Imaging prices at Princeton Community Hospital
Princeton, WV · every code in this section with a posted price and a Medicare benchmark.
263 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 |
$825–$887 | $1,650–$1,774 | varies |
| Abdomen 1 View (74018) | $213 | $426 | 2.6× |
| Abdomen 2 views (74019) | $213 | $426 | 2.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$1,063.50–$1,143.50 | $2,127–$2,287 | varies |
| Angiography extremity bilateral rs&i (75716) | $5,676.50 | $11,353 | 1.9× |
| Angiography extremity unilateral rs&i (75710) | $5,676.50 | $11,353 | 1.9× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$194–$209 | $388–$418 | varies |
| Basic radiation dosimetry calculation (77300) range across 5 matching MRF lines |
$154–$2,127 | $308–$4,254 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$322.50–$355 | $645–$710 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$245.50–$264 | $491–$528 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$1,063.50–$1,130.50 | $2,127–$2,261 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,063.50–$1,143.50 | $2,127–$2,287 | varies |
| Bone survey infant (77076) | $322.50 | $645 | 3.2× |
| Brain Flow Imaging Only (78610) | $603 | $1,206 | 1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,633 | $9,266 | 3.4× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$193.50–$387 | $387–$774 | varies |
| Chest 2 views (71046) | $193.50 | $387 | 2.3× |
| Chest 4 or more views (71048) | $65.50 | $131 | 0.7× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$54–$108 | $108–$216 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $120 | $240 | 1.2× |
| Continuing medical physics consltj pr wk (77336) range across 4 matching MRF lines |
$87.50–$709 | $175–$1,418 | varies |
| Contrast Exam Abdominl Aorta (75625) | $5,676.50 | $11,353 | 1.9× |
| Contrast X-Ray Bladder (74430) | $719 | $1,438 | 2.1× |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$2,029.50–$2,182 | $4,059–$4,364 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$1,593–$1,712.50 | $3,186–$3,425 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,395.50–$1,500.50 | $2,791–$3,001 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,395.50–$1,500.50 | $2,791–$3,001 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$662–$712 | $1,324–$1,424 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$2,029.50–$2,182 | $4,059–$4,364 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,395.50–$1,500.50 | $2,791–$3,001 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,395.50–$1,500.50 | $2,791–$3,001 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$219–$235.50 | $438–$471 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$109.50–$2,791 | $219–$5,582 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,395.50–$1,500.50 | $2,791–$3,001 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,395.50–$1,500.50 | $2,791–$3,001 | varies |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $1,578 | $3,156 | 9.4× |
| CT cervical spine w/ contrast (72126) | $2,029.50 | $4,059 | 6.1× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$662–$712 | $1,324–$1,424 | varies |
| CT cervical spine w/wo cont (72127) | $1,383.50 | $2,767 | 8.2× |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$1,395.50–$1,500.50 | $2,791–$3,001 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$109.50–$118 | $219–$236 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$109.50–$118 | $219–$236 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,395.50–$1,500.50 | $2,791–$3,001 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$89.50–$99 | $179–$198 | varies |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$109.50–$118 | $219–$236 | varies |
| CT l-spine w&w/o contrast (72133) | $1,395.50 | $2,791 | 8.3× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$662–$1,424 | $1,324–$2,848 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$109.50–$219 | $219–$438 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$229–$246.50 | $458–$493 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$657–$706.50 | $1,314–$1,413 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,395.50–$1,500.50 | $2,791–$3,001 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$662–$712 | $1,324–$1,424 | varies |
| CT neck tissue combo (70492) | $109.50 | $219 | 0.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $109.50 | $219 | 0.7× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$662–$712 | $1,324–$1,424 | varies |
| CT pelvis w&w/o contrast (72194) | $1,395.50 | $2,791 | 8.3× |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$662–$712 | $1,324–$1,424 | varies |
| CT scan of leg combo (73702) | $109.50 | $219 | 0.7× |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,395.50–$1,500.50 | $2,791–$3,001 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,395.50–$1,500.50 | $2,791–$3,001 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$662–$712 | $1,324–$1,424 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$109.50–$118 | $219–$236 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$657–$706.50 | $1,314–$1,413 | varies |
| CT thoracic spine w/wo cont (72130) | $1,383.50 | $2,767 | 8.2× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$662–$712 | $1,324–$1,424 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$662–$712 | $1,324–$1,424 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,395.50 | $2,791 | 8.3× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$2,029.50–$2,182 | $4,059–$4,364 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$1,383.50–$2,767 | $2,767–$5,534 | varies |
| Cta Abdomen (74175) | $109.50 | $219 | 0.7× |
| Diskography lumbar (72295) | $2,197 | $4,394 | 1.2× |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$322.50–$694 | $645–$1,388 | varies |
| Dxa bone density study (77085) | $627.50 | $1,255 | 6.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $172.50 | $345 | 2.1× |
| Esophagram (74220) range across 2 matching MRF lines |
$354–$381 | $708–$762 | varies |
| Fetal Biophys Profile W/Nst (76818) | $363 | $726 | 3.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$558–$1,116 | $1,116–$2,232 | varies |
| Fluoroscopy up to 1 hr (76000) | $692 | $1,384 | 3.0× |
| Foot 2 views (73620) | $194 | $388 | 2.3× |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$194–$388 | $388–$776 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,063.50–$1,143.50 | $2,127–$2,287 | varies |
| Gated Heart Planar Single (78472) | $264 | $528 | 0.7× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$194–$209 | $388–$418 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,410.50–$1,516.50 | $2,821–$3,033 | varies |
| Hepatobiliary System Imaging (78226) | $245.50 | $491 | 0.6× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$1,235.50–$1,359.50 | $2,471–$2,719 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$335–$368.50 | $670–$737 | varies |
| K Flow/Funct Image W/Drug (78708) | $1,410.50 | $2,821 | 2.7× |
| K Flow/Funct Image W/O Drug (78707) range across 3 matching MRF lines |
$1,410.50–$1,552 | $2,821–$3,104 | varies |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$194–$418 | $388–$836 | varies |
| Lung perfusion differential (78597) | $1,063.50 | $2,127 | 2.8× |
| Lung Ventilat&Perfus Imaging (78582) | $322 | $644 | 0.6× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,410.50–$1,516.50 | $2,821–$3,033 | varies |
| Magnetic Image Jaw Joint (70336) | $1,690.50 | $3,381 | 7.4× |
| Meckels Divert Exam (78290) | $1,063.50 | $2,127 | 2.8× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$220–$236.50 | $440–$473 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$2,757–$2,964 | $5,514–$5,928 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,674.50–$1,800.50 | $3,349–$3,601 | varies |
| MRA head with contrast (70545) | $2,757 | $5,514 | 8.2× |
| MRA neck w contrast (70548) | $2,757 | $5,514 | 8.2× |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$2,757–$2,964 | $5,514–$5,928 | varies |
| MRA neck w/o contrast (70547) | $1,674.50 | $3,349 | 7.3× |
| MRI abdomen w contrast (74182) | $2,783.50 | $5,567 | 8.3× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,690.50–$1,817.50 | $3,381–$3,635 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,783.50–$2,992.50 | $5,567–$5,985 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,783.50–$2,992.50 | $5,567–$5,985 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,783.50–$2,992.50 | $5,567–$5,985 | varies |
| MRI cervical spine w contrast (72142) | $2,757 | $5,514 | 8.2× |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$1,674.50–$1,800.50 | $3,349–$3,601 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$1,690.50–$1,817.50 | $3,381–$3,635 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$2,783.50–$2,992.50 | $5,567–$5,985 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,783.50–$2,992.50 | $5,567–$5,985 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,690.50–$1,817.50 | $3,381–$3,635 | varies |
| MRI lumbar spine w contrast (72149) | $2,783.50 | $5,567 | 8.3× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$2,757–$2,964 | $5,514–$5,928 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $1,674.50 | $3,349 | 7.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$2,757–$2,964 | $5,514–$5,928 | varies |
| MRI pelvis w contrast (72196) | $2,783.50 | $5,567 | 8.3× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$2,783.50–$2,992.50 | $5,567–$5,985 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,690.50–$1,817.50 | $3,381–$3,635 | varies |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$1,690.50–$1,817.50 | $3,381–$3,635 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$1,690.50–$3,381 | $3,381–$6,762 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$2,783.50–$2,992.50 | $5,567–$5,985 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$2,783.50–$2,992.50 | $5,567–$5,985 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$2,783.50–$2,992.50 | $5,567–$5,985 | varies |
| MRI, dorsal spine contrast (72147) | $2,783.50 | $5,567 | 8.3× |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$1,690.50–$3,635 | $3,381–$7,270 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$229–$246.50 | $458–$493 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$2,783.50–$2,992.50 | $5,567–$5,985 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$3,543–$3,809 | $7,086–$7,618 | varies |
| N-invas est c ffr sw aly CTA (75580) | $2,287.50 | $4,575 | 2.8× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$54–$58.50 | $108–$117 | varies |
| Nonvascular Shunt X-Ray (75809) | $119.50 | $239 | 1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$825–$887 | $1,650–$1,774 | varies |
| Nuclear Rx Oral Admin (79005) | $935 | $1,870 | 4.2× |
| Parathyroid Planar Imaging (78070) | $1,063.50 | $2,127 | 2.8× |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$1,063.50–$1,143.50 | $2,127–$2,287 | varies |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$322.50–$347 | $645–$694 | varies |
| Peritoneogram Rs&I (74190) | $663.50 | $1,327 | 1.3× |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$4,633–$4,980.50 | $9,266–$9,961 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$4,633–$4,980.50 | $9,266–$9,961 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,063.50 | $2,127 | 2.8× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) | $1,069.50 | $2,139 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$354–$381 | $708–$762 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$194–$388 | $388–$776 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$54–$58.50 | $108–$117 | varies |
| Radex elbow complete minimum 3 views (73080) | $194 | $388 | 2.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$65.50–$121 | $131–$242 | varies |
| Radex fingr minimum 2 views (73140) | $194 | $388 | 2.3× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$194–$388 | $388–$776 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$194–$388 | $388–$776 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $194 | $388 | 2.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $319.50 | $639 | 3.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$54–$58.50 | $108–$117 | varies |
| Radex Ribs Unilateral 2 Views (71100) | $194 | $388 | 2.3× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$194–$388 | $388–$776 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $194 | $388 | 2.3× |
| Radex Spine 1 View Specify Level (72020) | $194 | $388 | 2.3× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$194–$209 | $388–$418 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$54–$58.50 | $108–$117 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$54–$100.50 | $108–$201 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$319.50–$639 | $639–$1,278 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$194–$388 | $388–$776 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $221 | $442 | 2.2× |
| Radiation treatment delivery level 1 (77402) | $377 | $754 | 3.9× |
| Radiation treatment delivery level 2 (77407) | $377 | $754 | 1.0× |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$160–$635 | $320–$1,270 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$65.50–$70.50 | $131–$141 | varies |
| Radiologic exam colon double contrast study (74280) | $668.50 | $1,337 | 4.0× |
| Radiologic exam colon single contrast study (74270) | $354 | $708 | 2.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$354–$381 | $708–$762 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$322.50–$645 | $645–$1,290 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $322.50 | $645 | 3.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $354 | $708 | 2.1× |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$354–$381 | $708–$762 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$354–$381 | $708–$762 | varies |
| Radiologic examination femur 1 view (73551) | $194 | $388 | 2.3× |
| Radiologic examination femur minimum 2 views (73552) | $194 | $388 | 2.3× |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$194–$418 | $388–$836 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$194–$388 | $388–$776 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$322.50–$347 | $645–$694 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,543 | $7,086 | 6.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,543 | $7,086 | 6.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$845.50–$909 | $1,691–$1,818 | varies |
| Scapula (73010) range across 4 matching MRF lines |
$65.50–$131 | $131–$262 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$29–$63 | $58–$126 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$194–$388 | $388–$776 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$322.50–$347 | $645–$694 | varies |
| Special dosimetry (77331) | $87.50 | $175 | 0.7× |
| Special teletherapy port plan (77321) | $220 | $440 | 0.6× |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$350.50–$377 | $701–$754 | varies |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$1,674–$1,800 | $3,348–$3,600 | varies |
| Sternoclavicular joints (71130) | $194 | $388 | 2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$357–$384 | $714–$768 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 3 matching MRF lines |
$220–$236.50 | $440–$473 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$81–$87.50 | $162–$175 | varies |
| Thoracic spine 2 views (72070) | $322.50 | $645 | 3.2× |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$65.50–$121 | $131–$242 | varies |
| Thoracolumbar 2 views (72080) | $194 | $388 | 2.3× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$322–$346.50 | $644–$693 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$1,063.50–$1,143.50 | $2,127–$2,287 | varies |
| Tx Devices Design & Construction Complex (77334) range across 6 matching MRF lines |
$220–$1,320 | $440–$2,640 | varies |
| Tx devices design & construction intermediate (77333) | $331.50 | $663 | 2.6× |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$81–$87.50 | $162–$175 | varies |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$335–$670 | $670–$1,340 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$558–$600 | $1,116–$1,200 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$558–$600 | $1,116–$1,200 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$354–$381 | $708–$762 | varies |
| Urethrocystogram voiding (74455) | $1,224.50 | $2,449 | 5.3× |
| Us breast unilateral complete (76641) range across 7 matching MRF lines |
$65.50–$670 | $131–$1,340 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$335–$360.50 | $670–$721 | varies |
| Us exam, pelvic, limited (76857) | $335 | $670 | 3.3× |
| Us head (76506) range across 2 matching MRF lines |
$332.50–$366 | $665–$732 | varies |
| Us kidney transplant (76776) | $558 | $1,116 | 5.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$335–$670 | $670–$1,340 | varies |
| Us ob limited 1 or more fetuses (76815) | $558 | $1,116 | 5.6× |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$558–$600 | $1,116–$1,200 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$558–$600 | $1,116–$1,200 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $558 | $1,116 | 5.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$335–$360.50 | $670–$721 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$558–$600 | $1,116–$1,200 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$558–$600 | $1,116–$1,200 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$437.50–$600 | $875–$1,200 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$335–$368.50 | $670–$737 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$558–$600 | $1,116–$1,200 | varies |
| Venography caval inferior serialography rs&i (75825) | $6,102.50 | $12,205 | 2.0× |
| Venography extremity unilateral rs&i (75820) | $1,591 | $3,182 | 1.1× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$54–$58.50 | $108–$117 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $209 | $418 | 2.5× |
| X-Ray Aorta Leg Arteries (75630) | $6,102.50 | $12,205 | 2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$194–$209 | $388–$418 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$1,110–$1,193.50 | $2,220–$2,387 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $194 | $388 | 2.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$322.50–$347 | $645–$694 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $227 | $454 | 2.3× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$54–$58.50 | $108–$117 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $194 | $388 | 2.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $197 | $394 | 2.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $190 | $380 | 1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $322.50 | $645 | 3.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $200.50 | $401 | 2.0× |
| X-Ray Exam L-S Spine Bending (72114) | $322.50 | $645 | 3.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $322.50 | $645 | 3.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$65.50–$70.50 | $131–$141 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) | $322.50 | $645 | 3.2× |
| X-ray eye for foreign body (70030) | $211.50 | $423 | 2.5× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$194–$388 | $388–$776 | varies |
| X-ray IV pyelogram (ivp) (74400) | $668.50 | $1,337 | 4.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$54–$58.50 | $108–$117 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $322.50 | $645 | 3.2× |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$668.50–$735.50 | $1,337–$1,471 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$65.50–$70.50 | $131–$141 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$65.50–$121 | $131–$242 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$194–$209 | $388–$418 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$54–$58.50 | $108–$117 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$65.50–$70.50 | $131–$141 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$326.50–$351 | $653–$702 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$1,224.50–$1,316.50 | $2,449–$2,633 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$65.50–$70.50 | $131–$141 | varies |
| X-Rays Bone Survey Complete (77075) | $65.50 | $131 | 0.7× |
| Xr c-spine 4 or 5 views (72050) | $322.50 | $645 | 3.2× |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$194–$209 | $388–$418 | varies |
| Xr orbits complete 4 views (70200) | $322.50 | $645 | 3.2× |
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.