Imaging prices at Osf Saint Anthony's Health Center
Alton, IL · every code in this section with a posted price and a Medicare benchmark.
325 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) | $6,799.80 | $11,333 | 4.6× |
| Abdomen 1 View (74018) | $277.20 | $462 | 3.0× |
| Abdomen 2 views (74019) | $337.80 | $563 | 3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,284 | $2,140 | 3.0× |
| Angio pulmonary bilat (75743) | $4,207.20 | $7,012 | 1.2× |
| Angiography extremity bilateral rs&i (75716) | $4,044 | $6,740 | 1.2× |
| Angiography extremity unilateral rs&i (75710) | $3,579.60 | $5,966 | 1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,037.80 | $5,063 | 0.9× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$335.40–$420.60 | $559–$701 | varies |
| Artery X-Rays Abdomen (75726) | $3,911.40 | $6,519 | 0.7× |
| Arthrogram ankle (73615) | $512.40 | $854 | 1.4× |
| Arthrogram hip (73525) | $880.20 | $1,467 | 2.4× |
| Arthrogram Wrist (73115) | $946.80 | $1,578 | 2.5× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$970.20–$1,035 | $1,617–$1,725 | varies |
| Bone age studies (77072) | $292.80 | $488 | 2.6× |
| Bone Imaging 3 Phase (78315) | $2,627.40 | $4,379 | 6.1× |
| Bone Imaging Limited Area (78300) | $1,956 | $3,260 | 4.6× |
| Bone Imaging Whole Body (78306) | $3,067.20 | $5,112 | 7.2× |
| Bone marrow imaging; whole body (78104) | $1,121.40 | $1,869 | 2.6× |
| Bone survey infant (77076) | $337.20 | $562 | 3.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,012.60 | $5,021 | 2.0× |
| Cat Scan Follow-Up Study (76380) | $1,335 | $2,225 | 14.3× |
| Cerebrospinal Fluid Scan (78630) | $1,717.80 | $2,863 | 3.0× |
| Chest 1 view (71045) | $236.40 | $394 | 2.5× |
| Chest 2 views (71046) | $279.60 | $466 | 3.0× |
| Chest 3 views (71047) | $332.40 | $554 | 3.6× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$375.60–$409.80 | $626–$683 | varies |
| Cisternography Positive Contrast Rs&I (70015) | $764.40 | $1,274 | 0.9× |
| Clavicle complete (73000) | $495 | $825 | 5.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $176.40 | $294 | 1.6× |
| Continuing medical physics consltj pr wk (77336) | $820.80 | $1,368 | 5.7× |
| Contrast Exam Abdominl Aorta (75625) | $3,695.40 | $6,159 | 1.1× |
| Contrast X-Ray Bladder (74430) | $468.60 | $781 | 1.3× |
| Contrast X-Ray Of Elbow (73085) | $523.20 | $872 | 1.4× |
| Contrast X-Ray Of Knee Joint (73580) | $691.20 | $1,152 | 1.8× |
| Contrast Xray Throat/Cerv Esopha (74210) | $754.80 | $1,258 | 4.0× |
| CT abdomen and pelvis without and with contrast (74178) | $4,270.20 | $7,117 | 11.4× |
| CT abdomen and pelvis without contrast (74176) | $3,376.80 | $5,628 | 13.2× |
| CT abdomen w contrast (74160) | $2,716.20 | $4,527 | 14.5× |
| CT abdomen w wo contrast (74170) | $2,814.60 | $4,691 | 15.0× |
| CT abdomen w/o contrast (74150) | $2,434.80 | $4,058 | 21.7× |
| CT Angio Abdomen and Pelvis (74174) | $3,623.40 | $6,039 | 9.7× |
| CT Angio Chest (71275) | $2,409 | $4,015 | 12.8× |
| CT Angio Head (70496) | $2,290.80 | $3,818 | 12.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,323.20–$3,484.80 | $3,872–$5,808 | varies |
| CT Angio Neck (70498) | $2,422.80 | $4,038 | 12.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$2,143.20–$3,215.40 | $3,572–$5,359 | varies |
| CT cervical spine w/ contrast (72126) | $2,637.60 | $4,396 | 7.1× |
| CT cervical spine w/o contrast (72125) | $2,469.60 | $4,116 | 22.0× |
| CT cervical spine w/wo cont (72127) | $3,152.40 | $5,254 | 16.8× |
| CT chest w contrast (71260) | $2,601 | $4,335 | 13.8× |
| CT chest w/wo contrast (71270) | $2,764.80 | $4,608 | 14.7× |
| CT head/brain with contrast (70460) | $2,253 | $3,755 | 12.0× |
| CT head/brain without and with contrast (70470) | $2,524.80 | $4,208 | 13.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $117 | $195 | 1.3× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$2,932.20–$3,341.40 | $4,887–$5,569 | varies |
| CT l-spine w&w/o contrast (72133) | $3,345.60 | $5,576 | 17.8× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$2,222.40–$3,333.60 | $3,704–$5,556 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$2,282.40–$3,423.60 | $3,804–$5,706 | varies |
| CT lumbar spine w contrast (72132) | $2,416.20 | $4,027 | 6.5× |
| CT lumbar spine w/o contrast (72131) | $2,107.20 | $3,512 | 18.8× |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$2,431.80–$2,757 | $4,053–$4,595 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,917–$2,613.60 | $3,195–$4,356 | varies |
| CT neck tissue combo (70492) | $3,207 | $5,345 | 17.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$2,525.40–$3,207 | $4,209–$5,345 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$2,613.60–$2,932.20 | $4,356–$4,887 | varies |
| CT pelvis w&w/o contrast (72194) | $2,647.20 | $4,412 | 14.1× |
| CT pelvis w/o contrast (72192) | $2,157.60 | $3,596 | 19.3× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,431.80–$3,648 | $4,053–$6,080 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$2,489.40–$2,734.20 | $4,149–$4,557 | varies |
| CT soft tissue neck w contrast (70491) | $3,122.40 | $5,204 | 16.6× |
| CT soft tissue neck w/o contrast (70490) | $2,490.60 | $4,151 | 22.2× |
| CT thoracic spine w contrast (72129) | $3,061.80 | $5,103 | 16.3× |
| CT thoracic spine w/o contrast (72128) | $2,469.60 | $4,116 | 22.0× |
| CT thoracic spine w/wo cont (72130) | $3,152.40 | $5,254 | 16.8× |
| CT thorax w/o contrast (71250) | $2,334.60 | $3,891 | 20.8× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$2,554.80–$3,832.80 | $4,258–$6,388 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,554.80–$3,832.80 | $4,258–$6,388 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$2,785.20–$4,178.40 | $4,642–$6,964 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,183.40 | $3,639 | 11.6× |
| Cta Abdomen (74175) | $2,935.20 | $4,892 | 15.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,250 | $3,750 | 6.0× |
| CTA pelvis (72191) | $3,243 | $5,405 | 17.3× |
| Discography Cerv/Thor Spine (72285) | $1,230 | $2,050 | 0.6× |
| Diskography lumbar (72295) | $1,230 | $2,050 | 0.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $303.60 | $506 | 2.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $466.80 | $778 | 4.2× |
| Dxa Bone Density Axial (77080) | $461.40 | $769 | 4.1× |
| Dxa bone density study (77085) | $301.80 | $503 | 2.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $433.80 | $723 | 4.7× |
| Echo exam of fetal heart (76825) | $831.60 | $1,386 | 1.4× |
| Echo exam uterus (76831) | $436.20 | $727 | 1.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $334.20 | $557 | 1.3× |
| Esophagram (74220) | $805.20 | $1,342 | 4.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $946.80 | $1,578 | 8.5× |
| Fluoroscopy up to 1 hr (76000) | $787.80 | $1,313 | 3.1× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$331.20–$414 | $552–$690 | varies |
| Forearm 2 views (73090) | $331.20 | $552 | 3.6× |
| Gastric emptying imaging study (78264) | $2,943.60 | $4,906 | 6.9× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $2,758.20 | $4,597 | 6.4× |
| Gated Heart Planar Single (78472) | $1,923 | $3,205 | 4.5× |
| Gated Heart, Multiple (78473) | $2,469.60 | $4,116 | 5.8× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $3,585 | $5,975 | 6.2× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$331.20–$414 | $552–$690 | varies |
| Hepatobil Syst Image W/Drug (78227) | $3,385.80 | $5,643 | 5.8× |
| Hepatobiliary System Imaging (78226) | $2,619 | $4,365 | 6.1× |
| Ht Muscle Image Spect Sing (78451) | $3,692.40 | $6,154 | 2.7× |
| Hysterosalpingogram (74740) | $1,573.80 | $2,623 | 6.2× |
| Joint Survey Single View (77077) | $370.80 | $618 | 3.3× |
| K Flow/Funct Image Multiple (78709) | $3,507.60 | $5,846 | 6.0× |
| K Flow/Funct Image W/Drug (78708) | $1,343.40 | $2,239 | 2.3× |
| K Flow/Funct Image W/O Drug (78707) | $1,283.40 | $2,139 | 2.2× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $554.40 | $924 | 1.3× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$381–$475.20 | $635–$792 | varies |
| Liver & Spleen Imaging Static Only (78215) | $2,196.60 | $3,661 | 5.1× |
| Lung Perf&Ventilat Diferentl (78598) | $1,582.20 | $2,637 | 2.7× |
| Lung perfusion differential (78597) | $1,404 | $2,340 | 3.3× |
| Lung Ventilat&Perfus Imaging (78582) | $2,281.20 | $3,802 | 3.9× |
| Lymph System Imaging (78195) | $339 | $565 | 0.6× |
| Mammary ductogram or galactogram multiple (77054) | $2,513.40 | $4,189 | 9.8× |
| Mammary ductogram or galactogram single (77053) | $1,400.40 | $2,334 | 5.5× |
| Meckels Divert Exam (78290) | $2,066.40 | $3,444 | 4.8× |
| Mlc imrt design & construction per imrt plan (77338) | $976.20 | $1,627 | 2.4× |
| Mr safety determination physician/other qhp (76016) | $134.40 | $224 | 1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $37.80 | $63 | 1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $194.40 | $324 | 1.9× |
| Mr safety implt pos&/immoblj (76019) | $90.60 | $151 | 1.4× |
| Mr safety med physics xm customization plng&mntr (76017) | $369.60 | $616 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $2,346.60 | $3,911 | 6.3× |
| MRA head w/o contrast (70544) | $1,487.40 | $2,479 | 5.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,439.60 | $4,066 | 6.5× |
| MRA neck w/o contrast (70547) | $1,487.40 | $2,479 | 5.8× |
| MRI abdomen w contrast (74182) | $3,193.80 | $5,323 | 8.5× |
| MRI abdomen w/o contrast (74181) | $3,134.40 | $5,224 | 12.3× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$3,250.20–$4,876.20 | $5,417–$8,127 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,808.80–$5,713.80 | $6,348–$9,523 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,580.20 | $5,967 | 4.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $4,125 | $6,875 | 16.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,749.80 | $4,583 | 10.8× |
| MRI cervical spine w contrast (72142) | $3,558.60 | $5,931 | 9.5× |
| MRI cervical spine w/o cont (72141) | $3,291 | $5,485 | 12.9× |
| MRI chest w/o contrast (71550) | $3,019.20 | $5,032 | 11.8× |
| MRI chest with contrast (71551) | $3,678 | $6,130 | 4.4× |
| MRI chest wo w contrast (71552) | $4,336.80 | $7,228 | 11.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,262.80 | $5,438 | 8.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$3,770.40–$5,655.60 | $6,284–$9,426 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$3,150–$4,725 | $5,250–$7,875 | varies |
| MRI lumbar spine w contrast (72149) | $3,435.60 | $5,726 | 9.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,027.20 | $6,712 | 10.8× |
| MRI orbit face &/neck w/o contrast (70540) | $3,052.80 | $5,088 | 11.9× |
| MRI orbit face neck w contrast (70542) | $3,265.20 | $5,442 | 8.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$3,277.20–$3,522.60 | $5,462–$5,871 | varies |
| MRI pelvis w contrast (72196) | $3,589.20 | $5,982 | 9.6× |
| MRI pelvis w/o & w contrast (72197) | $4,062.60 | $6,771 | 10.9× |
| MRI pelvis w/o contrast (72195) | $3,188.40 | $5,314 | 12.5× |
| MRI thoracic spine w/o contrast (72146) | $3,354.60 | $5,591 | 13.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$3,549.60–$5,325 | $5,916–$8,875 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$3,499.20–$5,249.40 | $5,832–$8,749 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$3,590.40–$5,386.20 | $5,984–$8,977 | varies |
| MRI, abdomen, combo (74183) | $3,682.20 | $6,137 | 9.8× |
| MRI, dorsal spine combo (72157) | $4,027.20 | $6,712 | 10.8× |
| MRI, dorsal spine contrast (72147) | $3,403.80 | $5,673 | 9.1× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$3,358.20–$5,037 | $5,597–$8,395 | varies |
| MRI, joint upper extrem combo (73223) | $3,714 | $6,190 | 9.9× |
| MRI, lumbar spine combo (72158) | $4,033.80 | $6,723 | 10.8× |
| Myocardial Spect Multiple Studies (78452) | $6,490.20 | $10,817 | 4.7× |
| Neck soft tissue (70360) | $395.40 | $659 | 4.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $502.20 | $837 | 1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $8,284.20 | $13,807 | 5.6× |
| Nuclear Rx Oral Admin (79005) | $1,683 | $2,805 | 6.7× |
| Parathyroid Planar Imaging (78070) | $587.40 | $979 | 1.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,058.40 | $1,764 | 2.5× |
| Pelvis 1 or 2 views (72170) | $567 | $945 | 5.1× |
| Pet Image W/Ct Lmtd (78814) | $5,326.80 | $8,878 | 3.5× |
| PET image w/CT, full body (78816) | $5,685.60 | $9,476 | 3.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,685.60 | $9,476 | 3.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,030.80 | $1,718 | 2.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $570 | $950 | 5.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,126.20 | $1,877 | 1.9× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$374.40–$468.60 | $624–$781 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $264.60 | $441 | 2.8× |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$332.40–$415.20 | $554–$692 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $616.20 | $1,027 | 5.5× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$194.40–$258 | $324–$430 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$395.40–$495 | $659–$825 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$384.60–$480 | $641–$800 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$273.60–$343.20 | $456–$572 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$644.40–$805.80 | $1,074–$1,343 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $569.40 | $949 | 6.1× |
| Radex Ribs Unilateral 2 Views (71100) | $585 | $975 | 6.3× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$381–$475.20 | $635–$792 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $372.60 | $621 | 4.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,435.20 | $2,392 | 7.6× |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$301.80–$324 | $503–$540 | varies |
| Radex Sternum Minimum 2 Views (71120) | $572.40 | $954 | 6.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $559.20 | $932 | 6.0× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$194.40–$241.80 | $324–$403 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $280.20 | $467 | 2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$395.40–$495 | $659–$825 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $385.20 | $642 | 3.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $17,185.80 | $28,643 | 2.2× |
| Radiation treatment delivery level 1 (77402) | $679.80 | $1,133 | 6.2× |
| Radiation treatment delivery level 2 (77407) | $2,569.20 | $4,282 | 6.2× |
| Radiation treatment delivery level 3 (77412) | $3,176.40 | $5,294 | 5.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $616.20 | $1,027 | 5.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $389.40 | $649 | 3.5× |
| Radiologic exam colon double contrast study (74280) | $1,215.60 | $2,026 | 6.5× |
| Radiologic exam colon single contrast study (74270) | $1,277.40 | $2,129 | 6.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,207.80 | $2,013 | 6.4× |
| Radiologic exam knee complete 4/more views (73564) | $489.60 | $816 | 4.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $534 | $890 | 4.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,215.60 | $2,026 | 6.5× |
| Radiologic exam swallow function contrast study (74230) | $660.60 | $1,101 | 3.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,796.40 | $2,994 | 9.6× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$173.40–$347.40 | $289–$579 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$342.60–$684.60 | $571–$1,141 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$202.80–$254.40 | $338–$424 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$318–$397.20 | $530–$662 | varies |
| Ribs bilateral 3 views (71110) | $720 | $1,200 | 6.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,131.20 | $3,552 | 3.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,906.20 | $3,177 | 3.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,860.80 | $4,768 | 2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,814.20 | $6,357 | 2.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,542.20 | $4,237 | 1.8× |
| Rp Therapy Intravenous Administration (79101) | $382.20 | $637 | 1.5× |
| Scapula (73010) range across 3 matching MRF lines |
$382.80–$447.60 | $638–$746 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $37.20 | $62 | 1.6× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$237–$297 | $395–$495 | varies |
| Shoulder Arthrography (73040) | $982.80 | $1,638 | 2.6× |
| Sialogram (70390) | $571.20 | $952 | 2.2× |
| Skull less than 4 views (70250) | $256.80 | $428 | 2.3× |
| Special dosimetry (77331) | $239.40 | $399 | 1.7× |
| Special Physics Consult (77370) | $1,248 | $2,080 | 8.7× |
| Special teletherapy port plan (77321) | $1,285.80 | $2,143 | 3.2× |
| Special treatment procedure (77470) | $2,509.80 | $4,183 | 4.2× |
| Srs Multisource (77371) | $35,698.20 | $59,497 | 4.5× |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$8,924.40–$11,599.20 | $14,874–$19,332 | varies |
| Sternoclavicular joints (71130) | $238.20 | $397 | 2.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,724 | $4,540 | 6.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,689 | $2,815 | 4.2× |
| Temporomandble Jt Arthrography Rs&I (70332) | $256.20 | $427 | 1.0× |
| Testicular Imaging W/Flow (78761) | $602.40 | $1,004 | 1.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,417.40 | $4,029 | 6.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $3,027 | $5,045 | 7.5× |
| Ther rad simulaj-aided field setting simple (77280) | $898.20 | $1,497 | 6.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $803.40 | $1,339 | 4.3× |
| Thoracic spine 2 views (72070) | $405 | $675 | 3.6× |
| Thoracic spine 3 views (72072) | $465.60 | $776 | 4.2× |
| Thoracolumbar 2 views (72080) | $198 | $330 | 2.1× |
| Thyroid Imaging With Vascular Flow (78013) | $1,275 | $2,125 | 3.0× |
| Thyroid Met Imaging Body (78018) | $2,402.40 | $4,004 | 4.1× |
| Thyroid Uptake Measurement (78012) | $424.80 | $708 | 1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,699.80 | $2,833 | 4.0× |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$2,342.40–$2,499.60 | $3,904–$4,166 | varies |
| Tx devices design & construction intermediate (77333) | $1,053 | $1,755 | 7.3× |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$778.20–$831 | $1,297–$1,385 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$585–$603 | $975–$1,005 | varies |
| Ultrasound Exam Aaa Screen (76706) | $504 | $840 | 4.5× |
| Ultrasound, abdomen limited (76705) | $720 | $1,200 | 6.4× |
| Umbilical-artery Doppler (OB) (76820) | $633.60 | $1,056 | 5.7× |
| Unlisted Dx Radiographic Procedure (76499) | $306.60 | $511 | 3.3× |
| Unlisted us procedure (76999) | $271.80 | $453 | 2.9× |
| Upper gi w/o kub (74240) | $607.20 | $1,012 | 3.2× |
| Urethrocystogram voiding (74455) | $1,066.80 | $1,778 | 4.2× |
| Urethrocystography retrograde (74450) | $741 | $1,235 | 2.9× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$603–$755.40 | $1,005–$1,259 | varies |
| Us chest (76604) | $454.80 | $758 | 4.1× |
| Us complete joint (76881) | $720 | $1,200 | 6.4× |
| Us exam, pelvic, limited (76857) | $699.60 | $1,166 | 6.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $720 | $1,200 | 6.4× |
| Us ob detailed single fetus (76811) | $800.40 | $1,334 | 3.1× |
| Us ob limited 1 or more fetuses (76815) | $622.80 | $1,038 | 5.6× |
| Us ob transvaginal (76817) | $535.80 | $893 | 4.8× |
| Us pelvic non ob complete (76856) | $720 | $1,200 | 6.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $596.40 | $994 | 5.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $420 | $700 | 3.7× |
| Us retroperitoneal complete (76770) | $720 | $1,200 | 6.4× |
| Us retroperitoneal limited (76775) | $720 | $1,200 | 6.4× |
| Us scrotum and contents (76870) | $766.20 | $1,277 | 6.8× |
| Us spinal canal and contents (76800) | $613.80 | $1,023 | 5.5× |
| Us thyroid (76536) | $720 | $1,200 | 6.4× |
| Us transrectal (76872) | $1,345.20 | $2,242 | 12.0× |
| Venography caval inferior serialography rs&i (75825) | $4,140.60 | $6,901 | 1.2× |
| Venography extremity bilateral rs&i (75822) | $4,569.60 | $7,616 | 2.7× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$1,397.40–$1,491 | $2,329–$2,485 | varies |
| Venous sampling by catheter (75893) | $3,650.40 | $6,084 | 0.6× |
| Vertebral fracture assessment via dxa (77086) | $418.20 | $697 | 4.5× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$264.60–$331.20 | $441–$552 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $536.40 | $894 | 5.8× |
| X-ray antegrade pyelogram tube (74425) | $486.60 | $811 | 1.3× |
| X-Ray Aorta Leg Arteries (75630) | $4,703.40 | $7,839 | 1.4× |
| X-Ray Bend Only L-S Spine (72120) | $415.80 | $693 | 3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$264.60–$331.20 | $441–$552 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$329.40–$345.60 | $549–$576 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $260.40 | $434 | 2.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $301.80 | $503 | 2.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $334.20 | $557 | 3.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $184.20 | $307 | 2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $418.20 | $697 | 4.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $614.40 | $1,024 | 5.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $652.20 | $1,087 | 5.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $733.80 | $1,223 | 6.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $820.20 | $1,367 | 7.3× |
| X-Ray Exam L-S Spine Bending (72114) | $540.60 | $901 | 4.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $412.80 | $688 | 4.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $560.40 | $934 | 5.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $720 | $1,200 | 6.4× |
| X-ray eye for foreign body (70030) | $174 | $290 | 1.9× |
| X-ray humerus (73060) | $475.20 | $792 | 5.1× |
| X-ray IV pyelogram (ivp) (74400) | $828.60 | $1,381 | 4.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $261.60 | $436 | 2.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $415.80 | $693 | 3.7× |
| X-ray nose-rectum child f.b. (76010) | $225.60 | $376 | 2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $720 | $1,200 | 6.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $513.60 | $856 | 4.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $569.40 | $949 | 6.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $572.40 | $954 | 6.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $426.60 | $711 | 3.8× |
| X-ray thoracic spine 4 vw (72074) | $502.20 | $837 | 4.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $667.80 | $1,113 | 1.8× |
| X-Rays Bone Length Studies (77073) | $421.20 | $702 | 3.8× |
| X-Rays Bone Survey Complete (77075) | $499.80 | $833 | 4.5× |
| Xr c-spine 4 or 5 views (72050) | $510 | $850 | 4.6× |
| Xr facial bones less than 3 views (70140) | $397.20 | $662 | 4.3× |
| Xr orbits complete 4 views (70200) | $577.20 | $962 | 5.2× |
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.