Imaging prices at Northwest Health-la Porte
La Porte, IN · every code in this section with a posted price and a Medicare benchmark.
368 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 4 matching MRF lines |
$20.13–$148.53 | $61–$450.10 | varies |
| Abdomen 2 views (74019) range across 4 matching MRF lines |
$19.47–$128.29 | $59–$388.77 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $910.56 | $2,759.26 | 2.1× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $555.11 | $1,682.15 | 0.4× |
| Adrenal Cortex & Medulla Img (78075) | $1,746.85 | $5,293.49 | 1.3× |
| Angio internal mammary (75756) | $3,909.06 | $11,845.65 | 1.2× |
| Angio pulmonary bilat (75743) range across 3 matching MRF lines |
$1,678.82–$3,909.06 | $5,087.32–$11,845.65 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,909.06 | $11,845.65 | 1.2× |
| Angiography extremity bilateral rs&i (75716) range across 5 matching MRF lines |
$2,115.18–$3,909.06 | $170–$11,845.65 | varies |
| Angiography extremity unilateral rs&i (75710) range across 6 matching MRF lines |
$2,020.10–$3,909.06 | $419–$11,845.65 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 5 matching MRF lines |
$1,100.99–$3,909.06 | $3,336.32–$11,845.65 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 3 matching MRF lines |
$868.24–$3,909.06 | $2,631.03–$11,845.65 | varies |
| Ankle 2 views (73600) range across 8 matching MRF lines |
$17.82–$121.54 | $54–$368.30 | varies |
| Aortography thoracic serialography rs&i (75605) range across 3 matching MRF lines |
$1,930.98–$6,511.80 | $5,851.45–$19,732.73 | varies |
| Aortography thoracic w/o serialography rs&i (75600) range across 2 matching MRF lines |
$1,522.74–$3,909.06 | $4,614.35–$11,845.65 | varies |
| Artery X-Rays Abdomen (75726) | $6,511.80 | $19,732.73 | 1.1× |
| Artery X-Rays Adrenal Gland (75731) | $3,909.06 | $11,845.65 | 1.2× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$1,930.98–$6,511.80 | $5,851.45–$19,732.73 | varies |
| Artery X-Rays Spine (75705) | $6,511.80 | $19,732.73 | 1.1× |
| Arthrogram ankle (73615) | $356.89 | $1,081.48 | 1.0× |
| Arthrogram hip (73525) | $386.81 | $1,172.14 | 1.0× |
| Arthrogram Wrist (73115) | $386.81 | $1,172.14 | 1.0× |
| Basic radiation dosimetry calculation (77300) | $282.13 | $854.95 | 2.0× |
| Bone age studies (77072) range across 3 matching MRF lines |
$11.22–$135.04 | $34–$409.21 | varies |
| Bone Imaging 3 Phase (78315) | $1,416.96 | $4,293.83 | 3.3× |
| Bone Imaging Limited Area (78300) | $1,307.96 | $3,963.51 | 3.1× |
| Bone Imaging Whole Body (78306) | $1,307.96 | $3,963.51 | 3.1× |
| Bone marrow imaging limited area (78102) | $338.09 | $1,024.50 | 0.8× |
| Bone survey infant (77076) range across 3 matching MRF lines |
$51.81–$131.18 | $157–$397.51 | varies |
| Brain Flow Imaging Only (78610) | $349.18 | $1,058.13 | 0.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,083.71 | $3,283.96 | 1.9× |
| Brain Imaging Minimum 4 Static Views (78605) | $893.19 | $2,706.65 | 1.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$114.51–$1,618.55 | $347–$4,904.71 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) | $131.34 | $398 | 0.2× |
| Cardiac Shunt Detection (78428) | $989.66 | $2,998.98 | 2.3× |
| Cat Scan Follow-Up Study (76380) | $353.04 | $1,069.83 | 3.8× |
| Cerebrospinal Fluid Scan (78630) | $2,495.84 | $7,563.16 | 4.3× |
| Chest 1 view (71045) range across 13 matching MRF lines |
$8.25–$114.77 | $25–$347.80 | varies |
| Chest 2 views (71046) range across 6 matching MRF lines |
$24.09–$182.30 | $73–$552.41 | varies |
| Chest 3 views (71047) range across 8 matching MRF lines |
$28.67–$191.95 | $86.88–$581.67 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$35.64–$211.25 | $108–$640.14 | varies |
| Cholecystography Oral Contrast (74290) | $216.05 | $654.71 | 1.2× |
| Clavicle complete (73000) range across 7 matching MRF lines |
$7.59–$148.53 | $23–$450.10 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $153.36 | $464.74 | 1.4× |
| Contrast Exam Abdominl Aorta (75625) range across 4 matching MRF lines |
$2,128.49–$3,909.06 | $355–$11,845.65 | varies |
| Contrast X-Ray Bladder (74430) | $350.62 | $1,062.48 | 0.9× |
| Contrast X-Ray Of Elbow (73085) | $336.63 | $1,020.09 | 0.9× |
| Contrast X-Ray Of Knee Joint (73580) | $386.81 | $1,172.14 | 1.0× |
| Contrast Xray Throat/Cerv Esopha (74210) | $249.34 | $755.59 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) | $1,272.76 | $3,856.86 | 3.4× |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$77.06–$1,018.10 | $233.52–$3,085.14 | varies |
| CT abdomen w contrast (74160) | $1,145.43 | $3,471.01 | 6.2× |
| CT abdomen w wo contrast (74170) | $1,272.76 | $3,856.86 | 6.8× |
| CT abdomen w/o contrast (74150) | $1,018.10 | $3,085.14 | 9.2× |
| CT Angio Abdomen and Pelvis (74174) | $1,272.76 | $3,856.86 | 3.4× |
| CT Angio Chest (71275) | $1,272.76 | $3,856.86 | 6.8× |
| CT Angio Head (70496) | $1,272.76 | $3,856.86 | 6.8× |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$105.93–$1,272.76 | $321–$3,856.86 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,272.76 | $3,856.86 | 6.8× |
| CT Angio Neck (70498) | $1,272.76 | $3,856.86 | 6.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,272.76 | $3,856.86 | 6.8× |
| CT cervical spine w/ contrast (72126) | $1,145.43 | $3,471.01 | 3.1× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$35.27–$1,018.10 | $106.88–$3,085.14 | varies |
| CT cervical spine w/wo cont (72127) | $1,272.76 | $3,856.86 | 6.8× |
| CT chest w contrast (71260) | $1,145.43 | $3,471.01 | 6.2× |
| CT chest w/wo contrast (71270) | $1,272.76 | $3,856.86 | 6.8× |
| CT colonography screening (74263) | $538.24 | $1,631.03 | 2.1× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,213.92 | $3,678.54 | 6.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,018.10 | $3,085.14 | 9.2× |
| CT head/brain with contrast (70460) | $1,214.39 | $3,679.96 | 6.5× |
| CT head/brain without and with contrast (70470) | $1,272.76 | $3,856.86 | 6.8× |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$77.22–$1,272.27 | $234–$3,855.36 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 3 matching MRF lines |
$25.74–$95.49 | $78–$289.35 | varies |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$112.86–$1,348.95 | $342–$4,087.74 | varies |
| CT iac w contrast (70481) | $1,145.43 | $3,471.01 | 6.2× |
| CT l-spine w&w/o contrast (72133) | $1,272.76 | $3,856.86 | 6.8× |
| CT lower ext w/o (73700) | $1,018.10 | $3,085.14 | 9.2× |
| CT lower extremity w/contrast material (73701) | $1,145.43 | $3,471.01 | 6.2× |
| CT lumbar spine w contrast (72132) | $1,145.43 | $3,471.01 | 3.1× |
| CT lumbar spine w/o contrast (72131) | $1,018.10 | $3,085.14 | 9.2× |
| CT maxillofacial w contrast (70487) | $1,145.43 | $3,471.01 | 6.2× |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$134.74–$1,018.10 | $408.31–$3,085.14 | varies |
| CT neck tissue combo (70492) | $1,272.76 | $3,856.86 | 6.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,272.76 | $3,856.86 | 6.8× |
| CT orbits w/o contrast (70480) | $1,018.10 | $3,085.14 | 9.2× |
| CT pelvis w&w/o contrast (72194) | $1,272.76 | $3,856.86 | 6.8× |
| CT pelvis w/o contrast (72192) | $1,018.10 | $3,085.14 | 9.2× |
| CT scan of leg combo (73702) | $1,272.76 | $3,856.86 | 6.8× |
| CT scans face/jaw combo (70488) | $1,272.76 | $3,856.86 | 6.8× |
| CT soft tissue neck w contrast (70491) | $1,145.43 | $3,471.01 | 6.2× |
| CT soft tissue neck w/o contrast (70490) | $1,018.10 | $3,085.14 | 9.2× |
| CT thoracic spine w contrast (72129) | $1,145.43 | $3,471.01 | 6.2× |
| CT thoracic spine w/o contrast (72128) | $1,018.10 | $3,085.14 | 9.2× |
| CT thoracic spine w/wo cont (72130) | $1,272.76 | $3,856.86 | 6.8× |
| CT thorax w/o contrast (71250) range across 4 matching MRF lines |
$55.69–$1,018.10 | $168.77–$3,085.14 | varies |
| CT upper ext wo (73200) | $1,018.10 | $3,085.14 | 9.2× |
| CT upper extremity w/o & w/contrast material (73202) | $1,272.27 | $3,855.36 | 6.8× |
| CT upper extremity with contrast (73201) | $1,145.43 | $3,471.01 | 3.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,272.76 | $3,856.86 | 6.8× |
| Cta Abdomen (74175) | $1,272.76 | $3,856.86 | 6.8× |
| CTA pelvis (72191) | $1,272.76 | $3,856.86 | 6.8× |
| Dilation ureters/urethra rs&i (74485) | $2,445.01 | $7,409.12 | 1.1× |
| Discography Cerv/Thor Spine (72285) range across 5 matching MRF lines |
$682.44–$2,397.76 | $2,068–$7,265.94 | varies |
| Diskography lumbar (72295) | $643.85 | $1,951.06 | 0.3× |
| Doppler Fetal Mid Cerebral Artery (76821) | $172.66 | $523.22 | 1.6× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$9.24–$261.40 | $28–$792.12 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $119.89 | $363.29 | 1.3× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$103.29–$462.99 | $313–$1,403.01 | varies |
| Echo Guide For Artery Repair (76936) | $373.29 | $1,131.17 | 1.6× |
| Esophagram (74220) range across 3 matching MRF lines |
$20.46–$243.08 | $62–$736.61 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$106.92–$654.47 | $324–$1,983.25 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$78.21–$402.71 | $237–$1,220.32 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $391.14 | $1,185.27 | 1.5× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$104.61–$162.05 | $23–$491.07 | varies |
| Follow-Up Angiography (75898) | $3,909.06 | $11,845.65 | 1.2× |
| Foot 2 views (73620) range across 7 matching MRF lines |
$15.18–$141.80 | $46–$429.69 | varies |
| Forearm 2 views (73090) range across 9 matching MRF lines |
$7.59–$155.30 | $23–$470.60 | varies |
| Gastric emptying imaging study (78264) | $959.75 | $2,908.33 | 2.3× |
| Gastroesophageal Reflux Exam (78262) | $602.86 | $1,826.85 | 1.4× |
| Gated Heart Planar Single (78472) range across 3 matching MRF lines |
$42.90–$595.63 | $130–$1,804.93 | varies |
| Gated Heart, Multiple (78473) | $757.68 | $2,296.01 | 1.8× |
| Hand 2 views (73120) range across 10 matching MRF lines |
$14.85–$108.04 | $45–$327.39 | varies |
| Heart first pass single,planar (78481) | $589.36 | $1,785.95 | 1.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,909.06 | $11,845.65 | 1.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,909.06 | $11,845.65 | 1.2× |
| Hepatobil Syst Image W/Drug (78227) | $1,200.42 | $3,637.63 | 2.1× |
| Hepatobiliary System Imaging (78226) | $1,259.24 | $3,815.89 | 3.0× |
| Ht Muscle Image Spect Sing (78451) range across 4 matching MRF lines |
$299.31–$908.62 | $182–$2,753.39 | varies |
| Hysterosalpingogram (74740) | $397.88 | $1,205.69 | 1.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $476.49 | $1,443.92 | 5.2× |
| Infant hip ultrasound, limited static exam (76886) | $423.44 | $1,283.14 | 4.6× |
| K Flow/Funct Image Multiple (78709) | $1,156.99 | $3,506.04 | 2.0× |
| K Flow/Funct Image W/Drug (78708) | $691.11 | $2,094.28 | 1.2× |
| K Flow/Funct Image W/O Drug (78707) | $599 | $1,815.14 | 1.0× |
| Knee 3 Views (73562) range across 12 matching MRF lines |
$8.58–$155.30 | $26–$470.60 | varies |
| Liver & Spleen Imaging Static Only (78215) | $846.40 | $2,564.86 | 2.0× |
| Liver imaging static only (78201) | $635.18 | $1,924.80 | 1.1× |
| Lung Perf&Ventilat Diferentl (78598) | $1,855.84 | $5,623.75 | 3.2× |
| Lung perfusion differential (78597) | $1,259.24 | $3,815.89 | 3.0× |
| Lung Ventilat&Perfus Imaging (78582) | $2,456.76 | $7,444.73 | 4.3× |
| Lung Ventilation Imaging (78579) | $1,259.24 | $3,815.89 | 3.0× |
| Lymph System Imaging (78195) | $278.27 | $843.24 | 0.5× |
| Magnetic Image Jaw Joint (70336) | $1,348.95 | $4,087.74 | 5.3× |
| Mammary ductogram or galactogram multiple (77054) | $209.79 | $635.72 | 0.8× |
| Mammary ductogram or galactogram single (77053) | $241.14 | $730.74 | 1.0× |
| Meckels Divert Exam (78290) | $809.28 | $2,452.35 | 1.9× |
| Mra Head W/O & W/Contrast Material (70546) | $1,527.41 | $4,628.51 | 4.1× |
| MRA head w/o contrast (70544) | $1,272.76 | $3,856.86 | 5.0× |
| MRA head with contrast (70545) | $1,527.41 | $4,628.51 | 4.1× |
| MRA neck w contrast (70548) | $1,527.41 | $4,628.51 | 4.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,527.41 | $4,628.51 | 4.1× |
| MRA neck w/o contrast (70547) | $1,272.76 | $3,856.86 | 5.0× |
| MRI abdomen w contrast (74182) | $1,400.07 | $4,242.65 | 3.8× |
| MRI abdomen w/o contrast (74181) | $1,272.76 | $3,856.86 | 5.0× |
| MRI any jt lower extrem w/contrast material (73722) | $1,400.07 | $4,242.65 | 1.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,527.41 | $4,628.51 | 4.1× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,400.07 | $4,242.65 | 1.7× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,272.76 | $3,856.86 | 5.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,272.76 | $3,856.86 | 5.0× |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$103.62–$1,348.95 | $314–$4,087.74 | varies |
| MRI cervical spine w contrast (72142) | $1,527.41 | $4,628.51 | 4.1× |
| MRI cervical spine w/o cont (72141) | $1,272.76 | $3,856.86 | 5.0× |
| MRI chest w/o contrast (71550) | $1,272.76 | $3,856.86 | 5.0× |
| MRI chest with contrast (71551) | $1,527.41 | $4,628.51 | 1.8× |
| MRI chest wo w contrast (71552) | $1,527.41 | $4,628.51 | 4.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,272.76 | $3,856.86 | 3.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,527.41 | $4,628.51 | 4.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 7 matching MRF lines |
$278.26–$1,272.76 | $843.22–$3,856.86 | varies |
| MRI lumbar spine w contrast (72149) | $1,527.41 | $4,628.51 | 4.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,527.41 | $4,628.51 | 4.1× |
| MRI orbit face &/neck w/o contrast (70540) | $1,272.76 | $3,856.86 | 5.0× |
| MRI orbit face neck w contrast (70542) | $1,527.41 | $4,628.51 | 4.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,527.41 | $4,628.51 | 4.1× |
| MRI pelvis w contrast (72196) | $1,527.41 | $4,628.51 | 4.1× |
| MRI pelvis w/o & w contrast (72197) | $1,527.41 | $4,628.51 | 4.1× |
| MRI pelvis w/o contrast (72195) | $1,272.76 | $3,856.86 | 5.0× |
| MRI thoracic spine w/o contrast (72146) | $1,272.76 | $3,856.86 | 5.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,400.07 | $4,242.65 | 3.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,272.76 | $3,856.86 | 5.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,527.41 | $4,628.51 | 4.1× |
| MRI, abdomen, combo (74183) | $1,527.41 | $4,628.51 | 4.1× |
| MRI, dorsal spine combo (72157) | $1,527.41 | $4,628.51 | 4.1× |
| MRI, dorsal spine contrast (72147) | $1,527.41 | $4,628.51 | 4.1× |
| MRI, joint upper extrem (73221) range across 8 matching MRF lines |
$76.89–$1,272.76 | $233.01–$3,856.86 | varies |
| MRI, joint upper extrem combo (73223) | $1,527.41 | $4,628.51 | 4.1× |
| MRI, lumbar spine combo (72158) | $1,527.41 | $4,628.51 | 4.1× |
| Myelogram cervical (72240) | $976.95 | $2,960.45 | 1.2× |
| Myelogram Lumbar (72265) | $976.95 | $2,960.45 | 1.2× |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$440.55–$976.95 | $1,335–$2,960.45 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $750.92 | $2,275.53 | 1.8× |
| Myocardial Spect Multiple Studies (78452) range across 5 matching MRF lines |
$70.62–$1,608.92 | $214–$4,875.51 | varies |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) range across 2 matching MRF lines |
$1,836.36–$1,928.18 | $5,564.74–$5,842.98 | varies |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) range across 2 matching MRF lines |
$1,836.36–$1,928.18 | $5,564.74–$5,842.98 | varies |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $1,928.18 | $5,842.98 | 0.8× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) range across 2 matching MRF lines |
$1,836.36–$1,928.18 | $5,564.74–$5,842.98 | varies |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$16.50–$135.04 | $50–$409.21 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $260.44 | $789.21 | 0.6× |
| Nm csf leak detection (78650) | $1,746.85 | $5,293.49 | 1.3× |
| Nonvascular Shunt X-Ray (75809) | $148.67 | $450.51 | 1.3× |
| Nuclear Rx Intra-Arterial (79445) | $574.40 | $1,740.61 | 2.3× |
| Nuclear Rx Oral Admin (79005) | $1,165.20 | $3,530.91 | 4.7× |
| Ob us nuchal meas 1 gest (76813) range across 3 matching MRF lines |
$106.26–$130.20 | $322–$394.56 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $28.05 | $85 | 0.3× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $13.20 | $40 | 0.4× |
| Panoramic X-ray of jaws (70355) | $141.80 | $429.69 | 1.5× |
| Parathyroid Planar Imaging (78070) | $790.48 | $2,395.39 | 1.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,349.92 | $4,090.66 | 3.2× |
| Pelvis 1 or 2 views (72170) range across 6 matching MRF lines |
$7.92–$128.29 | $24–$388.77 | varies |
| Perineogram (74775) | $632.28 | $1,916.01 | 2.5× |
| Peritoneogram Rs&I (74190) range across 3 matching MRF lines |
$658.31–$659.81 | $1,994.88–$1,999.43 | varies |
| Pet Image W/Ct Lmtd (78814) | $1,928.18 | $5,842.98 | 1.3× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$1,928.18–$2,386.35 | $5,842.98–$7,231.35 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$1,874.65–$1,928.18 | $5,680.77–$5,842.98 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,500.39 | $4,546.63 | 1.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,909.06 | $11,845.65 | 1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,008.93 | $3,057.37 | 2.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$23.76–$51.13 | $72–$154.93 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 6 matching MRF lines |
$268.60–$659.81 | $813.93–$1,999.43 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 10 matching MRF lines |
$7.92–$155.30 | $24–$470.60 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 9 matching MRF lines |
$7.26–$141.80 | $22–$429.69 | varies |
| Radex elbow complete minimum 3 views (73080) range across 11 matching MRF lines |
$18.81–$121.54 | $57–$368.30 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 6 matching MRF lines |
$23.43–$128.29 | $71–$388.77 | varies |
| Radex fingr minimum 2 views (73140) range across 41 matching MRF lines |
$6.27–$128.29 | $19–$388.77 | varies |
| Radex foot complete minimum 3 views (73630) range across 12 matching MRF lines |
$7.59–$155.30 | $23–$470.60 | varies |
| Radex Hand Minimum 3 Views (73130) range across 9 matching MRF lines |
$7.92–$141.80 | $24–$429.69 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 6 matching MRF lines |
$16.50–$148.53 | $50–$450.10 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$31.35–$165.42 | $95–$501.28 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$7.92–$155.30 | $24–$470.60 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 9 matching MRF lines |
$9.90–$175.56 | $30–$531.99 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 10 matching MRF lines |
$8.58–$175.56 | $26–$531.99 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$17.49–$128.29 | $53–$388.77 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $438.40 | $1,328.48 | 2.4× |
| Radex Spine 1 View Specify Level (72020) range across 6 matching MRF lines |
$11.88–$141.80 | $36–$429.69 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 5 matching MRF lines |
$10.28–$168.80 | $31.15–$511.51 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$29.70–$202.55 | $90–$613.80 | varies |
| Radex Toe Minimum 2 Views (73660) range across 32 matching MRF lines |
$5.94–$121.54 | $18–$368.30 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 6 matching MRF lines |
$16.50–$114.77 | $50–$347.80 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 14 matching MRF lines |
$7.92–$142.27 | $24–$431.12 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 5 matching MRF lines |
$21.12–$222.34 | $64–$673.76 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 6 matching MRF lines |
$19.80–$202.55 | $60–$613.80 | varies |
| Radiologic exam colon double contrast study (74280) | $647.71 | $1,962.77 | 3.5× |
| Radiologic exam colon single contrast study (74270) | $505.92 | $1,533.08 | 2.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $243.07 | $736.59 | 1.3× |
| Radiologic exam knee complete 4/more views (73564) range across 15 matching MRF lines |
$9.90–$155.30 | $30–$470.60 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$22.77–$141.80 | $69–$429.69 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $472.16 | $1,430.78 | 2.5× |
| Radiologic exam swallow function contrast study (74230) | $283.59 | $859.37 | 1.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $443.70 | $1,344.55 | 2.4× |
| Radiologic examination femur 1 view (73551) range across 6 matching MRF lines |
$16.50–$141.80 | $50–$429.69 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 8 matching MRF lines |
$19.47–$168.80 | $59–$511.51 | varies |
| Radiologic examination knee 1/2 views (73560) range across 11 matching MRF lines |
$7.59–$141.80 | $23–$429.69 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 3 matching MRF lines |
$34.98–$101.28 | $106–$306.92 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) range across 4 matching MRF lines |
$22.44–$294.67 | $68–$892.94 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 9 matching MRF lines |
$7.59–$155.30 | $23–$470.60 | varies |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$19.80–$155.30 | $60–$470.60 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$29.70–$833.40 | $90–$2,525.46 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,227.42 | $3,719.45 | 2.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,609.89 | $4,878.44 | 2.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,921.42 | $5,822.48 | 3.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,227.42 | $3,719.44 | 2.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,609.88 | $4,878.41 | 1.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,609.88 | $4,878.41 | 1.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,227.42 | $3,719.45 | 0.9× |
| Rp Therapy Intravenous Administration (79101) | $532.44 | $1,613.46 | 2.2× |
| Salivary Gland Imaging Serial Images (78231) | $1,157.97 | $3,509 | 2.7× |
| Scapula (73010) range across 6 matching MRF lines |
$17.49–$155.30 | $53–$470.60 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 10 matching MRF lines |
$19.65–$25.56 | $59.55–$77.46 | varies |
| Sella turcica (70240) | $74.28 | $225.09 | 0.8× |
| Shoulder 1 view (73020) range across 6 matching MRF lines |
$12.54–$135.04 | $38–$409.21 | varies |
| Shoulder Arthrography (73040) | $386.81 | $1,172.14 | 1.0× |
| Sialogram (70390) | $208.82 | $632.79 | 0.8× |
| Skull less than 4 views (70250) range across 4 matching MRF lines |
$11.22–$208.82 | $34–$632.79 | varies |
| Speech evaluation, complex (70371) | $249.34 | $755.59 | 1.0× |
| Spleen Imaging (78185) | $941.91 | $2,854.27 | 2.2× |
| Sternoclavicular joints (71130) range across 4 matching MRF lines |
$9.90–$171.70 | $30–$520.29 | varies |
| Superior sagittal sinus venogram (75870) | $3,909.06 | $11,845.65 | 1.2× |
| Temporomandble Jt Arthrography Rs&I (70332) | $336.63 | $1,020.09 | 1.3× |
| Testicular Imaging W/Flow (78761) | $710.40 | $2,152.73 | 1.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $418.14 | $1,267.09 | 2.2× |
| Thoracic spine 2 views (72070) range across 5 matching MRF lines |
$19.14–$189.05 | $58–$572.89 | varies |
| Thoracic spine 3 views (72072) range across 6 matching MRF lines |
$9.57–$222.34 | $29–$673.76 | varies |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$16.50–$188.58 | $50–$571.46 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $643.38 | $1,949.63 | 1.5× |
| Thyroid Met Imaging Body (78018) | $1,307.96 | $3,963.51 | 2.3× |
| Thyroid Uptake Measurement (78012) | $380.51 | $1,153.07 | 0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,023.89 | $3,102.70 | 2.4× |
| Ultrasound Breast Limited (76642) range across 5 matching MRF lines |
$26.70–$270.78 | $80.90–$820.56 | varies |
| Ultrasound Exam Aaa Screen (76706) | $134.08 | $406.29 | 1.2× |
| Ultrasound, abdomen limited (76705) range across 8 matching MRF lines |
$26.40–$524.25 | $80–$1,588.63 | varies |
| Umbilical-artery Doppler (OB) (76820) | $398.38 | $1,207.20 | 3.6× |
| Upper gi w/o kub (74240) range across 4 matching MRF lines |
$88.25–$443.70 | $267.42–$1,344.55 | varies |
| Ureteral Reflux Study (78740) | $456.73 | $1,384.02 | 1.1× |
| Urethrocystogram voiding (74455) | $350.62 | $1,062.48 | 1.4× |
| Urethrocystography retrograde (74450) | $844.97 | $2,560.50 | 3.3× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$353.04–$609.95 | $1,069.83–$1,848.32 | varies |
| Us chest (76604) | $385.35 | $1,167.73 | 3.5× |
| Us complete joint (76881) | $422 | $1,278.80 | 3.8× |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$41.91–$374.24 | $127–$1,134.07 | varies |
| Us head (76506) | $460.09 | $1,394.22 | 4.2× |
| Us kidney transplant (76776) | $390.65 | $1,183.78 | 3.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$21.78–$367.02 | $66–$1,112.17 | varies |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$159.39–$583.57 | $483–$1,768.38 | varies |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$73.59–$407.54 | $223–$1,234.97 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$84.48–$512.19 | $256–$1,552.08 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$37.13–$580.67 | $112.51–$1,759.60 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 4 matching MRF lines |
$107.25–$578.74 | $325–$1,753.75 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$100.32–$467.33 | $304–$1,416.15 | varies |
| Us retroperitoneal complete (76770) | $562.34 | $1,704.06 | 5.1× |
| Us retroperitoneal limited (76775) range across 5 matching MRF lines |
$25.74–$489.05 | $78–$1,481.96 | varies |
| Us scrotum and contents (76870) | $511.22 | $1,549.15 | 4.6× |
| Us spinal canal and contents (76800) | $436.46 | $1,322.62 | 3.9× |
| Us thyroid (76536) range across 5 matching MRF lines |
$25.08–$482.76 | $76–$1,462.91 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$30.03–$357.38 | $91–$1,082.97 | varies |
| Vein X-Ray Chest (75827) range across 3 matching MRF lines |
$1,920.83 | $148–$5,820.71 | 1.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,909.06 | $11,845.65 | 1.2× |
| Vein X-Ray Skull Epidural (75872) | $528.58 | $1,601.75 | 0.8× |
| Vein X-Ray Spleen/Liver (75810) | $3,909.06 | $11,845.65 | 1.2× |
| Venogram Sinus/Jugular (75860) | $3,909.06 | $11,845.65 | 1.2× |
| Venography Adrenal Unilateral (75840) | $3,909.06 | $11,845.65 | 1.2× |
| Venography caval inferior serialography rs&i (75825) | $3,909.06 | $11,845.65 | 1.2× |
| Venography extremity bilateral rs&i (75822) range across 6 matching MRF lines |
$485.77–$1,920.23 | $1,472.03–$5,818.87 | varies |
| Venography extremity unilateral rs&i (75820) range across 9 matching MRF lines |
$615.95–$1,920.23 | $93–$5,818.87 | varies |
| Venography Orbital Rs&I (75880) | $528.58 | $1,601.75 | 0.8× |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$868.24–$3,909.06 | $2,631.03–$11,845.65 | varies |
| Venography Renal Unilateral (75831) range across 6 matching MRF lines |
$456.61–$3,909.06 | $1,383.66–$11,845.65 | varies |
| Venous sampling by catheter (75893) | $6,511.80 | $19,732.73 | 1.1× |
| Vertebral fracture assessment via dxa (77086) | $205.95 | $624.09 | 2.2× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$17.16–$114.77 | $52–$347.80 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $162.05 | $491.07 | 1.8× |
| X-ray antegrade pyelogram tube (74425) | $502.86 | $1,523.81 | 1.4× |
| X-Ray Aorta Leg Arteries (75630) range across 4 matching MRF lines |
$4,014.01–$4,214.71 | $234–$12,771.84 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$24.42–$195.82 | $74–$593.38 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 9 matching MRF lines |
$7.26–$108.04 | $22–$327.39 | varies |
| X-Ray Exam Breast Specimen (76098) | $102.74 | $311.33 | 0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 3 matching MRF lines |
$27.57–$173.63 | $83.55–$526.14 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 4 matching MRF lines |
$35.96–$216.05 | $108.97–$654.71 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 3 matching MRF lines |
$42.24–$270.56 | $128–$819.89 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 12 matching MRF lines |
$16.83–$141.80 | $51–$429.69 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 18 matching MRF lines |
$9.90–$141.80 | $30–$429.69 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 12 matching MRF lines |
$31.35–$237.28 | $95–$719.04 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 7 matching MRF lines |
$23.43–$212.69 | $71–$644.50 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 7 matching MRF lines |
$28.38–$355.45 | $86–$1,077.12 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 6 matching MRF lines |
$33.99–$355.45 | $103–$1,077.12 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 4 matching MRF lines |
$38.28–$350.62 | $116–$1,062.48 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 6 matching MRF lines |
$9.90–$175.56 | $30–$531.99 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$31.68–$316.86 | $96–$960.18 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 9 matching MRF lines |
$12.21–$216.05 | $37–$654.71 | varies |
| X-ray eye for foreign body (70030) range across 10 matching MRF lines |
$16.17–$128.15 | $49–$388.32 | varies |
| X-ray humerus (73060) range across 6 matching MRF lines |
$17.16–$148.53 | $52–$450.10 | varies |
| X-ray IV pyelogram (ivp) (74400) | $586.93 | $1,778.58 | 3.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 3 matching MRF lines |
$19.80–$135.04 | $60–$409.21 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$22.77–$81.02 | $69–$245.50 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 5 matching MRF lines |
$9.90–$195.82 | $30–$593.38 | varies |
| X-ray nose-rectum child f.b. (76010) range across 3 matching MRF lines |
$14.19–$139.86 | $43–$423.83 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$26.40–$283.59 | $80–$859.37 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$19.80–$168.80 | $60–$511.51 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $114.77 | $347.80 | 1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 4 matching MRF lines |
$16.17–$168.80 | $49–$511.51 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$20.79–$222.34 | $63–$673.76 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 5 matching MRF lines |
$23.43–$263.34 | $71–$797.99 | varies |
| X-ray thoracic spine 4 vw (72074) range across 4 matching MRF lines |
$27.57–$208.82 | $83.55–$632.79 | varies |
| X-Ray Tmj Unilat (70328) range across 6 matching MRF lines |
$17.82–$189.05 | $54–$572.89 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$647.71 | $48–$1,962.77 | 1.8× |
| X-Rays Bone Length Studies (77073) range across 4 matching MRF lines |
$17.82–$290.83 | $54–$881.29 | varies |
| X-Rays Bone Survey Complete (77075) | $422.48 | $1,280.23 | 3.8× |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$13.86–$265.74 | $42–$805.28 | varies |
| Xr facial bones less than 3 views (70140) range across 4 matching MRF lines |
$16.17–$168.80 | $49–$511.51 | varies |
| Xr orbits complete 4 views (70200) range across 6 matching MRF lines |
$23.43–$208.82 | $71–$632.79 | 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.