Imaging prices at Northern Montana Hospital
Havre, MT · 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 2 matching MRF lines |
$10.50–$294.35 | $15–$420.50 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$12.60–$320.78 | $18–$458.25 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 3 matching MRF lines |
$38.50–$1,506.58 | $55–$2,152.25 | varies |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$9.10–$294.35 | $13–$420.50 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$32.20–$1,268.93 | $46–$1,812.75 | varies |
| Bone age studies (77072) | $294.35 | $420.50 | 2.8× |
| Bone Imaging 3 Phase (78315) | $1,118.08 | $1,597.25 | 2.7× |
| Bone Imaging Limited Area (78300) | $33.60 | $48 | 0.1× |
| Bone Imaging Whole Body (78306) | $1,771.70 | $2,531 | 4.3× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$37.80–$553 | $54–$790 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,064.83 | $2,949.75 | 3.7× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$51.10–$622.30 | $73–$889 | varies |
| Chest 1 view (71045) | $10.50 | $15 | 0.1× |
| Chest 2 views (71046) | $11.90 | $17 | 0.1× |
| Chest 4 or more views (71048) | $16.80 | $24 | 0.2× |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$17.50–$588.35 | $25–$840.50 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$9.10–$294.35 | $13–$420.50 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 3 matching MRF lines |
$57.40–$486.68 | $82–$695.25 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$32.20–$1,021.48 | $46–$1,459.25 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$32.20–$1,268.93 | $46–$1,812.75 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$107.10–$2,349.55 | $153–$3,356.50 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$93.10–$1,456 | $133–$2,080 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$68.60–$1,976.63 | $98–$2,823.75 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$74.90–$2,349.55 | $107–$3,356.50 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$64.40–$1,456 | $92–$2,080 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$116.20–$2,298.80 | $166–$3,284 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$97.30–$2,298.80 | $139–$3,284 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$93.10–$2,298.80 | $133–$3,284 | varies |
| CT angio hrt w/3d image (75574) | $1,976.63 | $2,823.75 | 5.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$100.10–$2,297.23 | $143–$3,281.75 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$93.10–$2,298.80 | $133–$3,284 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$95.20–$2,298.80 | $136–$3,284 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$65.10–$1,976.63 | $93–$2,823.75 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$53.90–$1,456 | $77–$2,080 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$68.60–$2,349.55 | $98–$3,356.50 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$61.60–$1,976.63 | $88–$2,823.75 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$67.20–$2,349.55 | $96–$3,356.50 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$60.20–$1,976.63 | $86–$2,823.75 | varies |
| CT head/brain without and with contrast (70470) | $2,349.55 | $3,356.50 | 13.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,976.63 | $2,823.75 | 5.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $175.53 | $250.75 | 2.0× |
| CT hrt w/3d image congen (75573) | $1,976.63 | $2,823.75 | 5.5× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$60.20–$1,976.63 | $86–$2,823.75 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$68.60–$2,349.55 | $98–$3,356.50 | varies |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$53.90–$1,456 | $77–$2,080 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$61.60–$1,976.63 | $88–$2,823.75 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$65.10–$1,976.63 | $93–$2,823.75 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$53.90–$1,456 | $77–$2,080 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$60.20–$1,976.63 | $86–$2,823.75 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$45.50–$1,456 | $65–$2,080 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$86.10–$2,349.55 | $123–$3,356.50 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$67.90–$2,349.55 | $97–$3,356.50 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$68.60–$1,456 | $98–$2,080 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$65.10–$2,349.55 | $93–$3,356.50 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$58.10–$1,456 | $83–$2,080 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$65.10–$2,349.55 | $93–$3,356.50 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$67.90–$2,349.55 | $97–$3,356.50 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$74.20–$1,976.63 | $106–$2,823.75 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$67.90–$1,456 | $97–$2,080 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$65.80–$1,976.63 | $94–$2,823.75 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$53.90–$1,456 | $77–$2,080 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$67.90–$2,349.55 | $97–$3,356.50 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$57.40–$1,456 | $82–$2,080 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$53.90–$1,456 | $77–$2,080 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$65.10–$2,349.55 | $93–$3,356.50 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$61.60–$1,976.63 | $88–$2,823.75 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$126–$1,976.63 | $180–$2,823.75 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$95.90–$2,298.80 | $137–$3,284 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$95.20–$2,298.80 | $136–$3,284 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) | $404.95 | $578.50 | 3.8× |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$11.20–$563.85 | $16–$805.50 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$39.20–$86.10 | $56–$123 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$32.20–$588.35 | $46–$840.50 | varies |
| Fetal Biophys Profile W/Nst (76818) | $56.70 | $81 | 0.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $550.73 | $786.75 | 5.2× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$343.35–$532.70 | $490.50–$761 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$8.40–$294.35 | $12–$420.50 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$9.10–$294.35 | $13–$420.50 | varies |
| Gastric emptying imaging study (78264) | $42 | $60 | 0.1× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$51.80–$1,744.40 | $74–$2,492 | varies |
| Hand 2 views (73120) range across 4 matching MRF lines |
$9.10–$294.35 | $13–$420.50 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$47.60–$1,721.83 | $68–$2,459.75 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$39.20–$1,721.83 | $56–$2,459.75 | varies |
| Ht Muscle Image Spect Sing (78451) | $3,425.45 | $4,893.50 | 2.6× |
| Hysterosalpingogram (74740) | $21 | $30 | 0.1× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$63–$1,657.95 | $90–$2,368.50 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$49.70–$1,459.85 | $71–$2,085.50 | varies |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$10.50–$298.20 | $15–$426 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) range across 3 matching MRF lines |
$29.40–$1,721.83 | $42–$2,459.75 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$56–$2,399.43 | $80–$3,427.75 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$25.90–$1,325.63 | $37–$1,893.75 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$62.30–$1,565.03 | $89–$2,235.75 | varies |
| Magnetic Image Jaw Joint (70336) | $2,262.93 | $3,232.75 | 9.3× |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$19.60–$819.88 | $28–$1,171.25 | varies |
| Meckels Divert Exam (78290) | $1,506.58 | $2,152.25 | 3.7× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$79.10–$3,719.45 | $113–$5,313.50 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$64.40–$2,603.65 | $92–$3,719.50 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$64.40–$2,765.70 | $92–$3,951 | varies |
| MRA neck w contrast (70548) range across 4 matching MRF lines |
$23.10–$2,765.70 | $33–$3,951 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$95.90–$3,719.45 | $137–$5,313.50 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$64.40–$2,603.65 | $92–$3,719.50 | varies |
| MRI abdomen w contrast (74182) range across 7 matching MRF lines |
$1,939.35–$2,765.70 | $2,770.50–$3,951 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$78.40–$2,603.65 | $112–$3,719.50 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$87.50–$2,653.70 | $125–$3,791 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$114.10–$3,571.23 | $163–$5,101.75 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$87.50–$4,148.90 | $125–$5,927 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$85.40–$2,603.65 | $122–$3,719.50 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$77.70–$2,205 | $111–$3,150 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$95.20–$2,765.70 | $136–$3,951 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$79.80–$2,603.65 | $114–$3,719.50 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$78.40–$2,603.65 | $112–$3,719.50 | varies |
| MRI chest with contrast (71551) | $4,006.45 | $5,723.50 | 5.0× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$119.70–$4,006.45 | $171–$5,723.50 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$86.80–$2,765.70 | $124–$3,951 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$114.10–$3,395.70 | $163–$4,851 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$72.10–$2,603.65 | $103–$3,719.50 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$95.20–$2,765.70 | $136–$3,951 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$121.80–$3,719.45 | $174–$5,313.50 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$72.10–$2,603.65 | $103–$3,719.50 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$86.10–$2,765.70 | $123–$3,951 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$114.10–$3,719.45 | $163–$5,313.50 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$92.40–$2,765.70 | $132–$3,951 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$116.90–$3,719.45 | $167–$5,313.50 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$78.40–$2,603.65 | $112–$3,719.50 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$79.10–$2,603.65 | $113–$3,719.50 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$87.50–$2,765.70 | $125–$3,951 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$72.80–$1,465.28 | $104–$2,093.25 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$114.80–$3,395.70 | $164–$4,851 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$116.90–$3,719.45 | $167–$5,313.50 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$121.80–$3,719.45 | $174–$5,313.50 | varies |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$73.50–$2,603.65 | $105–$3,719.50 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$114.80–$3,719.45 | $164–$5,313.50 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$121.80–$3,719.45 | $174–$5,313.50 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $52.50 | $75 | 0.0× |
| Myocardial Spect Multiple Studies (78452) | $85.40 | $122 | 0.1× |
| Neck soft tissue (70360) | $10.50 | $15 | 0.1× |
| Nonvascular Shunt X-Ray (75809) | $312.03 | $445.75 | 2.9× |
| Ob us nuchal meas 1 gest (76813) | $404.95 | $578.50 | 3.8× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $636.65 | $909.50 | 6.0× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $9.10 | $13 | 0.3× |
| Parathyroid Planar Imaging (78070) | $1,234.45 | $1,763.50 | 3.0× |
| Pelvis 1 or 2 views (72170) | $9.80 | $14 | 0.1× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$39.20–$1,325.63 | $56–$1,893.75 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $17.50 | $25 | 0.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $679.35 | $970.50 | 1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$9.80–$305.90 | $14–$437 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$9.10–$294.35 | $13–$420.50 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$9.80–$306.78 | $14–$438.25 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$14–$325.50 | $20–$465 | varies |
| Radex fingr minimum 2 views (73140) range across 7 matching MRF lines |
$7.70–$294.35 | $11–$420.50 | varies |
| Radex foot complete minimum 3 views (73630) range across 5 matching MRF lines |
$9.10–$299.60 | $13–$428 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$9.80–$309.75 | $14–$442.50 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$9.10–$325.50 | $13–$465 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $325.50 | $465 | 3.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$9.80–$316.93 | $14–$452.75 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$12.60–$311.33 | $18–$444.75 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 9 matching MRF lines |
$10.50–$457.56 | $15–$653.65 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$9.80–$329.18 | $14–$470.25 | varies |
| Radex Spine 1 View Specify Level (72020) | $9.10 | $13 | 0.1× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$11.20–$325.50 | $16–$465 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$13.30–$325.50 | $19–$465 | varies |
| Radex Toe Minimum 2 Views (73660) range across 7 matching MRF lines |
$7.70–$248.50 | $11–$355 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$9.10–$325.50 | $13–$465 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$9.80–$304.33 | $14–$434.75 | varies |
| Radiation treatment delivery level 1 (77402) | $237.30 | $339 | 2.3× |
| Radiation treatment delivery level 2 (77407) | $250.60 | $358 | 0.6× |
| Radiation treatment delivery level 3 (77412) | $362.08 | $517.25 | 0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$13.30–$325.50 | $19–$465 | varies |
| Radiologic exam colon double contrast study (74280) | $67.20 | $96 | 0.4× |
| Radiologic exam colon single contrast study (74270) range across 3 matching MRF lines |
$55.30–$653.63 | $79–$933.75 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$12.60–$396.20 | $18–$566 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$14–$511.88 | $20–$731.25 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$43.40–$653.63 | $62–$933.75 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$28.70–$588.35 | $41–$840.50 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$47.60–$653.63 | $68–$933.75 | varies |
| Radiologic examination femur 1 view (73551) | $311.33 | $444.75 | 3.5× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$10.50–$369.08 | $15–$527.25 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$9.10–$294.35 | $13–$420.50 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$23.80–$553 | $34–$790 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$9.10–$294.35 | $13–$420.50 | varies |
| Ribs bilateral 3 views (71110) | $16.10 | $23 | 0.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,654.80 | $2,364 | 4.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,837.15 | $2,624.50 | 3.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,837.15 | $2,624.50 | 3.3× |
| Scapula (73010) range across 2 matching MRF lines |
$10.50–$310.45 | $15–$443.50 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$28.56–$36.75 | $40.80–$52.50 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$8.40–$294.35 | $12–$420.50 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$30.80–$1,395.98 | $44–$1,994.25 | varies |
| Sialogram (70390) | $679.35 | $970.50 | 2.8× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$10.50–$329.18 | $15–$470.25 | varies |
| Sternoclavicular joints (71130) | $11.90 | $17 | 0.1× |
| Testicular Imaging W/Flow (78761) | $1,459.85 | $2,085.50 | 3.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$95.55–$396.20 | $136.50–$566 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $396.20 | $566 | 1.0× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$44.10–$223.83 | $63–$319.75 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$11.20–$310.45 | $16–$443.50 | varies |
| Thoracic spine 3 views (72072) | $12.60 | $18 | 0.1× |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$11.90–$326.90 | $17–$467 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $985.95 | $1,408.50 | 2.4× |
| Thyroid Met Imaging Body (78018) | $1,866.03 | $2,665.75 | 3.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $985.95 | $1,408.50 | 2.4× |
| Tx Devices Design & Construction Complex (77334) | $271.43 | $387.75 | 0.7× |
| Tx devices design & construction intermediate (77333) | $271.43 | $387.75 | 2.0× |
| Tx devices design & construction simple (77332) | $271.43 | $387.75 | 2.0× |
| Ultrasound Breast Limited (76642) | $374.50 | $535 | 4.2× |
| Ultrasound Exam Aaa Screen (76706) | $670.08 | $957.25 | 6.3× |
| Ultrasound, abdomen limited (76705) | $636.65 | $909.50 | 6.0× |
| Umbilical-artery Doppler (OB) (76820) | $404.95 | $578.50 | 3.8× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$42.70–$653.63 | $61–$933.75 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$17.50–$1,021.48 | $25–$1,459.25 | varies |
| Urethrocystography retrograde (74450) range across 3 matching MRF lines |
$17.50–$1,021.48 | $25–$1,459.25 | varies |
| Us breast unilateral complete (76641) | $398.65 | $569.50 | 3.7× |
| Us chest (76604) | $636.65 | $909.50 | 6.0× |
| Us complete joint (76881) range across 2 matching MRF lines |
$33.60–$636.65 | $48–$909.50 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$26.60–$350.35 | $38–$500.50 | varies |
| Us head (76506) range across 2 matching MRF lines |
$37.80–$443.10 | $54–$633 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $404.95 | $578.50 | 3.8× |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$102.20–$537.60 | $146–$768 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$91–$550.73 | $130–$786.75 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$104.65–$636.65 | $149.50–$909.50 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$52.50–$636.65 | $75–$909.50 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$122.50–$369.08 | $175–$527.25 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$39.90–$706.65 | $57–$1,009.50 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$35–$636.65 | $50–$909.50 | varies |
| Us thyroid (76536) | $636.65 | $909.50 | 6.0× |
| Us transrectal (76872) range across 2 matching MRF lines |
$36.40–$636.65 | $52–$909.50 | varies |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$9.10–$294.35 | $13–$420.50 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$10.50–$309.75 | $15–$442.50 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$12.60–$316.93 | $18–$452.75 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$9.10–$294.35 | $13–$420.50 | varies |
| X-Ray Exam Breast Specimen (76098) | $17.50 | $25 | 0.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$14–$498.58 | $20–$712.25 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$17.50–$649.60 | $25–$928 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$10.50–$254.63 | $15–$363.75 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 6 matching MRF lines |
$12.60–$553 | $18–$790 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$15.40–$394.10 | $22–$563 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $394.10 | $563 | 3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $16.10 | $23 | 0.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $16.80 | $24 | 0.2× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$16.80–$508.03 | $24–$725.75 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $12.60 | $18 | 0.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$16.10–$537.60 | $23–$768 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$14.70–$325.50 | $21–$465 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$10.50–$294.35 | $15–$420.50 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$9.10–$294.35 | $13–$420.50 | varies |
| X-ray IV pyelogram (ivp) (74400) | $864.50 | $1,235 | 4.8× |
| X-ray IV pyelogram+tomography (74415) | $25.90 | $37 | 0.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $10.50 | $15 | 0.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$9.80–$294.35 | $14–$420.50 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$12.60–$316.93 | $18–$452.75 | varies |
| X-ray nose-rectum child f.b. (76010) | $288.05 | $411.50 | 3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $17.50 | $25 | 0.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$12.60–$325.50 | $18–$465 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$9.10–$301 | $13–$430 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$9.80–$323.93 | $14–$462.75 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$11.90–$325.50 | $17–$465 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $15.40 | $22 | 0.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $864.50 | $1,235 | 2.4× |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$15.40–$513.28 | $22–$733.25 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$15.40–$533.58 | $22–$762.25 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$11.20–$12.60 | $16–$18 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$15.40–$325.50 | $22–$465 | varies |
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.