Imaging prices at Saint Luke's Hospital of Kansas City
Kansas City, MO · every code in this section with a posted price and a Medicare benchmark.
378 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) | $6,470.40 | $10,784 | 4.7× |
| Abdomen 1 View (74018) | $539.40 | $899 | 6.2× |
| Abdomen 2 views (74019) | $621 | $1,035 | 5.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,663.80 | $2,773 | 4.2× |
| Angio internal mammary (75756) | $7,256.40 | $12,094 | 2.3× |
| Angio pulmonary bilat (75743) | $5,643.60 | $9,406 | 1.8× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $6,789.60 | $11,316 | 2.1× |
| Angiography extremity bilateral rs&i (75716) | $5,643.60 | $9,406 | 1.8× |
| Angiography extremity unilateral rs&i (75710) | $4,379.40 | $7,299 | 1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $4,571.40 | $7,619 | 1.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $6,789.60 | $11,316 | 2.1× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$441–$661.80 | $735–$1,103 | varies |
| Aortography thoracic serialography rs&i (75605) | $4,461 | $7,435 | 0.8× |
| Artery X-Rays Abdomen (75726) | $3,319.80 | $5,533 | 0.6× |
| Artery X-Rays Adrenal Gland (75731) | $2,261.40 | $3,769 | 0.7× |
| Artery X-Rays Pelvis (75736) | $3,319.80 | $5,533 | 0.6× |
| Artery X-Rays Spine (75705) | $3,306 | $5,510 | 0.6× |
| Arthrogram hip (73525) | $1,178.40 | $1,964 | 3.4× |
| Basic radiation dosimetry calculation (77300) | $961.80 | $1,603 | 7.1× |
| Bone age studies (77072) | $263.40 | $439 | 2.5× |
| Bone Imaging 3 Phase (78315) | $2,195.40 | $3,659 | 5.5× |
| Bone Imaging Limited Area (78300) | $1,441.80 | $2,403 | 3.6× |
| Bone Imaging Whole Body (78306) | $1,872.60 | $3,121 | 4.7× |
| Bone survey infant (77076) | $377.40 | $629 | 3.6× |
| Brachytx isodose complex (77318) | $3,636 | $6,060 | 9.7× |
| Brachytx isodose intermed (77317) | $3,226.20 | $5,377 | 8.6× |
| Brachytx Isodose Plan Simple (77316) | $2,449.20 | $4,082 | 6.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,311 | $2,185 | 2.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,373.40 | $7,289 | 3.1× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $879 | $1,465 | 2.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,470.80 | $4,118 | 7.1× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,553.60 | $4,256 | 3.3× |
| Cat Scan Follow-Up Study (76380) | $1,394.40 | $2,324 | 16.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,002.60 | $1,671 | 1.8× |
| Cerebrospinal Fluid Scan (78630) | $1,946.40 | $3,244 | 3.6× |
| Chest 1 view (71045) | $490.20 | $817 | 5.6× |
| Chest 2 views (71046) | $818.40 | $1,364 | 9.4× |
| Chest 3 views (71047) | $859.20 | $1,432 | 9.9× |
| Chest 4 or more views (71048) | $902.40 | $1,504 | 8.6× |
| Cisternography Positive Contrast Rs&I (70015) | $1,208.40 | $2,014 | 1.5× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$477–$715.80 | $795–$1,193 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $144 | $240 | 1.4× |
| Continuing medical physics consltj pr wk (77336) | $1,477.20 | $2,462 | 11.0× |
| Contrast Exam Abdominl Aorta (75625) | $3,019.80 | $5,033 | 1.0× |
| Contrast X-Ray Bladder (74430) | $851.40 | $1,419 | 2.4× |
| Contrast X-Ray Of Knee Joint (73580) | $997.20 | $1,662 | 2.9× |
| CT abdomen and pelvis without and with contrast (74178) | $3,888.60 | $6,481 | 11.1× |
| CT abdomen and pelvis without contrast (74176) | $2,812.80 | $4,688 | 11.8× |
| CT abdomen w contrast (74160) | $1,854.60 | $3,091 | 10.6× |
| CT abdomen w wo contrast (74170) | $2,097 | $3,495 | 11.9× |
| CT abdomen w/o contrast (74150) | $1,737 | $2,895 | 16.6× |
| CT Angio Abdomen and Pelvis (74174) | $4,093.20 | $6,822 | 11.7× |
| CT Angio Chest (71275) | $2,320.80 | $3,868 | 13.2× |
| CT Angio Head (70496) | $2,255.40 | $3,759 | 12.8× |
| CT angio hrt w/3d image (75574) | $1,004.40 | $1,674 | 2.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,691–$4,036.80 | $4,485–$6,728 | varies |
| CT Angio Neck (70498) | $2,046 | $3,410 | 11.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,046 | $3,410 | 11.6× |
| CT cervical spine w/ contrast (72126) | $1,940.40 | $3,234 | 5.6× |
| CT cervical spine w/o contrast (72125) | $1,911 | $3,185 | 18.3× |
| CT cervical spine w/wo cont (72127) | $2,046 | $3,410 | 11.6× |
| CT chest w contrast (71260) | $1,917.60 | $3,196 | 10.9× |
| CT chest w/wo contrast (71270) | $2,097 | $3,495 | 11.9× |
| CT head/brain with contrast (70460) | $2,134.20 | $3,557 | 12.1× |
| CT head/brain without and with contrast (70470) | $2,148 | $3,580 | 12.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $965.40 | $1,609 | 2.8× |
| CT hrt w/3d image congen (75573) | $984.60 | $1,641 | 2.8× |
| CT iac w contrast (70481) | $2,134.20 | $3,557 | 12.1× |
| CT l-spine w&w/o contrast (72133) | $2,046 | $3,410 | 11.6× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$1,905.60–$2,858.40 | $3,176–$4,764 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$1,996.20–$2,994.60 | $3,327–$4,991 | varies |
| CT lumbar spine w contrast (72132) | $1,940.40 | $3,234 | 5.6× |
| CT lumbar spine w/o contrast (72131) | $1,911 | $3,185 | 18.3× |
| CT maxillofacial w contrast (70487) | $2,134.20 | $3,557 | 12.1× |
| CT maxillofacial wo contrast (70486) | $1,911 | $3,185 | 18.3× |
| CT neck tissue combo (70492) | $1,962.60 | $3,271 | 11.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,241 | $3,735 | 12.8× |
| CT orbits w/o contrast (70480) | $1,754.40 | $2,924 | 16.8× |
| CT pelvis w&w/o contrast (72194) | $1,860 | $3,100 | 10.6× |
| CT pelvis w/o contrast (72192) | $1,571.40 | $2,619 | 15.0× |
| CT scan of leg combo (73702) range across 9 matching MRF lines |
$2,562.60–$3,844.20 | $4,271–$6,407 | varies |
| CT scans face/jaw combo (70488) | $2,241 | $3,735 | 12.8× |
| CT soft tissue neck w contrast (70491) | $1,621.20 | $2,702 | 9.2× |
| CT soft tissue neck w/o contrast (70490) | $1,394.40 | $2,324 | 13.3× |
| CT thoracic spine w contrast (72129) | $1,940.40 | $3,234 | 11.0× |
| CT thoracic spine w/o contrast (72128) | $1,911 | $3,185 | 18.3× |
| CT thoracic spine w/wo cont (72130) | $2,097 | $3,495 | 11.9× |
| CT thorax w/o contrast (71250) | $1,893 | $3,155 | 18.1× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,563.60–$2,345.40 | $2,606–$3,909 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,723.80–$2,586 | $2,873–$4,310 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,641.60–$2,462.40 | $2,736–$4,104 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,042.40 | $3,404 | 11.6× |
| Cta Abdomen (74175) | $2,046 | $3,410 | 11.6× |
| CTA pelvis (72191) | $2,046 | $3,410 | 11.6× |
| Dilation ureters/urethra rs&i (74485) | $3,284.40 | $5,474 | 1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $768.60 | $1,281 | 7.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $1,198.80 | $1,998 | 11.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $349.80 | $583 | 3.3× |
| Echo exam of fetal heart (76825) | $1,175.40 | $1,959 | 2.1× |
| Echo exam uterus (76831) | $666.60 | $1,111 | 2.8× |
| Echo Guide For Artery Repair (76936) | $936 | $1,560 | 4.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $882.60 | $1,471 | 3.7× |
| Esophagram (74220) | $516.60 | $861 | 2.9× |
| Fetal Biophys Profile W/Nst (76818) | $843 | $1,405 | 8.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $550.20 | $917 | 5.3× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $903 | $1,505 | 3.8× |
| Fluoroscopy up to 1 hr (76000) | $748.80 | $1,248 | 3.1× |
| Follow-Up Angiography (75898) | $1,720.20 | $2,867 | 0.5× |
| Foot 2 views (73620) range across 6 matching MRF lines |
$359.40–$539.40 | $599–$899 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$433.20–$649.80 | $722–$1,083 | varies |
| Gastric emptying imaging study (78264) | $1,934.40 | $3,224 | 4.8× |
| Gated Heart Planar Single (78472) | $1,441.20 | $2,402 | 3.6× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$332.40–$498.60 | $554–$831 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $2,887.20 | $4,812 | 4.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $2,830.80 | $4,718 | 4.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $2,775 | $4,625 | 4.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,173.60 | $6,956 | 1.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,348.60 | $5,581 | 1.1× |
| Hepatobil Syst Image W/Drug (78227) | $2,970 | $4,950 | 5.5× |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$1,500.60–$1,854.60 | $2,501–$3,091 | varies |
| Ht Muscle Image Spect Sing (78451) | $5,877 | $9,795 | 4.5× |
| Hysterosalpingogram (74740) | $997.20 | $1,662 | 4.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $190.20 | $317 | 2.2× |
| Interstitial radiation source applic complex (77778) | $14,374.80 | $23,958 | 20.6× |
| Intracavitary Radiation Source Applic Complex (77763) | $20,797.80 | $34,663 | 29.8× |
| Intracavitary Radiation Source Applic Intermed (77762) | $20,389.80 | $33,983 | 36.8× |
| Intracavitary radiation source applic simple (77761) | $19,990.20 | $33,317 | 36.1× |
| K Flow/Funct Image W/Drug (78708) | $1,150.80 | $1,918 | 2.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,641.60 | $2,736 | 3.0× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $879 | $1,465 | 2.2× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$472.80–$709.20 | $788–$1,182 | varies |
| Leveen/Shunt Patency Exam (78291) | $850.80 | $1,418 | 2.1× |
| Liver & Spleen Imaging Static Only (78215) | $1,593.60 | $2,656 | 4.0× |
| Liver imaging static only (78201) | $1,149.60 | $1,916 | 2.1× |
| Lung Perf&Ventilat Diferentl (78598) | $1,853.40 | $3,089 | 3.4× |
| Lung perfusion differential (78597) | $990 | $1,650 | 2.5× |
| Lung Ventilat&Perfus Imaging (78582) | $2,089.20 | $3,482 | 3.8× |
| Lung Ventilation Imaging (78579) | $971.40 | $1,619 | 2.4× |
| Lymph System Imaging (78195) | $1,890 | $3,150 | 3.5× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $4,335 | $7,225 | 2.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $7,150.20 | $11,917 | 2.3× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $3,101.40 | $5,169 | 1.0× |
| Magnetic Image Jaw Joint (70336) | $1,852.80 | $3,088 | 7.8× |
| Mammary ductogram or galactogram single (77053) | $353.40 | $589 | 1.5× |
| Meckels Divert Exam (78290) | $1,006.80 | $1,678 | 2.5× |
| Mlc imrt design & construction per imrt plan (77338) | $1,170.60 | $1,951 | 3.1× |
| Mr safety determination physician/other qhp (76016) | $193.80 | $323 | 2.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $64.20 | $107 | 2.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $206.40 | $344 | 2.2× |
| Mr safety implt pos&/immoblj (76019) | $315.60 | $526 | 5.3× |
| Mra Head W/O & W/Contrast Material (70546) | $3,276.60 | $5,461 | 9.4× |
| MRA head w/o contrast (70544) | $2,606.40 | $4,344 | 10.9× |
| MRA head with contrast (70545) | $2,795.40 | $4,659 | 8.0× |
| MRA neck w contrast (70548) | $2,346.60 | $3,911 | 6.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,460.60 | $4,101 | 7.0× |
| MRA neck w/o contrast (70547) | $2,132.40 | $3,554 | 8.9× |
| MRI abdomen w contrast (74182) | $1,753.20 | $2,922 | 5.0× |
| MRI abdomen w/o contrast (74181) | $1,669.80 | $2,783 | 7.0× |
| MRI any jt lower extrem w/contrast material (73722) | $2,580 | $4,300 | 3.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$2,781.60–$4,172.40 | $4,636–$6,954 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$3,462–$5,193 | $5,770–$8,655 | varies |
| MRI brain functional w/o physician admnistration (70554) | $2,058.60 | $3,431 | 8.6× |
| MRI brain functional w/physician admnistration (70555) | $862.80 | $1,438 | 3.6× |
| MRI cardiac w/o cont stress (75559) | $2,030.40 | $3,384 | 3.7× |
| MRI cardiac w/o contrast (75557) | $1,933.80 | $3,223 | 8.1× |
| MRI cervical spine w contrast (72142) | $2,091 | $3,485 | 6.0× |
| MRI cervical spine w/o cont (72141) | $1,943.40 | $3,239 | 8.1× |
| MRI chest w/o contrast (71550) | $1,669.80 | $2,783 | 7.0× |
| MRI chest wo w contrast (71552) | $3,007.80 | $5,013 | 8.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,460.60–$3,691.20 | $4,101–$6,152 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$1,816.80–$2,725.20 | $3,028–$4,542 | varies |
| MRI lumbar spine w contrast (72149) | $2,264.40 | $3,774 | 6.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,605.20 | $4,342 | 7.5× |
| MRI orbit face &/neck w/o contrast (70540) | $1,391.40 | $2,319 | 5.8× |
| MRI orbit face neck w contrast (70542) | $1,461 | $2,435 | 4.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,460.60 | $4,101 | 7.0× |
| MRI pelvis w contrast (72196) | $1,852.80 | $3,088 | 5.3× |
| MRI pelvis w/o & w contrast (72197) | $3,007.80 | $5,013 | 8.6× |
| MRI pelvis w/o contrast (72195) | $2,040.60 | $3,401 | 8.5× |
| MRI spectroscopy (76390) | $158.40 | $264 | 1.8× |
| MRI thoracic spine w/o contrast (72146) | $2,040.60 | $3,401 | 8.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 6 matching MRF lines |
$1,734–$2,601 | $2,890–$4,335 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 6 matching MRF lines |
$3,007.80–$4,512 | $5,013–$7,520 | varies |
| MRI, abdomen, combo (74183) | $3,007.80 | $5,013 | 8.6× |
| MRI, dorsal spine combo (72157) | $3,007.80 | $5,013 | 8.6× |
| MRI, dorsal spine contrast (72147) | $2,264.40 | $3,774 | 6.5× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,040.60–$3,061.20 | $3,401–$5,102 | varies |
| MRI, joint upper extrem combo (73223) | $4,184.40 | $6,974 | 12.0× |
| MRI, lumbar spine combo (72158) | $3,007.80 | $5,013 | 8.6× |
| Myocardial Spect Multiple Studies (78452) | $7,548 | $12,580 | 5.8× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $3,451.20 | $5,752 | 2.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $4,218 | $7,030 | 2.9× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $5,943.60 | $9,906 | 2.7× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $6,922.80 | $11,538 | 3.1× |
| N-invas est c ffr sw aly CTA (75580) | $3,585.60 | $5,976 | 4.2× |
| Neck soft tissue (70360) | $370.20 | $617 | 4.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $918.60 | $1,531 | 2.3× |
| Nonvascular Shunt X-Ray (75809) | $1,597.20 | $2,662 | 15.3× |
| Ntsty modul radthx pln dose-vol histos (77301) | $14,391.60 | $23,986 | 10.4× |
| Nuclear Rx Intra-Arterial (79445) | $1,344.60 | $2,241 | 5.8× |
| Nuclear Rx Oral Admin (79005) | $1,637.40 | $2,729 | 7.0× |
| Ob us nuchal meas 1 gest (76813) | $487.80 | $813 | 4.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $295.20 | $492 | 2.8× |
| Panoramic X-ray of jaws (70355) | $558 | $930 | 6.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,611 | $2,685 | 3.0× |
| Parathyroid Planar Imaging (78070) | $1,261.20 | $2,102 | 3.1× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,450.20 | $2,417 | 3.6× |
| Pelvis 1 or 2 views (72170) | $472.80 | $788 | 4.5× |
| Peritoneogram Rs&I (74190) | $751.80 | $1,253 | 1.4× |
| Pet Image W/Ct Lmtd (78814) | $3,791.40 | $6,319 | 2.6× |
| PET image w/CT, full body (78816) | $5,522.40 | $9,204 | 3.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,271 | $8,785 | 3.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,452 | $7,420 | 1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,195.80 | $1,993 | 3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $757.20 | $1,262 | 7.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $910.20 | $1,517 | 1.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$635.40–$953.40 | $1,059–$1,589 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$396.60–$595.20 | $661–$992 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$498.60–$748.20 | $831–$1,247 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $625.80 | $1,043 | 6.0× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$375.60–$563.40 | $626–$939 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$466.80–$700.20 | $778–$1,167 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$482.40–$723.60 | $804–$1,206 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$223.80–$336 | $373–$560 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $539.40 | $899 | 6.2× |
| Radex Ribs Unilateral 2 Views (71100) | $492 | $820 | 5.6× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$687.60–$1,031.40 | $1,146–$1,719 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $469.20 | $782 | 5.4× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $994.20 | $1,657 | 5.7× |
| Radex Spine 1 View Specify Level (72020) | $399 | $665 | 4.6× |
| Radex Sternum Minimum 2 Views (71120) | $460.80 | $768 | 5.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $228 | $380 | 2.6× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$366.60–$550.20 | $611–$917 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$234.60–$352.20 | $391–$587 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$490.20–$735.60 | $817–$1,226 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $700.20 | $1,167 | 6.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $18,138 | $30,230 | 2.5× |
| Radiation treatment delivery level 1 (77402) | $487.20 | $812 | 4.8× |
| Radiation treatment delivery level 2 (77407) | $792.60 | $1,321 | 2.1× |
| Radiation treatment delivery level 3 (77412) | $1,270.80 | $2,118 | 2.3× |
| Radiolog exam mandible compl minimum 4 views (70110) | $418.80 | $698 | 4.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $652.20 | $1,087 | 6.2× |
| Radiologic exam colon double contrast study (74280) | $1,280.40 | $2,134 | 7.3× |
| Radiologic exam colon single contrast study (74270) | $1,219.20 | $2,032 | 6.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $573.60 | $956 | 3.3× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$774.60–$1,162.20 | $1,291–$1,937 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $612.60 | $1,021 | 5.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $946.80 | $1,578 | 5.4× |
| Radiologic exam swallow function contrast study (74230) | $925.80 | $1,543 | 5.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $808.80 | $1,348 | 4.6× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$211.80–$318 | $353–$530 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$222.60–$334.20 | $371–$557 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$407.40–$611.40 | $679–$1,019 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $536.40 | $894 | 5.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$439.20–$658.80 | $732–$1,098 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $613.20 | $1,022 | 1.6× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $613.20 | $1,022 | 1.6× |
| Renal Cyst Study (74470) | $747 | $1,245 | 1.4× |
| Ribs bilateral 3 views (71110) | $880.80 | $1,468 | 8.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $784.80 | $1,308 | 2.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,024 | $5,040 | 5.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,700.60 | $4,501 | 5.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,000.60 | $5,001 | 5.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,723.60 | $6,206 | 2.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,834.60 | $6,391 | 2.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,650.40 | $6,084 | 2.8× |
| Rp Therapy Intravenous Administration (79101) | $663.60 | $1,106 | 2.8× |
| Scapula (73010) range across 3 matching MRF lines |
$435.60–$653.40 | $726–$1,089 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $18 | $30 | 0.8× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$418.80–$628.20 | $698–$1,047 | varies |
| Shoulder Arthrography (73040) | $747 | $1,245 | 2.1× |
| Sialogram (70390) | $1,383.60 | $2,306 | 5.8× |
| Skull less than 4 views (70250) | $414.60 | $691 | 4.0× |
| Special Physics Consult (77370) | $1,634.40 | $2,724 | 12.1× |
| Special teletherapy port plan (77321) | $3,412.80 | $5,688 | 9.1× |
| Special treatment procedure (77470) | $2,611.20 | $4,352 | 4.7× |
| Stereotactic Body Radiation Delivery (77373) | $10,692.60 | $17,821 | 6.0× |
| Sternoclavicular joints (71130) | $483.60 | $806 | 5.5× |
| Superior sagittal sinus venogram (75870) | $3,460.80 | $5,768 | 1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,847 | $4,745 | 7.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,467.60 | $2,446 | 3.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,188.80 | $3,648 | 5.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,263 | $2,105 | 3.4× |
| Ther rad simulaj-aided field setting simple (77280) | $789 | $1,315 | 5.9× |
| Thoracic spine 2 views (72070) | $442.80 | $738 | 4.2× |
| Thoracic spine 3 views (72072) | $664.20 | $1,107 | 6.3× |
| Thoracolumbar 2 views (72080) | $614.40 | $1,024 | 7.0× |
| Thyroid Imaging With Vascular Flow (78013) | $893.40 | $1,489 | 2.2× |
| Thyroid Met Imaging Body (78018) | $2,630.40 | $4,384 | 4.8× |
| Thyroid Uptake Measurement (78012) | $768 | $1,280 | 1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,407 | $2,345 | 3.5× |
| Tx Devices Design & Construction Complex (77334) | $1,776.60 | $2,961 | 4.7× |
| Tx devices design & construction simple (77332) | $673.80 | $1,123 | 5.0× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$255.60–$383.40 | $426–$639 | varies |
| Ultrasound Exam Aaa Screen (76706) | $319.80 | $533 | 3.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $473.40 | $789 | 1.4× |
| Ultrasound, abdomen limited (76705) | $660.60 | $1,101 | 6.3× |
| Umbilical-artery Doppler (OB) (76820) | $376.80 | $628 | 3.6× |
| Unlisted Dx Radiographic Procedure (76499) | $214.20 | $357 | 2.5× |
| Unlisted fluoroscopic procedure (76496) | $339.60 | $566 | 3.9× |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$171.60–$2,058.60 | $286–$3,431 | varies |
| Unlisted Procedure Clinical Brachytherapy (77799) | $322.20 | $537 | 3.2× |
| Unlisted us procedure (76999) | $202.20 | $337 | 2.3× |
| Upper gi w/o kub (74240) | $533.40 | $889 | 3.0× |
| Urethrocystogram voiding (74455) | $1,167.60 | $1,946 | 4.9× |
| Urethrocystography retrograde (74450) | $1,068.60 | $1,781 | 4.5× |
| Us breast unilateral complete (76641) range across 6 matching MRF lines |
$329.40–$494.40 | $549–$824 | varies |
| Us chest (76604) | $724.80 | $1,208 | 6.9× |
| Us complete joint (76881) | $1,070.40 | $1,784 | 10.2× |
| Us exam, pelvic, limited (76857) | $615 | $1,025 | 5.9× |
| Us head (76506) | $843.60 | $1,406 | 8.1× |
| Us kidney transplant (76776) | $1,050 | $1,750 | 10.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,035.60 | $1,726 | 9.9× |
| Us ob detailed single fetus (76811) | $885 | $1,475 | 3.7× |
| Us ob limited 1 or more fetuses (76815) | $378.60 | $631 | 3.6× |
| Us ob transvaginal (76817) | $972 | $1,620 | 9.3× |
| Us pelvic non ob complete (76856) | $1,075.20 | $1,792 | 10.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $942 | $1,570 | 9.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $749.40 | $1,249 | 7.2× |
| Us retroperitoneal complete (76770) | $1,041 | $1,735 | 9.9× |
| Us retroperitoneal limited (76775) | $643.80 | $1,073 | 6.1× |
| Us scrotum and contents (76870) | $1,051.20 | $1,752 | 10.0× |
| Us spinal canal and contents (76800) | $433.80 | $723 | 4.1× |
| Us thyroid (76536) | $1,029 | $1,715 | 9.8× |
| Us transrectal (76872) | $357 | $595 | 3.4× |
| Vein X-Ray Chest (75827) | $5,226 | $8,710 | 3.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,838.80 | $6,398 | 1.2× |
| Vein X-Ray Spleen/Liver (75810) | $3,139.20 | $5,232 | 1.0× |
| Venogram Sinus/Jugular (75860) | $3,645 | $6,075 | 1.2× |
| Venography Adrenal Unilateral (75840) | $3,433.80 | $5,723 | 1.1× |
| Venography caval inferior serialography rs&i (75825) | $5,123.40 | $8,539 | 1.6× |
| Venography extremity bilateral rs&i (75822) | $1,445.40 | $2,409 | 0.9× |
| Venography extremity unilateral rs&i (75820) | $1,398 | $2,330 | 0.9× |
| Venography Orbital Rs&I (75880) | $1,854.60 | $3,091 | 3.0× |
| Venography Renal Bilateral (75833) | $3,838.80 | $6,398 | 1.2× |
| Venography Renal Unilateral (75831) | $3,275.40 | $5,459 | 1.0× |
| Venous sampling by catheter (75893) | $3,306 | $5,510 | 0.6× |
| Wrist 2 views (73100) range across 5 matching MRF lines |
$319.80–$480 | $533–$800 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $446.40 | $744 | 5.1× |
| X-ray antegrade pyelogram tube (74425) | $958.20 | $1,597 | 2.7× |
| X-Ray Aorta Leg Arteries (75630) | $5,643.60 | $9,406 | 1.8× |
| X-Ray Bend Only L-S Spine (72120) | $211.80 | $353 | 2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$348.60–$523.20 | $581–$872 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $193.80 | $323 | 2.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $285.60 | $476 | 2.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $666.60 | $1,111 | 6.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $193.80 | $323 | 2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $211.80 | $353 | 2.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $349.20 | $582 | 3.3× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$234–$267.60 | $390–$446 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $349.20 | $582 | 3.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $666.60 | $1,111 | 6.4× |
| X-Ray Exam L-S Spine Bending (72114) | $830.40 | $1,384 | 7.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $472.20 | $787 | 5.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,077 | $1,795 | 10.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $861.60 | $1,436 | 8.2× |
| X-ray eye for foreign body (70030) | $466.80 | $778 | 5.4× |
| X-ray humerus (73060) range across 5 matching MRF lines |
$446.40–$669.60 | $744–$1,116 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,366.80 | $2,278 | 7.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $397.20 | $662 | 4.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $495 | $825 | 5.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $502.80 | $838 | 4.8× |
| X-ray nose-rectum child f.b. (76010) | $195.60 | $326 | 2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $924.60 | $1,541 | 8.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $429.60 | $716 | 4.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $357 | $595 | 3.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $435.60 | $726 | 5.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $515.40 | $859 | 5.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $573.60 | $956 | 5.5× |
| X-ray thoracic spine 4 vw (72074) | $847.20 | $1,412 | 8.1× |
| X-Ray Tmj Unilat (70328) | $199.80 | $333 | 2.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,302.60 | $2,171 | 3.7× |
| X-Rays Bone Length Studies (77073) | $327.60 | $546 | 3.1× |
| X-Rays Bone Survey Complete (77075) | $2,342.40 | $3,904 | 22.4× |
| Xr c-spine 4 or 5 views (72050) | $745.20 | $1,242 | 7.1× |
| Xr facial bones less than 3 views (70140) | $474.60 | $791 | 5.4× |
| Xr orbits complete 4 views (70200) | $520.20 | $867 | 5.0× |
| Xr Tomogram Single Plane (76100) | $1,223.40 | $2,039 | 11.7× |
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.