Imaging prices at Onslow Memorial Hospital
Jacksonville, NC · every code in this section with a posted price and a Medicare benchmark.
328 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) | $400 | $400 | 4.8× |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$543–$594 | $543–$594 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,228 | $1,228 | 3.2× |
| Angio internal mammary (75756) | $3,038 | $3,038 | 1.0× |
| Angio pulmonary bilat (75743) | $3,798 | $3,798 | 1.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,624.75 | $3,624.75 | 1.2× |
| Angiography extremity bilateral rs&i (75716) | $6,796 | $6,796 | 2.2× |
| Angiography extremity unilateral rs&i (75710) | $4,641 | $4,641 | 1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,038 | $3,038 | 1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,038 | $3,038 | 1.0× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$350–$500 | $350–$500 | varies |
| Aortography thoracic serialography rs&i (75605) | $5,236 | $5,236 | 1.0× |
| Aortography thoracic w/o serialography rs&i (75600) | $3,038 | $3,038 | 1.0× |
| Artery X-Rays Abdomen (75726) | $8,219 | $8,219 | 1.5× |
| Artery X-Rays Adrenal Gland (75731) | $3,038 | $3,038 | 1.0× |
| Artery X-Rays Pelvis (75736) | $5,236 | $5,236 | 1.0× |
| Artery X-Rays Spine (75705) | $11,737 | $11,737 | 2.2× |
| Arthrogram ankle (73615) | $608 | $608 | 1.8× |
| Arthrogram hip (73525) | $964 | $964 | 2.9× |
| Arthrogram Wrist (73115) | $839 | $839 | 2.5× |
| Bone age studies (77072) range across 2 matching MRF lines |
$268–$289 | $268–$289 | varies |
| Bone Imaging 3 Phase (78315) | $2,405 | $2,405 | 6.2× |
| Bone Imaging Multiple Areas (78305) | $1,662 | $1,662 | 4.3× |
| Bone Imaging Whole Body (78306) | $2,208 | $2,208 | 5.7× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$242–$303 | $242–$303 | varies |
| Brain Flow Imaging Only (78610) | $515 | $515 | 1.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $986.36 | $986.36 | 1.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $6,000 | $6,000 | 4.4× |
| Cat Scan Follow-Up Study (76380) | $998 | $998 | 11.9× |
| Cerebrospinal Fluid Scan (78630) | $1,540 | $1,540 | 2.9× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$275–$288 | $275–$288 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$373–$392 | $373–$392 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$372–$563 | $372–$563 | varies |
| Chest 4 or more views (71048) | $652 | $652 | 6.5× |
| Cholecystography Oral Contrast (74290) | $331.99 | $331.99 | 2.0× |
| Clavicle complete (73000) | $432 | $432 | 5.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $2,004 | $2,004 | 19.9× |
| Contrast Exam Abdominl Aorta (75625) | $3,754 | $3,754 | 1.2× |
| Contrast X-Ray Bladder (74430) | $673 | $673 | 2.0× |
| Contrast X-Ray Of Elbow (73085) | $888 | $888 | 2.6× |
| Contrast X-Ray Of Knee Joint (73580) | $987 | $987 | 2.9× |
| CT abdomen and pelvis without and with contrast (74178) | $5,394 | $5,394 | 16.1× |
| CT abdomen and pelvis without contrast (74176) | $3,900 | $3,900 | 17.0× |
| CT abdomen w contrast (74160) | $3,190 | $3,190 | 18.9× |
| CT abdomen w wo contrast (74170) | $3,422 | $3,422 | 20.3× |
| CT abdomen w/o contrast (74150) | $2,535 | $2,535 | 25.2× |
| CT Angio Abdomen and Pelvis (74174) | $4,400 | $4,400 | 13.1× |
| CT Angio Chest (71275) | $3,100 | $3,100 | 18.4× |
| CT Angio Head (70496) | $2,500 | $2,500 | 14.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,958 | $2,958 | 17.5× |
| CT Angio Neck (70498) | $2,300 | $2,300 | 13.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $3,012 | $3,012 | 17.8× |
| CT cervical spine w/ contrast (72126) | $3,171 | $3,171 | 9.4× |
| CT cervical spine w/o contrast (72125) | $2,100 | $2,100 | 20.9× |
| CT cervical spine w/wo cont (72127) | $3,415 | $3,415 | 20.2× |
| CT chest w contrast (71260) | $2,810 | $2,810 | 16.6× |
| CT chest w/wo contrast (71270) | $3,418 | $3,418 | 20.2× |
| CT head/brain with contrast (70460) | $2,368 | $2,368 | 14.0× |
| CT head/brain without and with contrast (70470) | $2,987 | $2,987 | 17.7× |
| CT iac w contrast (70481) | $2,694 | $2,694 | 15.9× |
| CT l-spine w&w/o contrast (72133) | $3,417 | $3,417 | 20.2× |
| CT lower ext w/o (73700) | $2,406 | $2,406 | 23.9× |
| CT lower extremity w/contrast material (73701) | $2,948 | $2,948 | 17.5× |
| CT lumbar spine w contrast (72132) | $3,044 | $3,044 | 9.1× |
| CT lumbar spine w/o contrast (72131) | $2,321 | $2,321 | 23.1× |
| CT maxillofacial w contrast (70487) | $2,725 | $2,725 | 16.1× |
| CT maxillofacial wo contrast (70486) | $2,137 | $2,137 | 21.2× |
| CT neck tissue combo (70492) | $3,143 | $3,143 | 18.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,963 | $2,963 | 17.5× |
| CT orbits w/o contrast (70480) | $2,191 | $2,191 | 21.8× |
| CT pelvis w&w/o contrast (72194) | $2,993 | $2,993 | 17.7× |
| CT pelvis w/o contrast (72192) | $2,053 | $2,053 | 20.4× |
| CT scan of leg combo (73702) | $3,123 | $3,123 | 18.5× |
| CT scans face/jaw combo (70488) | $3,222 | $3,222 | 19.1× |
| CT soft tissue neck w contrast (70491) | $2,762 | $2,762 | 16.4× |
| CT soft tissue neck w/o contrast (70490) | $1,917 | $1,917 | 19.0× |
| CT thoracic spine w contrast (72129) | $2,781 | $2,781 | 16.5× |
| CT thoracic spine w/o contrast (72128) | $1,955 | $1,955 | 19.4× |
| CT thoracic spine w/wo cont (72130) | $3,855 | $3,855 | 22.8× |
| CT thorax w/o contrast (71250) | $2,050 | $2,050 | 20.4× |
| CT upper ext wo (73200) | $2,500 | $2,500 | 24.8× |
| CT upper extremity w/o & w/contrast material (73202) | $2,771 | $2,771 | 16.4× |
| CT upper extremity with contrast (73201) | $2,976 | $2,976 | 8.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,940 | $2,940 | 17.4× |
| Cta Abdomen (74175) | $3,230 | $3,230 | 19.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,000 | $1,000 | 3.0× |
| CTA pelvis (72191) | $3,355 | $3,355 | 19.9× |
| Dilation ureters/urethra rs&i (74485) | $1,941 | $1,941 | 1.0× |
| Discography Cerv/Thor Spine (72285) | $2,003.76 | $2,003.76 | 1.1× |
| Diskography lumbar (72295) | $1,840 | $1,840 | 1.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$656–$656.19 | $656–$656.19 | varies |
| Dxa Bone Density Axial (77080) | $636 | $636 | 6.3× |
| Dxa bone density study (77085) | $459 | $459 | 4.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $87 | $87 | 1.0× |
| Echo exam of fetal heart (76825) | $526 | $526 | 1.0× |
| Echo exam uterus (76831) | $1,424 | $1,424 | 6.2× |
| Echo Guide For Artery Repair (76936) | $424 | $424 | 2.0× |
| Echograp Trans R Pros Study (76873) | $549.59 | $549.59 | 5.5× |
| Esophagram (74220) | $611 | $611 | 3.6× |
| Fetal Biophys Profile W/Nst (76818) | $524 | $524 | 5.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $540 | $540 | 5.4× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$678–$707.94 | $678–$707.94 | varies |
| Follow-Up Angiography (75898) | $3,038 | $3,038 | 1.0× |
| Foot 2 views (73620) range across 5 matching MRF lines |
$396–$418.19 | $396–$418.19 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$516–$550 | $516–$550 | varies |
| Gastric emptying imaging study (78264) | $2,315 | $2,315 | 6.0× |
| Gastroesophageal Reflux Exam (78262) | $1,109.52 | $1,109.52 | 2.9× |
| Gated Heart Planar Single (78472) | $1,759 | $1,759 | 4.6× |
| Gated Heart, Multiple (78473) | $3,263 | $3,263 | 8.5× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$378–$455 | $378–$455 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,207 | $2,207 | 4.2× |
| Hepatobiliary System Imaging (78226) | $2,173 | $2,173 | 5.6× |
| Ht Muscle Image Spect Sing (78451) | $2,979 | $2,979 | 2.4× |
| Hysterosalpingogram (74740) | $599 | $599 | 2.6× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $559 | $559 | 6.7× |
| Infant hip ultrasound, limited static exam (76886) | $474 | $474 | 5.7× |
| K Flow/Funct Image Multiple (78709) | $2,984 | $2,984 | 5.7× |
| K Flow/Funct Image W/Drug (78708) | $2,339 | $2,339 | 4.5× |
| K Flow/Funct Image W/O Drug (78707) | $1,804 | $1,804 | 3.4× |
| Kidney Imaging Morphol (78700) | $732.78 | $732.78 | 1.9× |
| Knee 3 Views (73562) | $689 | $689 | 8.2× |
| Liver & Spleen Imaging Static Only (78215) | $1,512 | $1,512 | 3.9× |
| Liver imaging w/vascular flow (78202) | $882 | $882 | 1.7× |
| Lung perfusion differential (78597) | $876 | $876 | 2.3× |
| Lung Ventilat&Perfus Imaging (78582) | $1,484 | $1,484 | 2.8× |
| Lung Ventilation Imaging (78579) | $888 | $888 | 2.3× |
| Lymph System Imaging (78195) | $1,700 | $1,700 | 3.3× |
| Magnetic Image Jaw Joint (70336) | $3,315 | $3,315 | 14.4× |
| Mammary ductogram or galactogram multiple (77054) | $569.25 | $569.25 | 2.5× |
| Mammary ductogram or galactogram single (77053) | $1,305 | $1,305 | 5.7× |
| Meckels Divert Exam (78290) | $1,183 | $1,183 | 3.1× |
| Mra Head W/O & W/Contrast Material (70546) | $5,463 | $5,463 | 16.3× |
| MRA head w/o contrast (70544) | $3,244 | $3,244 | 14.1× |
| MRA head with contrast (70545) | $3,202.13 | $3,202.13 | 9.5× |
| MRA neck w contrast (70548) | $2,910 | $2,910 | 8.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,137 | $4,137 | 12.3× |
| MRA neck w/o contrast (70547) | $3,072 | $3,072 | 13.4× |
| MRI abdomen w contrast (74182) | $4,716 | $4,716 | 14.0× |
| MRI abdomen w/o contrast (74181) | $3,835 | $3,835 | 16.7× |
| MRI any jt lower extrem w/contrast material (73722) | $3,802 | $3,802 | 5.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,743 | $4,743 | 14.1× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$4,230–$4,375 | $4,230–$4,375 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $2,781 | $2,781 | 12.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $589 | $589 | 2.6× |
| MRI cervical spine w contrast (72142) | $4,398 | $4,398 | 13.1× |
| MRI cervical spine w/o cont (72141) | $3,632 | $3,632 | 15.8× |
| MRI chest w/o contrast (71550) | $3,344 | $3,344 | 14.6× |
| MRI chest with contrast (71551) | $3,588.35 | $3,588.35 | 4.8× |
| MRI chest wo w contrast (71552) | $4,857 | $4,857 | 14.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,746 | $3,746 | 11.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $4,767 | $4,767 | 14.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,472 | $3,472 | 15.1× |
| MRI lumbar spine w contrast (72149) | $4,188 | $4,188 | 12.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,920 | $4,920 | 14.6× |
| MRI orbit face &/neck w/o contrast (70540) | $3,066.53 | $3,066.53 | 13.3× |
| MRI orbit face neck w contrast (70542) | $3,847 | $3,847 | 11.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,005 | $5,005 | 14.9× |
| MRI pelvis w contrast (72196) | $3,625 | $3,625 | 10.8× |
| MRI pelvis w/o & w contrast (72197) | $4,995 | $4,995 | 14.9× |
| MRI pelvis w/o contrast (72195) | $3,600 | $3,600 | 15.7× |
| MRI thoracic spine w/o contrast (72146) | $3,403 | $3,403 | 14.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$3,524–$3,901 | $3,524–$3,901 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$3,270–$4,905 | $3,270–$4,905 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$4,659–$5,225 | $4,659–$5,225 | varies |
| MRI, abdomen, combo (74183) | $4,959 | $4,959 | 14.8× |
| MRI, dorsal spine combo (72157) | $4,742 | $4,742 | 14.1× |
| MRI, dorsal spine contrast (72147) | $4,248 | $4,248 | 12.6× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$3,081–$3,875 | $3,081–$3,875 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$4,745–$5,345 | $4,745–$5,345 | varies |
| MRI, lumbar spine combo (72158) | $4,900 | $4,900 | 14.6× |
| Myelogram cervical (72240) | $1,162.31 | $1,162.31 | 1.5× |
| Myelogram Lumbar (72265) range across 3 matching MRF lines |
$1,100.21–$1,760 | $1,100.21–$1,760 | varies |
| Myelography thoracic (72255) | $1,097.10 | $1,097.10 | 1.5× |
| Myelograpy 2/more regions rs&i (72270) | $1,199.57 | $1,199.57 | 1.6× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $596 | $596 | 1.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,203.52 | $2,203.52 | 1.8× |
| Myocardial Spect Multiple Studies (78452) | $4,877 | $4,877 | 3.9× |
| Neck soft tissue (70360) | $413 | $413 | 4.9× |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$202–$225 | $202–$225 | varies |
| Nuclear Rx Oral Admin (79005) | $1,381 | $1,381 | 6.1× |
| Parathyroid Planar Imaging (78070) | $1,469 | $1,469 | 3.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $656 | $656 | 1.7× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$432–$464 | $432–$464 | varies |
| Perineogram (74775) | $284.63 | $284.63 | 1.2× |
| Pet Image Skull-Thigh (78812) | $3,622.50 | $3,622.50 | 2.6× |
| Pet Image W/Ct Lmtd (78814) | $7,943 | $7,943 | 5.8× |
| PET image w/CT, full body (78816) | $6,678 | $6,678 | 4.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$4,529–$6,485 | $4,529–$6,485 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $3,105 | $3,105 | 2.5× |
| PET whole body (78813) | $3,829.50 | $3,829.50 | 2.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,263 | $1,263 | 3.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$747–$784 | $747–$784 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 3 matching MRF lines |
$788–$850 | $788–$850 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$499–$549 | $499–$549 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 7 matching MRF lines |
$411–$484 | $411–$484 | varies |
| Radex elbow complete minimum 3 views (73080) | $587 | $587 | 7.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$504–$584 | $504–$584 | varies |
| Radex fingr minimum 2 views (73140) | $395 | $395 | 4.7× |
| Radex foot complete minimum 3 views (73630) | $565 | $565 | 6.7× |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$558–$690 | $558–$690 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $258 | $258 | 3.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $244 | $244 | 2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$333–$419 | $333–$419 | varies |
| Radex Ribs Unilateral 2 Views (71100) | $452 | $452 | 5.4× |
| Radex shoulder complete minimum 2 views (73030) | $582 | $582 | 6.9× |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$217–$317 | $217–$317 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,123 | $1,123 | 6.6× |
| Radex Spine 1 View Specify Level (72020) | $389 | $389 | 4.6× |
| Radex Sternum Minimum 2 Views (71120) | $438 | $438 | 5.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$367–$408 | $367–$408 | varies |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$318–$357 | $318–$357 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $173 | $173 | 1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$589–$605 | $589–$605 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $629 | $629 | 6.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$532–$742 | $532–$742 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$985–$1,007 | $985–$1,007 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$838–$844 | $838–$844 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $464 | $464 | 2.7× |
| Radiologic exam knee complete 4/more views (73564) | $690 | $690 | 6.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$320.32–$519 | $320.32–$519 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$805–$834 | $805–$834 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$474–$515 | $474–$515 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$779–$844.56 | $779–$844.56 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$483–$484 | $483–$484 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$521–$653 | $521–$653 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$450–$488 | $450–$488 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$392–$588 | $392–$588 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $575 | $575 | 1.1× |
| Renal Cyst Study (74470) | $526 | $526 | 1.0× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$596–$607 | $596–$607 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,154 | $1,154 | 3.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,492 | $1,492 | 3.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,534.72 | $2,534.72 | 4.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,213 | $3,213 | 6.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,804 | $1,804 | 3.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $750 | $750 | 3.3× |
| Rp Therapy Intravenous Administration (79101) | $1,098 | $1,098 | 4.9× |
| Scapula (73010) range across 4 matching MRF lines |
$424–$447 | $424–$447 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 12 matching MRF lines |
$22.13–$75 | $22.13–$75 | varies |
| Sella turcica (70240) | $125 | $125 | 1.5× |
| Shoulder 1 view (73020) | $378 | $378 | 4.5× |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$966–$983 | $966–$983 | varies |
| Sialogram (70390) | $633 | $633 | 2.8× |
| Skull less than 4 views (70250) | $517 | $517 | 5.1× |
| Speech evaluation, complex (70371) | $810.41 | $810.41 | 3.5× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$142–$332 | $142–$332 | varies |
| Testicular Imaging W/Flow (78761) | $527.85 | $527.85 | 1.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$424–$552.69 | $424–$552.69 | varies |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$487–$547 | $487–$547 | varies |
| Thoracic spine 3 views (72072) | $492 | $492 | 4.9× |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$499–$526 | $499–$526 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $979 | $979 | 2.5× |
| Thyroid Met Imaging Body (78018) | $2,274 | $2,274 | 4.3× |
| Thyroid Uptake Measurement (78012) | $475 | $475 | 1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,253 | $1,253 | 3.3× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$30.38–$480 | $30.38–$480 | varies |
| Ultrasound Exam Aaa Screen (76706) | $450 | $450 | 4.5× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$925–$975 | $925–$975 | varies |
| Unlisted magnetic resonance procedure (76498) | $822 | $822 | 9.8× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $864 | $864 | 2.2× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$557–$780 | $557–$780 | varies |
| Ureteral Reflux Study (78740) | $850.77 | $850.77 | 2.2× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$821–$873 | $821–$873 | varies |
| Urethrocystography retrograde (74450) | $616 | $616 | 2.7× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$32.67–$724 | $32.67–$724 | varies |
| Us chest (76604) | $558 | $558 | 5.5× |
| Us complete joint (76881) | $732 | $732 | 7.3× |
| Us exam, pelvic, limited (76857) | $700 | $700 | 7.0× |
| Us head (76506) | $679 | $679 | 6.7× |
| Us kidney transplant (76776) | $864 | $864 | 8.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $510 | $510 | 5.1× |
| Us ob limited 1 or more fetuses (76815) | $574 | $574 | 5.7× |
| Us ob transvaginal (76817) | $702 | $702 | 7.0× |
| Us pelvic non ob complete (76856) | $1,144 | $1,144 | 11.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $745 | $745 | 7.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $388 | $388 | 3.9× |
| Us retroperitoneal complete (76770) | $1,084 | $1,084 | 10.8× |
| Us retroperitoneal limited (76775) | $688 | $688 | 6.8× |
| Us scrotum and contents (76870) | $933 | $933 | 9.3× |
| Us spinal canal and contents (76800) | $327 | $327 | 3.2× |
| Us thyroid (76536) | $905 | $905 | 9.0× |
| Us transrectal (76872) | $1,300 | $1,300 | 12.9× |
| Vascular Flow Imaging (78445) | $558.90 | $558.90 | 1.5× |
| Vein X-Ray Chest (75827) | $2,872 | $2,872 | 1.9× |
| Vein X-Ray Skull Epidural (75872) | $2,161.08 | $2,161.08 | 3.6× |
| Venography Adrenal Unilateral (75840) | $3,038 | $3,038 | 1.0× |
| Venography caval inferior serialography rs&i (75825) | $5,563 | $5,563 | 1.8× |
| Venography extremity bilateral rs&i (75822) | $1,977 | $1,977 | 1.3× |
| Venography extremity unilateral rs&i (75820) | $1,672 | $1,672 | 1.1× |
| Venography Renal Bilateral (75833) | $8,243 | $8,243 | 2.7× |
| Venography Renal Unilateral (75831) | $7,041 | $7,041 | 2.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,340.33 | $1,340.33 | 3.5× |
| Vertebral fracture assessment via dxa (77086) | $125 | $125 | 1.5× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$364–$388 | $364–$388 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$239–$386 | $239–$386 | varies |
| X-ray antegrade pyelogram tube (74425) range across 3 matching MRF lines |
$852–$878 | $852–$878 | varies |
| X-Ray Aorta Leg Arteries (75630) | $3,777 | $3,777 | 1.2× |
| X-Ray Bend Only L-S Spine (72120) | $448 | $448 | 4.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$391–$516 | $391–$516 | varies |
| X-Ray Exam Breast Specimen (76098) | $658 | $658 | 1.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $445 | $445 | 4.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $283 | $283 | 3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $362 | $362 | 4.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$439–$504 | $439–$504 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $858 | $858 | 8.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $641 | $641 | 7.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$938–$958 | $938–$958 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) | $628 | $628 | 6.2× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$397–$425 | $397–$425 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$1,214–$3,268 | $1,214–$3,268 | varies |
| X-ray IV pyelogram+tomography (74415) | $491.63 | $491.63 | 2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $366 | $366 | 4.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $588 | $588 | 5.8× |
| X-ray nose-rectum child f.b. (76010) | $162 | $162 | 1.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$744–$806 | $744–$806 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $415 | $415 | 4.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $313 | $313 | 3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $444 | $444 | 5.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $550 | $550 | 6.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$678–$680 | $678–$680 | varies |
| X-ray thoracic spine 4 vw (72074) | $338 | $338 | 3.4× |
| X-Ray Tmj Unilat (70328) | $148 | $148 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$1,287.86–$1,446 | $1,287.86–$1,446 | varies |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$304–$619 | $304–$619 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$933–$1,014 | $933–$1,014 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$883–$914 | $883–$914 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$400–$550 | $400–$550 | varies |
| Xr Tomogram Single Plane (76100) | $478.17 | $478.17 | 4.7× |
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.