Imaging prices at Ridgeview Le Sueur Medical Center
Le Sueur, MN · every code in this section with a posted price and a Medicare benchmark.
285 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) | $539.70 | $771 | 0.4× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$21–$283.50 | $30–$405 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$25.90–$386.40 | $37–$552 | varies |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$174.30–$219.10 | $249–$313 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$167.30–$196 | $239–$280 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$125.30–$200.90 | $179–$287 | varies |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$18.90–$248.50 | $27–$355 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$126.70–$165.20 | $181–$236 | varies |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$187.60–$222.60 | $268–$318 | varies |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$123.20–$223.30 | $176–$319 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$65.80–$244.30 | $94–$349 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$67.90–$244.30 | $97–$349 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$64.40–$261.80 | $92–$374 | varies |
| Basic radiation dosimetry calculation (77300) | $78.40 | $112 | 0.6× |
| Bone age studies (77072) range across 2 matching MRF lines |
$22.40–$264.60 | $32–$378 | varies |
| Bone Imaging 3 Phase (78315) | $1,953.70 | $2,791 | 4.7× |
| Bone Imaging Whole Body (78306) | $1,581.30 | $2,259 | 3.8× |
| Bone survey infant (77076) | $79.80 | $114 | 0.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $611.80 | $874 | 1.7× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$108.50–$216.30 | $155–$309 | varies |
| Chest 1 view (71045) range across 2 matching MRF lines |
$20.30–$258.30 | $29–$369 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$25.20–$307.30 | $36–$439 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$31.50–$71.40 | $45–$102 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$35–$76.30 | $50–$109 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$36.40–$169.40 | $52–$242 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$19.60–$260.40 | $28–$372 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$122.50–$218.40 | $175–$312 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$144.90–$160.30 | $207–$229 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$36.40–$63.70 | $52–$91 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$61.60–$180.60 | $88–$258 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$73.50–$194.60 | $105–$278 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$226.80–$4,888.10 | $324–$6,983 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$196.70–$3,977.40 | $281–$5,682 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$144.20–$2,440.20 | $206–$3,486 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$158.20–$2,620.10 | $226–$3,743 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$135.10–$2,078.30 | $193–$2,969 | varies |
| CT Angio Abdomen and Pelvis (74174) | $4,015.20 | $5,736 | 11.0× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$205.80–$2,336.60 | $294–$3,338 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$197.40–$2,204.30 | $282–$3,149 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$269.50–$528.50 | $385–$755 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$212.80–$1,555.40 | $304–$2,222 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$197.40–$2,161.60 | $282–$3,088 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$202.30–$534.10 | $289–$763 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$137.90–$280.70 | $197–$401 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$112.70–$2,248.40 | $161–$3,212 | varies |
| CT cervical spine w/wo cont (72127) | $143.50 | $205 | 0.8× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$132.30–$2,054.50 | $189–$2,935 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$141.40–$2,300.90 | $202–$3,287 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$128.10–$1,707.30 | $183–$2,439 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$144.20–$2,237.20 | $206–$3,196 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$196–$368.20 | $280–$526 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$65.80–$182 | $94–$260 | varies |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$286.30–$466.20 | $409–$666 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$128.10–$1,906.10 | $183–$2,723 | varies |
| CT l-spine w&w/o contrast (72133) | $143.50 | $205 | 0.8× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$112.70–$1,546.30 | $161–$2,209 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$131.60–$1,151.50 | $188–$1,645 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$137.90–$2,474.50 | $197–$3,535 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$112.70–$2,248.40 | $161–$3,212 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$127.40–$1,897 | $182–$2,710 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$96.60–$1,553.30 | $138–$2,219 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$182–$2,642.50 | $260–$3,775 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$143.50–$379.40 | $205–$542 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$146.30–$1,884.40 | $209–$2,692 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$137.20–$490 | $196–$700 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$123.20–$1,884.40 | $176–$2,692 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$137.20–$347.20 | $196–$496 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$143.50–$2,058 | $205–$2,940 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$156.80–$2,401.70 | $224–$3,431 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$144.90–$1,848.70 | $207–$2,641 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$138.60–$2,126.60 | $198–$3,038 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$112.70–$2,248.40 | $161–$3,212 | varies |
| CT thoracic spine w/wo cont (72130) | $144.20 | $206 | 0.8× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$122.50–$1,884.40 | $175–$2,692 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$112.70–$1,572.20 | $161–$2,246 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$137.20–$616.70 | $196–$881 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$131.60–$366.80 | $188–$524 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$267.40–$2,701.30 | $382–$3,859 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$205.10–$2,723.70 | $293–$3,891 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$202.30–$1,715 | $289–$2,450 | varies |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$93.10–$196 | $133–$280 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$79.80–$135.80 | $114–$194 | varies |
| Dxa Bone Density Axial (77080) | $72.10 | $103 | 0.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$23.10–$54.60 | $33–$78 | varies |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$189–$443.80 | $270–$634 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$82.60–$199.50 | $118–$285 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$222.60–$406.70 | $318–$581 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) range across 2 matching MRF lines |
$93.80–$285.60 | $134–$408 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$67.90–$168 | $97–$240 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$119.70–$168 | $171–$240 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$87.50–$511.70 | $125–$731 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$35.70–$67.90 | $51–$97 | varies |
| Follow-Up Angiography (75898) | $217 | $310 | 0.1× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$18.20–$243.60 | $26–$348 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$18.90–$267.40 | $27–$382 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$19.60–$243.60 | $28–$348 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 2 matching MRF lines |
$123.20–$175 | $176–$250 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$123.20–$176.40 | $176–$252 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,703.10 | $2,433 | 3.0× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$44.10–$183.40 | $63–$262 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$84–$244.30 | $120–$349 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$70.70–$170.80 | $101–$244 | varies |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$22.40–$315 | $32–$450 | varies |
| Leveen/Shunt Patency Exam (78291) | $485.80 | $694 | 1.2× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$167.30–$2,282.70 | $239–$3,261 | varies |
| Mlc imrt design & construction per imrt plan (77338) | $540.40 | $772 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$168–$2,480.80 | $240–$3,544 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$135.80–$2,267.30 | $194–$3,239 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$135.80–$2,308.60 | $194–$3,298 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$170.10–$2,619.40 | $243–$3,742 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$203–$3,133.20 | $290–$4,476 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$135.80–$401.10 | $194–$573 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$195.30–$1,413.30 | $279–$2,019 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$165.20–$2,467.50 | $236–$3,525 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$184.10–$2,758 | $263–$3,940 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$243.60–$4,011.70 | $348–$5,731 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$184.80–$594.30 | $264–$849 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $363.30 | $519 | 1.5× |
| MRI cardiac w/o contrast (75557) | $428.40 | $612 | 1.7× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$203–$2,531.90 | $290–$3,617 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$168–$2,494.80 | $240–$3,564 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$165.20–$2,300.90 | $236–$3,287 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$255.50–$916.30 | $365–$1,309 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$183.40–$2,639.70 | $262–$3,771 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$242.90–$3,845.80 | $347–$5,494 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$152.60–$3,339 | $218–$4,770 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$202.30–$2,922.50 | $289–$4,175 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$259.70–$3,617.60 | $371–$5,168 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$152.60–$1,610 | $218–$2,300 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$183.40–$484.40 | $262–$692 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$242.90–$3,746.40 | $347–$5,352 | varies |
| MRI pelvis w contrast (72196) range across 3 matching MRF lines |
$195.30–$667.10 | $279–$953 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$248.50–$3,203.90 | $355–$4,577 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$165.90–$2,258.90 | $237–$3,227 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$168–$2,572.50 | $240–$3,675 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$184.10–$640.50 | $263–$915 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$154–$2,296 | $220–$3,280 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$243.60–$3,107.30 | $348–$4,439 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$248.50–$3,437.70 | $355–$4,911 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$259.70–$3,583.30 | $371–$5,119 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$201.60–$2,125.20 | $288–$3,036 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$154–$2,485 | $220–$3,550 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$244.30–$3,279.50 | $349–$4,685 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$259.70–$3,677.80 | $371–$5,254 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$104.30–$167.30 | $149–$239 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$103.60–$157.50 | $148–$225 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$179.90–$3,693.90 | $257–$5,277 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$21–$249.20 | $30–$356 | varies |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$54.60–$143.50 | $78–$205 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,005.90 | $1,437 | 0.7× |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$133.70–$146.30 | $191–$209 | varies |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $77 | $110 | 0.8× |
| Optic foramina (70190) range across 2 matching MRF lines |
$25.90–$65.80 | $37–$94 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$20.30–$256.20 | $29–$366 | varies |
| Pet Image W/Ct Lmtd (78814) | $3,122 | $4,460 | 2.1× |
| PET image w/CT, full body (78816) | $3,637.20 | $5,196 | 2.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,637.20 | $5,196 | 2.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) range across 2 matching MRF lines |
$154.70–$175 | $221–$250 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$36.40–$425.60 | $52–$608 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$58.80–$85.40 | $84–$122 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$20.30–$287.70 | $29–$411 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$18.90–$251.30 | $27–$359 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$20.30–$396.20 | $29–$566 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$30.10–$380.10 | $43–$543 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$16.10–$233.80 | $23–$334 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$19.60–$283.50 | $28–$405 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$20.30–$285.60 | $29–$408 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$18.90–$170.80 | $27–$244 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$39.20–$111.30 | $56–$159 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$19.60–$373.80 | $28–$534 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$25.20–$360.50 | $36–$515 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$22.40–$401.80 | $32–$574 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$20.30–$233.80 | $29–$334 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$18.90–$364.70 | $27–$521 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$23.10–$306.60 | $33–$438 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$28–$100.80 | $40–$144 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$15.40–$231.70 | $22–$331 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$18.90–$58.10 | $27–$83 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$20.30–$307.30 | $29–$439 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$28.70–$438.20 | $41–$626 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$30.80–$73.50 | $44–$105 | varies |
| Radiologic exam colon double contrast study (74280) | $142.80 | $204 | 0.8× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$116.90–$254.10 | $167–$363 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$26.60–$380.80 | $38–$544 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$29.40–$399.70 | $42–$571 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$91–$203 | $130–$290 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$60.90–$240.80 | $87–$344 | varies |
| Radiologic exam upr gi trc double contrast study (74246) | $101.50 | $145 | 0.6× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$19.60–$51.80 | $28–$74 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$21–$294.70 | $30–$421 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$19.60–$273 | $28–$390 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$18.90–$276.50 | $27–$395 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) range across 2 matching MRF lines |
$41.30–$109.20 | $59–$156 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$33.60–$73.50 | $48–$105 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $73.50 | $105 | 0.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $159.60 | $228 | 0.1× |
| Scapula (73010) range across 2 matching MRF lines |
$21–$303.10 | $30–$433 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$67.90–$126.70 | $97–$181 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$18.20–$223.30 | $26–$319 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$63.70–$254.80 | $91–$364 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$21–$345.80 | $30–$494 | varies |
| Special treatment procedure (77470) | $256.20 | $366 | 0.4× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$25.20–$74.90 | $36–$107 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $364.70 | $521 | 0.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $197.40 | $282 | 0.5× |
| Ther rad simulaj-aided field setting simple (77280) | $90.30 | $129 | 0.6× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$23.80–$229.60 | $34–$328 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$25.90–$419.30 | $37–$599 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$24.50–$60.20 | $35–$86 | varies |
| Tx Devices Design & Construction Complex (77334) | $144.90 | $207 | 0.4× |
| Tx devices design & construction intermediate (77333) | $94.50 | $135 | 0.7× |
| Tx devices design & construction simple (77332) | $57.40 | $82 | 0.4× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$77.70–$128.10 | $111–$183 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$62.30–$545.30 | $89–$779 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$66.50–$594.30 | $95–$849 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$51.80–$56.70 | $74–$81 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$91–$205.80 | $130–$294 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$37.10–$214.20 | $53–$306 | varies |
| Urethrocystography retrograde (74450) | $37.10 | $53 | 0.1× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$83.30–$165.20 | $119–$236 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$64.40–$499.10 | $92–$713 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$26.60–$427 | $38–$610 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$56–$428.40 | $80–$612 | varies |
| Us head (76506) range across 2 matching MRF lines |
$74.20–$199.50 | $106–$285 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$85.40–$270.90 | $122–$387 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 6 matching MRF lines |
$74.90–$334.60 | $107–$478 | varies |
| Us ob detailed single fetus (76811) | $686 | $980 | 2.7× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$73.50–$397.60 | $105–$568 | varies |
| Us ob transvaginal (76817) | $476.70 | $681 | 4.4× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$77.70–$618.10 | $111–$883 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$112–$513.10 | $160–$733 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$96.60–$380.80 | $138–$544 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$84–$648.20 | $120–$926 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$65.80–$562.80 | $94–$804 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$72.10–$569.10 | $103–$813 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$148.40–$270.20 | $212–$386 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$63.70–$544.60 | $91–$778 | varies |
| Us transrectal (76872) | $77.70 | $111 | 0.7× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$127.40–$159.60 | $182–$228 | varies |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$126.70–$176.40 | $181–$252 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$126.70–$149.10 | $181–$213 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$158.90–$163.80 | $227–$234 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$116.90–$143.50 | $167–$205 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$165.90–$191.80 | $237–$274 | varies |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$122.50–$165.90 | $175–$237 | varies |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$19.60–$238.70 | $28–$341 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$22.40–$295.40 | $32–$422 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$56.70–$271.60 | $81–$388 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$156.80–$222.60 | $224–$318 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$25.90–$72.80 | $37–$104 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$19.60–$241.50 | $28–$345 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$36.40–$67.20 | $52–$96 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$30.10–$276.50 | $43–$395 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$36.40–$403.90 | $52–$577 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$22.40–$213.50 | $32–$305 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$25.90–$305.90 | $37–$437 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$31.50–$355.60 | $45–$508 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$25.90–$471.10 | $37–$673 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$34.30–$96.60 | $49–$138 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$36.40–$471.10 | $52–$673 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$35–$114.10 | $50–$163 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$25.90–$329 | $37–$470 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$35–$116.90 | $50–$167 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$30.80–$386.40 | $44–$552 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$20.30–$268.80 | $29–$384 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$18.90–$277.20 | $27–$396 | varies |
| X-ray IV pyelogram (ivp) (74400) | $56 | $80 | 0.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$21–$319.20 | $30–$456 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$19.60–$252 | $28–$360 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$25.90–$408.10 | $37–$583 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$20.30–$240.80 | $29–$344 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$37.10–$486.50 | $53–$695 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$25.90–$361.90 | $37–$517 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$19.60–$61.60 | $28–$88 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$20.30–$356.30 | $29–$509 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$25.20–$380.10 | $36–$543 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$32.20–$76.30 | $46–$109 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$21–$63 | $30–$90 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $58.10 | $83 | 0.2× |
| X-Rays Bone Length Studies (77073) | $31.50 | $45 | 0.3× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$63–$703.50 | $90–$1,005 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$30.80–$480.20 | $44–$686 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$23.10–$55.30 | $33–$79 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$21–$72.10 | $30–$103 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$32.20–$84 | $46–$120 | 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.