Imaging prices at PeaceHealth St. John Medical Center
Longview, WA · every code in this section with a posted price and a Medicare benchmark.
326 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) range across 2 matching MRF lines |
$8,598.85–$9,200.75 | $13,229–$14,155 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$283.40–$289.25 | $436–$445 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$326.95–$536.90 | $503–$826 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,594.45 | $2,453 | 3.6× |
| Angio pulmonary bilat (75743) | $5,271.50 | $8,110 | 1.5× |
| Angiography extremity bilateral rs&i (75716) | $10,775.70 | $16,578 | 3.1× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$10,564.45–$10,775.70 | $16,253–$16,578 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,399.50 | $5,230 | 1.0× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$256.10–$268.45 | $394–$413 | varies |
| Aortography thoracic serialography rs&i (75605) | $5,616.65 | $8,641 | 0.9× |
| Artery X-Rays Abdomen (75726) range across 3 matching MRF lines |
$18,390.45–$54,089.10 | $28,293–$83,214 | varies |
| Artery X-Rays Adrenal Gland (75731) | $5,749.90 | $8,846 | 1.6× |
| Artery X-Rays Pelvis (75736) | $19,921.20 | $30,648 | 3.2× |
| Arthrogram hip (73525) | $918.45 | $1,413 | 2.4× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$702–$1,311.70 | $1,080–$2,018 | varies |
| Bone age studies (77072) range across 3 matching MRF lines |
$503.75–$514.15 | $775–$791 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,488.50–$1,533.35 | $2,290–$2,359 | varies |
| Bone Imaging Limited Area (78300) | $1,197.95 | $1,843 | 2.7× |
| Bone Imaging Whole Body (78306) range across 3 matching MRF lines |
$1,259.05–$1,296.75 | $1,937–$1,995 | varies |
| Bone survey infant (77076) | $512.20 | $788 | 4.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$6,291.35–$6,417.45 | $9,679–$9,873 | varies |
| Chest 1 view (71045) range across 3 matching MRF lines |
$304.20–$608.40 | $468–$936 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$297.05–$302.90 | $457–$466 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$262.60–$317.20 | $404–$488 | varies |
| Chest 4 or more views (71048) | $391.95 | $603 | 3.4× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $483.60 | $744 | 4.1× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$295.75–$603.20 | $455–$928 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$258.05–$283.40 | $397–$436 | varies |
| Continuing medical physics consltj pr wk (77336) range across 3 matching MRF lines |
$674.05–$721.50 | $1,037–$1,110 | varies |
| Contrast Exam Abdominl Aorta (75625) | $10,775.70 | $16,578 | 3.1× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$565.50–$576.55 | $870–$887 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $854.10 | $1,314 | 2.2× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$5,645.90–$5,815.55 | $8,686–$8,947 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$2,933.45–$3,021.20 | $4,513–$4,648 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$2,566.85–$2,643.55 | $3,949–$4,067 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$2,566.85–$2,643.55 | $3,949–$4,067 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,646.45–$1,695.85 | $2,533–$2,609 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$4,908.80–$5,056.35 | $7,552–$7,779 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$2,566.85–$2,643.55 | $3,949–$4,067 | varies |
| CT Angio Head (70496) range across 4 matching MRF lines |
$2,206.10–$7,450.30 | $3,394–$11,462 | varies |
| CT angio hrt w/3d image (75574) range across 3 matching MRF lines |
$2,701.40–$2,782.65 | $4,156–$4,281 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,566.85–$5,133.70 | $3,949–$7,898 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$2,951.65–$5,903.30 | $4,541–$9,082 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$1,975.35–$5,903.30 | $3,039–$9,082 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $2,881.45 | $4,433 | 14.7× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,601.60–$1,607.45 | $2,464–$2,473 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$1,431.30–$1,474.20 | $2,202–$2,268 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$1,792.70–$2,043.60 | $2,758–$3,144 | varies |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$2,566.85–$2,643.55 | $3,949–$4,067 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$2,622.75–$2,701.40 | $4,035–$4,156 | varies |
| CT colonography screening (74263) | $1,541.15 | $2,371 | 5.8× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $2,990 | $4,600 | 15.3× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,312.35 | $2,019 | 11.3× |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$1,101.75–$1,179.75 | $1,695–$1,815 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,467.05–$1,511.25 | $2,257–$2,325 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$2,622.75–$2,701.40 | $4,035–$4,156 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$168.35–$173.55 | $259–$267 | varies |
| CT hrt w/3d image congen (75573) | $2,701.40 | $4,156 | 6.9× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,337.70–$1,378 | $2,058–$2,120 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$2,215.85–$2,525.90 | $3,409–$3,886 | varies |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$1,431.30–$2,948.40 | $2,202–$4,536 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$2,566.85–$5,133.70 | $3,949–$7,898 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,871.35–$1,927.25 | $2,879–$2,965 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,431.30–$1,474.20 | $2,202–$2,268 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$2,566.85–$2,643.55 | $3,949–$4,067 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$1,431.30–$1,474.20 | $2,202–$2,268 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,348.75–$1,629.55 | $2,075–$2,507 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,643.20–$1,692.60 | $2,528–$2,604 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$867.75–$969.15 | $1,335–$1,491 | varies |
| CT pelvis w&w/o contrast (72194) | $1,555.45 | $2,393 | 7.9× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,431.30–$1,474.20 | $2,202–$2,268 | varies |
| CT scan of leg combo (73702) | $1,457.30 | $2,242 | 7.4× |
| CT scans face/jaw combo (70488) | $1,275.95 | $1,963 | 6.5× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$2,566.85–$2,643.55 | $3,949–$4,067 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,431.30–$1,474.20 | $2,202–$2,268 | varies |
| CT thoracic spine w contrast (72129) | $1,487.85 | $2,289 | 7.6× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,551.55–$1,598.35 | $2,387–$2,459 | varies |
| CT thoracic spine w/wo cont (72130) | $1,835.60 | $2,824 | 9.4× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,431.30–$1,474.20 | $2,202–$2,268 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,431.30–$1,474.20 | $2,202–$2,268 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,727.70 | $2,658 | 8.8× |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$4,908.80–$5,056.35 | $7,552–$7,779 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$2,951.65–$3,040.05 | $4,541–$4,677 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$2,951.65–$3,040.05 | $4,541–$4,677 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) range across 2 matching MRF lines |
$3,577.60–$8,503.95 | $5,504–$13,083 | varies |
| CTA pelvis (72191) | $2,943.20 | $4,528 | 15.0× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$463.45–$472.55 | $713–$727 | varies |
| Dxa bone density study (77085) range across 3 matching MRF lines |
$419.25–$427.70 | $645–$658 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$223.60–$228.15 | $344–$351 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$535.60–$546 | $824–$840 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$1,006.20–$1,026.35 | $1,548–$1,579 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$607.10–$619.45 | $934–$953 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$837.85–$854.75 | $1,289–$1,315 | varies |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$950.30–$1,129.05 | $1,462–$1,737 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$295.75–$591.50 | $455–$910 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$295.75–$591.50 | $455–$910 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,533.35–$1,579.50 | $2,359–$2,430 | varies |
| Gated Heart Planar Single (78472) | $1,250.60 | $1,924 | 2.8× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$309.40–$679.90 | $476–$1,046 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,959.85 | $9,169 | 1.7× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,976–$2,035.15 | $3,040–$3,131 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$1,886.30–$2,150.20 | $2,902–$3,308 | varies |
| Ht Muscle Image Spect Sing (78451) | $2,834.65 | $4,361 | 2.0× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$570.05–$581.75 | $877–$895 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 3 matching MRF lines |
$394.55–$402.35 | $607–$619 | varies |
| Infant hip ultrasound, limited static exam (76886) | $360.10 | $554 | 3.7× |
| Joint Survey Single View (77077) range across 3 matching MRF lines |
$488.15–$497.90 | $751–$766 | varies |
| K Flow/Funct Image Multiple (78709) | $1,207.70 | $1,858 | 2.0× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,331.20–$1,370.85 | $2,048–$2,109 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$1,431.30–$1,474.20 | $2,202–$2,268 | varies |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$339.95–$679.90 | $523–$1,046 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,283.10 | $1,974 | 2.9× |
| Lung Ventilat&Perfus Imaging (78582) range across 3 matching MRF lines |
$1,976–$2,035.15 | $3,040–$3,131 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,308.45–$1,347.45 | $2,013–$2,073 | varies |
| Magnetic Image Jaw Joint (70336) | $3,505.45 | $5,393 | 13.2× |
| Mammary ductogram or galactogram multiple (77054) | $1,188.85 | $1,829 | 4.5× |
| Mammary ductogram or galactogram single (77053) | $654.55 | $1,007 | 2.5× |
| Meckels Divert Exam (78290) | $1,382.55 | $2,127 | 3.1× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$1,396.20–$1,493.70 | $2,148–$2,298 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 3 matching MRF lines |
$5,112.25–$5,265.65 | $7,865–$8,101 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$2,655.25–$2,735.20 | $4,085–$4,208 | varies |
| MRA head with contrast (70545) | $1,291.55 | $1,987 | 3.3× |
| MRA neck w contrast (70548) range across 3 matching MRF lines |
$5,187.65–$5,913.70 | $7,981–$9,098 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$5,112.25–$5,265.65 | $7,865–$8,101 | varies |
| MRA neck w/o contrast (70547) range across 3 matching MRF lines |
$3,075.15–$3,167.45 | $4,731–$4,873 | varies |
| MRI abdomen w contrast (74182) | $2,200.90 | $3,386 | 5.7× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$2,655.25–$2,735.20 | $4,085–$4,208 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,423.20–$2,898.35 | $3,728–$4,459 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,315.95–$2,385.50 | $3,563–$3,670 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$1,902.55–$1,959.75 | $2,927–$3,015 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $657.80 | $1,012 | 2.5× |
| MRI cervical spine w contrast (72142) | $2,324.40 | $3,576 | 6.0× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$2,655.25–$2,735.20 | $4,085–$4,208 | varies |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$1,901.90–$2,168.40 | $2,926–$3,336 | varies |
| MRI chest wo w contrast (71552) range across 3 matching MRF lines |
$2,507.05–$2,582.45 | $3,857–$3,973 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,154.10 | $3,314 | 5.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 4 matching MRF lines |
$5,112.25–$10,224.50 | $7,865–$15,730 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$2,655.25–$5,310.50 | $4,085–$8,170 | varies |
| MRI lumbar spine w contrast (72149) | $2,202.20 | $3,388 | 5.7× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$5,112.25–$5,265.65 | $7,865–$8,101 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,897.35–$1,954.55 | $2,919–$3,007 | varies |
| MRI orbit face neck w contrast (70542) | $2,399.80 | $3,692 | 6.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$4,584.45–$4,722.25 | $7,053–$7,265 | varies |
| MRI pelvis w contrast (72196) | $1,836.25 | $2,825 | 4.7× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$5,112.25–$5,265.65 | $7,865–$8,101 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$2,655.25–$2,735.20 | $4,085–$4,208 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$2,655.25–$2,735.20 | $4,085–$4,208 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,383.55 | $3,667 | 6.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,783.30–$2,866.50 | $4,282–$4,410 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$4,963.40–$5,112.25 | $7,636–$7,865 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$5,112.25–$5,265.65 | $7,865–$8,101 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$5,112.25–$5,265.65 | $7,865–$8,101 | varies |
| MRI, dorsal spine contrast (72147) | $1,981.20 | $3,048 | 5.1× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,655.25–$5,310.50 | $4,085–$8,170 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$2,941.90–$3,359.20 | $4,526–$5,168 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$5,112.25–$5,265.65 | $7,865–$8,101 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) range across 2 matching MRF lines |
$2,644.85–$3,015.35 | $4,069–$4,639 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$5,331.95–$5,491.85 | $8,203–$8,449 | varies |
| N-invas est c ffr sw aly CTA (75580) | $3,229.85 | $4,969 | 3.4× |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$295.75–$301.60 | $455–$464 | varies |
| Nonvascular Shunt X-Ray (75809) | $383.50 | $590 | 3.3× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 3 matching MRF lines |
$7,185.75–$7,688.85 | $11,055–$11,829 | varies |
| Nuclear Rx Oral Admin (79005) range across 3 matching MRF lines |
$972.40–$1,001.65 | $1,496–$1,541 | varies |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$655.85–$668.85 | $1,009–$1,029 | varies |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $650 | $1,000 | 5.6× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) | $614.90 | $946 | 4.1× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $166.40 | $256 | 1.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$542.75–$655.85 | $835–$1,009 | varies |
| Ophthalmic us dx quantitative a-scan only (76511) | $812.50 | $1,250 | 7.0× |
| Panoramic X-ray of jaws (70355) | $294.45 | $453 | 3.0× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$2,013.70–$2,295.80 | $3,098–$3,532 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 3 matching MRF lines |
$1,155.05–$1,189.50 | $1,777–$1,830 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$329.55–$615.55 | $507–$947 | varies |
| Peritoneogram Rs&I (74190) | $2,135.90 | $3,286 | 3.5× |
| Pet Image W/Ct Lmtd (78814) | $7,263.75 | $11,175 | 4.6× |
| PET image w/CT, full body (78816) range across 3 matching MRF lines |
$6,108.05–$6,230.25 | $9,397–$9,585 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$6,291.35–$6,417.45 | $9,679–$9,873 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,310.80 | $6,632 | 1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,396.20 | $2,148 | 3.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$533.65–$544.05 | $821–$837 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,090.40 | $3,216 | 3.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$295.75–$591.50 | $455–$910 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$245.70–$339.95 | $378–$523 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$339.95–$679.90 | $523–$1,046 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$368.55–$463.45 | $567–$713 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$295.75–$591.50 | $455–$910 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$339.95–$679.90 | $523–$1,046 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$615.55–$1,231.10 | $947–$1,894 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $274.30 | $422 | 2.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $323.70 | $498 | 2.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$249.60–$256.10 | $384–$394 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$277.55–$295.75 | $427–$455 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$339.95–$679.90 | $523–$1,046 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$252.85–$311.35 | $389–$479 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$287.30–$293.15 | $442–$451 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$272.35–$339.95 | $419–$523 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$213.20–$217.75 | $328–$335 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$255.45–$591.50 | $393–$910 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$277.55–$583.05 | $427–$897 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$339.95–$679.90 | $523–$1,046 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $529.10 | $814 | 4.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 2 matching MRF lines |
$19,918.60–$23,416.90 | $30,644–$36,026 | varies |
| Radiation treatment delivery level 1 (77402) | $421.20 | $648 | 3.7× |
| Radiation treatment delivery level 2 (77407) | $578.50 | $890 | 1.3× |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$1,119.30–$1,197.95 | $1,722–$1,843 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$313.95–$320.45 | $483–$493 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$321.75–$397.15 | $495–$611 | varies |
| Radiologic exam colon double contrast study (74280) | $868.40 | $1,336 | 4.4× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$699.40–$874.25 | $1,076–$1,345 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$615.55–$1,231.10 | $947–$1,894 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$364.65–$449.80 | $561–$692 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $723.45 | $1,113 | 3.7× |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$488.15–$497.90 | $751–$766 | varies |
| Radiologic exam teeth complete full mouth (70320) | $990.60 | $1,524 | 3.7× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$874.25–$891.80 | $1,345–$1,372 | varies |
| Radiologic examination femur 1 view (73551) | $443.30 | $682 | 4.6× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$341.90–$683.80 | $526–$1,052 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$339.95–$679.90 | $523–$1,046 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $495.30 | $762 | 4.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$295.75–$591.50 | $455–$910 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$380.25–$533.65 | $585–$821 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,609.15 | $7,091 | 7.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,196.05 | $4,917 | 5.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$3,779.10–$3,892.20 | $5,814–$5,988 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,285.75 | $5,055 | 2.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,997.80 | $4,612 | 1.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,778.45 | $5,813 | 2.6× |
| Scapula (73010) range across 3 matching MRF lines |
$296.40–$520.65 | $456–$801 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$53.30–$54.60 | $82–$84 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$339.95–$692.90 | $523–$1,066 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$2,462.20–$2,511.60 | $3,788–$3,864 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$279.50–$615.55 | $430–$947 | varies |
| Special dosimetry (77331) | $346.45 | $533 | 2.3× |
| Special Physics Consult (77370) | $699.40 | $1,076 | 4.7× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$1,209–$1,293.50 | $1,860–$1,990 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$2,231.45–$2,387.45 | $3,433–$3,673 | varies |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$6,370.65–$6,816.55 | $9,801–$10,487 | varies |
| Sternoclavicular joints (71130) | $251.55 | $387 | 2.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 3 matching MRF lines |
$1,596.40–$1,708.20 | $2,456–$2,628 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $900.90 | $1,386 | 2.2× |
| Testicular Imaging W/Flow (78761) | $1,255.15 | $1,931 | 2.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$2,005.25–$2,145.65 | $3,085–$3,301 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$811.85–$868.40 | $1,249–$1,336 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$313.95–$615.55 | $483–$947 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$354.90–$615.55 | $546–$947 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$304.20–$318.50 | $468–$490 | varies |
| Thyroid Met Imaging Body (78018) range across 3 matching MRF lines |
$1,379.95–$1,421.55 | $2,123–$2,187 | varies |
| Thyroid Uptake Measurement (78012) | $724.75 | $1,115 | 1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$1,058.85–$1,090.70 | $1,629–$1,678 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$1,474.85–$1,578.20 | $2,269–$2,428 | varies |
| Tx devices design & construction intermediate (77333) | $830.05 | $1,277 | 5.5× |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$655.85–$702 | $1,009–$1,080 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$344.50–$689 | $530–$1,060 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 2 matching MRF lines |
$400.40–$408.20 | $616–$628 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$536.90–$547.95 | $826–$843 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$622.70–$635.05 | $958–$977 | varies |
| Umbilical-artery Doppler (OB) (76820) | $386.75 | $595 | 3.3× |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$874.25–$891.80 | $1,345–$1,372 | varies |
| Urethrocystogram voiding (74455) | $596.70 | $918 | 2.2× |
| Urethrocystography retrograde (74450) | $596.70 | $918 | 2.2× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$622.70–$1,270.10 | $958–$1,954 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$716.30–$730.60 | $1,102–$1,124 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$622.70–$635.05 | $958–$977 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$622.70–$635.05 | $958–$977 | varies |
| Us head (76506) range across 2 matching MRF lines |
$794.30–$809.90 | $1,222–$1,246 | varies |
| Us kidney transplant (76776) | $536.90 | $826 | 4.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$622.70–$1,245.40 | $958–$1,916 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$1,343.55–$1,370.20 | $2,067–$2,108 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$721.50–$735.80 | $1,110–$1,132 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$622.70–$635.05 | $958–$977 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$622.70–$635.05 | $958–$977 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$622.70–$635.05 | $958–$977 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$622.70–$635.05 | $958–$977 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$622.70–$635.05 | $958–$977 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$622.70–$635.05 | $958–$977 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$716.30–$730.60 | $1,102–$1,124 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$722.15–$736.45 | $1,111–$1,133 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$622.70–$635.05 | $958–$977 | varies |
| Vein X-Ray Chest (75827) | $3,001.05 | $4,617 | 1.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,069.60 | $3,184 | 0.6× |
| Venogram Sinus/Jugular (75860) | $3,316.30 | $5,102 | 0.9× |
| Venography caval inferior serialography rs&i (75825) | $4,434.95 | $6,823 | 1.3× |
| Venography extremity bilateral rs&i (75822) | $1,898.65 | $2,921 | 1.1× |
| Venography extremity unilateral rs&i (75820) | $1,792.05 | $2,757 | 1.0× |
| Venography Renal Bilateral (75833) | $7,484.10 | $11,514 | 2.1× |
| Venous sampling by catheter (75893) | $3,725.15 | $5,731 | 0.6× |
| Vertebral fracture assessment via dxa (77086) | $174.85 | $269 | 1.8× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$339.95–$692.90 | $523–$1,066 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$302.25–$308.10 | $465–$474 | varies |
| X-ray antegrade pyelogram tube (74425) | $708.50 | $1,090 | 1.8× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$324.35–$661.05 | $499–$1,017 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$256.10–$261.30 | $394–$402 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$1,409.85–$1,437.80 | $2,169–$2,212 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$232.70–$237.25 | $358–$365 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines |
$278.20–$472.55 | $428–$727 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $434.85 | $669 | 3.7× |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$256.10–$522.60 | $394–$804 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$376.35–$752.70 | $579–$1,158 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $345.15 | $531 | 3.0× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$267.80–$328.25 | $412–$505 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$337.35–$593.45 | $519–$913 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$505.05–$610.35 | $777–$939 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$535.60–$615.55 | $824–$947 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$339.95–$341.25 | $523–$525 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$514.80–$602.55 | $792–$927 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$354.90–$463.45 | $546–$713 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$254.80–$260 | $392–$400 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$301.60–$679.90 | $464–$1,046 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$232.70–$254.15 | $358–$391 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$211.25–$215.80 | $325–$332 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$615.55–$627.90 | $947–$966 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$504.40–$514.80 | $776–$792 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$450.45–$597.35 | $693–$919 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$326.30–$615.55 | $502–$947 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$249.60–$254.80 | $384–$392 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$219.70–$224.25 | $338–$345 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$295.75–$313.95 | $455–$483 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$450.45–$647.40 | $693–$996 | varies |
| X-ray thoracic spine 4 vw (72074) | $400.40 | $616 | 3.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,657.50 | $2,550 | 4.3× |
| X-Rays Bone Length Studies (77073) | $497.90 | $766 | 4.3× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$488.15–$497.90 | $751–$766 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$446.55–$560.95 | $687–$863 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$244.40–$249.60 | $376–$384 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $248.30 | $382 | 2.1× |
| Xr orbits complete 4 views (70200) | $354.25 | $545 | 3.0× |
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.