Imaging prices at North Central Kansas Medical Center
Concordia, KS · every code in this section with a posted price and a Medicare benchmark.
381 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) | $434.42 | $620.60 | 0.3× |
| Abdomen 1 View (74018) | $313.39 | $447.70 | 3.9× |
| Abdomen 2 views (74019) | $420.42 | $600.60 | 4.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $801.78 | $1,145.40 | 2.2× |
| Adrenal Cortex & Medulla Img (78075) | $985.18 | $1,407.40 | 0.8× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$4,572.54 | $198–$6,532.20 | 1.6× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$4,572.54 | $209.30–$6,532.20 | 1.6× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$508.13–$4,572.54 | $725.90–$6,532.20 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $4,572.54 | $6,532.20 | 1.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,850.45 | $2,643.50 | 0.6× |
| Ankle 2 views (73600) | $383.25 | $547.50 | 4.8× |
| Aortography thoracic serialography rs&i (75605) | $4,572.54 | $6,532.20 | 0.9× |
| Aortography thoracic w/o serialography rs&i (75600) | $4,572.54 | $6,532.20 | 1.6× |
| Artery X-Rays Abdomen (75726) | $4,572.54 | $6,532.20 | 0.9× |
| Artery X-Rays Pelvis (75736) | $4,572.54 | $6,532.20 | 0.9× |
| Arthrogram ankle (73615) | $475.86 | $679.80 | 1.5× |
| Arthrogram hip (73525) | $497.14 | $710.20 | 1.5× |
| Arthrogram Wrist (73115) | $569.73 | $813.90 | 1.8× |
| Basic radiation dosimetry calculation (77300) | $64.12 | $91.60 | 0.5× |
| Bone age studies (77072) | $383.25 | $547.50 | 4.0× |
| Bone Imaging 3 Phase (78315) | $573.93 | $819.90 | 1.6× |
| Bone Imaging Limited Area (78300) | $1,036.49 | $1,480.70 | 2.8× |
| Bone Imaging Multiple Areas (78305) | $1,221.43 | $1,744.90 | 3.3× |
| Bone Imaging Whole Body (78306) | $1,887.34 | $2,696.20 | 5.1× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$337.40–$386.40 | $482–$552 | varies |
| Brachytx isodose complex (77318) | $340.69 | $486.70 | 1.0× |
| Brachytx isodose intermed (77317) | $212.45 | $303.50 | 0.6× |
| Brachytx Isodose Plan Simple (77316) | $201.18 | $287.40 | 0.6× |
| Brain Flow Imaging Only (78610) | $400.40 | $572 | 0.8× |
| Brain Image W/Flow < 4 Views (78601) | $719.39 | $1,027.70 | 2.0× |
| Brain imaging < 4 static views (78600) | $596.82 | $852.60 | 1.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,192.87 | $1,704.10 | 2.4× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,104.74 | $1,578.20 | 2.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,965.87 | $7,094.10 | 3.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $1,670.90 | $2,387 | 4.5× |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$160.30–$678.02 | $229–$968.60 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $686.42 | $980.60 | 1.4× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $806.05 | $1,151.50 | 1.6× |
| Cerebrospinal Fluid Scan (78630) | $1,005.13 | $1,435.90 | 2.0× |
| Chest 1 view (71045) | $259.63 | $370.90 | 3.2× |
| Chest 2 views (71046) | $394.80 | $564 | 4.9× |
| Chest 3 views (71047) | $480.20 | $686 | 6.0× |
| Chest 4 or more views (71048) | $548.45 | $783.50 | 5.7× |
| Cholecystography Oral Contrast (74290) | $458.64 | $655.20 | 2.8× |
| Clavicle complete (73000) | $407.54 | $582.20 | 5.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $285.53 | $407.90 | 3.0× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$4,572.54 | $174.50–$6,532.20 | 1.6× |
| Contrast X-Ray Bladder (74430) | $736.05 | $1,051.50 | 2.3× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$362.25–$905.52 | $517.50–$1,293.60 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $749.14 | $1,070.20 | 2.3× |
| Contrast Xray Throat/Cerv Esopha (74210) | $509.95 | $728.50 | 3.2× |
| CT abdomen and pelvis without and with contrast (74178) | $2,277.24 | $3,253.20 | 7.1× |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$595.56–$1,891.75 | $850.80–$2,702.50 | varies |
| CT abdomen w contrast (74160) | $1,891.75 | $2,702.50 | 11.7× |
| CT abdomen w wo contrast (74170) | $2,277.24 | $3,253.20 | 14.1× |
| CT abdomen w/o contrast (74150) | $1,891.75 | $2,702.50 | 19.7× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$974.61–$3,415.58 | $1,392.30–$4,879.40 | varies |
| CT Angio Chest (71275) | $2,277.24 | $3,253.20 | 14.1× |
| CT Angio Head (70496) | $2,277.24 | $3,253.20 | 14.1× |
| CT angio hrt w/3d image (75574) | $626.92 | $895.60 | 2.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,277.24 | $3,253.20 | 14.1× |
| CT Angio Neck (70498) | $2,277.24 | $3,253.20 | 14.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,277.24 | $3,253.20 | 14.1× |
| CT bone density (77078) | $1,281.21 | $1,830.30 | 16.0× |
| CT cervical spine w/ contrast (72126) | $1,891.75 | $2,702.50 | 5.9× |
| CT cervical spine w/o contrast (72125) | $1,891.75 | $2,702.50 | 19.7× |
| CT cervical spine w/wo cont (72127) | $2,277.24 | $3,253.20 | 14.1× |
| CT chest w contrast (71260) | $1,891.75 | $2,702.50 | 11.7× |
| CT chest w/wo contrast (71270) | $2,277.24 | $3,253.20 | 14.1× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,774.92 | $2,535.60 | 11.0× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,774.92 | $2,535.60 | 18.5× |
| CT head/brain with contrast (70460) | $1,891.75 | $2,702.50 | 11.7× |
| CT head/brain without and with contrast (70470) | $2,277.24 | $3,253.20 | 14.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $626.92 | $895.60 | 2.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $210 | $300 | 2.6× |
| CT hrt w/3d image congen (75573) | $626.92 | $895.60 | 2.0× |
| CT iac w contrast (70481) | $1,891.75 | $2,702.50 | 11.7× |
| CT l-spine w&w/o contrast (72133) | $2,277.24 | $3,253.20 | 14.1× |
| CT lower ext w/o (73700) | $1,891.75 | $2,702.50 | 19.7× |
| CT lower extremity w/contrast material (73701) | $1,891.75 | $2,702.50 | 11.7× |
| CT lumbar spine w contrast (72132) | $1,891.75 | $2,702.50 | 5.9× |
| CT lumbar spine w/o contrast (72131) | $1,891.75 | $2,702.50 | 19.7× |
| CT maxillofacial w contrast (70487) | $1,891.75 | $2,702.50 | 11.7× |
| CT maxillofacial wo contrast (70486) | $1,891.75 | $2,702.50 | 19.7× |
| CT neck tissue combo (70492) | $2,277.24 | $3,253.20 | 14.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,277.24 | $3,253.20 | 14.1× |
| CT orbits w/o contrast (70480) | $1,891.75 | $2,702.50 | 19.7× |
| CT pelvis w&w/o contrast (72194) | $2,277.24 | $3,253.20 | 14.1× |
| CT pelvis w/o contrast (72192) | $1,891.75 | $2,702.50 | 19.7× |
| CT scan of leg combo (73702) | $2,277.24 | $3,253.20 | 14.1× |
| CT scans face/jaw combo (70488) | $2,277.24 | $3,253.20 | 14.1× |
| CT soft tissue neck w contrast (70491) | $1,891.75 | $2,702.50 | 11.7× |
| CT soft tissue neck w/o contrast (70490) | $1,891.75 | $2,702.50 | 19.7× |
| CT thoracic spine w contrast (72129) | $1,891.75 | $2,702.50 | 11.7× |
| CT thoracic spine w/o contrast (72128) | $1,891.75 | $2,702.50 | 19.7× |
| CT thoracic spine w/wo cont (72130) | $2,277.24 | $3,253.20 | 14.1× |
| CT thorax w/o contrast (71250) | $1,891.75 | $2,702.50 | 19.7× |
| CT unlisted procedure (76497) | $400.75 | $572.50 | 5.0× |
| CT upper ext wo (73200) | $1,891.75 | $2,702.50 | 19.7× |
| CT upper extremity w/o & w/contrast material (73202) | $2,277.24 | $3,253.20 | 14.1× |
| CT upper extremity with contrast (73201) | $1,891.75 | $2,702.50 | 5.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,623.64 | $6,605.20 | 28.7× |
| Cta Abdomen (74175) | $2,277.24 | $3,253.20 | 14.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,277.24 | $3,253.20 | 7.1× |
| CTA pelvis (72191) | $2,277.24 | $3,253.20 | 14.1× |
| Discography Cerv/Thor Spine (72285) | $2,345.56 | $3,350.80 | 1.3× |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$2,345.56–$2,443.63 | $3,350.80–$3,490.90 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) | $223.65 | $319.50 | 2.3× |
| Dxa Bone Density Axial (77080) range across 4 matching MRF lines |
$39.34–$392.07 | $56.20–$560.10 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$21.70–$154.35 | $31–$220.50 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$120.26–$1,409.31 | $171.80–$2,013.30 | varies |
| Echo Guide For Artery Repair (76936) | $1,093.54 | $1,562.20 | 5.5× |
| Echograp Trans R Pros Study (76873) | $1,323.77 | $1,891.10 | 13.8× |
| Esophagram (74220) | $369.18 | $527.40 | 2.3× |
| Fetal Biophys Profile W/Nst (76818) | $200.41 | $286.30 | 2.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$154.63–$1,237.11 | $220.90–$1,767.30 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$27.30–$475.86 | $39–$679.80 | varies |
| Foot 2 views (73620) | $383.25 | $547.50 | 4.8× |
| Forearm 2 views (73090) | $374.92 | $535.60 | 4.7× |
| Gastric emptying imaging study (78264) | $1,944.46 | $2,777.80 | 5.3× |
| Gastroesophageal Reflux Exam (78262) | $1,018.08 | $1,454.40 | 2.8× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$73.43–$1,706.25 | $104.90–$2,437.50 | varies |
| Hand 2 views (73120) | $383.25 | $547.50 | 4.0× |
| Heart first pass single,planar (78481) | $1,706.25 | $2,437.50 | 3.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $4,572.54 | $6,532.20 | 1.6× |
| Hepatobil Syst Image W/Drug (78227) | $1,550.15 | $2,214.50 | 3.1× |
| Hepatobiliary System Imaging (78226) | $1,550.15 | $2,214.50 | 4.2× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$102.62–$3,876.60 | $146.60–$5,538 | varies |
| Hysterosalpingogram (74740) | $651 | $930 | 3.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,409.31 | $2,013.30 | 17.6× |
| Infant hip ultrasound, limited static exam (76886) | $154 | $220 | 1.9× |
| Infusion Ivp (74410) | $1,089.06 | $1,555.80 | 6.8× |
| Joint Survey Single View (77077) | $366.17 | $523.10 | 3.8× |
| K Flow/Funct Image Multiple (78709) | $1,999.76 | $2,856.80 | 4.0× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$385.49–$1,999.76 | $550.70–$2,856.80 | varies |
| K Flow/Funct Image W/O Drug (78707) | $1,504.72 | $2,149.60 | 3.0× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $969.64 | $1,385.20 | 2.6× |
| Kidney Imaging Morphol (78700) | $1,045.31 | $1,493.30 | 2.8× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$138.46–$454.51 | $197.80–$649.30 | varies |
| Leveen/Shunt Patency Exam (78291) | $740.60 | $1,058 | 2.0× |
| Liver & Spleen Imaging Static Only (78215) | $1,070.51 | $1,529.30 | 2.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,541.75 | $2,202.50 | 4.2× |
| Liver imaging static only (78201) | $797.37 | $1,139.10 | 1.6× |
| Liver imaging w/vascular flow (78202) | $1,018.08 | $1,454.40 | 2.0× |
| Lung Perf&Ventilat Diferentl (78598) | $2,574.04 | $3,677.20 | 5.2× |
| Lung perfusion differential (78597) | $1,073.73 | $1,533.90 | 2.9× |
| Lung Ventilat&Perfus Imaging (78582) | $1,886.01 | $2,694.30 | 3.8× |
| Lung Ventilation Imaging (78579) | $1,074.92 | $1,535.60 | 2.9× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$102.62–$841.47 | $146.60–$1,202.10 | varies |
| Magnetic Image Jaw Joint (70336) | $814.24 | $1,163.20 | 3.7× |
| Mammary ductogram or galactogram multiple (77054) | $521.29 | $744.70 | 2.4× |
| Mammary ductogram or galactogram single (77053) | $557.13 | $795.90 | 2.5× |
| Meckels Divert Exam (78290) | $1,109.08 | $1,584.40 | 3.0× |
| Mlc imrt design & construction per imrt plan (77338) | $450.45 | $643.50 | 1.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $43.75 | $62.50 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $3,960.39 | $5,657.70 | 12.3× |
| MRA head w/o contrast (70544) | $2,988.72 | $4,269.60 | 13.6× |
| MRA head with contrast (70545) | $2,988.72 | $4,269.60 | 9.3× |
| MRA neck w contrast (70548) | $2,988.72 | $4,269.60 | 9.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,960.39 | $5,657.70 | 12.3× |
| MRA neck w/o contrast (70547) | $2,988.72 | $4,269.60 | 13.6× |
| MRI abdomen w contrast (74182) | $2,988.72 | $4,269.60 | 9.3× |
| MRI abdomen w/o contrast (74181) | $2,988.72 | $4,269.60 | 13.6× |
| MRI any jt lower extrem w/contrast material (73722) | $2,741.90 | $3,917 | 3.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,185.07 | $4,550.10 | 9.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,741.90 | $3,917 | 3.8× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,988.72 | $4,269.60 | 13.6× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,988.72 | $4,269.60 | 13.6× |
| MRI cervical spine w contrast (72142) | $2,988.72 | $4,269.60 | 9.3× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$710.50–$2,988.72 | $1,015–$4,269.60 | varies |
| MRI chest w/o contrast (71550) | $2,988.72 | $4,269.60 | 13.6× |
| MRI chest with contrast (71551) | $2,988.72 | $4,269.60 | 4.1× |
| MRI chest wo w contrast (71552) | $3,960.39 | $5,657.70 | 12.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,741.90 | $3,917 | 8.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,185.07 | $4,550.10 | 9.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,741.90 | $3,917 | 12.5× |
| MRI lumbar spine w contrast (72149) | $2,988.72 | $4,269.60 | 9.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,960.39 | $5,657.70 | 12.3× |
| MRI orbit face &/neck w/o contrast (70540) | $2,741.90 | $3,917 | 12.5× |
| MRI orbit face neck w contrast (70542) | $2,988.72 | $4,269.60 | 9.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,960.39 | $5,657.70 | 12.3× |
| MRI pelvis w contrast (72196) | $2,988.72 | $4,269.60 | 9.3× |
| MRI pelvis w/o & w contrast (72197) | $3,960.39 | $5,657.70 | 12.3× |
| MRI pelvis w/o contrast (72195) | $2,988.72 | $4,269.60 | 13.6× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$710.50–$2,988.72 | $1,015–$4,269.60 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,741.90 | $3,917 | 8.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,741.90 | $3,917 | 12.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,185.07 | $4,550.10 | 9.9× |
| MRI, abdomen, combo (74183) | $3,960.39 | $5,657.70 | 12.3× |
| MRI, dorsal spine combo (72157) | $3,960.39 | $5,657.70 | 12.3× |
| MRI, dorsal spine contrast (72147) | $2,988.72 | $4,269.60 | 9.3× |
| MRI, joint upper extrem (73221) | $2,741.90 | $3,917 | 12.5× |
| MRI, joint upper extrem combo (73223) | $3,185.07 | $4,550.10 | 9.9× |
| MRI, lumbar spine combo (72158) | $3,960.39 | $5,657.70 | 12.3× |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$4,202.94–$4,773.02 | $6,004.20–$6,818.60 | varies |
| Myelography thoracic (72255) | $4,773.02 | $6,818.60 | 6.6× |
| Myelograpy 2/more regions rs&i (72270) | $5,039.16 | $7,198.80 | 7.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,965.87 | $7,094.10 | 4.2× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$142.31–$4,194.40 | $203.30–$5,992 | varies |
| Neck soft tissue (70360) | $349.16 | $498.80 | 4.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $810.32 | $1,157.60 | 0.6× |
| Nuclear Rx Intra-Arterial (79445) | $613.97 | $877.10 | 2.9× |
| Nuclear Rx Oral Admin (79005) | $467.46 | $667.80 | 2.2× |
| Ob us nuchal meas 1 gest (76813) | $172.41 | $246.30 | 1.8× |
| Optic foramina (70190) | $467.46 | $667.80 | 5.8× |
| Parathyroid Planar Imaging (78070) | $985.18 | $1,407.40 | 2.7× |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$523.46–$900.48 | $747.80–$1,286.40 | varies |
| Pelvis 1 or 2 views (72170) | $411.95 | $588.50 | 4.3× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$4,965.87–$9,115.75 | $7,094.10–$13,022.50 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,965.87 | $7,094.10 | 3.8× |
| PET whole body (78813) | $4,965.87 | $7,094.10 | 3.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $703.57 | $1,005.10 | 1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $823.06 | $1,175.80 | 8.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$507.43–$735.91 | $724.90–$1,051.30 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $501.41 | $716.30 | 6.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $383.25 | $547.50 | 4.8× |
| Radex elbow complete minimum 3 views (73080) | $451.71 | $645.30 | 5.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $548.45 | $783.50 | 5.7× |
| Radex fingr minimum 2 views (73140) | $181.79 | $259.70 | 2.3× |
| Radex foot complete minimum 3 views (73630) | $411.95 | $588.50 | 5.1× |
| Radex Hand Minimum 3 Views (73130) | $426.16 | $608.80 | 5.3× |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$43.33–$279.30 | $61.90–$399 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $582.68 | $832.40 | 6.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $370.51 | $529.30 | 4.6× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $366.24 | $523.20 | 4.6× |
| Radex Ribs Unilateral 2 Views (71100) | $319.41 | $456.30 | 4.0× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$55.09–$431.83 | $78.70–$616.90 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $399 | $570 | 5.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,611.33 | $2,301.90 | 10.0× |
| Radex Spine 1 View Specify Level (72020) | $400.40 | $572 | 5.0× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$45.64–$514.29 | $65.20–$734.70 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $394.80 | $564 | 4.9× |
| Radex Toe Minimum 2 Views (73660) | $181.79 | $259.70 | 2.3× |
| Radex upper extremity infant minimum 2 views (73092) | $243.74 | $348.20 | 2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) | $426.16 | $608.80 | 5.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $573.93 | $819.90 | 6.0× |
| Radiologic exam colon double contrast study (74280) | $1,188.95 | $1,698.50 | 7.4× |
| Radiologic exam colon single contrast study (74270) | $938.28 | $1,340.40 | 5.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $472.78 | $675.40 | 2.9× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$94.43–$481.39 | $134.90–$687.70 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $433.02 | $618.60 | 4.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $823.06 | $1,175.80 | 5.1× |
| Radiologic exam swallow function contrast study (74230) | $665.07 | $950.10 | 4.1× |
| Radiologic exam teeth complete full mouth (70320) | $312.13 | $445.90 | 1.4× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $245.42 | $350.60 | 1.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $986.72 | $1,409.60 | 6.1× |
| Radiologic examination femur 1 view (73551) | $108.08 | $154.40 | 1.4× |
| Radiologic examination femur minimum 2 views (73552) | $431.83 | $616.90 | 5.4× |
| Radiologic examination knee 1/2 views (73560) | $263.97 | $377.10 | 3.3× |
| Radiologic Examination Osseous Survey Limited (77074) | $657.86 | $939.80 | 6.8× |
| Radiologic Examination Salivary Gland Calculus (70380) | $352.17 | $503.10 | 4.4× |
| Radiologic examination tibia & fibula 2 views (73590) | $420.42 | $600.60 | 5.3× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $191.38 | $273.40 | 2.4× |
| Ribs bilateral 3 views (71110) | $362.25 | $517.50 | 3.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $362.25 | $517.50 | 1.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$435.89–$1,315.37 | $622.70–$1,879.10 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 3 matching MRF lines |
$2,379.72–$3,943.45 | $3,399.60–$5,633.50 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,630.18 | $3,757.40 | 5.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines |
$80.50–$2,284.31 | $115–$3,263.30 | varies |
| Rp Therapy Intravenous Administration (79101) | $613.97 | $877.10 | 2.9× |
| Salivary Gland Imaging (78230) | $695.80 | $994 | 1.9× |
| Scapula (73010) | $426.16 | $608.80 | 4.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $59.92 | $85.60 | 2.6× |
| Sella turcica (70240) | $312.13 | $445.90 | 3.9× |
| Shoulder 1 view (73020) | $294.98 | $421.40 | 3.7× |
| Shoulder Arthrography (73040) | $878.71 | $1,255.30 | 2.7× |
| Sialogram (70390) | $407.54 | $582.20 | 1.9× |
| Skull less than 4 views (70250) | $455.98 | $651.40 | 4.7× |
| Special dosimetry (77331) | $89.04 | $127.20 | 0.7× |
| Special treatment procedure (77470) | $206.85 | $295.50 | 0.4× |
| Spleen Imaging (78185) | $841.47 | $1,202.10 | 2.3× |
| Sternoclavicular joints (71130) | $383.25 | $547.50 | 4.8× |
| Superior sagittal sinus venogram (75870) | $4,572.54 | $6,532.20 | 1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $294.98 | $421.40 | 0.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $264.53 | $377.90 | 0.8× |
| Temporomandble Jt Arthrography Rs&I (70332) | $571.13 | $815.90 | 2.6× |
| Testicular Imaging W/Flow (78761) | $1,074.92 | $1,535.60 | 2.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $158.76 | $226.80 | 0.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $110.67 | $158.10 | 0.3× |
| Ther rad simulaj-aided field setting simple (77280) | $73.01 | $104.30 | 0.6× |
| Thoracic spine 2 views (72070) | $611.24 | $873.20 | 6.4× |
| Thoracic spine 3 views (72072) | $649.32 | $927.60 | 6.8× |
| Thoracolumbar 2 views (72080) | $564.06 | $805.80 | 7.0× |
| Thyroid Imaging With Vascular Flow (78013) | $793.80 | $1,134 | 2.2× |
| Thyroid Met Imaging Body (78018) | $1,419.39 | $2,027.70 | 2.8× |
| Thyroid Uptake Measurement (78012) | $481.39 | $687.70 | 1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,101.87 | $1,574.10 | 3.0× |
| Tx Devices Design & Construction Complex (77334) | $112.21 | $160.30 | 0.3× |
| Tx devices design & construction intermediate (77333) | $73.78 | $105.40 | 0.6× |
| Tx devices design & construction simple (77332) | $44.94 | $64.20 | 0.4× |
| Ultrasound Breast Limited (76642) | $426.37 | $609.10 | 5.3× |
| Ultrasound Elastography Parenchyma (76981) | $279.09 | $398.70 | 2.9× |
| Ultrasound Exam Aaa Screen (76706) | $284.41 | $406.30 | 3.0× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$116.27–$389.20 | $166.10–$556 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$84.21–$287.56 | $120.30–$410.80 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $579.74 | $828.20 | 7.2× |
| Unlisted respiratory px dx nuclear medicine (78599) | $861.63 | $1,230.90 | 2.3× |
| Unlisted us procedure (76999) | $220.15 | $314.50 | 2.8× |
| Upper gi w/o kub (74240) | $965.02 | $1,378.60 | 6.0× |
| Urethrocystogram voiding (74455) | $679.42 | $970.60 | 3.1× |
| Urethrocystography retrograde (74450) | $679.42 | $970.60 | 3.1× |
| Us breast unilateral complete (76641) | $639.38 | $913.40 | 6.6× |
| Us chest (76604) range across 2 matching MRF lines |
$56.14–$1,237.11 | $80.20–$1,767.30 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$160.30–$1,237.11 | $229–$1,767.30 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$319.83–$971.04 | $456.90–$1,387.20 | varies |
| Us head (76506) | $1,237.11 | $1,767.30 | 12.9× |
| Us kidney transplant (76776) | $1,237.11 | $1,767.30 | 12.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $761.74 | $1,088.20 | 7.9× |
| Us ob detailed single fetus (76811) | $240.45 | $343.50 | 1.1× |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$170.80–$411.95 | $244–$588.50 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$160.30–$392.07 | $229–$560.10 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$239.68–$1,386.42 | $342.40–$1,980.60 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$203.70–$480.27 | $291–$686.10 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 4 matching MRF lines |
$188.72–$392.07 | $269.60–$560.10 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$56.56–$1,237.11 | $80.80–$1,767.30 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$56.14–$389.20 | $80.20–$556 | varies |
| Us scrotum and contents (76870) | $1,237.11 | $1,767.30 | 12.9× |
| Us spinal canal and contents (76800) | $1,261.33 | $1,801.90 | 13.1× |
| Us thyroid (76536) | $1,237.11 | $1,767.30 | 12.9× |
| Us transrectal (76872) | $1,323.77 | $1,891.10 | 13.8× |
| Vascular Flow Imaging (78445) | $182 | $260 | 0.5× |
| Vasogram (74440) | $501.41 | $716.30 | 2.3× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$97.37–$1,850.45 | $139.10–$2,643.50 | varies |
| Vein X-Ray Skull Epidural (75872) | $1,850.45 | $2,643.50 | 3.2× |
| Vein X-Ray Spleen/Liver (75810) | $564.06 | $805.80 | 0.2× |
| Venogram Sinus/Jugular (75860) range across 3 matching MRF lines |
$112.21–$258.93 | $160.30–$369.90 | varies |
| Venography Adrenal Unilateral (75840) | $4,572.54 | $6,532.20 | 1.6× |
| Venography caval inferior serialography rs&i (75825) | $4,572.54 | $6,532.20 | 1.6× |
| Venography extremity bilateral rs&i (75822) | $1,850.45 | $2,643.50 | 1.3× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$182–$1,850.45 | $260–$2,643.50 | varies |
| Venography Renal Bilateral (75833) | $4,572.54 | $6,532.20 | 1.6× |
| Venography Renal Unilateral (75831) | $4,572.54 | $6,532.20 | 1.6× |
| Venous sampling by catheter (75893) | $4,572.54 | $6,532.20 | 0.9× |
| Venous thrombosis imaging (78457) | $955.50 | $1,365 | 1.9× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,235.71 | $1,765.30 | 3.4× |
| Wrist 2 views (73100) | $383.25 | $547.50 | 4.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $455.98 | $651.40 | 5.7× |
| X-ray antegrade pyelogram tube (74425) | $643.79 | $919.70 | 2.0× |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$4,572.54 | $214.20–$6,532.20 | 1.6× |
| X-Ray Bend Only L-S Spine (72120) | $521.29 | $744.70 | 5.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $411.95 | $588.50 | 5.1× |
| X-Ray Exam Breast Specimen (76098) | $515.55 | $736.50 | 1.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $108.08 | $154.40 | 1.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$180.60–$1,342.46 | $258–$1,917.80 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$145.53–$263.97 | $207.90–$377.10 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$145.53–$434.63 | $207.90–$620.90 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $215.11 | $307.30 | 2.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $713.58 | $1,019.40 | 7.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $298.69 | $426.70 | 3.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $334.39 | $477.70 | 3.5× |
| X-Ray Exam L-S Spine Bending (72114) | $760.48 | $1,086.40 | 7.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $455.98 | $651.40 | 5.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $713.58 | $1,019.40 | 7.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $557.13 | $795.90 | 5.8× |
| X-ray eye for foreign body (70030) | $366.17 | $523.10 | 4.6× |
| X-ray head for orthodontia (70350) | $98.07 | $140.10 | 1.2× |
| X-ray humerus (73060) | $335.23 | $478.90 | 4.2× |
| X-ray IV pyelogram (ivp) (74400) | $894.04 | $1,277.20 | 5.5× |
| X-ray IV pyelogram+tomography (74415) | $1,406.44 | $2,009.20 | 8.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $504.28 | $720.40 | 6.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $267.68 | $382.40 | 3.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $557.13 | $795.90 | 5.8× |
| X-ray nose-rectum child f.b. (76010) | $389.20 | $556 | 4.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $512.82 | $732.60 | 5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $428.68 | $612.40 | 4.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $363.37 | $519.10 | 3.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $428.68 | $612.40 | 5.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $565.46 | $807.80 | 7.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $536.97 | $767.10 | 5.6× |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$15.33–$99.40 | $21.90–$142 | varies |
| X-ray thoracic spine 4 vw (72074) | $429.94 | $614.20 | 4.5× |
| X-Ray Tmj Unilat (70328) | $265.30 | $379 | 3.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $894.04 | $1,277.20 | 2.8× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$431.97–$820.19 | $617.10–$1,171.70 | varies |
| X-Rays Bone Survey Complete (77075) | $1,261.33 | $1,801.90 | 13.1× |
| Xr c-spine 4 or 5 views (72050) | $635.18 | $907.40 | 6.6× |
| Xr facial bones less than 3 views (70140) | $333.55 | $476.50 | 4.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $435.89 | $622.70 | 4.5× |
| Xr myelogram posterior fossa (70010) | $1,025.22 | $1,464.60 | 3.2× |
| Xr orbits complete 4 views (70200) | $521.29 | $744.70 | 5.4× |
| Xr Tomogram Single Plane (76100) | $871.22 | $1,244.60 | 9.1× |
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.