Imaging prices at Ridgeview Sibley Medical Center
Arlington, MN · every code in this section with a posted price and a Medicare benchmark.
282 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) range across 2 matching MRF lines |
$501.15–$3,451.37 | $771–$5,309.80 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$19.50–$174.85 | $30–$269 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$24.05–$271.05 | $37–$417 | varies |
| Angiography extremity bilateral rs&i (75716) | $203.45 | $313 | 0.1× |
| Angiography extremity unilateral rs&i (75710) | $182 | $280 | 0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $116.35 | $179 | 0.0× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$17.55–$174.85 | $27–$269 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$117.65 | $181 | 0.0× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$206.70 | $318 | 0.0× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$114.40 | $176 | 0.0× |
| Arthrogram ankle (73615) | $61.10 | $94 | 0.2× |
| Arthrogram hip (73525) | $63.05 | $97 | 0.2× |
| Arthrogram Wrist (73115) | $59.80 | $92 | 0.2× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$72.80–$348.93 | $112–$536.82 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$20.80–$235.95 | $32–$363 | varies |
| Bone Imaging Whole Body (78306) | $1,388.40 | $2,136 | 3.4× |
| Bone survey infant (77076) | $74.10 | $114 | 0.7× |
| Cat Scan Follow-Up Study (76380) | $100.75 | $155 | 1.1× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$18.85–$174.85 | $29–$269 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$23.40–$278.85 | $36–$429 | varies |
| Chest 3 views (71047) | $29.25 | $45 | 0.3× |
| Chest 4 or more views (71048) | $32.50 | $50 | 0.3× |
| Cholecystography Oral Contrast (74290) | $33.80 | $52 | 0.2× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$18.20–$218.40 | $28–$336 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$113.75–$881.40 | $175–$1,356 | varies |
| Continuing medical physics consltj pr wk (77336) | $428.23 | $658.82 | 3.1× |
| Contrast Exam Abdominl Aorta (75625) | $148.85 | $229 | 0.0× |
| Contrast X-Ray Bladder (74430) | $33.80 | $52 | 0.1× |
| Contrast X-Ray Of Elbow (73085) | $57.20 | $88 | 0.2× |
| Contrast X-Ray Of Knee Joint (73580) | $68.25 | $105 | 0.2× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$210.60–$3,426.80 | $324–$5,272 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$182.65–$2,977 | $281–$4,580 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$133.90–$1,573 | $206–$2,420 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$146.90–$1,761.50 | $226–$2,710 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$125.45–$769.60 | $193–$1,184 | varies |
| CT Angio Abdomen and Pelvis (74174) | $2,907.45 | $4,473 | 8.0× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$191.10–$1,554.80 | $294–$2,392 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$183.30–$1,851.20 | $282–$2,848 | varies |
| CT angio hrt w/3d image (75574) | $250.25 | $385 | 0.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$197.60–$1,444.30 | $304–$2,222 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$183.30–$1,900.60 | $282–$2,924 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $187.85 | $289 | 1.0× |
| CT cervical spine w/ contrast (72126) | $128.05 | $197 | 0.4× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$104.65–$1,457.30 | $161–$2,242 | varies |
| CT cervical spine w/wo cont (72127) | $133.25 | $205 | 0.7× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$122.85–$1,355.25 | $189–$2,085 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$131.30–$1,677 | $202–$2,580 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$118.95–$1,227.20 | $183–$1,888 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$133.90–$1,321.45 | $206–$2,033 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $182 | $280 | 0.5× |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$61.10–$73.45 | $94–$113 | varies |
| CT hrt w/3d image congen (75573) | $265.85 | $409 | 0.7× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$118.95–$1,162.20 | $183–$1,788 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$133.25–$1,610.70 | $205–$2,478 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$104.65–$1,294.80 | $161–$1,992 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$122.20–$1,069.25 | $188–$1,645 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$128.05–$1,443.65 | $197–$2,221 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$104.65–$1,521 | $161–$2,340 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$118.30–$1,355.25 | $182–$2,085 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$89.70–$1,456 | $138–$2,240 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$169–$1,519.70 | $260–$2,338 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$133.25–$1,461.20 | $205–$2,248 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$135.85–$1,360.45 | $209–$2,093 | varies |
| CT pelvis w&w/o contrast (72194) | $127.40 | $196 | 0.7× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$114.40–$1,426.10 | $176–$2,194 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$127.40–$1,261 | $196–$1,940 | varies |
| CT scans face/jaw combo (70488) | $133.25 | $205 | 0.7× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$145.60–$1,227.20 | $224–$1,888 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$134.55–$1,426.10 | $207–$2,194 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$128.70–$1,974.70 | $198–$3,038 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$104.65–$1,554.80 | $161–$2,392 | varies |
| CT thoracic spine w/wo cont (72130) | $133.90 | $206 | 0.7× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$113.75–$1,554.80 | $175–$2,392 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$104.65–$1,459.90 | $161–$2,246 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $127.40 | $196 | 0.7× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$122.20–$1,273.35 | $188–$1,959 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$248.30–$2,009.15 | $382–$3,091 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$190.45–$2,529.15 | $293–$3,891 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$187.85–$1,592.50 | $289–$2,450 | varies |
| Dilation ureters/urethra rs&i (74485) | $86.45 | $133 | 0.0× |
| Doppler Fetal Mid Cerebral Artery (76821) | $74.10 | $114 | 0.7× |
| Dxa Bone Density Axial (77080) | $297.05 | $457 | 2.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $21.45 | $33 | 0.2× |
| Echo exam of fetal heart (76825) | $175.50 | $270 | 0.3× |
| Echo exam uterus (76831) | $76.70 | $118 | 0.3× |
| Echo Guide For Artery Repair (76936) | $206.70 | $318 | 0.9× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $87.10 | $134 | 0.4× |
| Esophagram (74220) | $63.05 | $97 | 0.3× |
| Fetal Biophys Profile W/Nst (76818) | $111.15 | $171 | 1.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$81.25–$475.15 | $125–$731 | varies |
| Fluoroscopy up to 1 hr (76000) | $33.15 | $51 | 0.1× |
| Follow-Up Angiography (75898) | $201.50 | $310 | 0.1× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$16.90–$174.85 | $26–$269 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$17.55–$218.40 | $27–$336 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$18.20–$226.20 | $28–$348 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $114.40 | $176 | 0.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $114.40 | $176 | 0.0× |
| Hepatobil Syst Image W/Drug (78227) | $1,360.45 | $2,093 | 2.4× |
| Hysterosalpingogram (74740) | $40.95 | $63 | 0.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $78 | $120 | 0.9× |
| Infant hip ultrasound, limited static exam (76886) | $65.65 | $101 | 0.7× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$20.80–$278.85 | $32–$429 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$155.35–$2,119.65 | $239–$3,261 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$501.80–$823.36 | $772–$1,266.71 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$156–$2,303.60 | $240–$3,544 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$126.10–$2,105.35 | $194–$3,239 | varies |
| MRA head with contrast (70545) | $126.10 | $194 | 0.3× |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$157.95–$2,432.30 | $243–$3,742 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$188.50–$2,909.40 | $290–$4,476 | varies |
| MRA neck w/o contrast (70547) | $126.10 | $194 | 0.5× |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$181.35–$1,312.35 | $279–$2,019 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$153.40–$2,043.60 | $236–$3,144 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$170.95–$2,561 | $263–$3,940 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$226.20–$3,725.15 | $348–$5,731 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $171.60 | $264 | 0.2× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$188.50–$2,351.05 | $290–$3,617 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$156–$2,082.60 | $240–$3,204 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$153.40–$2,136.55 | $236–$3,287 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$237.25–$1,955.20 | $365–$3,008 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$170.30–$2,451.15 | $262–$3,771 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$225.55–$3,571.10 | $347–$5,494 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$141.70–$1,955.85 | $218–$3,009 | varies |
| MRI lumbar spine w contrast (72149) | $187.85 | $289 | 0.5× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$241.15–$2,634.45 | $371–$4,053 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$141.70–$1,495 | $218–$2,300 | varies |
| MRI orbit face neck w contrast (70542) | $170.30 | $262 | 0.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$225.55–$3,478.80 | $347–$5,352 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$181.35–$1,503.45 | $279–$2,313 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$230.75–$2,578.55 | $355–$3,967 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$154.05–$2,078.70 | $237–$3,198 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$156–$2,167.75 | $240–$3,335 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$170.95–$1,045.85 | $263–$1,609 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$143–$1,803.10 | $220–$2,774 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$226.20–$2,885.35 | $348–$4,439 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$230.75–$3,192.15 | $355–$4,911 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$241.15–$2,663.05 | $371–$4,097 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$187.20–$1,973.40 | $288–$3,036 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$143–$1,957.15 | $220–$3,011 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$226.85–$3,045.25 | $349–$4,685 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$241.15–$3,415.10 | $371–$5,254 | varies |
| Myelogram cervical (72240) | $96.85 | $149 | 0.1× |
| Myelography thoracic (72255) | $96.20 | $148 | 0.1× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$167.05–$3,430.05 | $257–$5,277 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$19.50–$121.55 | $30–$187 | varies |
| Nonvascular Shunt X-Ray (75809) | $50.70 | $78 | 0.5× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$934.05–$2,910.74 | $1,437–$4,478.06 | varies |
| Ob us nuchal meas 1 gest (76813) | $124.15 | $191 | 1.1× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $71.50 | $110 | 0.8× |
| Optic foramina (70190) | $24.05 | $37 | 0.3× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$18.85–$218.40 | $29–$336 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $143.65 | $221 | 0.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$33.80–$318.50 | $52–$490 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $54.60 | $84 | 0.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$18.85–$218.40 | $29–$336 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$17.55–$218.40 | $27–$336 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$18.85–$218.40 | $29–$336 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$27.95–$352.95 | $43–$543 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$14.95–$174.85 | $23–$269 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$18.20–$218.40 | $28–$336 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$18.85–$218.40 | $29–$336 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$17.55–$198.90 | $27–$306 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $36.40 | $56 | 0.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$18.20–$251.55 | $28–$387 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$23.40–$218.40 | $36–$336 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$20.80–$263.25 | $32–$405 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$18.85–$170.30 | $29–$262 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$17.55–$338.65 | $27–$521 | varies |
| Radex Sternum Minimum 2 Views (71120) | $21.45 | $33 | 0.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $26 | $40 | 0.3× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$14.30–$215.15 | $22–$331 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $17.55 | $27 | 0.2× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$18.85–$218.40 | $29–$336 | varies |
| Radiation treatment delivery level 1 (77402) | $295.15 | $454.07 | 2.8× |
| Radiation treatment delivery level 3 (77412) | $506.84 | $779.76 | 0.9× |
| Radiolog exam mandible compl minimum 4 views (70110) | $26.65 | $41 | 0.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $28.60 | $44 | 0.3× |
| Radiologic exam colon double contrast study (74280) | $132.60 | $204 | 0.7× |
| Radiologic exam colon single contrast study (74270) | $108.55 | $167 | 0.6× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$24.70–$273.65 | $38–$421 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$27.30–$371.15 | $42–$571 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $84.50 | $130 | 0.5× |
| Radiologic exam swallow function contrast study (74230) | $56.55 | $87 | 0.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $94.25 | $145 | 0.5× |
| Radiologic examination femur 1 view (73551) | $18.20 | $28 | 0.2× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$19.50–$304.20 | $30–$468 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$18.20–$218.40 | $28–$336 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$17.55–$218.40 | $27–$336 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $38.35 | $59 | 0.1× |
| Ribs bilateral 3 views (71110) | $31.20 | $48 | 0.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $68.25 | $105 | 0.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $148.20 | $228 | 0.1× |
| Scapula (73010) range across 2 matching MRF lines |
$19.50–$218.40 | $30–$336 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$63.05–$117.65 | $97–$181 | varies |
| Shoulder 1 view (73020) | $16.90 | $26 | 0.2× |
| Shoulder Arthrography (73040) | $59.15 | $91 | 0.2× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$19.50–$321.10 | $30–$494 | varies |
| Special Physics Consult (77370) | $551.67 | $848.72 | 4.0× |
| Special teletherapy port plan (77321) | $781.30 | $1,202 | 2.0× |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$237.90–$1,381.93 | $366–$2,126.04 | varies |
| Stereotactic Body Radiation Delivery (77373) | $21,983.03 | $33,820.05 | 11.9× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$23.40–$266.50 | $36–$410 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$338.65–$3,199.68 | $521–$4,922.58 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$183.30–$1,081.27 | $282–$1,663.49 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$83.85–$579.25 | $129–$891.16 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$22.10–$213.20 | $34–$328 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$24.05–$274.30 | $37–$422 | varies |
| Thoracolumbar 2 views (72080) | $22.75 | $35 | 0.3× |
| Tx Devices Design & Construction Complex (77334) range across 3 matching MRF lines |
$134.55–$899.91 | $207–$1,384.47 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$87.75–$402.02 | $135–$618.50 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$53.30–$330.31 | $82–$508.17 | varies |
| Ultrasound Breast Limited (76642) | $72.15 | $111 | 0.8× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$57.85–$308.75 | $89–$475 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$61.75–$416 | $95–$640 | varies |
| Umbilical-artery Doppler (OB) (76820) | $52.65 | $81 | 0.5× |
| Upper gi w/o kub (74240) | $84.50 | $130 | 0.5× |
| Urethrocystogram voiding (74455) | $34.45 | $53 | 0.1× |
| Urethrocystography retrograde (74450) | $34.45 | $53 | 0.1× |
| Us breast unilateral complete (76641) | $77.35 | $119 | 0.7× |
| Us chest (76604) range across 2 matching MRF lines |
$59.80–$359.45 | $92–$553 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$96.20–$396.50 | $148–$610 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$52–$359.45 | $80–$553 | varies |
| Us head (76506) | $68.90 | $106 | 0.6× |
| Us kidney transplant (76776) | $79.30 | $122 | 0.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$72.80–$310.70 | $112–$478 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$68.25–$338.65 | $105–$521 | varies |
| Us ob transvaginal (76817) | $368.55 | $567 | 3.4× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$72.15–$570.70 | $111–$878 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$104–$338.65 | $160–$521 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$89.70–$353.60 | $138–$544 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$78–$601.90 | $120–$926 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$61.10–$491.40 | $94–$756 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$66.95–$500.50 | $103–$770 | varies |
| Us spinal canal and contents (76800) | $137.80 | $212 | 1.3× |
| Us thyroid (76536) range across 2 matching MRF lines |
$59.15–$500.50 | $91–$770 | varies |
| Us transrectal (76872) | $72.15 | $111 | 0.7× |
| Vein X-Ray Chest (75827) | $118.30 | $182 | 0.1× |
| Venogram Sinus/Jugular (75860) | $117.65 | $181 | 0.0× |
| Venography caval inferior serialography rs&i (75825) | $117.65 | $181 | 0.0× |
| Venography extremity bilateral rs&i (75822) | $152.10 | $234 | 0.1× |
| Venography extremity unilateral rs&i (75820) | $108.55 | $167 | 0.1× |
| Venography Renal Bilateral (75833) | $154.05 | $237 | 0.0× |
| Venography Renal Unilateral (75831) | $113.75 | $175 | 0.0× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$18.20–$174.85 | $28–$269 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $20.80 | $32 | 0.2× |
| X-ray antegrade pyelogram tube (74425) | $52.65 | $81 | 0.1× |
| X-Ray Aorta Leg Arteries (75630) | $206.70 | $318 | 0.1× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$24.05–$239.85 | $37–$369 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$18.20–$224.25 | $28–$345 | varies |
| X-Ray Exam Breast Specimen (76098) | $33.80 | $52 | 0.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$27.95–$256.75 | $43–$395 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$33.80–$375.05 | $52–$577 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$20.80–$174.85 | $32–$269 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$24.05–$278.85 | $37–$429 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $29.25 | $45 | 0.3× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$24.05–$384.15 | $37–$591 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $31.85 | $49 | 0.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$33.80–$530.40 | $52–$816 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $32.50 | $50 | 0.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$24.05–$218.40 | $37–$336 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $32.50 | $50 | 0.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$28.60–$218.40 | $44–$336 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$18.85–$109.20 | $29–$168 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$17.55–$271.70 | $27–$418 | varies |
| X-ray IV pyelogram (ivp) (74400) | $52 | $80 | 0.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$19.50–$296.40 | $30–$456 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$18.20–$234 | $28–$360 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$24.05–$278.85 | $37–$429 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$18.85–$223.60 | $29–$344 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$34.45–$218.40 | $53–$336 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$24.05–$336.05 | $37–$517 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $18.20 | $28 | 0.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$18.85–$278.85 | $29–$429 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$23.40–$262.60 | $36–$404 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $29.90 | $46 | 0.3× |
| X-Ray Tmj Unilat (70328) | $19.50 | $30 | 0.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $53.95 | $83 | 0.1× |
| X-Rays Bone Length Studies (77073) | $29.25 | $45 | 0.3× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$58.50–$572.65 | $90–$881 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$28.60–$352.95 | $44–$543 | varies |
| Xr facial bones less than 3 views (70140) | $21.45 | $33 | 0.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $19.50 | $30 | 0.2× |
| Xr orbits complete 4 views (70200) | $29.90 | $46 | 0.3× |
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.