Imaging prices at Ochsner Lafayette General Medical Center
Lafayette, LA · every code in this section with a posted price and a Medicare benchmark.
334 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $1,184.40 | $5,640 | 0.9× |
| Abdomen 1 View (74018) | $196.35 | $935 | 2.5× |
| Abdomen 2 views (74019) | $55.86 | $266 | 0.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $419.37 | $1,997 | 1.2× |
| Angio internal mammary (75756) | $1,110.06 | $5,286 | 0.4× |
| Angio pulmonary bilat (75743) | $1,781.43 | $8,483 | 0.6× |
| Angiography extremity bilateral rs&i (75716) | $2,148.30 | $10,230 | 0.8× |
| Angiography extremity unilateral rs&i (75710) | $1,947.12 | $9,272 | 0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,133.58 | $5,398 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,168.44 | $5,564 | 0.4× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$44.94–$89.88 | $214–$428 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,842.12 | $8,772 | 0.4× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$1,781.43 | $8,483 | 0.4× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,479.47 | $11,807 | 0.5× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$1,001.70 | $4,770 | 0.2× |
| Arthrogram hip (73525) | $175.14 | $834 | 0.6× |
| Arthrogram Wrist (73115) | $306.60 | $1,460 | 1.0× |
| Basic radiation dosimetry calculation (77300) | $105 | $500 | 0.9× |
| Bone age studies (77072) | $77.70 | $370 | 0.8× |
| Bone Imaging 3 Phase (78315) | $271.95 | $1,295 | 0.8× |
| Bone Imaging Limited Area (78300) | $265.65 | $1,265 | 0.7× |
| Bone Imaging Whole Body (78306) | $248.64 | $1,184 | 0.7× |
| Bone survey infant (77076) | $102.90 | $490 | 1.1× |
| Brachytx isodose complex (77318) range across 2 matching MRF lines |
$141.57–$315.42 | $429–$1,502 | varies |
| Brachytx isodose intermed (77317) | $315.42 | $1,502 | 0.9× |
| Brachytx Isodose Plan Simple (77316) | $481.95 | $2,295 | 1.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $328.44 | $1,564 | 0.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,350.51 | $6,431 | 1.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $187.11 | $891 | 0.5× |
| Cat Scan Follow-Up Study (76380) | $63.63 | $303 | 0.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $244.02 | $1,162 | 0.5× |
| Cerebrospinal Fluid Scan (78630) | $299.04 | $1,424 | 0.6× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$9.90–$45.57 | $30–$217 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$12.87–$55.86 | $39–$266 | varies |
| Chest 3 views (71047) | $52.50 | $250 | 0.7× |
| Chest 4 or more views (71048) | $58.80 | $280 | 0.6× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $76.44 | $364 | 0.8× |
| Cisternography Positive Contrast Rs&I (70015) | $719.67 | $3,427 | 1.0× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$44.31–$88.62 | $211–$422 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $95.13 | $453 | 1.0× |
| Continuing medical physics consltj pr wk (77336) | $158.13 | $753 | 1.3× |
| Contrast Exam Abdominl Aorta (75625) | $1,947.12 | $9,272 | 0.7× |
| Contrast X-Ray Bladder (74430) | $161.07 | $767 | 0.5× |
| Contrast X-Ray Of Elbow (73085) | $175.14 | $834 | 0.6× |
| Contrast Xray Throat/Cerv Esopha (74210) | $88.62 | $422 | 0.6× |
| CT abdomen and pelvis without and with contrast (74178) | $689.01 | $3,281 | 2.2× |
| CT abdomen and pelvis without contrast (74176) | $515.76 | $2,456 | 2.4× |
| CT abdomen w contrast (74160) | $401.94 | $1,914 | 2.5× |
| CT abdomen w wo contrast (74170) | $459.48 | $2,188 | 2.9× |
| CT abdomen w/o contrast (74150) | $343.98 | $1,638 | 3.6× |
| CT Angio Abdomen and Pelvis (74174) | $193.41 | $921 | 0.6× |
| CT Angio Chest (71275) | $492.24 | $2,344 | 3.1× |
| CT Angio Head (70496) | $492.24 | $2,344 | 3.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$738.36–$1,476.72 | $3,516–$7,032 | varies |
| CT Angio Neck (70498) | $492.24 | $2,344 | 3.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $492.24 | $2,344 | 3.1× |
| CT cervical spine w/ contrast (72126) | $393.54 | $1,874 | 1.2× |
| CT cervical spine w/o contrast (72125) | $377.58 | $1,798 | 4.0× |
| CT cervical spine w/wo cont (72127) | $455.28 | $2,168 | 2.9× |
| CT chest w contrast (71260) | $399.42 | $1,902 | 2.5× |
| CT chest w/wo contrast (71270) | $492.24 | $2,344 | 3.1× |
| CT head/brain with contrast (70460) | $349.86 | $1,666 | 2.2× |
| CT head/brain without and with contrast (70470) | $409.71 | $1,951 | 2.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $42.21 | $201 | 0.5× |
| CT iac w contrast (70481) | $445.83 | $2,123 | 2.8× |
| CT l-spine w&w/o contrast (72133) | $455.28 | $2,168 | 2.9× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$343.98–$687.96 | $1,638–$3,276 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$372.54–$745.08 | $1,774–$3,548 | varies |
| CT lumbar spine w contrast (72132) | $393.54 | $1,874 | 1.2× |
| CT lumbar spine w/o contrast (72131) | $383.46 | $1,826 | 4.1× |
| CT maxillofacial w contrast (70487) | $360.78 | $1,718 | 2.3× |
| CT maxillofacial wo contrast (70486) | $395.01 | $1,881 | 4.2× |
| CT neck tissue combo (70492) | $481.53 | $2,293 | 3.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $481.53 | $2,293 | 3.0× |
| CT orbits w/o contrast (70480) | $409.71 | $1,951 | 4.3× |
| CT pelvis w&w/o contrast (72194) | $459.48 | $2,188 | 2.9× |
| CT pelvis w/o contrast (72192) | $343.98 | $1,638 | 3.6× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$409.71–$819.42 | $1,951–$3,902 | varies |
| CT scans face/jaw combo (70488) | $408.87 | $1,947 | 2.6× |
| CT soft tissue neck w contrast (70491) | $349.86 | $1,666 | 2.2× |
| CT soft tissue neck w/o contrast (70490) | $343.98 | $1,638 | 3.6× |
| CT thoracic spine w contrast (72129) | $391.44 | $1,864 | 2.5× |
| CT thoracic spine w/o contrast (72128) | $364.14 | $1,734 | 3.8× |
| CT thoracic spine w/wo cont (72130) | $455.28 | $2,168 | 2.9× |
| CT thorax w/o contrast (71250) | $355.74 | $1,694 | 3.8× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$343.98–$687.96 | $1,638–$3,276 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$409.71–$819.42 | $1,951–$3,902 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$372.54–$745.08 | $1,774–$3,548 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $430.08 | $2,048 | 2.7× |
| Cta Abdomen (74175) | $492.24 | $2,344 | 3.1× |
| CTA pelvis (72191) | $492.24 | $2,344 | 3.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $26.67 | $127 | 0.3× |
| Doppler Fetal Mid Cerebral Artery (76821) | $33.33 | $101 | 0.4× |
| Dxa Bone Density Axial (77080) | $97.86 | $466 | 1.0× |
| Dxa bone density study (77085) | $53.97 | $257 | 0.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $59.64 | $284 | 0.8× |
| Echo exam of fetal heart (76825) | $114.66 | $546 | 0.2× |
| Echo exam uterus (76831) | $43.89 | $133 | 0.2× |
| Esophagram (74220) | $102.06 | $486 | 0.6× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$43.23–$176.19 | $131–$839 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$31.68–$134.82 | $96–$642 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $315 | $1,500 | 1.5× |
| Fluoroscopy up to 1 hr (76000) | $111.30 | $530 | 0.5× |
| Follow-Up Angiography (75898) | $876.54 | $4,174 | 0.3× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$44.94–$89.88 | $214–$428 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$44.94–$89.88 | $214–$428 | varies |
| Gastric emptying imaging study (78264) | $294.84 | $1,404 | 0.8× |
| Gated Heart Planar Single (78472) | $386.82 | $1,842 | 1.1× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$44.94–$89.88 | $214–$428 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,798.65 | $8,565 | 2.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $364.77 | $1,737 | 0.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,686.93 | $8,033 | 0.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,330.98 | $6,338 | 0.5× |
| Hepatobil Syst Image W/Drug (78227) | $289.80 | $1,380 | 0.6× |
| Hepatobiliary System Imaging (78226) | $518.91 | $2,471 | 1.4× |
| Hysterosalpingogram (74740) | $212.52 | $1,012 | 1.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $26.25 | $125 | 0.3× |
| Infant hip ultrasound, limited static exam (76886) | $36.54 | $174 | 0.5× |
| Interstitial radiation source applic complex (77778) | $686.07 | $3,267 | 1.1× |
| Joint Survey Single View (77077) | $56.70 | $270 | 0.6× |
| K Flow/Funct Image W/Drug (78708) | $289.80 | $1,380 | 0.6× |
| K Flow/Funct Image W/O Drug (78707) | $244.02 | $1,162 | 0.5× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$15.51–$111.72 | $47–$532 | varies |
| Liver & Spleen Imaging Static Only (78215) | $289.80 | $1,380 | 0.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $196.14 | $934 | 0.5× |
| Liver imaging static only (78201) | $84.21 | $401 | 0.2× |
| Lung perfusion differential (78597) | $351.75 | $1,675 | 1.0× |
| Lung Ventilat&Perfus Imaging (78582) | $315.42 | $1,502 | 0.6× |
| Lung Ventilation Imaging (78579) | $248.43 | $1,183 | 0.7× |
| Lymph System Imaging (78195) | $244.02 | $1,162 | 0.5× |
| Magnetic Image Jaw Joint (70336) | $580.65 | $2,765 | 2.7× |
| Meckels Divert Exam (78290) | $259.14 | $1,234 | 0.7× |
| Mlc imrt design & construction per imrt plan (77338) | $218.19 | $1,039 | 0.6× |
| Mra Head W/O & W/Contrast Material (70546) | $916.44 | $4,364 | 2.9× |
| MRA head w/o contrast (70544) | $588.63 | $2,803 | 2.7× |
| MRA head with contrast (70545) | $679.98 | $3,238 | 2.2× |
| MRA neck w contrast (70548) | $588.63 | $2,803 | 1.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,145.97 | $5,457 | 3.6× |
| MRA neck w/o contrast (70547) | $588.63 | $2,803 | 2.7× |
| MRI abdomen w contrast (74182) | $711.69 | $3,389 | 2.3× |
| MRI abdomen w/o contrast (74181) | $560.91 | $2,671 | 2.6× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$711.69–$1,423.38 | $3,389–$6,778 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$893.76–$1,787.52 | $4,256–$8,512 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$711.69–$1,423.38 | $3,389–$6,778 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,629.18 | $7,758 | 7.5× |
| MRI cervical spine w contrast (72142) | $711.69 | $3,389 | 2.3× |
| MRI cervical spine w/o cont (72141) | $560.91 | $2,671 | 2.6× |
| MRI chest w/o contrast (71550) | $560.91 | $2,671 | 2.6× |
| MRI chest wo w contrast (71552) | $1,054.62 | $5,022 | 3.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$315–$630 | $1,500–$3,000 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $893.76 | $4,256 | 2.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$580.65–$1,161.30 | $2,765–$5,530 | varies |
| MRI lumbar spine w contrast (72149) | $711.69 | $3,389 | 2.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,256.01 | $5,981 | 4.0× |
| MRI orbit face &/neck w/o contrast (70540) | $580.65 | $2,765 | 2.7× |
| MRI orbit face neck w contrast (70542) | $711.69 | $3,389 | 2.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,086.12 | $5,172 | 3.4× |
| MRI pelvis w contrast (72196) | $315 | $1,500 | 1.0× |
| MRI pelvis w/o & w contrast (72197) | $658.35 | $3,135 | 2.1× |
| MRI pelvis w/o contrast (72195) | $560.91 | $2,671 | 2.6× |
| MRI thoracic spine w/o contrast (72146) | $560.91 | $2,671 | 2.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$315–$630 | $1,500–$3,000 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$893.76–$1,787.52 | $4,256–$8,512 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $580.65 | $2,765 | 1.8× |
| MRI, abdomen, combo (74183) | $1,054.62 | $5,022 | 3.3× |
| MRI, dorsal spine combo (72157) | $1,256.01 | $5,981 | 4.0× |
| MRI, dorsal spine contrast (72147) | $711.69 | $3,389 | 2.3× |
| MRI, joint upper extrem (73221) | $580.65 | $2,765 | 2.7× |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$893.76–$1,787.52 | $4,256–$8,512 | varies |
| MRI, lumbar spine combo (72158) | $1,256.01 | $5,981 | 4.0× |
| Myelogram Lumbar (72265) | $719.67 | $3,427 | 1.0× |
| Myocardial Spect Multiple Studies (78452) | $210.42 | $1,002 | 0.2× |
| Neck soft tissue (70360) | $44.94 | $214 | 0.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $26.46 | $126 | 0.1× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,041.60 | $4,960 | 0.8× |
| Nuclear Rx Intra-Arterial (79445) | $730.17 | $3,477 | 3.5× |
| Ob us nuchal meas 1 gest (76813) | $44.55 | $135 | 0.5× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $25.08 | $76 | 0.3× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $28.05 | $85 | 0.3× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $26.07 | $79 | 0.2× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) | $17.49 | $53 | 0.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $18.15 | $55 | 0.2× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $4.62 | $14 | 0.2× |
| Ophthalmic us dx quantitative a-scan only (76511) | $21.12 | $64 | 0.2× |
| Parathyroid Planar Imaging (78070) | $358.05 | $1,705 | 1.0× |
| Parathyroid planar imaging w/wo subtraction (78071) | $163.59 | $779 | 0.5× |
| Pelvis 1 or 2 views (72170) | $45.57 | $217 | 0.5× |
| PET image w/CT, full body (78816) | $1,889.79 | $8,999 | 1.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,889.79 | $8,999 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $212.10 | $1,010 | 0.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $77.70 | $370 | 0.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $121.17 | $577 | 0.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$44.94–$89.88 | $214–$428 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$44.94–$89.88 | $214–$428 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$47.25–$94.50 | $225–$450 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $51.24 | $244 | 0.5× |
| Radex fingr minimum 2 views (73140) | $44.94 | $214 | 0.6× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$44.94–$89.88 | $214–$428 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$44.94–$89.88 | $214–$428 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$51.24–$102.48 | $244–$488 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $44.31 | $211 | 0.6× |
| Radex Ribs Unilateral 2 Views (71100) | $50.82 | $242 | 0.6× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$50.82–$101.64 | $242–$484 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $44.94 | $214 | 0.6× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $92.82 | $442 | 0.6× |
| Radex Spine 1 View Specify Level (72020) | $49.77 | $237 | 0.6× |
| Radex Sternum Minimum 2 Views (71120) | $55.86 | $266 | 0.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $71.61 | $341 | 0.9× |
| Radex Toe Minimum 2 Views (73660) | $44.94 | $214 | 0.6× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$53.55–$107.10 | $255–$510 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$44.94–$89.88 | $214–$428 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) likely a partial charge, not the full procedure |
$467.67 | $2,227 | 0.1× |
| Radiation treatment delivery level 3 (77412) | $481.95 | $2,295 | 1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $62.58 | $298 | 0.7× |
| Radiologic exam colon double contrast study (74280) | $153.93 | $733 | 1.0× |
| Radiologic exam colon single contrast study (74270) | $129.15 | $615 | 0.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $102.06 | $486 | 0.6× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$76.02–$152.04 | $362–$724 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $58.17 | $277 | 0.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $102.06 | $486 | 0.6× |
| Radiologic exam swallow function contrast study (74230) | $177.66 | $846 | 1.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $185.01 | $881 | 1.2× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$50.82–$101.64 | $242–$484 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$46.62–$93.24 | $222–$444 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $69.30 | $330 | 0.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$44.94–$89.88 | $214–$428 | varies |
| Ribs bilateral 3 views (71110) | $40.74 | $194 | 0.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $196.14 | $934 | 0.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $317.73 | $1,513 | 0.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $758.73 | $3,613 | 1.5× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $289.80 | $1,380 | 0.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $431.76 | $2,056 | 0.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,458.87 | $6,947 | 1.1× |
| Rp Therapy Intravenous Administration (79101) | $271.95 | $1,295 | 1.3× |
| Scapula (73010) range across 2 matching MRF lines |
$44.94–$89.88 | $214–$428 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $46.62 | $222 | 2.0× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$47.88–$95.76 | $228–$456 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$175.14–$350.28 | $834–$1,668 | varies |
| Skull less than 4 views (70250) | $44.31 | $211 | 0.5× |
| Special Physics Consult (77370) | $212.10 | $1,010 | 1.7× |
| Special teletherapy port plan (77321) | $217.35 | $1,035 | 0.6× |
| Special treatment procedure (77470) | $454.65 | $2,165 | 0.9× |
| Stereotactic Body Radiation Delivery (77373) | $747.39 | $3,559 | 0.5× |
| Sternoclavicular joints (71130) | $50.82 | $242 | 0.6× |
| Superior sagittal sinus venogram (75870) | $1,487.43 | $7,083 | 0.5× |
| Tbs technical calculation only (77091) | $88.20 | $420 | 1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $225.12 | $1,072 | 0.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $153.93 | $733 | 0.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $360.78 | $1,718 | 1.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $304.29 | $1,449 | 0.9× |
| Ther rad simulaj-aided field setting simple (77280) | $183.75 | $875 | 1.5× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$12.54–$30.66 | $38–$146 | varies |
| Thoracic spine 3 views (72072) | $184.80 | $880 | 2.0× |
| Thoracolumbar 2 views (72080) | $50.19 | $239 | 0.6× |
| Thyroid Met Imaging Body (78018) | $244.02 | $1,162 | 0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $228.69 | $1,089 | 0.6× |
| Tx Devices Design & Construction Complex (77334) | $218.19 | $1,039 | 0.6× |
| Tx devices design & construction intermediate (77333) | $197.61 | $941 | 1.6× |
| Tx devices design & construction simple (77332) | $182.70 | $870 | 1.5× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$40.92–$354.06 | $124–$1,686 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$82.83–$88.20 | $251–$420 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$46.20–$143.85 | $140–$685 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$17.16–$26.88 | $52–$128 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $1,487.43 | $7,083 | 18.9× |
| Unlisted fluoroscopic procedure (76496) | $1,487.43 | $7,083 | 18.9× |
| Unlisted us procedure (76999) | $26.25 | $125 | 0.3× |
| Upper gi w/o kub (74240) | $107.31 | $511 | 0.7× |
| Urethrocystogram voiding (74455) | $161.07 | $767 | 0.7× |
| Urethrocystography retrograde (74450) | $161.07 | $767 | 0.7× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$34.32–$380.10 | $104–$1,810 | varies |
| Us chest (76604) | $116.55 | $555 | 1.2× |
| Us complete joint (76881) range across 3 matching MRF lines |
$53.79–$55.86 | $163–$266 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$18.15–$123.69 | $55–$589 | varies |
| Us head (76506) | $161.07 | $767 | 1.7× |
| Us kidney transplant (76776) | $58.59 | $279 | 0.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$12.54–$113.82 | $38–$542 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$66–$163.59 | $200–$779 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$31.02–$135.87 | $94–$647 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$35.31–$150.15 | $107–$715 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$39.93–$148.89 | $121–$709 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$44.22–$143.01 | $134–$681 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$41.58–$143.01 | $126–$681 | varies |
| Us retroperitoneal complete (76770) | $139.86 | $666 | 1.5× |
| Us retroperitoneal limited (76775) | $93.03 | $443 | 1.0× |
| Us scrotum and contents (76870) | $126 | $600 | 1.3× |
| Us spinal canal and contents (76800) | $156.87 | $747 | 1.7× |
| Us thyroid (76536) range across 3 matching MRF lines |
$42.24–$120.75 | $128–$575 | varies |
| Us transrectal (76872) | $75.57 | $229 | 0.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $727.23 | $3,463 | 0.3× |
| Vein X-Ray Spleen/Liver (75810) | $727.23 | $3,463 | 0.3× |
| Venogram Sinus/Jugular (75860) | $1,373.40 | $6,540 | 0.5× |
| Venography caval inferior serialography rs&i (75825) | $1,313.55 | $6,255 | 0.5× |
| Venography extremity bilateral rs&i (75822) | $1,131.69 | $5,389 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $1,256.85 | $5,985 | 0.9× |
| Venography Renal Unilateral (75831) | $1,487.43 | $7,083 | 0.5× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$44.94–$89.88 | $214–$428 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $52.92 | $252 | 0.7× |
| X-ray antegrade pyelogram tube (74425) | $483.84 | $2,304 | 1.5× |
| X-Ray Aorta Leg Arteries (75630) | $1,947.12 | $9,272 | 0.7× |
| X-Ray Bend Only L-S Spine (72120) | $59.22 | $282 | 0.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$44.94–$89.88 | $214–$428 | varies |
| X-Ray Exam Breast Specimen (76098) | $119.28 | $568 | 0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $25.41 | $121 | 0.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $58.17 | $277 | 0.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $46.83 | $223 | 0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $51.03 | $243 | 0.6× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$15.51–$56.07 | $47–$267 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $53.97 | $257 | 0.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $74.97 | $357 | 0.8× |
| X-Ray Exam L-S Spine Bending (72114) | $78.54 | $374 | 0.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$14.85–$58.17 | $45–$277 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $73.71 | $351 | 0.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $66.36 | $316 | 0.7× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$56.70–$113.40 | $270–$540 | varies |
| X-ray humerus (73060) | $44.94 | $214 | 0.6× |
| X-ray IV pyelogram (ivp) (74400) | $161.07 | $767 | 1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $16.17 | $77 | 0.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $92.61 | $441 | 1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$15.18–$58.80 | $46–$280 | varies |
| X-ray nose-rectum child f.b. (76010) | $42.21 | $201 | 0.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $102.48 | $488 | 1.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $55.86 | $266 | 0.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $132.72 | $632 | 1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $44.94 | $214 | 0.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $58.80 | $280 | 0.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $77.70 | $370 | 0.8× |
| X-ray thoracic spine 4 vw (72074) | $58.17 | $277 | 0.6× |
| X-Ray Tmj Unilat (70328) | $58.38 | $278 | 0.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $161.07 | $767 | 0.5× |
| X-Rays Bone Length Studies (77073) | $73.71 | $351 | 0.8× |
| X-Rays Bone Survey Complete (77075) | $177.87 | $847 | 1.9× |
| Xr c-spine 4 or 5 views (72050) | $77.70 | $370 | 0.8× |
| Xr facial bones less than 3 views (70140) | $48.72 | $232 | 0.6× |
| Xr orbits complete 4 views (70200) | $56.70 | $270 | 0.6× |
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.