Imaging prices at Nacogdoches Medical Center
Nacogdoches, TX · every code in this section with a posted price and a Medicare benchmark.
305 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $6,885 | $9,180 | 5.0× |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$671.25–$915 | $895–$1,220 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$855.75–$1,490.25 | $1,141–$1,987 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,742.75 | $3,657 | 6.8× |
| Adrenal Cortex & Medulla Img (78075) | $4,398 | $5,864 | 3.4× |
| Angio internal mammary (75756) | $8,730.75 | $11,641 | 2.8× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$8,658–$9,280.50 | $11,544–$12,374 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$6,885–$8,457.75 | $9,180–$11,277 | varies |
| Ankle 2 views (73600) | $1,563 | $2,084 | 17.9× |
| Artery X-Rays Abdomen (75726) | $24,009 | $32,012 | 4.3× |
| Arthrogram hip (73525) | $3,920.25 | $5,227 | 11.2× |
| Arthrogram Wrist (73115) | $4,202.25 | $5,603 | 12.0× |
| Basic radiation dosimetry calculation (77300) | $1,877.25 | $2,503 | 13.9× |
| Bone age studies (77072) range across 2 matching MRF lines |
$761.25–$1,061.25 | $1,015–$1,415 | varies |
| Bone Imaging 3 Phase (78315) | $5,682 | $7,576 | 14.1× |
| Bone Imaging Limited Area (78300) | $1,360.50 | $1,814 | 3.4× |
| Bone Imaging Whole Body (78306) | $2,799 | $3,732 | 7.0× |
| Brain Flow Imaging Only (78610) | $2,363.25 | $3,151 | 4.3× |
| Brain Imaging Minimum 4 Static Views (78605) | $8,889 | $11,852 | 16.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $10,093.50 | $13,458 | 7.0× |
| Cat Scan Follow-Up Study (76380) | $1,233.75 | $1,645 | 14.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $472.50 | $630 | 0.9× |
| Cerebrospinal Fluid Scan (78630) | $4,142.25 | $5,523 | 7.6× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$792–$1,023.75 | $1,056–$1,365 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$1,101–$1,206 | $1,468–$1,608 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$660–$1,962.75 | $880–$2,617 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$2,941.50–$3,205.50 | $3,922–$4,274 | varies |
| Clavicle complete (73000) | $1,651.50 | $2,202 | 18.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $474 | $632 | 4.5× |
| Continuing medical physics consltj pr wk (77336) | $3,911.25 | $5,215 | 29.0× |
| Contrast Exam Abdominl Aorta (75625) | $21,759.75 | $29,013 | 6.9× |
| Contrast X-Ray Bladder (74430) | $1,211.25 | $1,615 | 3.5× |
| Contrast X-Ray Of Elbow (73085) | $3,636.75 | $4,849 | 10.4× |
| Contrast X-Ray Of Knee Joint (73580) | $2,999.25 | $3,999 | 8.6× |
| CT abdomen and pelvis without and with contrast (74178) | $11,484.75 | $15,313 | 32.8× |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$9,405–$11,847.75 | $12,540–$15,797 | varies |
| CT abdomen w contrast (74160) | $5,115 | $6,820 | 29.0× |
| CT abdomen w wo contrast (74170) | $5,666.25 | $7,555 | 32.2× |
| CT abdomen w/o contrast (74150) | $5,217 | $6,956 | 49.7× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$11,614.50–$11,942.25 | $15,486–$15,923 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$6,052.50–$6,222 | $8,070–$8,296 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$4,516.50–$8,744.25 | $6,022–$11,659 | varies |
| CT angio hrt w/3d image (75574) | $2,772 | $3,696 | 7.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$3,720.75–$4,051.50 | $4,961–$5,402 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$4,431–$6,303 | $5,908–$8,404 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $5,153.25 | $6,871 | 29.2× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$4,110.75–$4,476.75 | $5,481–$5,969 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$5,273.25–$6,282.75 | $7,031–$8,377 | varies |
| CT cervical spine w/wo cont (72127) | $4,856.25 | $6,475 | 27.6× |
| CT chest w contrast (71260) | $6,303.75 | $8,405 | 35.8× |
| CT chest w/wo contrast (71270) | $5,655.75 | $7,541 | 32.1× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$3,376.50–$4,554 | $4,502–$6,072 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$6,064.50–$6,234.75 | $8,086–$8,313 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $385.50 | $514 | 4.4× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$5,505.75–$5,998.50 | $7,341–$7,998 | varies |
| CT l-spine w&w/o contrast (72133) | $5,920.50 | $7,894 | 33.6× |
| CT lower ext w/o (73700) | $3,046.50 | $4,062 | 29.0× |
| CT lower extremity w/contrast material (73701) | $3,551.25 | $4,735 | 20.2× |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$6,357.75–$6,924.75 | $8,477–$9,233 | varies |
| CT lumbar spine w/o contrast (72131) | $6,158.25 | $8,211 | 58.6× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$2,994.75–$4,916.25 | $3,993–$6,555 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$474–$6,497.25 | $632–$8,663 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$4,403.25–$4,528.50 | $5,871–$6,038 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $6,312 | $8,416 | 35.8× |
| CT orbits w/o contrast (70480) | $4,229.25 | $5,639 | 40.3× |
| CT pelvis w&w/o contrast (72194) | $6,663 | $8,884 | 37.8× |
| CT pelvis w/o contrast (72192) | $5,042.25 | $6,723 | 48.0× |
| CT scan of leg combo (73702) | $3,225.75 | $4,301 | 18.3× |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$687.75–$6,945 | $917–$9,260 | varies |
| CT soft tissue neck w contrast (70491) | $6,348.75 | $8,465 | 36.0× |
| CT soft tissue neck w/o contrast (70490) | $5,284.50 | $7,046 | 50.3× |
| CT thoracic spine w contrast (72129) | $5,886 | $7,848 | 33.4× |
| CT thoracic spine w/o contrast (72128) | $5,342.25 | $7,123 | 50.9× |
| CT thoracic spine w/wo cont (72130) | $6,261.75 | $8,349 | 35.5× |
| CT thorax w/o contrast (71250) | $4,108.50 | $5,478 | 39.1× |
| CT upper ext wo (73200) | $4,049.25 | $5,399 | 38.6× |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$4,507.50–$4,910.25 | $6,010–$6,547 | varies |
| CT upper extremity with contrast (73201) | $4,172.25 | $5,563 | 11.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$7,079.25–$9,200.25 | $9,439–$12,267 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$5,624.25–$6,126 | $7,499–$8,168 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$5,494.50–$5,985 | $7,326–$7,980 | varies |
| Dxa Bone Density Axial (77080) | $1,143 | $1,524 | 10.9× |
| Esophagram (74220) | $2,722.50 | $3,630 | 15.5× |
| Fetal Biophys Profile W/Nst (76818) | $205.50 | $274 | 2.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$657–$716.25 | $876–$955 | varies |
| Fluoroscopy up to 1 hr (76000) | $1,051.50 | $1,402 | 4.4× |
| Follow-Up Angiography (75898) | $2,132.25 | $2,843 | 0.7× |
| Foot 2 views (73620) | $1,368 | $1,824 | 15.6× |
| Forearm 2 views (73090) | $990 | $1,320 | 11.3× |
| Gastric emptying imaging study (78264) | $3,516.75 | $4,689 | 8.8× |
| Gated Heart Planar Single (78472) | $3,938.25 | $5,251 | 9.8× |
| Hand 2 views (73120) | $981 | $1,308 | 9.3× |
| Hepatobil Syst Image W/Drug (78227) | $10,975.50 | $14,634 | 20.1× |
| Hepatobiliary System Imaging (78226) | $2,477.25 | $3,303 | 6.2× |
| Hysterosalpingogram (74740) | $2,469 | $3,292 | 10.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $2,480.25 | $3,307 | 28.4× |
| Interstitial radiation source applic complex (77778) | $9,165 | $12,220 | 13.1× |
| K Flow/Funct Image W/Drug (78708) | $6,372.75 | $8,497 | 11.7× |
| K Flow/Funct Image W/O Drug (78707) | $3,259.50 | $4,346 | 6.0× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$1,147.50–$1,170 | $1,530–$1,560 | varies |
| Liver & Spleen Imaging Static Only (78215) | $3,384.75 | $4,513 | 8.4× |
| Liver imaging static only (78201) | $8,774.25 | $11,699 | 16.1× |
| Lung Ventilat&Perfus Imaging (78582) | $5,487.75 | $7,317 | 10.1× |
| Lung Ventilation Imaging (78579) | $2,505 | $3,340 | 6.2× |
| Lymph System Imaging (78195) | $2,580.75 | $3,441 | 4.7× |
| Mammary ductogram or galactogram multiple (77054) | $2,089.50 | $2,786 | 8.7× |
| Mammary ductogram or galactogram single (77053) | $1,733.25 | $2,311 | 7.2× |
| Meckels Divert Exam (78290) | $3,463.50 | $4,618 | 8.6× |
| Mlc imrt design & construction per imrt plan (77338) | $35,505.75 | $47,341 | 94.4× |
| Mr safety determination physician/other qhp (76016) | $339.75 | $453 | 3.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $94.50 | $126 | 3.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $354.75 | $473 | 3.7× |
| Mr safety implt pos&/immoblj (76019) | $229.50 | $306 | 3.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $933.75 | $1,245 | 3.9× |
| Mra Head W/O & W/Contrast Material (70546) | $5,115 | $6,820 | 14.6× |
| MRA head w/o contrast (70544) | $4,547.25 | $6,063 | 19.0× |
| MRA head with contrast (70545) | $4,738.50 | $6,318 | 13.5× |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$4,326.75–$4,713.75 | $5,769–$6,285 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$7,020.75–$7,646.25 | $9,361–$10,195 | varies |
| MRA neck w/o contrast (70547) | $7,467 | $9,956 | 31.2× |
| MRI abdomen w contrast (74182) | $4,214.25 | $5,619 | 12.0× |
| MRI abdomen w/o contrast (74181) | $6,042.75 | $8,057 | 25.2× |
| MRI any jt lower extrem w/contrast material (73722) | $9,143.25 | $12,191 | 11.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$9,420.75–$9,684.75 | $12,561–$12,913 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $8,079 | $10,772 | 10.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,388.25 | $1,851 | 5.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,388.25 | $1,851 | 5.8× |
| MRI cervical spine w contrast (72142) | $6,420.75 | $8,561 | 18.3× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$6,463.50–$9,147.75 | $8,618–$12,197 | varies |
| MRI chest w/o contrast (71550) | $4,471.50 | $5,962 | 18.7× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$6,164.25–$6,413.25 | $8,219–$8,551 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $4,989.75 | $6,653 | 14.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $8,274.75 | $11,033 | 23.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$7,803.75–$7,971 | $10,405–$10,628 | varies |
| MRI lumbar spine w contrast (72149) | $6,192 | $8,256 | 17.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $7,521.75 | $10,029 | 21.5× |
| MRI orbit face &/neck w/o contrast (70540) | $9,837.75 | $13,117 | 41.0× |
| MRI orbit face neck w contrast (70542) | $13,019.25 | $17,359 | 37.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $10,274.25 | $13,699 | 29.3× |
| MRI pelvis w contrast (72196) | $5,688 | $7,584 | 16.2× |
| MRI pelvis w/o & w contrast (72197) | $4,777.50 | $6,370 | 13.6× |
| MRI pelvis w/o contrast (72195) | $3,648.75 | $4,865 | 15.2× |
| MRI thoracic spine w/o contrast (72146) | $5,607 | $7,476 | 23.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $6,934.50 | $9,246 | 28.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $8,339.25 | $11,119 | 23.8× |
| MRI, abdomen, combo (74183) | $6,175.50 | $8,234 | 17.6× |
| MRI, dorsal spine combo (72157) | $7,347 | $9,796 | 21.0× |
| MRI, dorsal spine contrast (72147) | $6,863.25 | $9,151 | 19.6× |
| MRI, joint upper extrem (73221) | $8,733 | $11,644 | 36.4× |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$10,062.75–$10,958.25 | $13,417–$14,611 | varies |
| MRI, lumbar spine combo (72158) | $6,627.75 | $8,837 | 18.9× |
| Myelogram cervical (72240) | $2,590.50 | $3,454 | 3.3× |
| Myelogram Lumbar (72265) | $2,232.75 | $2,977 | 2.8× |
| Myelograpy 2/more regions rs&i (72270) | $6,870.75 | $9,161 | 8.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $10,959.75 | $14,613 | 27.3× |
| Myocardial Spect Multiple Studies (78452) | $13,422 | $17,896 | 10.3× |
| Neck soft tissue (70360) | $1,491 | $1,988 | 17.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $17,475.75 | $23,301 | 12.6× |
| Nuclear Rx Oral Admin (79005) | $1,950 | $2,600 | 8.3× |
| Panoramic X-ray of jaws (70355) | $1,978.50 | $2,638 | 22.6× |
| Parathyroid Planar Imaging (78070) | $2,262.75 | $3,017 | 5.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $3,806.25 | $5,075 | 9.5× |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$624–$996 | $832–$1,328 | varies |
| PET image w/CT, full body (78816) | $11,406 | $15,208 | 7.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $11,073.75 | $14,765 | 7.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,634.75 | $3,513 | 6.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$1,887–$2,063.25 | $2,516–$2,751 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,534.50 | $2,046 | 2.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$1,594.50–$1,820.25 | $2,126–$2,427 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $483 | $644 | 5.5× |
| Radex elbow complete minimum 3 views (73080) | $763.50 | $1,018 | 8.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $790.50 | $1,054 | 7.5× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$1,167.75–$1,307.25 | $1,557–$1,743 | varies |
| Radex foot complete minimum 3 views (73630) | $2,023.50 | $2,698 | 23.1× |
| Radex Hand Minimum 3 Views (73130) | $1,559.25 | $2,079 | 17.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $777 | $1,036 | 7.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $612 | $816 | 7.0× |
| Radex Ribs Unilateral 2 Views (71100) | $2,046.75 | $2,729 | 23.4× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$642–$1,145.25 | $856–$1,527 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $1,044.75 | $1,393 | 12.0× |
| Radex Spine 1 View Specify Level (72020) | $874.50 | $1,166 | 10.0× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$483–$525 | $644–$700 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $3,296.25 | $4,395 | 37.7× |
| Radex Toe Minimum 2 Views (73660) | $642 | $856 | 7.3× |
| Radex Wrist Complete Minimum 3 Views (73110) | $1,538.25 | $2,051 | 17.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $44,890.50 | $59,854 | 6.1× |
| Radiation treatment delivery level 2 (77407) | $5,150.25 | $6,867 | 13.3× |
| Radiation treatment delivery level 3 (77412) | $5,150.25 | $6,867 | 9.3× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$771.75–$842.25 | $1,029–$1,123 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,490.25 | $1,987 | 14.2× |
| Radiologic exam colon double contrast study (74280) | $4,305.75 | $5,741 | 24.4× |
| Radiologic exam colon single contrast study (74270) | $2,670.75 | $3,561 | 15.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,019.25 | $1,359 | 5.8× |
| Radiologic exam knee complete 4/more views (73564) | $756 | $1,008 | 7.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $2,316 | $3,088 | 13.1× |
| Radiologic exam swallow function contrast study (74230) | $966.75 | $1,289 | 5.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,284 | $1,712 | 7.3× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$624–$630 | $832–$840 | varies |
| Radiologic examination femur minimum 2 views (73552) | $1,382.25 | $1,843 | 15.8× |
| Radiologic examination knee 1/2 views (73560) | $750.75 | $1,001 | 8.6× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$2,214.75–$2,261.25 | $2,953–$3,015 | varies |
| Ribs bilateral 3 views (71110) | $642 | $856 | 6.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,860.50 | $3,814 | 7.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $3,944.25 | $5,259 | 9.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $13,476.75 | $17,969 | 24.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $4,654.50 | $6,206 | 8.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $7,113.75 | $9,485 | 13.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $7,113.75 | $9,485 | 5.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $8,069.25 | $10,759 | 5.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $7,113.75 | $9,485 | 5.5× |
| Salivary Gland Function Study (78232) | $3,705 | $4,940 | 9.2× |
| Salivary Gland Imaging Serial Images (78231) | $3,941.25 | $5,255 | 9.8× |
| Scapula (73010) range across 2 matching MRF lines |
$736.50–$801.75 | $982–$1,069 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $167.25 | $223 | 7.2× |
| Shoulder 1 view (73020) | $401.25 | $535 | 4.6× |
| Shoulder Arthrography (73040) | $1,499.25 | $1,999 | 4.3× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$899.25–$979.50 | $1,199–$1,306 | varies |
| Special dosimetry (77331) | $3,077.25 | $4,103 | 22.8× |
| Special Physics Consult (77370) | $3,942 | $5,256 | 29.2× |
| Special teletherapy port plan (77321) | $4,220.25 | $5,627 | 11.2× |
| Special treatment procedure (77470) | $2,939.25 | $3,919 | 5.3× |
| Stereotactic Body Radiation Delivery (77373) | $17,098.50 | $22,798 | 9.5× |
| Sternoclavicular joints (71130) | $783.75 | $1,045 | 9.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $8,581.50 | $11,442 | 22.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $5,001 | $6,668 | 13.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $5,578.50 | $7,438 | 14.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $3,676.50 | $4,902 | 9.8× |
| Ther rad simulaj-aided field setting simple (77280) | $2,853 | $3,804 | 21.1× |
| Thoracic spine 2 views (72070) | $3,212.25 | $4,283 | 30.6× |
| Thoracic spine 3 views (72072) | $614.25 | $819 | 5.8× |
| Thoracolumbar 2 views (72080) | $1,896.75 | $2,529 | 21.7× |
| Thyroid Imaging With Vascular Flow (78013) | $2,442 | $3,256 | 6.1× |
| Thyroid Met Imaging Body (78018) | $2,804.25 | $3,739 | 5.1× |
| Thyroid Uptake Measurement (78012) | $2,058.75 | $2,745 | 5.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,042.25 | $2,723 | 5.1× |
| Tx Devices Design & Construction Complex (77334) | $7,176.75 | $9,569 | 19.1× |
| Tx devices design & construction intermediate (77333) | $4,220.25 | $5,627 | 31.3× |
| Tx devices design & construction simple (77332) | $2,419.50 | $3,226 | 17.9× |
| Ultrasound Breast Limited (76642) | $1,904.25 | $2,539 | 21.8× |
| Ultrasound Exam Aaa Screen (76706) | $1,344.75 | $1,793 | 12.8× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$2,319–$2,782.50 | $3,092–$3,710 | varies |
| Umbilical-artery Doppler (OB) (76820) | $527.25 | $703 | 5.0× |
| Upper gi w/o kub (74240) | $1,429.50 | $1,906 | 8.1× |
| Ureteral Reflux Study (78740) | $2,948.25 | $3,931 | 7.3× |
| Urethrocystogram voiding (74455) | $1,824 | $2,432 | 7.6× |
| Urethrocystography retrograde (74450) | $2,774.25 | $3,699 | 11.6× |
| Us breast unilateral complete (76641) | $1,659.75 | $2,213 | 15.8× |
| Us chest (76604) range across 2 matching MRF lines |
$681–$742.50 | $908–$990 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$698.25–$1,098.75 | $931–$1,465 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$1,029.75–$1,328.25 | $1,373–$1,771 | varies |
| Us head (76506) | $1,139.25 | $1,519 | 10.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$527.25–$738.75 | $703–$985 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$2,547–$2,618.25 | $3,396–$3,491 | varies |
| Us ob limited 1 or more fetuses (76815) | $760.50 | $1,014 | 7.2× |
| Us ob transvaginal (76817) | $4,526.25 | $6,035 | 43.1× |
| Us pelvic non ob complete (76856) | $3,687 | $4,916 | 35.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,400.25 | $1,867 | 13.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$736.50–$802.50 | $982–$1,070 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$2,932.50–$3,796.50 | $3,910–$5,062 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$669.75–$729 | $893–$972 | varies |
| Us scrotum and contents (76870) | $4,105.50 | $5,474 | 39.1× |
| Us spinal canal and contents (76800) | $1,139.25 | $1,519 | 10.8× |
| Us thyroid (76536) | $3,178.50 | $4,238 | 30.3× |
| Us transrectal (76872) | $2,089.50 | $2,786 | 19.9× |
| Vein X-Ray Chest (75827) | $8,937 | $11,916 | 5.7× |
| Venography caval inferior serialography rs&i (75825) | $15,006.75 | $20,009 | 4.7× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$2,565–$5,882.25 | $3,420–$7,843 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$1,364.25–$6,984 | $1,819–$9,312 | varies |
| Wrist 2 views (73100) | $981 | $1,308 | 11.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $709.50 | $946 | 8.1× |
| X-ray antegrade pyelogram tube (74425) | $916.50 | $1,222 | 2.6× |
| X-Ray Aorta Leg Arteries (75630) | $21,759.75 | $29,013 | 6.9× |
| X-Ray Bend Only L-S Spine (72120) | $552.75 | $737 | 5.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $763.50 | $1,018 | 8.7× |
| X-Ray Exam Breast Specimen (76098) | $1,073.25 | $1,431 | 2.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $1,097.25 | $1,463 | 10.4× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$339–$774 | $452–$1,032 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$581.25–$690.75 | $775–$921 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $932.25 | $1,243 | 8.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $932.25 | $1,243 | 8.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$987.75–$1,075.50 | $1,317–$1,434 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $2,465.25 | $3,287 | 23.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $1,594.50 | $2,126 | 18.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $3,313.50 | $4,418 | 31.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $2,621.25 | $3,495 | 25.0× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$2,214.75–$2,261.25 | $2,953–$3,015 | varies |
| X-ray IV pyelogram (ivp) (74400) | $3,381 | $4,508 | 19.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $193.50 | $258 | 2.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$168.75–$638.25 | $225–$851 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$2,099.25–$2,287.50 | $2,799–$3,050 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $2,023.50 | $2,698 | 19.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $681 | $908 | 6.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $346.50 | $462 | 3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $2,991 | $3,988 | 34.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $2,418.75 | $3,225 | 27.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,098.75 | $1,465 | 10.5× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$592.50–$608.25 | $790–$811 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$378–$545.25 | $504–$727 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,665 | $2,220 | 4.8× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$1,332.75–$1,452.75 | $1,777–$1,937 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$1,389–$1,428 | $1,852–$1,904 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$3,867.75–$4,213.50 | $5,157–$5,618 | varies |
| Xr facial bones less than 3 views (70140) | $157.50 | $210 | 1.8× |
| XR Mastoids < 3 Views Bilateral (70120) | $569.25 | $759 | 5.4× |
| Xr orbits complete 4 views (70200) | $624.75 | $833 | 5.9× |
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.