Imaging prices at Montgomery General Hospital
Montgomery, WV · every code in this section with a posted price and a Medicare benchmark.
232 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) range across 4 matching MRF lines |
$59.68–$124.57 | $79.57–$166.09 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$29.55–$129.39 | $39.40–$172.53 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$81.11–$477.60 | $108.15–$636.80 | varies |
| Ankle 2 views (73600) | $106.03 | $141.37 | 1.3× |
| Bone age studies (77072) range across 2 matching MRF lines |
$16.22–$113.94 | $21.63–$151.93 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$113.17–$479.72 | $150.90–$639.63 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$36.69–$383.35 | $48.93–$511.14 | varies |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$64.89–$381.23 | $86.52–$508.31 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$95.98–$424.49 | $127.98–$565.99 | varies |
| Chest 1 view (71045) range across 2 matching MRF lines |
$20.09–$106.41 | $26.78–$141.88 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$68.95–$125.53 | $91.93–$167.38 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$111.63–$125.53 | $148.84–$167.38 | varies |
| Clavicle complete (73000) range across 8 matching MRF lines |
$81.11–$180.38 | $108.15–$240.51 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$115.88–$200.85 | $154.50–$267.80 | varies |
| Contrast X-Ray Bladder (74430) | $579.38 | $772.50 | 1.7× |
| Contrast Xray Throat/Cerv Esopha (74210) | $145.23 | $193.64 | 0.9× |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$288.92–$1,505.02 | $385.22–$2,006.70 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$251.64–$1,150.25 | $335.52–$1,533.67 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$316.34–$638.86 | $421.79–$851.81 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$154.89–$756.86 | $206.52–$1,009.14 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$130.94–$625.15 | $174.59–$833.53 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$209.15–$1,045 | $278.87–$1,393.33 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$144.46–$1,045 | $192.61–$1,393.33 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 6 matching MRF lines |
$154.11–$2,090 | $205.49–$2,786.67 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$146–$1,045 | $194.67–$1,393.33 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,045–$2,090 | $1,393.33–$2,786.67 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$127.85–$721.13 | $170.47–$961.51 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$136.54–$686.56 | $182.05–$915.41 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$152.57–$756.86 | $203.43–$1,009.14 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$81.11–$625.15 | $108.15–$833.53 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$140.79–$722.67 | $187.72–$963.57 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$102.36–$483.20 | $136.48–$644.27 | varies |
| CT lower ext w/o (73700) range across 6 matching MRF lines |
$120.70–$798.57 | $160.94–$1,064.76 | varies |
| CT lower extremity w/contrast material (73701) range across 6 matching MRF lines |
$115.88–$849.36 | $154.50–$1,132.49 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$115.88–$521.44 | $154.50–$695.25 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$128.62–$699.31 | $171.50–$932.41 | varies |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$102.36–$447.28 | $136.48–$596.37 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$101.39–$374.86 | $135.19–$499.81 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$86.71–$512.36 | $115.62–$683.15 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$113.56–$580.53 | $151.41–$774.05 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$102.36–$426.42 | $136.48–$568.56 | varies |
| CT pelvis w&w/o contrast (72194) range across 4 matching MRF lines |
$131.33–$748.17 | $175.10–$997.56 | varies |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$115.88–$525.30 | $154.50–$700.40 | varies |
| CT scan of leg combo (73702) range across 6 matching MRF lines |
$71.26–$1,024.53 | $95.02–$1,366.04 | varies |
| CT scans face/jaw combo (70488) range across 4 matching MRF lines |
$101.39–$540.94 | $135.19–$721.26 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$152.57–$411.74 | $203.43–$548.99 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$100.62–$275.40 | $134.16–$367.20 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$81.11–$699.31 | $108.15–$932.41 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$127.85–$625.15 | $170.47–$833.53 | varies |
| CT upper ext wo (73200) range across 6 matching MRF lines |
$86.13–$798.57 | $114.85–$1,064.76 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 6 matching MRF lines |
$97.34–$1,024.53 | $129.78–$1,366.04 | varies |
| CT upper extremity with contrast (73201) range across 6 matching MRF lines |
$71.26–$849.36 | $95.02–$1,132.49 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$202.78–$1,426.23 | $270.38–$1,901.64 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$207.61–$1,045 | $276.81–$1,393.33 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$207.61–$1,045 | $276.81–$1,393.33 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$33.41–$224.22 | $44.55–$298.96 | varies |
| Echo exam of fetal heart (76825) | $772.50 | $1,030 | 1.5× |
| Esophagram (74220) range across 2 matching MRF lines |
$51.18–$157.40 | $68.24–$209.86 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$118.39–$284.28 | $157.85–$379.04 | varies |
| Fluoroscopy up to 1 hr (76000) | $386.25 | $515 | 1.7× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$96.37–$192.74 | $128.49–$256.99 | varies |
| Forearm 2 views (73090) range across 7 matching MRF lines |
$48.67–$228.08 | $64.89–$304.11 | varies |
| Gastric emptying imaging study (78264) range across 3 matching MRF lines |
$61.80–$406.53 | $82.40–$542.04 | varies |
| Gastric Mucosa Imaging (78261) | $399 | $532 | 1.0× |
| Gastroesophageal Reflux Exam (78262) range across 2 matching MRF lines |
$61.80–$477.60 | $82.40–$636.80 | varies |
| Gated Heart Planar Single (78472) | $78.02 | $104.03 | 0.2× |
| Gated Heart, Multiple (78473) | $712.82 | $950.43 | 1.9× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$93.67–$382 | $124.89–$509.34 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$93.67–$382 | $124.89–$509.34 | varies |
| Ht Muscle Image Spect Sing (78451) range across 4 matching MRF lines |
$162.80–$2,317.50 | $217.07–$3,090 | varies |
| Infusion Ivp (74410) | $280.42 | $373.89 | 1.7× |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$106.80–$611.43 | $142.40–$815.25 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $40.56 | $54.08 | 0.1× |
| Knee 3 Views (73562) range across 7 matching MRF lines |
$127.66–$268.25 | $170.21–$357.67 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$40.56–$351.10 | $54.08–$468.14 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$140.40–$650.83 | $187.20–$867.78 | varies |
| Magnetic Image Jaw Joint (70336) range across 3 matching MRF lines |
$109.50–$1,253.96 | $146–$1,671.95 | varies |
| Meckels Divert Exam (78290) | $61.80 | $82.40 | 0.2× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$162.23–$998.26 | $216.30–$1,331.02 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$73–$856.70 | $97.34–$1,142.27 | varies |
| MRA head with contrast (70545) | $998.26 | $1,331.02 | 3.0× |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$81.11–$998.26 | $108.15–$1,331.02 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$97.34–$998.26 | $129.78–$1,331.02 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$81.11–$856.70 | $108.15–$1,142.27 | varies |
| MRI abdomen w contrast (74182) range across 10 matching MRF lines |
$127.85–$998.26 | $170.47–$1,331.02 | varies |
| MRI abdomen w/o contrast (74181) range across 12 matching MRF lines |
$121.67–$856.70 | $162.23–$1,142.27 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 5 matching MRF lines |
$129.78–$1,996.33 | $173.04–$2,661.78 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 7 matching MRF lines |
$178.45–$1,996.33 | $237.93–$2,661.78 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 13 matching MRF lines |
$133.84–$1,996.33 | $178.45–$2,661.78 | varies |
| MRI bone marrow blood supply (77084) | $856.70 | $1,142.27 | 3.7× |
| MRI cervical spine w contrast (72142) | $963.11 | $1,284.15 | 2.9× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$177.29–$856.70 | $236.39–$1,142.27 | varies |
| MRI chest w/o contrast (71550) | $856.70 | $1,142.27 | 3.7× |
| MRI chest with contrast (71551) | $998.26 | $1,331.02 | 1.3× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$178.45–$998.26 | $237.93–$1,331.02 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 11 matching MRF lines |
$147.16–$1,996.33 | $196.22–$2,661.78 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 13 matching MRF lines |
$178.45–$2,529.55 | $237.93–$3,372.74 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 14 matching MRF lines |
$83.62–$1,805.72 | $111.50–$2,407.63 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$134.42–$963.11 | $179.22–$1,284.15 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$162.23–$1,712.05 | $216.30–$2,282.74 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$109.50–$856.70 | $146–$1,142.27 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$109.50–$997.30 | $146–$1,329.73 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$178.45–$998.26 | $237.93–$1,331.02 | varies |
| MRI pelvis w contrast (72196) range across 6 matching MRF lines |
$85.17–$1,996.33 | $113.56–$2,661.78 | varies |
| MRI pelvis w/o & w contrast (72197) range across 6 matching MRF lines |
$85.17–$1,996.33 | $113.56–$2,661.78 | varies |
| MRI pelvis w/o contrast (72195) range across 3 matching MRF lines |
$85.17–$1,713.21 | $113.56–$2,284.28 | varies |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$177.29–$856.70 | $236.39–$1,142.27 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 8 matching MRF lines |
$147.16–$1,996.33 | $196.22–$2,661.78 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 8 matching MRF lines |
$109.50–$1,996.33 | $146–$2,661.78 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 8 matching MRF lines |
$178.45–$1,996.33 | $237.93–$2,661.78 | varies |
| MRI, abdomen, combo (74183) range across 11 matching MRF lines |
$133.84–$998.26 | $178.45–$1,331.02 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$186.56–$1,712.05 | $248.75–$2,282.74 | varies |
| MRI, dorsal spine contrast (72147) | $963.11 | $1,284.15 | 2.9× |
| MRI, joint upper extrem (73221) range across 13 matching MRF lines |
$101.39–$1,713.21 | $135.19–$2,284.28 | varies |
| MRI, joint upper extrem combo (73223) range across 11 matching MRF lines |
$178.45–$1,996.33 | $237.93–$2,661.78 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$186.56–$1,712.05 | $248.75–$2,282.74 | varies |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $48.67 | $64.89 | 0.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,158.75 | $1,545 | 0.9× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$162.80–$1,703.36 | $217.07–$2,271.15 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$19.31–$83.43 | $25.75–$111.24 | varies |
| Optic foramina (70190) | $107.76 | $143.69 | 1.3× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$60.83–$378.53 | $81.11–$504.70 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$19.31–$115.10 | $25.75–$153.47 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$60.83–$356.90 | $81.11–$475.86 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$59.68–$176.52 | $79.57–$235.36 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $44.61 | $59.48 | 0.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 7 matching MRF lines |
$20.28–$211.86 | $27.04–$282.48 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 8 matching MRF lines |
$18.54–$160.29 | $24.72–$213.73 | varies |
| Radex elbow complete minimum 3 views (73080) range across 7 matching MRF lines |
$106.41–$211.86 | $141.88–$282.48 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 7 matching MRF lines |
$28.78–$327.73 | $38.37–$436.98 | varies |
| Radex fingr minimum 2 views (73140) range across 22 matching MRF lines |
$82.46–$173.04 | $109.95–$230.72 | varies |
| Radex foot complete minimum 3 views (73630) range across 7 matching MRF lines |
$20.28–$192.74 | $27.04–$256.99 | varies |
| Radex Hand Minimum 3 Views (73130) range across 7 matching MRF lines |
$48.67–$204.52 | $64.89–$272.69 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 6 matching MRF lines |
$18.54–$146 | $24.72–$194.67 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$27.62–$184.63 | $36.82–$246.17 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$19.31–$115.10 | $25.75–$153.47 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $145.23 | $193.64 | 1.7× |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$20.09–$221.51 | $26.78–$295.35 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$14.68–$154.50 | $19.57–$206 | varies |
| Radex Spine 1 View Specify Level (72020) range across 8 matching MRF lines |
$17–$114.72 | $22.66–$152.96 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$22.40–$131.13 | $29.87–$174.84 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 4 matching MRF lines |
$60.83–$270.18 | $81.11–$360.24 | varies |
| Radex Toe Minimum 2 Views (73660) range across 22 matching MRF lines |
$48.67–$160.29 | $64.89–$213.73 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 6 matching MRF lines |
$27.62–$173.81 | $36.82–$231.75 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 7 matching MRF lines |
$48.67–$204.52 | $64.89–$272.69 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$27.23–$135.19 | $36.31–$180.25 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$109.31–$383.74 | $145.75–$511.65 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$75.90–$297.41 | $101.20–$396.55 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 7 matching MRF lines |
$25.88–$322.13 | $34.51–$429.51 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $115.10 | $153.47 | 1.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$51.95–$192.35 | $69.27–$256.47 | varies |
| Radiologic exam upr gi trc double contrast study (74246) | $289.49 | $385.99 | 1.7× |
| Radiologic examination femur minimum 2 views (73552) range across 7 matching MRF lines |
$19.31–$258.98 | $25.75–$345.31 | varies |
| Radiologic examination knee 1/2 views (73560) range across 7 matching MRF lines |
$20.47–$204.52 | $27.30–$272.69 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $285.05 | $380.07 | 2.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 7 matching MRF lines |
$60.83–$237.35 | $81.11–$316.47 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $579.38 | $772.50 | 1.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$64.89–$383.35 | $86.52–$511.14 | varies |
| Scapula (73010) range across 7 matching MRF lines |
$19.31–$180.38 | $25.75–$240.51 | varies |
| Sella turcica (70240) range across 2 matching MRF lines |
$20.28–$106.03 | $27.04–$141.37 | varies |
| Shoulder 1 view (73020) | $17 | $22.66 | 0.2× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$19.51–$135.19 | $26.01–$180.25 | varies |
| Speech evaluation, complex (70371) | $306.30 | $408.40 | 1.3× |
| Spleen Imaging (78185) | $383.35 | $511.14 | 1.0× |
| Sternoclavicular joints (71130) range across 4 matching MRF lines |
$17.96–$180.38 | $23.95–$240.51 | varies |
| Testicular Imaging W/Flow (78761) range across 3 matching MRF lines |
$60.83–$338.55 | $81.11–$451.40 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$24.14–$139.05 | $32.19–$185.40 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $347.63 | $463.50 | 0.9× |
| Thyroid Uptake Measurement (78012) | $386.25 | $515 | 1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$55.04–$753.19 | $73.39–$1,004.25 | varies |
| Ultrasound Breast Limited (76642) range across 5 matching MRF lines |
$63.35–$249.90 | $84.46–$333.21 | varies |
| Ultrasound Elastography Parenchyma (76981) | $57.94 | $77.25 | 0.6× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$65.66–$249.90 | $87.55–$333.21 | varies |
| Ultrasound, abdomen limited (76705) range across 6 matching MRF lines |
$65.66–$249.90 | $87.55–$333.21 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$228.47–$302.05 | $304.62–$402.73 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$37.08–$226.73 | $49.44–$302.31 | varies |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$60.26–$500.57 | $80.34–$667.42 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$48.75–$157.50 | $65–$210 | varies |
| Us complete joint (76881) range across 4 matching MRF lines |
$65.66–$249.90 | $87.55–$333.21 | varies |
| Us exam, pelvic, limited (76857) | $204.52 | $272.69 | 2.0× |
| Us head (76506) | $236.96 | $315.95 | 2.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$65.66–$499.81 | $87.55–$666.41 | varies |
| Us ob detailed single fetus (76811) | $249.71 | $332.95 | 1.1× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$100.23–$141.95 | $133.64–$189.26 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$93.28–$161.84 | $124.37–$215.79 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$117.61–$273.08 | $156.82–$364.11 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$92.70–$161.84 | $123.60–$215.79 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $100.23 | $133.64 | 1.0× |
| Us retroperitoneal complete (76770) range across 4 matching MRF lines |
$65.66–$249.90 | $87.55–$333.21 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$92.70–$251.06 | $123.60–$334.75 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$153.34–$273.08 | $204.46–$364.11 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$61.41–$230.40 | $81.89–$307.20 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$77.06–$273.08 | $102.74–$364.11 | varies |
| Venogram Sinus/Jugular (75860) | $81.11 | $108.15 | 0.0× |
| Venography extremity unilateral rs&i (75820) | $77.44 | $103.26 | 0.1× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $386.25 | $515 | 1.0× |
| Wrist 2 views (73100) | $102.36 | $136.48 | 1.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$23.56–$106.03 | $31.42–$141.37 | varies |
| X-ray antegrade pyelogram tube (74425) | $270.38 | $360.50 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$19.51–$173.81 | $26.01–$231.75 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 7 matching MRF lines |
$96.56–$211.86 | $128.75–$282.48 | varies |
| X-Ray Exam Breast Specimen (76098) range across 6 matching MRF lines |
$579.38–$772.50 | $32.45–$1,030 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $25.88 | $34.51 | 0.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$40.56–$385.86 | $54.08–$514.49 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 7 matching MRF lines |
$19.31–$223.83 | $25.75–$298.44 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 6 matching MRF lines |
$19.31–$250.48 | $25.75–$333.98 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 6 matching MRF lines |
$22.79–$764.58 | $30.39–$1,019.44 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$115.88–$231.75 | $154.50–$309 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$135.19–$270.38 | $180.25–$360.50 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$154.50–$309 | $206–$412 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$38.63–$231.75 | $51.50–$309 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$24.14–$114.72 | $32.19–$152.96 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$31.67–$161.07 | $42.23–$214.76 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 6 matching MRF lines |
$29.55–$152.38 | $39.40–$203.17 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$20.28–$84.78 | $27.04–$113.04 | varies |
| X-ray humerus (73060) range across 6 matching MRF lines |
$19.31–$238.51 | $25.75–$318.01 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$39.01–$237.74 | $52.02–$316.98 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$54.27–$377.75 | $72.36–$503.67 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $134.22 | $178.96 | 1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$25.88–$128.24 | $34.51–$170.98 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$35.15–$197.57 | $46.87–$263.42 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$20.28–$93.28 | $27.04–$124.37 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$99.85–$104.87 | $133.13–$139.82 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 5 matching MRF lines |
$19.31–$106.03 | $25.75–$141.37 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$44.61–$184.63 | $59.48–$246.17 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$37.47–$163.96 | $49.96–$218.62 | varies |
| X-Ray Stress View (77071) | $37.47 | $49.96 | 0.4× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$40.56–$285.05 | $54.08–$380.07 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$40.17–$90.38 | $53.56–$120.51 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$12.17–$122.06 | $16.22–$162.74 | varies |
| Xr orbits complete 4 views (70200) range across 8 matching MRF lines |
$22.79–$248.17 | $30.39–$330.89 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$47.12–$178.25 | $62.83–$237.67 | varies |
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.