Imaging prices at New Ulm Medical Center
New Ulm, MN · every code in this section with a posted price and a Medicare benchmark.
262 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$171.81–$257.66 | $306.80–$460.10 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$171.81–$257.66 | $306.80–$460.10 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,296.34 | $4,100.60 | 5.6× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$163.69–$245.45 | $292.30–$438.30 | varies |
| Arthrogram hip (73525) | $343.56 | $613.50 | 1.0× |
| Bone age studies (77072) | $171.81 | $306.80 | 1.6× |
| Bone Imaging 3 Phase (78315) | $960.96 | $1,716 | 2.3× |
| Bone Imaging Limited Area (78300) | $765.41 | $1,366.80 | 1.9× |
| Bone Imaging Multiple Areas (78305) | $1,148.22 | $2,050.40 | 2.8× |
| Bone Imaging Whole Body (78306) | $768.71 | $1,372.70 | 1.9× |
| Bone survey infant (77076) | $343.56 | $613.50 | 3.2× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$171.81–$257.66 | $306.80–$460.10 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$163.69–$245.45 | $292.30–$438.30 | varies |
| Chest 3 views (71047) | $171.81 | $306.80 | 1.9× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$171.81–$257.66 | $306.80–$460.10 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $794.70 | $1,419.10 | 7.4× |
| Contrast X-Ray Bladder (74430) | $1,832.15 | $3,271.70 | 5.1× |
| Contrast X-Ray Of Elbow (73085) | $811.38 | $1,448.90 | 2.3× |
| Contrast X-Ray Of Knee Joint (73580) | $343.56 | $613.50 | 1.0× |
| CT abdomen and pelvis without and with contrast (74178) | $1,986.77 | $3,547.80 | 5.5× |
| CT abdomen and pelvis without contrast (74176) | $1,192.13 | $2,128.80 | 4.8× |
| CT abdomen w contrast (74160) | $1,192.13 | $2,128.80 | 6.6× |
| CT abdomen w wo contrast (74170) | $1,589.34 | $2,838.10 | 8.8× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$596.01–$794.70 | $1,064.30–$1,419.10 | varies |
| CT Angio Abdomen and Pelvis (74174) | $2,781.41 | $4,966.80 | 7.7× |
| CT Angio Chest (71275) | $794.70 | $1,419.10 | 4.4× |
| CT Angio Head (70496) | $1,589.34 | $2,838.10 | 8.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,986.77 | $3,547.80 | 11.0× |
| CT Angio Neck (70498) | $1,192.13 | $2,128.80 | 6.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,589.34 | $2,838.10 | 8.8× |
| CT cervical spine w/ contrast (72126) | $1,192.13 | $2,128.80 | 3.3× |
| CT cervical spine w/o contrast (72125) | $794.70 | $1,419.10 | 7.4× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$397.43–$794.70 | $709.70–$1,419.10 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$397.43–$1,192.07 | $709.70–$2,128.70 | varies |
| CT head/brain with contrast (70460) | $1,192.13 | $2,128.80 | 6.6× |
| CT head/brain without and with contrast (70470) | $1,589.34 | $2,838.10 | 8.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $794.70 | $1,419.10 | 8.8× |
| CT iac w contrast (70481) | $1,192.13 | $2,128.80 | 6.6× |
| CT l-spine w&w/o contrast (72133) | $1,589.34 | $2,838.10 | 8.8× |
| CT lower ext w/o (73700) | $1,324.51 | $2,365.20 | 12.3× |
| CT lower extremity w/contrast material (73701) | $1,721.78 | $3,074.60 | 9.5× |
| CT lumbar spine w contrast (72132) | $1,192.13 | $2,128.80 | 3.3× |
| CT lumbar spine w/o contrast (72131) | $794.70 | $1,419.10 | 7.4× |
| CT maxillofacial w contrast (70487) | $1,192.13 | $2,128.80 | 6.6× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,361.92–$1,589.34 | $2,432–$2,838.10 | varies |
| CT neck tissue combo (70492) | $1,192.13 | $2,128.80 | 6.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,589.34 | $2,838.10 | 8.8× |
| CT orbits w/o contrast (70480) | $794.70 | $1,419.10 | 7.4× |
| CT pelvis w&w/o contrast (72194) | $1,589.34 | $2,838.10 | 8.8× |
| CT pelvis w/o contrast (72192) | $1,192.13 | $2,128.80 | 11.0× |
| CT scan of leg combo (73702) | $2,119.26 | $3,784.40 | 11.7× |
| CT scans face/jaw combo (70488) | $1,589.34 | $2,838.10 | 8.8× |
| CT soft tissue neck w contrast (70491) | $794.70 | $1,419.10 | 4.4× |
| CT soft tissue neck w/o contrast (70490) | $529.76 | $946 | 4.9× |
| CT thoracic spine w contrast (72129) | $1,192.13 | $2,128.80 | 6.6× |
| CT thoracic spine w/o contrast (72128) | $794.70 | $1,419.10 | 7.4× |
| CT thorax w/o contrast (71250) range across 4 matching MRF lines |
$163.24–$794.70 | $291.50–$1,419.10 | varies |
| CT upper ext wo (73200) | $1,192.13 | $2,128.80 | 11.0× |
| CT upper extremity w/o & w/contrast material (73202) | $1,986.77 | $3,547.80 | 11.0× |
| CT upper extremity with contrast (73201) | $1,589.34 | $2,838.10 | 4.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,589.34 | $2,838.10 | 8.8× |
| Cta Abdomen (74175) | $1,589.34 | $2,838.10 | 8.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,849.46 | $3,302.60 | 5.1× |
| CTA pelvis (72191) | $1,192.13 | $2,128.80 | 6.6× |
| Doppler Fetal Mid Cerebral Artery (76821) | $141.68 | $253 | 1.3× |
| Dxa Bone Density Axial (77080) | $176.85 | $315.80 | 1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $114.58 | $204.60 | 1.3× |
| Echo exam of fetal heart (76825) | $141.68 | $253 | 0.3× |
| Esophagram (74220) | $257.66 | $460.10 | 1.4× |
| Fetal Biophys Profile W/Nst (76818) | $425.21 | $759.30 | 3.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$425.21–$637.90 | $759.30–$1,139.10 | varies |
| Fluoroscopy up to 1 hr (76000) range across 8 matching MRF lines |
$353.30–$2,743.10 | $630.90–$4,898.40 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$128.91–$257.66 | $230.20–$460.10 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$21.45–$257.66 | $38.30–$460.10 | varies |
| Gastric emptying imaging study (78264) | $1,729.78 | $3,088.90 | 4.2× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $2,208.53 | $3,943.80 | 5.4× |
| Gated Heart Planar Single (78472) | $1,148.22 | $2,050.40 | 2.8× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$128.86–$257.66 | $230.10–$460.10 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,537.59 | $2,745.70 | 2.7× |
| Hepatobiliary System Imaging (78226) | $1,345.29 | $2,402.30 | 3.3× |
| Ht Muscle Image Spect Sing (78451) | $2,296.34 | $4,100.60 | 1.7× |
| Hysterosalpingogram (74740) | $257.66 | $460.10 | 1.0× |
| Infant hip ultrasound, limited static exam (76886) | $425.21 | $759.30 | 4.7× |
| Infusion Ivp (74410) | $343.56 | $613.50 | 1.9× |
| K Flow/Funct Image Multiple (78709) | $960.96 | $1,716 | 1.7× |
| K Flow/Funct Image W/Drug (78708) | $1,153.21 | $2,059.30 | 2.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,148.22 | $2,050.40 | 2.0× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$163.69–$245.62 | $292.30–$438.60 | varies |
| Liver & Spleen Imaging Static Only (78215) | $694.96 | $1,241 | 1.7× |
| Lung Perf&Ventilat Diferentl (78598) | $768.82 | $1,372.90 | 1.4× |
| Lung Ventilat&Perfus Imaging (78582) | $768.71 | $1,372.70 | 1.4× |
| Lung Ventilation Imaging (78579) | $576.69 | $1,029.80 | 1.4× |
| Lymph System Imaging (78195) | $1,921.98 | $3,432.10 | 3.4× |
| Magnetic Image Jaw Joint (70336) | $1,816.70 | $3,244.10 | 7.4× |
| Magnetic Resonance Elastography (76391) | $2,140.15 | $3,821.70 | 8.7× |
| Meckels Divert Exam (78290) | $765.41 | $1,366.80 | 1.9× |
| Mra Head W/O & W/Contrast Material (70546) | $2,422.17 | $4,325.30 | 6.7× |
| MRA head w/o contrast (70544) | $1,614.76 | $2,883.50 | 6.6× |
| MRA head with contrast (70545) | $2,018.46 | $3,604.40 | 5.6× |
| MRA neck w contrast (70548) | $1,614.76 | $2,883.50 | 4.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,018.46 | $3,604.40 | 5.6× |
| MRA neck w/o contrast (70547) | $1,211.06 | $2,162.60 | 4.9× |
| MRI abdomen w/o contrast (74181) | $2,422.17 | $4,325.30 | 9.8× |
| MRI any jt lower extrem w/contrast material (73722) | $3,633.28 | $6,488 | 4.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,825.93 | $5,046.30 | 7.8× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,825.93 | $5,046.30 | 3.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,009.29 | $1,802.30 | 4.1× |
| MRI cervical spine w contrast (72142) | $1,614.76 | $2,883.50 | 4.5× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$908.32–$1,211.06 | $1,622–$2,162.60 | varies |
| MRI chest w/o contrast (71550) | $1,816.70 | $3,244.10 | 7.4× |
| MRI chest with contrast (71551) | $2,220.34 | $3,964.90 | 2.7× |
| MRI chest wo w contrast (71552) | $2,624.10 | $4,685.90 | 7.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,614.20 | $2,882.50 | 4.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,027.75 | $5,406.70 | 8.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,422.17 | $4,325.30 | 9.8× |
| MRI lumbar spine w contrast (72149) | $1,614.76 | $2,883.50 | 4.5× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$1,626.46–$2,018.46 | $2,904.40–$3,604.40 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $1,614.76 | $2,883.50 | 6.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,229.63 | $5,767.20 | 9.0× |
| MRI pelvis w contrast (72196) | $2,329.04 | $4,159 | 6.5× |
| MRI pelvis w/o & w contrast (72197) | $2,825.93 | $5,046.30 | 7.8× |
| MRI pelvis w/o contrast (72195) | $2,018.46 | $3,604.40 | 8.2× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$908.32–$1,211.06 | $1,622–$2,162.60 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,422.17 | $4,325.30 | 9.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,229.63 | $5,767.20 | 9.0× |
| MRI, abdomen, combo (74183) | $3,027.75 | $5,406.70 | 8.4× |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,513.90–$2,018.46 | $2,703.40–$3,604.40 | varies |
| MRI, dorsal spine contrast (72147) | $1,614.76 | $2,883.50 | 4.5× |
| MRI, joint upper extrem (73221) | $2,018.46 | $3,604.40 | 8.2× |
| MRI, joint upper extrem combo (73223) | $2,825.93 | $5,046.30 | 7.8× |
| MRI, lumbar spine combo (72158) | $2,018.46 | $3,604.40 | 5.6× |
| Myelogram cervical (72240) | $343.56 | $613.50 | 0.4× |
| Myelogram Lumbar (72265) | $343.56 | $613.50 | 0.4× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,679.15 | $4,784.20 | 2.0× |
| Myocardial Spect Multiple Studies (78452) | $2,306.30 | $4,118.40 | 1.7× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$171.81–$257.66 | $306.80–$460.10 | varies |
| Ophthalmic us dx quantitative a-scan only (76511) | $237.94 | $424.90 | 2.2× |
| Panoramic X-ray of jaws (70355) | $257.66 | $460.10 | 2.9× |
| Parathyroid Planar Imaging (78070) | $2,306.30 | $4,118.40 | 5.6× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$171.81–$257.66 | $306.80–$460.10 | varies |
| PET image w/CT, full body (78816) | $2,813.33 | $5,023.80 | 1.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,813.33 | $5,023.80 | 1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $574.17 | $1,025.30 | 1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $171.81 | $306.80 | 1.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $257.66 | $460.10 | 0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$163.69–$245.45 | $292.30–$438.30 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$127.85–$171.81 | $228.30–$306.80 | varies |
| Radex elbow complete minimum 3 views (73080) | $171.81 | $306.80 | 1.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $171.81 | $306.80 | 1.6× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$171.81–$257.66 | $306.80–$460.10 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$163.69–$245.45 | $292.30–$438.30 | varies |
| Radex Hand Minimum 3 Views (73130) | $171.81 | $306.80 | 1.9× |
| Radex lower extremity infant minimum 2 views (73592) | $171.81 | $306.80 | 1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $171.81 | $306.80 | 1.9× |
| Radex Ribs Unilateral 2 Views (71100) | $171.81 | $306.80 | 1.9× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$163.69–$245.45 | $292.30–$438.30 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $171.81 | $306.80 | 1.9× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$171.81–$257.66 | $306.80–$460.10 | varies |
| Radex Sternum Minimum 2 Views (71120) | $171.81 | $306.80 | 1.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $171.81 | $306.80 | 1.9× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$171.81–$257.66 | $306.80–$460.10 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $171.81 | $306.80 | 1.6× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$171.81–$257.66 | $306.80–$460.10 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $393.34 | $702.40 | 3.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $171.81 | $306.80 | 1.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $171.81 | $306.80 | 1.6× |
| Radiologic exam colon double contrast study (74280) | $343.56 | $613.50 | 1.9× |
| Radiologic exam colon single contrast study (74270) | $343.56 | $613.50 | 1.9× |
| Radiologic exam knee complete 4/more views (73564) | $163.69 | $292.30 | 1.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $171.81 | $306.80 | 1.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $515.42 | $920.40 | 2.8× |
| Radiologic exam swallow function contrast study (74230) | $257.66 | $460.10 | 1.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $257.66 | $460.10 | 1.4× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$171.81–$257.82 | $306.80–$460.40 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$128.86–$286.33 | $230.10–$511.30 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$163.69–$245.45 | $292.30–$438.30 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$128.86–$257.66 | $230.10–$460.10 | varies |
| Ribs bilateral 3 views (71110) | $171.81 | $306.80 | 1.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,184.55 | $5,686.70 | 5.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,041.20 | $3,645 | 3.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $956.82 | $1,708.60 | 1.7× |
| Scapula (73010) | $171.81 | $306.80 | 1.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$23.58–$25.37 | $42.10–$45.30 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$163.69–$245.45 | $292.30–$438.30 | varies |
| Shoulder Arthrography (73040) | $343.56 | $613.50 | 1.0× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$171.81–$257.66 | $306.80–$460.10 | varies |
| Sternoclavicular joints (71130) | $171.81 | $306.80 | 1.9× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$171.81–$257.66 | $306.80–$460.10 | varies |
| Thoracic spine 3 views (72072) | $171.81 | $306.80 | 1.6× |
| Thoracolumbar 2 views (72080) | $171.81 | $306.80 | 1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $768.71 | $1,372.70 | 1.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$307.16–$322.39 | $548.50–$575.70 | varies |
| Ultrasound elastography first target lesion (76982) | $283.53 | $506.30 | 2.6× |
| Ultrasound Elastography Parenchyma (76981) | $283.53 | $506.30 | 2.6× |
| Ultrasound Exam Aaa Screen (76706) | $336.39 | $600.70 | 3.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $310.30 | $554.10 | 0.9× |
| Ultrasound, abdomen limited (76705) range across 6 matching MRF lines |
$283.53–$472.42 | $506.30–$843.60 | varies |
| Umbilical-artery Doppler (OB) (76820) | $141.68 | $253 | 1.3× |
| Unlisted magnetic resonance procedure (76498) | $2,422.17 | $4,325.30 | 27.0× |
| Unlisted us procedure (76999) | $425.21 | $759.30 | 4.7× |
| Upper gi w/o kub (74240) | $257.66 | $460.10 | 1.4× |
| Ureteral Reflux Study (78740) | $765.41 | $1,366.80 | 1.9× |
| Urethrocystogram voiding (74455) | $515.42 | $920.40 | 2.1× |
| Urethrocystography retrograde (74450) | $343.56 | $613.50 | 1.4× |
| Us breast unilateral complete (76641) | $409.36 | $731 | 3.8× |
| Us chest (76604) range across 4 matching MRF lines |
$212.52–$283.53 | $379.50–$506.30 | varies |
| Us complete joint (76881) | $425.21 | $759.30 | 3.9× |
| Us exam, pelvic, limited (76857) range across 6 matching MRF lines |
$283.53–$470.57 | $506.30–$840.30 | varies |
| Us head (76506) | $283.53 | $506.30 | 2.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $283.53 | $506.30 | 2.6× |
| Us ob detailed single fetus (76811) | $425.21 | $759.30 | 1.7× |
| Us ob limited 1 or more fetuses (76815) range across 5 matching MRF lines |
$242.37–$635.26 | $432.80–$1,134.40 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$212.52–$283.53 | $379.50–$506.30 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$283.53–$472.53 | $506.30–$843.80 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$340.20–$425.21 | $607.50–$759.30 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$209.50–$637.90 | $374.10–$1,139.10 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$283.53–$472.42 | $506.30–$843.60 | varies |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$268.69–$457.18 | $479.80–$816.40 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$425.21–$735.62 | $759.30–$1,313.60 | varies |
| Us spinal canal and contents (76800) | $425.21 | $759.30 | 3.9× |
| Us thyroid (76536) range across 2 matching MRF lines |
$335.78–$425.21 | $599.60–$759.30 | varies |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$171.81–$257.66 | $306.80–$460.10 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $171.81 | $306.80 | 1.9× |
| X-Ray Bend Only L-S Spine (72120) | $171.81 | $306.80 | 1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$128.80–$257.66 | $230–$460.10 | varies |
| X-Ray Exam Breast Specimen (76098) | $85.96 | $153.50 | 0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $257.66 | $460.10 | 2.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $311.92 | $557 | 2.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $339.02 | $605.40 | 3.1× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$343.73–$515.37 | $613.80–$920.30 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$229.10–$515.37 | $409.10–$920.30 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$293.55–$660.24 | $524.20–$1,179 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$354.37–$531.55 | $632.80–$949.20 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $461.78 | $824.60 | 4.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $307.89 | $549.80 | 2.9× |
| X-Ray Exam L-S Spine Bending (72114) | $171.81 | $306.80 | 1.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$171.81–$257.66 | $306.80–$460.10 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $257.66 | $460.10 | 2.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $171.81 | $306.80 | 1.6× |
| X-ray eye for foreign body (70030) | $175 | $312.50 | 1.9× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$21.45–$257.66 | $38.30–$460.10 | varies |
| X-ray IV pyelogram (ivp) (74400) | $257.66 | $460.10 | 1.4× |
| X-ray IV pyelogram+tomography (74415) | $343.56 | $613.50 | 1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $171.81 | $306.80 | 1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $171.81 | $306.80 | 1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$163.69–$245.45 | $292.30–$438.30 | varies |
| X-ray nose-rectum child f.b. (76010) | $171.81 | $306.80 | 1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $171.81 | $306.80 | 1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $171.81 | $306.80 | 1.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $170.58 | $304.60 | 1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $171.81 | $306.80 | 1.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $171.81 | $306.80 | 1.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $171.81 | $306.80 | 1.6× |
| X-Ray Stress View (77071) | $171.81 | $306.80 | 1.9× |
| X-ray thoracic spine 4 vw (72074) | $171.81 | $306.80 | 1.6× |
| X-Ray Tmj Unilat (70328) | $171.81 | $306.80 | 1.9× |
| X-Rays Bone Length Studies (77073) | $257.66 | $460.10 | 2.4× |
| X-Rays Bone Survey Complete (77075) | $257.66 | $460.10 | 2.4× |
| Xr c-spine 4 or 5 views (72050) | $171.81 | $306.80 | 1.6× |
| Xr facial bones less than 3 views (70140) | $171.81 | $306.80 | 1.9× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$96.66–$128.80 | $172.60–$230 | varies |
| Xr Tomogram Single Plane (76100) | $257.66 | $460.10 | 2.4× |
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.