Imaging prices at Monroe Surgical Hospital
Monroe, LA · every code in this section with a posted price and a Medicare benchmark.
296 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) | $200.11 | $266.81 | 2.5× |
| Abdomen 2 views (74019) | $246.17 | $328.23 | 2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $876.91 | $1,169.21 | 2.4× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $3,036.68 | $4,048.90 | 2.6× |
| Adrenal Cortex & Medulla Img (78075) | $3,036.68 | $4,048.90 | 2.6× |
| Angiography extremity bilateral rs&i (75716) | $3,374.59 | $4,499.45 | 1.2× |
| Ankle 2 views (73600) | $200.11 | $266.81 | 2.5× |
| Arthrogram ankle (73615) | $855.98 | $1,141.31 | 2.7× |
| Arthrogram hip (73525) range across 4 matching MRF lines |
$855.98–$1,283.97 | $1,141.31–$1,711.96 | varies |
| Arthrogram Wrist (73115) | $855.98 | $1,141.31 | 2.7× |
| Bone age studies (77072) | $246.17 | $328.23 | 2.6× |
| Bone Imaging 3 Phase (78315) | $876.91 | $1,169.21 | 2.4× |
| Bone Imaging Limited Area (78300) | $876.91 | $1,169.21 | 2.4× |
| Bone Imaging Multiple Areas (78305) | $840.26 | $1,120.35 | 2.3× |
| Bone Imaging Whole Body (78306) | $876.91 | $1,169.21 | 2.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,137.99 | $1,517.32 | 2.3× |
| Cardiac Shunt Detection (78428) | $876.91 | $1,169.21 | 2.4× |
| Cat Scan Follow-Up Study (76380) | $1,717.54 | $2,290.05 | 21.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,137.99 | $1,517.32 | 2.3× |
| Chest 1 view (71045) | $200.11 | $266.81 | 2.5× |
| Chest 2 views (71046) | $200.11 | $266.81 | 2.5× |
| Chest 3 views (71047) | $200.11 | $266.81 | 2.5× |
| Chest 4 or more views (71048) | $246.17 | $328.23 | 2.6× |
| Cholecystography Oral Contrast (74290) | $415.37 | $553.82 | 2.6× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,717.54 | $2,290.05 | 18.1× |
| Contrast X-Ray Bladder (74430) | $848.58 | $1,131.44 | 2.7× |
| Contrast X-Ray Of Elbow (73085) | $855.98 | $1,141.31 | 2.7× |
| Contrast X-Ray Of Knee Joint (73580) | $855.98 | $1,141.31 | 2.7× |
| Contrast Xray Throat/Cerv Esopha (74210) | $415.37 | $553.82 | 2.6× |
| CT abdomen and pelvis without and with contrast (74178) | $1,717.54 | $2,290.05 | 5.4× |
| CT abdomen and pelvis without contrast (74176) | $1,717.54 | $2,290.05 | 7.9× |
| CT abdomen w contrast (74160) | $1,717.54 | $2,290.05 | 10.8× |
| CT abdomen w wo contrast (74170) | $1,717.54 | $2,290.05 | 10.8× |
| CT abdomen w/o contrast (74150) | $1,717.54 | $2,290.05 | 18.1× |
| CT Angio Abdomen and Pelvis (74174) | $1,717.54 | $2,290.05 | 5.4× |
| CT Angio Chest (71275) | $1,717.54 | $2,290.05 | 10.8× |
| CT Angio Head (70496) | $1,717.54 | $2,290.05 | 10.8× |
| CT angio hrt w/3d image (75574) | $1,717.54 | $2,290.05 | 5.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,717.54 | $2,290.05 | 10.8× |
| CT Angio Neck (70498) | $1,717.54 | $2,290.05 | 10.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,717.54 | $2,290.05 | 10.8× |
| CT cervical spine w/ contrast (72126) | $1,717.54 | $2,290.05 | 5.4× |
| CT cervical spine w/o contrast (72125) | $1,717.54 | $2,290.05 | 18.1× |
| CT cervical spine w/wo cont (72127) | $1,717.54 | $2,290.05 | 10.8× |
| CT chest w contrast (71260) | $1,717.54 | $2,290.05 | 10.8× |
| CT chest w/wo contrast (71270) | $1,717.54 | $2,290.05 | 10.8× |
| CT head/brain with contrast (70460) | $1,717.54 | $2,290.05 | 10.8× |
| CT head/brain without and with contrast (70470) | $1,717.54 | $2,290.05 | 10.8× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,717.54 | $2,290.05 | 5.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $1,717.54 | $2,290.05 | 21.8× |
| CT hrt w/3d image congen (75573) | $1,717.54 | $2,290.05 | 5.4× |
| CT iac w contrast (70481) | $1,717.54 | $2,290.05 | 10.8× |
| CT l-spine w&w/o contrast (72133) | $1,717.54 | $2,290.05 | 10.8× |
| CT lower ext w/o (73700) | $1,717.54 | $2,290.05 | 18.1× |
| CT lower extremity w/contrast material (73701) | $1,717.54 | $2,290.05 | 10.8× |
| CT lumbar spine w contrast (72132) | $1,717.54 | $2,290.05 | 5.4× |
| CT lumbar spine w/o contrast (72131) | $1,717.54 | $2,290.05 | 18.1× |
| CT maxillofacial w contrast (70487) | $1,717.54 | $2,290.05 | 10.8× |
| CT maxillofacial wo contrast (70486) | $1,717.54 | $2,290.05 | 18.1× |
| CT neck tissue combo (70492) | $1,717.54 | $2,290.05 | 10.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,717.54 | $2,290.05 | 10.8× |
| CT orbits w/o contrast (70480) | $1,717.54 | $2,290.05 | 18.1× |
| CT pelvis w&w/o contrast (72194) | $1,717.54 | $2,290.05 | 10.8× |
| CT pelvis w/o contrast (72192) | $1,717.54 | $2,290.05 | 18.1× |
| CT scan of leg combo (73702) | $1,717.54 | $2,290.05 | 10.8× |
| CT scans face/jaw combo (70488) | $1,717.54 | $2,290.05 | 10.8× |
| CT soft tissue neck w contrast (70491) | $1,717.54 | $2,290.05 | 10.8× |
| CT soft tissue neck w/o contrast (70490) | $1,717.54 | $2,290.05 | 18.1× |
| CT thoracic spine w contrast (72129) | $1,717.54 | $2,290.05 | 10.8× |
| CT thoracic spine w/o contrast (72128) | $1,717.54 | $2,290.05 | 18.1× |
| CT thoracic spine w/wo cont (72130) | $1,717.54 | $2,290.05 | 10.8× |
| CT thorax w/o contrast (71250) | $1,717.54 | $2,290.05 | 18.1× |
| CT unlisted procedure (76497) | $1,717.54 | $2,290.05 | 21.8× |
| CT upper ext wo (73200) | $1,717.54 | $2,290.05 | 18.1× |
| CT upper extremity w/o & w/contrast material (73202) | $1,717.54 | $2,290.05 | 10.8× |
| CT upper extremity with contrast (73201) | $1,717.54 | $2,290.05 | 5.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,717.54 | $2,290.05 | 10.8× |
| Cta Abdomen (74175) | $1,717.54 | $2,290.05 | 10.8× |
| CTA pelvis (72191) | $1,717.54 | $2,290.05 | 10.8× |
| Dilation ureters/urethra rs&i (74485) | $4,272.21 | $5,696.28 | 2.3× |
| Dxa Bone Density Axial (77080) range across 4 matching MRF lines |
$246.17–$252.75 | $328.23–$337 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $200.11 | $266.81 | 2.5× |
| Esophageal Motility Study (78258) | $608.42 | $811.23 | 1.7× |
| Esophagram (74220) | $415.37 | $553.82 | 2.6× |
| Fluoroscopy up to 1 hr (76000) | $537.85 | $717.13 | 2.5× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Gastric emptying imaging study (78264) | $876.91 | $1,169.21 | 2.4× |
| Gastroesophageal Reflux Exam (78262) | $876.91 | $1,169.21 | 2.4× |
| Gated Heart Planar Single (78472) | $876.91 | $1,169.21 | 2.4× |
| GI Endoscopic US S&I (76975) | $537.85 | $717.13 | 2.5× |
| Hand 2 views (73120) | $246.17 | $328.23 | 2.6× |
| Heart first pass single,planar (78481) | $1,137.99 | $1,517.32 | 2.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,137.99 | $1,517.32 | 2.3× |
| Hepatobiliary System Imaging (78226) | $876.91 | $1,169.21 | 2.4× |
| Ht Muscle Image Spect Sing (78451) | $3,036.68 | $4,048.90 | 2.6× |
| Infusion Ivp (74410) | $415.37 | $553.82 | 2.6× |
| K Flow/Funct Image Multiple (78709) | $1,137.99 | $1,517.32 | 2.3× |
| K Flow/Funct Image W/Drug (78708) | $1,137.99 | $1,517.32 | 2.3× |
| K Flow/Funct Image W/O Drug (78707) | $1,137.99 | $1,517.32 | 2.3× |
| Kidney Imaging Morphol (78700) | $876.91 | $1,169.21 | 2.4× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Leveen/Shunt Patency Exam (78291) | $876.91 | $1,169.21 | 2.4× |
| Liver & Spleen Imaging Static Only (78215) | $876.91 | $1,169.21 | 2.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $608.42 | $811.23 | 1.7× |
| Liver imaging w/vascular flow (78202) | $1,137.99 | $1,517.32 | 2.3× |
| Lung Perf&Ventilat Diferentl (78598) | $1,137.99 | $1,517.32 | 2.3× |
| Lung perfusion differential (78597) | $876.91 | $1,169.21 | 2.4× |
| Lung Ventilat&Perfus Imaging (78582) | $1,137.99 | $1,517.32 | 2.3× |
| Lung Ventilation Imaging (78579) | $876.91 | $1,169.21 | 2.4× |
| Lymph System Imaging (78195) | $1,137.99 | $1,517.32 | 2.3× |
| Magnetic Image Jaw Joint (70336) range across 3 matching MRF lines |
$1,717.54–$2,145.15 | $2,290.05–$2,860.20 | varies |
| Mammary ductogram or galactogram multiple (77054) | $537.85 | $717.13 | 2.5× |
| Mammary ductogram or galactogram single (77053) | $537.85 | $717.13 | 2.5× |
| Meckels Divert Exam (78290) | $876.91 | $1,169.21 | 2.4× |
| MRA head w/o contrast (70544) | $2,145.15 | $2,860.20 | 9.9× |
| MRA neck w/o contrast (70547) | $2,145.15 | $2,860.20 | 9.9× |
| MRI abdomen w/o contrast (74181) | $2,145.15 | $2,860.20 | 9.9× |
| MRI any jt lower extrem w/contrast material (73722) range across 12 matching MRF lines |
$2,145.15–$3,075.21 | $2,860.20–$4,100.28 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 13 matching MRF lines |
$1,541.73–$3,217.73 | $2,055.64–$4,290.30 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 10 matching MRF lines |
$2,145.15–$2,228.90 | $2,860.20–$2,971.87 | varies |
| MRI cervical spine w contrast (72142) | $2,145.15 | $2,860.20 | 6.8× |
| MRI cervical spine w/o cont (72141) | $2,145.15 | $2,860.20 | 9.9× |
| MRI chest w/o contrast (71550) | $2,145.15 | $2,860.20 | 9.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 15 matching MRF lines |
$2,145.15–$3,217.73 | $2,860.20–$4,290.30 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 15 matching MRF lines |
$2,145.15–$3,217.73 | $2,860.20–$4,290.30 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 16 matching MRF lines |
$2,145.15–$3,217.73 | $2,860.20–$4,290.30 | varies |
| MRI lumbar spine w contrast (72149) | $2,145.15 | $2,860.20 | 6.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,145.15 | $2,860.20 | 6.8× |
| MRI orbit face &/neck w/o contrast (70540) | $2,145.15 | $2,860.20 | 9.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,145.15 | $2,860.20 | 6.8× |
| MRI pelvis w contrast (72196) | $2,145.15 | $2,860.20 | 6.8× |
| MRI pelvis w/o & w contrast (72197) | $2,145.15 | $2,860.20 | 6.8× |
| MRI pelvis w/o contrast (72195) | $2,145.15 | $2,860.20 | 9.9× |
| MRI thoracic spine w/o contrast (72146) | $2,145.15 | $2,860.20 | 9.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 16 matching MRF lines |
$2,145.15–$3,217.73 | $2,860.20–$4,290.30 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 16 matching MRF lines |
$2,145.15–$3,217.73 | $2,860.20–$4,290.30 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 16 matching MRF lines |
$2,145.15–$3,217.73 | $2,860.20–$4,290.30 | varies |
| MRI, abdomen, combo (74183) | $2,145.15 | $2,860.20 | 6.8× |
| MRI, dorsal spine combo (72157) | $2,145.15 | $2,860.20 | 6.8× |
| MRI, dorsal spine contrast (72147) | $2,145.15 | $2,860.20 | 6.8× |
| MRI, joint upper extrem (73221) range across 10 matching MRF lines |
$2,145.15–$3,217.73 | $2,860.20–$4,290.30 | varies |
| MRI, joint upper extrem combo (73223) range across 10 matching MRF lines |
$2,145.15–$3,217.73 | $2,860.20–$4,290.30 | varies |
| MRI, lumbar spine combo (72158) | $2,145.15 | $2,860.20 | 6.8× |
| Myelogram cervical (72240) | $1,706.12 | $2,274.82 | 2.4× |
| Myelogram Lumbar (72265) | $1,706.12 | $2,274.82 | 2.4× |
| Myelography thoracic (72255) | $1,706.12 | $2,274.82 | 2.4× |
| Myelograpy 2/more regions rs&i (72270) | $1,706.12 | $2,274.82 | 2.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $876.91 | $1,169.21 | 2.4× |
| Myocardial Spect Multiple Studies (78452) | $3,036.68 | $4,048.90 | 2.6× |
| Neck soft tissue (70360) | $200.11 | $266.81 | 2.5× |
| Nm csf leak detection (78650) | $3,036.68 | $4,048.90 | 2.6× |
| Nm myocard infarct spect (78469) | $1,137.99 | $1,517.32 | 2.3× |
| Optic foramina (70190) | $200.11 | $266.81 | 2.5× |
| Parathyroid Planar Imaging (78070) | $876.91 | $1,169.21 | 2.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $876.91 | $1,169.21 | 2.4× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$144.80–$246.17 | $193.06–$328.23 | varies |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) | $608.42 | $811.23 | 0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $876.91 | $1,169.21 | 2.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $246.17 | $328.23 | 2.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $246.17 | $328.23 | 2.6× |
| Radex fingr minimum 2 views (73140) | $200.11 | $266.81 | 2.5× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $246.17 | $328.23 | 2.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $200.11 | $266.81 | 2.5× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $200.11 | $266.81 | 2.5× |
| Radex Ribs Unilateral 2 Views (71100) | $200.11 | $266.81 | 2.5× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $200.11 | $266.81 | 2.5× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $415.37 | $553.82 | 2.6× |
| Radex Spine 1 View Specify Level (72020) | $200.11 | $266.81 | 2.5× |
| Radex Sternum Minimum 2 Views (71120) | $200.11 | $266.81 | 2.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $200.11 | $266.81 | 2.5× |
| Radex Toe Minimum 2 Views (73660) | $200.11 | $266.81 | 2.5× |
| Radex upper extremity infant minimum 2 views (73092) | $246.17 | $328.23 | 2.6× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $246.17 | $328.23 | 2.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $246.17 | $328.23 | 2.6× |
| Radiologic exam colon double contrast study (74280) | $415.37 | $553.82 | 2.6× |
| Radiologic exam colon single contrast study (74270) | $415.37 | $553.82 | 2.6× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$246.17–$369.26 | $328.23–$492.35 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $415.37 | $553.82 | 2.6× |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$237.25–$415.37 | $316.33–$553.82 | varies |
| Radiologic exam upr gi trc double contrast study (74246) | $415.37 | $553.82 | 2.6× |
| Radiologic examination femur 1 view (73551) | $200.11 | $266.81 | 2.5× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $246.17 | $328.23 | 2.6× |
| Radiologic Examination Salivary Gland Calculus (70380) | $200.11 | $266.81 | 2.5× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $1,158.83 | $1,545.10 | 2.3× |
| Radiopharm Dacryocystography (78660) | $876.91 | $1,169.21 | 2.4× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $608.42 | $811.23 | 1.7× |
| Renal Cyst Study (74470) | $1,158.83 | $1,545.10 | 2.3× |
| Ribs bilateral 3 views (71110) | $246.17 | $328.23 | 2.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $840.26 | $1,120.35 | 2.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $840.26 | $1,120.35 | 2.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,036.68 | $4,048.90 | 6.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,036.68 | $4,048.90 | 6.2× |
| Salivary Gland Function Study (78232) | $608.42 | $811.23 | 1.7× |
| Salivary Gland Imaging (78230) | $876.91 | $1,169.21 | 2.4× |
| Scapula (73010) | $246.17 | $328.23 | 2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $226.13 | $301.50 | 9.7× |
| Sella turcica (70240) | $200.11 | $266.81 | 2.5× |
| Shoulder 1 view (73020) | $200.11 | $266.81 | 2.5× |
| Shoulder Arthrography (73040) | $855.98 | $1,141.31 | 2.7× |
| Sialogram (70390) | $537.85 | $717.13 | 2.5× |
| Skull less than 4 views (70250) | $246.17 | $328.23 | 2.6× |
| Sternoclavicular joints (71130) | $200.11 | $266.81 | 2.5× |
| Temporomandble Jt Arthrography Rs&I (70332) | $537.85 | $717.13 | 2.5× |
| Testicular Imaging W/Flow (78761) | $876.91 | $1,169.21 | 2.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $415.37 | $553.82 | 2.6× |
| Thoracic spine 2 views (72070) | $246.17 | $328.23 | 2.6× |
| Thoracic spine 3 views (72072) | $246.17 | $328.23 | 2.6× |
| Thoracolumbar 2 views (72080) | $200.11 | $266.81 | 2.5× |
| Thyroid Imaging With Vascular Flow (78013) | $876.91 | $1,169.21 | 2.4× |
| Thyroid Met Imaging Body (78018) | $1,137.99 | $1,517.32 | 2.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $876.91 | $1,169.21 | 2.4× |
| Ultrasound Breast Limited (76642) | $477 | $636 | 6.1× |
| Ultrasound Exam Aaa Screen (76706) | $477 | $636 | 5.0× |
| Ultrasound, abdomen limited (76705) | $477 | $636 | 5.0× |
| Unlisted Dx Radiographic Procedure (76499) | $121.22 | $161.62 | 1.5× |
| Upper gi w/o kub (74240) | $415.37 | $553.82 | 2.6× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $16.34 | $21.78 | 1.5× |
| Urea breath test c-14 isotopic analysis (78268) | $139.40 | $185.87 | 1.5× |
| Ureteral Reflux Study (78740) | $876.91 | $1,169.21 | 2.4× |
| Urethrocystogram voiding (74455) | $537.85 | $717.13 | 2.5× |
| Urethrocystography retrograde (74450) | $537.85 | $717.13 | 2.5× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$477–$715.50 | $636–$954 | varies |
| Us chest (76604) | $477 | $636 | 5.0× |
| Us exam, pelvic, limited (76857) | $477 | $636 | 5.0× |
| Us head (76506) | $477 | $636 | 5.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$477–$715.50 | $636–$954 | varies |
| Us ob limited 1 or more fetuses (76815) | $477 | $636 | 5.0× |
| Us pelvic non ob complete (76856) | $477 | $636 | 5.0× |
| Us retroperitoneal complete (76770) | $477 | $636 | 5.0× |
| Us retroperitoneal limited (76775) | $477 | $636 | 5.0× |
| Us scrotum and contents (76870) | $477 | $636 | 5.0× |
| Us thyroid (76536) | $477 | $636 | 5.0× |
| Us transrectal (76872) | $477 | $636 | 5.0× |
| Vascular Flow Imaging (78445) | $876.91 | $1,169.21 | 2.4× |
| Vasogram (74440) | $537.85 | $717.13 | 2.5× |
| Vein X-Ray Chest (75827) | $2,452.25 | $3,269.67 | 1.7× |
| Venography caval inferior serialography rs&i (75825) | $4,990.61 | $6,654.15 | 1.7× |
| Venography extremity bilateral rs&i (75822) | $2,452.25 | $3,269.67 | 1.7× |
| Venography extremity unilateral rs&i (75820) | $2,452.25 | $3,269.67 | 1.7× |
| Venous thrombosis imaging (78457) | $1,137.99 | $1,517.32 | 2.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $876.91 | $1,169.21 | 2.4× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $200.11 | $266.81 | 2.5× |
| X-ray antegrade pyelogram tube (74425) | $848.58 | $1,131.44 | 2.7× |
| X-Ray Bend Only L-S Spine (72120) | $246.17 | $328.23 | 2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,158.83 | $1,545.10 | 2.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $200.11 | $266.81 | 2.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $246.17 | $328.23 | 2.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $200.11 | $266.81 | 2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $200.11 | $266.81 | 2.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $246.17 | $328.23 | 2.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $246.17 | $328.23 | 2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $246.17 | $328.23 | 2.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $246.17 | $328.23 | 2.6× |
| X-Ray Exam L-S Spine Bending (72114) | $246.17 | $328.23 | 2.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $200.11 | $266.81 | 2.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $246.17 | $328.23 | 2.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $246.17 | $328.23 | 2.6× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$200.11–$300.17 | $266.81–$400.23 | varies |
| X-ray IV pyelogram (ivp) (74400) | $415.37 | $553.82 | 2.6× |
| X-ray IV pyelogram+tomography (74415) | $415.37 | $553.82 | 2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $200.11 | $266.81 | 2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $200.11 | $266.81 | 2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $246.17 | $328.23 | 2.6× |
| X-ray nose-rectum child f.b. (76010) | $200.11 | $266.81 | 2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $246.17 | $328.23 | 2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $246.17 | $328.23 | 2.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $246.17 | $328.23 | 2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $200.11 | $266.81 | 2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $200.11 | $266.81 | 2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $246.17 | $328.23 | 2.6× |
| X-Ray Stress View (77071) | $200.11 | $266.81 | 2.5× |
| X-ray thoracic spine 4 vw (72074) | $246.17 | $328.23 | 2.6× |
| X-Ray Tmj Unilat (70328) | $200.11 | $266.81 | 2.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $848.58 | $1,131.44 | 2.7× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$246.17–$1,717.54 | $328.23–$2,290.05 | varies |
| X-Rays Bone Survey Complete (77075) | $246.17 | $328.23 | 2.6× |
| Xr c-spine 4 or 5 views (72050) | $246.17 | $328.23 | 2.6× |
| Xr facial bones less than 3 views (70140) | $200.11 | $266.81 | 2.5× |
| XR Mastoids < 3 Views Bilateral (70120) | $246.17 | $328.23 | 2.6× |
| Xr orbits complete 4 views (70200) | $246.17 | $328.23 | 2.6× |
| Xr Tomogram Single Plane (76100) | $246.17 | $328.23 | 2.6× |
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.