Imaging prices at Novant Health Pender Medical Center
Burgaw, NC · every code in this section with a posted price and a Medicare benchmark.
360 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) | $100.35 | $223 | 1.2× |
| Abdomen 2 views (74019) | $111.60 | $248 | 1.1× |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$1,826.55–$2,069.55 | $4,059–$4,599 | varies |
| Angio pulmonary bilat (75743) | $4,433.85 | $9,853 | 1.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,379.15 | $5,287 | 0.8× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$2,952–$4,433.85 | $6,560–$9,853 | varies |
| Angiography extremity unilateral rs&i (75710) | $2,956.50 | $6,570 | 0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,699.65 | $3,777 | 0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,473.30 | $3,274 | 0.5× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$96.30–$100.35 | $214–$223 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$2,643.75–$6,324.75 | $5,875–$14,055 | varies |
| Artery X-Rays Abdomen (75726) | $5,179.05 | $11,509 | 0.9× |
| Artery X-Rays Adrenal Gland (75731) | $1,929.60 | $4,288 | 0.6× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,529.90 | $5,622 | 0.5× |
| Artery X-Rays Spine (75705) | $5,179.05 | $11,509 | 0.9× |
| Arthrogram ankle (73615) | $357.30 | $794 | 1.0× |
| Arthrogram hip (73525) | $531.45 | $1,181 | 1.5× |
| Arthrogram Wrist (73115) | $374.40 | $832 | 1.1× |
| Bone age studies (77072) | $234.90 | $522 | 2.2× |
| Bone survey infant (77076) | $70.20 | $156 | 0.7× |
| Brachytx isodose complex (77318) | $575.10 | $1,278 | 1.5× |
| Brachytx isodose intermed (77317) | $453.60 | $1,008 | 1.2× |
| Brachytx Isodose Plan Simple (77316) | $428.40 | $952 | 1.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,766.60 | $6,148 | 7.9× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,918.35 | $4,263 | 2.4× |
| Cat Scan Follow-Up Study (76380) | $386.55 | $859 | 4.4× |
| Chest 1 view (71045) | $103.05 | $229 | 1.2× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$123.75–$1,177.20 | $275–$2,616 | varies |
| Chest 3 views (71047) | $306.90 | $682 | 3.5× |
| Chest 4 or more views (71048) | $324 | $720 | 3.1× |
| Cholecystography Oral Contrast (74290) | $197.10 | $438 | 1.1× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $179.55 | $399 | 1.7× |
| Clavicle complete (73000) | $128.25 | $285 | 1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $177.30 | $394 | 1.7× |
| Continuing medical physics consltj pr wk (77336) | $552.60 | $1,228 | 4.1× |
| Contrast Exam Abdominl Aorta (75625) | $1,834.20 | $4,076 | 0.6× |
| Contrast X-Ray Bladder (74430) | $377.10 | $838 | 1.1× |
| Contrast X-Ray Of Elbow (73085) | $508.50 | $1,130 | 1.5× |
| Contrast X-Ray Of Knee Joint (73580) | $479.25 | $1,065 | 1.4× |
| Corpora cavernosography (74445) | $360 | $800 | 3.4× |
| CT abdomen and pelvis without and with contrast (74178) | $1,813.95 | $4,031 | 5.2× |
| CT abdomen and pelvis without contrast (74176) | $1,260 | $2,800 | 5.3× |
| CT abdomen w contrast (74160) | $888.75 | $1,975 | 5.1× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,066.50–$1,533.15 | $2,370–$3,407 | varies |
| CT abdomen w/o contrast (74150) | $740.25 | $1,645 | 7.1× |
| CT Angio Abdomen and Pelvis (74174) | $1,172.70 | $2,606 | 3.4× |
| CT Angio Chest (71275) | $1,231.65 | $2,737 | 7.0× |
| CT Angio Head (70496) | $799.65 | $1,777 | 4.6× |
| CT angio hrt w/3d image (75574) range across 3 matching MRF lines |
$913.05–$1,253.70 | $2,029–$2,786 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$933.75–$1,283.40 | $2,075–$2,852 | varies |
| CT Angio Neck (70498) | $831.60 | $1,848 | 4.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$933.75–$1,241.10 | $2,075–$2,758 | varies |
| CT bone density (77078) | $202.95 | $451 | 2.3× |
| CT cervical spine w/ contrast (72126) | $922.95 | $2,051 | 2.6× |
| CT cervical spine w/o contrast (72125) | $800.10 | $1,778 | 7.6× |
| CT cervical spine w/wo cont (72127) | $1,107.45 | $2,461 | 6.3× |
| CT chest w contrast (71260) | $933.75 | $2,075 | 5.3× |
| CT chest w/wo contrast (71270) | $1,727.10 | $3,838 | 9.8× |
| CT colonography screening (74263) | $1,103.85 | $2,453 | 4.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,092.15 | $2,427 | 10.4× |
| CT head/brain with contrast (70460) | $810 | $1,800 | 4.6× |
| CT head/brain without and with contrast (70470) | $1,011.60 | $2,248 | 5.8× |
| CT heart contrast eval cardiac structure&morph (75572) | $921.15 | $2,047 | 2.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $125 | $277.78 | 1.4× |
| CT hrt w/3d image congen (75573) | $1,086.75 | $2,415 | 3.1× |
| CT iac w contrast (70481) | $769.05 | $1,709 | 4.4× |
| CT l-spine w&w/o contrast (72133) | $1,107.45 | $2,461 | 6.3× |
| CT lower ext w/o (73700) | $611.10 | $1,358 | 5.8× |
| CT lower extremity w/contrast material (73701) | $706.95 | $1,571 | 4.0× |
| CT lumbar spine w contrast (72132) | $959.85 | $2,133 | 2.7× |
| CT lumbar spine w/o contrast (72131) | $800.10 | $1,778 | 7.6× |
| CT maxillofacial w contrast (70487) | $769.05 | $1,709 | 4.4× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$666.90–$917.10 | $1,482–$2,038 | varies |
| CT neck tissue combo (70492) | $1,727.10 | $3,838 | 9.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $922.95 | $2,051 | 5.3× |
| CT orbits w/o contrast (70480) | $666.90 | $1,482 | 6.4× |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,075.95–$1,180.80 | $2,391–$2,624 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$777.60–$940.95 | $1,728–$2,091 | varies |
| CT scan of leg combo (73702) | $1,727.10 | $3,838 | 9.8× |
| CT scans face/jaw combo (70488) | $959.85 | $2,133 | 5.5× |
| CT soft tissue neck w contrast (70491) | $959.85 | $2,133 | 5.5× |
| CT soft tissue neck w/o contrast (70490) | $641.25 | $1,425 | 6.1× |
| CT thoracic spine w contrast (72129) | $959.85 | $2,133 | 5.5× |
| CT thoracic spine w/o contrast (72128) | $800.10 | $1,778 | 7.6× |
| CT thoracic spine w/wo cont (72130) | $1,107.45 | $2,461 | 6.3× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$747–$777.60 | $1,660–$1,728 | varies |
| CT unlisted procedure (76497) | $500.85 | $1,113 | 5.7× |
| CT upper ext wo (73200) | $587.25 | $1,305 | 5.6× |
| CT upper extremity w/o & w/contrast material (73202) | $1,726.65 | $3,837 | 9.8× |
| CT upper extremity with contrast (73201) | $704.70 | $1,566 | 2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $914.85 | $2,033 | 5.2× |
| Cta Abdomen (74175) | $1,128.15 | $2,507 | 6.4× |
| CTA pelvis (72191) | $1,776.15 | $3,947 | 10.1× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $315.45 | $701 | 1.3× |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$1,157.85–$2,088 | $2,573–$4,640 | varies |
| Discography Cerv/Thor Spine (72285) | $1,800.90 | $4,002 | 0.9× |
| Diskography lumbar (72295) | $2,403.90 | $5,342 | 1.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $146.70 | $326 | 1.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $442.35 | $983 | 4.2× |
| Doppler Fetal Mid Cerebral Artery (76821) | $149.85 | $333 | 1.4× |
| Dxa Bone Density Axial (77080) | $123.30 | $274 | 1.2× |
| Dxa bone density study (77085) | $206.10 | $458 | 2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $186.75 | $415 | 2.1× |
| Echo exam of fetal heart (76825) | $1,091.25 | $2,425 | 2.0× |
| Echo exam uterus (76831) | $378.90 | $842 | 1.6× |
| Echo Guide For Artery Repair (76936) | $173.25 | $385 | 0.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $608.85 | $1,353 | 2.5× |
| Echograp Trans R Pros Study (76873) | $725.85 | $1,613 | 6.9× |
| Esophagram (74220) | $242.10 | $538 | 1.4× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$309.60–$340.20 | $688–$756 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$250.65–$262.35 | $557–$583 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $350.55 | $779 | 1.5× |
| Fluoroscopy up to 1 hr (76000) | $295.65 | $657 | 1.2× |
| Follow-Up Angiography (75898) | $1,840.95 | $4,091 | 0.6× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$81–$96.30 | $180–$214 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$122.40–$206.10 | $272–$458 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$83.25–$96.30 | $185–$214 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,376.10 | $3,058 | 2.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,099.80 | $2,444 | 1.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,283.75 | $5,075 | 0.7× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,955.60 | $6,568 | 0.9× |
| Hysterosalpingogram (74740) | $355.05 | $789 | 1.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $546.30 | $1,214 | 6.3× |
| Infant hip ultrasound, limited static exam (76886) | $373.05 | $829 | 4.3× |
| Infusion Ivp (74410) | $351.45 | $781 | 2.0× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$136.35–$173.70 | $303–$386 | varies |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$141.75–$247.95 | $315–$551 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $727.20 | $1,616 | 0.5× |
| Lymphangiography extremity only unilateral rs&i (75801) | $575.10 | $1,278 | 0.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,595.25 | $3,545 | 0.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,473.30 | $3,274 | 0.5× |
| Magnetic Image Jaw Joint (70336) range across 3 matching MRF lines |
$1,202.85–$1,684.35 | $2,673–$3,743 | varies |
| Magnetic Resonance Elastography (76391) | $264.60 | $588 | 1.1× |
| Mammary ductogram or galactogram multiple (77054) | $518.40 | $1,152 | 2.2× |
| Mammary ductogram or galactogram single (77053) | $652.95 | $1,451 | 2.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $50.40 | $112 | 1.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $187.65 | $417 | 2.0× |
| Mr safety implt pos&/immoblj (76019) | $121.50 | $270 | 2.1× |
| Mr safety med physics xm customization plng&mntr (76017) | $495 | $1,100 | 2.1× |
| Mra Head W/O & W/Contrast Material (70546) | $1,739.25 | $3,865 | 5.0× |
| MRA head w/o contrast (70544) | $798.30 | $1,774 | 3.3× |
| MRA head with contrast (70545) | $1,963.80 | $4,364 | 5.6× |
| MRA neck w contrast (70548) | $1,895.40 | $4,212 | 5.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,409.40 | $3,132 | 4.0× |
| MRA neck w/o contrast (70547) | $810 | $1,800 | 3.4× |
| MRI abdomen w contrast (74182) | $2,252.70 | $5,006 | 6.4× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,233.90–$1,341 | $2,742–$2,980 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,030.05–$2,252.70 | $2,289–$5,006 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,556.55–$1,597.95 | $3,459–$3,551 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,252.70 | $5,006 | 2.9× |
| MRI bone marrow blood supply (77084) | $252.90 | $562 | 1.1× |
| MRI brain functional w/o physician admnistration (70554) | $787.50 | $1,750 | 3.3× |
| MRI brain functional w/physician admnistration (70555) | $787.50 | $1,750 | 3.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $964.35 | $2,143 | 4.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $963.90 | $2,142 | 4.0× |
| MRI cardiac w/o cont stress (75559) | $1,231.20 | $2,736 | 2.2× |
| MRI cardiac w/o contrast (75557) | $655.20 | $1,456 | 2.7× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$1,423.80–$1,957.50 | $3,164–$4,350 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,233.90–$1,796.85 | $2,742–$3,993 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$1,134.90–$1,678.50 | $2,522–$3,730 | varies |
| MRI chest with contrast (71551) | $1,543.05 | $3,429 | 2.0× |
| MRI chest wo w contrast (71552) | $1,424.25 | $3,165 | 4.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,660.50 | $3,690 | 4.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,442.70 | $3,206 | 4.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$972.90–$1,109.70 | $2,162–$2,466 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$1,357.20–$2,252.70 | $3,016–$5,006 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$1,708.65–$2,281.95 | $3,797–$5,071 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$660.60–$1,109.25 | $1,468–$2,465 | varies |
| MRI orbit face neck w contrast (70542) | $1,687.95 | $3,751 | 4.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,617.30 | $3,594 | 4.6× |
| MRI pelvis w contrast (72196) | $2,251.35 | $5,003 | 6.4× |
| MRI pelvis w/o & w contrast (72197) | $1,193.85 | $2,653 | 3.4× |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$993.60–$1,103.40 | $2,208–$2,452 | varies |
| MRI spectroscopy (76390) | $547.20 | $1,216 | 6.3× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,233.90–$1,796.85 | $2,742–$3,993 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,836.90 | $4,082 | 5.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$978.75–$1,109.70 | $2,175–$2,466 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,597.95 | $3,551 | 4.6× |
| MRI, abdomen, combo (74183) | $1,777.50 | $3,950 | 5.1× |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,777.50–$2,281.95 | $3,950–$5,071 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$2,252.70–$2,815.65 | $5,006–$6,257 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$976.50–$1,154.25 | $2,170–$2,565 | varies |
| MRI, joint upper extrem combo (73223) | $1,598.40 | $3,552 | 4.6× |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,777.50–$2,281.95 | $3,950–$5,071 | varies |
| Myelogram cervical (72240) | $751.50 | $1,670 | 1.0× |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$868.50–$924.30 | $1,930–$2,054 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$666–$2,173.95 | $1,480–$4,831 | varies |
| Myelograpy 2/more regions rs&i (72270) | $996.75 | $2,215 | 1.3× |
| N-invas est c ffr sw aly CTA (75580) | $2,394 | $5,320 | 2.8× |
| Neck soft tissue (70360) | $73.35 | $163 | 0.8× |
| Nonvascular Shunt X-Ray (75809) | $98.55 | $219 | 0.9× |
| Ob us nuchal meas 1 gest (76813) | $186.75 | $415 | 1.8× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $206.55 | $459 | 2.0× |
| Optic foramina (70190) | $108.45 | $241 | 1.2× |
| Panoramic X-ray of jaws (70355) | $256.50 | $570 | 2.9× |
| Pelvis 1 or 2 views (72170) | $100.35 | $223 | 1.0× |
| Perineogram (74775) | $409.95 | $911 | 1.7× |
| Peritoneogram Rs&I (74190) | $301.05 | $669 | 0.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,955.60 | $6,568 | 0.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $147.60 | $328 | 1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $718.65 | $1,597 | 1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) | $144.45 | $321 | 1.7× |
| Radex Calcaneus Minimum 2 Views (73650) | $119.25 | $265 | 1.4× |
| Radex elbow complete minimum 3 views (73080) | $144.45 | $321 | 1.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $101.25 | $225 | 1.0× |
| Radex fingr minimum 2 views (73140) range across 11 matching MRF lines |
$94.50–$173.70 | $210–$386 | varies |
| Radex foot complete minimum 3 views (73630) | $124.65 | $277 | 1.4× |
| Radex Hand Minimum 3 Views (73130) | $144.45 | $321 | 1.7× |
| Radex lower extremity infant minimum 2 views (73592) | $243.90 | $542 | 2.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $247.95 | $551 | 2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $77.85 | $173 | 0.9× |
| Radex Ribs Unilateral 2 Views (71100) | $120.60 | $268 | 1.4× |
| Radex shoulder complete minimum 2 views (73030) | $120.60 | $268 | 1.4× |
| Radex Sinuses Paransl < 3 Views (70210) | $65.25 | $145 | 0.7× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $571.05 | $1,269 | 3.3× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$56.25–$173.70 | $125–$386 | varies |
| Radex Sternum Minimum 2 Views (71120) | $117.45 | $261 | 1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $295.65 | $657 | 3.4× |
| Radex Toe Minimum 2 Views (73660) range across 11 matching MRF lines |
$77.85–$173.70 | $173–$386 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $261 | $580 | 2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) | $144.45 | $321 | 1.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $240.30 | $534 | 2.3× |
| Radiation treatment delivery level 3 (77412) | $736.65 | $1,637 | 1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $154.80 | $344 | 1.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $302.85 | $673 | 2.9× |
| Radiologic exam colon double contrast study (74280) | $594.45 | $1,321 | 3.4× |
| Radiologic exam colon single contrast study (74270) range across 3 matching MRF lines |
$440.55–$666 | $979–$1,480 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $316.80 | $704 | 1.8× |
| Radiologic exam knee complete 4/more views (73564) | $160.65 | $357 | 1.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $106.65 | $237 | 1.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $469.80 | $1,044 | 2.7× |
| Radiologic exam swallow function contrast study (74230) | $323.10 | $718 | 1.8× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $158.85 | $353 | 0.7× |
| Radiologic exam upr gi trc double contrast study (74246) | $477 | $1,060 | 2.7× |
| Radiologic examination femur 1 view (73551) | $122.40 | $272 | 1.4× |
| Radiologic examination femur minimum 2 views (73552) | $128.70 | $286 | 1.5× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$121.95–$184.95 | $271–$411 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $435.15 | $967 | 4.2× |
| Radiologic Examination Salivary Gland Calculus (70380) | $62.10 | $138 | 0.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$96.30–$119.25 | $214–$265 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $302.85 | $673 | 0.6× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $42.30 | $94 | 0.5× |
| Renal Cyst Study (74470) | $621 | $1,380 | 1.1× |
| Ribs bilateral 3 views (71110) | $166.95 | $371 | 1.6× |
| Scapula (73010) | $252.45 | $561 | 2.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $23.40 | $52 | 1.0× |
| Sella turcica (70240) | $116.55 | $259 | 1.3× |
| Shoulder 1 view (73020) | $80.55 | $179 | 0.9× |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$472.05–$494.10 | $1,049–$1,098 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$335.70–$373.05 | $746–$829 | varies |
| Skull less than 4 views (70250) | $93.60 | $208 | 0.9× |
| Special dosimetry (77331) | $351.45 | $781 | 2.6× |
| Special Physics Consult (77370) | $542.70 | $1,206 | 4.0× |
| Special teletherapy port plan (77321) | $591.75 | $1,315 | 1.6× |
| Special treatment procedure (77470) | $962.55 | $2,139 | 1.7× |
| Sternoclavicular joints (71130) | $208.35 | $463 | 2.4× |
| Superior sagittal sinus venogram (75870) | $1,840.95 | $4,091 | 0.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $926.10 | $2,058 | 2.5× |
| Temporomandble Jt Arthrography Rs&I (70332) range across 2 matching MRF lines |
$504–$691.20 | $1,120–$1,536 | varies |
| Ther rad simulaj-aided field setting simple (77280) | $733.95 | $1,631 | 5.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $145.80 | $324 | 0.8× |
| Thoracic spine 2 views (72070) | $113.85 | $253 | 1.1× |
| Thoracic spine 3 views (72072) | $135.45 | $301 | 1.3× |
| Thoracolumbar 2 views (72080) | $70.20 | $156 | 0.8× |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$728.10–$853.65 | $1,618–$1,897 | varies |
| Tx devices design & construction intermediate (77333) | $400.95 | $891 | 3.0× |
| Tx devices design & construction simple (77332) | $292.05 | $649 | 2.2× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$138.60–$288 | $308–$640 | varies |
| Ultrasound elastography first target lesion (76982) | $144.45 | $321 | 1.4× |
| Ultrasound Elastography Parenchyma (76981) | $130.95 | $291 | 1.3× |
| Ultrasound Exam Aaa Screen (76706) | $85.50 | $190 | 0.8× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $495 | $1,100 | 1.4× |
| Ultrasound, abdomen limited (76705) range across 5 matching MRF lines |
$214.20–$453.15 | $476–$1,007 | varies |
| Umbilical-artery Doppler (OB) (76820) | $149.85 | $333 | 1.4× |
| Unlisted Dx Radiographic Procedure (76499) | $696.60 | $1,548 | 8.0× |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$537.75–$605.25 | $1,195–$1,345 | varies |
| Unlisted us procedure (76999) | $109.35 | $243 | 1.3× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$481.50–$519.30 | $1,070–$1,154 | varies |
| Urethrocystogram voiding (74455) | $469.80 | $1,044 | 2.0× |
| Urethrocystography retrograde (74450) | $398.70 | $886 | 1.7× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$208.35–$296.10 | $463–$658 | varies |
| Us chest (76604) | $170.55 | $379 | 1.6× |
| Us complete joint (76881) | $390.60 | $868 | 3.7× |
| Us exam, pelvic, limited (76857) | $361.80 | $804 | 3.5× |
| Us head (76506) range across 2 matching MRF lines |
$401.85–$442.35 | $893–$983 | varies |
| Us kidney transplant (76776) | $373.05 | $829 | 3.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $111.60 | $248 | 1.1× |
| Us ob detailed single fetus (76811) | $324.90 | $722 | 1.4× |
| Us ob limited 1 or more fetuses (76815) | $195.30 | $434 | 1.9× |
| Us ob transvaginal (76817) | $128.70 | $286 | 1.2× |
| Us pelvic non ob complete (76856) | $244.35 | $543 | 2.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $195.30 | $434 | 1.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$210.15–$242.10 | $467–$538 | varies |
| Us retroperitoneal complete (76770) | $219.60 | $488 | 2.1× |
| Us retroperitoneal limited (76775) | $169.20 | $376 | 1.6× |
| Us scrotum and contents (76870) | $156.15 | $347 | 1.5× |
| Us spinal canal and contents (76800) | $446.85 | $993 | 4.3× |
| Us thyroid (76536) | $150.75 | $335 | 1.4× |
| Us transrectal (76872) | $1,347.75 | $2,995 | 12.9× |
| Vein X-Ray Chest (75827) | $1,227.60 | $2,728 | 0.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,840.95 | $4,091 | 0.6× |
| Vein X-Ray Skull Epidural (75872) | $922.95 | $2,051 | 1.5× |
| Vein X-Ray Spleen/Liver (75810) | $2,449.35 | $5,443 | 0.8× |
| Venogram Sinus/Jugular (75860) | $1,504.80 | $3,344 | 0.5× |
| Venography Adrenal Unilateral (75840) | $2,448.90 | $5,442 | 0.8× |
| Venography caval inferior serialography rs&i (75825) | $2,956.50 | $6,570 | 0.9× |
| Venography extremity bilateral rs&i (75822) | $904.95 | $2,011 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $847.35 | $1,883 | 0.5× |
| Venography Orbital Rs&I (75880) | $1,099.80 | $2,444 | 1.8× |
| Venography Renal Bilateral (75833) | $4,432.95 | $9,851 | 1.4× |
| Venography Renal Unilateral (75831) | $2,955.60 | $6,568 | 0.9× |
| Venous sampling by catheter (75893) | $2,956.50 | $6,570 | 0.5× |
| Vertebral fracture assessment via dxa (77086) | $67.50 | $150 | 0.8× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$83.25–$148.95 | $185–$331 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $191.25 | $425 | 2.2× |
| X-ray antegrade pyelogram tube (74425) | $501.30 | $1,114 | 1.4× |
| X-Ray Aorta Leg Arteries (75630) | $1,834.20 | $4,076 | 0.6× |
| X-Ray Bend Only L-S Spine (72120) | $88.20 | $196 | 0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$66.60–$69.75 | $148–$155 | varies |
| X-Ray Exam Breast Specimen (76098) | $436.05 | $969 | 0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $305.55 | $679 | 3.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $237.60 | $528 | 2.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $240.30 | $534 | 2.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $69.75 | $155 | 0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $157.05 | $349 | 1.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $234 | $520 | 2.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $131.85 | $293 | 1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $263.70 | $586 | 2.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $172.80 | $384 | 1.7× |
| X-Ray Exam L-S Spine Bending (72114) | $120.15 | $267 | 1.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $121.95 | $271 | 1.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $147.60 | $328 | 1.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $166.50 | $370 | 1.6× |
| X-ray eye for foreign body (70030) | $77.40 | $172 | 0.9× |
| X-ray head for orthodontia (70350) | $121.95 | $271 | 1.4× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$96.30–$111.60 | $214–$248 | varies |
| X-ray IV pyelogram (ivp) (74400) | $371.25 | $825 | 2.1× |
| X-ray IV pyelogram+tomography (74415) | $397.80 | $884 | 2.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $74.25 | $165 | 0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $72.90 | $162 | 0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $166.50 | $370 | 1.6× |
| X-ray nose-rectum child f.b. (76010) | $70.65 | $157 | 0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $194.85 | $433 | 1.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $105.30 | $234 | 1.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$55.80–$211.05 | $124–$469 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $126.45 | $281 | 1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $122.40 | $272 | 1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $154.80 | $344 | 1.5× |
| X-Ray Stress View (77071) | $114.75 | $255 | 1.3× |
| X-ray thoracic spine 4 vw (72074) | $212.40 | $472 | 2.0× |
| X-Ray Tmj Unilat (70328) | $152.55 | $339 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $562.05 | $1,249 | 1.6× |
| X-Rays Bone Length Studies (77073) | $335.70 | $746 | 3.2× |
| X-Rays Bone Survey Complete (77075) | $688.05 | $1,529 | 6.6× |
| Xr c-spine 4 or 5 views (72050) | $141.75 | $315 | 1.4× |
| Xr facial bones less than 3 views (70140) | $59.40 | $132 | 0.7× |
| XR Mastoids < 3 Views Bilateral (70120) | $206.10 | $458 | 2.0× |
| Xr myelogram posterior fossa (70010) | $608.40 | $1,352 | 1.7× |
| Xr orbits complete 4 views (70200) | $80.55 | $179 | 0.8× |
| Xr Tomogram Single Plane (76100) | $194.85 | $433 | 1.9× |
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.