Imaging prices at Saint Francis Hospital South, LLC
Tulsa, OK · every code in this section with a posted price and a Medicare benchmark.
383 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) | $3,743.42 | $9,358.54 | 2.8× |
| Abdomen 1 View (74018) | $185.82 | $464.55 | 2.2× |
| Abdomen 2 views (74019) | $253.46 | $633.65 | 2.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $668.80 | $1,672 | 1.7× |
| Angio internal mammary (75756) | $420.28 | $1,050.70 | 0.1× |
| Angio pulmonary bilat (75743) | $3,768.46 | $9,421.15 | 1.2× |
| Angiography extremity bilateral rs&i (75716) | $4,431.18 | $11,077.95 | 1.5× |
| Angiography extremity unilateral rs&i (75710) | $1,932.30 | $4,830.75 | 0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,057.92 | $2,644.80 | 0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,076.92 | $2,692.30 | 0.4× |
| Ankle 2 views (73600) | $346.18 | $865.45 | 4.1× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,085.06 | $5,212.65 | 0.4× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,434.66 | $6,086.65 | 0.5× |
| Artery X-Rays Adrenal Gland (75731) | $233.70 | $584.25 | 0.1× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$1,736.60 | $4,341.50 | 0.3× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$302.86 | $757.15 | 0.1× |
| Arthrogram ankle (73615) | $352.26 | $880.65 | 1.0× |
| Arthrogram hip (73525) | $363.66 | $909.15 | 1.1× |
| Arthrogram Wrist (73115) | $375.44 | $938.60 | 1.1× |
| Basic radiation dosimetry calculation (77300) | $325.60 | $814 | 2.5× |
| Bone age studies (77072) | $124.26 | $310.65 | 1.2× |
| Bone Imaging 3 Phase (78315) | $1,236.52 | $3,091.30 | 3.2× |
| Bone Imaging Limited Area (78300) | $670.32 | $1,675.80 | 1.7× |
| Bone Imaging Multiple Areas (78305) | $592.42 | $1,481.05 | 1.5× |
| Bone Imaging Whole Body (78306) | $919.60 | $2,299 | 2.4× |
| Bone marrow imaging limited area (78102) | $441.94 | $1,104.85 | 1.1× |
| Bone marrow imaging; multiple areas (78103) | $432.06 | $1,080.15 | 1.1× |
| Bone marrow imaging; whole body (78104) | $210.52 | $526.30 | 0.5× |
| Bone survey infant (77076) | $184.68 | $461.70 | 1.8× |
| Brain Image W/Flow < 4 Views (78601) | $457.52 | $1,143.80 | 1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,211.76 | $8,029.40 | 2.3× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $609.14 | $1,522.85 | 1.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,668.20 | $4,170.50 | 5.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,668.20 | $4,170.50 | 2.2× |
| Cardiac Shunt Detection (78428) | $505.40 | $1,263.50 | 1.3× |
| Cat Scan Follow-Up Study (76380) | $120.08 | $300.20 | 1.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $471.58 | $1,178.95 | 0.9× |
| Cerebrospinal Fluid Scan (78630) | $1,078.44 | $2,696.10 | 2.1× |
| Chest 1 view (71045) | $218.40 | $546 | 2.6× |
| Chest 2 views (71046) | $328.32 | $820.80 | 3.9× |
| Chest 3 views (71047) | $338.40 | $846 | 4.0× |
| Chest 4 or more views (71048) | $466.08 | $1,165.20 | 4.6× |
| Clavicle complete (73000) | $183.16 | $457.90 | 2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $40.66 | $101.65 | 0.4× |
| Continuing medical physics consltj pr wk (77336) | $364.35 | $910.88 | 2.8× |
| Contrast Exam Abdominl Aorta (75625) | $3,972.90 | $9,932.25 | 1.3× |
| Contrast X-Ray Bladder (74430) | $400.14 | $1,000.35 | 1.2× |
| Contrast X-Ray Of Elbow (73085) | $250.80 | $627 | 0.7× |
| Contrast X-Ray Of Knee Joint (73580) | $372.40 | $931 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) | $1,895.82 | $4,739.55 | 5.7× |
| CT abdomen and pelvis without contrast (74176) | $1,338.74 | $3,346.85 | 5.8× |
| CT abdomen w contrast (74160) | $1,057.16 | $2,642.90 | 6.3× |
| CT abdomen w wo contrast (74170) | $1,307.20 | $3,268 | 7.7× |
| CT abdomen w/o contrast (74150) | $954.18 | $2,385.45 | 9.5× |
| CT Angio Abdomen and Pelvis (74174) | $2,248.46 | $5,621.15 | 6.7× |
| CT Angio Chest (71275) | $1,478.20 | $3,695.50 | 8.8× |
| CT Angio Head (70496) | $1,196.24 | $2,990.60 | 7.1× |
| CT angio hrt w/3d image (75574) | $1,264.26 | $3,160.65 | 3.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,529.50 | $3,823.75 | 9.1× |
| CT Angio Neck (70498) | $1,124.04 | $2,810.10 | 6.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,372.94 | $3,432.35 | 8.1× |
| CT cervical spine w/ contrast (72126) | $959.88 | $2,399.70 | 2.9× |
| CT cervical spine w/o contrast (72125) | $902.88 | $2,257.20 | 9.0× |
| CT cervical spine w/wo cont (72127) | $1,302.26 | $3,255.65 | 7.7× |
| CT chest w contrast (71260) | $1,123.66 | $2,809.15 | 6.7× |
| CT chest w/wo contrast (71270) | $1,237.66 | $3,094.15 | 7.3× |
| CT head/brain with contrast (70460) | $1,210.30 | $3,025.75 | 7.2× |
| CT head/brain without and with contrast (70470) | $1,280.98 | $3,202.45 | 7.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,271.48 | $3,178.70 | 3.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $74.48 | $186.20 | 0.9× |
| CT hrt w/3d image congen (75573) | $1,131.64 | $2,829.10 | 3.4× |
| CT iac w contrast (70481) | $1,049.94 | $2,624.85 | 6.2× |
| CT l-spine w&w/o contrast (72133) | $2,207.80 | $5,519.50 | 13.1× |
| CT lower ext w/o (73700) | $883.12 | $2,207.80 | 8.8× |
| CT lower extremity w/contrast material (73701) | $1,084.52 | $2,711.30 | 6.4× |
| CT lumbar spine w contrast (72132) | $1,030.18 | $2,575.45 | 3.1× |
| CT lumbar spine w/o contrast (72131) | $1,010.42 | $2,526.05 | 10.0× |
| CT maxillofacial w contrast (70487) | $882.74 | $2,206.85 | 5.2× |
| CT maxillofacial wo contrast (70486) | $878.94 | $2,197.35 | 8.7× |
| CT neck tissue combo (70492) | $1,083.38 | $2,708.45 | 6.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,132.02 | $2,830.05 | 6.7× |
| CT orbits w/o contrast (70480) | $949.24 | $2,373.10 | 9.4× |
| CT pelvis w&w/o contrast (72194) | $1,222.84 | $3,057.10 | 7.2× |
| CT pelvis w/o contrast (72192) | $964.44 | $2,411.10 | 9.6× |
| CT scan of leg combo (73702) | $1,127.84 | $2,819.60 | 6.7× |
| CT scans face/jaw combo (70488) | $1,170.40 | $2,926 | 6.9× |
| CT soft tissue neck w contrast (70491) | $1,011.18 | $2,527.95 | 6.0× |
| CT soft tissue neck w/o contrast (70490) | $847.02 | $2,117.55 | 8.4× |
| CT thoracic spine w contrast (72129) | $970.90 | $2,427.25 | 5.8× |
| CT thoracic spine w/o contrast (72128) | $1,013.08 | $2,532.70 | 10.1× |
| CT thoracic spine w/wo cont (72130) | $1,233.10 | $3,082.75 | 7.3× |
| CT thorax w/o contrast (71250) | $927.58 | $2,318.95 | 9.2× |
| CT upper ext wo (73200) | $3,412.02 | $8,530.05 | 33.9× |
| CT upper extremity w/o & w/contrast material (73202) | $1,242.98 | $3,107.45 | 7.4× |
| CT upper extremity with contrast (73201) | $993.32 | $2,483.30 | 3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,610.06 | $4,025.15 | 9.5× |
| Cta Abdomen (74175) | $1,460.34 | $3,650.85 | 8.7× |
| CTA pelvis (72191) | $1,460.34 | $3,650.85 | 8.7× |
| Discography Cerv/Thor Spine (72285) | $180.50 | $451.25 | 0.1× |
| Diskography lumbar (72295) | $1,703.54 | $4,258.85 | 0.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $300.58 | $751.45 | 3.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $203.30 | $508.25 | 2.0× |
| Doppler Fetal Mid Cerebral Artery (76821) | $224.96 | $562.40 | 2.2× |
| Dxa Bone Density Axial (77080) | $68.78 | $171.95 | 0.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $108.30 | $270.75 | 1.3× |
| Echo exam of fetal heart (76825) | $343.14 | $857.85 | 0.7× |
| Echo exam uterus (76831) | $424.84 | $1,062.10 | 1.9× |
| Echo Guide For Artery Repair (76936) | $290.32 | $725.80 | 1.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $362.52 | $906.30 | 1.6× |
| Esophagram (74220) | $286.90 | $717.25 | 1.7× |
| Fetal Biophys Profile W/Nst (76818) | $245.48 | $613.70 | 2.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $308.18 | $770.45 | 3.1× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $330.60 | $826.50 | 1.4× |
| Fluoroscopy up to 1 hr (76000) | $207.10 | $517.75 | 0.9× |
| Follow-Up Angiography (75898) | $503.88 | $1,259.70 | 0.2× |
| Foot 2 views (73620) | $367.08 | $917.70 | 4.4× |
| Forearm 2 views (73090) | $380.76 | $951.90 | 4.5× |
| Gastric emptying imaging study (78264) | $889.96 | $2,224.90 | 2.3× |
| Gastroesophageal Reflux Exam (78262) | $453.72 | $1,134.30 | 1.2× |
| Gated Heart Planar Single (78472) | $973.94 | $2,434.85 | 2.5× |
| Hand 2 views (73120) | $390.26 | $975.65 | 3.9× |
| Heart Image (Pet) Multiple (78492) | $2,018.18 | $5,045.45 | 1.5× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $936.32 | $2,340.80 | 0.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,185.98 | $2,964.95 | 2.3× |
| Hepatobiliary System Imaging (78226) | $1,153.30 | $2,883.25 | 3.0× |
| Ht Muscle Image Spect Sing (78451) | $2,183.10 | $5,457.75 | 1.8× |
| Hysterosalpingogram (74740) | $444.60 | $1,111.50 | 1.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $259.54 | $648.85 | 3.1× |
| Infant hip ultrasound, limited static exam (76886) | $211.66 | $529.15 | 2.5× |
| K Flow/Funct Image W/Drug (78708) | $1,270.34 | $3,175.85 | 2.4× |
| K Flow/Funct Image W/O Drug (78707) | $1,032.84 | $2,582.10 | 2.0× |
| Kidney Imaging Morphol (78700) | $584.82 | $1,462.05 | 1.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $584.82 | $1,462.05 | 1.5× |
| Knee 3 Views (73562) | $424.84 | $1,062.10 | 5.1× |
| Liver & Spleen Imaging Static Only (78215) | $567.34 | $1,418.35 | 1.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $588.62 | $1,471.55 | 1.5× |
| Liver imaging static only (78201) | $476.14 | $1,190.35 | 0.9× |
| Liver imaging w/vascular flow (78202) | $294.12 | $735.30 | 0.6× |
| Lung Perf&Ventilat Diferentl (78598) | $786.98 | $1,967.45 | 1.5× |
| Lung perfusion differential (78597) | $1,068.56 | $2,671.40 | 2.8× |
| Lung Ventilat&Perfus Imaging (78582) | $898.70 | $2,246.75 | 1.7× |
| Lung Ventilation Imaging (78579) | $370.12 | $925.30 | 1.0× |
| Lymph System Imaging (78195) | $1,065.90 | $2,664.75 | 2.0× |
| Magnetic Image Jaw Joint (70336) | $785.46 | $1,963.65 | 3.4× |
| Mammary ductogram or galactogram multiple (77054) | $289.44 | $723.60 | 1.3× |
| Mammary ductogram or galactogram single (77053) | $572.64 | $1,431.60 | 2.5× |
| Meckels Divert Exam (78290) | $500.08 | $1,250.20 | 1.3× |
| Mlc imrt design & construction per imrt plan (77338) | $2,696.70 | $6,741.74 | 7.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $27.74 | $69.35 | 1.0× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $104.50 | $261.25 | 1.1× |
| Mr safety implt pos&/immoblj (76019) | $67.64 | $169.10 | 1.2× |
| Mr safety med physics xm customization plng&mntr (76017) | $275.50 | $688.75 | 1.2× |
| Mra Head W/O & W/Contrast Material (70546) | $1,064 | $2,660 | 3.2× |
| MRA head w/o contrast (70544) | $796.86 | $1,992.15 | 3.5× |
| MRA head with contrast (70545) | $789.26 | $1,973.15 | 2.4× |
| MRA neck w contrast (70548) | $908.58 | $2,271.45 | 2.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,324.68 | $3,311.70 | 3.9× |
| MRA neck w/o contrast (70547) | $905.16 | $2,262.90 | 3.9× |
| MRI abdomen w contrast (74182) | $999.02 | $2,497.55 | 3.0× |
| MRI abdomen w/o contrast (74181) | $986.48 | $2,466.20 | 4.3× |
| MRI any jt lower extrem w/contrast material (73722) | $1,269.96 | $3,174.90 | 1.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,825.30 | $7,063.25 | 8.4× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,127.46 | $2,818.65 | 1.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $861.46 | $2,153.65 | 3.8× |
| MRI cardiac w/o cont stress (75559) | $763.80 | $1,909.50 | 1.5× |
| MRI cardiac w/o contrast (75557) | $1,090.22 | $2,725.55 | 4.8× |
| MRI cervical spine w contrast (72142) | $1,259.32 | $3,148.30 | 3.8× |
| MRI cervical spine w/o cont (72141) | $1,018.02 | $2,545.05 | 4.4× |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$1,033.60–$1,057.16 | $2,584–$2,642.90 | varies |
| MRI chest with contrast (71551) | $1,033.60 | $2,584 | 1.4× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$1,312.90–$1,375.60 | $3,282.25–$3,439 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $846.26 | $2,115.65 | 2.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,206.88 | $3,017.20 | 3.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,035.50 | $2,588.75 | 4.5× |
| MRI lumbar spine w contrast (72149) | $1,466.04 | $3,665.10 | 4.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,460.34 | $3,650.85 | 4.4× |
| MRI orbit face &/neck w/o contrast (70540) | $1,160.14 | $2,900.35 | 5.1× |
| MRI orbit face neck w contrast (70542) | $1,160.14 | $2,900.35 | 3.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,336.08 | $3,340.20 | 4.0× |
| MRI pelvis w contrast (72196) | $846.26 | $2,115.65 | 2.5× |
| MRI pelvis w/o & w contrast (72197) | $1,252.48 | $3,131.20 | 3.7× |
| MRI pelvis w/o contrast (72195) | $931.76 | $2,329.40 | 4.1× |
| MRI spectroscopy (76390) | $440.04 | $1,100.10 | 5.3× |
| MRI thoracic spine w/o contrast (72146) | $1,017.26 | $2,543.15 | 4.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $998.26 | $2,495.65 | 3.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $998.26 | $2,495.65 | 4.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,333.42 | $3,333.55 | 4.0× |
| MRI, abdomen, combo (74183) | $2,876.60 | $7,191.50 | 8.6× |
| MRI, dorsal spine combo (72157) | $1,443.62 | $3,609.05 | 4.3× |
| MRI, dorsal spine contrast (72147) | $1,294.66 | $3,236.65 | 3.9× |
| MRI, joint upper extrem (73221) | $2,257.96 | $5,644.90 | 9.8× |
| MRI, joint upper extrem combo (73223) | $1,260.08 | $3,150.20 | 3.8× |
| MRI, lumbar spine combo (72158) | $1,537.48 | $3,843.70 | 4.6× |
| Myelogram cervical (72240) | $555.56 | $1,388.90 | 0.7× |
| Myelogram Lumbar (72265) | $623.96 | $1,559.90 | 0.8× |
| Myelography thoracic (72255) | $427.88 | $1,069.70 | 0.6× |
| Myelograpy 2/more regions rs&i (72270) | $632.70 | $1,581.75 | 0.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $384.94 | $962.35 | 1.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) range across 2 matching MRF lines |
$1,473.26–$2,037.94 | $3,683.15–$5,094.85 | varies |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $359.48 | $898.70 | 0.7× |
| Myocardial Spect Multiple Studies (78452) | $2,672.54 | $6,681.35 | 2.1× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $3,950.48 | $9,876.20 | 1.9× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $4,828.66 | $12,071.65 | 2.3× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $4,828.66 | $12,071.65 | 3.3× |
| N-invas est c ffr sw aly CTA (75580) | $2,353.34 | $5,883.35 | 2.8× |
| Neck soft tissue (70360) | $161.50 | $403.75 | 1.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $92.72 | $231.80 | 0.2× |
| Nm csf leak detection (78650) | $284.62 | $711.55 | 0.2× |
| Nm myocard infarct spect (78469) | $625.86 | $1,564.65 | 1.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $5,482.48 | $13,706.21 | 4.1× |
| Nuclear Rx Intra-Arterial (79445) | $402.04 | $1,005.10 | 1.8× |
| Nuclear Rx Oral Admin (79005) | $720.48 | $1,801.20 | 3.2× |
| Ob us nuchal meas 1 gest (76813) | $221.92 | $554.80 | 2.2× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $254.98 | $637.45 | 2.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $555.56 | $1,388.90 | 1.1× |
| Parathyroid Planar Imaging (78070) | $798.38 | $1,995.95 | 2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $674.12 | $1,685.30 | 1.8× |
| Pelvis 1 or 2 views (72170) | $192.28 | $480.70 | 1.9× |
| Pet Image Skull-Thigh (78812) | $2,034.52 | $5,086.30 | 1.5× |
| Pet Image W/Ct Lmtd (78814) | $2,261.76 | $5,654.40 | 1.6× |
| PET image w/CT, full body (78816) | $3,818.62 | $9,546.55 | 2.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,981.64 | $9,954.10 | 2.9× |
| Pet Myocardial Sngl Study (78491) | $1,921.66 | $4,804.15 | 1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $590.14 | $1,475.35 | 1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $316.54 | $791.35 | 3.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $391.40 | $978.50 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$174.80–$413.44 | $437–$1,033.60 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $161.88 | $404.70 | 1.9× |
| Radex elbow complete minimum 3 views (73080) | $205.58 | $513.95 | 2.5× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $205.58 | $513.95 | 2.0× |
| Radex fingr minimum 2 views (73140) | $160.74 | $401.85 | 1.9× |
| Radex foot complete minimum 3 views (73630) | $427.88 | $1,069.70 | 5.1× |
| Radex Hand Minimum 3 Views (73130) | $430.54 | $1,076.35 | 5.1× |
| Radex lower extremity infant minimum 2 views (73592) | $71.82 | $179.55 | 0.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $82.08 | $205.20 | 0.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $163.40 | $408.50 | 2.0× |
| Radex Ribs Unilateral 2 Views (71100) | $234.08 | $585.20 | 2.8× |
| Radex shoulder complete minimum 2 views (73030) | $394.06 | $985.15 | 4.7× |
| Radex Sinuses Paransl < 3 Views (70210) | $159.98 | $399.95 | 1.9× |
| Radex Spine 1 View Specify Level (72020) | $207.48 | $518.70 | 2.5× |
| Radex Sternum Minimum 2 Views (71120) | $171.38 | $428.45 | 2.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $157.32 | $393.30 | 1.9× |
| Radex Toe Minimum 2 Views (73660) | $149.34 | $373.35 | 1.8× |
| Radex upper extremity infant minimum 2 views (73092) | $59.28 | $148.20 | 0.6× |
| Radex Wrist Complete Minimum 3 Views (73110) | $419.14 | $1,047.85 | 5.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $265.62 | $664.05 | 2.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $18,599.22 | $46,498.05 | 2.6× |
| Radiation treatment delivery level 1 (77402) | $211.34 | $528.35 | 2.2× |
| Radiation treatment delivery level 2 (77407) | $345.58 | $863.94 | 0.9× |
| Radiation treatment delivery level 3 (77412) | $561.71 | $1,404.28 | 1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $213.56 | $533.90 | 2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $327.18 | $817.95 | 3.3× |
| Radiologic exam colon double contrast study (74280) | $572.66 | $1,431.65 | 3.4× |
| Radiologic exam colon single contrast study (74270) | $368.98 | $922.45 | 2.2× |
| Radiologic exam knee complete 4/more views (73564) | $508.44 | $1,271.10 | 5.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $240.92 | $602.30 | 2.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $321.86 | $804.65 | 1.9× |
| Radiologic exam swallow function contrast study (74230) | $327.18 | $817.95 | 1.9× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $93.86 | $234.65 | 0.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $451.44 | $1,128.60 | 2.7× |
| Radiologic examination femur 1 view (73551) | $102.60 | $256.50 | 1.2× |
| Radiologic examination femur minimum 2 views (73552) | $456.76 | $1,141.90 | 5.5× |
| Radiologic examination knee 1/2 views (73560) | $362.52 | $906.30 | 4.3× |
| Radiologic Examination Osseous Survey Limited (77074) | $247.38 | $618.45 | 2.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $369.36 | $923.40 | 4.4× |
| Ribs bilateral 3 views (71110) | $292.98 | $732.45 | 2.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $606.48 | $1,516.20 | 1.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $454.86 | $1,137.15 | 1.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,858.96 | $4,647.40 | 3.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $726.56 | $1,816.40 | 1.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,314.42 | $3,286.05 | 2.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,232.88 | $5,582.20 | 1.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,533.46 | $6,333.65 | 1.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,232.88 | $5,582.20 | 1.8× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $902.90 | $2,257.24 | 4.0× |
| Rp Therapy Intravenous Administration (79101) | $542.26 | $1,355.65 | 2.4× |
| Scapula (73010) | $182.02 | $455.05 | 1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $87.36 | $218.40 | 3.7× |
| Shoulder 1 view (73020) | $194.18 | $485.45 | 2.3× |
| Shoulder Arthrography (73040) | $352.64 | $881.60 | 1.1× |
| Sialogram (70390) | $129.96 | $324.90 | 0.6× |
| Skull less than 4 views (70250) | $178.98 | $447.45 | 1.8× |
| Special dosimetry (77331) | $391.12 | $977.80 | 3.0× |
| Special Physics Consult (77370) | $588.08 | $1,470.20 | 4.5× |
| Special teletherapy port plan (77321) | $724.71 | $1,811.78 | 2.0× |
| Special treatment procedure (77470) | $1,665.56 | $4,163.90 | 3.1× |
| Speech evaluation, complex (70371) | $176.32 | $440.80 | 0.8× |
| Stereotactic Body Radiation Delivery (77373) | $7,951.06 | $19,877.65 | 4.6× |
| Sternoclavicular joints (71130) | $114 | $285 | 1.4× |
| Superior sagittal sinus venogram (75870) | $841.70 | $2,104.25 | 0.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $211.34 | $528.35 | 2.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,629.60 | $4,074.01 | 4.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,116.23 | $2,790.58 | 3.1× |
| Testicular Imaging W/Flow (78761) | $239.02 | $597.55 | 0.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,037.53 | $2,593.82 | 2.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $648.80 | $1,622.01 | 1.8× |
| Ther rad simulaj-aided field setting simple (77280) | $649.60 | $1,624.01 | 5.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $300.96 | $752.40 | 1.8× |
| Thoracic spine 2 views (72070) | $133 | $332.50 | 1.3× |
| Thoracic spine 3 views (72072) | $258.02 | $645.05 | 2.6× |
| Thoracolumbar 2 views (72080) | $169.48 | $423.70 | 2.0× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $501.60 | $1,254 | 1.3× |
| Thyroid Imaging With Vascular Flow (78013) | $341.24 | $853.10 | 0.9× |
| Thyroid Met Imaging Body (78018) | $901.74 | $2,254.35 | 1.7× |
| Thyroid Uptake Measurement (78012) | $210.90 | $527.25 | 0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $650.56 | $1,626.40 | 1.7× |
| Tx Devices Design & Construction Complex (77334) | $1,032.34 | $2,580.84 | 2.9× |
| Tx devices design & construction intermediate (77333) | $569.70 | $1,424.26 | 4.4× |
| Tx devices design & construction simple (77332) | $755.08 | $1,887.69 | 5.8× |
| Ultrasound Breast Limited (76642) | $628.90 | $1,572.25 | 7.5× |
| Ultrasound elastography first target lesion (76982) | $307.42 | $768.55 | 3.1× |
| Ultrasound Elastography Parenchyma (76981) | $307.42 | $768.55 | 3.1× |
| Ultrasound Exam Aaa Screen (76706) | $364.80 | $912 | 3.6× |
| Ultrasound, abdomen limited (76705) | $415.72 | $1,039.30 | 4.1× |
| Umbilical-artery Doppler (OB) (76820) | $238.64 | $596.60 | 2.4× |
| Unlisted Dx Radiographic Procedure (76499) | $66.12 | $165.30 | 0.8× |
| Unlisted magnetic resonance procedure (76498) | $941.64 | $2,354.10 | 11.3× |
| Upper gi w/o kub (74240) | $380.38 | $950.95 | 2.3× |
| Ureteral Reflux Study (78740) | $467.78 | $1,169.45 | 1.2× |
| Urethrocystogram voiding (74455) | $463.98 | $1,159.95 | 2.0× |
| Urethrocystography retrograde (74450) | $360.62 | $901.55 | 1.6× |
| Us breast unilateral complete (76641) | $259.54 | $648.85 | 2.6× |
| Us chest (76604) | $565.06 | $1,412.65 | 5.6× |
| Us exam, pelvic, limited (76857) | $318.44 | $796.10 | 3.2× |
| Us head (76506) | $240.16 | $600.40 | 2.4× |
| Us kidney transplant (76776) | $470.06 | $1,175.15 | 4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $259.16 | $647.90 | 2.6× |
| Us ob detailed single fetus (76811) | $552.14 | $1,380.35 | 2.4× |
| Us ob limited 1 or more fetuses (76815) | $335.54 | $838.85 | 3.3× |
| Us ob transvaginal (76817) | $337.06 | $842.65 | 3.4× |
| Us pelvic non ob complete (76856) | $504.26 | $1,260.65 | 5.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$113.60–$429.40 | $284–$1,073.50 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $322.62 | $806.55 | 3.2× |
| Us retroperitoneal complete (76770) | $472.72 | $1,181.80 | 4.7× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$64.40–$317.68 | $161–$794.20 | varies |
| Us scrotum and contents (76870) | $355.30 | $888.25 | 3.5× |
| Us spinal canal and contents (76800) | $221.92 | $554.80 | 2.2× |
| Us thyroid (76536) | $415.72 | $1,039.30 | 4.1× |
| Us transrectal (76872) | $501.60 | $1,254 | 5.0× |
| Vein X-Ray Chest (75827) | $1,084.90 | $2,712.25 | 0.7× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $843.22 | $2,108.05 | 0.3× |
| Venogram Sinus/Jugular (75860) | $744.80 | $1,862 | 0.2× |
| Venography caval inferior serialography rs&i (75825) | $1,426.14 | $3,565.35 | 0.5× |
| Venography extremity bilateral rs&i (75822) | $1,604.74 | $4,011.85 | 1.1× |
| Venography extremity unilateral rs&i (75820) | $1,318.22 | $3,295.55 | 0.9× |
| Venography Renal Bilateral (75833) | $377.72 | $944.30 | 0.1× |
| Venography Renal Unilateral (75831) | $648.28 | $1,620.70 | 0.2× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$250.42 | $626.05 | 0.0× |
| Wrist 2 views (73100) | $346.94 | $867.35 | 4.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $133.38 | $333.45 | 1.6× |
| X-ray antegrade pyelogram tube (74425) | $434.34 | $1,085.85 | 1.3× |
| X-Ray Aorta Leg Arteries (75630) | $2,184.24 | $5,460.60 | 0.7× |
| X-Ray Bend Only L-S Spine (72120) | $201.40 | $503.50 | 2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $173.66 | $434.15 | 2.1× |
| X-Ray Exam Breast Specimen (76098) | $411.84 | $1,029.60 | 0.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $265.62 | $664.05 | 2.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $265.62 | $664.05 | 2.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $140.60 | $351.50 | 1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $311.60 | $779 | 3.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $311.60 | $779 | 3.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $142.12 | $355.30 | 1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $214.70 | $536.75 | 2.1× |
| X-Ray Exam L-S Spine Bending (72114) | $356.82 | $892.05 | 3.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $204.44 | $511.10 | 2.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $282.34 | $705.85 | 2.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $292.22 | $730.55 | 2.9× |
| X-ray eye for foreign body (70030) | $56.62 | $141.55 | 0.7× |
| X-ray humerus (73060) | $380.76 | $951.90 | 4.5× |
| X-ray IV pyelogram (ivp) (74400) | $492.10 | $1,230.25 | 2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $110.58 | $276.45 | 1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $211.66 | $529.15 | 2.1× |
| X-ray nose-rectum child f.b. (76010) | $108.68 | $271.70 | 1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $336.68 | $841.70 | 3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $190 | $475 | 1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $177.84 | $444.60 | 2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $206.72 | $516.80 | 2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $270.18 | $675.45 | 2.7× |
| X-ray thoracic spine 4 vw (72074) | $238.64 | $596.60 | 2.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $392.92 | $982.30 | 1.2× |
| X-Rays Bone Survey Complete (77075) | $459.04 | $1,147.60 | 4.6× |
| Xr c-spine 4 or 5 views (72050) | $262.96 | $657.40 | 2.6× |
| Xr facial bones less than 3 views (70140) | $179.74 | $449.35 | 2.1× |
| Xr orbits complete 4 views (70200) | $197.22 | $493.05 | 2.0× |
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.