Imaging prices at Dignity Health - St. Rose Dominican, San Martín Campus
Las Vegas, NV · every code in this section with a posted price and a Medicare benchmark.
329 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) | $640.22 | $3,123 | 0.4× |
| Abdomen 1 View (74018) | $322.06 | $1,571 | 3.4× |
| Abdomen 2 views (74019) | $505.53 | $2,466 | 4.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $772.85 | $3,770 | 1.8× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $662.15 | $3,230 | 0.5× |
| Adrenal Cortex & Medulla Img (78075) | $1,202.94 | $5,868 | 0.9× |
| Angio internal mammary (75756) | $648.62 | $3,164 | 0.2× |
| Angio pulmonary bilat (75743) | $1,689.82 | $8,243 | 0.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $1,399.95 | $6,829 | 0.4× |
| Angiography extremity bilateral rs&i (75716) | $2,966.35 | $14,470 | 0.9× |
| Angiography extremity unilateral rs&i (75710) | $2,551.02 | $12,444 | 0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$1,453.25–$1,875.75 | $7,089–$9,150 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $743.54 | $3,627 | 0.2× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$311.40–$463.51 | $1,519–$2,261 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$1,261.57 | $6,154 | 0.2× |
| Aortography thoracic w/o serialography rs&i (75600) | $1,468.83 | $7,165 | 0.4× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$1,774.48 | $8,656 | 0.3× |
| Artery X-Rays Adrenal Gland (75731) | $1,261.57 | $6,154 | 0.4× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$1,892.36 | $9,231 | 0.3× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$2,233.89 | $10,897 | 0.4× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$489.95–$978.47 | $2,390–$4,773 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$389.91–$777.57 | $1,902–$3,793 | varies |
| Basic radiation dosimetry calculation (77300) | $101.89 | $497 | 0.7× |
| Bone age studies (77072) | $143.50 | $700 | 1.3× |
| Bone Imaging 3 Phase (78315) | $1,400.36 | $6,831 | 3.2× |
| Bone Imaging Limited Area (78300) | $725.70 | $3,540 | 1.7× |
| Bone Imaging Whole Body (78306) | $1,022.13 | $4,986 | 2.3× |
| Bone survey infant (77076) | $525.83 | $2,565 | 4.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $418 | $2,039 | 0.7× |
| Cat Scan Follow-Up Study (76380) | $80.57 | $393 | 0.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $375.77 | $1,833 | 0.6× |
| Cerebrospinal Fluid Scan (78630) | $657.44 | $3,207 | 1.1× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$118.49–$320.01 | $578–$1,561 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$118.49–$396.88 | $578–$1,936 | varies |
| Chest 3 views (71047) | $483.19 | $2,357 | 5.1× |
| Chest 4 or more views (71048) | $499.18 | $2,435 | 4.4× |
| Cholecystography Oral Contrast (74290) | $261.38 | $1,275 | 1.4× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$258.51–$387.86 | $1,261–$1,892 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $79.95 | $390 | 0.7× |
| Continuing medical physics consltj pr wk (77336) | $101.89 | $497 | 0.7× |
| Contrast Exam Abdominl Aorta (75625) | $2,777.14 | $13,547 | 0.8× |
| Contrast X-Ray Bladder (74430) | $520.50 | $2,539 | 1.4× |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$278.80–$556.37 | $1,360–$2,714 | varies |
| Corpora cavernosography (74445) | $1,072.36 | $5,231 | 9.4× |
| CT abdomen and pelvis without and with contrast (74178) | $4,330.83 | $21,126 | 11.4× |
| CT abdomen and pelvis without contrast (74176) | $2,452.83 | $11,965 | 9.4× |
| CT abdomen w contrast (74160) | $1,828.40 | $8,919 | 9.5× |
| CT abdomen w wo contrast (74170) | $2,473.74 | $12,067 | 12.9× |
| CT abdomen w/o contrast (74150) | $989.54 | $4,827 | 8.7× |
| CT Angio Abdomen and Pelvis (74174) | $1,363.25 | $6,650 | 3.6× |
| CT Angio Chest (71275) | $2,481.12 | $12,103 | 12.9× |
| CT Angio Head (70496) | $2,347.05 | $11,449 | 12.2× |
| CT angio hrt w/3d image (75574) | $3,102.68 | $15,135 | 8.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,395.03–$2,145.94 | $6,805–$10,468 | varies |
| CT Angio Neck (70498) | $2,250.49 | $10,978 | 11.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $821.03 | $4,005 | 4.3× |
| CT cervical spine w/ contrast (72126) | $2,760.74 | $13,467 | 7.2× |
| CT cervical spine w/o contrast (72125) | $1,579.53 | $7,705 | 13.8× |
| CT chest w contrast (71260) | $1,996.09 | $9,737 | 10.4× |
| CT chest w/wo contrast (71270) | $2,235.53 | $10,905 | 11.7× |
| CT head/brain with contrast (70460) | $1,911.01 | $9,322 | 10.0× |
| CT head/brain without and with contrast (70470) | $2,252.34 | $10,987 | 11.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $3,102.68 | $15,135 | 8.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $2,637.33 | $12,865 | 27.7× |
| CT hrt w/3d image congen (75573) | $3,102.68 | $15,135 | 8.1× |
| CT iac w contrast (70481) | $1,296.01 | $6,322 | 6.8× |
| CT l-spine w&w/o contrast (72133) | $3,111.70 | $15,179 | 16.2× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,406.92–$2,110.27 | $6,863–$10,294 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,772.64–$2,616.83 | $8,647–$12,765 | varies |
| CT lumbar spine w contrast (72132) | $2,779.80 | $13,560 | 7.3× |
| CT lumbar spine w/o contrast (72131) | $1,382.93 | $6,746 | 12.1× |
| CT maxillofacial w contrast (70487) | $1,917.57 | $9,354 | 10.0× |
| CT maxillofacial wo contrast (70486) | $1,584.65 | $7,730 | 13.9× |
| CT neck tissue combo (70492) | $2,342.33 | $11,426 | 12.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,412.66 | $6,891 | 7.4× |
| CT orbits w/o contrast (70480) | $1,101.47 | $5,373 | 9.6× |
| CT pelvis w&w/o contrast (72194) | $2,051.03 | $10,005 | 10.7× |
| CT pelvis w/o contrast (72192) | $957.15 | $4,669 | 8.4× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$2,152.50–$3,278.16 | $10,500–$15,991 | varies |
| CT scans face/jaw combo (70488) | $2,111.50 | $10,300 | 11.0× |
| CT soft tissue neck w contrast (70491) | $1,985.02 | $9,683 | 10.4× |
| CT soft tissue neck w/o contrast (70490) | $1,627.70 | $7,940 | 14.2× |
| CT thoracic spine w contrast (72129) | $2,900.34 | $14,148 | 15.1× |
| CT thoracic spine w/o contrast (72128) | $1,443 | $7,039 | 12.6× |
| CT thorax w/o contrast (71250) | $997.94 | $4,868 | 8.7× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,515.77–$2,273.66 | $7,394–$11,091 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$2,349.51–$3,546.91 | $11,461–$17,302 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,879.65–$2,773.86 | $9,169–$13,531 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $671.17 | $3,274 | 3.5× |
| Cta Abdomen (74175) | $1,076.87 | $5,253 | 5.6× |
| CTA pelvis (72191) | $953.87 | $4,653 | 5.0× |
| Dilation ureters/urethra rs&i (74485) | $835.99 | $4,078 | 0.4× |
| Discography Cerv/Thor Spine (72285) | $983.39 | $4,797 | 0.5× |
| Diskography lumbar (72295) | $983.39 | $4,797 | 0.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $53.51 | $261 | 0.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $56.58 | $276 | 0.5× |
| Echo exam of fetal heart (76825) | $369.41 | $1,802 | 0.6× |
| Echo Guide For Artery Repair (76936) | $228.17 | $1,113 | 1.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $218.74 | $1,067 | 0.8× |
| Esophagram (74220) | $520.70 | $2,540 | 2.7× |
| Fluoroscopy up to 1 hr (76000) | $130.79 | $638 | 0.5× |
| Follow-Up Angiography (75898) | $635.30 | $3,099 | 0.2× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$304.63–$448.34 | $1,486–$2,187 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$301.56–$452.23 | $1,471–$2,206 | varies |
| Gastric emptying imaging study (78264) | $806.47 | $3,934 | 1.8× |
| Gated Heart Planar Single (78472) | $850.75 | $4,150 | 1.9× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$259.33–$379.87 | $1,265–$1,853 | varies |
| Heart first pass single,planar (78481) | $666.05 | $3,249 | 1.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $2,096.54 | $10,227 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $2,052.26 | $10,011 | 3.5× |
| Hepatobiliary System Imaging (78226) | $1,497.94 | $7,307 | 3.4× |
| Ht Musc Image Planar Mult (78454) | $4,363.84 | $21,287 | 3.1× |
| Ht Muscle Image Spect Sing (78451) | $3,621.94 | $17,668 | 2.6× |
| Hysterosalpingogram (74740) | $219.35 | $1,070 | 0.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $261.99 | $1,278 | 2.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $330.46 | $1,612 | 0.8× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$330.67–$516.81 | $1,613–$2,521 | varies |
| Liver & Spleen Imaging Static Only (78215) | $467.20 | $2,279 | 1.1× |
| Lung Perf&Ventilat Diferentl (78598) | $521.73 | $2,545 | 0.9× |
| Lung perfusion differential (78597) | $273.06 | $1,332 | 0.6× |
| Lung Ventilat&Perfus Imaging (78582) | $1,161.33 | $5,665 | 2.0× |
| Lung Ventilation Imaging (78579) | $638.78 | $3,116 | 1.5× |
| Lymph System Imaging (78195) | $2,973.53 | $14,505 | 5.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $1,083.02 | $5,283 | 0.3× |
| Magnetic Image Jaw Joint (70336) | $734.52 | $3,583 | 2.8× |
| Mammary ductogram or galactogram multiple (77054) | $327.59 | $1,598 | 1.3× |
| Meckels Divert Exam (78290) | $560.06 | $2,732 | 1.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $21.53 | $105 | 0.7× |
| Mra Head W/O & W/Contrast Material (70546) | $2,264.64 | $11,047 | 5.9× |
| MRA head w/o contrast (70544) | $1,340.09 | $6,537 | 5.1× |
| MRA head with contrast (70545) | $1,996.70 | $9,740 | 5.2× |
| MRA neck w contrast (70548) | $1,990.96 | $9,712 | 5.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,258.08 | $11,015 | 5.9× |
| MRA neck w/o contrast (70547) | $1,336.19 | $6,518 | 5.1× |
| MRI abdomen w contrast (74182) | $2,199.24 | $10,728 | 5.8× |
| MRI abdomen w/o contrast (74181) | $1,476 | $7,200 | 5.7× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,057.38–$3,010.02 | $10,036–$14,683 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,333.52–$3,465.53 | $11,383–$16,905 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,677.51–$3,917.55 | $13,061–$19,110 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $886.01 | $4,322 | 3.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $767.52 | $3,744 | 2.9× |
| MRI cardiac w/o contrast (75557) | $231.86 | $1,131 | 0.9× |
| MRI cervical spine w contrast (72142) | $2,712.15 | $13,230 | 7.1× |
| MRI cervical spine w/o cont (72141) | $2,054.72 | $10,023 | 7.9× |
| MRI chest w/o contrast (71550) | $878.63 | $4,286 | 3.4× |
| MRI chest with contrast (71551) | $1,310.57 | $6,393 | 1.5× |
| MRI chest wo w contrast (71552) | $1,489.33 | $7,265 | 3.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,410.80 | $11,760 | 6.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,426.60–$2,139.79 | $6,959–$10,438 | varies |
| MRI lumbar spine w contrast (72149) | $2,920.84 | $14,248 | 7.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,493 | $17,039 | 9.2× |
| MRI orbit face &/neck w/o contrast (70540) | $923.94 | $4,507 | 3.5× |
| MRI orbit face neck w contrast (70542) | $1,378.22 | $6,723 | 3.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,566.20 | $7,640 | 4.1× |
| MRI pelvis w contrast (72196) | $1,912.86 | $9,331 | 5.0× |
| MRI pelvis w/o & w contrast (72197) | $2,173.62 | $10,603 | 5.7× |
| MRI pelvis w/o contrast (72195) | $1,282.48 | $6,256 | 4.9× |
| MRI thoracic spine w/o contrast (72146) | $1,300.32 | $6,343 | 5.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $294.18 | $1,435 | 0.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$919.02–$1,387.65 | $4,483–$6,769 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,553.08–$2,334.34 | $7,576–$11,387 | varies |
| MRI, abdomen, combo (74183) | $2,494.44 | $12,168 | 6.5× |
| MRI, dorsal spine combo (72157) | $2,203.96 | $10,751 | 5.8× |
| MRI, dorsal spine contrast (72147) | $1,939.51 | $9,461 | 5.1× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,797.03–$2,695.55 | $8,766–$13,149 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$3,036.87–$4,510.41 | $14,814–$22,002 | varies |
| MRI, lumbar spine combo (72158) | $3,313.01 | $16,161 | 8.7× |
| Myelogram cervical (72240) | $317.34 | $1,548 | 0.4× |
| Myelogram Lumbar (72265) | $412.46 | $2,012 | 0.5× |
| Myelography thoracic (72255) | $317.34 | $1,548 | 0.4× |
| Myelograpy 2/more regions rs&i (72270) | $317.34 | $1,548 | 0.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $392.78 | $1,916 | 0.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $997.12 | $4,864 | 0.7× |
| Myocardial Spect Multiple Studies (78452) | $4,363.84 | $21,287 | 3.1× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $931.73 | $4,545 | 0.6× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $931.73 | $4,545 | 0.6× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $1,453.45 | $7,090 | 0.6× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $1,453.45 | $7,090 | 0.6× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $1,453.45 | $7,090 | 0.9× |
| N-invas est c ffr sw aly CTA (75580) | $502.05 | $2,449 | 0.5× |
| Neck soft tissue (70360) | $335.18 | $1,635 | 3.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $260.56 | $1,271 | 0.6× |
| Nuclear Rx Intra-Arterial (79445) | $203.16 | $991 | 0.8× |
| Nuclear Rx Oral Admin (79005) | $1,194.95 | $5,829 | 4.7× |
| Ob us nuchal meas 1 gest (76813) | $142.27 | $694 | 1.2× |
| Parathyroid Planar Imaging (78070) | $863.87 | $4,214 | 2.0× |
| Pelvis 1 or 2 views (72170) | $282.29 | $1,377 | 2.5× |
| Peritoneogram Rs&I (74190) | $1,028.49 | $5,017 | 1.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,404.25 | $6,850 | 0.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,146.77 | $5,594 | 0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $824.51 | $4,022 | 1.9× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $608.65 | $2,969 | 5.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $407.34 | $1,987 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$362.03–$543.05 | $1,766–$2,649 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$246.62–$369.82 | $1,203–$1,804 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$348.91–$624.64 | $1,702–$3,047 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $290.69 | $1,418 | 2.5× |
| Radex fingr minimum 2 views (73140) | $257.69 | $1,257 | 2.7× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$342.15–$513.32 | $1,669–$2,504 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$301.56–$452.23 | $1,471–$2,206 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $285.57 | $1,393 | 2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $246 | $1,200 | 2.6× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $137.56 | $671 | 1.4× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$339.48–$509.22 | $1,656–$2,484 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $181.63 | $886 | 1.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,587.32 | $7,743 | 8.3× |
| Radex Spine 1 View Specify Level (72020) | $268.35 | $1,309 | 2.8× |
| Radex Sternum Minimum 2 Views (71120) | $335.18 | $1,635 | 3.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $304.84 | $1,487 | 3.2× |
| Radex Toe Minimum 2 Views (73660) | $277.98 | $1,356 | 2.9× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$351.17–$526.65 | $1,713–$2,569 | varies |
| Radiation treatment delivery level 1 (77402) | $51.66 | $252 | 0.5× |
| Radiation treatment delivery level 3 (77412) | $99.84 | $487 | 0.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $399.55 | $1,949 | 3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $505.53 | $2,466 | 4.4× |
| Radiologic exam colon double contrast study (74280) | $881.71 | $4,301 | 4.6× |
| Radiologic exam colon single contrast study (74270) | $629.76 | $3,072 | 3.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $541.82 | $2,643 | 2.8× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$380.07–$596.55 | $1,854–$2,910 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $391.96 | $1,912 | 2.0× |
| Radiologic exam swallow function contrast study (74230) | $499.59 | $2,437 | 2.6× |
| Radiologic examination femur 1 view (73551) | $522.55 | $2,549 | 5.5× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$118.49–$985.85 | $578–$4,809 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$281.26–$421.69 | $1,372–$2,057 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $352.19 | $1,718 | 3.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$252.97–$575.03 | $1,234–$2,805 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $242.93 | $1,185 | 0.4× |
| Renal Cyst Study (74470) | $291.31 | $1,421 | 0.5× |
| Ribs bilateral 3 views (71110) | $372.90 | $1,819 | 3.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,095.93 | $5,346 | 2.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,830.24 | $8,928 | 3.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,041.20 | $5,079 | 1.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,095.93 | $5,346 | 1.8× |
| Rp Therapy Intravenous Administration (79101) | $295 | $1,439 | 1.2× |
| Scapula (73010) range across 2 matching MRF lines |
$335.18–$502.66 | $1,635–$2,452 | varies |
| Sella turcica (70240) | $117.47 | $573 | 1.2× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$271.63–$387.04 | $1,325–$1,888 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$284.54–$624.84 | $1,388–$3,048 | varies |
| Sialogram (70390) | $336.41 | $1,641 | 1.3× |
| Skull less than 4 views (70250) | $322.88 | $1,575 | 2.8× |
| Special dosimetry (77331) | $101.89 | $497 | 0.7× |
| Special treatment procedure (77470) | $268.35 | $1,309 | 0.4× |
| Sternoclavicular joints (71130) | $412.26 | $2,011 | 4.3× |
| Superior sagittal sinus venogram (75870) | $406.93 | $1,985 | 0.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $78.11 | $381 | 0.2× |
| Temporomandble Jt Arthrography Rs&I (70332) | $389.71 | $1,901 | 1.5× |
| Testicular Imaging W/Flow (78761) | $602.29 | $2,938 | 1.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $256.25 | $1,250 | 0.6× |
| Ther rad simulaj-aided field setting simple (77280) | $182.04 | $888 | 1.2× |
| Thoracic spine 3 views (72072) | $438.50 | $2,139 | 3.8× |
| Thoracolumbar 2 views (72080) | $280.65 | $1,369 | 3.0× |
| Thyroid Imaging With Vascular Flow (78013) | $614.59 | $2,998 | 1.4× |
| Thyroid Met Imaging Body (78018) | $878.63 | $4,286 | 1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $740.46 | $3,612 | 1.7× |
| Tx Devices Design & Construction Complex (77334) | $190.86 | $931 | 0.5× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$126.49–$194.75 | $617–$950 | varies |
| Ultrasound Exam Aaa Screen (76706) | $101.48 | $495 | 0.9× |
| Ultrasound, abdomen limited (76705) | $713.81 | $3,482 | 6.2× |
| Upper gi w/o kub (74240) | $477.04 | $2,327 | 2.5× |
| Ureteral Reflux Study (78740) | $560.06 | $2,732 | 1.3× |
| Urethrocystogram voiding (74455) | $415.54 | $2,027 | 1.6× |
| Urethrocystography retrograde (74450) | $415.54 | $2,027 | 1.6× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$126.49–$194.75 | $617–$950 | varies |
| Us chest (76604) | $213.82 | $1,043 | 1.9× |
| Us complete joint (76881) | $486.47 | $2,373 | 4.3× |
| Us head (76506) | $217.92 | $1,063 | 1.9× |
| Us kidney transplant (76776) | $281.47 | $1,373 | 2.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $150.88 | $736 | 1.3× |
| Us ob detailed single fetus (76811) | $198.24 | $967 | 0.8× |
| Us ob limited 1 or more fetuses (76815) | $676.91 | $3,302 | 5.9× |
| Us ob transvaginal (76817) | $777.98 | $3,795 | 6.8× |
| Us pelvic non ob complete (76856) | $799.09 | $3,898 | 7.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $413.08 | $2,015 | 3.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $917.99 | $4,478 | 8.0× |
| Us retroperitoneal complete (76770) | $735.34 | $3,587 | 6.4× |
| Us retroperitoneal limited (76775) | $375.15 | $1,830 | 3.3× |
| Us scrotum and contents (76870) | $728.57 | $3,554 | 6.4× |
| Us spinal canal and contents (76800) | $144.94 | $707 | 1.3× |
| Us thyroid (76536) | $679.17 | $3,313 | 5.9× |
| Us transrectal (76872) | $245.80 | $1,199 | 2.2× |
| Vein X-Ray Chest (75827) | $575.03 | $2,805 | 0.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $1,327.79 | $6,477 | 0.4× |
| Vein X-Ray Skull Epidural (75872) | $648.62 | $3,164 | 0.9× |
| Venogram Sinus/Jugular (75860) | $585.48 | $2,856 | 0.2× |
| Venography Adrenal Unilateral (75840) | $1,301.96 | $6,351 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $1,797.03 | $8,766 | 0.5× |
| Venography extremity bilateral rs&i (75822) | $972.11 | $4,742 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $826.36 | $4,031 | 0.5× |
| Venography Renal Bilateral (75833) | $1,301.96 | $6,351 | 0.4× |
| Venography Renal Unilateral (75831) | $1,301.96 | $6,351 | 0.4× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,261.57 | $6,154 | 0.2× |
| Venous thrombosis imaging (78457) | $468.84 | $2,287 | 0.8× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$291.51–$438.91 | $1,422–$2,141 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $185.53 | $905 | 2.0× |
| X-ray antegrade pyelogram tube (74425) | $527.06 | $2,571 | 1.4× |
| X-Ray Aorta Leg Arteries (75630) | $3,415.92 | $16,663 | 1.0× |
| X-Ray Bend Only L-S Spine (72120) | $425.99 | $2,078 | 3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$307.09–$523.57 | $1,498–$2,554 | varies |
| X-Ray Exam Breast Specimen (76098) | $381.30 | $1,860 | 0.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $68.88 | $336 | 0.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $268.35 | $1,309 | 2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $319.60 | $1,559 | 3.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $99.02 | $483 | 0.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $504.92 | $2,463 | 4.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $504.92 | $2,463 | 4.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $581.59 | $2,837 | 5.1× |
| X-Ray Exam L-S Spine Bending (72114) | $659.28 | $3,216 | 5.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $374.95 | $1,829 | 3.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $633.66 | $3,091 | 5.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $362.03 | $1,766 | 3.2× |
| X-ray eye for foreign body (70030) | $194.55 | $949 | 2.0× |
| X-ray humerus (73060) | $287.41 | $1,402 | 3.0× |
| X-ray IV pyelogram (ivp) (74400) | $1,054.32 | $5,143 | 5.5× |
| X-ray IV pyelogram+tomography (74415) | $1,286.38 | $6,275 | 6.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$48.18–$370.44 | $235–$1,807 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $470.68 | $2,296 | 4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $420.05 | $2,049 | 3.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $365.72 | $1,784 | 3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $362.03 | $1,766 | 3.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $226.94 | $1,107 | 2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $406.93 | $1,985 | 3.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $527.06 | $2,571 | 1.4× |
| X-Rays Bone Length Studies (77073) | $207.87 | $1,014 | 1.8× |
| X-Rays Bone Survey Complete (77075) | $483.80 | $2,360 | 4.2× |
| Xr c-spine 4 or 5 views (72050) | $506.15 | $2,469 | 4.4× |
| Xr facial bones less than 3 views (70140) | $209.10 | $1,020 | 2.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $137.56 | $671 | 1.2× |
| Xr orbits complete 4 views (70200) | $283.52 | $1,383 | 2.5× |
| Xr Tomogram Single Plane (76100) | $271.83 | $1,326 | 2.4× |
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.