Imaging prices at Roper St. Francis Berkeley Hospital

Summerville, SC · every code in this section with a posted price and a Medicare benchmark.

355 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) $4,208.10 $6,474 3.3×
Abdomen 1 View (74018) $438.10 $674 5.4×
Abdomen 2 views (74019) $578.50 $890 5.9×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,368.90 $2,106 3.7×
Angio internal mammary (75756) $4,325.10 $6,654 1.5×
Angio pulmonary bilat (75743) $4,687.15 $7,211 1.6×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $1,905.80 $2,932 0.6×
Angiography extremity bilateral rs&i (75716) $3,963.70 $6,098 1.3×
Angiography extremity unilateral rs&i (75710) $2,345.20 $3,608 0.8×
Angiography pulmonary unilateral slctv rs&i (75741) $2,009.80 $3,092 0.7×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $2,089.10 $3,214 0.7×
Ankle 2 views (73600) $297.70 $458 3.7×
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure		 $2,529.80 $3,892 0.5×
Aortography thoracic w/o serialography rs&i (75600) $4,468.75 $6,875 1.5×
Artery X-Rays Abdomen (75726) $5,861.05 $9,017 1.1×
Artery X-Rays Adrenal Gland (75731) $2,042.30 $3,142 0.7×
Artery X-Rays Pelvis (75736) $4,402.45 $6,773 0.9×
Artery X-Rays Spine (75705)
unusually low: confirm this is the full procedure		 $2,124.85 $3,269 0.4×
Arthrogram ankle (73615) $658.45 $1,013 2.0×
Arthrogram hip (73525) $658.45 $1,013 2.0×
Arthrogram Wrist (73115) $390.65 $601 1.2×
Basic radiation dosimetry calculation (77300) $380.90 $586 3.0×
Bone age studies (77072) $163.80 $252 1.7×
Bone Imaging 3 Phase (78315) $2,290.60 $3,524 6.2×
Bone Imaging Limited Area (78300) $1,233.70 $1,898 3.3×
Bone Imaging Multiple Areas (78305) $1,472.25 $2,265 4.0×
Bone Imaging Whole Body (78306) $1,828.45 $2,813 4.9×
Bone marrow imaging limited area (78102) $876.20 $1,348 2.4×
Bone survey infant (77076) $307.45 $473 3.2×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $1,867.45 $2,873 3.7×
Cardiac MRI w/w/o contrast & further seq (75561) $3,020.55 $4,647 9.3×
Cat Scan Follow-Up Study (76380) $1,799.85 $2,769 22.2×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $1,320.15 $2,031 2.6×
Cerebrospinal Fluid Scan (78630) $2,084.55 $3,207 4.1×
Chest 1 view (71045) $175.50 $270 2.2×
Chest 2 views (71046) $466.70 $718 5.8×
Chest 3 views (71047) $537.55 $827 6.6×
Chest 4 or more views (71048) $692.90 $1,066 7.1×
Clavicle complete (73000) $681.85 $1,049 8.4×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $343.85 $529 3.5×
Continuing medical physics consltj pr wk (77336) $393.25 $605 3.1×
Contrast Exam Abdominl Aorta (75625) $1,936.35 $2,979 0.7×
Contrast X-Ray Bladder (74430) $585 $900 1.8×
Contrast X-Ray Of Elbow (73085) $2,409.55 $3,707 7.4×
Contrast X-Ray Of Knee Joint (73580) $432.90 $666 1.3×
CT abdomen and pelvis without and with contrast (74178) $2,442.05 $3,757 7.5×
CT abdomen and pelvis without contrast (74176) $3,185.65 $4,901 14.4×
CT abdomen w contrast (74160) $1,282.45 $1,973 7.9×
CT abdomen w wo contrast (74170) $1,282.45 $1,973 7.9×
CT abdomen w/o contrast (74150) $1,282.45 $1,973 13.2×
CT Angio Abdomen and Pelvis (74174) $1,794 $2,760 5.5×
CT Angio Chest (71275) $2,172.95 $3,343 13.3×
CT Angio Head (70496) $2,069.60 $3,184 12.7×
CT angio hrt w/3d image (75574) $1,552.20 $2,388 4.8×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,282.45 $1,973 7.9×
CT Angio Neck (70498) $1,709.50 $2,630 10.5×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,709.50 $2,630 10.5×
CT cervical spine w/ contrast (72126) $1,282.45 $1,973 4.0×
CT cervical spine w/o contrast (72125) $1,282.45 $1,973 13.2×
CT cervical spine w/wo cont (72127) $1,709.50 $2,630 10.5×
CT chest w contrast (71260) $1,282.45 $1,973 7.9×
CT chest w/wo contrast (71270) $1,709.50 $2,630 10.5×
CT colonography screening (74263) $1,799.85 $2,769 8.1×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $1,709.50 $2,630 10.5×
CT colonogrphy dx image postprocess w/o contrast (74261) $1,709.50 $2,630 17.6×
CT head/brain with contrast (70460) $1,709.50 $2,630 10.5×
CT head/brain without and with contrast (70470) $1,282.45 $1,973 7.9×
CT heart contrast eval cardiac structure&morph (75572) $1,552.20 $2,388 4.8×
CT heart no contrast quant eval coronry calcium (75571)
range across 2 matching MRF lines		 $175–$362 $175–$362 varies
CT hrt w/3d image congen (75573) $2,069.60 $3,184 6.4×
CT iac w contrast (70481) $1,282.45 $1,973 7.9×
CT l-spine w&w/o contrast (72133) $1,709.50 $2,630 10.5×
CT lower ext w/o (73700) $1,350.05 $2,077 13.9×
CT lower extremity w/contrast material (73701) $1,799.85 $2,769 11.0×
CT lumbar spine w contrast (72132) $1,282.45 $1,973 4.0×
CT lumbar spine w/o contrast (72131) $1,282.45 $1,973 13.2×
CT maxillofacial w contrast (70487) $1,709.50 $2,630 10.5×
CT maxillofacial wo contrast (70486) $1,282.45 $1,973 13.2×
CT neck tissue combo (70492) $1,552.20 $2,388 9.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,709.50 $2,630 10.5×
CT orbits w/o contrast (70480) $1,282.45 $1,973 13.2×
CT pelvis w&w/o contrast (72194) $1,709.50 $2,630 10.5×
CT pelvis w/o contrast (72192) $1,282.45 $1,973 13.2×
CT scan of leg combo (73702) $1,799.85 $2,769 11.0×
CT scans face/jaw combo (70488) $1,709.50 $2,630 10.5×
CT soft tissue neck w contrast (70491) $1,552.20 $2,388 9.5×
CT soft tissue neck w/o contrast (70490) $1,552.20 $2,388 16.0×
CT thoracic spine w contrast (72129) $1,709.50 $2,630 10.5×
CT thoracic spine w/o contrast (72128) $1,709.50 $2,630 17.6×
CT thoracic spine w/wo cont (72130) $1,709.50 $2,630 10.5×
CT thorax w/o contrast (71250) $1,282.45 $1,973 13.2×
CT upper ext wo (73200) $1,282.45 $1,973 13.2×
CT upper extremity w/o & w/contrast material (73202) $1,709.50 $2,630 10.5×
CT upper extremity with contrast (73201) $2,906.80 $4,472 9.0×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,282.45 $1,973 7.9×
Cta Abdomen (74175) $3,043.95 $4,683 18.7×
CTA pelvis (72191) $2,069.60 $3,184 12.7×
Dilation ureters/urethra rs&i (74485) $1,084.20 $1,668 0.6×
Discography Cerv/Thor Spine (72285) $2,280.85 $3,509 1.3×
Diskography lumbar (72295) $2,167.10 $3,334 1.2×
Echo exam uterus (76831) $623.35 $959 2.8×
Echo Guide For Artery Repair (76936) $2,087.15 $3,211 10.4×
Esophagram (74220) $609.05 $937 3.7×
Fetal Biophys Profile W/Nst (76818) $664.30 $1,022 6.8×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $587.60 $904 6.0×
Fluoroscopy up to 1 hr (76000) $464.10 $714 2.1×
Follow-Up Angiography (75898) $4,468.75 $6,875 1.5×
Foot 2 views (73620) $393.90 $606 4.9×
Forearm 2 views (73090) $367.25 $565 4.5×
Gastric emptying imaging study (78264) $1,817.40 $2,796 4.9×
Gated Heart Planar Single (78472) $1,250.60 $1,924 3.4×
GI Endoscopic US S&I (76975) $174.85 $269 0.8×
Hand 2 views (73120) $226.20 $348 2.3×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $3,781.05 $5,817 1.3×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $3,554.20 $5,468 1.2×
Hepatobil Syst Image W/Drug (78227) $2,874.95 $4,423 5.7×
Hepatobiliary System Imaging (78226) $2,237.30 $3,442 6.0×
Ht Muscle Image Spect Sing (78451) $2,538.25 $3,905 2.1×
Hysterosalpingogram (74740) $445.90 $686 2.0×
Joint Survey Single View (77077) $525.85 $809 5.4×
K Flow/Funct Image Multiple (78709) $2,502.50 $3,850 5.0×
K Flow/Funct Image W/Drug (78708) $1,801.15 $2,771 3.6×
K Flow/Funct Image W/O Drug (78707) $1,350.70 $2,078 2.7×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $1,566.50 $2,410 4.2×
Knee 3 Views (73562) $243.10 $374 3.0×
Leveen/Shunt Patency Exam (78291) $1,432.60 $2,204 3.9×
Liver & Spleen Imaging Static Only (78215) $1,426.75 $2,195 3.8×
Liver & Spleen Imaging W/Vascular Flow (78216) $287.30 $442 0.8×
Liver imaging w/vascular flow (78202) $1,716.65 $2,641 3.4×
Lung Perf&Ventilat Diferentl (78598) $3,016.65 $4,641 6.0×
Lung perfusion differential (78597) $1,899.95 $2,923 5.1×
Lung Ventilat&Perfus Imaging (78582) $3,298.75 $5,075 6.5×
Lung Ventilation Imaging (78579) $2,093.65 $3,221 5.6×
Lymph System Imaging (78195) $1,594.45 $2,453 3.2×
Lymphangiography Extremity Only Bilateral Rs&I (75803) $1,657.50 $2,550 1.1×
Lymphangiography extremity only unilateral rs&i (75801) $4,468.75 $6,875 7.7×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $1,861.60 $2,864 0.6×
Magnetic Image Jaw Joint (70336) $2,837.25 $4,365 12.8×
Mammary ductogram or galactogram multiple (77054) $2,409.55 $3,707 10.9×
Mammary ductogram or galactogram single (77053) $763.75 $1,175 3.4×
Meckels Divert Exam (78290) $2,126.80 $3,272 5.7×
Mlc imrt design & construction per imrt plan (77338) $1,035.45 $1,593 3.0×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $50.05 $77 1.9×
Mr safety implt electronics prepj supvj phys/qhp (76018) $187.85 $289 2.1×
Mra Head W/O & W/Contrast Material (70546) $3,116.10 $4,794 9.6×
MRA head w/o contrast (70544) $2,085.85 $3,209 9.4×
MRA head with contrast (70545) $2,780.70 $4,278 8.6×
MRA neck w contrast (70548) $2,361.45 $3,633 7.3×
Mra Neck W/O &W/Contrast Material (70549) $3,205.80 $4,932 9.9×
MRA neck w/o contrast (70547) $3,148.60 $4,844 14.2×
MRI abdomen w contrast (74182) $3,262.35 $5,019 10.1×
MRI abdomen w/o contrast (74181) $2,446.60 $3,764 11.0×
MRI any jt lower extrem w/contrast material (73722) $3,262.35 $5,019 4.5×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,743 $4,220 8.5×
MRI any jt upper extremity w/contrast matrl (73222) $2,446.60 $3,764 3.4×
MRI Breast W/O Contrast Bilateral (77047) $3,262.35 $5,019 14.7×
MRI cardiac w/o contrast (75557) $2,694.90 $4,146 12.1×
MRI cervical spine w contrast (72142) $2,723.50 $4,190 8.4×
MRI cervical spine w/o cont (72141) $2,042.95 $3,143 9.2×
MRI chest w/o contrast (71550) $2,723.50 $4,190 12.3×
MRI chest with contrast (71551) $2,723.50 $4,190 3.7×
MRI chest wo w contrast (71552) $3,052.40 $4,696 9.4×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $3,262.35 $5,019 10.1×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,743 $4,220 8.5×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $2,446.60 $3,764 11.0×
MRI lumbar spine w contrast (72149) $2,694.90 $4,146 8.3×
Mri Neck Spine W/O & W/Dye (72156) $2,265.90 $3,486 7.0×
MRI orbit face &/neck w/o contrast (70540) $2,893.15 $4,451 13.0×
MRI orbit face neck w contrast (70542) $2,893.15 $4,451 8.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $3,276 $5,040 10.1×
MRI pelvis w contrast (72196) $3,006.90 $4,626 9.3×
MRI pelvis w/o & w contrast (72197) $3,371.55 $5,187 10.4×
MRI pelvis w/o contrast (72195) $3,006.90 $4,626 13.5×
MRI thoracic spine w/o contrast (72146) $3,396.25 $5,225 15.3×
MRI upper extremity oth than jt w/contr matrl (73219) $3,234.40 $4,976 10.0×
MRI upper extremity oth than jt w/o contr matrl (73218) $3,234.40 $4,976 14.6×
Mri Uppr Extremity W/O&W/Dye (73220) $3,625.70 $5,578 11.2×
MRI, abdomen, combo (74183) $2,743 $4,220 8.5×
MRI, dorsal spine combo (72157) $2,265.90 $3,486 7.0×
MRI, dorsal spine contrast (72147) $2,694.90 $4,146 8.3×
MRI, joint upper extrem (73221) $2,446.60 $3,764 11.0×
MRI, joint upper extrem combo (73223) $2,743 $4,220 8.5×
MRI, lumbar spine combo (72158) $2,265.90 $3,486 7.0×
Myelogram cervical (72240) $2,409.55 $3,707 3.3×
Myelogram Lumbar (72265) $2,409.55 $3,707 3.3×
Myelography thoracic (72255) $2,409.55 $3,707 3.3×
Myelograpy 2/more regions rs&i (72270) $2,409.55 $3,707 3.3×
Myocardial Spect Multiple Studies (78452) $3,173.95 $4,883 2.6×
N-invas est c ffr sw aly CTA (75580)
range across 2 matching MRF lines		 $3,690.70–$4,921.80 $5,678–$7,572 varies
Neck soft tissue (70360) $477.10 $734 5.9×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $219.70 $338 0.6×
Nm myocard infarct spect (78469) $1,875.90 $2,886 3.7×
Nonvascular Shunt X-Ray (75809) $2,409.55 $3,707 24.8×
Ntsty modul radthx pln dose-vol histos (77301) $9,445.80 $14,532 7.3×
Nuclear Rx Oral Admin (79005) $853.45 $1,313 3.9×
Ob us nuchal meas 1 gest (76813) $523.90 $806 5.4×
Parathyroid Planar Imaging (78070) $2,527.20 $3,888 6.8×
Parathyroid planar imaging w/wo subtraction (78071) $5,335.20 $8,208 14.3×
Pelvis 1 or 2 views (72170) $273 $420 2.8×
Peritoneogram Rs&I (74190) $590.20 $908 1.2×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $4,634.50 $7,130 1.6×
Pulmonary Perfusion Imaging Particulate (78580) $1,343.55 $2,067 3.6×
Radex abscess/fistula/sinus tract rs&i (76080) $390 $600 0.8×
Radex Ankle Complete Minimum 3 Views (73610) $362.70 $558 4.5×
Radex Calcaneus Minimum 2 Views (73650) $244.40 $376 3.0×
Radex elbow complete minimum 3 views (73080) $429 $660 5.3×
Radex Facial Bones Complete Minimum 3 Views (70150) $358.80 $552 3.7×
Radex fingr minimum 2 views (73140) $258.05 $397 3.2×
Radex foot complete minimum 3 views (73630) $442 $680 5.5×
Radex Hand Minimum 3 Views (73130) $404.95 $623 5.0×
Radex lower extremity infant minimum 2 views (73592) $178.10 $274 2.2×
Radex Nasal Bones Complete Minimum 3 Views (70160) $450.45 $693 5.6×
Radex Ribs Unilateral 2 Views (71100) $323.05 $497 4.0×
Radex shoulder complete minimum 2 views (73030) $276.25 $425 3.4×
Radex Sinuses Paransl < 3 Views (70210) $281.45 $433 3.5×
Radex Spine 1 View Specify Level (72020) $151.45 $233 1.9×
Radex Sternum Minimum 2 Views (71120) $434.20 $668 5.4×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $586.30 $902 7.2×
Radex Toe Minimum 2 Views (73660) $269.10 $414 3.3×
Radex upper extremity infant minimum 2 views (73092) $179.40 $276 1.8×
Radex Wrist Complete Minimum 3 Views (73110) $365.30 $562 4.5×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $969.80 $1,492 10.0×
Radiation Delivery Stereotactic Cranial Linear (77372) $14,149.85 $21,769 2.1×
Radiation treatment delivery level 1 (77402) $399.10 $614 4.2×
Radiation treatment delivery level 2 (77407) $1,567.15 $2,411 4.4×
Radiation treatment delivery level 3 (77412) $2,008.50 $3,090 3.9×
Radiolog exam mandible compl minimum 4 views (70110) $612.30 $942 6.3×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $537.55 $827 5.5×
Radiologic exam colon double contrast study (74280) $1,179.75 $1,815 7.2×
Radiologic exam colon single contrast study (74270) $910.65 $1,401 5.6×
Radiologic Exam Esophagus Double Contrast Study (74221) $700.05 $1,077 4.3×
Radiologic exam knee complete 4/more views (73564) $400.40 $616 4.1×
Radiologic exam pelvis compl minimum 3 views (72190) $333.45 $513 3.4×
Radiologic Exam Small Int Single Contrast Study (74250) $1,106.30 $1,702 6.8×
Radiologic exam swallow function contrast study (74230) $557.05 $857 3.4×
Radiologic exam upr gi trc double contrast study (74246) $917.80 $1,412 5.6×
Radiologic examination femur 1 view (73551) $173.55 $267 2.1×
Radiologic examination femur minimum 2 views (73552) $327.60 $504 4.0×
Radiologic examination knee 1/2 views (73560) $275.60 $424 3.4×
Radiologic Examination Osseous Survey Limited (77074) $83.20 $128 0.9×
Radiologic examination tibia & fibula 2 views (73590) $398.45 $613 4.9×
Renal Cyst Study (74470) $4,468.75 $6,875 8.8×
Ribs bilateral 3 views (71110) $475.80 $732 4.9×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,099.15 $1,691 3.0×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,742.65 $2,681 4.7×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $3,289 $5,060 6.5×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $1,742.65 $2,681 3.5×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $3,268.20 $5,028 6.5×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $1,742.65 $2,681 1.4×
Scapula (73010) $369.85 $569 3.8×
Screening Digital Breast Tomosynthesis Bi (77063) $71.50 $110 3.1×
Shoulder 1 view (73020) $154.70 $238 1.9×
Shoulder Arthrography (73040) $774.15 $1,191 2.4×
Skull less than 4 views (70250) $176.80 $272 1.8×
Special dosimetry (77331) $436.80 $672 3.5×
Special Physics Consult (77370) $937.95 $1,443 7.5×
Special teletherapy port plan (77321) $2,114.45 $3,253 6.1×
Special treatment procedure (77470) $2,458.30 $3,782 4.8×
Stereotactic Body Radiation Delivery (77373) $12,116.65 $18,641 7.3×
Sternoclavicular joints (71130) $507.65 $781 6.3×
Telethx isodose pln cplx w/basic dosimetry (77307) $2,152.15 $3,311 6.2×
Telethx isodose pln smpl w/dosimetry calculation (77306) $1,593.15 $2,451 4.6×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $1,884.35 $2,899 5.4×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $799.50 $1,230 2.3×
Ther rad simulaj-aided field setting simple (77280) $799.50 $1,230 6.4×
Thoracic spine 2 views (72070) $151.45 $233 1.6×
Thoracic spine 3 views (72072) $387.40 $596 4.0×
Thoracolumbar 2 views (72080) $185.90 $286 2.3×
Thyroid Imaging With Vascular Flow (78013) $1,200.55 $1,847 3.2×
Thyroid Met Imaging Body (78018) $1,424.80 $2,192 2.8×
Thyroid Uptake Measurement (78012) $897 $1,380 2.4×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $3,045.25 $4,685 8.2×
Tx Devices Design & Construction Complex (77334) $1,479.40 $2,276 4.2×
Tx devices design & construction intermediate (77333) $956.15 $1,471 7.6×
Tx devices design & construction simple (77332) $754.65 $1,161 6.0×
Ultrasound Breast Limited (76642) $793.65 $1,221 9.8×
Ultrasound Elastography Parenchyma (76981) $829.40 $1,276 8.5×
Ultrasound Exam Aaa Screen (76706) $572.65 $881 5.9×
Ultrasound, abdomen limited (76705) $868.40 $1,336 8.9×
Umbilical-artery Doppler (OB) (76820) $394.55 $607 4.1×
Unlisted fluoroscopic procedure (76496) $62.40 $96 0.8×
Unlisted us procedure (76999) $179.40 $276 2.2×
Upper gi w/o kub (74240) $1,205.75 $1,855 7.4×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $754 $1,160 68.2×
Ureteral Reflux Study (78740) $611 $940 1.6×
Urethrocystogram voiding (74455) $617.50 $950 2.8×
Urethrocystography retrograde (74450) $592.15 $911 2.7×
Us breast unilateral complete (76641) $703.30 $1,082 7.2×
Us chest (76604) $889.85 $1,369 9.2×
Us complete joint (76881) $263.25 $405 2.7×
Us exam, pelvic, limited (76857) $793 $1,220 8.2×
Us head (76506) $543.40 $836 5.6×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $797.55 $1,227 8.2×
Us ob detailed single fetus (76811) $887.90 $1,366 4.0×
Us ob limited 1 or more fetuses (76815) $483.60 $744 5.0×
Us ob transvaginal (76817) $820.95 $1,263 8.4×
Us pelvic non ob complete (76856) $797.55 $1,227 8.2×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $837.20 $1,288 8.6×
Us preg uterus real time f/u trnsabdl per fetus (76816) $824.85 $1,269 8.5×
Us retroperitoneal complete (76770) $1,146.60 $1,764 11.8×
Us retroperitoneal limited (76775) $626.60 $964 6.4×
Us scrotum and contents (76870) $1,134.25 $1,745 11.7×
Us spinal canal and contents (76800) $450.45 $693 4.6×
Us thyroid (76536) $1,085.50 $1,670 11.2×
Us transrectal (76872) $631.15 $971 6.5×
Vein X-Ray Chest (75827) $1,953.90 $3,006 1.3×
Vein X-Ray Liver W/O Hemodyn (75887) $4,634.50 $7,130 1.6×
Vein X-Ray Spleen/Liver (75810) $4,468.75 $6,875 1.5×
Venogram Sinus/Jugular (75860) $4,634.50 $7,130 1.6×
Venography caval inferior serialography rs&i (75825) $1,953.90 $3,006 0.7×
Venography extremity bilateral rs&i (75822) $834.60 $1,284 0.6×
Venography extremity unilateral rs&i (75820) $661.05 $1,017 0.5×
Venography Renal Bilateral (75833) $2,057.25 $3,165 0.7×
Venography Renal Unilateral (75831) $2,057.25 $3,165 0.7×
Venous sampling by catheter (75893) $4,634.50 $7,130 0.9×
Wrist 2 views (73100) $186.55 $287 2.3×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $438.75 $675 5.4×
X-ray antegrade pyelogram tube (74425) $965.25 $1,485 3.0×
X-Ray Aorta Leg Arteries (75630) $4,303.65 $6,621 1.5×
X-Ray Bend Only L-S Spine (72120) $408.20 $628 4.2×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $322.40 $496 4.0×
X-Ray Exam Breast Specimen (76098) $367.90 $566 0.7×
X-Ray Exam Entire Spi 1 Vw (72081) $629.85 $969 7.8×
X-Ray Exam Entire Spi 2/3 Vw (72082) $629.85 $969 6.5×
X-Ray Exam Hip Uni 1 View (73501) $299 $460 3.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $239.20 $368 3.0×
X-Ray Exam Hip Uni 4/> Views (73503) $83.20 $128 0.9×
X-Ray Exam Hips Bi 2 Views (73521) $439.40 $676 4.5×
X-Ray Exam Hips Bi 3-4 Views (73522) $554.45 $853 5.7×
X-Ray Exam Hips Bi 5/> Views (73523) $83.20 $128 0.9×
X-Ray Exam L-S Spine Bending (72114) $923 $1,420 9.5×
X-Ray Exam Neck Spine 2-3 Vw (72040) $344.50 $530 4.3×
X-Ray Exam Neck Spine 6/>Vws (72052) $752.05 $1,157 7.7×
X-Ray Exam Unilat Ribs/Chest (71101) $354.90 $546 3.6×
X-ray eye for foreign body (70030) $778.05 $1,197 9.6×
X-ray humerus (73060) $250.90 $386 3.1×
X-ray IV pyelogram (ivp) (74400) $604.50 $930 3.7×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $493.35 $759 6.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $389.35 $599 4.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $306.15 $471 3.1×
X-ray nose-rectum child f.b. (76010) $62.40 $96 0.8×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $510.90 $786 5.3×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $609.70 $938 6.3×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $83.20 $128 0.9×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $432.25 $665 5.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $431.60 $664 5.3×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $647.40 $996 6.7×
X-ray thoracic spine 4 vw (72074) $516.75 $795 5.3×
X-Ray Tmj Unilat (70328) $62.40 $96 0.8×
X-Ray Urinary Tract Exam With Contrast Material (74420) $772.20 $1,188 2.4×
X-Rays Bone Length Studies (77073) $521.30 $802 5.4×
X-Rays Bone Survey Complete (77075) $960.05 $1,477 9.9×
Xr c-spine 4 or 5 views (72050) $479.05 $737 4.9×
Xr facial bones less than 3 views (70140) $289.90 $446 3.6×
Xr orbits complete 4 views (70200) $792.35 $1,219 8.1×

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.