Imaging prices at Munson Healthcare Otsego Memorial Hospital
Gaylord, MI · every code in this section with a posted price and a Medicare benchmark.
280 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) | $225.25 | $265 | 2.6× |
| Abdomen 2 views (74019) | $241.40 | $284 | 2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,734.85 | $2,041 | 4.4× |
| Angiography extremity bilateral rs&i (75716) | $4,166.70 | $4,902 | 1.3× |
| Angiography extremity unilateral rs&i (75710) | $4,465.05 | $5,253 | 1.4× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$214.20–$249.05 | $252–$293 | varies |
| Aortography thoracic serialography rs&i (75605) | $4,845.85 | $5,701 | 0.9× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$421.60 | $496 | 0.1× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$650.25–$680 | $765–$800 | varies |
| Arthrogram hip (73525) range across 5 matching MRF lines |
$516.80–$783.70 | $608–$922 | varies |
| Arthrogram Wrist (73115) range across 4 matching MRF lines |
$824.50–$1,231.65 | $970–$1,449 | varies |
| Bone age studies (77072) | $198.90 | $234 | 1.9× |
| Bone Imaging 3 Phase (78315) range across 4 matching MRF lines |
$1,715.30–$1,834.30 | $2,018–$2,158 | varies |
| Bone Imaging Limited Area (78300) | $1,149.20 | $1,352 | 2.9× |
| Bone Imaging Whole Body (78306) range across 6 matching MRF lines |
$1,487.50–$1,591.20 | $1,750–$1,872 | varies |
| Bone marrow imaging; multiple areas (78103) range across 3 matching MRF lines |
$99.45–$1,155.15 | $117–$1,359 | varies |
| Bone survey infant (77076) | $413.95 | $487 | 4.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,732.30 | $2,038 | 3.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,543.25 | $5,345 | 3.2× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,722.10 | $2,026 | 4.3× |
| Cerebrospinal Fluid Scan (78630) range across 5 matching MRF lines |
$1,756.10–$2,163.25 | $2,066–$2,545 | varies |
| Chest 1 view (71045) range across 9 matching MRF lines |
$202.30–$211.65 | $238–$249 | varies |
| Chest 2 views (71046) range across 5 matching MRF lines |
$249.90–$564.40 | $294–$664 | varies |
| Chest 3 views (71047) | $302.60 | $356 | 3.5× |
| Chest 4 or more views (71048) | $379.10 | $446 | 3.6× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $294.10 | $346 | 2.8× |
| Clavicle complete (73000) | $224.40 | $264 | 2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $548.25 | $645 | 5.3× |
| Contrast Exam Abdominl Aorta (75625) | $4,394.50 | $5,170 | 1.4× |
| Contrast X-Ray Bladder (74430) | $616.25 | $725 | 1.8× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$360.40–$1,013.20 | $424–$1,192 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 6 matching MRF lines |
$412.25–$668.10 | $485–$786 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $3,648.20 | $4,292 | 10.5× |
| CT abdomen and pelvis without contrast (74176) range across 8 matching MRF lines |
$2,391.05–$2,499.85 | $2,813–$2,941 | varies |
| CT abdomen w contrast (74160) range across 9 matching MRF lines |
$1,761.20–$1,841.10 | $2,072–$2,166 | varies |
| CT abdomen w wo contrast (74170) range across 7 matching MRF lines |
$2,235.50–$2,337.50 | $2,630–$2,750 | varies |
| CT abdomen w/o contrast (74150) range across 9 matching MRF lines |
$1,297.10–$1,355.75 | $1,526–$1,595 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 9 matching MRF lines |
$2,972.45–$3,106.75 | $3,497–$3,655 | varies |
| CT Angio Chest (71275) range across 8 matching MRF lines |
$2,078.25–$2,173.45 | $2,445–$2,557 | varies |
| CT Angio Head (70496) | $2,054.45 | $2,417 | 11.8× |
| CT angio hrt w/3d image (75574) | $2,576.35 | $3,031 | 7.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$479.40–$2,182.80 | $564–$2,568 | varies |
| CT Angio Neck (70498) | $2,320.50 | $2,730 | 13.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,182.80 | $2,568 | 12.5× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $228.65 | $269 | 1.3× |
| CT cervical spine w/ contrast (72126) | $1,641.35 | $1,931 | 4.7× |
| CT cervical spine w/o contrast (72125) | $1,431.40 | $1,684 | 13.7× |
| CT cervical spine w/wo cont (72127) | $1,739.10 | $2,046 | 10.0× |
| CT chest w contrast (71260) range across 8 matching MRF lines |
$1,745.90–$1,824.95 | $2,054–$2,147 | varies |
| CT chest w/wo contrast (71270) | $2,236.35 | $2,631 | 12.8× |
| CT head/brain with contrast (70460) | $1,729.75 | $2,035 | 9.9× |
| CT head/brain without and with contrast (70470) | $2,048.50 | $2,410 | 11.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,361.70 | $1,602 | 3.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $473.45 | $557 | 5.5× |
| CT iac w contrast (70481) | $1,978.80 | $2,328 | 11.3× |
| CT l-spine w&w/o contrast (72133) | $3,124.60 | $3,676 | 17.9× |
| CT lower ext w/o (73700) range across 6 matching MRF lines |
$1,308.15–$1,368.50 | $1,539–$1,610 | varies |
| CT lower extremity w/contrast material (73701) | $1,781.60 | $2,096 | 10.2× |
| CT lumbar spine w contrast (72132) | $1,868.30 | $2,198 | 5.4× |
| CT lumbar spine w/o contrast (72131) | $1,439.90 | $1,694 | 13.8× |
| CT maxillofacial w contrast (70487) | $1,648.15 | $1,939 | 9.4× |
| CT maxillofacial wo contrast (70486) | $1,251.20 | $1,472 | 12.0× |
| CT neck tissue combo (70492) | $2,182.80 | $2,568 | 12.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,284.80 | $2,688 | 13.1× |
| CT orbits w/o contrast (70480) | $1,531.70 | $1,802 | 14.7× |
| CT pelvis w&w/o contrast (72194) | $1,813.90 | $2,134 | 10.4× |
| CT pelvis w/o contrast (72192) | $1,320.05 | $1,553 | 12.7× |
| CT scan of leg combo (73702) | $1,897.20 | $2,232 | 10.9× |
| CT scans face/jaw combo (70488) | $1,730.60 | $2,036 | 9.9× |
| CT soft tissue neck w contrast (70491) range across 5 matching MRF lines |
$1,617.55–$1,698.30 | $1,903–$1,998 | varies |
| CT soft tissue neck w/o contrast (70490) range across 5 matching MRF lines |
$1,212.10–$1,272.45 | $1,426–$1,497 | varies |
| CT thoracic spine w contrast (72129) | $1,884.45 | $2,217 | 10.8× |
| CT thoracic spine w/o contrast (72128) | $1,422.05 | $1,673 | 13.7× |
| CT thoracic spine w/wo cont (72130) | $2,104.60 | $2,476 | 12.0× |
| CT thorax w/o contrast (71250) | $1,337.90 | $1,574 | 12.8× |
| CT unlisted procedure (76497) | $707.20 | $832 | 8.2× |
| CT upper ext wo (73200) | $1,310.70 | $1,542 | 12.6× |
| CT upper extremity w/o & w/contrast material (73202) | $2,030.65 | $2,389 | 11.6× |
| CT upper extremity with contrast (73201) | $1,846.20 | $2,172 | 5.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,276.30 | $2,678 | 13.0× |
| Cta Abdomen (74175) range across 5 matching MRF lines |
$2,136.90–$2,704.70 | $2,514–$3,182 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,240.60 | $2,636 | 6.4× |
| CTA pelvis (72191) | $1,932.90 | $2,274 | 11.1× |
| Dxa Bone Density Axial (77080) | $493 | $580 | 4.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $289 | $340 | 3.3× |
| Echo exam uterus (76831) | $344.25 | $405 | 1.4× |
| Esophagram (74220) | $510.85 | $601 | 2.9× |
| Fetal Biophys Profile W/Nst (76818) | $715.70 | $842 | 6.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 18 matching MRF lines |
$445.40–$746.30 | $524–$878 | varies |
| Fluoroscopy up to 1 hr (76000) | $791.35 | $931 | 3.3× |
| Foot 2 views (73620) | $205.70 | $242 | 2.4× |
| Forearm 2 views (73090) | $220.15 | $259 | 2.5× |
| Gastric emptying imaging study (78264) | $1,813.90 | $2,134 | 4.6× |
| Gastroesophageal Reflux Exam (78262) | $306.85 | $361 | 0.8× |
| Gated Heart Planar Single (78472) range across 5 matching MRF lines |
$309.40–$1,292 | $364–$1,520 | varies |
| Hand 2 views (73120) | $194.65 | $229 | 1.9× |
| Hepatobil Syst Image W/Drug (78227) | $2,289.90 | $2,694 | 4.2× |
| Hepatobiliary System Imaging (78226) | $1,681.30 | $1,978 | 4.2× |
| Ht Muscle Image Spect Sing (78451) range across 3 matching MRF lines |
$1,682.15–$2,805 | $1,979–$3,300 | varies |
| Hysterosalpingogram (74740) | $665.55 | $783 | 2.8× |
| K Flow/Funct Image Multiple (78709) | $777.75 | $915 | 1.4× |
| K Flow/Funct Image W/Drug (78708) | $777.75 | $915 | 1.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 3 matching MRF lines |
$777.75–$1,212.95 | $915–$1,427 | varies |
| Knee 3 Views (73562) range across 5 matching MRF lines |
$267.75–$280.50 | $315–$330 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,062.50 | $1,250 | 2.7× |
| Lung Perf&Ventilat Diferentl (78598) | $886.55 | $1,043 | 1.6× |
| Lung Ventilat&Perfus Imaging (78582) | $978.35 | $1,151 | 1.8× |
| Lung Ventilation Imaging (78579) | $1,010.65 | $1,189 | 2.5× |
| Lymph System Imaging (78195) | $1,717 | $2,020 | 3.2× |
| Magnetic Image Jaw Joint (70336) | $2,307.75 | $2,715 | 9.7× |
| Meckels Divert Exam (78290) | $997.05 | $1,173 | 2.5× |
| Mra Head W/O & W/Contrast Material (70546) | $3,915.10 | $4,606 | 11.3× |
| MRA head w/o contrast (70544) | $2,773.55 | $3,263 | 11.7× |
| MRA head with contrast (70545) | $2,901.90 | $3,414 | 8.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,100.40 | $4,824 | 11.8× |
| MRA neck w/o contrast (70547) | $2,482.85 | $2,921 | 10.4× |
| MRI abdomen w contrast (74182) | $2,065.50 | $2,430 | 5.9× |
| MRI abdomen w/o contrast (74181) | $2,085.05 | $2,453 | 8.8× |
| MRI any jt lower extrem w/contrast material (73722) | $2,820.30 | $3,318 | 3.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,627.80 | $4,268 | 10.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,958 | $3,480 | 3.8× |
| MRI bone marrow blood supply (77084) | $1,341.30 | $1,578 | 5.6× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,258.45 | $2,657 | 9.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,484.10 | $1,746 | 6.2× |
| MRI cervical spine w contrast (72142) | $2,624.80 | $3,088 | 7.6× |
| MRI cervical spine w/o cont (72141) | $2,285.65 | $2,689 | 9.6× |
| MRI chest w/o contrast (71550) | $2,690.25 | $3,165 | 11.3× |
| MRI chest wo w contrast (71552) | $4,143.75 | $4,875 | 11.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,986.05 | $3,513 | 8.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,807.15 | $4,479 | 11.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,842.40 | $3,344 | 12.0× |
| MRI lumbar spine w contrast (72149) | $3,133.10 | $3,686 | 9.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,079.15 | $4,799 | 11.7× |
| MRI orbit face &/neck w/o contrast (70540) | $3,070.20 | $3,612 | 12.9× |
| MRI orbit face neck w contrast (70542) | $2,649.45 | $3,117 | 7.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,908.30 | $4,598 | 11.2× |
| MRI pelvis w contrast (72196) | $2,436.95 | $2,867 | 7.0× |
| MRI pelvis w/o & w contrast (72197) | $3,844.55 | $4,523 | 11.1× |
| MRI pelvis w/o contrast (72195) range across 5 matching MRF lines |
$2,368.10–$2,475.20 | $2,786–$2,912 | varies |
| MRI thoracic spine w/o contrast (72146) | $2,331.55 | $2,743 | 9.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,876.40 | $3,384 | 8.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,391.05 | $2,813 | 10.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,601.45 | $4,237 | 10.4× |
| MRI, abdomen, combo (74183) | $3,621 | $4,260 | 10.4× |
| MRI, dorsal spine combo (72157) | $4,075.75 | $4,795 | 11.7× |
| MRI, dorsal spine contrast (72147) | $2,623.95 | $3,087 | 7.5× |
| MRI, joint upper extrem (73221) | $2,384.25 | $2,805 | 10.0× |
| MRI, joint upper extrem combo (73223) | $3,691.55 | $4,343 | 10.6× |
| MRI, lumbar spine combo (72158) | $4,046.85 | $4,761 | 11.6× |
| Myelogram cervical (72240) | $1,611.60 | $1,896 | 2.1× |
| Myelogram Lumbar (72265) | $1,865.75 | $2,195 | 2.4× |
| Myelograpy 2/more regions rs&i (72270) | $2,163.25 | $2,545 | 2.8× |
| Myocardial Spect Multiple Studies (78452) range across 6 matching MRF lines |
$3,182.40–$3,556.40 | $3,744–$4,184 | varies |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $943.50 | $1,110 | 0.7× |
| N-invas est c ffr sw aly CTA (75580) | $4,455.70 | $5,242 | 5.2× |
| Neck soft tissue (70360) | $221 | $260 | 2.5× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $702.10 | $826 | 5.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$335.75–$370.60 | $395–$436 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,480.70 | $1,742 | 2.7× |
| Parathyroid Planar Imaging (78070) | $1,480.70 | $1,742 | 3.7× |
| Pelvis 1 or 2 views (72170) | $210.80 | $248 | 2.0× |
| Pet Image W/Ct Lmtd (78814) | $4,543.25 | $5,345 | 3.2× |
| PET image w/CT, full body (78816) range across 13 matching MRF lines |
$5,322.70–$5,564.95 | $6,262–$6,547 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,519.90 | $6,494 | 3.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $927.35 | $1,091 | 2.3× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,211.25 | $1,425 | 1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $369.75 | $435 | 3.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 7 matching MRF lines |
$573.75–$1,095.65 | $675–$1,289 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$247.35–$290.70 | $291–$342 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $205.70 | $242 | 2.4× |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$221.85–$232.05 | $261–$273 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $393.55 | $463 | 3.8× |
| Radex fingr minimum 2 views (73140) | $201.45 | $237 | 2.3× |
| Radex foot complete minimum 3 views (73630) | $250.75 | $295 | 2.9× |
| Radex Hand Minimum 3 Views (73130) | $246.50 | $290 | 2.8× |
| Radex lower extremity infant minimum 2 views (73592) | $162.35 | $191 | 1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $248.20 | $292 | 2.9× |
| Radex Ribs Unilateral 2 Views (71100) | $239.70 | $282 | 2.8× |
| Radex shoulder complete minimum 2 views (73030) | $249.05 | $293 | 2.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $209.10 | $246 | 2.4× |
| Radex Spine 1 View Specify Level (72020) | $224.40 | $264 | 2.6× |
| Radex Sternum Minimum 2 Views (71120) | $249.05 | $293 | 2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $332.35 | $391 | 3.8× |
| Radex Toe Minimum 2 Views (73660) | $209.95 | $247 | 2.4× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 5 matching MRF lines |
$236.30–$247.35 | $278–$291 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $355.30 | $418 | 3.4× |
| Radiologic exam colon double contrast study (74280) | $971.55 | $1,143 | 5.6× |
| Radiologic exam colon single contrast study (74270) | $680.85 | $801 | 3.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $787.10 | $926 | 4.5× |
| Radiologic exam knee complete 4/more views (73564) | $330.65 | $389 | 3.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $290.70 | $342 | 2.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $497.25 | $585 | 2.8× |
| Radiologic exam swallow function contrast study (74230) | $616.25 | $725 | 3.5× |
| Radiologic exam upr gi trc double contrast study (74246) range across 5 matching MRF lines |
$671.50–$701.25 | $790–$825 | varies |
| Radiologic examination femur minimum 2 views (73552) | $248.20 | $292 | 2.9× |
| Radiologic examination knee 1/2 views (73560) | $198.05 | $233 | 2.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $269.45 | $317 | 3.1× |
| Ribs bilateral 3 views (71110) | $393.55 | $463 | 3.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 6 matching MRF lines |
$1,391.45–$2,163.25 | $1,637–$2,545 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,422.95 | $4,027 | 6.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 7 matching MRF lines |
$268.60–$2,470.10 | $316–$2,906 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,852.20 | $4,532 | 3.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $4,709 | $5,540 | 3.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 10 matching MRF lines |
$2,470.10–$2,603.55 | $2,906–$3,063 | varies |
| Scapula (73010) | $268.60 | $316 | 2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $70.55 | $83 | 3.0× |
| Shoulder 1 view (73020) | $212.50 | $250 | 2.5× |
| Shoulder Arthrography (73040) range across 7 matching MRF lines |
$345.95–$605.20 | $407–$712 | varies |
| Sialogram (70390) | $1,075.25 | $1,265 | 4.5× |
| Skull less than 4 views (70250) | $291.55 | $343 | 2.8× |
| Sternoclavicular joints (71130) | $243.95 | $287 | 2.8× |
| Testicular Imaging W/Flow (78761) | $1,091.40 | $1,284 | 2.7× |
| Thoracic spine 2 views (72070) | $226.10 | $266 | 2.2× |
| Thoracic spine 3 views (72072) | $336.60 | $396 | 3.2× |
| Thoracolumbar 2 views (72080) | $284.75 | $335 | 3.3× |
| Thyroid Imaging With Vascular Flow (78013) | $1,095.65 | $1,289 | 2.8× |
| Thyroid Met Imaging Body (78018) | $1,205.30 | $1,418 | 2.2× |
| Thyroid Uptake Measurement (78012) | $352.75 | $415 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,239.30 | $1,458 | 3.1× |
| Ultrasound Breast Limited (76642) range across 7 matching MRF lines |
$353.60–$621.35 | $416–$731 | varies |
| Ultrasound Exam Aaa Screen (76706) | $507.45 | $597 | 4.9× |
| Ultrasound, abdomen limited (76705) range across 12 matching MRF lines |
$556.75–$734.40 | $655–$864 | varies |
| Umbilical-artery Doppler (OB) (76820) | $494.70 | $582 | 4.7× |
| Unlisted us procedure (76999) | $384.20 | $452 | 4.4× |
| Upper gi w/o kub (74240) range across 6 matching MRF lines |
$572.05–$596.70 | $673–$702 | varies |
| Ureteral Reflux Study (78740) | $445.40 | $524 | 1.1× |
| Urethrocystogram voiding (74455) | $782.85 | $921 | 3.3× |
| Urethrocystography retrograde (74450) | $546.55 | $643 | 2.3× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$452.20–$453.05 | $532–$533 | varies |
| Us chest (76604) range across 10 matching MRF lines |
$370.60–$650.25 | $436–$765 | varies |
| Us exam, pelvic, limited (76857) range across 6 matching MRF lines |
$370.60–$502.35 | $436–$591 | varies |
| Us head (76506) | $529.55 | $623 | 5.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 16 matching MRF lines |
$353.60–$778.60 | $416–$916 | varies |
| Us ob detailed single fetus (76811) range across 9 matching MRF lines |
$854.25–$878.05 | $1,005–$1,033 | varies |
| Us ob limited 1 or more fetuses (76815) range across 8 matching MRF lines |
$370.60–$720.80 | $436–$848 | varies |
| Us pelvic non ob complete (76856) range across 5 matching MRF lines |
$701.25–$702.95 | $825–$827 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 12 matching MRF lines |
$658.75–$689.35 | $775–$811 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $612 | $720 | 5.9× |
| Us retroperitoneal complete (76770) range across 5 matching MRF lines |
$678.30–$709.75 | $798–$835 | varies |
| Us retroperitoneal limited (76775) range across 5 matching MRF lines |
$370.60–$676.60 | $436–$796 | varies |
| Us scrotum and contents (76870) range across 6 matching MRF lines |
$581.40–$607.75 | $684–$715 | varies |
| Us spinal canal and contents (76800) | $524.45 | $617 | 5.0× |
| Us thyroid (76536) | $617.95 | $727 | 5.9× |
| Us transrectal (76872) range across 5 matching MRF lines |
$729.30–$953.70 | $858–$1,122 | varies |
| Venography caval inferior serialography rs&i (75825) | $4,113.15 | $4,839 | 1.3× |
| Venography extremity bilateral rs&i (75822) | $141.10 | $166 | 0.1× |
| Venography extremity unilateral rs&i (75820) | $2,011.95 | $2,367 | 1.3× |
| Wrist 2 views (73100) | $208.25 | $245 | 2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $277.95 | $327 | 3.2× |
| X-ray antegrade pyelogram tube (74425) range across 9 matching MRF lines |
$695.30–$2,062.10 | $818–$2,426 | varies |
| X-Ray Aorta Leg Arteries (75630) | $3,869.20 | $4,552 | 1.2× |
| X-Ray Bend Only L-S Spine (72120) | $547.40 | $644 | 5.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $213.35 | $251 | 2.5× |
| X-Ray Exam Breast Specimen (76098) range across 8 matching MRF lines |
$684.25–$715.70 | $805–$842 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $96.05 | $113 | 1.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $371.45 | $437 | 3.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $212.50 | $250 | 2.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 5 matching MRF lines |
$262.65–$273.70 | $309–$322 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $326.40 | $384 | 3.1× |
| X-Ray Exam L-S Spine Bending (72114) | $377.40 | $444 | 3.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $266.90 | $314 | 3.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $431.80 | $508 | 4.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$360.40–$376.55 | $424–$443 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$220.15–$264.35 | $259–$311 | varies |
| X-ray IV pyelogram (ivp) (74400) | $997.90 | $1,174 | 5.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $244.80 | $288 | 2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $284.75 | $335 | 2.7× |
| X-ray nose-rectum child f.b. (76010) | $181.05 | $213 | 2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $408 | $480 | 3.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $224.40 | $264 | 2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $269.45 | $317 | 3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $326.40 | $384 | 3.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $442.85 | $521 | 4.3× |
| X-ray thoracic spine 4 vw (72074) | $536.35 | $631 | 5.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $782 | $920 | 2.2× |
| X-Rays Bone Length Studies (77073) | $348.50 | $410 | 3.3× |
| X-Rays Bone Survey Complete (77075) | $455.60 | $536 | 4.4× |
| Xr c-spine 4 or 5 views (72050) | $357.85 | $421 | 3.4× |
| Xr facial bones less than 3 views (70140) | $229.50 | $270 | 2.6× |
| Xr orbits complete 4 views (70200) | $325.55 | $383 | 3.1× |
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.