Imaging prices at Monroe Hospital
Bloomington, IN · every code in this section with a posted price and a Medicare benchmark.
283 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) | $91 | $413.05 | 1.0× |
| Abdomen 2 views (74019) | $110 | $540 | 1.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $420 | $1,785.89 | 1.0× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $1,363 | $3,646.21 | 1.0× |
| Adrenal Cortex & Medulla Img (78075) | $1,363 | $4,169.02 | 1.0× |
| Angio internal mammary (75756) | $3,324 | $2,719 | 1.0× |
| Angio pulmonary bilat (75743) | $3,324 | $15,185 | 1.0× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$3,324 | $4,742.24–$6,259.89 | 1.0× |
| Angiography extremity unilateral rs&i (75710) range across 5 matching MRF lines |
$3,324 | $4,170.20–$6,259.89 | 1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,324 | $3,747 | 1.0× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$91 | $462.35–$639.67 | 1.0× |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$5,858 | $4,257–$6,259.89 | 1.0× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$5,858 | $4,264.96–$5,200 | 1.0× |
| Artery X-Rays Spine (75705) | $5,858 | $5,045.22 | 1.0× |
| Arthrogram hip (73525) | $367 | $1,758.55 | 1.0× |
| Arthrogram Wrist (73115) | $367 | $999.38 | 1.0× |
| Bone age studies (77072) | $110 | $191 | 1.0× |
| Bone Imaging 3 Phase (78315) | $420 | $2,364.71 | 1.0× |
| Bone Imaging Limited Area (78300) | $420 | $2,296.25 | 1.0× |
| Bone Imaging Multiple Areas (78305) | $420 | $2,296.25 | 1.0× |
| Bone Imaging Whole Body (78306) | $420 | $2,296.25 | 1.0× |
| Bone survey infant (77076) | $110 | $265 | 1.0× |
| Cat Scan Follow-Up Study (76380) range across 4 matching MRF lines |
$91 | $1,596–$3,840.62 | 1.0× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$91 | $89.60–$376.92 | 1.0× |
| Chest 2 views (71046) range across 4 matching MRF lines |
$91 | $89.60–$480.70 | 1.0× |
| Chest 3 views (71047) range across 2 matching MRF lines |
$91 | $89.60–$313 | 1.0× |
| Chest 4 or more views (71048) | $110 | $313 | 1.0× |
| Clavicle complete (73000) | $91 | $927.58 | 1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $110 | $2,462 | 1.0× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$3,324 | $4,315–$6,259.89 | 1.0× |
| Contrast X-Ray Bladder (74430) | $367 | $470 | 1.0× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$367 | $550–$1,758.55 | 1.0× |
| Contrast X-Ray Of Knee Joint (73580) | $367 | $701 | 1.0× |
| CT abdomen and pelvis without and with contrast (74178) | $367 | $6,511 | 1.0× |
| CT abdomen and pelvis without contrast (74176) | $251 | $4,802.13 | 1.0× |
| CT abdomen w contrast (74160) | $184 | $3,382.99 | 1.0× |
| CT abdomen w wo contrast (74170) | $184 | $3,840.62 | 1.0× |
| CT abdomen w/o contrast (74150) | $110 | $2,829 | 1.0× |
| CT Angio Abdomen and Pelvis (74174) | $367 | $6,221.43 | 1.0× |
| CT Angio Chest (71275) | $184 | $3,620 | 1.0× |
| CT Angio Head (70496) | $184 | $5,090 | 1.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$184 | $1,015.41–$4,349 | 1.0× |
| CT Angio Neck (70498) | $184 | $5,220 | 1.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $184 | $2,955.50 | 1.0× |
| CT cervical spine w/ contrast (72126) | $367 | $901.47 | 1.0× |
| CT cervical spine w/o contrast (72125) | $110 | $2,756.89 | 1.0× |
| CT cervical spine w/wo cont (72127) | $184 | $1,002.27 | 1.0× |
| CT chest w contrast (71260) | $184 | $3,000 | 1.0× |
| CT chest w/wo contrast (71270) | $184 | $3,605 | 1.0× |
| CT head/brain with contrast (70460) | $184 | $2,594.43 | 1.0× |
| CT head/brain without and with contrast (70470) | $184 | $3,152 | 1.0× |
| CT heart contrast eval cardiac structure&morph (75572) | $367 | $2,490.95 | 1.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $91 | $399.05 | 1.0× |
| CT iac w contrast (70481) | $184 | $2,892 | 1.0× |
| CT l-spine w&w/o contrast (72133) | $184 | $1,002.27 | 1.0× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$110 | $575.67–$2,316 | 1.0× |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$184 | $901.47–$3,028 | 1.0× |
| CT lumbar spine w contrast (72132) | $367 | $901.47 | 1.0× |
| CT lumbar spine w/o contrast (72131) | $110 | $3,089.25 | 1.0× |
| CT maxillofacial w contrast (70487) | $184 | $2,887.82 | 1.0× |
| CT maxillofacial wo contrast (70486) | $110 | $2,408 | 1.0× |
| CT neck tissue combo (70492) | $184 | $4,264 | 1.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $184 | $1,002.27 | 1.0× |
| CT orbits w/o contrast (70480) | $110 | $2,460 | 1.0× |
| CT pelvis w&w/o contrast (72194) | $184 | $1,002.27 | 1.0× |
| CT pelvis w/o contrast (72192) | $110 | $2,487 | 1.0× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$184 | $1,002.27–$4,060 | 1.0× |
| CT scans face/jaw combo (70488) | $184 | $3,247.63 | 1.0× |
| CT soft tissue neck w contrast (70491) | $184 | $3,304.50 | 1.0× |
| CT soft tissue neck w/o contrast (70490) | $110 | $2,278 | 1.0× |
| CT thoracic spine w contrast (72129) | $184 | $901.47 | 1.0× |
| CT thoracic spine w/o contrast (72128) | $110 | $2,738.41 | 1.0× |
| CT thoracic spine w/wo cont (72130) | $184 | $1,002.27 | 1.0× |
| CT thorax w/o contrast (71250) | $110 | $2,462 | 1.0× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$110 | $575.67–$2,268 | 1.0× |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$184 | $1,002.27–$3,212.08 | 1.0× |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$367 | $901.47–$2,757 | 1.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $184 | $4,520 | 1.0× |
| Cta Abdomen (74175) | $184 | $4,410 | 1.0× |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$2,055 | $1,575–$2,047 | 1.0× |
| Dxa Bone Density Axial (77080) | $110 | $555.95 | 1.0× |
| Esophagram (74220) | $184 | $714.28 | 1.0× |
| Fluoroscopy up to 1 hr (76000) range across 5 matching MRF lines |
$251 | $791.51–$1,181.73 | 1.0× |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$3,324 | $1,310–$1,310.75 | 1.0× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$91 | $401–$688.38 | 1.0× |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$91 | $378–$756.49 | 1.0× |
| Gastric emptying imaging study (78264) | $420 | $2,107 | 1.0× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $420 | $1,663.25 | 1.0× |
| Gated Heart Planar Single (78472) | $420 | $2,315.83 | 1.0× |
| Gated Heart, Multiple (78473) | $420 | $2,494.92 | 1.0× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $571 | $2,206.80 | 1.0× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$110 | $378–$669 | 1.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,324 | $4,038 | 1.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,324 | $3,827 | 1.0× |
| Hepatobil Syst Image W/Drug (78227) | $571 | $3,000 | 1.0× |
| Hepatobiliary System Imaging (78226) | $420 | $1,924.95 | 1.0× |
| Ht Musc Image Planar Mult (78454) | $1,363 | $3,894.69 | 1.0× |
| Ht Muscle Image Spect Sing (78451) | $1,363 | $4,075.50 | 1.0× |
| Hysterosalpingogram (74740) | $251 | $793 | 1.0× |
| K Flow/Funct Image Multiple (78709) | $571 | $2,443 | 1.0× |
| K Flow/Funct Image W/Drug (78708) | $571 | $2,231 | 1.0× |
| K Flow/Funct Image W/O Drug (78707) | $571 | $2,194.80 | 1.0× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $420 | $1,252 | 1.0× |
| Kidney Imaging Morphol (78700) | $420 | $1,560.66 | 1.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $420 | $1,667.30 | 1.0× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$91 | $493–$856.51 | 1.0× |
| Leveen/Shunt Patency Exam (78291) | $420 | $1,285.72 | 1.0× |
| Liver & Spleen Imaging Static Only (78215) | $420 | $1,725.75 | 1.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $420 | $1,996.68 | 1.0× |
| Liver imaging static only (78201) | $571 | $1,502.31 | 1.0× |
| Liver imaging w/vascular flow (78202) | $571 | $1,751.88 | 1.0× |
| Lung Ventilat&Perfus Imaging (78582) | $571 | $2,281.25 | 1.0× |
| Lung Ventilation Imaging (78579) | $420 | $1,557.81 | 1.0× |
| Magnetic Image Jaw Joint (70336) | $251 | $3,280.62 | 1.0× |
| Meckels Divert Exam (78290) | $420 | $1,557.89 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $367 | $1,648.41 | 1.0× |
| MRA head w/o contrast (70544) | $251 | $4,510 | 1.0× |
| MRA head with contrast (70545) | $367 | $1,363.68 | 1.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $367 | $7,240 | 1.0× |
| MRA neck w/o contrast (70547) | $251 | $1,015.23 | 1.0× |
| MRI abdomen w contrast (74182) | $367 | $1,307.52 | 1.0× |
| MRI abdomen w/o contrast (74181) | $251 | $3,499.44 | 1.0× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$825 | $1,307.52–$3,995 | 1.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$367 | $1,602.09–$4,780 | 1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$825 | $1,307.52–$4,460 | 1.0× |
| MRI cervical spine w contrast (72142) | $367 | $1,307.52 | 1.0× |
| MRI cervical spine w/o cont (72141) | $251 | $3,920 | 1.0× |
| MRI chest w/o contrast (71550) | $251 | $1,015.23 | 1.0× |
| MRI chest with contrast (71551) | $825 | $1,307.52 | 1.0× |
| MRI chest wo w contrast (71552) | $367 | $6,950 | 1.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$367 | $1,307.52–$3,995 | 1.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$367 | $1,602.09–$4,780 | 1.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$251 | $1,015.23–$3,309 | 1.0× |
| MRI lumbar spine w contrast (72149) | $367 | $4,850 | 1.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $367 | $5,930 | 1.0× |
| MRI orbit face &/neck w/o contrast (70540) | $251 | $1,015.23 | 1.0× |
| MRI orbit face neck w contrast (70542) | $367 | $4,720 | 1.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $367 | $5,970 | 1.0× |
| MRI pelvis w contrast (72196) | $367 | $1,307.52 | 1.0× |
| MRI pelvis w/o & w contrast (72197) | $367 | $6,100 | 1.0× |
| MRI pelvis w/o contrast (72195) | $251 | $4,360 | 1.0× |
| MRI thoracic spine w/o contrast (72146) | $251 | $3,950 | 1.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $367 | $1,307.52 | 1.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$251 | $1,015.23–$4,380 | 1.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$367 | $1,602.09–$5,684 | 1.0× |
| MRI, abdomen, combo (74183) | $367 | $4,733.77 | 1.0× |
| MRI, dorsal spine combo (72157) | $367 | $5,550 | 1.0× |
| MRI, dorsal spine contrast (72147) | $367 | $4,430 | 1.0× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$251 | $1,015.23–$3,352.69 | 1.0× |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$367 | $1,602.09–$5,130.30 | 1.0× |
| MRI, lumbar spine combo (72158) | $367 | $5,840 | 1.0× |
| Myelogram cervical (72240) | $825 | $1,385 | 1.0× |
| Myelogram Lumbar (72265) | $825 | $3,339.65 | 1.0× |
| Myelography thoracic (72255) | $825 | $3,339.65 | 1.0× |
| Myelograpy 2/more regions rs&i (72270) | $825 | $3,339.65 | 1.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,363 | $3,350.24 | 1.0× |
| Myocardial Spect Multiple Studies (78452) | $1,363 | $5,297.75 | 1.0× |
| Neck soft tissue (70360) | $91 | $417.04 | 1.0× |
| Nm unlisted gi procedure (78299) | $420 | $1,166 | 1.0× |
| Nuclear medicine study of endocrine organs (78099) | $420 | $1,305.81 | 1.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $571 | $2,746.67 | 1.0× |
| Parathyroid Planar Imaging (78070) | $420 | $1,690 | 1.0× |
| Parathyroid planar imaging w/wo subtraction (78071) | $420 | $2,077.87 | 1.0× |
| Pelvis 1 or 2 views (72170) | $110 | $503.45 | 1.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,324 | $4,136.75 | 1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $420 | $1,537 | 1.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$110 | $403–$632.90 | 1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $575 | $793 | 1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$91 | $534.96–$754.70 | 1.0× |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$91 | $393.43–$605.51 | 1.0× |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$91 | $624.72–$897.65 | 1.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $110 | $645 | 1.0× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$91 | $570.94–$626.29 | 1.0× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$91 | $452–$756.50 | 1.0× |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$91 | $541.18–$794.29 | 1.0× |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$91 | $180–$361 | 1.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $110 | $151.04 | 1.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $91 | $474 | 1.0× |
| Radex Ribs Unilateral 2 Views (71100) | $91 | $483.18 | 1.0× |
| Radex shoulder complete minimum 2 views (73030) | $91 | $806.08 | 1.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $91 | $421 | 1.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $184 | $478 | 1.0× |
| Radex Spine 1 View Specify Level (72020) | $91 | $387.71 | 1.0× |
| Radex Sternum Minimum 2 Views (71120) | $91 | $619 | 1.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $91 | $89.60 | 1.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$91 | $304–$378 | 1.0× |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$110 | $191–$378 | 1.0× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$91 | $600.40–$817.11 | 1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $110 | $621.43 | 1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $110 | $555.95 | 1.0× |
| Radiologic exam colon double contrast study (74280) | $184 | $1,374.50 | 1.0× |
| Radiologic exam colon single contrast study (74270) | $184 | $1,068.57 | 1.0× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$110 | $607.36–$977.96 | 1.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $184 | $920.77 | 1.0× |
| Radiologic exam swallow function contrast study (74230) | $184 | $412 | 1.0× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$184 | $974–$1,118.77 | 1.0× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$91 | $469.27–$720 | 1.0× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$91 | $413–$670.59 | 1.0× |
| Radiologic Examination Osseous Survey Limited (77074) | $110 | $812 | 1.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$91 | $469.27–$720 | 1.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines |
$571 | $2,206.80–$2,358 | 1.0× |
| Scapula (73010) range across 3 matching MRF lines |
$110 | $191–$810 | 1.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $21 | $59 | 0.9× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$91 | $160–$717 | 1.0× |
| Shoulder Arthrography (73040) | $367 | $1,758.55 | 1.0× |
| Sialogram (70390) | $251 | $472.84 | 1.0× |
| Skull less than 4 views (70250) | $110 | $89.60 | 1.0× |
| Sternoclavicular joints (71130) | $91 | $191 | 1.0× |
| Testicular Imaging W/Flow (78761) | $420 | $1,663.25 | 1.0× |
| Thoracic spine 2 views (72070) | $110 | $517 | 1.0× |
| Thoracic spine 3 views (72072) | $110 | $598 | 1.0× |
| Thoracolumbar 2 views (72080) | $91 | $553.69 | 1.0× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $420 | $1,233.73 | 1.0× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $420 | $1,226 | 1.0× |
| Thyroid Imaging With Vascular Flow (78013) | $420 | $1,325.13 | 1.0× |
| Thyroid Met Imaging Body (78018) | $571 | $2,339.50 | 1.0× |
| Thyroid Uptake Measurement (78012) | $420 | $1,297.63 | 1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $420 | $1,625 | 1.0× |
| Ultrasound Breast Limited (76642) | $91 | $407 | 1.0× |
| Ultrasound Exam Aaa Screen (76706) | $110 | $544.85 | 1.0× |
| Ultrasound, abdomen limited (76705) | $110 | $903 | 1.0× |
| Upper gi w/o kub (74240) | $184 | $1,106.29 | 1.0× |
| Urethrocystogram voiding (74455) | $251 | $517 | 1.0× |
| Urethrocystography retrograde (74450) | $251 | $959.85 | 1.0× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$110 | $495–$814 | 1.0× |
| Us chest (76604) | $110 | $718 | 1.0× |
| Us complete joint (76881) | $110 | $1,050 | 1.0× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$110 | $288.93–$1,022.71 | 1.0× |
| Us ob detailed single fetus (76811) | $251 | $456.39 | 1.0× |
| Us ob limited 1 or more fetuses (76815) | $110 | $767.90 | 1.0× |
| Us ob transvaginal (76817) | $110 | $820 | 1.0× |
| Us pelvic non ob complete (76856) | $110 | $1,066 | 1.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $110 | $851 | 1.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $110 | $188.76 | 1.0× |
| Us retroperitoneal complete (76770) | $110 | $1,022.71 | 1.0× |
| Us retroperitoneal limited (76775) | $110 | $1,036.21 | 1.0× |
| Us scrotum and contents (76870) | $110 | $827 | 1.0× |
| Us spinal canal and contents (76800) | $110 | $288.93 | 1.0× |
| Us thyroid (76536) | $110 | $1,026.83 | 1.0× |
| Us transrectal (76872) | $110 | $288.93 | 1.0× |
| Vascular Flow Imaging (78445) | $420 | $997 | 1.0× |
| Vein X-Ray Chest (75827) | $1,657 | $4,173.26 | 1.0× |
| Venogram Sinus/Jugular (75860) | $3,324 | $2,408.10 | 1.0× |
| Venography Adrenal Unilateral (75840) | $3,324 | $4,335 | 1.0× |
| Venography caval inferior serialography rs&i (75825) | $3,324 | $4,173.26 | 1.0× |
| Venography extremity bilateral rs&i (75822) | $1,657 | $1,948 | 1.0× |
| Venography extremity unilateral rs&i (75820) | $1,657 | $1,350 | 1.0× |
| Venography Renal Bilateral (75833) | $3,324 | $4,335 | 1.0× |
| Venography Renal Unilateral (75831) | $3,324 | $3,268.25 | 1.0× |
| Venous thrombosis imaging (78457) | $571 | $1,756.56 | 1.0× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $420 | $2,206.80 | 1.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$91 | $378–$643.16 | 1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $91 | $468 | 1.0× |
| X-ray antegrade pyelogram tube (74425) | $367 | $701 | 1.0× |
| X-Ray Aorta Leg Arteries (75630) | $3,324 | $6,259.89 | 1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$91 | $378–$672.57 | 1.0× |
| X-Ray Exam Breast Specimen (76098) | $575 | $1,758.55 | 1.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $91 | $436.14 | 1.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $110 | $217 | 1.0× |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$91 | $240–$368 | 1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$91 | $191–$459.60 | 1.0× |
| X-Ray Exam L-S Spine Bending (72114) | $110 | $918.84 | 1.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $91 | $504.92 | 1.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $110 | $851.86 | 1.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $110 | $550 | 1.0× |
| X-ray eye for foreign body (70030) | $91 | $89.60 | 1.0× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$91 | $547.04–$808.45 | 1.0× |
| X-ray IV pyelogram (ivp) (74400) | $184 | $1,184.73 | 1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $91 | $621.43 | 1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$91 | $191–$378 | 1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $110 | $544 | 1.0× |
| X-ray nose-rectum child f.b. (76010) | $91 | $959.85 | 1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $110 | $503.45 | 1.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $110 | $191 | 1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $91 | $488.50 | 1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $91 | $655 | 1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $110 | $719 | 1.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $367 | $1,758.55 | 1.0× |
| X-Rays Bone Length Studies (77073) | $110 | $265 | 1.0× |
| X-Rays Bone Survey Complete (77075) | $110 | $965 | 1.0× |
| Xr c-spine 4 or 5 views (72050) | $110 | $718 | 1.0× |
| Xr facial bones less than 3 views (70140) | $91 | $89.60 | 1.0× |
| Xr orbits complete 4 views (70200) | $110 | $600 | 1.0× |
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.