Imaging prices at Salem Regional Medical Center
Salem, OH · 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) | $6,488 | $6,488 | 4.8× |
| Abdomen 1 View (74018) range across 4 matching MRF lines |
$325.50–$341.75 | $325.50–$341.75 | varies |
| Abdomen 2 views (74019) | $351.50 | $351.50 | 3.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,255.75 | $1,255.75 | 3.2× |
| Angiography extremity bilateral rs&i (75716) | $3,177.75 | $3,177.75 | 1.0× |
| Angiography extremity unilateral rs&i (75710) | $3,436.25 | $3,436.25 | 1.1× |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$179.25–$258.75 | $179.25–$258.75 | varies |
| Arthrogram hip (73525) | $1,146.50 | $1,146.50 | 3.4× |
| Basic radiation dosimetry calculation (77300) | $661.50 | $661.50 | 5.1× |
| Bone age studies (77072) | $198 | $198 | 2.0× |
| Bone Imaging 3 Phase (78315) | $617 | $617 | 1.6× |
| Bone Imaging Limited Area (78300) | $576 | $576 | 1.5× |
| Bone Imaging Multiple Areas (78305) | $829.25 | $829.25 | 2.1× |
| Bone Imaging Whole Body (78306) | $1,030 | $1,030 | 2.7× |
| Bone marrow imaging limited area (78102) | $1,371 | $1,371 | 3.5× |
| Bone survey infant (77076) | $422.50 | $422.50 | 4.2× |
| Brachytx isodose complex (77318) range across 3 matching MRF lines |
$625.25–$1,392.75 | $625.25–$1,392.75 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $822 | $822 | 1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $4,326 | $4,326 | 3.1× |
| Cat Scan Follow-Up Study (76380) | $871.50 | $871.50 | 10.4× |
| Cerebrospinal Fluid Scan (78630) | $1,036.25 | $1,036.25 | 2.0× |
| Chest 1 view (71045) | $233 | $233 | 2.8× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$263.75–$277 | $263.75–$277 | varies |
| Chest 3 views (71047) | $295.25 | $295.25 | 3.5× |
| Chest 4 or more views (71048) | $423.50 | $423.50 | 4.2× |
| Clavicle complete (73000) | $187.50 | $187.50 | 2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$513–$590 | $513–$590 | varies |
| Continuing medical physics consltj pr wk (77336) | $801.50 | $801.50 | 6.2× |
| Contrast Exam Abdominl Aorta (75625) | $3,177.75 | $3,177.75 | 1.0× |
| Contrast X-Ray Bladder (74430) | $377 | $377 | 1.1× |
| Contrast X-Ray Of Knee Joint (73580) | $848.75 | $848.75 | 2.5× |
| Contrast Xray Throat/Cerv Esopha (74210) | $533.75 | $533.75 | 3.1× |
| CT abdomen and pelvis without and with contrast (74178) | $3,904.75 | $3,904.75 | 11.6× |
| CT abdomen and pelvis without contrast (74176) range across 4 matching MRF lines |
$2,797.50–$2,840 | $2,797.50–$2,840 | varies |
| CT abdomen w contrast (74160) range across 4 matching MRF lines |
$1,622.25–$1,703.25 | $1,622.25–$1,703.25 | varies |
| CT abdomen w wo contrast (74170) | $1,955 | $1,955 | 11.5× |
| CT abdomen w/o contrast (74150) range across 4 matching MRF lines |
$1,408.25–$1,619.50 | $1,408.25–$1,619.50 | varies |
| CT Angio Abdomen and Pelvis (74174) | $2,797.50 | $2,797.50 | 8.3× |
| CT Angio Chest (71275) | $2,776 | $2,776 | 16.4× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$2,448.50–$2,815.75 | $2,448.50–$2,815.75 | varies |
| CT angio hrt w/3d image (75574) | $2,334.75 | $2,334.75 | 6.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,514.25 | $2,514.25 | 14.8× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$2,435–$2,448.50 | $2,435–$2,448.50 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,495.75 | $2,495.75 | 14.7× |
| CT cervical spine w/ contrast (72126) | $1,644 | $1,644 | 4.9× |
| CT cervical spine w/o contrast (72125) | $1,409.25 | $1,409.25 | 13.9× |
| CT cervical spine w/wo cont (72127) | $1,995.25 | $1,995.25 | 11.8× |
| CT chest w contrast (71260) range across 6 matching MRF lines |
$1,645–$1,653.25 | $1,645–$1,653.25 | varies |
| CT chest w/wo contrast (71270) | $2,019 | $2,019 | 11.9× |
| CT colonography screening (74263) | $780.75 | $780.75 | 3.4× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,099.25 | $1,099.25 | 6.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $882.75 | $882.75 | 8.7× |
| CT head/brain with contrast (70460) | $1,354.50 | $1,354.50 | 8.0× |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,650.25–$1,658.50 | $1,650.25–$1,658.50 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $61.75 | $61.75 | 0.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $42 | $42 | 0.5× |
| CT iac w contrast (70481) | $1,414.25 | $1,414.25 | 8.3× |
| CT l-spine w&w/o contrast (72133) | $1,995.25 | $1,995.25 | 11.8× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$1,207.25–$1,213.50 | $1,207.25–$1,213.50 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$1,402–$1,409.25 | $1,402–$1,409.25 | varies |
| CT lumbar spine w contrast (72132) | $1,644 | $1,644 | 4.9× |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,409.25–$1,620.75 | $1,409.25–$1,620.75 | varies |
| CT maxillofacial w contrast (70487) range across 4 matching MRF lines |
$1,391.75–$1,398.75 | $1,391.75–$1,398.75 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$1,174.25–$1,357.50 | $1,174.25–$1,357.50 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,701.75–$1,787 | $1,701.75–$1,787 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,702.75 | $1,702.75 | 10.0× |
| CT orbits w/o contrast (70480) | $1,216.50 | $1,216.50 | 12.0× |
| CT pelvis w&w/o contrast (72194) | $1,909.75 | $1,909.75 | 11.3× |
| CT pelvis w/o contrast (72192) | $1,393.75 | $1,393.75 | 13.8× |
| CT scan of leg combo (73702) range across 4 matching MRF lines |
$1,700.75–$1,710 | $1,700.75–$1,710 | varies |
| CT scans face/jaw combo (70488) range across 4 matching MRF lines |
$1,685.25–$1,693.50 | $1,685.25–$1,693.50 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,479.25–$1,701.25 | $1,479.25–$1,701.25 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,210.25–$1,216.50 | $1,210.25–$1,216.50 | varies |
| CT thoracic spine w contrast (72129) | $1,644 | $1,644 | 9.7× |
| CT thoracic spine w/o contrast (72128) | $1,409.25 | $1,409.25 | 13.9× |
| CT thoracic spine w/wo cont (72130) | $1,995.25 | $1,995.25 | 11.8× |
| CT thorax w/o contrast (71250) | $1,409.25 | $1,409.25 | 13.9× |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$1,207.25–$1,395.50 | $1,207.25–$1,395.50 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,713 | $1,713 | 10.1× |
| CT upper extremity with contrast (73201) range across 4 matching MRF lines |
$1,402–$1,479.25 | $1,402–$1,479.25 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,452.75 | $3,452.75 | 20.4× |
| Cta Abdomen (74175) | $2,707 | $2,707 | 16.0× |
| CTA pelvis (72191) | $2,689.50 | $2,689.50 | 15.9× |
| Dilation ureters/urethra rs&i (74485) | $1,971.50 | $1,971.50 | 1.0× |
| Dxa Bone Density Axial (77080) | $331.75 | $331.75 | 3.3× |
| Dxa bone density study (77085) | $1,137.25 | $1,137.25 | 11.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $273 | $273 | 3.2× |
| Echo exam uterus (76831) | $841.75 | $841.75 | 3.6× |
| Esophagram (74220) | $556.25 | $556.25 | 3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $604.75 | $604.75 | 6.0× |
| Fluoroscopy up to 1 hr (76000) | $393.50 | $393.50 | 1.7× |
| Follow-Up Angiography (75898) | $328.75 | $328.75 | 0.1× |
| Foot 2 views (73620) range across 7 matching MRF lines |
$179.25–$258.75 | $179.25–$258.75 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$187.50–$188.50 | $187.50–$188.50 | varies |
| Gastric emptying imaging study (78264) | $898.25 | $898.25 | 2.3× |
| Gated Heart Planar Single (78472) | $1,419.50 | $1,419.50 | 3.7× |
| Hand 2 views (73120) range across 7 matching MRF lines |
$179.25–$258.75 | $179.25–$258.75 | varies |
| Heart first pass single,planar (78481) | $1,140.25 | $1,140.25 | 2.2× |
| Hepatobil Syst Image W/Drug (78227) | $983.25 | $983.25 | 1.9× |
| Hepatobiliary System Imaging (78226) | $546 | $546 | 1.4× |
| Ht Muscle Image Spect Sing (78451) | $2,337.25 | $2,337.25 | 1.9× |
| Hysterosalpingogram (74740) | $464.75 | $464.75 | 2.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $570.75 | $570.75 | 6.8× |
| Infusion Ivp (74410) | $660.25 | $660.25 | 3.9× |
| Interstitial radiation source applic complex (77778) range across 2 matching MRF lines |
$1,576–$3,201.25 | $1,576–$3,201.25 | varies |
| K Flow/Funct Image Multiple (78709) | $1,100.25 | $1,100.25 | 2.1× |
| K Flow/Funct Image W/Drug (78708) | $1,414.25 | $1,414.25 | 2.7× |
| K Flow/Funct Image W/O Drug (78707) | $999.25 | $999.25 | 1.9× |
| Knee 3 Views (73562) range across 5 matching MRF lines |
$214.25–$325.75 | $214.25–$325.75 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $825.25 | $825.25 | 2.1× |
| Liver & Spleen Imaging Static Only (78215) | $625.25 | $625.25 | 1.6× |
| Liver imaging w/vascular flow (78202) | $757.25 | $757.25 | 1.4× |
| Lung Perf&Ventilat Diferentl (78598) | $978.50 | $978.50 | 1.9× |
| Lung perfusion differential (78597) | $502.75 | $502.75 | 1.3× |
| Lung Ventilat&Perfus Imaging (78582) | $929.25 | $929.25 | 1.8× |
| Lung Ventilation Imaging (78579) | $380.25 | $380.25 | 1.0× |
| Lymph System Imaging (78195) | $989 | $989 | 1.9× |
| Magnetic Image Jaw Joint (70336) | $1,907.75 | $1,907.75 | 8.3× |
| Magnetic Resonance Elastography (76391) | $1,884 | $1,884 | 8.2× |
| Mammary ductogram or galactogram multiple (77054) | $800.50 | $800.50 | 3.5× |
| Mammary ductogram or galactogram single (77053) | $584.25 | $584.25 | 2.5× |
| Meckels Divert Exam (78290) | $688.25 | $688.25 | 1.8× |
| Mlc imrt design & construction per imrt plan (77338) | $2,020 | $2,020 | 5.6× |
| Mra Head W/O & W/Contrast Material (70546) | $3,510.25 | $3,510.25 | 10.4× |
| MRA head w/o contrast (70544) | $1,678 | $1,678 | 7.3× |
| MRA head with contrast (70545) | $1,881.75 | $1,881.75 | 5.6× |
| MRA neck w contrast (70548) | $1,854 | $1,854 | 5.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,510.25 | $3,510.25 | 10.4× |
| MRA neck w/o contrast (70547) | $1,854 | $1,854 | 8.0× |
| MRI abdomen w contrast (74182) | $2,252.75 | $2,252.75 | 6.7× |
| MRI abdomen w/o contrast (74181) | $1,884 | $1,884 | 8.2× |
| MRI any jt lower extrem w/contrast material (73722) | $2,258.50 | $2,258.50 | 3.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,950.25 | $3,950.25 | 11.7× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,225 | $2,225 | 2.9× |
| MRI bone marrow blood supply (77084) | $1,930.25 | $1,930.25 | 8.4× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,197 | $1,197 | 5.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,097 | $1,097 | 4.8× |
| MRI cervical spine w contrast (72142) | $2,314.50 | $2,314.50 | 6.9× |
| MRI cervical spine w/o cont (72141) | $1,960.25 | $1,960.25 | 8.5× |
| MRI chest w/o contrast (71550) | $1,884 | $1,884 | 8.2× |
| MRI chest with contrast (71551) | $2,010.75 | $2,010.75 | 2.7× |
| MRI chest wo w contrast (71552) | $3,948 | $3,948 | 11.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,987 | $1,987 | 5.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,949.25 | $3,949.25 | 11.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,855.25 | $1,855.25 | 8.0× |
| MRI lumbar spine w contrast (72149) | $2,289.75 | $2,289.75 | 6.8× |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$2,792.50–$4,158 | $2,792.50–$4,158 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $1,869.50 | $1,869.50 | 8.1× |
| MRI orbit face neck w contrast (70542) | $2,225 | $2,225 | 6.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,950.25 | $3,950.25 | 11.7× |
| MRI pelvis w contrast (72196) | $2,010.75 | $2,010.75 | 6.0× |
| MRI pelvis w/o & w contrast (72197) | $3,984.25 | $3,984.25 | 11.8× |
| MRI pelvis w/o contrast (72195) | $1,885 | $1,885 | 8.2× |
| MRI thoracic spine w/o contrast (72146) | $2,139 | $2,139 | 9.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,988 | $1,988 | 5.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,855.25 | $1,855.25 | 8.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,950.25 | $3,950.25 | 11.7× |
| MRI, abdomen, combo (74183) | $4,582 | $4,582 | 13.6× |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$2,783.25–$4,155.75 | $2,783.25–$4,155.75 | varies |
| MRI, dorsal spine contrast (72147) | $2,313.50 | $2,313.50 | 6.9× |
| MRI, joint upper extrem (73221) | $1,883 | $1,883 | 8.2× |
| MRI, joint upper extrem combo (73223) | $3,950.25 | $3,950.25 | 11.7× |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$2,715.25–$4,056.25 | $2,715.25–$4,056.25 | varies |
| Myelogram cervical (72240) | $1,379.25 | $1,379.25 | 1.8× |
| Myocardial Spect Multiple Studies (78452) | $3,221 | $3,221 | 2.6× |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$182.50–$183.50 | $182.50–$183.50 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $282.25 | $282.25 | 0.7× |
| Nonvascular Shunt X-Ray (75809) | $358.50 | $358.50 | 3.5× |
| Ntsty modul radthx pln dose-vol histos (77301) | $7,700 | $7,700 | 5.8× |
| Nuclear Rx Oral Admin (79005) | $868.50 | $868.50 | 3.8× |
| Optic foramina (70190) | $233 | $233 | 2.8× |
| Parathyroid Planar Imaging (78070) | $914.75 | $914.75 | 2.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,268 | $1,268 | 3.3× |
| Pelvis 1 or 2 views (72170) | $190.75 | $190.75 | 1.9× |
| Pet Image W/Ct Lmtd (78814) | $4,501.25 | $4,501.25 | 3.3× |
| PET image w/CT, full body (78816) | $4,251 | $4,251 | 3.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,501.25 | $4,501.25 | 3.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $600.50 | $600.50 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$395.75–$415.50 | $395.75–$415.50 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$374–$449.25 | $374–$449.25 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$196.75–$298.75 | $196.75–$298.75 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $172.25 | $172.25 | 2.0× |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$365.75–$529.50 | $365.75–$529.50 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $339 | $339 | 3.4× |
| Radex fingr minimum 2 views (73140) | $155.75 | $155.75 | 1.9× |
| Radex foot complete minimum 3 views (73630) range across 5 matching MRF lines |
$196.75–$298.75 | $196.75–$298.75 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$196.75–$298.75 | $196.75–$298.75 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $179.25 | $179.25 | 2.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $317.25 | $317.25 | 3.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $149.50 | $149.50 | 1.8× |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$224.75–$226.75 | $224.75–$226.75 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$210.25–$305 | $210.25–$305 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $221.50 | $221.50 | 2.6× |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$293.75–$301 | $293.75–$301 | varies |
| Radex Sternum Minimum 2 Views (71120) | $237 | $237 | 2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $297.75 | $297.75 | 3.5× |
| Radex Toe Minimum 2 Views (73660) | $155.75 | $155.75 | 1.9× |
| Radex upper extremity infant minimum 2 views (73092) | $179.25 | $179.25 | 1.8× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 7 matching MRF lines |
$196.75–$284.50 | $196.75–$284.50 | varies |
| Radiation treatment delivery level 1 (77402) | $643.75 | $643.75 | 6.5× |
| Radiation treatment delivery level 2 (77407) | $796.25 | $796.25 | 2.1× |
| Radiation treatment delivery level 3 (77412) | $1,055.75 | $1,055.75 | 2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $339 | $339 | 3.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$253.50–$266.25 | $253.50–$266.25 | varies |
| Radiologic exam colon double contrast study (74280) | $896.25 | $896.25 | 5.3× |
| Radiologic exam colon single contrast study (74270) | $669.50 | $669.50 | 3.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $556.25 | $556.25 | 3.3× |
| Radiologic exam knee complete 4/more views (73564) range across 5 matching MRF lines |
$236–$357 | $236–$357 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $244.25 | $244.25 | 2.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $491.50 | $491.50 | 2.9× |
| Radiologic exam swallow function contrast study (74230) | $548 | $548 | 3.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,027 | $1,027 | 6.1× |
| Radiologic examination femur 1 view (73551) | $190.75 | $190.75 | 2.3× |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$207.25–$414.25 | $207.25–$414.25 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$190.75–$275.25 | $190.75–$275.25 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $408 | $408 | 4.0× |
| Radiologic Examination Salivary Gland Calculus (70380) | $233 | $233 | 2.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$190.75–$191.75 | $190.75–$191.75 | varies |
| Ribs bilateral 3 views (71110) | $291.50 | $291.50 | 2.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,096 | $1,096 | 2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,397.75 | $1,397.75 | 3.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,396 | $2,396 | 4.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,162 | $1,162 | 2.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,391.75 | $1,391.75 | 2.6× |
| Rp Therapy Intravenous Administration (79101) | $1,734.75 | $1,734.75 | 7.7× |
| Scapula (73010) | $190.75 | $190.75 | 1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 6 matching MRF lines |
$41.25–$92.50 | $41.25–$92.50 | varies |
| Sella turcica (70240) | $170 | $170 | 2.0× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$199–$288.50 | $199–$288.50 | varies |
| Shoulder Arthrography (73040) | $717 | $717 | 2.1× |
| Sialogram (70390) | $586.25 | $586.25 | 2.5× |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$318.50–$328.75 | $318.50–$328.75 | varies |
| Special dosimetry (77331) | $588.25 | $588.25 | 4.5× |
| Special Physics Consult (77370) | $1,017 | $1,017 | 7.8× |
| Special teletherapy port plan (77321) | $1,477.25 | $1,477.25 | 4.1× |
| Special treatment procedure (77470) | $2,667.75 | $2,667.75 | 5.0× |
| Speech evaluation, complex (70371) | $820 | $820 | 3.6× |
| Spleen Imaging (78185) | $625.25 | $625.25 | 1.6× |
| Stereotactic Body Radiation Delivery (77373) | $5,562 | $5,562 | 3.2× |
| Sternoclavicular joints (71130) | $256.50 | $256.50 | 3.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,844.75 | $1,844.75 | 5.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,102.25 | $1,102.25 | 3.0× |
| Temporomandble Jt Arthrography Rs&I (70332) | $725.25 | $725.25 | 3.1× |
| Testicular Imaging W/Flow (78761) | $723.25 | $723.25 | 1.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,117 | $2,117 | 5.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,669.75 | $1,669.75 | 4.6× |
| Ther rad simulaj-aided field setting simple (77280) | $1,077 | $1,077 | 8.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,321.50 | $1,321.50 | 7.8× |
| Thoracic spine 2 views (72070) | $242.25 | $242.25 | 2.4× |
| Thoracic spine 3 views (72072) | $264.75 | $264.75 | 2.6× |
| Thoracolumbar 2 views (72080) | $245.25 | $245.25 | 2.9× |
| Thyroid Imaging With Vascular Flow (78013) | $844.75 | $844.75 | 2.2× |
| Thyroid Uptake Measurement (78012) | $219.50 | $219.50 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,153.75 | $1,153.75 | 3.0× |
| Tx Devices Design & Construction Complex (77334) | $1,410.25 | $1,410.25 | 3.9× |
| Tx devices design & construction intermediate (77333) | $944.75 | $944.75 | 7.3× |
| Tx devices design & construction simple (77332) | $756.25 | $756.25 | 5.8× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$405–$569.75 | $405–$569.75 | varies |
| Ultrasound Elastography Parenchyma (76981) | $72.50 | $72.50 | 0.7× |
| Ultrasound Exam Aaa Screen (76706) | $617 | $617 | 6.1× |
| Ultrasound, abdomen limited (76705) range across 9 matching MRF lines |
$529.50–$609 | $529.50–$609 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $384.25 | $384.25 | 4.6× |
| Unlisted us procedure (76999) | $499.75 | $499.75 | 5.9× |
| Upper gi w/o kub (74240) | $964.25 | $964.25 | 5.7× |
| Urethrocystogram voiding (74455) | $521.25 | $521.25 | 2.3× |
| Urethrocystography retrograde (74450) | $484.25 | $484.25 | 2.1× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$661.50–$963.25 | $661.50–$963.25 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$236–$464.75 | $236–$464.75 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$501.75–$577 | $501.75–$577 | varies |
| Us exam, pelvic, limited (76857) | $498.75 | $498.75 | 4.9× |
| Us head (76506) | $526.50 | $526.50 | 5.2× |
| Us kidney transplant (76776) | $670.75 | $670.75 | 6.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$452.25–$520 | $452.25–$520 | varies |
| Us ob limited 1 or more fetuses (76815) | $525.50 | $525.50 | 5.2× |
| Us ob transvaginal (76817) | $696.50 | $696.50 | 6.9× |
| Us pelvic non ob complete (76856) | $559.50 | $559.50 | 5.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $782 | $782 | 7.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $517.25 | $517.25 | 5.1× |
| Us retroperitoneal complete (76770) | $670.75 | $670.75 | 6.6× |
| Us retroperitoneal limited (76775) | $529.50 | $529.50 | 5.2× |
| Us scrotum and contents (76870) | $745.25 | $745.25 | 7.4× |
| Us spinal canal and contents (76800) | $669.50 | $669.50 | 6.6× |
| Us thyroid (76536) range across 3 matching MRF lines |
$498.75–$571 | $498.75–$571 | varies |
| Us transrectal (76872) | $668.50 | $668.50 | 6.6× |
| Venography caval inferior serialography rs&i (75825) | $3,177.75 | $3,177.75 | 1.0× |
| Venography extremity bilateral rs&i (75822) | $1,111.50 | $1,111.50 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $1,111.50 | $1,111.50 | 0.7× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $909.50 | $909.50 | 2.4× |
| Vertebral fracture assessment via dxa (77086) | $254.50 | $254.50 | 3.0× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$185.50–$267 | $185.50–$267 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $242.25 | $242.25 | 2.9× |
| X-ray antegrade pyelogram tube (74425) | $359.50 | $359.50 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) | $351.25 | $351.25 | 3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$185.50–$267 | $185.50–$267 | varies |
| X-Ray Exam Breast Specimen (76098) | $633.50 | $633.50 | 1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $202 | $202 | 2.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $245.25 | $245.25 | 2.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $199 | $199 | 2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 7 matching MRF lines |
$193.75–$222.50 | $193.75–$222.50 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$334.75–$408 | $334.75–$408 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 3 matching MRF lines |
$293.75–$334.75 | $293.75–$334.75 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $408 | $408 | 4.0× |
| X-Ray Exam L-S Spine Bending (72114) | $630.50 | $630.50 | 6.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 5 matching MRF lines |
$336–$352.75 | $336–$352.75 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$410–$430.50 | $410–$430.50 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) | $264.75 | $264.75 | 2.6× |
| X-ray eye for foreign body (70030) | $155.75 | $155.75 | 1.9× |
| X-ray humerus (73060) range across 4 matching MRF lines |
$207.25–$208.25 | $207.25–$208.25 | varies |
| X-ray IV pyelogram (ivp) (74400) | $678.25 | $678.25 | 4.0× |
| X-ray IV pyelogram+tomography (74415) | $683 | $683 | 4.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $254.50 | $254.50 | 3.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $185.50 | $185.50 | 2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$245.25–$257.50 | $245.25–$257.50 | varies |
| X-ray nose-rectum child f.b. (76010) | $176.25 | $176.25 | 2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $339 | $339 | 3.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $226.75 | $226.75 | 2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $288.50 | $288.50 | 3.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $284.50 | $284.50 | 3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $345.25 | $345.25 | 3.4× |
| X-Ray Stress View (77071) | $259.75 | $259.75 | 3.1× |
| X-ray thoracic spine 4 vw (72074) | $273 | $273 | 2.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $787 | $787 | 2.3× |
| X-Rays Bone Length Studies (77073) | $318.50 | $318.50 | 3.1× |
| X-Rays Bone Survey Complete (77075) | $408 | $408 | 4.0× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$385.25–$404.50 | $385.25–$404.50 | varies |
| Xr facial bones less than 3 views (70140) | $254.50 | $254.50 | 3.0× |
| XR Mastoids < 3 Views Bilateral (70120) | $224.75 | $224.75 | 2.2× |
| Xr orbits complete 4 views (70200) | $293.75 | $293.75 | 2.9× |
| Xr Tomogram Single Plane (76100) | $514 | $514 | 5.1× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.