Imaging prices at Providence Queen of the Valley Medical Center
Napa, CA · every code in this section with a posted price and a Medicare benchmark.
315 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) | $4,796.55 | $9,405 | 2.4× |
| Abdomen 1 View (74018) | $144.33 | $283 | 1.2× |
| Abdomen 2 views (74019) | $244.80 | $480 | 1.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,434.63 | $2,813 | 2.5× |
| Angio pulmonary bilat (75743) | $4,628.76 | $9,076 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $5,884.89 | $11,539 | 1.3× |
| Angiography extremity unilateral rs&i (75710) | $5,884.89 | $11,539 | 1.3× |
| Ankle 2 views (73600) | $118.32 | $232 | 1.0× |
| Aortography thoracic serialography rs&i (75605) | $9,803.73 | $19,223 | 1.2× |
| Aortography thoracic w/o serialography rs&i (75600) | $4,627.74 | $9,074 | 1.0× |
| Artery X-Rays Abdomen (75726) | $9,803.73 | $19,223 | 1.2× |
| Artery X-Rays Adrenal Gland (75731) | $4,624.68 | $9,068 | 1.0× |
| Artery X-Rays Pelvis (75736) | $7,949.88 | $15,588 | 1.0× |
| Arthrogram hip (73525) | $2,628.54 | $5,154 | 5.3× |
| Arthrogram Wrist (73115) | $833.34 | $1,634 | 1.7× |
| Basic radiation dosimetry calculation (77300) | $1,126.08 | $2,208 | 5.9× |
| Bone age studies (77072) | $245.82 | $482 | 1.7× |
| Bone Imaging 3 Phase (78315) | $1,297.44 | $2,544 | 2.3× |
| Bone Imaging Limited Area (78300) | $717.06 | $1,406 | 1.3× |
| Bone Imaging Multiple Areas (78305) | $927.69 | $1,819 | 1.6× |
| Bone Imaging Whole Body (78306) | $1,227.06 | $2,406 | 2.2× |
| Bone survey infant (77076) | $171.87 | $337 | 1.2× |
| Brain Image W/Flow < 4 Views (78601) | $988.38 | $1,938 | 1.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,126.59 | $2,209 | 1.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,614.59 | $11,009 | 2.8× |
| Cat Scan Follow-Up Study (76380) | $889.95 | $1,745 | 7.2× |
| Chest 1 view (71045) | $183.60 | $360 | 1.5× |
| Chest 2 views (71046) | $183.60 | $360 | 1.5× |
| Chest 3 views (71047) | $208.08 | $408 | 1.7× |
| Chest 4 or more views (71048) | $223.89 | $439 | 1.5× |
| Cholecystography Oral Contrast (74290) | $252.96 | $496 | 1.0× |
| Clavicle complete (73000) | $121.38 | $238 | 1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $642.09 | $1,259 | 4.3× |
| Continuing medical physics consltj pr wk (77336) | $1,828.35 | $3,585 | 9.6× |
| Contrast Exam Abdominl Aorta (75625) | $5,884.89 | $11,539 | 1.3× |
| Contrast X-Ray Bladder (74430) | $833.34 | $1,634 | 1.7× |
| Contrast X-Ray Of Elbow (73085) | $534.48 | $1,048 | 1.1× |
| Contrast X-Ray Of Knee Joint (73580) | $556.41 | $1,091 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) | $2,552.04 | $5,004 | 5.2× |
| CT abdomen and pelvis without contrast (74176) | $1,011.33 | $1,983 | 3.0× |
| CT abdomen w contrast (74160) | $1,892.61 | $3,711 | 7.6× |
| CT abdomen w wo contrast (74170) | $2,343.45 | $4,595 | 9.4× |
| CT abdomen w/o contrast (74150) | $1,568.76 | $3,076 | 10.6× |
| CT Angio Abdomen and Pelvis (74174) | $3,640.89 | $7,139 | 7.4× |
| CT Angio Chest (71275) | $2,492.37 | $4,887 | 10.0× |
| CT Angio Head (70496) | $1,563.15 | $3,065 | 6.3× |
| CT angio hrt w/3d image (75574) | $1,993.59 | $3,909 | 4.0× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,103.24 | $4,124 | 8.4× |
| CT Angio Neck (70498) | $1,563.15 | $3,065 | 6.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,103.24 | $4,124 | 8.4× |
| CT cervical spine w/ contrast (72126) | $1,500.93 | $2,943 | 3.0× |
| CT cervical spine w/o contrast (72125) | $1,255.11 | $2,461 | 8.5× |
| CT cervical spine w/wo cont (72127) | $1,870.17 | $3,667 | 7.5× |
| CT chest w contrast (71260) | $1,957.38 | $3,838 | 7.9× |
| CT chest w/wo contrast (71270) | $2,439.33 | $4,783 | 9.8× |
| CT head/brain with contrast (70460) | $1,204.11 | $2,361 | 4.8× |
| CT head/brain without and with contrast (70470) | $1,501.44 | $2,944 | 6.0× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,316.31 | $2,581 | 2.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $334.05 | $655 | 2.7× |
| CT iac w contrast (70481) | $1,206.66 | $2,366 | 4.8× |
| CT l-spine w&w/o contrast (72133) | $2,438.31 | $4,781 | 9.8× |
| CT lower ext w/o (73700) | $1,375.47 | $2,697 | 9.3× |
| CT lower extremity w/contrast material (73701) | $1,635.57 | $3,207 | 6.6× |
| CT lumbar spine w contrast (72132) | $1,956.87 | $3,837 | 4.0× |
| CT lumbar spine w/o contrast (72131) | $1,635.57 | $3,207 | 11.0× |
| CT maxillofacial w contrast (70487) | $1,206.66 | $2,366 | 4.8× |
| CT maxillofacial wo contrast (70486) | $1,006.23 | $1,973 | 6.8× |
| CT neck tissue combo (70492) | $1,982.37 | $3,887 | 8.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,504.50 | $2,950 | 6.0× |
| CT orbits w/o contrast (70480) | $1,009.29 | $1,979 | 6.8× |
| CT pelvis w&w/o contrast (72194) | $2,140.47 | $4,197 | 8.6× |
| CT pelvis w/o contrast (72192) | $1,634.55 | $3,205 | 11.0× |
| CT scan of leg combo (73702) | $2,053.77 | $4,027 | 8.2× |
| CT scans face/jaw combo (70488) | $1,503.99 | $2,949 | 6.0× |
| CT soft tissue neck w contrast (70491) | $1,206.66 | $2,366 | 4.8× |
| CT soft tissue neck w/o contrast (70490) | $1,009.29 | $1,979 | 6.8× |
| CT thoracic spine w contrast (72129) | $1,956.87 | $3,837 | 7.9× |
| CT thoracic spine w/o contrast (72128) | $1,635.57 | $3,207 | 11.0× |
| CT thoracic spine w/wo cont (72130) | $2,438.31 | $4,781 | 9.8× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,495.83–$1,635.57 | $2,933–$3,207 | varies |
| CT upper ext wo (73200) | $1,375.47 | $2,697 | 9.3× |
| CT upper extremity w/o & w/contrast material (73202) | $2,053.77 | $4,027 | 8.2× |
| CT upper extremity with contrast (73201) | $1,635.57 | $3,207 | 3.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,394.96 | $4,696 | 9.6× |
| Cta Abdomen (74175) | $2,394.96 | $4,696 | 9.6× |
| CTA pelvis (72191) | $2,394.96 | $4,696 | 9.6× |
| Dxa Bone Density Axial (77080) | $662.49 | $1,299 | 4.5× |
| Dxa bone density study (77085) | $522.24 | $1,024 | 3.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $352.41 | $691 | 2.9× |
| Echo Guide For Artery Repair (76936) | $917.49 | $1,799 | 3.0× |
| Echograp Trans R Pros Study (76873) | $666.57 | $1,307 | 4.5× |
| Esophagram (74220) | $258.06 | $506 | 1.0× |
| Fetal Biophys Profile W/Nst (76818) | $523.26 | $1,026 | 3.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $523.26 | $1,026 | 3.5× |
| Fluoroscopy up to 1 hr (76000) | $291.21 | $571 | 0.9× |
| Foot 2 views (73620) | $119.34 | $234 | 1.0× |
| Forearm 2 views (73090) | $121.38 | $238 | 1.0× |
| Gastric emptying imaging study (78264) | $1,058.25 | $2,075 | 1.9× |
| Gated Heart Planar Single (78472) | $1,413.72 | $2,772 | 2.5× |
| Hand 2 views (73120) | $245.82 | $482 | 1.7× |
| Hepatobil Syst Image W/Drug (78227) | $2,461.26 | $4,826 | 3.2× |
| Hepatobiliary System Imaging (78226) | $2,461.26 | $4,826 | 4.3× |
| Ht Muscle Image Spect Sing (78451) | $2,838.15 | $5,565 | 1.5× |
| Hysterosalpingogram (74740) | $520.20 | $1,020 | 1.5× |
| Interstitial radiation source applic complex (77778) | $2,908.02 | $5,702 | 2.9× |
| K Flow/Funct Image Multiple (78709) | $1,316.31 | $2,581 | 1.7× |
| K Flow/Funct Image W/Drug (78708) | $1,316.31 | $2,581 | 1.7× |
| K Flow/Funct Image W/O Drug (78707) | $1,306.11 | $2,561 | 1.7× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $839.97 | $1,647 | 1.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,033.77 | $2,027 | 1.8× |
| Knee 3 Views (73562) | $133.11 | $261 | 1.1× |
| Liver imaging static only (78201) | $1,525.92 | $2,992 | 2.0× |
| Lung Perf&Ventilat Diferentl (78598) | $2,205.75 | $4,325 | 2.9× |
| Lung Ventilat&Perfus Imaging (78582) | $2,281.74 | $4,474 | 3.0× |
| Lung Ventilation Imaging (78579) | $1,270.92 | $2,492 | 2.2× |
| Lymph System Imaging (78195) | $863.43 | $1,693 | 1.1× |
| Magnetic Image Jaw Joint (70336) | $2,523.99 | $4,949 | 7.5× |
| Meckels Divert Exam (78290) | $895.56 | $1,756 | 1.6× |
| Mlc imrt design & construction per imrt plan (77338) | $1,831.92 | $3,592 | 3.4× |
| Mra Head W/O & W/Contrast Material (70546) | $5,744.64 | $11,264 | 11.6× |
| MRA head w/o contrast (70544) | $2,717.28 | $5,328 | 8.0× |
| MRA head with contrast (70545) | $2,922.30 | $5,730 | 5.9× |
| MRA neck w contrast (70548) | $2,922.30 | $5,730 | 5.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,744.64 | $11,264 | 11.6× |
| MRA neck w/o contrast (70547) | $2,717.28 | $5,328 | 8.0× |
| MRI abdomen w contrast (74182) | $3,451.68 | $6,768 | 7.0× |
| MRI abdomen w/o contrast (74181) | $3,111 | $6,100 | 9.2× |
| MRI any jt lower extrem w/contrast material (73722) | $2,407.20 | $4,720 | 2.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,628.14 | $7,114 | 7.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,407.20 | $4,720 | 2.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,136.39 | $4,189 | 6.3× |
| MRI cervical spine w contrast (72142) | $8,480.79 | $16,629 | 17.1× |
| MRI cervical spine w/o cont (72141) | $2,200.65 | $4,315 | 6.5× |
| MRI chest w/o contrast (71550) | $3,111 | $6,100 | 9.2× |
| MRI chest wo w contrast (71552) | $6,983.43 | $13,693 | 14.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,845.29 | $5,579 | 5.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,989–$2,188.41 | $3,900–$4,291 | varies |
| MRI lumbar spine w contrast (72149) | $2,407.20 | $4,720 | 4.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,893.74 | $5,674 | 5.8× |
| MRI orbit face &/neck w/o contrast (70540) | $2,840.19 | $5,569 | 8.4× |
| MRI orbit face neck w contrast (70542) | $3,462.39 | $6,789 | 7.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $6,410.70 | $12,570 | 12.9× |
| MRI pelvis w contrast (72196) | $3,277.26 | $6,426 | 6.6× |
| MRI pelvis w/o & w contrast (72197) | $7,025.76 | $13,776 | 14.2× |
| MRI pelvis w/o contrast (72195) | $3,171.18 | $6,218 | 9.4× |
| MRI thoracic spine w/o contrast (72146) | $2,333.76 | $4,576 | 6.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,771.85 | $5,435 | 5.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,333.76 | $4,576 | 6.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,771.85 | $5,435 | 5.6× |
| MRI, abdomen, combo (74183) | $7,025.76 | $13,776 | 14.2× |
| MRI, dorsal spine combo (72157) | $3,165.57 | $6,207 | 6.4× |
| MRI, dorsal spine contrast (72147) | $3,165.57 | $6,207 | 6.4× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,121.60–$2,333.76 | $4,160–$4,576 | varies |
| MRI, joint upper extrem combo (73223) | $3,628.14 | $7,114 | 7.3× |
| MRI, lumbar spine combo (72158) | $2,771.85 | $5,435 | 5.6× |
| Myelogram cervical (72240) | $1,205.13 | $2,363 | 1.1× |
| Myelogram Lumbar (72265) | $1,035.81 | $2,031 | 0.9× |
| Myocardial Spect Multiple Studies (78452) | $3,502.17 | $6,867 | 1.9× |
| Neck soft tissue (70360) | $183.60 | $360 | 1.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $839.97 | $1,647 | 1.5× |
| Nonvascular Shunt X-Ray (75809) | $182.58 | $358 | 1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,750.25 | $11,275 | 2.9× |
| Nuclear Rx Intra-Arterial (79445) | $1,013.88 | $1,988 | 3.1× |
| Nuclear Rx Oral Admin (79005) | $4,622.64 | $9,064 | 14.0× |
| Optic foramina (70190) | $144.33 | $283 | 1.2× |
| Parathyroid Planar Imaging (78070) | $839.97 | $1,647 | 1.5× |
| Pelvis 1 or 2 views (72170) | $245.82 | $482 | 1.7× |
| Pet Image Skull-Thigh (78812) | $2,504.10 | $4,910 | 1.2× |
| Pet Image W/Ct Lmtd (78814) | $2,145.57 | $4,207 | 1.1× |
| PET image w/CT, full body (78816) | $8,756.19 | $17,169 | 4.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $7,356.75 | $14,425 | 3.6× |
| PET whole body (78813) | $3,525.12 | $6,912 | 1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $904.23 | $1,773 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $258.06 | $506 | 1.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,092.42 | $2,142 | 1.4× |
| Radex Ankle Complete Minimum 3 Views (73610) | $137.19 | $269 | 1.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $109.65 | $215 | 0.9× |
| Radex elbow complete minimum 3 views (73080) | $133.11 | $261 | 1.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $183.09 | $359 | 1.2× |
| Radex fingr minimum 2 views (73140) | $183.09 | $359 | 1.5× |
| Radex foot complete minimum 3 views (73630) | $122.91 | $241 | 1.0× |
| Radex Hand Minimum 3 Views (73130) | $122.91 | $241 | 1.0× |
| Radex lower extremity infant minimum 2 views (73592) | $129.03 | $253 | 1.0× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $183.60 | $360 | 1.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $121.38 | $238 | 1.0× |
| Radex Ribs Unilateral 2 Views (71100) | $133.62 | $262 | 1.1× |
| Radex shoulder complete minimum 2 views (73030) | $133.11 | $261 | 1.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $143.82 | $282 | 1.2× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $303.96 | $596 | 1.2× |
| Radex Spine 1 View Specify Level (72020) | $183.60 | $360 | 1.5× |
| Radex Sternum Minimum 2 Views (71120) | $150.45 | $295 | 1.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $194.82 | $382 | 1.6× |
| Radex Toe Minimum 2 Views (73660) | $183.60 | $360 | 1.5× |
| Radex upper extremity infant minimum 2 views (73092) | $245.82 | $482 | 1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $142.80 | $280 | 1.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $15,769.71 | $30,921 | 1.5× |
| Radiation treatment delivery level 1 (77402) | $955.23 | $1,873 | 6.6× |
| Radiation treatment delivery level 2 (77407) | $1,742.67 | $3,417 | 3.2× |
| Radiation treatment delivery level 3 (77412) | $1,742.67 | $3,417 | 2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $245.82 | $482 | 1.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $258.06 | $506 | 1.7× |
| Radiologic exam colon double contrast study (74280) | $448.80 | $880 | 1.8× |
| Radiologic exam colon single contrast study (74270) | $384.54 | $754 | 1.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,076.10 | $2,110 | 4.3× |
| Radiologic exam knee complete 4/more views (73564) | $245.82 | $482 | 1.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $245.82 | $482 | 1.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $302.43 | $593 | 1.2× |
| Radiologic exam swallow function contrast study (74230) | $302.94 | $594 | 1.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $383.52 | $752 | 1.5× |
| Radiologic examination femur 1 view (73551) | $163.71 | $321 | 1.3× |
| Radiologic examination femur minimum 2 views (73552) | $285.60 | $560 | 2.3× |
| Radiologic examination knee 1/2 views (73560) | $120.87 | $237 | 1.0× |
| Radiologic examination tibia & fibula 2 views (73590) | $187.17 | $367 | 1.5× |
| Ribs bilateral 3 views (71110) | $183.60 | $360 | 1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,235.73 | $2,423 | 2.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,910.06 | $5,706 | 3.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,910.06 | $5,706 | 3.8× |
| Rp Therapy Intravenous Administration (79101) | $361.08 | $708 | 1.1× |
| Scapula (73010) | $245.82 | $482 | 1.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $61.20 | $120 | 2.6× |
| Shoulder 1 view (73020) | $110.16 | $216 | 0.9× |
| Shoulder Arthrography (73040) | $534.48 | $1,048 | 1.1× |
| Skull less than 4 views (70250) | $245.82 | $482 | 1.7× |
| Special dosimetry (77331) | $458.49 | $899 | 2.4× |
| Special Physics Consult (77370) | $683.91 | $1,341 | 3.6× |
| Special teletherapy port plan (77321) | $993.99 | $1,949 | 1.9× |
| Special treatment procedure (77470) | $2,097.63 | $4,113 | 2.7× |
| Stereotactic Body Radiation Delivery (77373) | $4,855.71 | $9,521 | 1.9× |
| Sternoclavicular joints (71130) | $162.18 | $318 | 1.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $7,259.85 | $14,235 | 13.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $3,593.97 | $7,047 | 6.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $4,411.50 | $8,650 | 8.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $3,363.45 | $6,595 | 6.3× |
| Ther rad simulaj-aided field setting simple (77280) | $1,374.96 | $2,696 | 7.2× |
| Thoracic spine 2 views (72070) | $150.45 | $295 | 1.0× |
| Thoracic spine 3 views (72072) | $171.87 | $337 | 1.2× |
| Thoracolumbar 2 views (72080) | $155.55 | $305 | 1.3× |
| Thyroid Imaging With Vascular Flow (78013) | $1,144.44 | $2,244 | 2.0× |
| Thyroid Met Imaging Body (78018) | $1,392.81 | $2,731 | 1.8× |
| Thyroid Uptake Measurement (78012) | $839.97 | $1,647 | 1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,610.58 | $3,158 | 2.8× |
| Tx Devices Design & Construction Complex (77334) | $2,435.25 | $4,775 | 4.6× |
| Tx devices design & construction intermediate (77333) | $1,285.71 | $2,521 | 6.7× |
| Tx devices design & construction simple (77332) | $914.43 | $1,793 | 4.8× |
| Ultrasound Breast Limited (76642) | $596.19 | $1,169 | 4.8× |
| Ultrasound Elastography Parenchyma (76981) | $381.99 | $749 | 2.6× |
| Ultrasound Exam Aaa Screen (76706) | $728.79 | $1,429 | 4.9× |
| Ultrasound, abdomen limited (76705) | $452.88 | $888 | 3.1× |
| Unlisted magnetic resonance procedure (76498) | $293.25 | $575 | 2.4× |
| Unlisted us procedure (76999) | $526.83 | $1,033 | 4.3× |
| Upper gi w/o kub (74240) | $340.17 | $667 | 1.4× |
| Urethrocystogram voiding (74455) | $355.98 | $698 | 1.1× |
| Urethrocystography retrograde (74450) | $337.62 | $662 | 1.0× |
| Us breast unilateral complete (76641) | $712.98 | $1,398 | 4.8× |
| Us chest (76604) | $415.65 | $815 | 2.8× |
| Us complete joint (76881) | $753.78 | $1,478 | 5.1× |
| Us exam, pelvic, limited (76857) | $337.11 | $661 | 2.3× |
| Us head (76506) | $390.66 | $766 | 2.6× |
| Us kidney transplant (76776) | $596.19 | $1,169 | 4.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $188.70 | $370 | 1.3× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$366.18–$434.01 | $718–$851 | varies |
| Us ob transvaginal (76817) | $499.29 | $979 | 3.4× |
| Us pelvic non ob complete (76856) | $488.58 | $958 | 3.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $349.86 | $686 | 2.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $306.51 | $601 | 2.1× |
| Us retroperitoneal complete (76770) | $629.34 | $1,234 | 4.2× |
| Us retroperitoneal limited (76775) | $452.88 | $888 | 3.1× |
| Us scrotum and contents (76870) | $438.09 | $859 | 3.0× |
| Us spinal canal and contents (76800) | $458.49 | $899 | 3.1× |
| Us thyroid (76536) | $452.88 | $888 | 3.1× |
| Us transrectal (76872) | $434.01 | $851 | 2.9× |
| Venography caval inferior serialography rs&i (75825) | $4,628.76 | $9,076 | 1.0× |
| Venography extremity bilateral rs&i (75822) | $1,669.74 | $3,274 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $2,266.95 | $4,445 | 1.0× |
| Wrist 2 views (73100) | $143.31 | $281 | 1.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $155.55 | $305 | 1.3× |
| X-ray antegrade pyelogram tube (74425) | $833.34 | $1,634 | 1.7× |
| X-Ray Aorta Leg Arteries (75630) | $5,884.89 | $11,539 | 1.3× |
| X-Ray Bend Only L-S Spine (72120) | $207.57 | $407 | 1.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $121.38 | $238 | 1.0× |
| X-Ray Exam Breast Specimen (76098) | $1,092.42 | $2,142 | 1.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $201.96 | $396 | 1.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $332.52 | $652 | 2.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $1,130.67 | $2,217 | 7.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $172.38 | $338 | 1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $201.96 | $396 | 1.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $315.69 | $619 | 2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $239.70 | $470 | 1.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $285.60 | $560 | 1.9× |
| X-Ray Exam L-S Spine Bending (72114) | $275.40 | $540 | 1.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $140.25 | $275 | 1.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $263.16 | $516 | 1.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $156.06 | $306 | 1.1× |
| X-ray eye for foreign body (70030) | $183.60 | $360 | 1.5× |
| X-ray humerus (73060) | $133.11 | $261 | 1.1× |
| X-ray IV pyelogram (ivp) (74400) | $390.66 | $766 | 1.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $768.57 | $1,507 | 6.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $115.26 | $226 | 0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $155.55 | $305 | 1.0× |
| X-ray nose-rectum child f.b. (76010) | $128.52 | $252 | 1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $208.08 | $408 | 1.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $245.82 | $482 | 1.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $245.82 | $482 | 1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $133.11 | $261 | 1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $183.09 | $359 | 1.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $245.82 | $482 | 1.7× |
| X-ray thoracic spine 4 vw (72074) | $211.65 | $415 | 1.4× |
| X-Ray Tmj Unilat (70328) | $115.26 | $226 | 0.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $534.48 | $1,048 | 1.1× |
| X-Rays Bone Length Studies (77073) | $183.60 | $360 | 1.2× |
| X-Rays Bone Survey Complete (77075) | $334.56 | $656 | 2.3× |
| Xr c-spine 4 or 5 views (72050) | $208.59 | $409 | 1.4× |
| Xr facial bones less than 3 views (70140) | $143.82 | $282 | 1.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $156.57 | $307 | 1.1× |
| Xr orbits complete 4 views (70200) | $183.60 | $360 | 1.2× |
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.