Imaging prices at Saint James Hospital
Pontiac, IL · every code in this section with a posted price and a Medicare benchmark.
291 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $369.60 | $462 | 4.0× |
| Abdomen 2 views (74019) | $450.40 | $563 | 4.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,441.60 | $1,802 | 3.4× |
| Angio pulmonary bilat (75743) | $2,644 | $3,305 | 0.8× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$436–$862.40 | $545–$1,078 | varies |
| Arthrogram hip (73525) | $1,993.60 | $2,492 | 5.3× |
| Arthrogram Wrist (73115) | $1,993.60 | $2,492 | 5.3× |
| Bone age studies (77072) range across 2 matching MRF lines |
$383.20–$436 | $479–$545 | varies |
| Bone Imaging 3 Phase (78315) | $2,161.60 | $2,702 | 5.0× |
| Bone Imaging Limited Area (78300) | $1,870.40 | $2,338 | 4.4× |
| Bone Imaging Multiple Areas (78305) | $1,823.20 | $2,279 | 4.3× |
| Bone Imaging Whole Body (78306) | $2,480 | $3,100 | 5.8× |
| Bone marrow imaging; whole body (78104) | $1,392.80 | $1,741 | 3.3× |
| Bone survey infant (77076) | $492 | $615 | 4.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $10,262.40 | $12,828 | 6.7× |
| Cat Scan Follow-Up Study (76380) | $1,599.20 | $1,999 | 17.1× |
| Chest 1 view (71045) | $315.20 | $394 | 3.4× |
| Chest 2 views (71046) | $372.80 | $466 | 4.0× |
| Chest 3 views (71047) | $443.20 | $554 | 4.8× |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$500.80–$657.60 | $626–$822 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$436–$862.40 | $545–$1,078 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $235.20 | $294 | 2.1× |
| Contrast Exam Abdominl Aorta (75625) | $3,088 | $3,860 | 0.9× |
| Contrast X-Ray Bladder (74430) | $964.80 | $1,206 | 2.6× |
| CT abdomen and pelvis without and with contrast (74178) | $6,403.20 | $8,004 | 17.1× |
| CT abdomen and pelvis without contrast (74176) | $4,655.20 | $5,819 | 18.2× |
| CT abdomen w contrast (74160) | $2,757.60 | $3,447 | 14.7× |
| CT abdomen w wo contrast (74170) | $3,193.60 | $3,992 | 17.0× |
| CT abdomen w/o contrast (74150) | $2,646.40 | $3,308 | 23.6× |
| CT Angio Abdomen and Pelvis (74174) | $4,778.40 | $5,973 | 12.8× |
| CT Angio Chest (71275) | $3,311.20 | $4,139 | 17.6× |
| CT Angio Head (70496) | $3,028.80 | $3,786 | 16.1× |
| CT angio hrt w/3d image (75574) | $2,927.20 | $3,659 | 7.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,168.80 | $2,711 | 11.5× |
| CT Angio Neck (70498) | $3,244.80 | $4,056 | 17.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$1,500–$2,251.20 | $1,875–$2,814 | varies |
| CT cervical spine w/ contrast (72126) | $2,993.60 | $3,742 | 8.0× |
| CT cervical spine w/o contrast (72125) | $2,656 | $3,320 | 23.7× |
| CT cervical spine w/wo cont (72127) | $4,934.40 | $6,168 | 26.3× |
| CT chest w contrast (71260) | $2,840.80 | $3,551 | 15.1× |
| CT chest w/wo contrast (71270) | $3,057.60 | $3,822 | 16.3× |
| CT colonography screening (74263) | $944.80 | $1,181 | 3.7× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $2,205.60 | $2,757 | 11.7× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $2,205.60 | $2,757 | 19.7× |
| CT head/brain with contrast (70460) | $2,445.60 | $3,057 | 13.0× |
| CT head/brain without and with contrast (70470) | $2,723.20 | $3,404 | 14.5× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,629.60 | $3,287 | 7.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $156 | $195 | 1.7× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$2,476–$2,484 | $3,095–$3,105 | varies |
| CT l-spine w&w/o contrast (72133) | $3,544.80 | $4,431 | 18.9× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$2,615.20–$3,923.20 | $3,269–$4,904 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$3,604.80–$5,407.20 | $4,506–$6,759 | varies |
| CT lumbar spine w contrast (72132) | $3,021.60 | $3,777 | 8.1× |
| CT lumbar spine w/o contrast (72131) | $2,638.40 | $3,298 | 23.6× |
| CT maxillofacial w contrast (70487) | $2,576.80 | $3,221 | 13.7× |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$1,639.20–$2,212 | $2,049–$2,765 | varies |
| CT neck tissue combo (70492) | $2,975.20 | $3,719 | 15.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,031.20 | $3,789 | 16.1× |
| CT orbits w/o contrast (70480) | $2,341.60 | $2,927 | 20.9× |
| CT pelvis w&w/o contrast (72194) | $3,340.80 | $4,176 | 17.8× |
| CT pelvis w/o contrast (72192) | $2,306.40 | $2,883 | 20.6× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$3,309.60–$4,964.80 | $4,137–$6,206 | varies |
| CT scans face/jaw combo (70488) | $3,136.80 | $3,921 | 16.7× |
| CT soft tissue neck w contrast (70491) | $2,815.20 | $3,519 | 15.0× |
| CT soft tissue neck w/o contrast (70490) | $2,216 | $2,770 | 19.8× |
| CT thoracic spine w contrast (72129) | $2,805.60 | $3,507 | 14.9× |
| CT thoracic spine w/o contrast (72128) | $2,691.20 | $3,364 | 24.0× |
| CT thoracic spine w/wo cont (72130) | $3,176 | $3,970 | 16.9× |
| CT thorax w/o contrast (71250) | $2,288.80 | $2,861 | 20.4× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$2,355.20–$3,533.60 | $2,944–$4,417 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$3,363.20–$5,044.80 | $4,204–$6,306 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$2,851.20–$4,276.80 | $3,564–$5,346 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,054.40 | $3,818 | 16.3× |
| Cta Abdomen (74175) | $4,778.40 | $5,973 | 25.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $3,000 | $3,750 | 8.0× |
| CTA pelvis (72191) | $3,291.20 | $4,114 | 17.5× |
| Discography Cerv/Thor Spine (72285) | $4,468 | $5,585 | 2.1× |
| Diskography lumbar (72295) | $4,468 | $5,585 | 2.1× |
| Dxa Bone Density Axial (77080) | $616.80 | $771 | 5.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $445.60 | $557 | 4.8× |
| Esophagram (74220) | $772 | $965 | 4.1× |
| Fetal Biophys Profile W/Nst (76818) | $1,100.80 | $1,376 | 9.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$766.40–$868.80 | $958–$1,086 | varies |
| Fluoroscopy up to 1 hr (76000) | $1,296 | $1,620 | 5.1× |
| Follow-Up Angiography (75898) | $2,644 | $3,305 | 0.8× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$436–$862.40 | $545–$1,078 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$533.60–$862.40 | $667–$1,078 | varies |
| Gastric emptying imaging study (78264) | $1,870.40 | $2,338 | 4.4× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $2,480 | $3,100 | 5.8× |
| Gated Heart Planar Single (78472) | $2,627.20 | $3,284 | 6.1× |
| Gated Heart, Multiple (78473) | $3,251.20 | $4,064 | 7.6× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $3,251.20 | $4,064 | 5.6× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$470.40–$862.40 | $588–$1,078 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,090.40 | $2,613 | 3.6× |
| Hepatobiliary System Imaging (78226) | $2,184.80 | $2,731 | 5.1× |
| Ht Musc Image Planar Mult (78454) | $5,137.60 | $6,422 | 3.7× |
| Ht Muscle Image Spect Sing (78451) | $4,767.20 | $5,959 | 3.4× |
| Hysterosalpingogram (74740) | $1,428 | $1,785 | 5.6× |
| Joint Survey Single View (77077) | $436 | $545 | 3.9× |
| K Flow/Funct Image W/Drug (78708) | $1,369.60 | $1,712 | 2.4× |
| K Flow/Funct Image W/O Drug (78707) | $924.80 | $1,156 | 1.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$492–$983.20 | $615–$1,229 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,532.80 | $1,916 | 3.6× |
| Lung Perf&Ventilat Diferentl (78598) | $2,627.20 | $3,284 | 4.5× |
| Lung perfusion differential (78597) | $2,627.20 | $3,284 | 6.1× |
| Lung Ventilat&Perfus Imaging (78582) | $2,627.20 | $3,284 | 4.5× |
| Lung Ventilation Imaging (78579) | $2,627.20 | $3,284 | 6.1× |
| Lymph System Imaging (78195) | $2,411.20 | $3,014 | 4.1× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,718.40–$3,372 | $2,148–$4,215 | varies |
| Mammary ductogram or galactogram single (77053) | $511.20 | $639 | 2.0× |
| Meckels Divert Exam (78290) | $3,611.20 | $4,514 | 8.4× |
| Mr safety determination physician/other qhp (76016) | $179.20 | $224 | 1.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $50.40 | $63 | 1.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $187.20 | $234 | 1.8× |
| Mr safety implt pos&/immoblj (76019) | $120.80 | $151 | 1.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $492.80 | $616 | 1.9× |
| Mra Head W/O & W/Contrast Material (70546) | $4,328.80 | $5,411 | 11.6× |
| MRA head w/o contrast (70544) | $3,364.80 | $4,206 | 13.2× |
| MRA head with contrast (70545) | $3,746.40 | $4,683 | 10.0× |
| MRA neck w contrast (70548) | $3,495.20 | $4,369 | 9.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,490.40 | $5,613 | 12.0× |
| MRA neck w/o contrast (70547) | $3,226.40 | $4,033 | 12.6× |
| MRI abdomen w contrast (74182) | $4,444 | $5,555 | 11.9× |
| MRI abdomen w/o contrast (74181) | $3,542.40 | $4,428 | 13.9× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$3,565.60–$5,348.80 | $4,457–$6,686 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$3,657.60–$5,486.40 | $4,572–$6,858 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$3,514.40–$5,272 | $4,393–$6,590 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $5,313.60 | $6,642 | 20.8× |
| MRI cervical spine w contrast (72142) | $4,444 | $5,555 | 11.9× |
| MRI cervical spine w/o cont (72141) | $3,684 | $4,605 | 14.4× |
| MRI chest w/o contrast (71550) | $3,880 | $4,850 | 15.2× |
| MRI chest with contrast (71551) | $4,651.20 | $5,814 | 5.5× |
| MRI chest wo w contrast (71552) | $5,927.20 | $7,409 | 15.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$3,612.80–$5,420 | $4,516–$6,775 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$3,876–$5,813.60 | $4,845–$7,267 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$3,425.60–$5,137.60 | $4,282–$6,422 | varies |
| MRI lumbar spine w contrast (72149) | $4,444 | $5,555 | 11.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,178.40 | $6,473 | 13.9× |
| MRI orbit face &/neck w/o contrast (70540) | $3,053.60 | $3,817 | 11.9× |
| MRI orbit face neck w contrast (70542) | $3,472 | $4,340 | 9.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,005.60 | $6,257 | 13.4× |
| MRI pelvis w contrast (72196) | $4,444 | $5,555 | 11.9× |
| MRI pelvis w/o & w contrast (72197) | $4,833.60 | $6,042 | 12.9× |
| MRI pelvis w/o contrast (72195) | $3,495.20 | $4,369 | 13.7× |
| MRI thoracic spine w/o contrast (72146) | $3,608.80 | $4,511 | 14.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$3,613.60–$5,420.80 | $4,517–$6,776 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$3,405.60–$5,108.80 | $4,257–$6,386 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$3,515.20–$5,273.60 | $4,394–$6,592 | varies |
| MRI, abdomen, combo (74183) | $5,116.80 | $6,396 | 13.7× |
| MRI, dorsal spine combo (72157) | $5,080.80 | $6,351 | 13.6× |
| MRI, dorsal spine contrast (72147) | $4,444 | $5,555 | 11.9× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$3,537.60–$5,305.60 | $4,422–$6,632 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$3,846.40–$5,769.60 | $4,808–$7,212 | varies |
| MRI, lumbar spine combo (72158) | $5,204 | $6,505 | 13.9× |
| Myocardial Spect Multiple Studies (78452) | $6,121.60 | $7,652 | 4.4× |
| Neck soft tissue (70360) | $546.40 | $683 | 5.9× |
| Parathyroid Planar Imaging (78070) | $1,532.80 | $1,916 | 3.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,014.40 | $2,518 | 4.7× |
| Pelvis 1 or 2 views (72170) | $436 | $545 | 3.9× |
| Pet Image W/Ct Lmtd (78814) | $8,679.20 | $10,849 | 5.7× |
| PET image w/CT, full body (78816) | $8,180.80 | $10,226 | 5.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $8,180.80 | $10,226 | 5.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $2,644 | $3,305 | 0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,556.80 | $1,946 | 3.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $744.80 | $931 | 6.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$492–$983.20 | $615–$1,229 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$436–$862.40 | $545–$1,078 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$492–$692.80 | $615–$866 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $564 | $705 | 5.0× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$381.60–$572 | $477–$715 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$492–$983.20 | $615–$1,229 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$492–$983.20 | $615–$1,229 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$436–$862.40 | $545–$1,078 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $800 | $1,000 | 7.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $564 | $705 | 6.0× |
| Radex Ribs Unilateral 2 Views (71100) | $508 | $635 | 5.4× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$492–$983.20 | $615–$1,229 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $436 | $545 | 4.7× |
| Radex Spine 1 View Specify Level (72020) range across 6 matching MRF lines |
$402.40–$432 | $503–$540 | varies |
| Radex Sternum Minimum 2 Views (71120) | $508 | $635 | 5.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $638.40 | $798 | 6.8× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$360–$541.60 | $450–$677 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$436–$862.40 | $545–$1,078 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$492–$983.20 | $615–$1,229 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $513.60 | $642 | 4.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $387.20 | $484 | 3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $519.20 | $649 | 4.6× |
| Radiologic exam colon double contrast study (74280) | $1,495.20 | $1,869 | 8.0× |
| Radiologic exam colon single contrast study (74270) | $964.80 | $1,206 | 5.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,034.40 | $1,293 | 5.5× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$651.20–$974.40 | $814–$1,218 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $536.80 | $671 | 4.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $964.80 | $1,206 | 5.1× |
| Radiologic exam swallow function contrast study (74230) | $772 | $965 | 4.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,001.60 | $1,252 | 5.3× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$486.40–$801.60 | $608–$1,002 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$522.40–$784.80 | $653–$981 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$484–$862.40 | $605–$1,078 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $492 | $615 | 4.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$552.80–$873.60 | $691–$1,092 | varies |
| Ribs bilateral 3 views (71110) | $638.40 | $798 | 5.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,345.60 | $2,932 | 5.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,363.20 | $4,204 | 5.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,345.60 | $2,932 | 4.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,313.60 | $2,892 | 4.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,470.40 | $4,338 | 2.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $4,626.40 | $5,783 | 3.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,084.80 | $3,856 | 2.2× |
| Scapula (73010) | $436 | $545 | 3.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $120 | $150 | 5.1× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$436–$661.60 | $545–$827 | varies |
| Shoulder Arthrography (73040) | $1,993.60 | $2,492 | 5.3× |
| Skull less than 4 views (70250) | $564 | $705 | 5.0× |
| Sternoclavicular joints (71130) | $528 | $660 | 5.7× |
| Thoracic spine 2 views (72070) | $540 | $675 | 4.8× |
| Thoracic spine 3 views (72072) | $620.80 | $776 | 5.5× |
| Thoracolumbar 2 views (72080) | $264 | $330 | 2.8× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,532.80 | $1,916 | 3.6× |
| Thyroid Imaging With Vascular Flow (78013) | $986.40 | $1,233 | 2.3× |
| Thyroid Met Imaging Body (78018) | $2,585.60 | $3,232 | 4.4× |
| Thyroid Uptake Measurement (78012) | $733.60 | $917 | 1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,608 | $2,010 | 3.8× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$580–$867.20 | $725–$1,084 | varies |
| Ultrasound Elastography Parenchyma (76981) | $485.60 | $607 | 4.3× |
| Ultrasound Exam Aaa Screen (76706) | $969.60 | $1,212 | 8.7× |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$1,029.60–$1,684.80 | $1,287–$2,106 | varies |
| Unlisted us procedure (76999) | $754.40 | $943 | 8.1× |
| Upper gi w/o kub (74240) | $1,020 | $1,275 | 5.4× |
| Ureteral Reflux Study (78740) | $946.40 | $1,183 | 2.2× |
| Urethrocystogram voiding (74455) | $1,188 | $1,485 | 4.6× |
| Urethrocystography retrograde (74450) | $1,188 | $1,485 | 4.6× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$640.80–$963.20 | $801–$1,204 | varies |
| Us chest (76604) | $756 | $945 | 6.7× |
| Us complete joint (76881) range across 3 matching MRF lines |
$1,018.40–$1,564.80 | $1,273–$1,956 | varies |
| Us exam, pelvic, limited (76857) | $835.20 | $1,044 | 7.5× |
| Us kidney transplant (76776) | $1,221.60 | $1,527 | 10.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$746.40–$1,144.80 | $933–$1,431 | varies |
| Us ob detailed single fetus (76811) | $1,544 | $1,930 | 6.0× |
| Us ob limited 1 or more fetuses (76815) | $868.80 | $1,086 | 7.8× |
| Us ob transvaginal (76817) | $754.40 | $943 | 6.7× |
| Us pelvic non ob complete (76856) | $1,284 | $1,605 | 11.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,020.80 | $1,276 | 9.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$868.80–$1,241.60 | $1,086–$1,552 | varies |
| Us retroperitoneal complete (76770) | $1,172 | $1,465 | 10.5× |
| Us retroperitoneal limited (76775) | $1,099.20 | $1,374 | 9.8× |
| Us scrotum and contents (76870) | $1,207.20 | $1,509 | 10.8× |
| Us thyroid (76536) | $1,022.40 | $1,278 | 9.1× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,644 | $3,305 | 0.8× |
| Venogram Sinus/Jugular (75860) | $2,644 | $3,305 | 0.8× |
| Venography extremity unilateral rs&i (75820) | $2,059.20 | $2,574 | 1.2× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$436–$862.40 | $545–$1,078 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $436 | $545 | 4.7× |
| X-ray antegrade pyelogram tube (74425) | $1,495.20 | $1,869 | 4.0× |
| X-Ray Aorta Leg Arteries (75630) | $5,603.20 | $7,004 | 1.7× |
| X-Ray Bend Only L-S Spine (72120) | $554.40 | $693 | 4.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$470.40–$707.20 | $588–$884 | varies |
| X-Ray Exam Breast Specimen (76098) | $635.20 | $794 | 1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $347.20 | $434 | 3.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $402.40 | $503 | 3.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $445.60 | $557 | 4.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $492 | $615 | 5.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $807.20 | $1,009 | 8.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,606.40 | $2,008 | 14.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $1,611.20 | $2,014 | 14.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $2,106.40 | $2,633 | 18.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $2,597.60 | $3,247 | 23.2× |
| X-Ray Exam L-S Spine Bending (72114) | $720.80 | $901 | 6.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $550.40 | $688 | 5.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $747.20 | $934 | 6.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $638.40 | $798 | 5.7× |
| X-ray eye for foreign body (70030) | $484.80 | $606 | 5.2× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$488.80–$725.60 | $611–$907 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 4 matching MRF lines |
$964.80–$1,140 | $1,206–$1,425 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $554.40 | $693 | 5.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $436 | $545 | 4.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $554.40 | $693 | 4.9× |
| X-ray nose-rectum child f.b. (76010) | $484.80 | $606 | 5.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $716.80 | $896 | 6.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $536.80 | $671 | 4.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $436 | $545 | 3.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $536.80 | $671 | 5.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $564 | $705 | 6.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $638.40 | $798 | 5.7× |
| X-ray thoracic spine 4 vw (72074) | $669.60 | $837 | 6.0× |
| X-Ray Tmj Unilat (70328) | $380 | $475 | 4.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,053.60 | $1,317 | 2.8× |
| X-Rays Bone Length Studies (77073) | $492 | $615 | 4.4× |
| X-Rays Bone Survey Complete (77075) | $856.80 | $1,071 | 7.6× |
| Xr c-spine 4 or 5 views (72050) | $680 | $850 | 6.1× |
| Xr facial bones less than 3 views (70140) | $439.20 | $549 | 4.7× |
| Xr orbits complete 4 views (70200) | $553.60 | $692 | 4.9× |
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.