Imaging prices at Overlake Medical Center & Clinics
Bellevue, WA · every code in this section with a posted price and a Medicare benchmark.
289 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) | $3,483.50 | $6,967 | 2.2× |
| Abdomen 1 View (74018) | $139 | $278 | 1.4× |
| Abdomen 2 views (74019) | $156.50 | $313 | 1.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $779.50 | $1,559 | 1.7× |
| Angio internal mammary (75756) | $1,245.78 | $2,491.55 | 0.3× |
| Angio pulmonary bilat (75743) | $2,825 | $5,650 | 0.8× |
| Angiography extremity bilateral rs&i (75716) | $2,842.50 | $5,685 | 0.8× |
| Angiography extremity unilateral rs&i (75710) | $2,402.50 | $4,805 | 0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,704 | $3,408 | 0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,113.50 | $2,227 | 0.3× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$119.50–$239 | $239–$478 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,753 | $5,506 | 0.4× |
| Aortography thoracic w/o serialography rs&i (75600) | $1,512 | $3,024 | 0.4× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,550 | $5,100 | 0.4× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,874.50 | $5,749 | 0.4× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$1,657 | $3,314 | 0.3× |
| Arthrogram hip (73525) | $567 | $1,134 | 1.4× |
| Arthrogram Wrist (73115) | $469 | $938 | 1.2× |
| Basic radiation dosimetry calculation (77300) | $301 | $602 | 1.9× |
| Bone age studies (77072) | $150.15 | $300.30 | 1.2× |
| Bone Imaging 3 Phase (78315) | $952 | $1,904 | 2.1× |
| Bone Imaging Limited Area (78300) | $285 | $570 | 0.6× |
| Bone Imaging Whole Body (78306) | $857.50 | $1,715 | 1.8× |
| Bone survey infant (77076) | $156 | $312 | 1.3× |
| Brain Image W/Flow < 4 Views (78601) | $754.50 | $1,509 | 1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $1,270.50 | $2,541 | 0.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,172 | $2,344 | 2.9× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,035 | $2,070 | 1.1× |
| Cat Scan Follow-Up Study (76380) | $229.50 | $459 | 2.3× |
| Chest 1 view (71045) | $103.50 | $207 | 1.0× |
| Chest 2 views (71046) | $116.50 | $233 | 1.2× |
| Chest 3 views (71047) | $125.50 | $251 | 1.2× |
| Chest 4 or more views (71048) | $150 | $300 | 1.2× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$120.50–$241 | $241–$482 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $216 | $432 | 1.8× |
| Continuing medical physics consltj pr wk (77336) | $457.50 | $915 | 2.9× |
| Contrast Exam Abdominl Aorta (75625) | $2,746.50 | $5,493 | 0.7× |
| Contrast X-Ray Bladder (74430) | $419 | $838 | 1.0× |
| CT abdomen and pelvis without and with contrast (74178) | $1,823.50 | $3,647 | 4.5× |
| CT abdomen and pelvis without contrast (74176) | $1,221 | $2,442 | 4.4× |
| CT abdomen w contrast (74160) | $823.50 | $1,647 | 4.0× |
| CT abdomen w wo contrast (74170) | $972 | $1,944 | 4.8× |
| CT abdomen w/o contrast (74150) | $631.50 | $1,263 | 5.2× |
| CT Angio Abdomen and Pelvis (74174) | $1,946 | $3,892 | 4.8× |
| CT Angio Chest (71275) | $944 | $1,888 | 4.6× |
| CT Angio Head (70496) | $872.50 | $1,745 | 4.3× |
| CT angio hrt w/3d image (75574) | $497.50 | $995 | 1.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$299.50–$582 | $599–$1,164 | varies |
| CT Angio Neck (70498) | $872.50 | $1,745 | 4.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $599.50 | $1,199 | 2.9× |
| CT cervical spine w/ contrast (72126) | $687.50 | $1,375 | 1.7× |
| CT cervical spine w/o contrast (72125) | $651.50 | $1,303 | 5.4× |
| CT cervical spine w/wo cont (72127) | $696 | $1,392 | 3.4× |
| CT chest w contrast (71260) | $827.50 | $1,655 | 4.1× |
| CT chest w/wo contrast (71270) | $1,059.88 | $2,119.75 | 5.2× |
| CT colonography screening (74263) | $213.50 | $427 | 0.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $598.42 | $1,196.85 | 4.9× |
| CT head/brain with contrast (70460) | $656 | $1,312 | 3.2× |
| CT head/brain without and with contrast (70470) | $835 | $1,670 | 4.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $326.50 | $653 | 0.8× |
| CT iac w contrast (70481) | $573 | $1,146 | 2.8× |
| CT l-spine w&w/o contrast (72133) | $757.50 | $1,515 | 3.7× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$547–$1,093.50 | $1,094–$2,187 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$622.50–$1,244.50 | $1,245–$2,489 | varies |
| CT lumbar spine w contrast (72132) | $723.50 | $1,447 | 1.8× |
| CT lumbar spine w/o contrast (72131) | $651.50 | $1,303 | 5.4× |
| CT maxillofacial w contrast (70487) | $688.50 | $1,377 | 3.4× |
| CT maxillofacial wo contrast (70486) | $462.50 | $925 | 3.8× |
| CT neck tissue combo (70492) | $821 | $1,642 | 4.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $634.50 | $1,269 | 3.1× |
| CT orbits w/o contrast (70480) | $497 | $994 | 4.1× |
| CT pelvis w&w/o contrast (72194) | $870 | $1,740 | 4.3× |
| CT pelvis w/o contrast (72192) | $589.50 | $1,179 | 4.9× |
| CT scan of leg combo (73702) | $663.50 | $1,327 | 3.3× |
| CT scans face/jaw combo (70488) | $786 | $1,572 | 3.9× |
| CT soft tissue neck w contrast (70491) | $733.50 | $1,467 | 3.6× |
| CT soft tissue neck w/o contrast (70490) | $650.45 | $1,300.90 | 5.4× |
| CT thoracic spine w contrast (72129) | $687.50 | $1,375 | 3.4× |
| CT thoracic spine w/o contrast (72128) | $651.50 | $1,303 | 5.4× |
| CT thoracic spine w/wo cont (72130) | $702.50 | $1,405 | 3.4× |
| CT thorax w/o contrast (71250) | $700.50 | $1,401 | 5.8× |
| CT upper ext wo (73200) | $485 | $970 | 4.0× |
| CT upper extremity with contrast (73201) | $583.50 | $1,167 | 1.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $668 | $1,336 | 3.3× |
| Cta Abdomen (74175) | $1,045.50 | $2,091 | 5.1× |
| CTA pelvis (72191) | $989 | $1,978 | 4.9× |
| Doppler Fetal Mid Cerebral Artery (76821) | $246 | $492 | 2.0× |
| Dxa Bone Density Axial (77080) | $212 | $424 | 1.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $65.50 | $131 | 0.6× |
| Echo exam uterus (76831) | $209.50 | $419 | 0.8× |
| Esophagram (74220) | $261.50 | $523 | 1.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $235 | $470 | 1.9× |
| Fluoroscopy up to 1 hr (76000) | $286 | $572 | 1.0× |
| Follow-Up Angiography (75898) | $447 | $894 | 0.1× |
| Foot 2 views (73620) | $113.50 | $227 | 1.1× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$125.50–$250.50 | $251–$501 | varies |
| Gastric emptying imaging study (78264) | $854 | $1,708 | 1.8× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$120.50–$241 | $241–$482 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $952.50 | $1,905 | 1.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,132 | $4,264 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $904 | $1,808 | 1.4× |
| Hepatobiliary System Imaging (78226) | $755.50 | $1,511 | 1.6× |
| Ht Muscle Image Spect Sing (78451) | $812.50 | $1,625 | 0.5× |
| Hysterosalpingogram (74740) | $558.50 | $1,117 | 2.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $340.50 | $681 | 3.4× |
| K Flow/Funct Image W/Drug (78708) | $901.50 | $1,803 | 1.4× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$131–$262.50 | $262–$525 | varies |
| Liver & Spleen Imaging Static Only (78215) | $618 | $1,236 | 1.3× |
| Lung Ventilat&Perfus Imaging (78582) | $851.50 | $1,703 | 1.4× |
| Lymph System Imaging (78195) | $762 | $1,524 | 1.2× |
| Magnetic Image Jaw Joint (70336) | $582 | $1,164 | 2.1× |
| Mlc imrt design & construction per imrt plan (77338) | $909 | $1,818 | 2.1× |
| Mra Head W/O & W/Contrast Material (70546) | $1,415 | $2,830 | 3.5× |
| MRA head w/o contrast (70544) | $1,004.50 | $2,009 | 3.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,279 | $2,558 | 3.2× |
| MRA neck w/o contrast (70547) | $1,004.50 | $2,009 | 3.6× |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$1,230.50–$1,296.50 | $2,461–$2,593 | varies |
| MRI abdomen w/o contrast (74181) | $986 | $1,972 | 3.6× |
| MRI any jt lower extrem w/contrast material (73722) | $1,035.50 | $2,071 | 1.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,281.50 | $2,563 | 3.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,035.50 | $2,071 | 1.1× |
| MRI bone marrow blood supply (77084) | $625.50 | $1,251 | 2.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $620.50 | $1,241 | 2.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $462.50 | $925 | 1.7× |
| MRI cardiac w/o contrast (75557) | $637 | $1,274 | 2.3× |
| MRI cervical spine w contrast (72142) | $1,064 | $2,128 | 2.6× |
| MRI cervical spine w/o cont (72141) | $979 | $1,958 | 3.5× |
| MRI chest w/o contrast (71550) | $937.50 | $1,875 | 3.4× |
| MRI chest wo w contrast (71552) | $1,202.50 | $2,405 | 3.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,025 | $2,050 | 2.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,281.50 | $2,563 | 3.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $938.50 | $1,877 | 3.4× |
| MRI lumbar spine w contrast (72149) | $1,251.98 | $2,503.95 | 3.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,140 | $2,280 | 2.8× |
| MRI orbit face &/neck w/o contrast (70540) | $913 | $1,826 | 3.3× |
| MRI orbit face neck w contrast (70542) | $947 | $1,894 | 2.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,208.50 | $2,417 | 3.0× |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$1,181–$1,243.50 | $2,362–$2,487 | varies |
| MRI pelvis w/o & w contrast (72197) | $1,212.50 | $2,425 | 3.0× |
| MRI pelvis w/o contrast (72195) | $942 | $1,884 | 3.4× |
| MRI thoracic spine w/o contrast (72146) | $979 | $1,958 | 3.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,171 | $2,342 | 2.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $938.50 | $1,877 | 3.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,281.50 | $2,563 | 3.2× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,212.50–$1,305.50 | $2,425–$2,611 | varies |
| MRI, dorsal spine combo (72157) | $1,140 | $2,280 | 2.8× |
| MRI, dorsal spine contrast (72147) | $1,064 | $2,128 | 2.6× |
| MRI, joint upper extrem (73221) | $1,104.15 | $2,208.30 | 4.0× |
| MRI, joint upper extrem combo (73223) | $1,281.50 | $2,563 | 3.2× |
| MRI, lumbar spine combo (72158) | $1,140 | $2,280 | 2.8× |
| Myocardial Spect Multiple Studies (78452) | $2,227 | $4,454 | 1.5× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $1,459 | $2,918 | 0.9× |
| Neck soft tissue (70360) | $152 | $304 | 1.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,088 | $8,176 | 2.5× |
| Nuclear Rx Intra-Arterial (79445) | $494 | $988 | 1.8× |
| Nuclear Rx Oral Admin (79005) | $731 | $1,462 | 2.7× |
| Ob us nuchal meas 1 gest (76813) | $152 | $304 | 1.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $762 | $1,524 | 1.2× |
| Parathyroid planar imaging w/wo subtraction (78071) | $762 | $1,524 | 1.6× |
| Pelvis 1 or 2 views (72170) | $129 | $258 | 1.1× |
| PET image w/CT, full body (78816) | $1,979.50 | $3,959 | 1.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,979.50 | $3,959 | 1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $508 | $1,016 | 1.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $200 | $400 | 1.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $361.50 | $723 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$136–$272 | $272–$544 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$117–$212.50 | $234–$425 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$143–$336.05 | $286–$672.10 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $217.50 | $435 | 1.8× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$104–$193 | $208–$386 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$122.50–$245 | $245–$490 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$131.50–$263 | $263–$526 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$77–$154.50 | $154–$309 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $153 | $306 | 1.5× |
| Radex Ribs Unilateral 2 Views (71100) | $127.50 | $255 | 1.3× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$145.50–$291.50 | $291–$583 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $127.50 | $255 | 1.3× |
| Radex Spine 1 View Specify Level (72020) | $127.50 | $255 | 1.3× |
| Radex Sternum Minimum 2 Views (71120) | $150.50 | $301 | 1.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $217.50 | $435 | 2.2× |
| Radex Toe Minimum 2 Views (73660) | $104 | $208 | 1.0× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$141.90–$217 | $283.80–$434 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$134–$268 | $268–$536 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $6,056 | $12,112 | 0.7× |
| Radiation treatment delivery level 3 (77412) | $544.50 | $1,089 | 0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $202 | $404 | 1.7× |
| Radiologic exam colon double contrast study (74280) | $488 | $976 | 2.4× |
| Radiologic exam colon single contrast study (74270) | $306.50 | $613 | 1.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $261.50 | $523 | 1.3× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$167.50–$335 | $335–$670 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $148 | $296 | 1.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $346.50 | $693 | 1.7× |
| Radiologic exam swallow function contrast study (74230) | $283.50 | $567 | 1.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $347.50 | $695 | 1.7× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$62–$133 | $124–$266 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$62–$124.50 | $124–$249 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$120.50–$241 | $241–$482 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$126–$252.50 | $252–$505 | varies |
| Ribs bilateral 3 views (71110) | $140 | $280 | 1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $545.50 | $1,091 | 1.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,345.50 | $2,691 | 2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,468 | $2,936 | 0.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,294 | $2,588 | 0.9× |
| Scapula (73010) | $128 | $256 | 1.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $35.50 | $71 | 1.5× |
| Shoulder 1 view (73020) | $120.50 | $241 | 1.2× |
| Shoulder Arthrography (73040) | $477.50 | $955 | 1.2× |
| Skull less than 4 views (70250) | $127.50 | $255 | 1.1× |
| Special dosimetry (77331) | $261 | $522 | 1.7× |
| Special Physics Consult (77370) | $480 | $960 | 3.1× |
| Special teletherapy port plan (77321) | $863 | $1,726 | 2.0× |
| Special treatment procedure (77470) | $1,749.50 | $3,499 | 2.7× |
| Stereotactic Body Radiation Delivery (77373) | $4,782.50 | $9,565 | 2.3× |
| Sternoclavicular joints (71130) | $135 | $270 | 1.3× |
| Superior sagittal sinus venogram (75870) | $365 | $730 | 0.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,373 | $2,746 | 3.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,152 | $2,304 | 2.6× |
| Ther rad simulaj-aided field setting simple (77280) | $605 | $1,210 | 3.9× |
| Thoracic spine 2 views (72070) | $159.50 | $319 | 1.3× |
| Thoracic spine 3 views (72072) | $189.50 | $379 | 1.6× |
| Thoracolumbar 2 views (72080) | $173 | $346 | 1.7× |
| Thyroid Met Imaging Body (78018) | $949 | $1,898 | 1.5× |
| Thyroid Uptake Measurement (78012) | $229.50 | $459 | 0.5× |
| Tx Devices Design & Construction Complex (77334) | $639.50 | $1,279 | 1.5× |
| Tx devices design & construction intermediate (77333) | $449.50 | $899 | 2.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$183.09–$311 | $366.18–$622 | varies |
| Ultrasound Elastography Parenchyma (76981) | $114.50 | $229 | 0.9× |
| Ultrasound Exam Aaa Screen (76706) | $86 | $172 | 0.7× |
| Ultrasound, abdomen limited (76705) | $242.50 | $485 | 2.0× |
| Umbilical-artery Doppler (OB) (76820) | $246 | $492 | 2.0× |
| Unlisted magnetic resonance procedure (76498) | $647.50 | $1,295 | 6.4× |
| Upper gi w/o kub (74240) | $300.50 | $601 | 1.5× |
| Urethrocystogram voiding (74455) | $365.12 | $730.25 | 1.3× |
| Urethrocystography retrograde (74450) | $416 | $832 | 1.5× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$311–$622.50 | $622–$1,245 | varies |
| Us chest (76604) | $188.50 | $377 | 1.6× |
| Us complete joint (76881) | $214 | $428 | 1.8× |
| Us exam, pelvic, limited (76857) | $190 | $380 | 1.6× |
| Us head (76506) | $245 | $490 | 2.0× |
| Us kidney transplant (76776) | $210 | $420 | 1.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $138.50 | $277 | 1.1× |
| Us ob detailed single fetus (76811) | $353.50 | $707 | 1.3× |
| Us ob limited 1 or more fetuses (76815) | $153 | $306 | 1.3× |
| Us ob transvaginal (76817) | $161.50 | $323 | 1.3× |
| Us pelvic non ob complete (76856) | $300.50 | $601 | 2.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $176 | $352 | 1.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $156.50 | $313 | 1.3× |
| Us retroperitoneal complete (76770) | $277 | $554 | 2.3× |
| Us retroperitoneal limited (76775) | $170.50 | $341 | 1.4× |
| Us scrotum and contents (76870) | $258.50 | $517 | 2.1× |
| Us spinal canal and contents (76800) | $167 | $334 | 1.4× |
| Us thyroid (76536) | $251.50 | $503 | 2.1× |
| Vein X-Ray Chest (75827) | $1,488.50 | $2,977 | 0.8× |
| Venogram Sinus/Jugular (75860) | $977 | $1,954 | 0.3× |
| Venography caval inferior serialography rs&i (75825) | $2,020 | $4,040 | 0.6× |
| Venography extremity bilateral rs&i (75822) | $1,129 | $2,258 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $711.50 | $1,423 | 0.4× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$140.52–$281.05 | $281.05–$562.10 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $165 | $330 | 1.6× |
| X-Ray Aorta Leg Arteries (75630) | $2,856.50 | $5,713 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $185 | $370 | 1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$119.50–$281.05 | $239–$562.10 | varies |
| X-Ray Exam Breast Specimen (76098) | $124.50 | $249 | 0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $62 | $124 | 0.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $103 | $206 | 0.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $120.50 | $241 | 1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $136 | $272 | 1.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $105 | $210 | 0.9× |
| X-Ray Exam L-S Spine Bending (72114) | $297.50 | $595 | 2.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $168 | $336 | 1.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $253 | $506 | 2.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $156.50 | $313 | 1.3× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$123–$246 | $246–$492 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $170.50 | $341 | 1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $116 | $232 | 1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $169 | $338 | 1.4× |
| X-ray nose-rectum child f.b. (76010) | $76 | $152 | 0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $189 | $378 | 1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $144 | $288 | 1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $144 | $288 | 1.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $211 | $422 | 2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $245.50 | $491 | 2.0× |
| X-Ray Stress View (77071) | $145.75 | $291.50 | 1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $424.50 | $849 | 1.0× |
| X-Rays Bone Length Studies (77073) | $173.50 | $347 | 1.4× |
| X-Rays Bone Survey Complete (77075) | $278 | $556 | 2.3× |
| Xr c-spine 4 or 5 views (72050) | $208 | $416 | 1.7× |
| Xr facial bones less than 3 views (70140) | $156 | $312 | 1.5× |
| Xr orbits complete 4 views (70200) | $199 | $398 | 1.6× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.