Imaging prices at Mosaic Life Care at St. Joseph - Medical Center

St. Joseph, MO · every code in this section with a posted price and a Medicare benchmark.

347 codes. Prices are the hospital's own posted facility charges.

Compare against other hospitals interactively →

ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $4,675 $5,500 3.4×
Abdomen 1 View (74018)
range across 2 matching MRF lines		 $170–$340 $200–$400 varies
Abdomen 2 views (74019)
range across 2 matching MRF lines		 $255–$425 $300–$500 varies
Acute Gastrointestinal Blood Loss Imaging (78278) $1,615 $1,900 4.0×
Angio pulmonary bilat (75743) $5,695 $6,700 1.8×
Angiography extremity bilateral rs&i (75716) $6,800 $8,000 2.2×
Angiography extremity unilateral rs&i (75710) $5,015 $5,900 1.6×
Angiography pulmonary unilateral slctv rs&i (75741) $5,100 $6,000 1.6×
Ankle 2 views (73600)
range across 2 matching MRF lines		 $340–$382.50 $400–$450 varies
Aortography thoracic serialography rs&i (75605) $5,695 $6,700 1.0×
Artery X-Rays Abdomen (75726) $6,375 $7,500 1.1×
Artery X-Rays Pelvis (75736)
range across 2 matching MRF lines		 $5,355–$6,375 $6,300–$7,500 varies
Artery X-Rays Spine (75705) $3,825 $4,500 0.7×
Arthrogram ankle (73615) $220.15 $259 0.6×
Arthrogram hip (73525)
range across 2 matching MRF lines		 $680–$1,020 $800–$1,200 varies
Arthrogram Wrist (73115) $850 $1,000 2.4×
Basic radiation dosimetry calculation (77300)
range across 2 matching MRF lines		 $340–$552.50 $400–$650 varies
Bone age studies (77072)
range across 2 matching MRF lines		 $382.50–$391 $450–$460 varies
Bone Imaging 3 Phase (78315) $2,125 $2,500 5.3×
Bone Imaging Limited Area (78300) $1,062.50 $1,250 2.7×
Bone Imaging Whole Body (78306) $1,870 $2,200 4.7×
Bone survey infant (77076) $585.65 $689 5.6×
Brachytx isodose complex (77318) $935 $1,100 2.5×
Brachytx isodose intermed (77317) $1,020 $1,200 2.7×
Brachytx Isodose Plan Simple (77316) $340 $400 0.9×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $1,989 $2,340 3.7×
Brain Imaging Pet Metabolic Evaluation (78608) $5,780 $6,800 4.0×
Cardiac MRI w/w/o contrast & further seq (75561) $3,825 $4,500 10.9×
Cardiac MRI w/w/o contrast w/stress (75563) $3,626.10 $4,266 4.6×
Cat Scan Follow-Up Study (76380) $284.75 $335 3.3×
Cerebrospinal Fluid Scan (78630) $2,125 $2,500 3.9×
Chest 1 view (71045)
range across 2 matching MRF lines		 $340–$361.25 $400–$425 varies
Chest 2 views (71046) $425 $500 4.9×
Chest 3 views (71047)
range across 2 matching MRF lines		 $395.25–$403.75 $465–$475 varies
Chest 4 or more views (71048) $595 $700 5.7×
Cineradiograpy/vidradiograpy xcpt where spec (76120) $425 $500 4.1×
Cisternography Positive Contrast Rs&I (70015) $361.25 $425 0.5×
Clavicle complete (73000) $382.50 $450 4.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $255 $300 2.4×
Continuing medical physics consltj pr wk (77336) $850 $1,000 6.3×
Contrast Exam Abdominl Aorta (75625) $5,100 $6,000 1.6×
Contrast X-Ray Bladder (74430)
range across 2 matching MRF lines		 $510–$807.50 $600–$950 varies
Contrast X-Ray Of Elbow (73085)
range across 2 matching MRF lines		 $850–$935 $1,000–$1,100 varies
Contrast X-Ray Of Knee Joint (73580) $850 $1,000 2.4×
CT abdomen and pelvis without and with contrast (74178)
range across 2 matching MRF lines		 $2,125–$3,825 $2,500–$4,500 varies
CT abdomen and pelvis without contrast (74176)
range across 2 matching MRF lines		 $1,275–$2,125 $1,500–$2,500 varies
CT abdomen w contrast (74160)
range across 2 matching MRF lines		 $1,785–$2,550 $2,100–$3,000 varies
CT abdomen w wo contrast (74170)
range across 2 matching MRF lines		 $2,125–$3,060 $2,500–$3,600 varies
CT abdomen w/o contrast (74150)
range across 2 matching MRF lines		 $935–$1,870 $1,100–$2,200 varies
CT Angio Abdomen and Pelvis (74174)
range across 2 matching MRF lines		 $2,380–$3,315 $2,800–$3,900 varies
CT Angio Chest (71275)
range across 2 matching MRF lines		 $2,125–$2,975 $2,500–$3,500 varies
CT Angio Head (70496)
range across 2 matching MRF lines		 $2,125–$2,975 $2,500–$3,500 varies
CT angio hrt w/3d image (75574)
range across 2 matching MRF lines		 $2,125–$2,975 $2,500–$3,500 varies
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 2 matching MRF lines		 $2,125–$2,975 $2,500–$3,500 varies
CT Angio Neck (70498)
range across 2 matching MRF lines		 $2,125–$2,975 $2,500–$3,500 varies
Ct Angio Upr Extrm W/O&W/Dye (73206)
range across 2 matching MRF lines		 $2,125–$2,975 $2,500–$3,500 varies
CT cervical spine w/ contrast (72126)
range across 2 matching MRF lines		 $1,190–$2,550 $1,400–$3,000 varies
CT cervical spine w/o contrast (72125)
range across 2 matching MRF lines		 $1,020–$2,125 $1,200–$2,500 varies
CT cervical spine w/wo cont (72127)
range across 2 matching MRF lines		 $1,445–$2,720 $1,700–$3,200 varies
CT chest w contrast (71260)
range across 2 matching MRF lines		 $1,870–$2,720 $2,200–$3,200 varies
CT chest w/wo contrast (71270)
range across 2 matching MRF lines		 $1,955–$2,975 $2,300–$3,500 varies
CT head/brain with contrast (70460)
range across 2 matching MRF lines		 $1,190–$2,550 $1,400–$3,000 varies
CT head/brain without and with contrast (70470)
range across 2 matching MRF lines		 $1,445–$2,720 $1,700–$3,200 varies
CT heart contrast eval cardiac structure&morph (75572)
range across 2 matching MRF lines		 $1,700–$2,550 $2,000–$3,000 varies
CT heart no contrast quant eval coronry calcium (75571) $42.50 $50 0.5×
CT hrt w/3d image congen (75573) $2,805 $3,300 8.0×
CT iac w contrast (70481)
range across 2 matching MRF lines		 $1,190–$2,550 $1,400–$3,000 varies
CT l-spine w&w/o contrast (72133)
range across 2 matching MRF lines		 $1,870–$2,805 $2,200–$3,300 varies
CT lower ext w/o (73700)
range across 2 matching MRF lines		 $1,445–$2,125 $1,700–$2,500 varies
CT lower extremity w/contrast material (73701)
range across 2 matching MRF lines		 $1,700–$2,550 $2,000–$3,000 varies
CT lumbar spine w contrast (72132)
range across 2 matching MRF lines		 $1,190–$2,550 $1,400–$3,000 varies
CT lumbar spine w/o contrast (72131)
range across 2 matching MRF lines		 $1,020–$2,125 $1,200–$2,500 varies
CT maxillofacial w contrast (70487)
range across 2 matching MRF lines		 $1,190–$2,550 $1,400–$3,000 varies
CT maxillofacial wo contrast (70486)
range across 2 matching MRF lines		 $935–$1,955 $1,100–$2,300 varies
CT neck tissue combo (70492)
range across 2 matching MRF lines		 $1,445–$2,720 $1,700–$3,200 varies
Ct Orbit/Ear/Fossa W/O&W/Dye (70482)
range across 2 matching MRF lines		 $1,445–$2,720 $1,700–$3,200 varies
CT orbits w/o contrast (70480)
range across 2 matching MRF lines		 $1,275–$1,955 $1,500–$2,300 varies
CT pelvis w&w/o contrast (72194) $2,720 $3,200 15.5×
CT pelvis w/o contrast (72192)
range across 2 matching MRF lines		 $850–$1,785 $1,000–$2,100 varies
CT scan of leg combo (73702)
range across 2 matching MRF lines		 $2,125–$2,720 $2,500–$3,200 varies
CT scans face/jaw combo (70488)
range across 2 matching MRF lines		 $1,445–$2,720 $1,700–$3,200 varies
CT soft tissue neck w contrast (70491)
range across 2 matching MRF lines		 $1,190–$2,550 $1,400–$3,000 varies
CT soft tissue neck w/o contrast (70490)
range across 2 matching MRF lines		 $935–$1,955 $1,100–$2,300 varies
CT thoracic spine w contrast (72129)
range across 2 matching MRF lines		 $1,870–$2,720 $2,200–$3,200 varies
CT thoracic spine w/o contrast (72128)
range across 2 matching MRF lines		 $1,020–$1,955 $1,200–$2,300 varies
CT thoracic spine w/wo cont (72130)
range across 2 matching MRF lines		 $2,125–$2,975 $2,500–$3,500 varies
CT thorax w/o contrast (71250)
range across 2 matching MRF lines		 $1,105–$2,125 $1,300–$2,500 varies
CT upper ext wo (73200)
range across 2 matching MRF lines		 $935–$1,700 $1,100–$2,000 varies
CT upper extremity w/o & w/contrast material (73202) $2,550 $3,000 14.5×
CT upper extremity with contrast (73201)
range across 2 matching MRF lines		 $1,530–$2,125 $1,800–$2,500 varies
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635)
range across 2 matching MRF lines		 $2,125–$2,975 $2,500–$3,500 varies
Cta Abdomen (74175)
range across 2 matching MRF lines		 $2,125–$2,975 $2,500–$3,500 varies
CTA pelvis (72191)
range across 2 matching MRF lines		 $2,125–$2,975 $2,500–$3,500 varies
Dilation ureters/urethra rs&i (74485) $2,167.50 $2,550 1.0×
Doppler Echo Fetal Spectral Display Complete (76827) $488.75 $575 4.7×
Dxa Bone Density Axial (77080) $425 $500 4.1×
Dxa bone density study 1/>sites appendiclr skel (77081)
range across 2 matching MRF lines		 $212.50–$276.25 $250–$325 varies
Echo Guide For Artery Repair (76936) $1,020 $1,200 4.7×
Esophagram (74220) $680 $800 3.9×
Fetal Biophys Profile W/Nst (76818) $807.50 $950 7.7×
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 2 matching MRF lines		 $595–$680 $700–$800 varies
Fluoroscopy up to 1 hr (76000) $1,020 $1,200 4.3×
Follow-Up Angiography (75898) $1,368.50 $1,610 0.4×
Foot 2 views (73620)
range across 2 matching MRF lines		 $340–$382.50 $400–$450 varies
Forearm 2 views (73090) $425 $500 4.9×
Gastric emptying imaging study (78264) $1,870 $2,200 4.7×
Gated Heart Planar Single (78472) $1,368.50 $1,610 3.4×
Hand 2 views (73120)
range across 2 matching MRF lines		 $340–$382.50 $400–$450 varies
Heart Image (Pet) Multiple (78492) $4,760 $5,600 3.3×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $4,675 $5,500 1.5×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $4,675 $5,500 1.5×
Hepatobil Syst Image W/Drug (78227) $2,125 $2,500 3.9×
Hepatobiliary System Imaging (78226) $1,955 $2,300 4.9×
High energy neutron radj tx dlvr 1/> isocenter (77423) $1,785 $2,100 3.2×
Ht Muscle Image Spect Sing (78451) $3,527.50 $4,150 2.7×
Hysterosalpingogram (74740)
range across 2 matching MRF lines		 $680–$850 $800–$1,000 varies
Image fusion (77399) $382.50 $450 2.8×
Infant hip ultrasound, limited static exam (76886) $935 $1,100 10.7×
Interstitial radiation source applic complex (77778) $1,955 $2,300 2.8×
Intracavitary Radiation Source Applic Complex (77763) $2,040 $2,400 2.9×
Intracavitary Radiation Source Applic Intermed (77762) $1,700 $2,000 3.1×
Intracavitary radiation source applic simple (77761) $1,700 $2,000 3.1×
K Flow/Funct Image Multiple (78709) $2,125 $2,500 3.9×
K Flow/Funct Image W/Drug (78708) $1,870 $2,200 3.4×
K Flow/Funct Image W/O Drug (78707) $1,768 $2,080 3.3×
Knee 3 Views (73562)
range across 2 matching MRF lines		 $382.50–$467.50 $450–$550 varies
Liver & Spleen Imaging Static Only (78215) $1,062.50 $1,250 2.7×
Liver imaging static only (78201) $2,125 $2,500 3.9×
Lung perfusion differential (78597) $1,615 $1,900 4.0×
Lung Ventilat&Perfus Imaging (78582) $2,125 $2,500 3.9×
Lymph System Imaging (78195) $1,955 $2,300 3.6×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $5,015 $5,900 1.6×
Magnetic Image Jaw Joint (70336)
range across 2 matching MRF lines		 $1,955–$3,315 $2,300–$3,900 varies
Magnetic Resonance Elastography (76391) $1,003 $1,180 4.2×
Meckels Divert Exam (78290) $1,365.95 $1,607 3.4×
Mlc imrt design & construction per imrt plan (77338) $1,275 $1,500 3.4×
Mr safety determination physician/other qhp (76016) $403.75 $475 4.6×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $112.20 $132 3.9×
Mra Head W/O & W/Contrast Material (70546)
range across 2 matching MRF lines		 $1,955–$2,720 $2,300–$3,200 varies
MRA head w/o contrast (70544)
range across 2 matching MRF lines		 $1,190–$2,380 $1,400–$2,800 varies
MRA head with contrast (70545)
range across 2 matching MRF lines		 $1,275–$2,380 $1,500–$2,800 varies
MRA neck w contrast (70548) $2,210 $2,600 6.3×
Mra Neck W/O &W/Contrast Material (70549)
range across 2 matching MRF lines		 $1,955–$3,060 $2,300–$3,600 varies
MRA neck w/o contrast (70547)
range across 2 matching MRF lines		 $1,955–$2,550 $2,300–$3,000 varies
MRI abdomen w contrast (74182)
range across 2 matching MRF lines		 $1,955–$2,465 $2,300–$2,900 varies
MRI abdomen w/o contrast (74181)
range across 2 matching MRF lines		 $1,275–$2,125 $1,500–$2,500 varies
MRI any jt lower extrem w/contrast material (73722)
range across 2 matching MRF lines		 $1,870–$2,550 $2,200–$3,000 varies
MRI any jt lower extrem w/o & w/contrast matrl (73723)
range across 2 matching MRF lines		 $2,125–$3,400 $2,500–$4,000 varies
MRI any jt upper extremity w/contrast matrl (73222)
range across 2 matching MRF lines		 $2,125–$2,975 $2,500–$3,500 varies
MRI brain functional w/o physician admnistration (70554) $1,003 $1,180 4.2×
MRI Breast W/O Contrast Bilateral (77047) $1,700 $2,000 7.1×
MRI cardiac w/o cont stress (75559) $2,516.85 $2,961 4.6×
MRI cardiac w/o contrast (75557) $1,109.25 $1,305 4.6×
MRI cervical spine w contrast (72142)
range across 2 matching MRF lines		 $1,785–$2,550 $2,100–$3,000 varies
MRI cervical spine w/o cont (72141)
range across 2 matching MRF lines		 $1,275–$2,125 $1,500–$2,500 varies
MRI chest w/o contrast (71550)
range across 2 matching MRF lines		 $1,275–$2,550 $1,500–$3,000 varies
MRI chest wo w contrast (71552)
range across 2 matching MRF lines		 $2,125–$3,400 $2,500–$4,000 varies
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 2 matching MRF lines		 $2,125–$3,400 $2,500–$4,000 varies
MRI lower extrem oth/thn jt w/o contr matrl (73718)
range across 2 matching MRF lines		 $1,530–$2,380 $1,800–$2,800 varies
MRI lumbar spine w contrast (72149)
range across 2 matching MRF lines		 $1,785–$2,550 $2,100–$3,000 varies
Mri Neck Spine W/O & W/Dye (72156)
range across 2 matching MRF lines		 $2,125–$3,485 $2,500–$4,100 varies
MRI orbit face &/neck w/o contrast (70540) $1,262.25 $1,485 5.3×
Mri Orbt/Fac/Nck W/O &W/Dye (70543)
range across 2 matching MRF lines		 $2,125–$3,655 $2,500–$4,300 varies
MRI pelvis w/o & w contrast (72197)
range across 2 matching MRF lines		 $2,125–$3,400 $2,500–$4,000 varies
MRI pelvis w/o contrast (72195)
range across 2 matching MRF lines		 $1,275–$2,550 $1,500–$3,000 varies
MRI spectroscopy (76390) $374 $440 4.3×
MRI thoracic spine w/o contrast (72146)
range across 2 matching MRF lines		 $1,275–$2,125 $1,500–$2,500 varies
MRI upper extremity oth than jt w/contr matrl (73219) $2,975 $3,500 8.5×
MRI upper extremity oth than jt w/o contr matrl (73218)
range across 2 matching MRF lines		 $1,275–$2,380 $1,500–$2,800 varies
Mri Uppr Extremity W/O&W/Dye (73220)
range across 2 matching MRF lines		 $2,125–$3,400 $2,500–$4,000 varies
MRI, abdomen, combo (74183)
range across 2 matching MRF lines		 $2,125–$3,315 $2,500–$3,900 varies
MRI, dorsal spine combo (72157)
range across 2 matching MRF lines		 $2,125–$3,485 $2,500–$4,100 varies
MRI, dorsal spine contrast (72147)
range across 2 matching MRF lines		 $1,785–$2,550 $2,100–$3,000 varies
MRI, joint upper extrem (73221)
range across 2 matching MRF lines		 $1,275–$2,380 $1,500–$2,800 varies
MRI, joint upper extrem combo (73223)
range across 2 matching MRF lines		 $2,550–$3,400 $3,000–$4,000 varies
MRI, lumbar spine combo (72158)
range across 2 matching MRF lines		 $2,125–$3,485 $2,500–$4,100 varies
Myocardial Imaging Pet Metabolic Evaluation (78459) $4,250 $5,000 3.3×
Myocardial Spect Multiple Studies (78452) $4,590 $5,400 3.5×
Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) $4,760 $5,600 3.3×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $4,760 $5,600 3.3×
Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) $7,225 $8,500 3.3×
Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) $6,205 $7,300 2.8×
Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) $5,950 $7,000 3.9×
N-invas est c ffr sw aly CTA (75580) $3,400 $4,000 4.0×
Neck soft tissue (70360) $425 $500 4.9×
Nm csf leak detection (78650) $1,912.50 $2,250 1.5×
Nonvascular Shunt X-Ray (75809) $531.25 $625 5.1×
Ntsty modul radthx pln dose-vol histos (77301) $7,225 $8,500 5.2×
Nuclear Rx Intra-Arterial (79445) $459 $540 2.0×
Nuclear Rx Oral Admin (79005) $1,190 $1,400 5.1×
Ophthalmic Ultrasonic Foreign Body Localization (76529) $391 $460 4.5×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512)
range across 2 matching MRF lines		 $425–$595 $500–$700 varies
Panoramic X-ray of jaws (70355) $361.25 $425 4.1×
Parathyroid Planar Imaging (78070) $1,700 $2,000 4.2×
Pelvis 1 or 2 views (72170)
range across 2 matching MRF lines		 $340–$361.25 $400–$425 varies
Peritoneogram Rs&I (74190) $935 $1,100 1.7×
Pet Image W/Ct Lmtd (78814) $4,760 $5,600 3.3×
PET image w/CT, full body (78816) $7,310 $8,600 5.1×
PET imaging CT attenuation skull base mid-thigh (78815) $6,630 $7,800 4.6×
Pet Imaging Limited Area Chest Head/Neck (78811) $4,250 $5,000 3.3×
Pet Myocardial Sngl Study (78491) $4,760 $5,600 3.3×
Proton trmt simple w/comp (77522) $4,250 $5,000 3.4×
Proton tx delivery complex (77525) $4,250 $5,000 3.4×
Proton tx delivery intermediate (77523) $4,080 $4,800 3.3×
Proton tx delivery simple w/o compensation (77520) $1,785 $2,100 3.2×
Pulmonary Perfusion Imaging Particulate (78580) $1,445 $1,700 3.6×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022)
range across 2 matching MRF lines		 $340–$595 $400–$700 varies
Radex abscess/fistula/sinus tract rs&i (76080) $1,105 $1,300 2.0×
Radex Ankle Complete Minimum 3 Views (73610)
range across 2 matching MRF lines		 $467.50–$510 $550–$600 varies
Radex Calcaneus Minimum 2 Views (73650) $340 $400 3.9×
Radex elbow complete minimum 3 views (73080) $510 $600 5.9×
Radex Facial Bones Complete Minimum 3 Views (70150) $510 $600 4.9×
Radex fingr minimum 2 views (73140)
range across 2 matching MRF lines		 $340–$382.50 $400–$450 varies
Radex foot complete minimum 3 views (73630)
range across 2 matching MRF lines		 $467.50–$510 $550–$600 varies
Radex Hand Minimum 3 Views (73130) $510 $600 5.9×
Radex lower extremity infant minimum 2 views (73592)
range across 2 matching MRF lines		 $382.50–$425 $450–$500 varies
Radex Nasal Bones Complete Minimum 3 Views (70160) $425 $500 4.9×
Radex Ribs Unilateral 2 Views (71100) $425 $500 4.9×
Radex shoulder complete minimum 2 views (73030) $425 $500 4.9×
Radex Sinuses Paransl < 3 Views (70210) $361.25 $425 4.1×
Radex Spine 1 View Specify Level (72020)
range across 2 matching MRF lines		 $340–$361.25 $400–$425 varies
Radex Sternum Minimum 2 Views (71120) $425 $500 4.9×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $510 $600 5.9×
Radex Toe Minimum 2 Views (73660)
range across 2 matching MRF lines		 $340–$382.50 $400–$450 varies
Radex upper extremity infant minimum 2 views (73092) $420.75 $495 4.0×
Radex Wrist Complete Minimum 3 Views (73110) $510 $600 5.9×
Radiation Delivery Stereotactic Cranial Linear (77372) $23,800 $28,000 3.2×
Radiation treatment delivery level 1 (77402) $425 $500 4.2×
Radiation treatment delivery level 2 (77407) $340 $400 0.9×
Radiation treatment delivery level 3 (77412) $1,020 $1,200 1.8×
Radiolog exam mandible compl minimum 4 views (70110) $510 $600 4.9×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021)
range across 2 matching MRF lines		 $340–$595 $400–$700 varies
Radiologic exam colon double contrast study (74280) $1,105 $1,300 6.3×
Radiologic exam colon single contrast study (74270) $1,020 $1,200 5.8×
Radiologic exam knee complete 4/more views (73564)
range across 2 matching MRF lines		 $467.50–$510 $550–$600 varies
Radiologic exam pelvis compl minimum 3 views (72190) $510 $600 4.9×
Radiologic Exam Small Int Single Contrast Study (74250) $935 $1,100 5.3×
Radiologic exam swallow function contrast study (74230)
range across 2 matching MRF lines		 $705.50–$722.50 $830–$850 varies
Radiologic exam teeth complete full mouth (70320) $722.50 $850 3.0×
Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) $765 $900 3.2×
Radiologic exam upr gi trc double contrast study (74246)
range across 2 matching MRF lines		 $1,105–$1,275 $1,300–$1,500 varies
Radiologic examination femur 1 view (73551)
range across 2 matching MRF lines		 $340–$361.25 $400–$425 varies
Radiologic examination femur minimum 2 views (73552) $425 $500 4.9×
Radiologic examination knee 1/2 views (73560)
range across 2 matching MRF lines		 $340–$382.50 $400–$450 varies
Radiologic examination tibia & fibula 2 views (73590)
range across 2 matching MRF lines		 $340–$382.50 $400–$450 varies
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) $637.50 $750 1.7×
Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) $616.25 $725 1.6×
Ribs bilateral 3 views (71110) $531.25 $625 5.1×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,615 $1,900 4.0×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $3,740 $4,400 6.9×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $3,400 $4,000 6.3×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $3,400 $4,000 6.3×
Rp Therapy Intravenous Administration (79101) $850 $1,000 3.6×
Scapula (73010) $425 $500 4.1×
Screening Digital Breast Tomosynthesis Bi (77063)
range across 2 matching MRF lines		 $76.50–$85 $90–$100 varies
Shoulder 1 view (73020)
range across 2 matching MRF lines		 $340–$361.25 $400–$425 varies
Shoulder Arthrography (73040) $1,105 $1,300 3.2×
Skull less than 4 views (70250) $425 $500 4.1×
Special dosimetry (77331) $425 $500 3.2×
Special Physics Consult (77370) $680 $800 5.1×
Special teletherapy port plan (77321) $1,105 $1,300 2.9×
Special treatment procedure (77470) $2,720 $3,200 4.9×
Srs Multisource (77371) $25,330 $29,800 3.4×
Stereotactic Body Radiation Delivery (77373) $5,525 $6,500 3.1×
Sternoclavicular joints (71130) $510 $600 5.9×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,275 $1,500 3.4×
Telethx isodose pln smpl w/dosimetry calculation (77306) $480.25 $565 1.3×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $1,530 $1,800 4.1×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $935 $1,100 2.5×
Ther rad simulaj-aided field setting simple (77280) $1,020 $1,200 7.6×
Thoracic spine 2 views (72070) $425 $500 4.1×
Thoracic spine 3 views (72072) $510 $600 4.9×
Thoracolumbar 2 views (72080) $425 $500 4.9×
Thyroid Met Imaging Body (78018) $2,040 $2,400 3.8×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,870 $2,200 4.7×
Tx Devices Design & Construction Complex (77334) $1,445 $1,700 3.9×
Tx devices design & construction intermediate (77333) $637.50 $750 4.7×
Tx devices design & construction simple (77332) $255 $300 1.9×
Ultrasound Breast Limited (76642)
range across 2 matching MRF lines		 $425–$510 $500–$600 varies
Ultrasound Elastography Parenchyma (76981) $595 $700 5.7×
Ultrasound Exam Aaa Screen (76706) $510 $600 4.9×
Ultrasound, abdomen limited (76705)
range across 3 matching MRF lines		 $765–$935 $900–$1,100 varies
Umbilical-artery Doppler (OB) (76820) $255 $300 2.4×
Unlisted fluoroscopic procedure (76496) $510 $600 5.9×
Unlisted magnetic resonance procedure (76498)
range across 2 matching MRF lines		 $1,785–$2,380 $2,100–$2,800 varies
Unlisted us procedure (76999) $425 $500 4.9×
Upper gi w/o kub (74240)
range across 2 matching MRF lines		 $935–$1,020 $1,100–$1,200 varies
Urethrocystogram voiding (74455) $1,483.25 $1,745 6.2×
Urethrocystography retrograde (74450) $263.50 $310 1.1×
Us breast unilateral complete (76641)
range across 2 matching MRF lines		 $637.50–$765 $750–$900 varies
Us chest (76604)
range across 2 matching MRF lines		 $595–$616.25 $700–$725 varies
Us complete joint (76881)
range across 2 matching MRF lines		 $595–$850 $700–$1,000 varies
Us exam, pelvic, limited (76857)
range across 2 matching MRF lines		 $510–$595 $600–$700 varies
Us kidney transplant (76776)
range across 2 matching MRF lines		 $680–$935 $800–$1,100 varies
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 2 matching MRF lines		 $510–$765 $600–$900 varies
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines		 $595–$637.50 $700–$750 varies
Us ob transvaginal (76817)
range across 2 matching MRF lines		 $765–$807.50 $900–$950 varies
Us pelvic non ob complete (76856)
range across 2 matching MRF lines		 $850–$1,020 $1,000–$1,200 varies
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801)
range across 2 matching MRF lines		 $510–$765 $600–$900 varies
Us preg uterus real time f/u trnsabdl per fetus (76816)
range across 2 matching MRF lines		 $255–$510 $300–$600 varies
Us retroperitoneal limited (76775)
range across 2 matching MRF lines		 $595–$850 $700–$1,000 varies
Us spinal canal and contents (76800)
range across 2 matching MRF lines		 $595–$935 $700–$1,100 varies
Us thyroid (76536)
range across 2 matching MRF lines		 $595–$935 $700–$1,100 varies
Us transrectal (76872) $603.50 $710 5.8×
Vein X-Ray Chest (75827) $2,550 $3,000 1.6×
Venogram Sinus/Jugular (75860) $4,675 $5,500 1.5×
Venography caval inferior serialography rs&i (75825) $5,100 $6,000 1.6×
Venography extremity bilateral rs&i (75822)
range across 2 matching MRF lines		 $1,700–$2,550 $2,000–$3,000 varies
Venography extremity unilateral rs&i (75820)
range across 2 matching MRF lines		 $1,700–$2,125 $2,000–$2,500 varies
Venography Renal Bilateral (75833) $5,015 $5,900 1.6×
Venography Renal Unilateral (75831) $4,675 $5,500 1.5×
Venous sampling by catheter (75893) $4,845 $5,700 0.9×
Wrist 2 views (73100)
range across 2 matching MRF lines		 $340–$382.50 $400–$450 varies
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $340 $400 3.9×
X-ray antegrade pyelogram tube (74425)
range across 2 matching MRF lines		 $680–$850 $800–$1,000 varies
X-Ray Aorta Leg Arteries (75630) $5,950 $7,000 1.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $425 $500 4.9×
X-Ray Exam Breast Specimen (76098) $935 $1,100 1.7×
X-Ray Exam Entire Spi 1 Vw (72081) $323.85 $381 3.7×
X-Ray Exam Entire Spi 2/3 Vw (72082)
range across 2 matching MRF lines		 $595–$637.50 $700–$750 varies
X-Ray Exam Hip Uni 1 View (73501)
range across 2 matching MRF lines		 $340–$361.25 $400–$425 varies
X-Ray Exam Hip Uni 2-3 Views (73502) $510 $600 5.9×
X-Ray Exam Hip Uni 4/> Views (73503) $595 $700 5.7×
X-Ray Exam Hips Bi 2 Views (73521) $510 $600 4.9×
X-Ray Exam Hips Bi 3-4 Views (73522) $425 $500 4.1×
X-Ray Exam Hips Bi 5/> Views (73523)
range across 2 matching MRF lines		 $595–$850 $700–$1,000 varies
X-Ray Exam L-S Spine Bending (72114)
range across 2 matching MRF lines		 $765–$807.50 $900–$950 varies
X-Ray Exam Neck Spine 2-3 Vw (72040) $510 $600 5.9×
X-Ray Exam Neck Spine 6/>Vws (72052) $680 $800 6.5×
X-Ray Exam Unilat Ribs/Chest (71101) $510 $600 4.9×
X-ray eye for foreign body (70030) $510 $600 5.9×
X-ray humerus (73060) $425 $500 4.9×
X-ray IV pyelogram+tomography (74415) $770.10 $906 4.4×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $425 $500 4.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $425 $500 4.1×
X-ray nose-rectum child f.b. (76010)
range across 2 matching MRF lines		 $170–$340 $200–$400 varies
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $552.50 $650 5.3×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $510 $600 4.9×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $425 $500 4.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $510 $600 5.9×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $531.25 $625 5.1×
X-Ray Urinary Tract Exam With Contrast Material (74420)
range across 2 matching MRF lines		 $850–$1,105 $1,000–$1,300 varies
X-Rays Bone Length Studies (77073)
range across 2 matching MRF lines		 $595–$637.50 $700–$750 varies
X-Rays Bone Survey Complete (77075) $680 $800 6.5×
Xr c-spine 4 or 5 views (72050) $531.25 $625 5.1×
Xr facial bones less than 3 views (70140) $425 $500 4.9×
Xr orbits complete 4 views (70200) $510 $600 4.9×

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.