Imaging prices at Osf Saint Paul Medical Center
Mendota, IL · every code in this section with a posted price and a Medicare benchmark.
283 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 | 3.4× |
| Abdomen 2 views (74019) | $383.20 | $479 | 3.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,456.80 | $1,821 | 3.4× |
| Angio pulmonary bilat (75743) | $2,644 | $3,305 | 0.8× |
| Angiography extremity bilateral rs&i (75716) | $5,750.40 | $7,188 | 1.7× |
| Angiography extremity unilateral rs&i (75710) | $3,833.60 | $4,792 | 1.1× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$294.40–$619.20 | $368–$774 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$1,096–$1,643.20 | $1,370–$2,054 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$425.60–$460 | $532–$575 | varies |
| Bone Imaging 3 Phase (78315) | $1,970.40 | $2,463 | 4.6× |
| Bone Imaging Limited Area (78300) | $1,048.80 | $1,311 | 2.4× |
| Bone Imaging Multiple Areas (78305) | $1,701.60 | $2,127 | 4.0× |
| Bone Imaging Whole Body (78306) | $1,537.60 | $1,922 | 3.6× |
| Bone survey infant (77076) | $592.80 | $741 | 5.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,280.80 | $1,601 | 2.2× |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$948–$1,405.60 | $1,185–$1,757 | varies |
| Chest 1 view (71045) | $268.80 | $336 | 2.9× |
| Chest 2 views (71046) | $316.80 | $396 | 3.4× |
| Chest 3 views (71047) | $376.80 | $471 | 4.0× |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$426.40–$768.80 | $533–$961 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$326.40–$639.20 | $408–$799 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $235.20 | $294 | 2.1× |
| Contrast X-Ray Bladder (74430) | $690.40 | $863 | 1.8× |
| CT abdomen and pelvis without and with contrast (74178) | $6,385.60 | $7,982 | 17.1× |
| CT abdomen and pelvis without contrast (74176) | $4,614.40 | $5,768 | 18.0× |
| CT abdomen w contrast (74160) | $2,149.60 | $2,687 | 11.4× |
| CT abdomen w wo contrast (74170) | $2,210.40 | $2,763 | 11.8× |
| CT abdomen w/o contrast (74150) | $1,660 | $2,075 | 14.8× |
| CT Angio Abdomen and Pelvis (74174) | $5,699.20 | $7,124 | 15.2× |
| CT Angio Chest (71275) | $3,716 | $4,645 | 19.8× |
| CT Angio Head (70496) | $4,348 | $5,435 | 23.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$3,617.60–$5,426.40 | $4,522–$6,783 | varies |
| CT Angio Neck (70498) | $4,360 | $5,450 | 23.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$925.60–$1,388.80 | $1,157–$1,736 | varies |
| CT cervical spine w/ contrast (72126) | $2,573.60 | $3,217 | 6.9× |
| CT cervical spine w/o contrast (72125) | $2,363.20 | $2,954 | 21.1× |
| CT chest w contrast (71260) | $2,765.60 | $3,457 | 14.7× |
| CT chest w/wo contrast (71270) | $2,705.60 | $3,382 | 14.4× |
| CT head/brain with contrast (70460) | $1,980.80 | $2,476 | 10.5× |
| CT head/brain without and with contrast (70470) | $2,198.40 | $2,748 | 11.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $156 | $195 | 1.7× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,673.60–$1,924 | $2,092–$2,405 | varies |
| CT l-spine w&w/o contrast (72133) | $2,411.20 | $3,014 | 12.8× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,883.20–$2,825.60 | $2,354–$3,532 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$2,296.80–$3,444.80 | $2,871–$4,306 | varies |
| CT lumbar spine w contrast (72132) | $2,363.20 | $2,954 | 6.3× |
| CT lumbar spine w/o contrast (72131) | $2,306.40 | $2,883 | 20.6× |
| CT maxillofacial w contrast (70487) | $2,222.40 | $2,778 | 11.8× |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$895.20–$1,764 | $1,119–$2,205 | varies |
| CT neck tissue combo (70492) | $1,981.60 | $2,477 | 10.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,456 | $3,070 | 13.1× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,570.40–$1,702.40 | $1,963–$2,128 | varies |
| CT pelvis w&w/o contrast (72194) | $2,113.60 | $2,642 | 11.2× |
| CT pelvis w/o contrast (72192) | $1,739.20 | $2,174 | 15.5× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,180–$3,270.40 | $2,725–$4,088 | varies |
| CT scans face/jaw combo (70488) | $2,262.40 | $2,828 | 12.0× |
| CT soft tissue neck w contrast (70491) | $1,848 | $2,310 | 9.8× |
| CT soft tissue neck w/o contrast (70490) | $1,584.80 | $1,981 | 14.1× |
| CT thoracic spine w contrast (72129) | $3,068.80 | $3,836 | 16.3× |
| CT thoracic spine w/o contrast (72128) | $2,315.20 | $2,894 | 20.7× |
| CT thorax w/o contrast (71250) | $1,752 | $2,190 | 15.6× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,905.60–$2,858.40 | $2,382–$3,573 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$2,164.80–$3,247.20 | $2,706–$4,059 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,967.20 | $3,709 | 15.8× |
| Cta Abdomen (74175) | $2,420.80 | $3,026 | 12.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,550.40 | $3,188 | 6.8× |
| CTA pelvis (72191) | $3,622.40 | $4,528 | 19.3× |
| Dxa Bone Density Axial (77080) | $441.60 | $552 | 3.9× |
| Dxa bone density study (77085) | $525.60 | $657 | 4.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $240.80 | $301 | 2.6× |
| Esophagram (74220) | $462.40 | $578 | 2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$752.80–$797.60 | $941–$997 | varies |
| Fluoroscopy up to 1 hr (76000) | $673.60 | $842 | 2.6× |
| Follow-Up Angiography (75898) | $2,644 | $3,305 | 0.8× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$326.40–$639.20 | $408–$799 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$341.60–$671.20 | $427–$839 | varies |
| Gastric emptying imaging study (78264) | $1,344 | $1,680 | 3.1× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $3,156.80 | $3,946 | 7.4× |
| Gastroesophageal Reflux Exam (78262) | $1,088 | $1,360 | 2.5× |
| Gated Heart Planar Single (78472) | $1,860 | $2,325 | 4.3× |
| Gated Heart, Multiple (78473) | $2,588.80 | $3,236 | 6.0× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$294.40–$580 | $368–$725 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,464.80 | $1,831 | 2.5× |
| Hepatobiliary System Imaging (78226) | $1,628 | $2,035 | 3.8× |
| Ht Muscle Image Spect Sing (78451) | $3,927.20 | $4,909 | 2.8× |
| Hysterosalpingogram (74740) | $824 | $1,030 | 3.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $459.20 | $574 | 4.9× |
| Infant hip ultrasound, limited static exam (76886) | $489.60 | $612 | 5.2× |
| Joint Survey Single View (77077) | $574.40 | $718 | 5.1× |
| K Flow/Funct Image Multiple (78709) | $1,728 | $2,160 | 3.0× |
| K Flow/Funct Image W/Drug (78708) | $1,404 | $1,755 | 2.4× |
| K Flow/Funct Image W/O Drug (78707) | $1,521.60 | $1,902 | 2.6× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,858.40 | $2,323 | 4.3× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$400.80–$781.60 | $501–$977 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,503.20 | $1,879 | 3.5× |
| Liver imaging w/vascular flow (78202) | $1,504 | $1,880 | 2.6× |
| Lung perfusion differential (78597) | $1,120.80 | $1,401 | 2.6× |
| Lung Ventilat&Perfus Imaging (78582) | $1,775.20 | $2,219 | 3.1× |
| Lymph System Imaging (78195) | $1,689.60 | $2,112 | 2.9× |
| Magnetic Image Jaw Joint (70336) | $2,309.60 | $2,887 | 9.0× |
| Mammary ductogram or galactogram multiple (77054) | $2,124 | $2,655 | 8.3× |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$1,028–$1,518.40 | $1,285–$1,898 | varies |
| Meckels Divert Exam (78290) | $3,672.80 | $4,591 | 8.6× |
| Mr safety determination physician/other qhp (76016) | $152 | $190 | 1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $43.20 | $54 | 1.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $159.20 | $199 | 1.6× |
| Mr safety implt pos&/immoblj (76019) | $102.40 | $128 | 1.6× |
| Mr safety med physics xm customization plng&mntr (76017) | $419.20 | $524 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $3,392.80 | $4,241 | 9.1× |
| MRA head w/o contrast (70544) | $2,733.60 | $3,417 | 10.7× |
| MRA head with contrast (70545) | $2,966.40 | $3,708 | 7.9× |
| MRA neck w contrast (70548) | $2,966.40 | $3,708 | 7.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,381.60 | $4,227 | 9.0× |
| MRA neck w/o contrast (70547) | $2,706.40 | $3,383 | 10.6× |
| MRI abdomen w contrast (74182) | $3,533.60 | $4,417 | 9.5× |
| MRI abdomen w/o contrast (74181) | $3,238.40 | $4,048 | 12.7× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$3,296.80–$4,945.60 | $4,121–$6,182 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,776–$5,664.80 | $4,720–$7,081 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$3,199.20–$4,799.20 | $3,999–$5,999 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $4,158.40 | $5,198 | 16.3× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,772 | $3,465 | 10.8× |
| MRI cervical spine w contrast (72142) | $3,337.60 | $4,172 | 8.9× |
| MRI cervical spine w/o cont (72141) | $3,301.60 | $4,127 | 12.9× |
| MRI chest w/o contrast (71550) | $3,140.80 | $3,926 | 12.3× |
| MRI chest with contrast (71551) | $3,533.60 | $4,417 | 4.2× |
| MRI chest wo w contrast (71552) | $4,121.60 | $5,152 | 11.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$3,232.80–$4,849.60 | $4,041–$6,062 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$3,599.20–$5,399.20 | $4,499–$6,749 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$3,177.60–$4,767.20 | $3,972–$5,959 | varies |
| MRI lumbar spine w contrast (72149) | $3,886.40 | $4,858 | 10.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,398.40 | $5,498 | 11.8× |
| MRI orbit face &/neck w/o contrast (70540) | $2,361.60 | $2,952 | 9.2× |
| MRI orbit face neck w contrast (70542) | $2,648.80 | $3,311 | 7.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,114.40 | $3,893 | 8.3× |
| MRI pelvis w contrast (72196) | $3,337.60 | $4,172 | 8.9× |
| MRI pelvis w/o & w contrast (72197) | $4,047.20 | $5,059 | 10.8× |
| MRI pelvis w/o contrast (72195) | $3,000.80 | $3,751 | 11.7× |
| MRI thoracic spine w/o contrast (72146) | $3,401.60 | $4,252 | 13.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$3,140.80–$4,712 | $3,926–$5,890 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,803.20–$4,204.80 | $3,504–$5,256 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$3,710.40–$5,565.60 | $4,638–$6,957 | varies |
| MRI, abdomen, combo (74183) | $4,221.60 | $5,277 | 11.3× |
| MRI, dorsal spine combo (72157) | $4,398.40 | $5,498 | 11.8× |
| MRI, dorsal spine contrast (72147) | $3,702.40 | $4,628 | 9.9× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$3,089.60–$4,634.40 | $3,862–$5,793 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$3,599.20–$5,399.20 | $4,499–$6,749 | varies |
| MRI, lumbar spine combo (72158) | $4,840 | $6,050 | 12.9× |
| Myocardial Spect Multiple Studies (78452) | $4,462.40 | $5,578 | 3.2× |
| Neck soft tissue (70360) | $340 | $425 | 3.6× |
| Parathyroid Planar Imaging (78070) | $1,177.60 | $1,472 | 2.7× |
| Pelvis 1 or 2 views (72170) | $343.20 | $429 | 3.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $9,436.80 | $11,796 | 6.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,644 | $3,305 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,283.20 | $1,604 | 3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $672 | $840 | 6.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $847.20 | $1,059 | 1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$377.60–$741.60 | $472–$927 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$317.60–$626.40 | $397–$783 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$341.60–$671.20 | $427–$839 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $483.20 | $604 | 4.3× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$264–$395.20 | $330–$494 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$393.60–$772 | $492–$965 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$341.60–$671.20 | $427–$839 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$420.80–$819.20 | $526–$1,024 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $1,271.20 | $1,589 | 11.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $378.40 | $473 | 4.1× |
| Radex Ribs Unilateral 2 Views (71100) | $501.60 | $627 | 5.4× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$419.20–$824 | $524–$1,030 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $356.80 | $446 | 3.8× |
| 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) | $388 | $485 | 4.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $781.60 | $977 | 8.4× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$270.40–$406.40 | $338–$508 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$387.20–$758.40 | $484–$948 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$359.20–$675.20 | $449–$844 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $436.80 | $546 | 3.9× |
| Radiolog exam mandible compl minimum 4 views (70110) | $503.20 | $629 | 4.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $441.60 | $552 | 3.9× |
| Radiologic exam colon double contrast study (74280) | $784 | $980 | 4.2× |
| Radiologic exam colon single contrast study (74270) | $739.20 | $924 | 3.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $694.40 | $868 | 3.7× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$441.60–$878.40 | $552–$1,098 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $776.80 | $971 | 6.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $627.20 | $784 | 3.3× |
| Radiologic exam swallow function contrast study (74230) | $634.40 | $793 | 3.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $999.20 | $1,249 | 5.3× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$332.80–$756.80 | $416–$946 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$407.20–$800 | $509–$1,000 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$364.80–$717.60 | $456–$897 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $666.40 | $833 | 5.9× |
| Radiologic Examination Salivary Gland Calculus (70380) | $284 | $355 | 3.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$396–$774.40 | $495–$968 | varies |
| Ribs bilateral 3 views (71110) | $654.40 | $818 | 5.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,535.20 | $1,919 | 3.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,650.40 | $2,063 | 3.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,440.80 | $5,551 | 7.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,702.40 | $3,378 | 4.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,608 | $2,010 | 2.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,410.40 | $3,013 | 1.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,214.40 | $4,018 | 2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,141.60 | $2,677 | 1.5× |
| Scapula (73010) range across 3 matching MRF lines |
$428.80–$844 | $536–$1,055 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $119.20 | $149 | 5.1× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$309.60–$608 | $387–$760 | varies |
| Shoulder Arthrography (73040) | $1,072.80 | $1,341 | 2.9× |
| Sialogram (70390) | $1,013.60 | $1,267 | 4.0× |
| Skull less than 4 views (70250) | $333.60 | $417 | 3.0× |
| Sternoclavicular joints (71130) | $355.20 | $444 | 3.8× |
| Testicular Imaging W/Flow (78761) | $1,602.40 | $2,003 | 3.7× |
| Thoracic spine 2 views (72070) | $459.20 | $574 | 4.1× |
| Thoracic spine 3 views (72072) | $527.20 | $659 | 4.7× |
| Thoracolumbar 2 views (72080) | $224 | $280 | 2.4× |
| Thyroid Imaging With Vascular Flow (78013) | $1,165.60 | $1,457 | 2.7× |
| Thyroid Uptake Measurement (78012) | $1,259.20 | $1,574 | 2.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,278.40 | $1,598 | 3.0× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$800–$1,200.80 | $1,000–$1,501 | varies |
| Ultrasound Exam Aaa Screen (76706) | $666.40 | $833 | 5.9× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$816–$1,115.20 | $1,020–$1,394 | varies |
| Unlisted us procedure (76999) | $559.20 | $699 | 6.0× |
| Upper gi w/o kub (74240) | $1,024.80 | $1,281 | 5.5× |
| Urethrocystogram voiding (74455) | $720 | $900 | 2.8× |
| Urethrocystography retrograde (74450) | $628 | $785 | 2.5× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$495.20–$796.80 | $619–$996 | varies |
| Us chest (76604) | $612.80 | $766 | 5.5× |
| Us complete joint (76881) | $676.80 | $846 | 6.0× |
| Us exam, pelvic, limited (76857) | $547.20 | $684 | 4.9× |
| Us head (76506) | $1,083.20 | $1,354 | 9.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$666.40–$967.20 | $833–$1,209 | varies |
| Us ob detailed single fetus (76811) | $1,060 | $1,325 | 4.1× |
| Us ob limited 1 or more fetuses (76815) | $275.20 | $344 | 2.5× |
| Us ob transvaginal (76817) | $924.80 | $1,156 | 8.3× |
| Us pelvic non ob complete (76856) | $1,092 | $1,365 | 9.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,060 | $1,325 | 9.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$520.80–$871.20 | $651–$1,089 | varies |
| Us retroperitoneal complete (76770) | $1,175.20 | $1,469 | 10.5× |
| Us retroperitoneal limited (76775) | $969.60 | $1,212 | 8.7× |
| Us scrotum and contents (76870) | $1,092 | $1,365 | 9.7× |
| Us spinal canal and contents (76800) | $832 | $1,040 | 7.4× |
| Us thyroid (76536) | $1,092 | $1,365 | 9.7× |
| Vascular Flow Imaging (78445) | $662.40 | $828 | 1.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,644 | $3,305 | 0.8× |
| Venogram Sinus/Jugular (75860) | $2,644 | $3,305 | 0.8× |
| Venography extremity bilateral rs&i (75822) | $2,580.80 | $3,226 | 1.5× |
| Venography extremity unilateral rs&i (75820) | $1,304.80 | $1,631 | 0.8× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$284–$556.80 | $355–$696 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $567.20 | $709 | 6.1× |
| X-Ray Bend Only L-S Spine (72120) | $471.20 | $589 | 4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$270.40–$536.80 | $338–$671 | varies |
| X-Ray Exam Breast Specimen (76098) | $563.20 | $704 | 1.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $295.20 | $369 | 3.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $341.60 | $427 | 3.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $379.20 | $474 | 3.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $555.20 | $694 | 6.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $629.60 | $787 | 6.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $596.80 | $746 | 5.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $549.60 | $687 | 4.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $666.40 | $833 | 5.9× |
| X-Ray Exam L-S Spine Bending (72114) | $612.80 | $766 | 5.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $468 | $585 | 5.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $635.20 | $794 | 5.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $690.40 | $863 | 6.2× |
| X-ray eye for foreign body (70030) | $204.80 | $256 | 2.2× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$377.60–$741.60 | $472–$927 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 4 matching MRF lines |
$234.40–$1,185.60 | $293–$1,482 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $285.60 | $357 | 3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $353.60 | $442 | 3.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $471.20 | $589 | 4.2× |
| X-ray nose-rectum child f.b. (76010) | $322.40 | $403 | 3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $856 | $1,070 | 7.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $396 | $495 | 3.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $390.40 | $488 | 3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $456.80 | $571 | 4.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $520 | $650 | 5.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $596 | $745 | 5.3× |
| X-ray thoracic spine 4 vw (72074) | $569.60 | $712 | 5.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $847.20 | $1,059 | 2.3× |
| X-Rays Bone Length Studies (77073) | $689.60 | $862 | 6.2× |
| X-Rays Bone Survey Complete (77075) | $1,256 | $1,570 | 11.2× |
| Xr c-spine 4 or 5 views (72050) | $577.60 | $722 | 5.2× |
| Xr facial bones less than 3 views (70140) | $363.20 | $454 | 3.9× |
| XR Mastoids < 3 Views Bilateral (70120) | $395.20 | $494 | 3.5× |
| Xr orbits complete 4 views (70200) | $503.20 | $629 | 4.5× |
| Xr Tomogram Single Plane (76100) range across 4 matching MRF lines |
$468.80–$1,528.80 | $586–$1,911 | 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.