Imaging prices at Novant Health Thomasville Medical Center
Thomasville, NC · every code in this section with a posted price and a Medicare benchmark.
382 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) | $235.20 | $392 | 2.8× |
| Abdomen 2 views (74019) | $279 | $465 | 2.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,092 | $1,820 | 2.8× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $1,561.82 | $2,603.04 | 1.2× |
| Angiography extremity bilateral rs&i (75716) | $3,712.20 | $6,187 | 1.2× |
| Angiography extremity unilateral rs&i (75710) | $3,373.20 | $5,622 | 1.1× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$171.60–$279 | $286–$465 | varies |
| Artery X-Rays Pelvis (75736) | $3,373.20 | $5,622 | 0.6× |
| Arthrogram ankle (73615) | $645 | $1,075 | 1.9× |
| Arthrogram hip (73525) | $750 | $1,250 | 2.2× |
| Arthrogram Wrist (73115) | $750 | $1,250 | 2.2× |
| Bone age studies (77072) | $155.40 | $259 | 1.5× |
| Bone Imaging 3 Phase (78315) | $1,491 | $2,485 | 3.8× |
| Bone Imaging Limited Area (78300) | $517.20 | $862 | 1.3× |
| Bone Imaging Whole Body (78306) | $1,322.40 | $2,204 | 3.4× |
| Bone marrow imaging limited area (78102) | $987.60 | $1,646 | 2.5× |
| Bone marrow imaging; multiple areas (78103) | $987.60 | $1,646 | 2.5× |
| Bone marrow imaging; whole body (78104) | $522 | $870 | 1.3× |
| Bone survey infant (77076) | $279 | $465 | 2.8× |
| Brain Flow Imaging Only (78610) | $1,309.80 | $2,183 | 2.5× |
| Brain Image W/Flow < 4 Views (78601) | $1,135.80 | $1,893 | 2.9× |
| Brain imaging < 4 static views (78600) | $540 | $900 | 1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,217.40 | $2,029 | 2.3× |
| Brain Imaging Minimum 4 Static Views (78605) | $873.60 | $1,456 | 1.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $924 | $1,540 | 2.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,820.40 | $3,034 | 5.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,223.60 | $3,706 | 2.9× |
| Cardiac Shunt Detection (78428) | $979.80 | $1,633 | 2.5× |
| Cat Scan Follow-Up Study (76380) | $594 | $990 | 7.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,217.40 | $2,029 | 2.3× |
| Cerebrospinal Fluid Scan (78630) | $1,217.40 | $2,029 | 2.3× |
| Chest 1 view (71045) | $235.20 | $392 | 2.8× |
| Chest 2 views (71046) | $279 | $465 | 3.3× |
| Chest 3 views (71047) | $336 | $560 | 4.0× |
| Chest 4 or more views (71048) | $357 | $595 | 3.5× |
| Cholecystography Oral Contrast (74290) | $266.40 | $444 | 1.6× |
| Clavicle complete (73000) | $235.20 | $392 | 2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $219.60 | $366 | 2.2× |
| Contrast Exam Abdominl Aorta (75625) | $2,318.40 | $3,864 | 0.8× |
| Contrast X-Ray Bladder (74430) | $336 | $560 | 1.0× |
| Contrast X-Ray Of Elbow (73085) | $750 | $1,250 | 2.2× |
| Contrast X-Ray Of Knee Joint (73580) | $750 | $1,250 | 2.2× |
| CT abdomen and pelvis without and with contrast (74178) | $3,898.20 | $6,497 | 11.5× |
| CT abdomen and pelvis without contrast (74176) | $2,751 | $4,585 | 11.9× |
| CT abdomen w contrast (74160) | $1,929.60 | $3,216 | 11.3× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$2,214.60–$2,221.80 | $3,691–$3,703 | varies |
| CT abdomen w/o contrast (74150) | $1,492.80 | $2,488 | 14.7× |
| CT Angio Abdomen and Pelvis (74174) | $3,198 | $5,330 | 9.5× |
| CT Angio Chest (71275) | $2,077.80 | $3,463 | 12.2× |
| CT Angio Head (70496) | $2,068.80 | $3,448 | 12.2× |
| CT angio hrt w/3d image (75574) | $1,182.60 | $1,971 | 3.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,816.80 | $3,028 | 10.7× |
| CT Angio Neck (70498) | $2,187.60 | $3,646 | 12.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,798.80 | $2,998 | 10.6× |
| CT bone density (77078) | $294.60 | $491 | 3.5× |
| CT cervical spine w/ contrast (72126) | $1,929.60 | $3,216 | 5.7× |
| CT cervical spine w/o contrast (72125) | $1,560 | $2,600 | 15.4× |
| CT cervical spine w/wo cont (72127) | $2,296.20 | $3,827 | 13.5× |
| CT chest w contrast (71260) | $1,719 | $2,865 | 10.1× |
| CT chest w/wo contrast (71270) | $2,102.40 | $3,504 | 12.4× |
| CT colonography screening (74263) | $1,429.80 | $2,383 | 6.2× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,414.20 | $2,357 | 13.9× |
| CT head/brain with contrast (70460) | $1,530.60 | $2,551 | 9.0× |
| CT head/brain without and with contrast (70470) | $1,757.40 | $2,929 | 10.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $593.40 | $989 | 1.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $150 | $250 | 1.8× |
| CT hrt w/3d image congen (75573) | $642 | $1,070 | 1.9× |
| CT iac w contrast (70481) | $1,719 | $2,865 | 10.1× |
| CT l-spine w&w/o contrast (72133) | $2,565.60 | $4,276 | 15.1× |
| CT lower ext w/o (73700) | $1,396.80 | $2,328 | 13.8× |
| CT lower extremity w/contrast material (73701) | $1,827.60 | $3,046 | 10.7× |
| CT lumbar spine w contrast (72132) | $2,058 | $3,430 | 6.1× |
| CT lumbar spine w/o contrast (72131) | $1,660.80 | $2,768 | 16.4× |
| CT maxillofacial w contrast (70487) | $1,312.80 | $2,188 | 7.7× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,129.80–$1,329 | $1,883–$2,215 | varies |
| CT neck tissue combo (70492) | $1,972.80 | $3,288 | 11.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,866 | $3,110 | 11.0× |
| CT orbits w/o contrast (70480) | $1,522.20 | $2,537 | 15.0× |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,711.20–$1,911.60 | $2,852–$3,186 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,363.80–$1,426.20 | $2,273–$2,377 | varies |
| CT scan of leg combo (73702) | $2,022 | $3,370 | 11.9× |
| CT scans face/jaw combo (70488) | $2,067.60 | $3,446 | 12.2× |
| CT soft tissue neck w contrast (70491) | $1,786.80 | $2,978 | 10.5× |
| CT soft tissue neck w/o contrast (70490) | $1,452 | $2,420 | 14.3× |
| CT thoracic spine w contrast (72129) | $1,724.40 | $2,874 | 10.1× |
| CT thoracic spine w/o contrast (72128) | $1,340.40 | $2,234 | 13.2× |
| CT thoracic spine w/wo cont (72130) | $1,920 | $3,200 | 11.3× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,082.40–$1,273.80 | $1,804–$2,123 | varies |
| CT unlisted procedure (76497) | $486.60 | $811 | 5.8× |
| CT upper ext wo (73200) | $1,601.40 | $2,669 | 15.8× |
| CT upper extremity w/o & w/contrast material (73202) | $1,959 | $3,265 | 11.5× |
| CT upper extremity with contrast (73201) | $1,798.80 | $2,998 | 5.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,169.60 | $3,616 | 12.8× |
| Cta Abdomen (74175) | $1,652.40 | $2,754 | 9.7× |
| CTA pelvis (72191) | $2,140.80 | $3,568 | 12.6× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $426.60 | $711 | 1.8× |
| Dilation ureters/urethra rs&i (74485) | $1,543.80 | $2,573 | 0.8× |
| Discography Cerv/Thor Spine (72285) | $2,264.40 | $3,774 | 1.2× |
| Diskography lumbar (72295) | $3,022.80 | $5,038 | 1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $241.20 | $402 | 2.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $247.20 | $412 | 2.4× |
| Dxa Bone Density Axial (77080) | $246 | $410 | 2.4× |
| Dxa bone density study (77085) | $177 | $295 | 1.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $252.60 | $421 | 3.0× |
| Echo exam uterus (76831) | $481.20 | $802 | 2.1× |
| Echo Guide For Artery Repair (76936) | $432.60 | $721 | 2.1× |
| Esophagram (74220) | $345 | $575 | 2.0× |
| Fetal Biophys Profile W/Nst (76818) range across 3 matching MRF lines |
$465–$561 | $775–$935 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$424.80–$432.60 | $708–$721 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $558 | $930 | 2.4× |
| Fluoroscopy up to 1 hr (76000) | $571.80 | $953 | 2.5× |
| Follow-Up Angiography (75898) | $2,454.60 | $4,091 | 0.8× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$171.60–$279 | $286–$465 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$107.40–$279 | $179–$465 | varies |
| Gastric emptying imaging study (78264) | $1,585.80 | $2,643 | 4.1× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,113.60 | $1,856 | 2.9× |
| Gastroesophageal Reflux Exam (78262) | $580.20 | $967 | 1.5× |
| Gated Heart Planar Single (78472) | $1,531.80 | $2,553 | 4.0× |
| Gated Heart, Multiple (78473) | $924 | $1,540 | 2.4× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $3,619.80 | $6,033 | 6.9× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$107.40–$279 | $179–$465 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,944 | $3,240 | 3.7× |
| Hepatobiliary System Imaging (78226) | $1,909.20 | $3,182 | 4.9× |
| Ht Muscle Image Spect Sing (78451) | $2,287.20 | $3,812 | 1.8× |
| Hysterosalpingogram (74740) | $715.20 | $1,192 | 3.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $332.40 | $554 | 3.9× |
| Infusion Ivp (74410) | $475.20 | $792 | 2.8× |
| Joint Survey Single View (77077) | $235.20 | $392 | 2.3× |
| K Flow/Funct Image Multiple (78709) | $2,036.40 | $3,394 | 3.9× |
| K Flow/Funct Image W/Drug (78708) | $1,406.40 | $2,344 | 2.7× |
| K Flow/Funct Image W/O Drug (78707) | $1,259.40 | $2,099 | 2.4× |
| Kidney Imaging Morphol (78700) | $734.40 | $1,224 | 1.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,743.60 | $2,906 | 4.5× |
| Knee 3 Views (73562) | $336 | $560 | 4.0× |
| Leveen/Shunt Patency Exam (78291) | $755.40 | $1,259 | 1.9× |
| Liver & Spleen Imaging Static Only (78215) | $839.40 | $1,399 | 2.2× |
| Liver imaging w/vascular flow (78202) | $939.60 | $1,566 | 1.8× |
| Lung Perf&Ventilat Diferentl (78598) | $1,552.80 | $2,588 | 2.9× |
| Lung perfusion differential (78597) | $1,184.40 | $1,974 | 3.1× |
| Lung Ventilat&Perfus Imaging (78582) | $1,531.80 | $2,553 | 2.9× |
| Lung Ventilation Imaging (78579) | $1,335 | $2,225 | 3.4× |
| Lymph System Imaging (78195) | $1,498.20 | $2,497 | 2.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $969.60 | $1,616 | 0.6× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $1,964.40 | $3,274 | 0.6× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,753.80–$2,341.20 | $2,923–$3,902 | varies |
| Magnetic Resonance Elastography (76391) | $306.60 | $511 | 1.3× |
| Mammary ductogram or galactogram multiple (77054) | $651.60 | $1,086 | 2.8× |
| Mammary ductogram or galactogram single (77053) | $406.20 | $677 | 1.8× |
| Meckels Divert Exam (78290) | $839.40 | $1,399 | 2.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $67.20 | $112 | 2.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $250.20 | $417 | 2.7× |
| Mr safety implt pos&/immoblj (76019) | $162 | $270 | 2.8× |
| Mr safety med physics xm customization plng&mntr (76017) | $660 | $1,100 | 2.9× |
| Mra Head W/O & W/Contrast Material (70546) | $2,864.40 | $4,774 | 8.5× |
| MRA head w/o contrast (70544) | $2,130 | $3,550 | 9.2× |
| MRA head with contrast (70545) | $2,572.20 | $4,287 | 7.6× |
| MRA neck w contrast (70548) | $2,482.20 | $4,137 | 7.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,767.20 | $4,612 | 8.2× |
| MRA neck w/o contrast (70547) | $1,896 | $3,160 | 8.2× |
| MRI abdomen w contrast (74182) | $2,362.80 | $3,938 | 7.0× |
| MRI abdomen w/o contrast (74181) | $2,122.20 | $3,537 | 9.2× |
| MRI any jt lower extrem w/contrast material (73722) | $1,969.80 | $3,283 | 2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,475.60 | $4,126 | 7.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,330.40 | $3,884 | 3.1× |
| MRI bone marrow blood supply (77084) | $330.60 | $551 | 1.4× |
| MRI brain functional w/o physician admnistration (70554) | $913.20 | $1,522 | 3.9× |
| MRI brain functional w/physician admnistration (70555) | $913.20 | $1,522 | 3.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,760 | $4,600 | 11.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,160 | $3,600 | 9.3× |
| MRI cardiac w/o cont stress (75559) | $1,426.80 | $2,378 | 2.7× |
| MRI cardiac w/o contrast (75557) | $1,078.20 | $1,797 | 4.7× |
| MRI cervical spine w contrast (72142) | $2,563.80 | $4,273 | 7.6× |
| MRI cervical spine w/o cont (72141) | $2,353.20 | $3,922 | 10.2× |
| MRI chest w/o contrast (71550) | $1,927.80 | $3,213 | 8.3× |
| MRI chest with contrast (71551) | $2,021.40 | $3,369 | 2.7× |
| MRI chest wo w contrast (71552) | $2,724 | $4,540 | 8.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,174.40 | $3,624 | 6.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,493 | $4,155 | 7.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,693.20 | $2,822 | 7.3× |
| MRI lumbar spine w contrast (72149) | $2,563.80 | $4,273 | 7.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,989.20 | $4,982 | 8.8× |
| MRI orbit face &/neck w/o contrast (70540) | $1,962.60 | $3,271 | 8.5× |
| MRI orbit face neck w contrast (70542) | $2,137.80 | $3,563 | 6.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,705.40 | $4,509 | 8.0× |
| MRI pelvis w contrast (72196) | $2,118 | $3,530 | 6.3× |
| MRI pelvis w/o & w contrast (72197) | $2,966.40 | $4,944 | 8.8× |
| MRI pelvis w/o contrast (72195) | $1,962.60 | $3,271 | 8.5× |
| MRI spectroscopy (76390) | $454.20 | $757 | 5.4× |
| MRI thoracic spine w/o contrast (72146) | $2,353.20 | $3,922 | 10.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,238 | $3,730 | 6.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,785.60 | $2,976 | 7.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,471.40 | $4,119 | 7.3× |
| MRI, abdomen, combo (74183) | $3,225 | $5,375 | 9.5× |
| MRI, dorsal spine combo (72157) | $2,989.20 | $4,982 | 8.8× |
| MRI, dorsal spine contrast (72147) | $2,563.80 | $4,273 | 7.6× |
| MRI, joint upper extrem (73221) | $2,032.80 | $3,388 | 8.8× |
| MRI, joint upper extrem combo (73223) | $2,931.60 | $4,886 | 8.7× |
| MRI, lumbar spine combo (72158) | $2,989.20 | $4,982 | 8.8× |
| Myelogram cervical (72240) | $945.60 | $1,576 | 1.2× |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$1,175.40–$1,232.40 | $1,959–$2,054 | varies |
| Myelography thoracic (72255) | $3,118.20 | $5,197 | 4.1× |
| Myelograpy 2/more regions rs&i (72270) | $1,348.80 | $2,248 | 1.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $738.60 | $1,231 | 1.9× |
| Myocardial Spect Multiple Studies (78452) | $3,798 | $6,330 | 3.0× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $2,275.80 | $3,793 | 1.6× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $3,510.60 | $5,851 | 1.6× |
| N-invas est c ffr sw aly CTA (75580) | $3,129.60 | $5,216 | 3.8× |
| Neck soft tissue (70360) | $235.20 | $392 | 2.8× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $319.56 | $532.60 | 0.9× |
| Nm csf leak detection (78650) | $1,561.82 | $2,603.04 | 1.2× |
| Nm whole blood volume (78122) | $1,322.40 | $2,204 | 2.5× |
| Nonvascular Shunt X-Ray (75809) | $225.60 | $376 | 2.2× |
| Nuclear Rx Oral Admin (79005) | $917.40 | $1,529 | 4.1× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $340.20 | $567 | 3.4× |
| Optic foramina (70190) | $147 | $245 | 1.7× |
| Panoramic X-ray of jaws (70355) | $307.80 | $513 | 3.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $3,328.20 | $5,547 | 6.3× |
| Parathyroid Planar Imaging (78070) | $965.40 | $1,609 | 2.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,214.40 | $2,024 | 3.1× |
| Pelvis 1 or 2 views (72170) | $279 | $465 | 2.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $755.40 | $1,259 | 1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $389.40 | $649 | 3.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $439.20 | $732 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) | $336 | $560 | 4.0× |
| Radex Calcaneus Minimum 2 Views (73650) | $279 | $465 | 3.3× |
| Radex elbow complete minimum 3 views (73080) | $336 | $560 | 4.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $336 | $560 | 3.3× |
| Radex fingr minimum 2 views (73140) range across 11 matching MRF lines |
$235.20–$279 | $392–$465 | varies |
| Radex foot complete minimum 3 views (73630) | $336 | $560 | 4.0× |
| Radex Hand Minimum 3 Views (73130) | $336 | $560 | 4.0× |
| Radex lower extremity infant minimum 2 views (73592) | $279 | $465 | 3.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $336 | $560 | 3.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $336 | $560 | 4.0× |
| Radex Ribs Unilateral 2 Views (71100) | $235.20 | $392 | 2.8× |
| Radex shoulder complete minimum 2 views (73030) | $279 | $465 | 3.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $189.60 | $316 | 2.2× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $385.80 | $643 | 2.3× |
| Radex Spine 1 View Specify Level (72020) | $235.20 | $392 | 2.8× |
| Radex Sternum Minimum 2 Views (71120) | $279 | $465 | 3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $258.60 | $431 | 3.1× |
| Radex Toe Minimum 2 Views (73660) range across 11 matching MRF lines |
$204.60–$235.20 | $341–$392 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $279 | $465 | 2.8× |
| Radex Wrist Complete Minimum 3 Views (73110) | $336 | $560 | 4.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $354 | $590 | 3.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $357 | $595 | 3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $336 | $560 | 3.3× |
| Radiologic exam colon double contrast study (74280) | $737.40 | $1,229 | 4.3× |
| Radiologic exam colon single contrast study (74270) | $737.40 | $1,229 | 4.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $345 | $575 | 2.0× |
| Radiologic exam knee complete 4/more views (73564) | $357 | $595 | 3.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $336 | $560 | 3.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $420 | $700 | 2.5× |
| Radiologic exam swallow function contrast study (74230) | $459.60 | $766 | 2.7× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $182.40 | $304 | 0.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $420 | $700 | 2.5× |
| Radiologic examination femur 1 view (73551) | $235.20 | $392 | 2.8× |
| Radiologic examination femur minimum 2 views (73552) | $279 | $465 | 3.3× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$204.60–$279 | $341–$465 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $217.20 | $362 | 2.1× |
| Radiologic Examination Salivary Gland Calculus (70380) | $69 | $115 | 0.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$107.40–$279 | $179–$465 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $409.80 | $683 | 0.8× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $56.40 | $94 | 0.7× |
| Radiopharm Dacryocystography (78660) | $453.64 | $756.07 | 1.2× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) | $556.20 | $927 | 2.5× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $685.80 | $1,143 | 3.0× |
| Ribs bilateral 3 views (71110) | $336 | $560 | 3.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $922.20 | $1,537 | 2.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $922.20 | $1,537 | 2.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,120.40 | $3,534 | 4.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,688.40 | $2,814 | 3.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,561.82 | $2,603.04 | 3.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,477.40 | $2,462.33 | 1.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,627.73 | $2,712.89 | 1.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,477.40 | $2,462.33 | 1.2× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $997.20 | $1,662 | 4.4× |
| Rp Therapy Intravenous Administration (79101) | $917.40 | $1,529 | 4.1× |
| Salivary Gland Imaging (78230) | $490.43 | $817.38 | 1.3× |
| Salivary Gland Imaging Serial Images (78231) | $508.20 | $847 | 1.3× |
| Scapula (73010) | $336 | $560 | 3.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $103.80 | $173 | 4.4× |
| Sella turcica (70240) | $157.80 | $263 | 1.9× |
| Shoulder 1 view (73020) | $235.20 | $392 | 2.8× |
| Shoulder Arthrography (73040) | $750 | $1,250 | 2.2× |
| Sialogram (70390) | $349.20 | $582 | 1.5× |
| Skull less than 4 views (70250) | $336 | $560 | 3.3× |
| Spleen Imaging (78185) | $895.20 | $1,492 | 2.3× |
| Sternoclavicular joints (71130) | $336 | $560 | 4.0× |
| Temporomandble Jt Arthrography Rs&I (70332) range across 2 matching MRF lines |
$634.20–$868.80 | $1,057–$1,448 | varies |
| Testicular Imaging W/Flow (78761) | $1,004.40 | $1,674 | 2.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $737.40 | $1,229 | 4.3× |
| Thoracic spine 2 views (72070) | $279 | $465 | 2.8× |
| Thoracic spine 3 views (72072) | $336 | $560 | 3.3× |
| Thoracolumbar 2 views (72080) | $279 | $465 | 3.3× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $945 | $1,575 | 2.4× |
| Thyroid Imaging With Vascular Flow (78013) | $714.60 | $1,191 | 1.8× |
| Thyroid Met Imaging Body (78018) | $1,636.80 | $2,728 | 3.1× |
| Thyroid Uptake Measurement (78012) | $504 | $840 | 1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $771.60 | $1,286 | 2.0× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$365.40–$394.20 | $609–$657 | varies |
| Ultrasound Exam Aaa Screen (76706) | $357.60 | $596 | 3.5× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $815.40 | $1,359 | 2.4× |
| Ultrasound, abdomen limited (76705) | $575.40 | $959 | 5.7× |
| Umbilical-artery Doppler (OB) (76820) | $247.20 | $412 | 2.4× |
| Unlisted Dx Radiographic Procedure (76499) | $942.60 | $1,571 | 11.2× |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$99.60–$623.40 | $166–$1,039 | varies |
| Unlisted us procedure (76999) | $180.60 | $301 | 2.1× |
| Upper gi w/o kub (74240) | $389.40 | $649 | 2.3× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $24.60 | $41 | 2.2× |
| Ureteral Reflux Study (78740) | $1,004.40 | $1,674 | 2.6× |
| Urethrocystogram voiding (74455) | $687.60 | $1,146 | 3.0× |
| Urethrocystography retrograde (74450) | $445.20 | $742 | 1.9× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$365.40–$394.20 | $609–$657 | varies |
| Us chest (76604) | $307.20 | $512 | 3.0× |
| Us complete joint (76881) | $453.60 | $756 | 4.5× |
| Us exam, pelvic, limited (76857) | $290.40 | $484 | 2.9× |
| Us head (76506) | $348.60 | $581 | 3.4× |
| Us kidney transplant (76776) | $499.80 | $833 | 4.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $215.40 | $359 | 2.1× |
| Us ob detailed single fetus (76811) | $673.20 | $1,122 | 2.9× |
| Us ob limited 1 or more fetuses (76815) | $373.80 | $623 | 3.7× |
| Us ob transvaginal (76817) | $465.60 | $776 | 4.6× |
| Us pelvic non ob complete (76856) | $776.40 | $1,294 | 7.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $474.60 | $791 | 4.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $307.20 | $512 | 3.0× |
| Us retroperitoneal complete (76770) | $676.80 | $1,128 | 6.7× |
| Us retroperitoneal limited (76775) | $415.80 | $693 | 4.1× |
| Us scrotum and contents (76870) | $621 | $1,035 | 6.1× |
| Us spinal canal and contents (76800) | $478.20 | $797 | 4.7× |
| Us thyroid (76536) | $549.60 | $916 | 5.4× |
| Us transrectal (76872) | $688.80 | $1,148 | 6.8× |
| Venography extremity bilateral rs&i (75822) | $1,228.80 | $2,048 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $1,129.80 | $1,883 | 0.7× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $540 | $900 | 1.4× |
| Vertebral fracture assessment via dxa (77086) | $201 | $335 | 2.4× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$107.40–$279 | $179–$465 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $336 | $560 | 4.0× |
| X-ray antegrade pyelogram tube (74425) | $368.40 | $614 | 1.1× |
| X-Ray Aorta Leg Arteries (75630) | $2,454 | $4,090 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $357 | $595 | 3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$107.40–$279 | $179–$465 | varies |
| X-Ray Exam Breast Specimen (76098) | $541.80 | $903 | 1.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $208.80 | $348 | 2.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $234 | $390 | 2.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $258 | $430 | 2.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $235.20 | $392 | 2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $298.80 | $498 | 3.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $357 | $595 | 3.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $279 | $465 | 2.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $357 | $595 | 3.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $385.80 | $643 | 3.8× |
| X-Ray Exam L-S Spine Bending (72114) | $466.80 | $778 | 4.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $336 | $560 | 4.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $446.40 | $744 | 4.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $279 | $465 | 2.8× |
| X-ray eye for foreign body (70030) | $235.20 | $392 | 2.8× |
| X-ray head for orthodontia (70350) | $165.60 | $276 | 2.0× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$107.40–$279 | $179–$465 | varies |
| X-ray IV pyelogram (ivp) (74400) | $436.80 | $728 | 2.6× |
| X-ray IV pyelogram+tomography (74415) | $534 | $890 | 3.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $357 | $595 | 4.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $357 | $595 | 4.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $336 | $560 | 3.3× |
| X-ray nose-rectum child f.b. (76010) | $235.20 | $392 | 2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $336 | $560 | 3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $336 | $560 | 3.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $336 | $560 | 3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $279 | $465 | 3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $336 | $560 | 4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $357 | $595 | 3.5× |
| X-Ray Stress View (77071) | $155.40 | $259 | 1.8× |
| X-ray thoracic spine 4 vw (72074) | $357 | $595 | 3.5× |
| X-Ray Tmj Unilat (70328) | $235.20 | $392 | 2.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $532.80 | $888 | 1.6× |
| X-Rays Bone Length Studies (77073) | $225.60 | $376 | 2.2× |
| X-Rays Bone Survey Complete (77075) | $402 | $670 | 4.0× |
| Xr c-spine 4 or 5 views (72050) | $357 | $595 | 3.5× |
| Xr facial bones less than 3 views (70140) | $279 | $465 | 3.3× |
| XR Mastoids < 3 Views Bilateral (70120) | $279 | $465 | 2.8× |
| Xr myelogram posterior fossa (70010) | $765 | $1,275 | 2.3× |
| Xr orbits complete 4 views (70200) | $357 | $595 | 3.5× |
| Xr Tomogram Single Plane (76100) | $263.40 | $439 | 2.6× |
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.