Imaging prices at Pulaski Memorial Hospital
Winamac, IN · every code in this section with a posted price and a Medicare benchmark.
262 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$17.78–$311.43 | $25.40–$444.90 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$22.68–$412.93 | $32.40–$589.90 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,065.96 | $1,522.80 | 2.5× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$15.68–$233.59 | $22.40–$333.70 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$56.35–$615.02 | $80.50–$878.60 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$54.95–$933.94 | $78.50–$1,334.20 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$18.48–$301.21 | $26.40–$430.30 | varies |
| Bone Imaging 3 Phase (78315) | $1,583.75 | $2,262.50 | 3.7× |
| Bone Imaging Limited Area (78300) | $1,065.96 | $1,522.80 | 2.5× |
| Bone Imaging Multiple Areas (78305) | $1,258.53 | $1,797.90 | 3.0× |
| Bone Imaging Whole Body (78306) | $1,485.54 | $2,122.20 | 3.5× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$68.39–$490.63 | $97.70–$700.90 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) | $4,619.02 | $6,598.60 | 12.5× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$92.05–$998.62 | $131.50–$1,426.60 | varies |
| Chest 1 view (71045) range across 2 matching MRF lines |
$17.78–$203.35 | $25.40–$290.50 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$21.28–$304.50 | $30.40–$435 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$26.81–$362.11 | $38.30–$517.30 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$30.31–$368.97 | $43.30–$527.10 | varies |
| Clavicle complete (73000) range across 4 matching MRF lines |
$16.38–$409.57 | $23.40–$585.10 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$34.30–$104.44 | $49–$149.20 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$30.73–$517.86 | $43.90–$739.80 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$52.71–$808.78 | $75.30–$1,155.40 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$61.25–$1,177.61 | $87.50–$1,682.30 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$194.18–$4,850.79 | $277.40–$6,929.70 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$168.28–$3,449.39 | $240.40–$4,927.70 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$122.92–$2,496.83 | $175.60–$3,566.90 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$134.82–$2,996 | $192.60–$4,280 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$114.87–$2,063.25 | $164.10–$2,947.50 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$212.03–$2,498.23 | $302.90–$3,568.90 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$175.98–$3,331.02 | $251.40–$4,758.60 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$169.05–$3,235.75 | $241.50–$4,622.50 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$182.35–$2,759.54 | $260.50–$3,942.20 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$169.05–$2,598.54 | $241.50–$3,712.20 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$173.32–$2,561.65 | $247.60–$3,659.50 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$117.67–$2,473.87 | $168.10–$3,534.10 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$96.39–$2,145.15 | $137.70–$3,064.50 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$122.22–$2,996 | $174.60–$4,280 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$112.77–$2,598.54 | $161.10–$3,712.20 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$120.82–$3,147.20 | $172.60–$4,496 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$109.27–$2,296.49 | $156.10–$3,280.70 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$122.92–$2,697.31 | $175.60–$3,853.30 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $34.30 | $49 | 0.4× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$109.27–$2,220.75 | $156.10–$3,172.50 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$122.22–$2,996 | $174.60–$4,280 | varies |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$96.39–$1,895.81 | $137.70–$2,708.30 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$112.07–$1,659.63 | $160.10–$2,370.90 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$117.67–$2,473.87 | $168.10–$3,534.10 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$96.39–$2,230.69 | $137.70–$3,186.70 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$109.27–$2,178.05 | $156.10–$3,111.50 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$83.09–$1,882.51 | $118.70–$2,689.30 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$156.10–$2,697.31 | $223–$3,853.30 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$122.22–$2,697.31 | $174.60–$3,853.30 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$124.25–$1,961.19 | $177.50–$2,801.70 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$117.67–$2,996 | $168.10–$4,280 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$105.14–$2,197.86 | $150.20–$3,139.80 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$117.04–$2,414.79 | $167.20–$3,449.70 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$122.22–$2,654.47 | $174.60–$3,792.10 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$133.35–$2,220.75 | $190.50–$3,172.50 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$124.25–$1,961.19 | $177.50–$2,801.70 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$118.02–$2,473.87 | $168.60–$3,534.10 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$96.39–$2,145.15 | $137.70–$3,064.50 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$122.92–$2,996 | $175.60–$4,280 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$104.44–$2,296.49 | $149.20–$3,280.70 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$96.39–$1,647.24 | $137.70–$2,353.20 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$117.04–$2,207.59 | $167.20–$3,153.70 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$112.07–$1,930.11 | $160.10–$2,757.30 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$228.97–$2,562.56 | $327.10–$3,660.80 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$175.35–$2,496.83 | $250.50–$3,566.90 | varies |
| CTA pelvis (72191) | $3,419.36 | $4,884.80 | 18.4× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$19.18–$876.96 | $27.40–$1,252.80 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$28.98–$1,114.40 | $41.40–$1,592 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$19.18–$276.78 | $27.40–$395.40 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$70.42–$994.91 | $100.60–$1,421.30 | varies |
| Esophagram (74220) range across 3 matching MRF lines |
$58.31–$511.14 | $83.30–$730.20 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$102.55–$856.24 | $146.50–$1,223.20 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$74.69–$815.71 | $106.70–$1,165.30 | varies |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$30.31–$1,275.68 | $43.30–$1,822.40 | varies |
| Foot 2 views (73620) range across 2 matching MRF lines |
$15.05–$230.23 | $21.50–$328.90 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$15.68–$460.18 | $22.40–$657.40 | varies |
| Gastric emptying imaging study (78264) | $1,093.19 | $1,561.70 | 2.6× |
| Gated Heart Planar Single (78472) | $1,468.74 | $2,098.20 | 3.5× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$16.38–$267.40 | $23.40–$382 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,502.48 | $2,146.40 | 2.6× |
| Hepatobiliary System Imaging (78226) | $1,502.48 | $2,146.40 | 3.6× |
| Ht Muscle Image Spect Sing (78451) | $3,173.94 | $4,534.20 | 2.3× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$37.03–$1,955.87 | $52.90–$2,794.10 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$71.96–$774.90 | $102.80–$1,107 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$60.41–$260.68 | $86.30–$372.40 | varies |
| K Flow/Funct Image Multiple (78709) | $1,688.40 | $2,412 | 2.9× |
| K Flow/Funct Image W/Drug (78708) | $1,333.43 | $1,904.90 | 2.3× |
| K Flow/Funct Image W/O Drug (78707) | $1,157.38 | $1,653.40 | 2.0× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$18.48–$477.26 | $26.40–$681.80 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,600.69 | $2,286.70 | 3.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,600.69 | $2,286.70 | 3.8× |
| Liver imaging static only (78201) | $1,404.34 | $2,006.20 | 2.4× |
| Liver imaging w/vascular flow (78202) | $1,404.34 | $2,006.20 | 2.4× |
| Lymph System Imaging (78195) | $1,494.57 | $2,135.10 | 2.6× |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$34.93–$375.27 | $49.90–$536.10 | varies |
| Meckels Divert Exam (78290) | $1,065.96 | $1,522.80 | 2.5× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$115.57–$4,050.55 | $165.10–$5,786.50 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$144.90–$4,276.93 | $207–$6,109.90 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 3 matching MRF lines |
$142.87–$4,480.98 | $204.10–$6,401.40 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$116.27–$4,050.55 | $166.10–$5,786.50 | varies |
| MRI abdomen w contrast (74182) | $166.95 | $238.50 | 0.5× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$140.77–$4,043.90 | $201.10–$5,777 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$157.43–$4,438.21 | $224.90–$6,340.30 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$208.81–$5,584.81 | $298.30–$7,978.30 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$157.43–$4,615.87 | $224.90–$6,594.10 | varies |
| MRI cardiac w/o contrast (75557) | $4,043.90 | $5,777 | 16.0× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$173.81–$4,615.87 | $248.30–$6,594.10 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$143.50–$4,043.90 | $205–$5,777 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$141.40–$4,043.90 | $202–$5,777 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$166.95–$4,615.87 | $238.50–$6,594.10 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$218.96–$5,279.19 | $312.80–$7,541.70 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $156.80 | $224 | 0.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$208.81–$6,209 | $298.30–$8,870 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$130.55–$4,435.06 | $186.50–$6,335.80 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$173.18–$4,615.87 | $247.40–$6,594.10 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$222.39–$5,279.19 | $317.70–$7,541.70 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$129.92–$4,043.90 | $185.60–$5,777 | varies |
| MRI orbit face neck w contrast (70542) | $4,615.87 | $6,594.10 | 12.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$208.11–$5,279.19 | $297.30–$7,541.70 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$166.95–$4,615.87 | $238.50–$6,594.10 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$213.01–$5,279.19 | $304.30–$7,541.70 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$141.40–$4,043.90 | $202–$5,777 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$143.50–$4,043.90 | $205–$5,777 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$156.80–$4,615.87 | $224–$6,594.10 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$131.25–$4,043.90 | $187.50–$5,777 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$208.81–$5,279.19 | $298.30–$7,541.70 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$213.01–$5,279.19 | $304.30–$7,541.70 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$222.39–$5,279.19 | $317.70–$7,541.70 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$172.48–$4,615.87 | $246.40–$6,594.10 | varies |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$131.25–$4,043.90 | $187.50–$5,777 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$208.81–$5,279.19 | $298.30–$7,541.70 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$222.39–$5,279.19 | $317.70–$7,541.70 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$88.34–$1,057.70 | $126.20–$1,511 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$81.62–$984.69 | $116.60–$1,406.70 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$87.99–$996.66 | $125.70–$1,423.80 | varies |
| Myelograpy 2/more regions rs&i (72270) | $132.58 | $189.40 | 0.2× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $1,550.29 | $2,214.70 | 1.1× |
| Myocardial Spect Multiple Studies (78452) | $4,553.57 | $6,505.10 | 3.3× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$17.78–$203.35 | $25.40–$290.50 | varies |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$46.41–$184.66 | $66.30–$263.80 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$79.10–$244.86 | $113–$349.80 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,749.25 | $3,927.50 | 4.8× |
| Parathyroid Planar Imaging (78070) | $1,468.74 | $2,098.20 | 3.5× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$17.08–$311.43 | $24.40–$444.90 | varies |
| Pet Image Skull-Thigh (78812) | $7,183.61 | $10,262.30 | 4.7× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,224.93 | $1,749.90 | 2.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$31.43–$588.91 | $44.90–$841.30 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$50.40–$669.97 | $72–$957.10 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$17.08–$304.50 | $24.40–$435 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$15.68–$389.48 | $22.40–$556.40 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$17.08–$348.74 | $24.40–$498.20 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$27.86–$660.03 | $39.80–$942.90 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$13.58–$274.19 | $19.40–$391.70 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$16.45–$572.04 | $23.50–$817.20 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$17.08–$477.26 | $24.40–$681.80 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$15.68–$311.43 | $22.40–$444.90 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$36.61–$382.55 | $52.30–$546.50 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$18.62–$257.32 | $26.60–$367.60 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$21.98–$298.13 | $31.40–$425.90 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$18.48–$565.32 | $26.40–$807.60 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$112.84–$663.88 | $161.20–$948.40 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$15.68–$189.56 | $22.40–$270.80 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$19.18–$257.32 | $27.40–$367.60 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$23.38–$341.95 | $33.40–$488.50 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$12.88–$223.37 | $18.40–$319.10 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$15.68–$284.41 | $22.40–$406.30 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$17.08–$304.50 | $24.40–$435 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $558.46 | $797.80 | 5.0× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$27.09–$538.02 | $38.70–$768.60 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$121.52–$1,022 | $173.60–$1,460 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$67.76–$524.65 | $96.80–$749.50 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$22.61–$511.14 | $32.30–$730.20 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$24.78–$355.39 | $35.40–$507.70 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$78.26–$856.24 | $111.80–$1,223.20 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$194.18–$801.99 | $277.40–$1,145.70 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$86.59–$1,153.95 | $123.70–$1,648.50 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$16.38–$233.59 | $23.40–$333.70 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$17.78–$311.43 | $25.40–$444.90 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$16.38–$426.44 | $23.40–$609.20 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$15.68–$426.44 | $22.40–$609.20 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$28.28–$595.70 | $40.40–$851 | varies |
| Scapula (73010) range across 3 matching MRF lines |
$17.71–$311.43 | $25.30–$444.90 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$58.31–$132.72 | $83.30–$189.60 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$14.98–$409.57 | $21.40–$585.10 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$54.67–$1,177.61 | $78.10–$1,682.30 | varies |
| Skull less than 4 views (70250) | $497.56 | $710.80 | 4.5× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$21.28–$280.98 | $30.40–$401.40 | varies |
| Temporomandble Jt Arthrography Rs&I (70332) | $52.71 | $75.30 | 0.2× |
| Testicular Imaging W/Flow (78761) | $1,546.37 | $2,209.10 | 3.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $3,601.85 | $5,145.50 | 9.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$205.38–$1,022 | $293.40–$1,460 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$19.88–$270.62 | $28.40–$386.60 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$21.98–$331.94 | $31.40–$474.20 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$20.58–$308.07 | $29.40–$440.10 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $774.90 | $1,107 | 1.8× |
| Tx Devices Design & Construction Complex (77334) | $1,298.36 | $1,854.80 | 3.3× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$66.36–$304.50 | $94.80–$435 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$52.78–$322.49 | $75.40–$460.70 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$56.91–$660.03 | $81.30–$942.90 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$48.51–$450.10 | $69.30–$643 | varies |
| Unlisted us procedure (76999) | $710.71 | $1,015.30 | 7.7× |
| Upper gi w/o kub (74240) range across 4 matching MRF lines |
$78.19–$978.04 | $111.70–$1,397.20 | varies |
| Ureteral Reflux Study (78740) | $1,235.08 | $1,764.40 | 2.9× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$31.78–$660.03 | $45.40–$942.90 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$31.78–$896.70 | $45.40–$1,281 | varies |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$71.19–$512.89 | $101.70–$732.70 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$63.56–$463.89 | $90.80–$662.70 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$87.92–$686.07 | $125.60–$980.10 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$48.23–$382.55 | $68.90–$546.50 | varies |
| Us head (76506) range across 2 matching MRF lines |
$61.46–$663.11 | $87.80–$947.30 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$73.36–$270.62 | $104.80–$386.60 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$67.06–$630.70 | $95.80–$901 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$63.21–$656.53 | $90.30–$937.90 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$72.94–$774.90 | $104.20–$1,107 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$66.71–$917.14 | $95.30–$1,310.20 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$96.32–$669.97 | $137.60–$957.10 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$83.02–$622.79 | $118.60–$889.70 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$71.26–$758.03 | $101.80–$1,082.90 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$56.21–$619.43 | $80.30–$884.90 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$61.81–$680.19 | $88.30–$971.70 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$123.34–$774.90 | $176.20–$1,107 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$54.81–$649.88 | $78.30–$928.40 | varies |
| Us transrectal (76872) | $720.72 | $1,029.60 | 6.5× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$138.32–$1,022 | $197.60–$1,460 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$98.35–$778.12 | $140.50–$1,111.60 | varies |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$16.45–$237.58 | $23.50–$339.40 | varies |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$16.38–$351.89 | $23.40–$502.70 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$18.48–$321.65 | $26.40–$459.50 | varies |
| X-Ray Bend Only L-S Spine (72120) | $21.98 | $31.40 | 0.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$16.38–$223.37 | $23.40–$319.10 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$30.73–$186.34 | $43.90–$266.20 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$25.48–$308.07 | $36.40–$440.10 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$30.73–$372.33 | $43.90–$531.90 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $436.66 | $623.80 | 3.9× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$18.48–$282.73 | $26.40–$403.90 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$21.98–$370.93 | $31.40–$529.90 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$21.98–$592.27 | $31.40–$846.10 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$29.96–$496.16 | $42.80–$708.80 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$21.98–$257.32 | $31.40–$367.60 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$29.33–$558.46 | $41.90–$797.80 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$26.18–$477.26 | $37.40–$681.80 | varies |
| X-ray eye for foreign body (70030) range across 5 matching MRF lines |
$17.78–$426.44 | $25.40–$609.20 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$15.68–$490.63 | $22.40–$700.90 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 3 matching MRF lines |
$46.83–$917.14 | $66.90–$1,310.20 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$17.01–$406.28 | $24.30–$580.40 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$21.98–$280.98 | $31.40–$401.40 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$17.78–$304.50 | $25.40–$435 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$31.43–$798.63 | $44.90–$1,140.90 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$21.98–$270.83 | $31.40–$386.90 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$17.08–$355.39 | $24.40–$507.70 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$19.46–$473.90 | $27.80–$677 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$30.10–$572.04 | $43–$817.20 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$74.41–$209.93 | $106.30–$299.90 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$50.26–$896.70 | $71.80–$1,281 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$26.46–$494.34 | $37.80–$706.20 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$53.41–$381.99 | $76.30–$545.70 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$26.81–$436.66 | $38.30–$623.80 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$30.10–$341.95 | $43–$488.50 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$56.21–$700.63 | $80.30–$1,000.90 | 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.