Imaging prices at OSF St. Francis Hospital
Escanaba, MI · every code in this section with a posted price and a Medicare benchmark.
354 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) | $314.40 | $393 | 3.6× |
| Abdomen 2 views (74019) | $383.20 | $479 | 3.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,148 | $2,685 | 5.4× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $2,230.40 | $2,788 | 1.7× |
| Angio pulmonary bilat (75743) | $2,537.60 | $3,172 | 0.8× |
| Angiography extremity bilateral rs&i (75716) | $9,851.20 | $12,314 | 3.1× |
| Angiography extremity unilateral rs&i (75710) | $8,212 | $10,265 | 2.6× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$383.20–$692.80 | $479–$866 | varies |
| Artery X-Rays Abdomen (75726) | $8,212 | $10,265 | 1.5× |
| Artery X-Rays Pelvis (75736) | $8,604 | $10,755 | 1.6× |
| Arthrogram ankle (73615) | $1,947.20 | $2,434 | 5.6× |
| Arthrogram hip (73525) | $1,947.20 | $2,434 | 5.6× |
| Arthrogram Wrist (73115) | $1,175.20 | $1,469 | 3.4× |
| Bone age studies (77072) range across 2 matching MRF lines |
$312–$407.20 | $390–$509 | varies |
| Bone Imaging 3 Phase (78315) | $2,314.40 | $2,893 | 5.8× |
| Bone Imaging Limited Area (78300) | $1,212.80 | $1,516 | 3.0× |
| Bone Imaging Multiple Areas (78305) | $1,789.60 | $2,237 | 4.5× |
| Bone Imaging Whole Body (78306) | $1,666.40 | $2,083 | 4.2× |
| Bone survey infant (77076) | $542.40 | $678 | 5.2× |
| Brain Flow Imaging Only (78610) | $1,703.20 | $2,129 | 3.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,664.80 | $2,081 | 3.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,826.40 | $7,283 | 4.1× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $2,816 | $3,520 | 5.2× |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$350.40–$741.60 | $438–$927 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,561.60 | $1,952 | 2.9× |
| Cerebrospinal Fluid Scan (78630) | $4,056.80 | $5,071 | 7.5× |
| Chest 1 view (71045) | $268.80 | $336 | 3.1× |
| Chest 2 views (71046) | $316.80 | $396 | 3.7× |
| Chest 3 views (71047) | $376.80 | $471 | 4.3× |
| Chest 4 or more views (71048) | $426.40 | $533 | 4.1× |
| Cholecystography Oral Contrast (74290) | $600 | $750 | 3.4× |
| Cisternography Positive Contrast Rs&I (70015) | $2,622.40 | $3,278 | 3.4× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$407.20–$742.40 | $509–$928 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $235.20 | $294 | 2.3× |
| Contrast Exam Abdominl Aorta (75625) | $5,153.60 | $6,442 | 1.6× |
| Contrast X-Ray Bladder (74430) | $936 | $1,170 | 2.7× |
| Contrast X-Ray Of Elbow (73085) | $1,947.20 | $2,434 | 5.6× |
| Contrast X-Ray Of Knee Joint (73580) | $2,434.40 | $3,043 | 7.0× |
| Corpora cavernosography (74445) | $908.80 | $1,136 | 8.7× |
| CT abdomen and pelvis without and with contrast (74178) | $4,739.20 | $5,924 | 13.6× |
| CT abdomen and pelvis without contrast (74176) | $3,764.80 | $4,706 | 15.8× |
| CT abdomen w contrast (74160) | $2,152.80 | $2,691 | 12.3× |
| CT abdomen w wo contrast (74170) | $2,525.60 | $3,157 | 14.5× |
| CT abdomen w/o contrast (74150) | $1,777.60 | $2,222 | 17.1× |
| CT Angio Abdomen and Pelvis (74174) | $2,525.60 | $3,157 | 7.3× |
| CT Angio Chest (71275) | $3,085.60 | $3,857 | 17.7× |
| CT Angio Head (70496) | $3,085.60 | $3,857 | 17.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,840.80–$4,260.80 | $3,551–$5,326 | varies |
| CT Angio Neck (70498) | $3,085.60 | $3,857 | 17.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$2,780–$4,169.60 | $3,475–$5,212 | varies |
| CT cervical spine w/ contrast (72126) | $2,164.80 | $2,706 | 6.2× |
| CT cervical spine w/o contrast (72125) | $1,881.60 | $2,352 | 18.1× |
| CT cervical spine w/wo cont (72127) | $2,211.20 | $2,764 | 12.7× |
| CT chest w contrast (71260) | $2,152.80 | $2,691 | 12.3× |
| CT chest w/wo contrast (71270) | $2,525.60 | $3,157 | 14.5× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,981.60 | $2,477 | 11.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,886.40 | $2,358 | 18.1× |
| CT head/brain with contrast (70460) | $1,823.20 | $2,279 | 10.4× |
| CT head/brain without and with contrast (70470) | $2,176.80 | $2,721 | 12.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $88 | $110 | 1.0× |
| CT iac w contrast (70481) | $1,960.80 | $2,451 | 11.2× |
| CT l-spine w&w/o contrast (72133) | $2,211.20 | $2,764 | 12.7× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,692.80–$2,539.20 | $2,116–$3,174 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$1,744.80–$2,617.60 | $2,181–$3,272 | varies |
| CT lumbar spine w contrast (72132) | $2,152.80 | $2,691 | 6.2× |
| CT lumbar spine w/o contrast (72131) | $1,777.60 | $2,222 | 17.1× |
| CT maxillofacial w contrast (70487) | $1,823.20 | $2,279 | 10.4× |
| CT maxillofacial wo contrast (70486) | $1,777.60 | $2,222 | 17.1× |
| CT neck tissue combo (70492) | $2,312 | $2,890 | 13.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,231.20 | $2,789 | 12.8× |
| CT orbits w/o contrast (70480) | $1,777.60 | $2,222 | 17.1× |
| CT pelvis w&w/o contrast (72194) | $2,336 | $2,920 | 13.4× |
| CT pelvis w/o contrast (72192) | $1,734.40 | $2,168 | 16.6× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$1,892.80–$2,839.20 | $2,366–$3,549 | varies |
| CT scans face/jaw combo (70488) | $2,131.20 | $2,664 | 12.2× |
| CT soft tissue neck w contrast (70491) | $2,152.80 | $2,691 | 12.3× |
| CT soft tissue neck w/o contrast (70490) | $1,777.60 | $2,222 | 17.1× |
| CT thoracic spine w contrast (72129) | $1,812.80 | $2,266 | 10.4× |
| CT thoracic spine w/o contrast (72128) | $1,777.60 | $2,222 | 17.1× |
| CT thoracic spine w/wo cont (72130) | $2,669.60 | $3,337 | 15.3× |
| CT thorax w/o contrast (71250) | $1,777.60 | $2,222 | 17.1× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,666.40–$2,500 | $2,083–$3,125 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,609.60–$3,915.20 | $3,262–$4,894 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,777.60–$2,666.40 | $2,222–$3,333 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,320 | $4,150 | 19.0× |
| Cta Abdomen (74175) | $2,525.60 | $3,157 | 14.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,550.40 | $3,188 | 7.3× |
| CTA pelvis (72191) | $2,091.20 | $2,614 | 12.0× |
| Dilation ureters/urethra rs&i (74485) | $3,983.20 | $4,979 | 1.9× |
| Discography Cerv/Thor Spine (72285) | $5,553.60 | $6,942 | 2.9× |
| Diskography lumbar (72295) | $5,553.60 | $6,942 | 2.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $789.60 | $987 | 7.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $1,177.60 | $1,472 | 11.3× |
| Dxa Bone Density Axial (77080) | $546.40 | $683 | 5.2× |
| Dxa bone density study (77085) | $1,317.60 | $1,647 | 12.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $248 | $310 | 2.9× |
| Echo exam uterus (76831) | $1,195.20 | $1,494 | 5.0× |
| Echo Guide For Artery Repair (76936) | $5,948.80 | $7,436 | 27.6× |
| Esophagram (74220) | $994.40 | $1,243 | 5.7× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$784–$1,259.20 | $980–$1,574 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$954.40–$1,240 | $1,193–$1,550 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $4,741.60 | $5,927 | 19.9× |
| Fluoroscopy up to 1 hr (76000) | $944.80 | $1,181 | 4.0× |
| Follow-Up Angiography (75898) | $2,537.60 | $3,172 | 0.8× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$383.20–$692.80 | $479–$866 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$407.20–$742.40 | $509–$928 | varies |
| Gastric emptying imaging study (78264) | $1,224.80 | $1,531 | 3.1× |
| Gastroesophageal Reflux Exam (78262) | $1,836 | $2,295 | 4.6× |
| Gated Heart Planar Single (78472) | $2,437.60 | $3,047 | 6.1× |
| Gated Heart, Multiple (78473) | $2,960.80 | $3,701 | 7.4× |
| GI Endoscopic US S&I (76975) | $744.80 | $931 | 3.1× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$383.20–$692.80 | $479–$866 | varies |
| Heart first pass single,planar (78481) | $3,485.60 | $4,357 | 6.4× |
| Hepatobil Syst Image W/Drug (78227) | $922.40 | $1,153 | 1.7× |
| Hepatobiliary System Imaging (78226) | $990.40 | $1,238 | 2.5× |
| Ht Muscle Image Spect Sing (78451) | $1,568.80 | $1,961 | 1.2× |
| Hysterosalpingogram (74740) | $1,161.60 | $1,452 | 4.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $668.80 | $836 | 7.7× |
| Infant hip ultrasound, limited static exam (76886) | $716 | $895 | 8.3× |
| Joint Survey Single View (77077) | $502.40 | $628 | 4.8× |
| K Flow/Funct Image Multiple (78709) | $2,311.20 | $2,889 | 4.3× |
| K Flow/Funct Image W/Drug (78708) | $1,916.80 | $2,396 | 3.5× |
| K Flow/Funct Image W/O Drug (78707) | $2,169.60 | $2,712 | 4.0× |
| Kidney Imaging Morphol (78700) | $1,471.20 | $1,839 | 3.7× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,460.80 | $1,826 | 3.7× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$448.80–$883.20 | $561–$1,104 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,317.60 | $1,647 | 3.3× |
| Liver & Spleen Imaging Static Only (78215) | $1,422.40 | $1,778 | 3.6× |
| Lung Ventilat&Perfus Imaging (78582) | $1,308.80 | $1,636 | 2.4× |
| Lymph System Imaging (78195) | $1,792.80 | $2,241 | 3.3× |
| Magnetic Image Jaw Joint (70336) | $2,804 | $3,505 | 11.8× |
| Mammary ductogram or galactogram multiple (77054) | $1,012 | $1,265 | 4.3× |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$510.40–$588 | $638–$735 | varies |
| Meckels Divert Exam (78290) | $3,862.40 | $4,828 | 9.7× |
| Mr safety determination physician/other qhp (76016) | $220 | $275 | 2.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $60.80 | $76 | 2.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $228.80 | $286 | 2.4× |
| Mr safety implt pos&/immoblj (76019) | $148 | $185 | 2.5× |
| Mr safety med physics xm customization plng&mntr (76017) | $603.20 | $754 | 2.5× |
| Mra Head W/O & W/Contrast Material (70546) | $5,266.40 | $6,583 | 15.1× |
| MRA head w/o contrast (70544) | $2,818.40 | $3,523 | 11.9× |
| MRA head with contrast (70545) | $3,364.80 | $4,206 | 9.7× |
| MRA neck w contrast (70548) | $3,364.80 | $4,206 | 9.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,977.60 | $7,472 | 17.2× |
| MRA neck w/o contrast (70547) | $2,706.40 | $3,383 | 11.4× |
| MRI abdomen w contrast (74182) | $3,280.80 | $4,101 | 9.4× |
| MRI abdomen w/o contrast (74181) | $2,910.40 | $3,638 | 12.2× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$4,139.20–$6,208.80 | $5,174–$7,761 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$5,114.40–$7,672 | $6,393–$9,590 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$4,556–$6,834.40 | $5,695–$8,543 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $4,732 | $5,915 | 19.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,118.40 | $2,648 | 8.9× |
| MRI cervical spine w contrast (72142) | $4,428 | $5,535 | 12.7× |
| MRI cervical spine w/o cont (72141) | $4,428 | $5,535 | 18.6× |
| MRI chest w/o contrast (71550) | $2,944 | $3,680 | 12.4× |
| MRI chest with contrast (71551) | $3,280.80 | $4,101 | 4.2× |
| MRI chest wo w contrast (71552) | $5,801.60 | $7,252 | 16.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$4,178.40–$6,268 | $5,223–$7,835 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$4,705.60–$7,058.40 | $5,882–$8,823 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$3,364.80–$5,048 | $4,206–$6,310 | varies |
| MRI lumbar spine w contrast (72149) | $4,504.80 | $5,631 | 13.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,506.40 | $5,633 | 13.0× |
| MRI orbit face &/neck w/o contrast (70540) | $2,692 | $3,365 | 11.3× |
| MRI orbit face neck w contrast (70542) | $3,280.80 | $4,101 | 9.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,553.60 | $4,442 | 10.2× |
| MRI pelvis w contrast (72196) | $4,801.60 | $6,002 | 13.8× |
| MRI pelvis w/o & w contrast (72197) | $5,112 | $6,390 | 14.7× |
| MRI pelvis w/o contrast (72195) | $4,801.60 | $6,002 | 20.2× |
| MRI spectroscopy (76390) | $2,018.40 | $2,523 | 23.3× |
| MRI thoracic spine w/o contrast (72146) | $4,715.20 | $5,894 | 19.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$4,960.80–$7,441.60 | $6,201–$9,302 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$3,364.80–$5,048 | $4,206–$6,310 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$5,352–$8,028 | $6,690–$10,035 | varies |
| MRI, abdomen, combo (74183) | $4,186.40 | $5,233 | 12.0× |
| MRI, dorsal spine combo (72157) | $5,984 | $7,480 | 17.2× |
| MRI, dorsal spine contrast (72147) | $4,715.20 | $5,894 | 13.6× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$4,240.80–$6,362.40 | $5,301–$7,953 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$5,776.80–$8,665.60 | $7,221–$10,832 | varies |
| MRI, lumbar spine combo (72158) | $6,354.40 | $7,943 | 18.3× |
| Myelogram cervical (72240) | $2,836.80 | $3,546 | 3.6× |
| Myelogram Lumbar (72265) | $3,072 | $3,840 | 3.9× |
| Myelography thoracic (72255) | $3,570.40 | $4,463 | 4.6× |
| Myelograpy 2/more regions rs&i (72270) | $4,147.20 | $5,184 | 5.3× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,143.20 | $1,429 | 2.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $7,305.60 | $9,132 | 5.7× |
| Myocardial Spect Multiple Studies (78452) | $5,949.60 | $7,437 | 4.6× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $5,625.60 | $7,032 | 3.9× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $5,625.60 | $7,032 | 3.9× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $8,772.80 | $10,966 | 4.0× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $10,721.60 | $13,402 | 4.9× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $10,721.60 | $13,402 | 7.1× |
| Neck soft tissue (70360) | $364.80 | $456 | 4.2× |
| Nm csf leak detection (78650) | $2,804 | $3,505 | 2.2× |
| Nm whole blood volume (78122) | $1,436.80 | $1,796 | 2.7× |
| Nuclear Rx Oral Admin (79005) | $1,096.80 | $1,371 | 4.7× |
| Ob us nuchal meas 1 gest (76813) | $441.60 | $552 | 4.2× |
| Panoramic X-ray of jaws (70355) | $2,263.20 | $2,829 | 26.1× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,262.40 | $1,578 | 2.3× |
| Parathyroid Planar Imaging (78070) | $812.80 | $1,016 | 2.0× |
| Parathyroid planar imaging w/wo subtraction (78071) | $749.60 | $937 | 1.9× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$407.20–$488.80 | $509–$611 | varies |
| Pet Image W/Ct Lmtd (78814) | $6,144.80 | $7,681 | 4.3× |
| PET image w/CT, full body (78816) | $6,568.80 | $8,211 | 4.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,482.40 | $8,103 | 4.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,537.60 | $3,172 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,664 | $2,080 | 4.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $620 | $775 | 6.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $859.20 | $1,074 | 1.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$420.80–$752 | $526–$940 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$368–$664.80 | $460–$831 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$448.80–$883.20 | $561–$1,104 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $645.60 | $807 | 6.2× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$273.60–$412.80 | $342–$516 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$420.80–$752 | $526–$940 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$420.80–$830.40 | $526–$1,038 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$368–$704 | $460–$880 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$579.20–$1,146.40 | $724–$1,433 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $407.20 | $509 | 4.7× |
| Radex Ribs Unilateral 2 Views (71100) | $448.80 | $561 | 5.2× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$448.80–$883.20 | $561–$1,104 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $503.20 | $629 | 5.8× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,029.60 | $1,287 | 5.9× |
| Radex Spine 1 View Specify Level (72020) range across 6 matching MRF lines |
$341.60–$366.40 | $427–$458 | varies |
| Radex Sternum Minimum 2 Views (71120) | $540 | $675 | 6.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $623.20 | $779 | 7.2× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$273.60–$412.80 | $342–$516 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$368–$704 | $460–$880 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$420.80–$830.40 | $526–$1,038 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $436.80 | $546 | 4.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $503.20 | $629 | 4.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $441.60 | $552 | 4.2× |
| Radiologic exam colon double contrast study (74280) | $1,996.80 | $2,496 | 11.4× |
| Radiologic exam colon single contrast study (74270) | $1,316 | $1,645 | 7.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,524.80 | $1,906 | 8.7× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$479.20–$953.60 | $599–$1,192 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $548 | $685 | 5.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $992.80 | $1,241 | 5.7× |
| Radiologic exam swallow function contrast study (74230) | $946.40 | $1,183 | 5.4× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$1,316–$1,627.20 | $1,645–$2,034 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$469.60–$925.60 | $587–$1,157 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$488.80–$883.20 | $611–$1,104 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$407.20–$883.20 | $509–$1,104 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $738.40 | $923 | 7.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$407.20–$883.20 | $509–$1,104 | varies |
| Radiopharm Dacryocystography (78660) | $919.20 | $1,149 | 2.3× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $709.60 | $887 | 3.1× |
| Renal Cyst Study (74470) | $2,173.60 | $2,717 | 4.0× |
| Ribs bilateral 3 views (71110) | $645.60 | $807 | 6.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,560 | $1,950 | 3.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,768.80 | $2,211 | 4.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,507.20 | $3,134 | 4.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,367.20 | $4,209 | 6.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $5,052.80 | $6,316 | 3.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $6,735.20 | $8,419 | 4.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $4,489.60 | $5,612 | 3.5× |
| Salivary Gland Function Study (78232) | $1,528 | $1,910 | 3.8× |
| Salivary Gland Imaging Serial Images (78231) | $1,576 | $1,970 | 4.0× |
| Scapula (73010) range across 3 matching MRF lines |
$429.60–$851.20 | $537–$1,064 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $133.60 | $167 | 5.7× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$338.40–$651.20 | $423–$814 | varies |
| Shoulder Arthrography (73040) | $2,186.40 | $2,733 | 6.3× |
| Sialogram (70390) | $1,427.20 | $1,784 | 6.0× |
| Skull less than 4 views (70250) | $479.20 | $599 | 4.6× |
| Sternoclavicular joints (71130) | $569.60 | $712 | 6.6× |
| Testicular Imaging W/Flow (78761) | $1,388 | $1,735 | 3.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $2,629.60 | $3,287 | 15.0× |
| Thoracic spine 2 views (72070) | $459.20 | $574 | 4.4× |
| Thoracic spine 3 views (72072) | $527.20 | $659 | 5.1× |
| Thoracolumbar 2 views (72080) | $224 | $280 | 2.6× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,359.20 | $1,699 | 3.4× |
| Thyroid Met Imaging Body (78018) | $2,395.20 | $2,994 | 4.4× |
| Thyroid Uptake Measurement (78012) | $1,043.20 | $1,304 | 2.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,056.80 | $1,321 | 2.7× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$792–$1,586.40 | $990–$1,983 | varies |
| Ultrasound Exam Aaa Screen (76706) | $692.80 | $866 | 6.7× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$1,077.60–$1,284 | $1,347–$1,605 | varies |
| Umbilical-artery Doppler (OB) (76820) | $484 | $605 | 4.6× |
| Unlisted us procedure (76999) | $762.40 | $953 | 8.8× |
| Upper gi w/o kub (74240) | $1,440.80 | $1,801 | 8.2× |
| Ureteral Reflux Study (78740) | $919.20 | $1,149 | 2.3× |
| Urethrocystogram voiding (74455) | $1,326.40 | $1,658 | 5.6× |
| Urethrocystography retrograde (74450) | $924 | $1,155 | 3.9× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$792–$1,586.40 | $990–$1,983 | varies |
| Us chest (76604) | $894.40 | $1,118 | 8.6× |
| Us complete joint (76881) range across 3 matching MRF lines |
$1,122.40–$1,604.80 | $1,403–$2,006 | varies |
| Us exam, pelvic, limited (76857) | $792 | $990 | 7.6× |
| Us head (76506) | $908 | $1,135 | 8.7× |
| Us kidney transplant (76776) | $1,365.60 | $1,707 | 13.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$702.40–$1,069.60 | $878–$1,337 | varies |
| Us ob detailed single fetus (76811) | $1,120 | $1,400 | 4.7× |
| Us ob limited 1 or more fetuses (76815) | $954.40 | $1,193 | 9.2× |
| Us ob transvaginal (76817) | $1,120 | $1,400 | 10.8× |
| Us pelvic non ob complete (76856) | $1,164.80 | $1,456 | 11.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,120 | $1,400 | 10.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$854.40–$1,240 | $1,068–$1,550 | varies |
| Us retroperitoneal complete (76770) | $1,365.60 | $1,707 | 13.1× |
| Us retroperitoneal limited (76775) | $985.60 | $1,232 | 9.5× |
| Us scrotum and contents (76870) | $1,265.60 | $1,582 | 12.1× |
| Us spinal canal and contents (76800) | $1,010.40 | $1,263 | 9.7× |
| Us thyroid (76536) | $1,077.60 | $1,347 | 10.3× |
| Us transrectal (76872) | $1,568.80 | $1,961 | 15.1× |
| Vascular Flow Imaging (78445) | $904 | $1,130 | 2.3× |
| Vein X-Ray Chest (75827) | $5,157.60 | $6,447 | 3.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,537.60 | $3,172 | 0.8× |
| Venogram Sinus/Jugular (75860) | $2,537.60 | $3,172 | 0.8× |
| Venography caval inferior serialography rs&i (75825) | $7,889.60 | $9,862 | 2.5× |
| Venography extremity bilateral rs&i (75822) | $3,054.40 | $3,818 | 1.9× |
| Venography extremity unilateral rs&i (75820) | $2,800.80 | $3,501 | 1.8× |
| Venous sampling by catheter (75893) | $7,031.20 | $8,789 | 1.3× |
| Vertebral fracture assessment via dxa (77086) | $1,317.60 | $1,647 | 15.2× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$383.20–$672 | $479–$840 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $548 | $685 | 6.3× |
| X-ray antegrade pyelogram tube (74425) | $1,140 | $1,425 | 3.3× |
| X-Ray Aorta Leg Arteries (75630) | $5,819.20 | $7,274 | 1.8× |
| X-Ray Bend Only L-S Spine (72120) | $471.20 | $589 | 4.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$407.20–$742.40 | $509–$928 | varies |
| X-Ray Exam Breast Specimen (76098) | $872.80 | $1,091 | 1.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $295.20 | $369 | 3.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $341.60 | $427 | 3.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $379.20 | $474 | 3.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $477.60 | $597 | 5.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $520.80 | $651 | 6.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $588.80 | $736 | 5.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $448.80 | $561 | 4.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $488.80 | $611 | 4.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $557.60 | $697 | 5.4× |
| X-Ray Exam L-S Spine Bending (72114) | $612.80 | $766 | 5.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $468 | $585 | 5.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $635.20 | $794 | 6.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $521.60 | $652 | 5.0× |
| X-ray eye for foreign body (70030) | $364.80 | $456 | 4.2× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$448.80–$767.20 | $561–$959 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 4 matching MRF lines |
$1,159.20–$1,300.80 | $1,449–$1,626 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $429.60 | $537 | 5.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $402.40 | $503 | 4.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $471.20 | $589 | 4.5× |
| X-ray nose-rectum child f.b. (76010) | $477.60 | $597 | 5.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $670.40 | $838 | 6.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $441.60 | $552 | 4.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $394.40 | $493 | 3.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $448.80 | $561 | 5.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $645.60 | $807 | 7.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $736 | $920 | 7.1× |
| X-Ray Stress View (77071) | $372 | $465 | 4.3× |
| X-ray thoracic spine 4 vw (72074) | $569.60 | $712 | 5.5× |
| X-Ray Tmj Unilat (70328) | $368 | $460 | 4.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,080.80 | $1,351 | 3.1× |
| X-Rays Bone Length Studies (77073) | $613.60 | $767 | 5.9× |
| X-Rays Bone Survey Complete (77075) | $1,168 | $1,460 | 11.2× |
| Xr c-spine 4 or 5 views (72050) | $577.60 | $722 | 5.5× |
| Xr facial bones less than 3 views (70140) | $503.20 | $629 | 5.8× |
| XR Mastoids < 3 Views Bilateral (70120) range across 3 matching MRF lines |
$452–$896.80 | $565–$1,121 | varies |
| Xr orbits complete 4 views (70200) | $645.60 | $807 | 6.2× |
| Xr Tomogram Single Plane (76100) range across 4 matching MRF lines |
$1,002.40–$2,114.40 | $1,253–$2,643 | varies |
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.