Imaging prices at Phelps Health Hospital
Rolla, MO · every code in this section with a posted price and a Medicare benchmark.
300 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 3 matching MRF lines |
$1,450.65–$7,241.49 | $2,072.36–$10,344.99 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$464.60–$478.54 | $663.72–$683.63 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$680.08–$700.48 | $971.54–$1,000.69 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,097.28 | $2,996.11 | 5.2× |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$5,555.21–$20,665.55 | $7,936.02–$29,522.21 | varies |
| Angiography extremity unilateral rs&i (75710) range across 7 matching MRF lines |
$4,452.18–$21,579.87 | $6,360.25–$30,828.38 | varies |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$637.78–$656.91 | $911.11–$938.44 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$1,191.73–$2,383.46 | $1,702.47–$3,404.94 | varies |
| Arthrogram Wrist (73115) | $1,066.84 | $1,524.05 | 3.1× |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$144.92–$2,004.45 | $207.03–$2,863.50 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$395.68–$407.55 | $565.26–$582.22 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$2,814.79–$2,899.23 | $4,021.13–$4,141.76 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$1,767.33–$1,820.34 | $2,524.75–$2,600.49 | varies |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$1,288.95–$1,327.61 | $1,841.35–$1,896.59 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$2,108.32–$2,171.57 | $3,011.88–$3,102.24 | varies |
| Bone survey infant (77076) | $704.34 | $1,006.20 | 6.7× |
| Brain Flow Imaging Only (78610) | $1,057.70 | $1,511 | 1.9× |
| Brain Image W/Flow < 4 Views (78601) | $1,531.90 | $2,188.43 | 3.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,214.50 | $7,449.29 | 3.6× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$1,427.58–$1,470.41 | $2,039.40–$2,100.58 | varies |
| Cerebrospinal Fluid Scan (78630) | $2,330.95 | $3,329.93 | 4.3× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$439.59–$879.19 | $627.99–$1,255.98 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$515.55–$531.02 | $736.50–$758.60 | varies |
| Chest 3 views (71047) | $609.33 | $870.47 | 7.0× |
| Chest 4 or more views (71048) | $688.59 | $983.70 | 6.6× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$541.32–$1,082.80 | $773.32–$1,546.86 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$2,369.39–$2,440.47 | $3,384.84–$3,486.39 | varies |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$905.81–$932.98 | $1,294.01–$1,332.83 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 4 matching MRF lines |
$274.30–$8,138.41 | $391.85–$11,626.30 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $1,252.31 | $1,789.01 | 3.6× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$7,925.53–$8,163.30 | $11,322.18–$11,661.85 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$5,245.14–$5,402.49 | $7,493.05–$7,717.84 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$3,368.81–$3,469.88 | $4,812.59–$4,956.97 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$3,998.64–$4,118.60 | $5,712.34–$5,883.71 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$2,555.71–$2,632.39 | $3,651.02–$3,760.55 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$6,849.83–$7,055.32 | $9,785.47–$10,079.03 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$4,319.36–$4,448.95 | $6,170.52–$6,355.64 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$3,917.26–$4,034.77 | $5,596.08–$5,763.96 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$4,511.28–$4,646.61 | $6,444.68–$6,638.02 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$4,438.85–$4,572.02 | $6,341.21–$6,531.45 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$3,774.37–$3,887.60 | $5,391.95–$5,553.71 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$2,849.90–$2,935.39 | $4,071.28–$4,193.42 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$3,206.66–$3,302.86 | $4,580.94–$4,718.37 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$2,866.72–$2,952.73 | $4,095.32–$4,218.18 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$3,438.11–$3,541.26 | $4,911.59–$5,058.94 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$3,592.62–$3,700.40 | $5,132.31–$5,286.28 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$2,292.58–$2,361.36 | $3,275.12–$3,373.37 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$3,276.56–$3,374.85 | $4,680.80–$4,821.22 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$3,759.53–$3,872.31 | $5,370.75–$5,531.87 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$2,365.94–$2,436.92 | $3,379.91–$3,481.31 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$3,295.15–$3,394.01 | $4,707.36–$4,848.58 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$2,545–$2,621.35 | $3,635.72–$3,744.79 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$2,603.37–$2,681.47 | $3,719.10–$3,830.67 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$3,656.35–$3,766.04 | $5,223.35–$5,380.05 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$3,163.20–$3,258.10 | $4,518.86–$4,654.43 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$2,827.64–$2,912.46 | $4,039.48–$4,160.66 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$2,306.96–$2,376.17 | $3,295.66–$3,394.53 | varies |
| CT neck tissue combo (70492) | $3,690.09 | $5,271.55 | 21.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,475.47 | $4,964.96 | 19.8× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$2,420.87–$2,493.49 | $3,458.38–$3,562.13 | varies |
| CT pelvis w&w/o contrast (72194) | $4,044.78 | $5,778.26 | 23.0× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$2,689.58–$2,770.26 | $3,842.25–$3,957.52 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$2,641.23–$2,720.47 | $3,773.19–$3,886.39 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$2,911.18–$2,998.51 | $4,158.83–$4,283.59 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$2,896.48–$2,983.37 | $4,137.83–$4,261.96 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$2,644.29–$2,723.62 | $3,777.56–$3,890.89 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$3,606.77–$3,714.98 | $5,152.53–$5,307.11 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$3,007.55–$3,097.78 | $4,296.50–$4,425.40 | varies |
| CT thoracic spine w/wo cont (72130) | $3,394.01 | $4,848.58 | 19.3× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$2,540.27–$2,616.47 | $3,628.95–$3,737.82 | varies |
| CT unlisted procedure (76497) | $771.07 | $1,101.53 | 8.8× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$2,388.88–$2,460.55 | $3,412.69–$3,515.07 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$3,152.79–$3,247.38 | $4,503.99–$4,639.11 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$2,576.29–$2,653.57 | $3,680.41–$3,790.82 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$5,221.20–$10,138.25 | $7,458.86–$14,483.22 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$4,455.68–$4,589.35 | $6,365.25–$6,556.21 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$4,152.08–$4,276.64 | $5,931.54–$6,109.49 | varies |
| Discography Cerv/Thor Spine (72285) | $4,583.12 | $6,547.31 | 2.3× |
| Diskography lumbar (72295) | $6,543.23 | $9,347.47 | 3.3× |
| Doppler Fetal Mid Cerebral Artery (76821) | $843.72 | $1,205.31 | 8.1× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$802.24–$826.30 | $1,146.05–$1,180.43 | varies |
| Dxa bone density study (77085) | $853.09 | $1,218.70 | 8.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $555.28 | $793.25 | 6.4× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$882.32–$908.79 | $1,260.46–$1,298.27 | varies |
| Echo Guide For Artery Repair (76936) | $638.84 | $912.63 | 3.0× |
| Esophagram (74220) range across 2 matching MRF lines |
$805.07–$829.22 | $1,150.10–$1,184.60 | varies |
| Fetal Biophys Profile W/Nst (76818) | $1,240.71 | $1,772.44 | 11.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$1,204.57–$2,409.15 | $1,720.82–$3,441.64 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$967.54–$996.57 | $1,382.20–$1,423.67 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$555.09–$1,110.19 | $792.99–$1,585.98 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$506.37–$521.56 | $723.39–$745.09 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$2,193.15–$2,258.94 | $3,133.07–$3,227.06 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$626.93–$645.74 | $895.61–$922.48 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 3 matching MRF lines |
$1,172.35–$6,898.86 | $1,674.78–$9,855.52 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 3 matching MRF lines |
$781.56–$5,519.79 | $1,116.52–$7,885.42 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$2,322.73–$2,392.41 | $3,318.18–$3,417.73 | varies |
| Hepatobiliary System Imaging (78226) | $2,228.37 | $3,183.39 | 5.6× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$4,023.88–$4,144.60 | $5,748.40–$5,920.85 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$745.49–$767.85 | $1,064.98–$1,096.93 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,458.35 | $2,083.36 | 16.7× |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$875.75–$902.02 | $1,251.07–$1,288.60 | varies |
| Intracavitary radiation source applic simple (77761) | $5,536.19 | $7,908.84 | 10.0× |
| Joint Survey Single View (77077) | $569.24 | $813.20 | 5.4× |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$2,531.85–$2,607.81 | $3,616.93–$3,725.44 | varies |
| K Flow/Funct Image W/Drug (78708) | $2,498.69 | $3,569.56 | 4.6× |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$1,835.09–$1,890.15 | $2,621.56–$2,700.21 | varies |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$601.14–$1,202.28 | $858.77–$1,717.54 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$2,110.31–$2,173.62 | $3,014.73–$3,105.17 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$2,240.72–$2,307.94 | $3,201.03–$3,297.06 | varies |
| Magnetic Image Jaw Joint (70336) | $4,275.47 | $6,107.81 | 17.9× |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$927.84–$955.67 | $1,325.48–$1,365.24 | varies |
| Meckels Divert Exam (78290) | $1,479.91 | $2,114.15 | 3.7× |
| Mlc imrt design & construction per imrt plan (77338) range across 3 matching MRF lines |
$963.26–$5,271.78 | $1,376.08–$7,531.11 | varies |
| Mr safety determination physician/other qhp (76016) | $128.70 | $183.86 | 1.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $36.05 | $51.50 | 1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $133.92 | $191.32 | 1.4× |
| Mr safety implt pos&/immoblj (76019) | $86.70 | $123.86 | 1.5× |
| Mr safety med physics xm customization plng&mntr (76017) | $352.75 | $503.93 | 1.5× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$4,369.09–$4,500.16 | $6,241.55–$6,428.80 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$3,832.80–$3,947.78 | $5,475.43–$5,639.69 | varies |
| MRA head with contrast (70545) | $3,996.72 | $5,709.60 | 11.4× |
| MRA neck w contrast (70548) | $3,826.93 | $5,467.04 | 11.0× |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$3,715.47–$3,826.93 | $5,307.81–$5,467.04 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$3,458.46–$3,562.21 | $4,940.65–$5,088.87 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$4,805.23–$4,949.39 | $6,864.62–$7,070.56 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$4,060.83–$4,182.66 | $5,801.19–$5,975.23 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$5,459.69–$10,919.37 | $7,799.55–$15,599.10 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$5,459.69–$5,905.06 | $7,799.55–$8,435.80 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$4,805.23–$4,949.39 | $6,864.62–$7,070.56 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$3,790.07–$7,359.35 | $5,414.38–$10,513.36 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $3,790.07 | $5,414.38 | 15.9× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$4,805.23–$4,949.39 | $6,864.62–$7,070.56 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$4,549.68–$4,686.17 | $6,499.54–$6,694.53 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$4,150.94–$4,275.47 | $5,929.91–$6,107.81 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$5,043.89–$5,195.20 | $7,205.55–$7,421.72 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$5,733.07–$5,905.06 | $8,190.10–$8,435.80 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$4,049.05–$4,170.52 | $5,784.36–$5,957.89 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$4,805.23–$4,949.39 | $6,864.62–$7,070.56 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$5,997.66–$6,177.58 | $8,568.08–$8,825.12 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 4 matching MRF lines |
$3,868.42–$4,116.47 | $5,526.31–$5,880.67 | varies |
| MRI orbit face neck w contrast (70542) | $4,765.43 | $6,807.75 | 13.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$5,318.33–$5,477.89 | $7,597.62–$7,825.55 | varies |
| MRI pelvis w contrast (72196) | $2,914.97 | $4,164.24 | 8.3× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$6,315.39–$6,504.86 | $9,021.99–$9,292.65 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$4,544.79–$4,681.13 | $6,492.55–$6,687.33 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$4,224.98–$4,351.73 | $6,035.69–$6,216.76 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $4,487.95 | $6,411.35 | 12.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$4,150.94–$4,275.47 | $5,929.91–$6,107.81 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$5,852.16–$6,027.73 | $8,360.23–$8,611.04 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$6,096.94–$6,279.85 | $8,709.91–$8,971.21 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$6,513.81–$6,709.22 | $9,305.44–$9,584.60 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$4,552.36–$4,688.93 | $6,503.37–$6,698.47 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$5,043.89–$5,195.20 | $7,205.55–$7,421.72 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$6,153.92–$6,338.54 | $8,791.32–$9,055.06 | varies |
| Myelogram cervical (72240) | $2,450.78 | $3,501.11 | 3.1× |
| Myelogram Lumbar (72265) | $2,450.78 | $3,501.11 | 3.1× |
| Myelography thoracic (72255) | $2,389.64 | $3,413.77 | 3.0× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,672.55 | $2,389.35 | 4.2× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$5,412.27–$5,574.63 | $7,731.81–$7,963.76 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$637.17–$656.29 | $910.24–$937.55 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 3 matching MRF lines |
$1,450.65–$6,749.18 | $2,072.36–$9,641.69 | varies |
| Nuclear Rx Oral Admin (79005) range across 3 matching MRF lines |
$279.75–$1,646.07 | $399.64–$2,351.53 | varies |
| Panoramic X-ray of jaws (70355) | $783.60 | $1,119.43 | 9.0× |
| Parathyroid Planar Imaging (78070) | $1,938.76 | $2,769.65 | 4.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,007.30 | $2,867.57 | 5.0× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$456.12–$912.24 | $651.60–$1,303.20 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$5,982.35–$6,161.83 | $8,546.22–$8,802.61 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$5,777.74–$5,951.08 | $8,253.92–$8,501.54 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$1,442.39–$1,485.67 | $2,060.56–$2,122.38 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$810.50–$834.81 | $1,157.85–$1,192.59 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $770.76 | $1,101.09 | 1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$663.87–$683.78 | $948.38–$976.83 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$526.72–$542.52 | $752.46–$775.03 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$529.47–$545.36 | $756.39–$779.08 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$788.47–$812.12 | $1,126.38–$1,160.17 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$477.23–$491.55 | $681.76–$702.21 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$602.45–$620.52 | $860.64–$886.46 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$708.61–$2,164.69 | $1,012.30–$3,092.42 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$422.07–$444.09 | $602.96–$634.42 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$788.47–$812.12 | $1,126.38–$1,160.17 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$701.11–$722.15 | $1,001.59–$1,031.64 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$561.97–$578.83 | $802.82–$826.90 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$701.11–$722.15 | $1,001.59–$1,031.64 | varies |
| Radex Spine 1 View Specify Level (72020) | $418.90 | $598.43 | 4.8× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$593.64–$611.45 | $848.06–$873.50 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$902.02–$1,751.50 | $1,288.60–$2,502.14 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$526.72–$542.52 | $752.46–$775.03 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$461.85–$475.71 | $659.79–$679.58 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$541.32–$557.56 | $773.32–$796.52 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $11,765.18 | $16,807.40 | 1.6× |
| Radiation treatment delivery level 1 (77402) | $821.35 | $1,173.35 | 8.0× |
| Radiation treatment delivery level 2 (77407) | $1,033.91 | $1,477.02 | 2.7× |
| Radiation treatment delivery level 3 (77412) range across 3 matching MRF lines |
$1,210.16–$2,420.32 | $1,728.80–$3,457.60 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$904.88–$932.03 | $1,292.69–$1,331.47 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$1,813.06–$1,867.45 | $2,590.09–$2,667.79 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$1,215.44–$1,251.90 | $1,736.34–$1,788.43 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$805.07–$829.22 | $1,150.10–$1,184.60 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$744.79–$767.14 | $1,063.99–$1,095.91 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$875.75–$902.02 | $1,251.07–$1,288.60 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$1,077.83–$1,110.17 | $1,539.76–$1,585.95 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$874.67–$900.91 | $1,249.53–$1,287.02 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$1,236.48–$1,273.57 | $1,766.40–$1,819.39 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$503.77–$518.88 | $719.67–$741.26 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$528.78–$1,057.56 | $755.40–$1,510.80 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$526.72–$542.52 | $752.46–$775.03 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $1,341.56 | $1,916.52 | 12.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$526.72–$1,053.44 | $752.46–$1,504.92 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$1,087.55–$2,111.75 | $1,553.64–$3,016.78 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$2,447.87–$2,521.30 | $3,496.95–$3,601.86 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$302.10–$1,572.17 | $431.57–$2,245.96 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$541.32–$557.56 | $773.32–$796.52 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 4 matching MRF lines |
$55.84–$83.67 | $79.77–$119.53 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$477.23–$491.55 | $681.76–$702.21 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$1,563.17–$1,610.06 | $2,233.10–$2,300.09 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$683.98–$704.50 | $977.12–$1,006.43 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$1,399.63–$1,441.62 | $1,999.47–$2,059.45 | varies |
| Special treatment procedure (77470) range across 4 matching MRF lines |
$620.06–$3,756.26 | $885.80–$5,366.08 | varies |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$12,578.85–$12,956.22 | $17,969.79–$18,508.88 | varies |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$680.93–$701.35 | $972.75–$1,001.93 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,239.48 | $3,199.26 | 6.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $2,011.48 | $2,873.54 | 5.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 3 matching MRF lines |
$957.49–$2,824.70 | $1,367.84–$4,035.29 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 3 matching MRF lines |
$532.10–$1,419.80 | $760.14–$2,028.28 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$641.61–$660.86 | $916.58–$944.08 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$843.70–$869.01 | $1,205.28–$1,241.44 | varies |
| Thoracolumbar 2 views (72080) | $681.10 | $973 | 7.8× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$2,072.53–$2,134.70 | $2,960.75–$3,049.57 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$1,673.55–$1,723.75 | $2,390.78–$2,462.50 | varies |
| Tx Devices Design & Construction Complex (77334) range across 3 matching MRF lines |
$388.62–$1,697.75 | $555.17–$2,425.36 | varies |
| Tx devices design & construction intermediate (77333) range across 3 matching MRF lines |
$455–$910 | $650–$1,300 | varies |
| Tx devices design & construction simple (77332) range across 3 matching MRF lines |
$144.92–$939.20 | $207.03–$1,341.72 | varies |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$846.60–$1,747.98 | $1,209.43–$2,497.12 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$1,147.29–$1,181.71 | $1,638.99–$1,688.16 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$1,193.10–$1,228.89 | $1,704.43–$1,755.56 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$819.14–$843.72 | $1,170.20–$1,205.31 | varies |
| Unlisted magnetic resonance procedure (76498) | $1,217.24 | $1,738.91 | 14.0× |
| Unlisted us procedure (76999) | $876.44 | $1,252.05 | 10.1× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$1,292.62–$1,331.40 | $1,846.60–$1,902 | varies |
| Urethrocystogram voiding (74455) | $1,147.29 | $1,638.98 | 4.8× |
| Us breast unilateral complete (76641) | $872 | $1,245.71 | 8.3× |
| Us chest (76604) range across 2 matching MRF lines |
$1,384.87–$1,426.41 | $1,978.38–$2,037.73 | varies |
| Us complete joint (76881) | $1,113.48 | $1,590.68 | 10.6× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$986.20–$1,015.78 | $1,408.85–$1,451.12 | varies |
| Us head (76506) range across 2 matching MRF lines |
$927.99–$955.83 | $1,325.70–$1,365.47 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$698.75–$719.71 | $998.21–$1,028.16 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$1,412.25–$1,454.62 | $2,017.50–$2,078.03 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$986.20–$1,015.78 | $1,408.85–$1,451.12 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$1,117.07–$1,150.58 | $1,595.82–$1,643.69 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$1,238.77–$1,275.93 | $1,769.67–$1,822.76 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$1,725.10–$1,776.85 | $2,464.43–$2,538.36 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$1,185.84–$1,221.41 | $1,694.05–$1,744.87 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$1,494.02–$1,538.84 | $2,134.31–$2,198.34 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$1,215.14–$1,251.59 | $1,735.91–$1,787.99 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$1,264.63–$1,302.57 | $1,806.61–$1,860.81 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$1,617.55–$1,666.07 | $2,310.78–$2,380.10 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$1,126.10–$1,159.89 | $1,608.72–$1,656.98 | varies |
| Us transrectal (76872) range across 6 matching MRF lines |
$194.82–$1,420.35 | $278.31–$2,029.07 | varies |
| Venography caval inferior serialography rs&i (75825) | $2,127.09 | $3,038.70 | 0.7× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$1,973.58–$2,127.09 | $2,819.40–$3,038.70 | varies |
| Venography extremity unilateral rs&i (75820) | $3,031.67 | $4,330.95 | 1.9× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$510.20–$1,018.78 | $728.85–$1,455.40 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$537.87–$1,044.41 | $768.39–$1,492.02 | varies |
| X-ray antegrade pyelogram tube (74425) | $1,156.41 | $1,652.02 | 3.3× |
| X-Ray Aorta Leg Arteries (75630) range across 7 matching MRF lines |
$4,593.20–$21,123.70 | $6,561.72–$30,176.71 | varies |
| X-Ray Bend Only L-S Spine (72120) | $830.09 | $1,185.84 | 7.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$494.75–$509.59 | $706.78–$727.98 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$1,171.91–$1,207.07 | $1,674.16–$1,724.38 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$812.34–$836.70 | $1,160.48–$1,195.29 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$852.41–$877.98 | $1,217.73–$1,254.26 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $970.64 | $1,386.63 | 9.3× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$390.87–$402.59 | $558.38–$575.13 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$475.62–$951.23 | $679.45–$1,358.90 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$660.88–$680.71 | $944.12–$972.44 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$706.40–$1,371.65 | $1,009.14–$1,959.50 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $799.12 | $1,141.60 | 7.6× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$1,160.82–$1,195.65 | $1,658.32–$1,708.07 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$705.17–$726.33 | $1,007.39–$1,037.61 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$1,181.18–$1,216.61 | $1,687.40–$1,738.02 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$919.27–$946.85 | $1,313.24–$1,352.64 | varies |
| X-ray eye for foreign body (70030) | $633.36 | $904.80 | 7.3× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$513.64–$529.05 | $733.77–$755.78 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$760.78–$783.60 | $1,086.83–$1,119.43 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$803.69–$1,560.57 | $1,148.13–$2,229.38 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$679.01–$699.38 | $970.01–$999.11 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$488.62–$503.28 | $698.03–$718.97 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$1,160.82–$1,195.65 | $1,658.32–$1,708.07 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$875.75–$902.02 | $1,251.07–$1,288.60 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$544.15–$560.48 | $777.36–$800.68 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$875.75–$902.02 | $1,251.07–$1,288.60 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$875.75–$902.02 | $1,251.07–$1,288.60 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$701.11–$722.15 | $1,001.59–$1,031.64 | varies |
| X-Ray Stress View (77071) | $806.76 | $1,152.52 | 9.3× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$1,006.54–$1,036.74 | $1,437.92–$1,481.06 | varies |
| X-Ray Tmj Unilat (70328) | $722.15 | $1,031.64 | 8.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $582.79 | $832.55 | 1.7× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$614.07–$632.49 | $877.24–$903.56 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$1,363.99–$1,404.91 | $1,948.55–$2,007.01 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$875.75–$902.02 | $1,251.07–$1,288.60 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$701.11–$722.15 | $1,001.59–$1,031.64 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$875.75–$902.02 | $1,251.07–$1,288.60 | 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.