Imaging prices at Missouri Delta Medical Center
Sikeston, MO · every code in this section with a posted price and a Medicare benchmark.
260 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $87.13 | $348.50 | 1.0× |
| Abdomen 2 views (74019) | $87.13 | $348.50 | 0.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $544.31 | $2,177.25 | 1.4× |
| Angiography extremity bilateral rs&i (75716) | $34.88 | $139.50 | 0.0× |
| Angiography extremity unilateral rs&i (75710) | $3,750.63 | $15,002.50 | 1.2× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$139.25–$278.44 | $557–$1,113.75 | varies |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$496.06–$992.25 | $1,984.25–$3,969 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$496.06–$992.25 | $1,984.25–$3,969 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$496.06–$992.25 | $1,984.25–$3,969 | varies |
| Bone age studies (77072) | $139.25 | $557 | 1.3× |
| Bone Imaging 3 Phase (78315) | $552.88 | $2,211.50 | 1.4× |
| Bone Imaging Limited Area (78300) | $486.75 | $1,947 | 1.2× |
| Bone Imaging Whole Body (78306) | $486.75 | $1,947 | 1.2× |
| Bone survey infant (77076) | $449.19 | $1,796.75 | 4.3× |
| Brain Image W/Flow < 4 Views (78601) | $816.19 | $3,264.75 | 2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,155.25 | $8,621 | 1.5× |
| Cat Scan Follow-Up Study (76380) | $197.13 | $788.50 | 2.3× |
| Chest 1 view (71045) | $87.13 | $348.50 | 1.0× |
| Chest 2 views (71046) range across 3 matching MRF lines |
$87.13–$139.25 | $348.50–$557 | varies |
| Chest 3 views (71047) | $98.50 | $394 | 1.1× |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$139.25–$233.75 | $557–$935 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$87.13–$173.88 | $348.50–$695.50 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $189.94 | $759.75 | 1.8× |
| Contrast Exam Abdominl Aorta (75625) | $409.50 | $1,638 | 0.1× |
| Contrast X-Ray Bladder (74430) | $388.69 | $1,554.75 | 1.1× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$496.06–$498.69 | $1,984.25–$1,994.75 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$496.06–$992.25 | $1,984.25–$3,969 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $149 | $596 | 0.8× |
| CT abdomen and pelvis without and with contrast (74178) | $1,220.69 | $4,882.75 | 3.5× |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$1,052.75–$1,094.94 | $4,211–$4,379.75 | varies |
| CT abdomen w contrast (74160) | $506.75 | $2,027 | 2.9× |
| CT abdomen w wo contrast (74170) | $548.31 | $2,193.25 | 3.1× |
| CT abdomen w/o contrast (74150) | $525.75 | $2,103 | 5.0× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$865.13–$899.81 | $3,460.50–$3,599.25 | varies |
| CT Angio Chest (71275) | $613.25 | $2,453 | 3.5× |
| CT Angio Head (70496) | $715.31 | $2,861.25 | 4.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $343.06 | $1,372.25 | 2.0× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$702.38–$730.50 | $2,809.50–$2,922 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $342.88 | $1,371.50 | 2.0× |
| CT cervical spine w/ contrast (72126) | $473.13 | $1,892.50 | 1.4× |
| CT cervical spine w/o contrast (72125) | $689.38 | $2,757.50 | 6.6× |
| CT cervical spine w/wo cont (72127) | $510.94 | $2,043.75 | 2.9× |
| CT chest w contrast (71260) | $556.38 | $2,225.50 | 3.2× |
| CT chest w/wo contrast (71270) | $473.13 | $1,892.50 | 2.7× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$421.81–$642.56 | $1,687.25–$2,570.25 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$569.56–$642.56 | $2,278.25–$2,570.25 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$89.63–$453.88 | $358.50–$1,815.50 | varies |
| CT l-spine w&w/o contrast (72133) | $505.06 | $2,020.25 | 2.9× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$647.88–$689.38 | $2,591.50–$2,757.50 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$473.13–$694.13 | $1,892.50–$2,776.50 | varies |
| CT lumbar spine w contrast (72132) | $473.13 | $1,892.50 | 1.4× |
| CT lumbar spine w/o contrast (72131) | $689.38 | $2,757.50 | 6.6× |
| CT maxillofacial w contrast (70487) | $453.88 | $1,815.50 | 2.6× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$266.75–$548.31 | $1,067–$2,193.25 | varies |
| CT neck tissue combo (70492) | $421.81 | $1,687.25 | 2.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $755.06 | $3,020.25 | 4.3× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$483.56–$483.69 | $1,934.25–$1,934.75 | varies |
| CT pelvis w&w/o contrast (72194) | $517.31 | $2,069.25 | 2.9× |
| CT pelvis w/o contrast (72192) | $527.25 | $2,109 | 5.0× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$505.06–$832.69 | $2,020.25–$3,330.75 | varies |
| CT scans face/jaw combo (70488) | $485.50 | $1,942 | 2.8× |
| CT soft tissue neck w contrast (70491) | $515.31 | $2,061.25 | 2.9× |
| CT soft tissue neck w/o contrast (70490) | $483.56 | $1,934.25 | 4.6× |
| CT thoracic spine w contrast (72129) | $353.13 | $1,412.50 | 2.0× |
| CT thoracic spine w/o contrast (72128) | $689.38 | $2,757.50 | 6.6× |
| CT thoracic spine w/wo cont (72130) | $510.94 | $2,043.75 | 2.9× |
| CT thorax w/o contrast (71250) | $535.94 | $2,143.75 | 5.1× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$670.69–$879 | $2,682.75–$3,516 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$505.06–$971.50 | $2,020.25–$3,886 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$473.13–$925.44 | $1,892.50–$3,701.75 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $910.31 | $3,641.25 | 5.2× |
| Cta Abdomen (74175) range across 3 matching MRF lines |
$125.81–$130.75 | $503.25–$523 | varies |
| Discography Cerv/Thor Spine (72285) | $4,881.88 | $19,527.50 | 2.5× |
| Esophagram (74220) | $164.56 | $658.25 | 0.9× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$216.06–$231 | $864.25–$924 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $231 | $924 | 2.2× |
| Fluoroscopy up to 1 hr (76000) | $233.75 | $935 | 1.0× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$87.13–$278.44 | $348.50–$1,113.75 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$87.13–$170.06 | $348.50–$680.25 | varies |
| Gastric emptying imaging study (78264) | $479 | $1,916 | 1.2× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $308.44 | $1,233.75 | 0.8× |
| Gated Heart Planar Single (78472) | $547.25 | $2,189 | 1.4× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $353.25 | $1,413 | 0.6× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$139.25–$278.44 | $557–$1,113.75 | varies |
| Hepatobil Syst Image W/Drug (78227) | $572.63 | $2,290.50 | 1.1× |
| Hepatobiliary System Imaging (78226) | $546.50 | $2,186 | 1.4× |
| Ht Musc Image Planar Mult (78454) | $1,670.75 | $6,683 | 1.3× |
| Ht Muscle Image Spect Sing (78451) | $1,670.75 | $6,683 | 1.3× |
| Hysterosalpingogram (74740) | $493.75 | $1,975 | 2.1× |
| Infant hip ultrasound, limited static exam (76886) | $112.13 | $448.50 | 1.3× |
| Joint Survey Single View (77077) | $139.25 | $557 | 1.3× |
| K Flow/Funct Image W/Drug (78708) | $616.25 | $2,465 | 1.1× |
| K Flow/Funct Image W/O Drug (78707) | $616.25 | $2,465 | 1.1× |
| Kidney Imaging Morphol (78700) | $616.25 | $2,465 | 1.5× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$139.25–$278.44 | $557–$1,113.75 | varies |
| Liver & Spleen Imaging Static Only (78215) | $546.50 | $2,186 | 1.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $546.50 | $2,186 | 1.4× |
| Liver imaging w/vascular flow (78202) | $546.50 | $2,186 | 1.0× |
| Lung Ventilat&Perfus Imaging (78582) | $707.19 | $2,828.75 | 1.3× |
| Lymph System Imaging (78195) | $541.63 | $2,166.50 | 1.0× |
| Magnetic Image Jaw Joint (70336) | $565.50 | $2,262 | 2.4× |
| Meckels Divert Exam (78290) | $479 | $1,916 | 1.2× |
| Mra Head W/O & W/Contrast Material (70546) | $921.94 | $3,687.75 | 2.6× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$83.06–$749.31 | $332.25–$2,997.25 | varies |
| MRA head with contrast (70545) | $749.31 | $2,997.25 | 2.1× |
| MRA neck w contrast (70548) | $576.31 | $2,305.25 | 1.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $921.94 | $3,687.75 | 2.6× |
| MRA neck w/o contrast (70547) | $576.44 | $2,305.75 | 2.4× |
| MRI abdomen w contrast (74182) | $863 | $3,452 | 2.5× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$707.19–$735.38 | $2,828.75–$2,941.50 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$863–$1,078.50 | $3,452–$4,314 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$863–$1,078.50 | $3,452–$4,314 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$863–$1,078.50 | $3,452–$4,314 | varies |
| MRI cervical spine w contrast (72142) | $806.50 | $3,226 | 2.3× |
| MRI cervical spine w/o cont (72141) | $795.19 | $3,180.75 | 3.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$863–$1,078.69 | $3,452–$4,314.75 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$863–$1,078.50 | $3,452–$4,314 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$735.38–$1,131 | $2,941.50–$4,524 | varies |
| MRI lumbar spine w contrast (72149) | $829.81 | $3,319.25 | 2.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $881 | $3,524 | 2.5× |
| MRI orbit face &/neck w/o contrast (70540) | $543.88 | $2,175.50 | 2.3× |
| MRI orbit face neck w contrast (70542) | $829.81 | $3,319.25 | 2.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $909.06 | $3,636.25 | 2.6× |
| MRI pelvis w contrast (72196) | $863 | $3,452 | 2.5× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$506.31–$916.69 | $2,025.25–$3,666.75 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$403.50–$599.94 | $1,614–$2,399.75 | varies |
| MRI spectroscopy (76390) | $728.69 | $2,914.75 | 8.4× |
| MRI thoracic spine w/o contrast (72146) | $707.06 | $2,828.25 | 3.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$863–$1,078.50 | $3,452–$4,314 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$735.38–$1,131 | $2,941.50–$4,524 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$863–$1,078.50 | $3,452–$4,314 | varies |
| MRI, abdomen, combo (74183) | $863 | $3,452 | 2.5× |
| MRI, dorsal spine combo (72157) | $924.13 | $3,696.50 | 2.6× |
| MRI, dorsal spine contrast (72147) | $577.50 | $2,310 | 1.7× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$827–$1,272.13 | $3,308–$5,088.50 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$863–$1,078.50 | $3,452–$4,314 | varies |
| MRI, lumbar spine combo (72158) | $924.13 | $3,696.50 | 2.6× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $547.25 | $2,189 | 1.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,670.75 | $6,683 | 1.3× |
| Myocardial Spect Multiple Studies (78452) | $1,797.63 | $7,190.50 | 1.4× |
| Neck soft tissue (70360) | $87.13 | $348.50 | 1.0× |
| Nonvascular Shunt X-Ray (75809) | $151.81 | $607.25 | 1.4× |
| Ob us nuchal meas 1 gest (76813) | $153.13 | $612.50 | 1.5× |
| Parathyroid Planar Imaging (78070) | $413.06 | $1,652.25 | 1.0× |
| Pelvis 1 or 2 views (72170) | $139.25 | $557 | 1.3× |
| PET image w/CT, full body (78816) | $2,218.75 | $8,875 | 1.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,155.25 | $8,621 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $462.75 | $1,851 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $139.25 | $557 | 1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $474.75 | $1,899 | 0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$139.25–$278.44 | $557–$1,113.75 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$87.13–$173.88 | $348.50–$695.50 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$87.13–$173.88 | $348.50–$695.50 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $139.25 | $557 | 1.3× |
| Radex fingr minimum 2 views (73140) | $87.13 | $348.50 | 1.0× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$87.13–$173.88 | $348.50–$695.50 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$87.13–$173.88 | $348.50–$695.50 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$139.25–$278.44 | $557–$1,113.75 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $139.25 | $557 | 1.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $87.13 | $348.50 | 1.0× |
| Radex Ribs Unilateral 2 Views (71100) | $87.13 | $348.50 | 1.0× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$139.25–$278.44 | $557–$1,113.75 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $87.13 | $348.50 | 1.0× |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$80.50–$87.13 | $322–$348.50 | varies |
| Radex Sternum Minimum 2 Views (71120) | $87.13 | $348.50 | 1.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $173.88 | $695.50 | 2.0× |
| Radex Toe Minimum 2 Views (73660) range across 11 matching MRF lines |
$76.69–$87.13 | $306.75–$348.50 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$139.25–$278.44 | $557–$1,113.75 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$87.13–$173.88 | $348.50–$695.50 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $133.94 | $535.75 | 1.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $139.25 | $557 | 1.3× |
| Radiologic exam colon double contrast study (74280) | $208.13 | $832.50 | 1.2× |
| Radiologic exam colon single contrast study (74270) | $267.31 | $1,069.25 | 1.5× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$139.25–$278.44 | $557–$1,113.75 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $139.25 | $557 | 1.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$180.81–$240.38 | $723.25–$961.50 | varies |
| Radiologic exam swallow function contrast study (74230) | $186.13 | $744.50 | 1.1× |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$221.25–$267.31 | $885–$1,069.25 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$87.13–$173.88 | $348.50–$695.50 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$87.13–$173.88 | $348.50–$695.50 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$87.13–$173.88 | $348.50–$695.50 | varies |
| Ribs bilateral 3 views (71110) | $235.06 | $940.25 | 2.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $367.38 | $1,469.50 | 0.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $367.38 | $1,469.50 | 0.7× |
| Scapula (73010) | $87.13 | $348.50 | 0.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $60 | $240 | 2.6× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$87.13–$173.88 | $348.50–$695.50 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$496.06–$992.25 | $1,984.25–$3,969 | varies |
| Sialogram (70390) | $493.75 | $1,975 | 2.1× |
| Skull less than 4 views (70250) | $139.25 | $557 | 1.3× |
| Spleen Imaging (78185) | $541.56 | $2,166.25 | 1.4× |
| Sternoclavicular joints (71130) | $88.31 | $353.25 | 1.0× |
| Testicular Imaging W/Flow (78761) | $616.25 | $2,465 | 1.5× |
| Thoracic spine 2 views (72070) | $139.25 | $557 | 1.3× |
| Thoracic spine 3 views (72072) | $139.25 | $557 | 1.3× |
| Thoracolumbar 2 views (72080) | $88.31 | $353.25 | 1.0× |
| Thyroid Imaging With Vascular Flow (78013) | $278.25 | $1,113 | 0.7× |
| Thyroid Met Imaging Body (78018) | $595.19 | $2,380.75 | 1.1× |
| Thyroid Uptake Measurement (78012) | $277.19 | $1,108.75 | 0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $413.06 | $1,652.25 | 1.0× |
| Ultrasound Breast Limited (76642) | $110.50 | $442 | 1.3× |
| Ultrasound Exam Aaa Screen (76706) | $38.88 | $155.50 | 0.4× |
| Ultrasound, abdomen limited (76705) | $224.56 | $898.25 | 2.1× |
| Unlisted us procedure (76999) | $136.13 | $544.50 | 1.6× |
| Upper gi w/o kub (74240) range across 4 matching MRF lines |
$224.56–$301.63 | $898.25–$1,206.50 | varies |
| Ureteral Reflux Study (78740) | $616.25 | $2,465 | 1.5× |
| Urethrocystogram voiding (74455) | $370.06 | $1,480.25 | 1.5× |
| Urethrocystography retrograde (74450) | $439.81 | $1,759.25 | 1.8× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$180.81–$301.63 | $723.25–$1,206.50 | varies |
| Us chest (76604) | $197.50 | $790 | 1.9× |
| Us complete joint (76881) range across 4 matching MRF lines |
$56.38–$112.63 | $225.50–$450.50 | varies |
| Us exam, pelvic, limited (76857) | $134.25 | $537 | 1.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $136.13 | $544.50 | 1.3× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$204.06–$228.63 | $816.25–$914.50 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$217.75–$226.50 | $871–$906 | varies |
| Us pelvic non ob complete (76856) | $243.88 | $975.50 | 2.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $231 | $924 | 2.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $142.88 | $571.50 | 1.4× |
| Us retroperitoneal complete (76770) | $180.63 | $722.50 | 1.7× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$217.75–$277.88 | $871–$1,111.50 | varies |
| Us scrotum and contents (76870) | $236.19 | $944.75 | 2.3× |
| Us spinal canal and contents (76800) | $145.13 | $580.50 | 1.4× |
| Us thyroid (76536) | $217.75 | $871 | 2.1× |
| Venography extremity unilateral rs&i (75820) | $1,212.25 | $4,849 | 0.8× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$87.13–$173.88 | $348.50–$695.50 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $278.44 | $1,113.75 | 3.2× |
| X-ray antegrade pyelogram tube (74425) | $388.69 | $1,554.75 | 1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$87.13–$173.88 | $348.50–$695.50 | varies |
| X-Ray Exam Breast Specimen (76098) | $493.75 | $1,975 | 0.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$139.25–$233.75 | $557–$935 | varies |
| X-Ray Exam Hip Uni 1 View (73501) | $87.13 | $348.50 | 1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $87.13 | $348.50 | 1.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $148 | $592 | 1.4× |
| X-Ray Exam Hips Bi 2 Views (73521) | $173.88 | $695.50 | 1.7× |
| X-Ray Exam L-S Spine Bending (72114) | $146.63 | $586.50 | 1.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $139.25 | $557 | 1.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $150.44 | $601.75 | 1.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $139.25 | $557 | 1.3× |
| X-ray eye for foreign body (70030) | $87.13 | $348.50 | 1.0× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$87.13–$173.88 | $348.50–$695.50 | varies |
| X-ray IV pyelogram (ivp) (74400) | $355.88 | $1,423.50 | 2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $87.13 | $348.50 | 1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $139.25 | $557 | 1.3× |
| X-ray nose-rectum child f.b. (76010) | $87.13 | $348.50 | 1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $139.25 | $557 | 1.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $139.25 | $557 | 1.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $87.13 | $348.50 | 0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $87.13 | $348.50 | 1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $139.25 | $557 | 1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $139.25 | $557 | 1.3× |
| X-ray thoracic spine 4 vw (72074) | $139.25 | $557 | 1.3× |
| X-Ray Tmj Unilat (70328) | $87.13 | $348.50 | 1.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$388.69–$538.88 | $1,554.75–$2,155.50 | varies |
| X-Rays Bone Length Studies (77073) | $139.25 | $557 | 1.3× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$425–$552.50 | $1,700–$2,210 | varies |
| Xr c-spine 4 or 5 views (72050) | $139.25 | $557 | 1.3× |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$87.13–$103.94 | $348.50–$415.75 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $87.13 | $348.50 | 0.8× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$139.25–$278.44 | $557–$1,113.75 | varies |
| Xr Tomogram Single Plane (76100) | $128.75 | $515 | 1.2× |
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.