Imaging prices at Nathan Littauer Hospital
Gloversville, NY · every code in this section with a posted price and a Medicare benchmark.
286 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) | $446.70 | $558.38 | 4.1× |
| Abdomen 2 views (74019) | $600.29 | $750.36 | 4.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,604.99 | $2,006.24 | 3.2× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$334.38–$402.90 | $417.98–$503.63 | varies |
| Arthrogram ankle (73615) | $837.33 | $1,046.66 | 1.9× |
| Arthrogram hip (73525) | $691.87 | $864.84 | 1.6× |
| Arthrogram Wrist (73115) | $1,066.17 | $1,332.71 | 2.4× |
| Bone age studies (77072) | $514.82 | $643.53 | 3.9× |
| Bone Imaging 3 Phase (78315) | $1,979.79 | $2,474.74 | 4.0× |
| Bone Imaging Limited Area (78300) | $1,647.80 | $2,059.75 | 3.3× |
| Bone Imaging Whole Body (78306) | $2,393.39 | $2,991.74 | 4.8× |
| Bone marrow imaging limited area (78102) | $1,512.17 | $1,890.21 | 3.0× |
| Bone marrow imaging; multiple areas (78103) | $1,587.95 | $1,984.94 | 3.2× |
| Bone marrow imaging; whole body (78104) | $1,714.26 | $2,142.83 | 3.4× |
| Bone survey infant (77076) | $1,011.83 | $1,264.79 | 7.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $9,995.05 | $12,493.81 | 5.6× |
| Cat Scan Follow-Up Study (76380) | $1,149.18 | $1,436.48 | 10.6× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$472.16–$529.49 | $590.20–$661.86 | varies |
| Chest 2 views (71046) | $725.17 | $906.46 | 6.7× |
| Chest 3 views (71047) | $722.16 | $902.70 | 6.6× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$692.49–$760.90 | $865.61–$951.12 | varies |
| Cholecystography Oral Contrast (74290) | $1,077.26 | $1,346.57 | 4.9× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$514.82–$568.92 | $643.53–$711.15 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $2,918.66 | $3,648.33 | 22.4× |
| Contrast X-Ray Bladder (74430) | $1,198.93 | $1,498.66 | 2.8× |
| Contrast X-Ray Of Elbow (73085) | $1,350.96 | $1,688.70 | 3.1× |
| Contrast X-Ray Of Knee Joint (73580) | $691.87 | $864.84 | 1.6× |
| CT abdomen and pelvis without and with contrast (74178) | $5,171.08 | $6,463.85 | 11.9× |
| CT abdomen and pelvis without contrast (74176) | $4,738.98 | $5,923.72 | 15.9× |
| CT abdomen w contrast (74160) | $3,259.91 | $4,074.89 | 14.9× |
| CT abdomen w wo contrast (74170) | $3,715.26 | $4,644.07 | 17.0× |
| CT abdomen w/o contrast (74150) | $3,034.94 | $3,793.68 | 23.3× |
| CT Angio Abdomen and Pelvis (74174) | $3,825.59 | $4,781.99 | 8.8× |
| CT Angio Chest (71275) | $3,259.91 | $4,074.89 | 14.9× |
| CT Angio Head (70496) | $3,478.39 | $4,347.99 | 15.9× |
| CT angio hrt w/3d image (75574) | $3,034.94 | $3,793.68 | 7.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$3,259.91–$3,313.99 | $4,074.89–$4,142.49 | varies |
| CT Angio Neck (70498) | $3,259.91 | $4,074.89 | 14.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$3,259.91–$3,313.99 | $4,074.89–$4,142.49 | varies |
| CT cervical spine w/ contrast (72126) | $2,989.51 | $3,736.89 | 6.9× |
| CT cervical spine w/o contrast (72125) | $2,474.69 | $3,093.36 | 19.0× |
| CT cervical spine w/wo cont (72127) | $2,659.79 | $3,324.74 | 12.1× |
| CT chest w contrast (71260) | $3,210.15 | $4,012.69 | 14.7× |
| CT chest w/wo contrast (71270) | $3,479.47 | $4,349.34 | 15.9× |
| CT colonography screening (74263) | $2,378.96 | $2,973.70 | 8.0× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $2,378.96 | $2,973.70 | 10.9× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $2,378.96 | $2,973.70 | 18.2× |
| CT head/brain with contrast (70460) | $3,479.47 | $4,349.34 | 15.9× |
| CT head/brain without and with contrast (70470) | $3,706.62 | $4,633.27 | 16.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $3,034.94 | $3,793.68 | 7.0× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$86.53–$3,034.94 | $108.16–$3,793.68 | varies |
| CT hrt w/3d image congen (75573) | $3,034.94 | $3,793.68 | 7.0× |
| CT iac w contrast (70481) | $3,259.91 | $4,074.89 | 14.9× |
| CT l-spine w&w/o contrast (72133) | $2,659.79 | $3,324.74 | 12.1× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$3,119.30–$3,173.39 | $3,899.13–$3,966.74 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$3,259.91–$3,313.99 | $4,074.89–$4,142.49 | varies |
| CT lumbar spine w contrast (72132) | $3,259.91 | $4,074.89 | 7.5× |
| CT lumbar spine w/o contrast (72131) | $3,034.94 | $3,793.68 | 23.3× |
| CT maxillofacial w contrast (70487) | $3,259.91 | $4,074.89 | 14.9× |
| CT maxillofacial wo contrast (70486) | $3,034.94 | $3,793.68 | 23.3× |
| CT neck tissue combo (70492) | $3,479.47 | $4,349.34 | 15.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,479.47 | $4,349.34 | 15.9× |
| CT orbits w/o contrast (70480) | $3,034.94 | $3,793.68 | 23.3× |
| CT pelvis w&w/o contrast (72194) | $3,195.55 | $3,994.44 | 14.6× |
| CT pelvis w/o contrast (72192) | $2,748.31 | $3,435.39 | 21.1× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$3,479.47–$3,533.57 | $4,349.34–$4,416.96 | varies |
| CT scans face/jaw combo (70488) | $3,479.47 | $4,349.34 | 15.9× |
| CT soft tissue neck w contrast (70491) | $3,259.91 | $4,074.89 | 14.9× |
| CT soft tissue neck w/o contrast (70490) | $3,034.94 | $3,793.68 | 23.3× |
| CT thoracic spine w contrast (72129) | $2,175.94 | $2,719.92 | 9.9× |
| CT thoracic spine w/o contrast (72128) | $2,474.69 | $3,093.36 | 19.0× |
| CT thoracic spine w/wo cont (72130) | $2,659.79 | $3,324.74 | 12.1× |
| CT thorax w/o contrast (71250) | $3,034.94 | $3,793.68 | 23.3× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$3,034.94–$3,089.02 | $3,793.68–$3,861.28 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$3,479.47–$3,539.51 | $4,349.34–$4,424.39 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$3,259.91–$3,313.99 | $4,074.89–$4,142.49 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$3,737.98–$4,464.81 | $4,672.47–$5,581.01 | varies |
| Cta Abdomen (74175) | $3,259.91 | $4,074.89 | 14.9× |
| CTA pelvis (72191) | $2,918.66 | $3,648.33 | 13.3× |
| Discography Cerv/Thor Spine (72285) | $2,363.81 | $2,954.76 | 1.0× |
| Diskography lumbar (72295) | $5,713.18 | $7,141.47 | 2.3× |
| Doppler Fetal Mid Cerebral Artery (76821) | $1,564.78 | $1,955.98 | 12.0× |
| Dxa Bone Density Axial (77080) | $855.54 | $1,069.43 | 6.6× |
| Dxa bone density study (77085) | $642.18 | $802.72 | 4.9× |
| Echo exam uterus (76831) | $1,397.95 | $1,747.44 | 4.7× |
| Esophagram (74220) | $857.16 | $1,071.45 | 3.9× |
| Fetal Biophys Profile W/Nst (76818) | $1,397.95 | $1,747.44 | 10.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $808.01 | $1,010.01 | 6.2× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$507.78–$783.91 | $634.72–$979.89 | varies |
| Foot 2 views (73620) range across 6 matching MRF lines |
$324.45–$402.90 | $405.56–$503.63 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$460.76–$514.82 | $575.95–$643.53 | varies |
| Gastric emptying imaging study (78264) | $1,979.79 | $2,474.74 | 4.0× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$56–$1,811.96 | $70–$2,264.95 | varies |
| Hand 2 views (73120) range across 6 matching MRF lines |
$381.77–$435.83 | $477.21–$544.79 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,138.42 | $2,673.02 | 3.2× |
| Hepatobiliary System Imaging (78226) | $2,124.63 | $2,655.79 | 4.3× |
| Ht Muscle Image Spect Sing (78451) | $2,787.28 | $3,484.10 | 1.7× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$895.56–$1,103.77 | $1,119.45–$1,379.71 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $900.97 | $1,126.21 | 8.3× |
| K Flow/Funct Image W/Drug (78708) | $2,647.18 | $3,308.98 | 3.9× |
| K Flow/Funct Image W/O Drug (78707) | $2,340.03 | $2,925.04 | 3.5× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$541.34–$595.42 | $676.67–$744.27 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,652.73 | $2,065.91 | 3.3× |
| Lung perfusion differential (78597) | $1,380.43 | $1,725.54 | 2.8× |
| Lung Ventilat&Perfus Imaging (78582) | $2,203.06 | $2,753.83 | 3.3× |
| Lymph System Imaging (78195) | $1,879.94 | $2,349.92 | 2.8× |
| Magnetic Image Jaw Joint (70336) | $3,143.10 | $3,928.87 | 10.6× |
| Meckels Divert Exam (78290) | $1,468.18 | $1,835.23 | 2.9× |
| Mra Head W/O & W/Contrast Material (70546) | $5,457.44 | $6,821.80 | 12.5× |
| MRA head w/o contrast (70544) | $3,462.79 | $4,328.49 | 11.6× |
| MRA head with contrast (70545) | $3,462.79 | $4,328.49 | 8.0× |
| MRA neck w contrast (70548) | $3,462.79 | $4,328.49 | 8.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,911.68 | $4,889.60 | 9.0× |
| MRA neck w/o contrast (70547) | $3,269.30 | $4,086.62 | 11.0× |
| MRI abdomen w contrast (74182) | $3,329.14 | $4,161.42 | 7.6× |
| MRI abdomen w/o contrast (74181) | $3,329.14 | $4,161.42 | 11.2× |
| MRI any jt lower extrem w/contrast material (73722) | $3,329.14 | $4,161.42 | 3.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,903.48–$5,855.22 | $4,879.35–$7,319.02 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,329.14 | $4,161.42 | 3.4× |
| MRI Breast W/O Contrast Bilateral (77047) | $3,383.22 | $4,229.02 | 11.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $3,203.24 | $4,004.05 | 10.8× |
| MRI cervical spine w contrast (72142) | $3,911.68 | $4,889.60 | 9.0× |
| MRI cervical spine w/o cont (72141) | $3,462.79 | $4,328.49 | 11.6× |
| MRI chest w/o contrast (71550) | $3,329.14 | $4,161.42 | 11.2× |
| MRI chest with contrast (71551) | $3,329.14 | $4,161.42 | 3.4× |
| MRI chest wo w contrast (71552) | $4,197.46 | $5,246.83 | 9.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,329.14 | $4,161.42 | 7.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,760.69 | $4,700.86 | 8.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$3,329.14–$4,993.71 | $4,161.42–$6,242.14 | varies |
| MRI lumbar spine w contrast (72149) | $3,760.69 | $4,700.86 | 8.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,858.51 | $7,323.14 | 13.5× |
| MRI orbit face &/neck w/o contrast (70540) | $3,462.79 | $4,328.49 | 11.6× |
| MRI orbit face neck w contrast (70542) | $3,462.79 | $4,328.49 | 8.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,911.68 | $4,889.60 | 9.0× |
| MRI pelvis w contrast (72196) | $3,143.10 | $3,928.87 | 7.2× |
| MRI pelvis w/o & w contrast (72197) | $3,911.03 | $4,888.79 | 9.0× |
| MRI pelvis w/o contrast (72195) | $3,329.14 | $4,161.42 | 11.2× |
| MRI thoracic spine w/o contrast (72146) | $3,329.14 | $4,161.42 | 11.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,329.14 | $4,161.42 | 7.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,329.14 | $4,161.42 | 11.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,760.69 | $4,700.86 | 8.6× |
| MRI, abdomen, combo (74183) | $3,908.87 | $4,886.09 | 9.0× |
| MRI, dorsal spine combo (72157) | $5,632.39 | $7,040.49 | 12.9× |
| MRI, dorsal spine contrast (72147) | $3,760.69 | $4,700.86 | 8.6× |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$3,329.14–$4,993.71 | $4,161.42–$6,242.14 | varies |
| MRI, joint upper extrem combo (73223) | $3,760.69 | $4,700.86 | 8.6× |
| MRI, lumbar spine combo (72158) | $5,632.39 | $7,040.49 | 12.9× |
| Myelogram cervical (72240) | $1,003.64 | $1,254.55 | 1.0× |
| Myelogram Lumbar (72265) | $2,187.66 | $2,734.57 | 2.2× |
| Myelography thoracic (72255) | $1,003.64 | $1,254.55 | 1.0× |
| Myelograpy 2/more regions rs&i (72270) | $2,355.94 | $2,944.93 | 2.4× |
| Myocardial Spect Multiple Studies (78452) | $3,802.34 | $4,752.92 | 2.4× |
| Neck soft tissue (70360) | $531.62 | $664.52 | 4.9× |
| Ob us nuchal meas 1 gest (76813) | $1,397.95 | $1,747.44 | 10.7× |
| Parathyroid Planar Imaging (78070) | $1,800.56 | $2,250.70 | 3.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $814.22 | $1,017.78 | 1.6× |
| Pelvis 1 or 2 views (72170) | $465.08 | $581.35 | 3.6× |
| Pet Image Skull-Thigh (78812) | $8,165.46 | $10,206.82 | 4.6× |
| Pet Image W/Ct Lmtd (78814) | $8,165.46 | $10,206.82 | 4.6× |
| PET image w/CT, full body (78816) | $8,165.46 | $10,206.82 | 4.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,165.46 | $10,206.82 | 4.6× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $8,165.46 | $10,206.82 | 5.1× |
| PET whole body (78813) | $8,165.46 | $10,206.82 | 4.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,622.14 | $2,027.67 | 3.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $687.90 | $859.87 | 5.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $857.16 | $1,071.45 | 1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$594.88–$648.96 | $743.60–$811.20 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$348.80–$402.90 | $436–$503.63 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$529.98–$584.06 | $662.48–$730.07 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $679.78 | $849.72 | 5.2× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$348.80–$402.90 | $436–$503.63 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$529.98–$584.06 | $662.48–$730.07 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$529.98–$584.06 | $662.48–$730.07 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $514.82 | $643.53 | 4.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $712.22 | $890.27 | 5.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $514.82 | $643.53 | 4.7× |
| Radex Ribs Unilateral 2 Views (71100) | $857.16 | $1,071.45 | 7.9× |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$514.82–$676 | $643.53–$845 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $454.48 | $568.10 | 4.2× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$983.17–$2,510.94 | $1,228.96–$3,138.68 | varies |
| Radex Spine 1 View Specify Level (72020) | $480.25 | $600.31 | 4.4× |
| Radex Sternum Minimum 2 Views (71120) | $501.86 | $627.32 | 4.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $505.10 | $631.38 | 4.6× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$348.80–$402.90 | $436–$503.63 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $514.82 | $643.53 | 3.9× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$529.98–$584.06 | $662.48–$730.07 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $679.78 | $849.72 | 5.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $406.44 | $508.05 | 3.1× |
| Radiologic exam colon double contrast study (74280) | $1,522.34 | $1,902.93 | 7.0× |
| Radiologic exam colon single contrast study (74270) | $1,005.88 | $1,257.35 | 4.6× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$466.73–$520.81 | $583.41–$651.01 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $382.87 | $478.59 | 2.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,027.51 | $1,284.39 | 4.7× |
| Radiologic exam swallow function contrast study (74230) | $352 | $440 | 1.6× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$664.78–$937.74 | $830.97–$1,172.18 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$451.03–$505.10 | $563.79–$631.38 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$451.03–$505.10 | $563.79–$631.38 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$380.67–$478.06 | $475.84–$597.57 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$475.35–$529.43 | $594.19–$661.79 | varies |
| Ribs bilateral 3 views (71110) | $911.23 | $1,139.04 | 7.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,496.90 | $1,871.13 | 3.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,496.90 | $1,871.13 | 3.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,979.70 | $4,974.62 | 5.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,878.70 | $3,598.38 | 4.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 5 matching MRF lines |
$2,479.75–$3,559.09 | $3,099.69–$4,448.86 | varies |
| Scapula (73010) range across 3 matching MRF lines |
$514.82–$568.92 | $643.53–$711.15 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $195.30 | $244.13 | 8.4× |
| Sella turcica (70240) | $514.82 | $643.53 | 4.7× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$348.80–$402.90 | $436–$503.63 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$1,066.17–$1,226.09 | $1,332.71–$1,532.61 | varies |
| Sialogram (70390) | $922.06 | $1,152.57 | 3.1× |
| Skull less than 4 views (70250) | $467.58 | $584.48 | 3.6× |
| Sternoclavicular joints (71130) | $679.78 | $849.72 | 6.3× |
| Testicular Imaging W/Flow (78761) | $1,411.71 | $1,764.64 | 2.8× |
| Thoracic spine 2 views (72070) | $365.83 | $457.29 | 2.8× |
| Thoracic spine 3 views (72072) | $679.78 | $849.72 | 5.2× |
| Thoracolumbar 2 views (72080) | $679.78 | $849.72 | 6.3× |
| Thyroid Imaging With Vascular Flow (78013) | $941.73 | $1,177.16 | 1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,979.79 | $2,474.74 | 4.0× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$1,027.51–$1,081.60 | $1,284.39–$1,352 | varies |
| Ultrasound Exam Aaa Screen (76706) | $457.95 | $572.44 | 3.5× |
| Ultrasound, abdomen limited (76705) range across 10 matching MRF lines |
$452.75–$1,397.95 | $565.94–$1,747.44 | varies |
| Umbilical-artery Doppler (OB) (76820) | $1,564.78 | $1,955.98 | 12.0× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$834.82–$1,397.95 | $1,043.52–$1,747.44 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$609.22–$720.88 | $761.53–$901.10 | varies |
| Urethrocystogram voiding (74455) | $1,174.61 | $1,468.26 | 3.9× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$513.76–$1,081.60 | $642.20–$1,352 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$754.39–$790.82 | $942.99–$988.53 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$754.39–$834.82 | $942.99–$1,043.52 | varies |
| Us head (76506) | $2,670.46 | $3,338.07 | 20.5× |
| Us kidney transplant (76776) | $1,397.95 | $1,747.44 | 10.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$818.75–$872.84 | $1,023.44–$1,091.05 | varies |
| Us ob detailed single fetus (76811) | $1,397.95 | $1,747.44 | 4.7× |
| Us ob limited 1 or more fetuses (76815) | $1,397.95 | $1,747.44 | 10.7× |
| Us ob transvaginal (76817) | $1,397.95 | $1,747.44 | 10.7× |
| Us pelvic non ob complete (76856) | $1,564.52 | $1,955.65 | 12.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,397.95 | $1,747.44 | 10.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$319.14–$345.50 | $398.92–$431.88 | varies |
| Us retroperitoneal complete (76770) | $1,564.52 | $1,955.65 | 12.0× |
| Us retroperitoneal limited (76775) | $784.15 | $980.19 | 6.0× |
| Us scrotum and contents (76870) | $1,397.95 | $1,747.44 | 10.7× |
| Us spinal canal and contents (76800) | $1,397.95 | $1,747.44 | 10.7× |
| Us thyroid (76536) range across 4 matching MRF lines |
$162.40–$1,397.95 | $203–$1,747.44 | varies |
| Us transrectal (76872) | $1,397.95 | $1,747.44 | 10.7× |
| Vein X-Ray Chest (75827) | $2,657.06 | $3,321.33 | 1.4× |
| Venography caval inferior serialography rs&i (75825) | $5,944.02 | $7,430.03 | 1.5× |
| Venography extremity bilateral rs&i (75822) | $3,437.67 | $4,297.09 | 1.7× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$4,117.44–$4,131.37 | $5,146.80–$5,164.21 | varies |
| Vertebral fracture assessment via dxa (77086) | $770.61 | $963.26 | 7.1× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$331.96–$402.90 | $414.95–$503.63 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $679.78 | $849.72 | 6.3× |
| X-ray antegrade pyelogram tube (74425) | $892.85 | $1,116.06 | 2.1× |
| X-Ray Bend Only L-S Spine (72120) | $271.41 | $339.26 | 2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$338.66–$402.90 | $423.33–$503.63 | varies |
| X-Ray Exam Breast Specimen (76098) | $385.70 | $482.13 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $857.16 | $1,071.45 | 7.9× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$348.80–$402.90 | $436–$503.63 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $712.22 | $890.27 | 6.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $766.30 | $957.87 | 5.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $692.56 | $865.70 | 5.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $837.62 | $1,047.02 | 6.4× |
| X-Ray Exam L-S Spine Bending (72114) | $1,522.34 | $1,902.93 | 11.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$499.15–$514.82 | $623.94–$643.53 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,011.83 | $1,264.79 | 7.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $457.40 | $571.75 | 3.5× |
| X-ray eye for foreign body (70030) | $465.08 | $581.35 | 4.3× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$514.82–$568.92 | $643.53–$711.15 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,794.37 | $2,242.96 | 8.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $510.50 | $638.13 | 4.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $430.51 | $538.14 | 4.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $897.71 | $1,122.14 | 6.9× |
| X-ray nose-rectum child f.b. (76010) | $348.80 | $436 | 3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $511.48 | $639.35 | 3.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $679.78 | $849.72 | 5.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$514.82–$598.13 | $643.53–$747.66 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $717.63 | $897.04 | 6.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,027.51 | $1,284.39 | 7.9× |
| X-ray thoracic spine 4 vw (72074) | $276.66 | $345.82 | 2.1× |
| X-Ray Tmj Unilat (70328) | $451.03 | $563.79 | 4.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $822.14 | $1,027.67 | 1.9× |
| X-Rays Bone Length Studies (77073) | $1,288.71 | $1,610.89 | 9.9× |
| X-Rays Bone Survey Complete (77075) | $1,431.54 | $1,789.43 | 11.0× |
| Xr c-spine 4 or 5 views (72050) | $855.54 | $1,069.43 | 6.6× |
| Xr facial bones less than 3 views (70140) | $514.82 | $643.53 | 4.7× |
| Xr orbits complete 4 views (70200) | $679.78 | $849.72 | 5.2× |
| Xr Tomogram Single Plane (76100) | $1,275.74 | $1,594.67 | 9.8× |
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.