Imaging prices at Putnam Hospital Center

Carmel, NY · every code in this section with a posted price and a Medicare benchmark.

369 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $8,875 $8,875 5.1×
Abdomen 1 View (74018) $438 $438 4.0×
Abdomen 2 views (74019) $529 $529 4.1×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,638 $1,638 3.3×
Angio pulmonary bilat (75743) $9,861 $9,861 2.5×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $9,861 $9,861 2.5×
Angiography extremity bilateral rs&i (75716) $9,861 $9,861 2.5×
Angiography extremity unilateral rs&i (75710) $9,861 $9,861 2.5×
Angiography pulmonary unilateral slctv rs&i (75741) $9,861 $9,861 2.5×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $9,861 $9,861 2.5×
Ankle 2 views (73600) $613 $613 5.6×
Aortography thoracic serialography rs&i (75605) $16,936 $16,936 2.4×
Artery X-Rays Abdomen (75726) $16,936 $16,936 2.4×
Artery X-Rays Adrenal Gland (75731) $9,861 $9,861 2.5×
Artery X-Rays Pelvis (75736) $16,936 $16,936 2.4×
Arthrogram hip (73525) $1,119 $1,119 2.6×
Arthrogram Wrist (73115) $2,483 $2,483 5.7×
Basic radiation dosimetry calculation (77300) $887 $887 5.3×
Bone age studies (77072) $739 $739 5.7×
Bone Imaging 3 Phase (78315) $1,638 $1,638 3.3×
Bone Imaging Limited Area (78300) $1,638 $1,638 3.3×
Bone Imaging Multiple Areas (78305) $1,638 $1,638 3.3×
Bone Imaging Whole Body (78306) $1,638 $1,638 3.3×
Bone marrow imaging limited area (78102) $1,638 $1,638 3.3×
Bone marrow imaging; multiple areas (78103) $1,638 $1,638 3.3×
Bone marrow imaging; whole body (78104) $1,638 $1,638 3.3×
Bone survey infant (77076) $739 $739 5.7×
Brachytx isodose complex (77318) $2,881 $2,881 6.2×
Brachytx isodose intermed (77317) $2,283 $2,283 4.9×
Brachytx Isodose Plan Simple (77316) $578 $578 1.2×
Brain imaging < 4 static views (78600) $1,638 $1,638 3.3×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $2,194 $2,194 3.2×
Brain Imaging Pet Metabolic Evaluation (78608) $6,120 $6,120 3.4×
Cat Scan Follow-Up Study (76380) $1,471 $1,471 13.5×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $2,194 $2,194 3.2×
Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) $2,194 $2,194 3.2×
Cerebrospinal Fluid Scan (78630) $2,194 $2,194 3.2×
Chest 1 view (71045) $656 $656 6.0×
Chest 2 views (71046) $656 $656 6.0×
Chest 3 views (71047) $656 $656 6.0×
Chest 4 or more views (71048) $792 $792 6.1×
Clavicle complete (73000) $613 $613 5.6×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $1,777 $1,777 13.6×
Continuing medical physics consltj pr wk (77336) $2,384 $2,384 14.2×
Contrast Exam Abdominl Aorta (75625) $9,861 $9,861 2.5×
Contrast X-Ray Bladder (74430) $1,776 $1,776 4.1×
CT abdomen and pelvis without and with contrast (74178) $5,969 $5,969 13.7×
CT abdomen and pelvis without contrast (74176) $4,040 $4,040 13.6×
CT abdomen w contrast (74160) $2,975 $2,975 13.6×
CT abdomen w wo contrast (74170) $2,975 $2,975 13.6×
CT abdomen w/o contrast (74150) $1,777 $1,777 13.6×
CT Angio Abdomen and Pelvis (74174) $5,969 $5,969 13.7×
CT Angio Chest (71275) $2,975 $2,975 13.6×
CT Angio Head (70496) $3,192 $3,192 14.6×
CT angio hrt w/3d image (75574) $5,969 $5,969 13.7×
Ct Angio Lwr Extr W/O&W/Dye (73706) $2,975 $2,975 13.6×
CT Angio Neck (70498) $3,192 $3,192 14.6×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,975 $2,975 13.6×
CT cervical spine w/ contrast (72126) $6,404 $6,404 14.7×
CT cervical spine w/o contrast (72125) $1,907 $1,907 14.6×
CT cervical spine w/wo cont (72127) $3,192 $3,192 14.6×
CT chest w contrast (71260) $2,975 $2,975 13.6×
CT chest w/wo contrast (71270) $2,975 $2,975 13.6×
CT head/brain with contrast (70460) $3,192 $3,192 14.6×
CT head/brain without and with contrast (70470) $3,192 $3,192 14.6×
CT heart contrast eval cardiac structure&morph (75572) $5,969 $5,969 13.7×
CT heart no contrast quant eval coronry calcium (75571) $99 $99 0.9×
CT hrt w/3d image congen (75573) $5,969 $5,969 13.7×
CT iac w contrast (70481) $3,192 $3,192 14.6×
CT l-spine w&w/o contrast (72133) $2,975 $2,975 13.6×
CT lower ext w/o (73700) $1,777 $1,777 13.6×
CT lower extremity w/contrast material (73701) $2,975 $2,975 13.6×
CT lumbar spine w contrast (72132) $5,969 $5,969 13.7×
CT lumbar spine w/o contrast (72131) $1,777 $1,777 13.6×
CT maxillofacial w contrast (70487) $3,192 $3,192 14.6×
CT maxillofacial wo contrast (70486) $1,907 $1,907 14.6×
CT neck tissue combo (70492) $3,192 $3,192 14.6×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $3,192 $3,192 14.6×
CT orbits w/o contrast (70480) $1,907 $1,907 14.6×
CT pelvis w&w/o contrast (72194) $2,975 $2,975 13.6×
CT pelvis w/o contrast (72192) $1,777 $1,777 13.6×
CT scans face/jaw combo (70488) $3,192 $3,192 14.6×
CT soft tissue neck w contrast (70491) $3,192 $3,192 14.6×
CT soft tissue neck w/o contrast (70490) $1,907 $1,907 14.6×
CT thoracic spine w contrast (72129) $2,975 $2,975 13.6×
CT thoracic spine w/o contrast (72128) $1,777 $1,777 13.6×
CT thoracic spine w/wo cont (72130) $2,975 $2,975 13.6×
CT thorax w/o contrast (71250) $1,777 $1,777 13.6×
CT unlisted procedure (76497) $1,471 $1,471 13.5×
CT upper ext wo (73200) $1,777 $1,777 13.6×
CT upper extremity w/o & w/contrast material (73202) $2,975 $2,975 13.6×
CT upper extremity with contrast (73201) $5,969 $5,969 13.7×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $2,975 $2,975 13.6×
Cta Abdomen (74175) $2,975 $2,975 13.6×
CTA pelvis (72191) $2,975 $2,975 13.6×
Dxa Bone Density Axial (77080) $739 $739 5.7×
Dxa bone density study 1/>sites appendiclr skel (77081) $613 $613 5.6×
Echo exam uterus (76831) $2,343 $2,343 7.9×
Echo Guide For Artery Repair (76936) $976 $976 3.6×
Echograp Trans R Pros Study (76873) $835 $835 6.4×
Esophagram (74220) $886 $886 4.0×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $1,030 $1,030 7.9×
Fluoroscopy up to 1 hr (76000) $757 $757 2.5×
Follow-Up Angiography (75898) $9,861 $9,861 2.5×
Foot 2 views (73620) $613 $613 5.6×
Forearm 2 views (73090) $613 $613 5.6×
Gastric emptying imaging study (78264) $1,638 $1,638 3.3×
Gastric Mucosa Imaging (78261) $1,638 $1,638 3.3×
Gastroesophageal Reflux Exam (78262) $1,638 $1,638 3.3×
Gated Heart Planar Single (78472) $1,638 $1,638 3.3×
Gated Heart, Multiple (78473) $1,638 $1,638 3.3×
Hand 2 views (73120) $739 $739 5.7×
Hdr Rdncl Ntrstl/Icav Brchtx (77772) $4,718 $4,718 5.4×
Hdr Rdncl Ntrstl/Icav Brchtx (77771) $4,522 $4,522 5.2×
Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) $3,587 $3,587 4.1×
Heart first pass single,planar (78481) $2,194 $2,194 3.2×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $9,861 $9,861 2.5×
Hepatobil Syst Image W/Drug (78227) $2,194 $2,194 3.2×
Hepatobiliary System Imaging (78226) $1,638 $1,638 3.3×
Ht Musc Image Planar Mult (78454) $5,321 $5,321 3.3×
Ht Muscle Image Spect Sing (78451) $5,321 $5,321 3.3×
Hysterosalpingogram (74740) $1,202 $1,202 4.0×
Infant hip ultrasound with hip movement (dynamic) (76885) $853 $853 7.9×
Infant hip ultrasound, limited static exam (76886) $853 $853 7.9×
Infusion Ivp (74410) $886 $886 4.0×
Interstitial radiation source applic complex (77778) $4,150 $4,150 4.8×
Joint Survey Single View (77077) $739 $739 5.7×
K Flow/Funct Image Multiple (78709) $2,194 $2,194 3.2×
K Flow/Funct Image W/Drug (78708) $2,194 $2,194 3.2×
K Flow/Funct Image W/O Drug (78707) $2,194 $2,194 3.2×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $1,638 $1,638 3.3×
Knee 3 Views (73562) $613 $613 5.6×
Leveen/Shunt Patency Exam (78291) $1,638 $1,638 3.3×
Liver & Spleen Imaging Static Only (78215) $1,638 $1,638 3.3×
Liver imaging static only (78201) $2,194 $2,194 3.2×
Lung Perf&Ventilat Diferentl (78598) $2,194 $2,194 3.2×
Lung Ventilat&Perfus Imaging (78582) $2,194 $2,194 3.2×
Lung Ventilation Imaging (78579) $1,638 $1,638 3.3×
Lymph System Imaging (78195) $2,194 $2,194 3.2×
Magnetic Image Jaw Joint (70336) $2,277 $2,277 7.6×
Magnetic Resonance Elastography (76391) $2,277 $2,277 7.6×
Mammary ductogram or galactogram multiple (77054) $1,799 $1,799 6.0×
Mammary ductogram or galactogram single (77053) $1,799 $1,799 6.0×
Meckels Divert Exam (78290) $1,638 $1,638 3.3×
Mlc imrt design & construction per imrt plan (77338) $1,900 $1,900 4.1×
Mr safety determination physician/other qhp (76016) $829 $829 7.6×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $231 $231 6.4×
Mr safety implt electronics prepj supvj phys/qhp (76018) $865 $865 7.3×
Mr safety implt pos&/immoblj (76019) $559 $559 7.6×
Mr safety med physics xm customization plng&mntr (76017) $2,277 $2,277 7.6×
Mra Head W/O & W/Contrast Material (70546) $3,387 $3,387 7.8×
MRA head w/o contrast (70544) $2,292 $2,292 7.7×
MRA head with contrast (70545) $3,387 $3,387 7.8×
MRA neck w contrast (70548) $3,387 $3,387 7.8×
Mra Neck W/O &W/Contrast Material (70549) $3,387 $3,387 7.8×
MRA neck w/o contrast (70547) $2,292 $2,292 7.7×
MRI abdomen w contrast (74182) $3,364 $3,364 7.7×
MRI abdomen w/o contrast (74181) $2,277 $2,277 7.6×
MRI any jt lower extrem w/contrast material (73722) $7,440 $7,440 7.6×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $3,364 $3,364 7.7×
MRI any jt upper extremity w/contrast matrl (73222) $7,440 $7,440 7.6×
MRI Breast W/O Contrast Bilateral (77047) $2,277 $2,277 7.6×
MRI Breast Without Contrast Material Unilateral (77046) $2,277 $2,277 7.6×
MRI cervical spine w contrast (72142) $3,387 $3,387 7.8×
MRI cervical spine w/o cont (72141) $2,292 $2,292 7.7×
MRI chest w/o contrast (71550) $2,277 $2,277 7.6×
MRI chest with contrast (71551) $7,440 $7,440 7.6×
MRI chest wo w contrast (71552) $3,364 $3,364 7.7×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $3,364 $3,364 7.7×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $3,364 $3,364 7.7×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,277 $2,277 7.6×
MRI lumbar spine w contrast (72149) $3,364 $3,364 7.7×
Mri Neck Spine W/O & W/Dye (72156) $3,387 $3,387 7.8×
MRI orbit face &/neck w/o contrast (70540) $2,292 $2,292 7.7×
MRI orbit face neck w contrast (70542) $3,387 $3,387 7.8×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,387 $3,387 7.8×
MRI pelvis w contrast (72196) $3,364 $3,364 7.7×
MRI pelvis w/o & w contrast (72197) $3,364 $3,364 7.7×
MRI pelvis w/o contrast (72195) $2,277 $2,277 7.6×
MRI thoracic spine w/o contrast (72146) $2,277 $2,277 7.6×
MRI upper extremity oth than jt w/contr matrl (73219) $3,364 $3,364 7.7×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,277 $2,277 7.6×
Mri Uppr Extremity W/O&W/Dye (73220) $3,364 $3,364 7.7×
MRI, abdomen, combo (74183) $3,364 $3,364 7.7×
MRI, dorsal spine combo (72157) $3,364 $3,364 7.7×
MRI, dorsal spine contrast (72147) $3,364 $3,364 7.7×
MRI, joint upper extrem (73221) $2,277 $2,277 7.6×
MRI, joint upper extrem combo (73223) $3,364 $3,364 7.7×
MRI, lumbar spine combo (72158) $3,364 $3,364 7.7×
Myelogram cervical (72240) $2,475 $2,475 2.5×
Myelogram Lumbar (72265) $2,475 $2,475 2.5×
Myelography thoracic (72255) $2,475 $2,475 2.5×
Myelograpy 2/more regions rs&i (72270) $2,475 $2,475 2.5×
Myocardial Imaging Pet Metabolic Evaluation (78459) $5,321 $5,321 3.3×
Myocardial Spect Multiple Studies (78452) $5,321 $5,321 3.3×
N-invas est c ffr sw aly CTA (75580) $17,005 $17,005 15.9×
Neck soft tissue (70360) $438 $438 4.0×
Nm csf leak detection (78650) $5,321 $5,321 3.3×
Nonvascular Shunt X-Ray (75809) $529 $529 4.1×
Ntsty modul radthx pln dose-vol histos (77301) $12,248 $12,248 7.1×
Nuclear Rx Oral Admin (79005) $914 $914 3.1×
Ophthalmic Ultrasonic Foreign Body Localization (76529) $853 $853 7.9×
Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) $1,030 $1,030 7.9×
Ophthalmic us dx quantitative a-scan only (76511) $1,030 $1,030 7.9×
Parathyroid Planar Imaging (78070) $1,638 $1,638 3.3×
Pelvis 1 or 2 views (72170) $739 $739 5.7×
Pet Image W/Ct Lmtd (78814) $6,120 $6,120 3.4×
PET image w/CT, full body (78816) $6,120 $6,120 3.4×
PET imaging CT attenuation skull base mid-thigh (78815) $5,945.40 $5,945.40 3.3×
Pet Myocardial Sngl Study (78491) $5,945 $5,945 3.3×
Pulmonary Perfusion Imaging Particulate (78580) $1,638 $1,638 3.3×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $529 $529 4.1×
Radex abscess/fistula/sinus tract rs&i (76080) $2,726 $2,726 4.0×
Radex Ankle Complete Minimum 3 Views (73610) $613 $613 5.6×
Radex Calcaneus Minimum 2 Views (73650) $613 $613 5.6×
Radex elbow complete minimum 3 views (73080) $613 $613 5.6×
Radex Facial Bones Complete Minimum 3 Views (70150) $739 $739 5.7×
Radex fingr minimum 2 views (73140) $613 $613 5.6×
Radex foot complete minimum 3 views (73630) $613 $613 5.6×
Radex Hand Minimum 3 Views (73130) $613 $613 5.6×
Radex lower extremity infant minimum 2 views (73592) $613 $613 5.6×
Radex Nasal Bones Complete Minimum 3 Views (70160) $613 $613 5.6×
Radex Ribs Unilateral 2 Views (71100) $613 $613 5.6×
Radex shoulder complete minimum 2 views (73030) $613 $613 5.6×
Radex Sinuses Paransl < 3 Views (70210) $613 $613 5.6×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $886 $886 4.0×
Radex Spine 1 View Specify Level (72020) $613 $613 5.6×
Radex Sternum Minimum 2 Views (71120) $613 $613 5.6×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $613 $613 5.6×
Radex Toe Minimum 2 Views (73660) $613 $613 5.6×
Radex upper extremity infant minimum 2 views (73092) $739 $739 5.7×
Radex Wrist Complete Minimum 3 Views (73110) $613 $613 5.6×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $739 $739 5.7×
Radiation Delivery Stereotactic Cranial Linear (77372) $19,493 $19,493 2.1×
Radiation treatment delivery level 1 (77402) $959 $959 7.5×
Radiation treatment delivery level 2 (77407) $1,133 $1,133 2.4×
Radiation treatment delivery level 3 (77412) $1,607 $1,607 2.3×
Radiolog exam mandible compl minimum 4 views (70110) $739 $739 5.7×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $529 $529 4.1×
Radiologic exam colon double contrast study (74280) $886 $886 4.0×
Radiologic exam colon single contrast study (74270) $886 $886 4.0×
Radiologic Exam Esophagus Double Contrast Study (74221) $886 $886 4.0×
Radiologic exam knee complete 4/more views (73564) $739 $739 5.7×
Radiologic exam pelvis compl minimum 3 views (72190) $739 $739 5.7×
Radiologic Exam Small Int Single Contrast Study (74250) $886 $886 4.0×
Radiologic exam swallow function contrast study (74230) $886 $886 4.0×
Radiologic exam upr gi trc double contrast study (74246) $886 $886 4.0×
Radiologic examination femur minimum 2 views (73552) $613 $613 5.6×
Radiologic examination knee 1/2 views (73560) $613 $613 5.6×
Radiologic Examination Salivary Gland Calculus (70380) $438 $438 4.0×
Radiologic examination tibia & fibula 2 views (73590) $613 $613 5.6×
Ribs bilateral 3 views (71110) $739 $739 5.7×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,638 $1,638 3.3×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,638 $1,638 3.3×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $5,321 $5,321 7.9×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $5,321 $5,321 7.9×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $5,321 $5,321 7.9×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $5,321 $5,321 3.3×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $5,321 $5,321 3.3×
Salivary Gland Imaging (78230) $1,638 $1,638 3.3×
Salivary Gland Imaging Serial Images (78231) $1,638 $1,638 3.3×
Scapula (73010) $739 $739 5.7×
Screening Digital Breast Tomosynthesis Bi (77063) $171 $171 7.3×
Shoulder 1 view (73020) $613 $613 5.6×
Shoulder Arthrography (73040) $1,119 $1,119 2.6×
Skull less than 4 views (70250) $739 $739 5.7×
Special dosimetry (77331) $1,167 $1,167 7.0×
Special Physics Consult (77370) $1,159 $1,159 6.9×
Special teletherapy port plan (77321) $1,955 $1,955 4.2×
Special treatment procedure (77470) $3,125 $3,125 4.5×
Spleen Imaging (78185) $1,638 $1,638 3.3×
Stereotactic Body Radiation Delivery (77373) $6,633 $6,633 3.0×
Sternoclavicular joints (71130) $613 $613 5.6×
Surface Applic Low Dose Rate Radionuclide Source (77789) $976 $976 7.7×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,796 $1,796 3.8×
Telethx isodose pln smpl w/dosimetry calculation (77306) $1,638 $1,638 3.5×
Testicular Imaging W/Flow (78761) $1,638 $1,638 3.3×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $4,276 $4,276 9.1×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $3,879 $3,879 8.3×
Ther rad simulaj-aided field setting simple (77280) $3,429 $3,429 20.4×
Thoracic spine 2 views (72070) $739 $739 5.7×
Thoracic spine 3 views (72072) $739 $739 5.7×
Thoracolumbar 2 views (72080) $613 $613 5.6×
Thyroid Imaging With Vascular Flow (78013) $1,638 $1,638 3.3×
Thyroid Met Imaging Body (78018) $2,194 $2,194 3.2×
Thyroid Uptake Measurement (78012) $1,638 $1,638 3.3×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $1,638 $1,638 3.3×
Tx Devices Design & Construction Complex (77334) $2,082 $2,082 4.5×
Tx devices design & construction intermediate (77333) $1,492 $1,492 8.9×
Tx devices design & construction simple (77332) $1,050 $1,050 6.3×
Ultrasound Breast Limited (76642) $853 $853 7.9×
Ultrasound Exam Aaa Screen (76706) $1,030 $1,030 7.9×
Ultrasound, abdomen limited (76705) $1,030 $1,030 7.9×
Unlisted Dx Radiographic Procedure (76499) $276 $276 2.5×
Unlisted fluoroscopic procedure (76496) $276 $276 2.5×
Unlisted magnetic resonance procedure (76498)
range across 3 matching MRF lines		 $821–$829 $821–$829 varies
Unlisted us procedure (76999) $853 $853 7.9×
Upper gi w/o kub (74240) $886 $886 4.0×
Ureteral Reflux Study (78740) $1,638 $1,638 3.3×
Urethrocystogram voiding (74455) $1,202 $1,202 4.0×
Urethrocystography retrograde (74450) $1,202 $1,202 4.0×
Us breast unilateral complete (76641) $1,030 $1,030 7.9×
Us chest (76604) $1,030 $1,030 7.9×
Us complete joint (76881) $1,030 $1,030 7.9×
Us exam, pelvic, limited (76857) $1,030 $1,030 7.9×
Us head (76506) $1,030 $1,030 7.9×
Us kidney transplant (76776) $1,030 $1,030 7.9×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $1,030 $1,030 7.9×
Us ob detailed single fetus (76811) $2,343 $2,343 7.9×
Us ob limited 1 or more fetuses (76815) $1,030 $1,030 7.9×
Us ob transvaginal (76817) $1,030 $1,030 7.9×
Us pelvic non ob complete (76856) $1,030 $1,030 7.9×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $1,030 $1,030 7.9×
Us preg uterus real time f/u trnsabdl per fetus (76816) $1,030 $1,030 7.9×
Us retroperitoneal complete (76770) $1,030 $1,030 7.9×
Us retroperitoneal limited (76775) $1,030 $1,030 7.9×
Us scrotum and contents (76870) $1,030 $1,030 7.9×
Us spinal canal and contents (76800) $1,030 $1,030 7.9×
Us thyroid (76536) $1,030 $1,030 7.9×
Us transrectal (76872) $1,030 $1,030 7.9×
Vein X-Ray Chest (75827) $4,867 $4,867 2.5×
Venogram Sinus/Jugular (75860) $9,861 $9,861 2.5×
Venography caval inferior serialography rs&i (75825) $9,861 $9,861 2.5×
Venography extremity bilateral rs&i (75822) $4,867 $4,867 2.5×
Venography extremity unilateral rs&i (75820) $4,867 $4,867 2.5×
Venography Renal Bilateral (75833) $9,861 $9,861 2.5×
Venography Renal Unilateral (75831) $9,861 $9,861 2.5×
Venous sampling by catheter (75893) $16,936 $16,936 2.4×
Wrist 2 views (73100) $613 $613 5.6×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $613 $613 5.6×
X-ray antegrade pyelogram tube (74425) $1,776 $1,776 4.1×
X-Ray Aorta Leg Arteries (75630) $9,861 $9,861 2.5×
X-Ray Bend Only L-S Spine (72120) $739 $739 5.7×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $613 $613 5.6×
X-Ray Exam Breast Specimen (76098) $4,080 $4,080 6.0×
X-Ray Exam Entire Spi 1 Vw (72081) $613 $613 5.6×
X-Ray Exam Entire Spi 2/3 Vw (72082) $739 $739 5.7×
X-Ray Exam Entire Spi 4/5 Vw (72083) $739 $739 5.7×
X-Ray Exam Hip Uni 1 View (73501) $613 $613 5.6×
X-Ray Exam Hip Uni 2-3 Views (73502) $613 $613 5.6×
X-Ray Exam Hip Uni 4/> Views (73503) $739 $739 5.7×
X-Ray Exam Hips Bi 2 Views (73521) $739 $739 5.7×
X-Ray Exam Hips Bi 3-4 Views (73522) $739 $739 5.7×
X-Ray Exam Hips Bi 5/> Views (73523) $739 $739 5.7×
X-Ray Exam L-S Spine Bending (72114) $739 $739 5.7×
X-Ray Exam Neck Spine 2-3 Vw (72040) $613 $613 5.6×
X-Ray Exam Neck Spine 6/>Vws (72052) $739 $739 5.7×
X-Ray Exam Unilat Ribs/Chest (71101) $739 $739 5.7×
X-ray eye for foreign body (70030) $438 $438 4.0×
X-ray humerus (73060) $613 $613 5.6×
X-ray IV pyelogram (ivp) (74400) $886 $886 4.0×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $613 $613 5.6×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $613 $613 5.6×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $739 $739 5.7×
X-ray nose-rectum child f.b. (76010) $438 $438 4.0×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $739 $739 5.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $739 $739 5.7×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $739 $739 5.7×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $613 $613 5.6×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $613 $613 5.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $739 $739 5.7×
X-ray thoracic spine 4 vw (72074) $739 $739 5.7×
X-Ray Tmj Unilat (70328) $613 $613 5.6×
X-Ray Urinary Tract Exam With Contrast Material (74420) $1,776 $1,776 4.1×
X-Rays Bone Length Studies (77073) $739 $739 5.7×
X-Rays Bone Survey Complete (77075) $739 $739 5.7×
Xr c-spine 4 or 5 views (72050) $739 $739 5.7×
Xr facial bones less than 3 views (70140) $613 $613 5.6×
Xr orbits complete 4 views (70200) $739 $739 5.7×

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.