA neck w/o contrast (70547) | $549 | $1,830 | 2.2× |
| MRI abdomen w contrast (74182) | $1,251.60 | $4,172 | 3.5× |
| MRI abdomen w/o contrast (74181) | $1,030.80 | $3,436 | 4.2× |
| MRI any jt lower extrem w/contrast material (73722) | $1,098.60 | $3,662 | 1.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,166.40 | $3,888 | 3.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,099.50 | $3,665 | 1.4× |
| MRI bone marrow blood supply (77084) | $733.80 | $2,446 | 3.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $787.20 | $2,624 | 3.2× |
| MRI Breast Without Contrast Material Unilateral (77046) range across 3 matching MRF lines |
$787.20–$982.80 | $2,624–$3,276 | varies |
| MRI cardiac w/o contrast (75557) | $554.70 | $1,849 | 2.3× |
| MRI cervical spine w contrast (72142) | $926.10 | $3,087 | 2.6× |
| MRI cervical spine w/o cont (72141) | $900.30 | $3,001 | 3.7× |
| MRI chest w/o contrast (71550) | $973.50 | $3,245 | 4.0× |
| MRI chest with contrast (71551) | $578.40 | $1,928 | 0.7× |
| MRI chest wo w contrast (71552) | $1,308.60 | $4,362 | 3.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $572.70 | $1,909 | 1.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,158.90 | $3,863 | 3.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $775.50 | $2,585 | 3.2× |
| MRI lumbar spine w contrast (72149) | $927.60 | $3,092 | 2.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,241.40 | $4,138 | 3.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,024.50 | $3,415 | 4.2× |
| MRI orbit face neck w contrast (70542) | $864 | $2,880 | 2.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,218.30 | $4,061 | 3.4× |
| MRI pelvis w contrast (72196) | $1,017 | $3,390 | 2.8× |
| MRI pelvis w/o & w contrast (72197) range across 4 matching MRF lines |
$997.80–$1,503.60 | $3,326–$5,012 | varies |
| MRI pelvis w/o contrast (72195) | $929.10 | $3,097 | 3.8× |
| MRI spectroscopy (76390) | $427.80 | $1,426 | 4.8× |
| MRI thoracic spine w/o contrast (72146) | $1,033.50 | $3,445 | 4.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$323.10–$838.20 | $1,077–$2,794 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $612 | $2,040 | 2.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $822.30 | $2,741 | 2.3× |
| MRI, abdomen, combo (74183) | $1,436.10 | $4,787 | 4.0× |
| MRI, dorsal spine combo (72157) | $1,147.20 | $3,824 | 3.2× |
| MRI, dorsal spine contrast (72147) | $778.50 | $2,595 | 2.2× |
| MRI, joint upper extrem (73221) | $900.30 | $3,001 | 3.7× |
| MRI, joint upper extrem combo (73223) | $1,159.20 | $3,864 | 3.2× |
| MRI, lumbar spine combo (72158) | $1,455.30 | $4,851 | 4.1× |
| Myelogram cervical (72240) | $599.70 | $1,999 | 0.7× |
| Myelogram Lumbar (72265) | $599.70 | $1,999 | 0.7× |
| Myelography thoracic (72255) | $599.70 | $1,999 | 0.7× |
| Myelograpy 2/more regions rs&i (72270) | $601.80 | $2,006 | 0.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $466.20 | $1,554 | 1.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $3,361.50 | $11,205 | 2.5× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $414 | $1,380 | 0.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $785.70 | $2,619 | 0.6× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$1,139.10–$1,592.10 | $3,797–$5,307 | varies |
| N-invas est c ffr sw aly CTA (75580) range across 2 matching MRF lines |
$898.80–$1,296.30 | $2,996–$4,321 | varies |
| Neck soft tissue (70360) | $100.50 | $335 | 1.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $326.10 | $1,087 | 0.8× |
| Nm csf leak detection (78650) | $743.40 | $2,478 | 0.6× |
| Nm myocard infarct spect (78469) | $769.80 | $2,566 | 1.4× |
| Nonvascular Shunt X-Ray (75809) | $108.60 | $362 | 1.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,948.50 | $6,495 | 1.4× |
| Nuclear Rx Oral Admin (79005) | $354.90 | $1,183 | 1.5× |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$132.90–$266.10 | $443–$887 | varies |
| Ophthalmic us dx quantitative a-scan only (76511) | $96.30 | $321 | 0.9× |
| Panoramic X-ray of jaws (70355) | $75 | $250 | 0.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $754.80 | $2,516 | 1.4× |
| Parathyroid Planar Imaging (78070) | $407.10 | $1,357 | 1.0× |
| Pelvis 1 or 2 views (72170) | $92.70 | $309 | 0.9× |
| Peritoneogram Rs&I (74190) | $314.40 | $1,048 | 0.6× |
| Pet Image W/Ct Lmtd (78814) range across 3 matching MRF lines |
$1,421.40–$3,648 | $4,738–$12,160 | varies |
| PET image w/CT, full body (78816) | $3,003.90 | $10,013 | 2.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,413.50 | $8,045 | 1.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,992.30 | $6,641 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $463.50 | $1,545 | 1.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $165.90 | $553 | 1.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $506.70 | $1,689 | 0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$108.30–$215.70 | $361–$719 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$77.40–$154.20 | $258–$514 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$108.30–$215.70 | $361–$719 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $140.70 | $469 | 1.3× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$106.20–$113.70 | $354–$379 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$94.20–$188.10 | $314–$627 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$108.30–$215.70 | $361–$719 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$44.70–$88.80 | $149–$296 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $129.60 | $432 | 1.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $111.90 | $373 | 1.3× |
| Radex Ribs Unilateral 2 Views (71100) | $102 | $340 | 1.1× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$108.30–$215.70 | $361–$719 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $74.10 | $247 | 0.8× |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$75–$77.10 | $250–$257 | varies |
| Radex Sternum Minimum 2 Views (71120) | $114.30 | $381 | 1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $153.30 | $511 | 1.7× |
| Radex Toe Minimum 2 Views (73660) | $65.70 | $219 | 0.7× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$46.50–$92.40 | $155–$308 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$108.30–$215.70 | $361–$719 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $221.40 | $738 | 2.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $13,189.80 | $43,966 | 1.7× |
| Radiation treatment delivery level 1 (77402) | $233.10 | $777 | 2.2× |
| Radiation treatment delivery level 2 (77407) | $300 | $1,000 | 0.8× |
| Radiation treatment delivery level 3 (77412) | $378.60 | $1,262 | 0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $127.20 | $424 | 1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $130.80 | $436 | 1.2× |
| Radiologic exam colon double contrast study (74280) | $278.10 | $927 | 1.5× |
| Radiologic exam colon single contrast study (74270) | $226.50 | $755 | 1.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $293.40 | $978 | 1.6× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$111–$213.90 | $370–$713 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $121.80 | $406 | 1.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $179.70 | $599 | 1.0× |
| Radiologic exam swallow function contrast study (74230) | $160.80 | $536 | 0.9× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$243.30–$324.30 | $811–$1,081 | varies |
| Radiologic examination femur 1 view (73551) | $108.30 | $361 | 1.2× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$108.30–$215.70 | $361–$719 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$108.30–$215.70 | $361–$719 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $243.60 | $812 | 2.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$108.30–$215.70 | $361–$719 | varies |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $354.90 | $1,183 | 1.5× |
| Renal Cyst Study (74470) | $374.40 | $1,248 | 0.7× |
| Ribs bilateral 3 views (71110) | $120.30 | $401 | 1.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $829.80 | $2,766 | 2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 3 matching MRF lines |
$410.70–$829.80 | $1,369–$2,766 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 4 matching MRF lines |
$410.70–$2,866.20 | $1,369–$9,554 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 6 matching MRF lines |
$409.20–$2,866.20 | $1,364–$9,554 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 7 matching MRF lines |
$842.70–$2,866.20 | $2,809–$9,554 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,866.20 | $9,554 | 2.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,251.40 | $10,838 | 2.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 8 matching MRF lines |
$1,421.40–$2,866.20 | $4,738–$9,554 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $348.30 | $1,161 | 1.5× |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$218.10–$238.20 | $727–$794 | varies |
| Rp Therapy Unlisted Procedure (79999) | $212.10 | $707 | 0.9× |
| Salivary Gland Imaging (78230) | $342 | $1,140 | 0.8× |
| Salivary Gland Imaging Serial Images (78231) | $326.10 | $1,087 | 0.8× |
| Scapula (73010) | $97.50 | $325 | 0.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $83.40 | $278 | 3.6× |
| Sella turcica (70240) | $95.10 | $317 | 1.1× |
| Shoulder 1 view (73020) | $92.40 | $308 | 1.0× |
| Shoulder Arthrography (73040) | $335.40 | $1,118 | 0.9× |
| Sialogram (70390) | $177.60 | $592 | 0.7× |
| Skull less than 4 views (70250) | $81.30 | $271 | 0.8× |
| Special dosimetry (77331) | $191.10 | $637 | 1.4× |
| Special Physics Consult (77370) | $191.10 | $637 | 1.4× |
| Special teletherapy port plan (77321) | $531.30 | $1,771 | 1.4× |
| Special treatment procedure (77470) | $857.10 | $2,857 | 1.5× |
| Stereotactic Body Radiation Delivery (77373) | $3,714.60 | $12,382 | 2.0× |
| Sternoclavicular joints (71130) | $87 | $290 | 1.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $191.10 | $637 | 0.5× |
| Temporomandble Jt Arthrography Rs&I (70332) | $121.80 | $406 | 0.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $631.20 | $2,104 | 1.6× |
| Ther rad simulaj-aided field setting simple (77280) | $420 | $1,400 | 3.1× |
| Thoracic spine 2 views (72070) | $112.20 | $374 | 1.0× |
| Thoracic spine 3 views (72072) | $138 | $460 | 1.3× |
| Thoracolumbar 2 views (72080) | $101.10 | $337 | 1.1× |
| Thyroid Imaging With Vascular Flow (78013) | $302.40 | $1,008 | 0.7× |
| Thyroid Met Imaging Body (78018) | $702.60 | $2,342 | 1.3× |
| Thyroid Uptake Measurement (78012) | $267.30 | $891 | 0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $545.70 | $1,819 | 1.3× |
| Tx Devices Design & Construction Complex (77334) | $364.20 | $1,214 | 1.0× |
| Tx devices design & construction intermediate (77333) | $364.20 | $1,214 | 2.6× |
| Tx devices design & construction simple (77332) | $364.20 | $1,214 | 2.6× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$90.90–$182.10 | $303–$607 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 4 matching MRF lines |
$73.80–$110.70 | $246–$369 | varies |
| Ultrasound, abdomen limited (76705) range across 5 matching MRF lines |
$132.90–$227.40 | $443–$758 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$105–$110.70 | $350–$369 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$45.60–$83.10 | $152–$277 | varies |
| Unlisted fluoroscopic procedure (76496) | $60.90 | $203 | 0.7× |
| Unlisted magnetic resonance procedure (76498) range across 3 matching MRF lines |
$900.30–$1,099.50 | $3,001–$3,665 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $128.10 | $427 | 0.3× |
| Unlisted Procedure Clinical Brachytherapy (77799) | $603.90 | $2,013 | 5.8× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$186.30–$244.80 | $621–$816 | varies |
| Urethrocystogram voiding (74455) | $177 | $590 | 0.7× |
| Urethrocystography retrograde (74450) | $218.10 | $727 | 0.9× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$90.90–$182.10 | $303–$607 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$96.30–$137.70 | $321–$459 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$61.20–$130.20 | $204–$434 | varies |
| Us head (76506) | $167.70 | $559 | 1.6× |
| Us kidney transplant (76776) | $137.40 | $458 | 1.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 6 matching MRF lines |
$96.30–$456.30 | $321–$1,521 | varies |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$78–$299.40 | $260–$998 | varies |
| Us ob limited 1 or more fetuses (76815) | $142.20 | $474 | 1.3× |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$117.30–$256.50 | $391–$855 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$256.20–$256.50 | $854–$855 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$99.90–$236.70 | $333–$789 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$76.50–$173.10 | $255–$577 | varies |
| Us retroperitoneal complete (76770) | $256.50 | $855 | 2.4× |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$99.30–$256.50 | $331–$855 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$256.20–$256.50 | $854–$855 | varies |
| Us spinal canal and contents (76800) | $151.20 | $504 | 1.4× |
| Us thyroid (76536) range across 2 matching MRF lines |
$96.30–$256.50 | $321–$855 | varies |
| Us transrectal (76872) range across 3 matching MRF lines |
$159.30–$256.50 | $531–$855 | varies |
| Vascular Flow Imaging (78445) | $391.20 | $1,304 | 1.0× |
| Vein X-Ray Chest (75827) | $686.40 | $2,288 | 0.4× |
| Vein X-Ray Skull Epidural (75872) | $743.40 | $2,478 | 1.2× |
| Venogram Sinus/Jugular (75860) | $1,742.70 | $5,809 | 0.5× |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$2,242.50–$2,309.70 | $7,475–$7,699 | varies |
| Venography extremity bilateral rs&i (75822) | $729.60 | $2,432 | 0.5× |
| Venography extremity unilateral rs&i (75820) | $1,371.30 | $4,571 | 0.9× |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$1,182–$2,019.30 | $3,940–$6,731 | varies |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$1,195.80–$2,019.30 | $3,986–$6,731 | varies |
| Venous sampling by catheter (75893) range across 2 matching MRF lines |
$1,672.20–$1,722.60 | $5,574–$5,742 | varies |
| Wrist 2 views (73100) | $94.50 | $315 | 1.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $85.80 | $286 | 1.0× |
| X-ray antegrade pyelogram tube (74425) range across 5 matching MRF lines |
$363.60–$748.20 | $1,212–$2,494 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$939–$2,019.30 | $3,130–$6,731 | varies |
| X-Ray Bend Only L-S Spine (72120) | $56.70 | $189 | 0.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $79.50 | $265 | 0.9× |
| X-Ray Exam Breast Specimen (76098) | $381.90 | $1,273 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $79.50 | $265 | 0.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $154.50 | $515 | 1.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $177.60 | $592 | 1.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $79.50 | $265 | 0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $91.50 | $305 | 1.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $176.10 | $587 | 1.6× |
| X-Ray Exam L-S Spine Bending (72114) | $162.90 | $543 | 1.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $96.90 | $323 | 1.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $237.60 | $792 | 2.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $137.70 | $459 | 1.3× |
| X-ray eye for foreign body (70030) | $84.90 | $283 | 1.0× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$108.30–$215.70 | $361–$719 | varies |
| X-ray IV pyelogram (ivp) (74400) | $269.10 | $897 | 1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $86.40 | $288 | 1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $93.60 | $312 | 1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $128.70 | $429 | 1.2× |
| X-ray nose-rectum child f.b. (76010) | $198.30 | $661 | 2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $155.70 | $519 | 1.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $111.30 | $371 | 1.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $101.40 | $338 | 0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $80.10 | $267 | 0.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $119.70 | $399 | 1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $115.20 | $384 | 1.1× |
| X-Ray Tmj Unilat (70328) | $81.60 | $272 | 0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $236.70 | $789 | 0.7× |
| X-Rays Bone Length Studies (77073) | $88.20 | $294 | 0.8× |
| X-Rays Bone Survey Complete (77075) | $248.40 | $828 | 2.3× |
| Xr c-spine 4 or 5 views (72050) | $128.70 | $429 | 1.2× |
| Xr facial bones less than 3 views (70140) | $78.90 | $263 | 0.9× |
| XR Mastoids < 3 Views Bilateral (70120) | $79.50 | $265 | 0.7× |
| Xr orbits complete 4 views (70200) | $133.50 | $445 | 1.2× |
| Xr Tomogram Single Plane (76100) | $186.60 | $622 | 1.7× |
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.