Imaging prices at Samaritan Hospital
Troy, NY · every code in this section with a posted price and a Medicare benchmark.
311 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) | $2,780.05 | $4,277 | 1.6× |
| Abdomen 1 View (74018) | $343.85 | $529 | 3.2× |
| Abdomen 2 views (74019) | $421.85 | $649 | 3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,622.40 | $2,496 | 3.3× |
| Angio pulmonary bilat (75743) | $6,414.85 | $9,869 | 1.6× |
| Angiography extremity bilateral rs&i (75716) | $4,815.85 | $7,409 | 1.2× |
| Angiography extremity unilateral rs&i (75710) | $4,815.85 | $7,409 | 1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $4,277 | $6,580 | 1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $5,798 | $8,920 | 1.5× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$524.55–$3,059.55 | — | varies |
| Aortography thoracic serialography rs&i (75605) | $5,229.90 | $8,046 | 0.8× |
| Artery X-Rays Abdomen (75726) | $5,229.90 | $8,046 | 0.8× |
| Artery X-Rays Pelvis (75736) | $5,229.90 | $8,046 | 0.8× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$631.15–$946.40 | $971–$1,456 | varies |
| Basic radiation dosimetry calculation (77300) | $613.60 | $944 | 3.7× |
| Bone age studies (77072) | $187.85 | $289 | 1.4× |
| Bone Imaging 3 Phase (78315) | $1,685.45 | $2,593 | 3.4× |
| Bone Imaging Limited Area (78300) | $1,408.55 | $2,167 | 2.8× |
| Bone Imaging Multiple Areas (78305) | $764.40 | $1,176 | 1.5× |
| Bone Imaging Whole Body (78306) | $1,695.85 | $2,609 | 3.4× |
| Bone survey infant (77076) | $300.30 | $462 | 2.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,468.40 | $5,336 | 8.0× |
| Cat Scan Follow-Up Study (76380) | $767.65 | $1,181 | 7.1× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$542.10–$11,024.67 | — | varies |
| Chest 2 views (71046) | $357.50 | — | 3.3× |
| Chest 3 views (71047) | $432.25 | $665 | 4.0× |
| Chest 4 or more views (71048) | $464.10 | $714 | 3.6× |
| Clavicle complete (73000) range across 9 matching MRF lines |
$278.20–$416.65 | $428–$641 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,756.30 | $2,702 | 13.5× |
| Continuing medical physics consltj pr wk (77336) | $16,794.05 | — | 100.1× |
| Contrast Exam Abdominl Aorta (75625) | $4,815.85 | $7,409 | 1.2× |
| Contrast X-Ray Bladder (74430) | $911.30 | $1,402 | 2.1× |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$896.35–$1,344.20 | $1,379–$2,068 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $3,210.35 | — | 7.4× |
| CT abdomen and pelvis without contrast (74176) | $2,293.85 | — | 7.7× |
| CT abdomen w contrast (74160) | $2,288 | $3,520 | 10.4× |
| CT abdomen w wo contrast (74170) | $2,809.95 | $4,323 | 12.8× |
| CT abdomen w/o contrast (74150) | $1,898 | $2,920 | 14.5× |
| CT Angio Abdomen and Pelvis (74174) | $1,768.65 | $2,721 | 4.1× |
| CT Angio Chest (71275) | $2,219.94 | — | 10.1× |
| CT Angio Head (70496) | $2,573.67 | — | 11.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 9 matching MRF lines |
$627.25–$939.90 | $965–$1,446 | varies |
| CT Angio Neck (70498) | $2,573.67 | — | 11.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,959.75 | $3,015 | 9.0× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $349.70 | $538 | 1.6× |
| CT cervical spine w/ contrast (72126) | $2,616.90 | $4,026 | 6.0× |
| CT cervical spine w/o contrast (72125) | $1,672.45 | — | 12.8× |
| CT cervical spine w/wo cont (72127) | $2,816.45 | $4,333 | 12.9× |
| CT chest w contrast (71260) | $5,146.05 | — | 23.5× |
| CT chest w/wo contrast (71270) | $2,826.20 | $4,348 | 12.9× |
| CT colonography screening (74263) | $567.45 | $873 | 1.9× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $702.65 | $1,081 | 3.2× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $573.30 | $882 | 4.4× |
| CT head/brain with contrast (70460) | $1,504.75 | $2,315 | 6.9× |
| CT head/brain without and with contrast (70470) | $2,412.80 | $3,712 | 11.0× |
| CT iac w contrast (70481) | $1,717.30 | — | 7.8× |
| CT l-spine w&w/o contrast (72133) | $2,455.70 | $3,778 | 11.2× |
| CT lower ext w/o (73700) range across 9 matching MRF lines |
$1,615.25–$2,423.20 | $2,485–$3,728 | varies |
| CT lower extremity w/contrast material (73701) | $2,534.35 | — | 11.6× |
| CT lumbar spine w contrast (72132) | $2,260.70 | $3,478 | 5.2× |
| CT lumbar spine w/o contrast (72131) | $2,067 | $3,180 | 15.8× |
| CT maxillofacial w contrast (70487) | $1,794.65 | $2,761 | 8.2× |
| CT maxillofacial wo contrast (70486) | $1,554.15 | — | 11.9× |
| CT neck tissue combo (70492) | $2,082.60 | $3,204 | 9.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,354.30 | $3,622 | 10.8× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,435.20–$2,854.80 | — | varies |
| CT pelvis w&w/o contrast (72194) | $2,820.35 | $4,339 | 12.9× |
| CT pelvis w/o contrast (72192) | $1,990.95 | — | 15.3× |
| CT scan of leg combo (73702) range across 6 matching MRF lines |
$1,708.85–$2,562.95 | $2,629–$3,943 | varies |
| CT scans face/jaw combo (70488) | $2,524.60 | $3,884 | 11.5× |
| CT soft tissue neck w contrast (70491) | $1,677.65 | $2,581 | 7.7× |
| CT soft tissue neck w/o contrast (70490) | $1,364.35 | $2,099 | 10.5× |
| CT thoracic spine w contrast (72129) | $2,203.50 | $3,390 | 10.1× |
| CT thoracic spine w/o contrast (72128) | $1,746.55 | $2,687 | 13.4× |
| CT thoracic spine w/wo cont (72130) | $2,816.45 | $4,333 | 12.9× |
| CT thorax w/o contrast (71250) | $1,745.25 | — | 13.4× |
| CT upper ext wo (73200) range across 9 matching MRF lines |
$1,944.80–$2,918.50 | $2,992–$4,490 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,104.70–$3,222.05 | $3,238–$4,957 | varies |
| CT upper extremity with contrast (73201) range across 9 matching MRF lines |
$1,977.95–$2,967.25 | $3,043–$4,565 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,642.55 | $2,527 | 7.5× |
| Cta Abdomen (74175) | $1,818.70 | $2,798 | 8.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $2,484.95 | $3,823 | 5.7× |
| CTA pelvis (72191) | $1,933.10 | $2,974 | 8.8× |
| Doppler Fetal Mid Cerebral Artery (76821) | $79.95 | $123 | 0.6× |
| Dxa Bone Density Axial (77080) | $520 | $800 | 4.0× |
| Dxa bone density study (77085) | $463.45 | $713 | 3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $165.10 | $254 | 1.5× |
| Echo Guide For Artery Repair (76936) | $2,925.65 | $4,501 | 10.9× |
| Esophagram (74220) | $682.50 | $1,050 | 3.1× |
| Fetal Biophys Profile W/Nst (76818) | $1,253.20 | $1,928 | 9.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,092 | — | 8.4× |
| Fluoroscopy up to 1 hr (76000) | $6,029.14 | — | 20.2× |
| Foot 2 views (73620) range across 12 matching MRF lines |
$204.75–$306.80 | $315–$472 | varies |
| Forearm 2 views (73090) | $676.65 | — | 6.2× |
| Gastric emptying imaging study (78264) | $1,691.95 | $2,603 | 3.4× |
| Gated Heart Planar Single (78472) | $1,327.95 | $2,043 | 2.7× |
| Hand 2 views (73120) range across 9 matching MRF lines |
$187.20–$282.75 | $288–$435 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,547.65 | $2,381 | 2.3× |
| Hepatobiliary System Imaging (78226) | $1,691.95 | $2,603 | 3.4× |
| Ht Muscle Image Spect Sing (78451) | $2,939.30 | $4,522 | 1.8× |
| Hysterosalpingogram (74740) | $414.05 | $637 | 1.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $343.85 | $529 | 3.2× |
| Infant hip ultrasound, limited static exam (76886) | $568.75 | $875 | 5.2× |
| K Flow/Funct Image Multiple (78709) | $991.25 | $1,525 | 1.5× |
| K Flow/Funct Image W/Drug (78708) | $1,409.85 | $2,169 | 2.1× |
| K Flow/Funct Image W/O Drug (78707) | $1,586.65 | $2,441 | 2.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $764.40 | $1,176 | 1.5× |
| Knee 3 Views (73562) range across 15 matching MRF lines |
$300.30–$451.10 | $462–$694 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,596.40 | $2,456 | 3.2× |
| Lung Perf&Ventilat Diferentl (78598) | $1,972.75 | $3,035 | 2.9× |
| Lung perfusion differential (78597) | $700.05 | $1,077 | 1.4× |
| Lung Ventilat&Perfus Imaging (78582) | $1,457.30 | $2,242 | 2.2× |
| Lung Ventilation Imaging (78579) | $726.05 | $1,117 | 1.5× |
| Lymph System Imaging (78195) | $1,367.60 | $2,104 | 2.0× |
| Magnetic Image Jaw Joint (70336) | $2,445.95 | $3,763 | 8.2× |
| Meckels Divert Exam (78290) | $1,480.70 | $2,278 | 3.0× |
| Mlc imrt design & construction per imrt plan (77338) | $12,686.70 | — | 27.1× |
| Mra Head W/O & W/Contrast Material (70546) | $2,539.55 | $3,907 | 5.8× |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$2,374.45–$3,626.35 | — | varies |
| MRA head with contrast (70545) | $2,681.25 | $4,125 | 6.2× |
| MRA neck w contrast (70548) | $2,551.90 | $3,926 | 5.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,863.60 | $5,944 | 8.9× |
| MRA neck w/o contrast (70547) | $2,554.50 | $3,930 | 8.6× |
| MRI abdomen w contrast (74182) | $2,678.65 | $4,121 | 6.2× |
| MRI abdomen w/o contrast (74181) | $2,616.25 | $4,025 | 8.8× |
| MRI any jt lower extrem w/contrast material (73722) range across 6 matching MRF lines |
$2,696.85–$4,044.95 | $4,149–$6,223 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 9 matching MRF lines |
$3,364.40–$5,047.25 | $5,176–$7,765 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$1,448.85–$2,173.60 | $2,229–$3,344 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $3,733.60 | $5,744 | 12.5× |
| MRI cervical spine w contrast (72142) | $2,762.50 | $4,250 | 6.3× |
| MRI cervical spine w/o cont (72141) | $2,416.70 | $3,718 | 8.1× |
| MRI chest w/o contrast (71550) | $2,983.50 | $4,590 | 10.0× |
| MRI chest wo w contrast (71552) | $3,707.60 | $5,704 | 8.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,005.60 | $4,624 | 6.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 6 matching MRF lines |
$3,097.90–$4,647.50 | $4,766–$7,150 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 6 matching MRF lines |
$2,622.75–$3,935.10 | $4,035–$6,054 | varies |
| MRI lumbar spine w contrast (72149) | $2,629.25 | $4,045 | 6.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,325.40 | $5,116 | 7.6× |
| MRI orbit face &/neck w/o contrast (70540) | $2,815.80 | $4,332 | 9.5× |
| MRI orbit face neck w contrast (70542) | $2,996.50 | $4,610 | 6.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,170.05 | $4,877 | 7.3× |
| MRI pelvis w contrast (72196) | $3,389.75 | $5,215 | 7.8× |
| MRI pelvis w/o & w contrast (72197) | $3,483.35 | $5,359 | 8.0× |
| MRI pelvis w/o contrast (72195) | $2,210 | $3,400 | 7.4× |
| MRI thoracic spine w/o contrast (72146) | $2,445.95 | $3,763 | 8.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 6 matching MRF lines |
$2,618.85–$3,927.95 | $4,029–$6,043 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 6 matching MRF lines |
$3,586.05–$5,379.40 | $5,517–$8,276 | varies |
| MRI, abdomen, combo (74183) | $3,616.60 | $5,564 | 8.3× |
| MRI, dorsal spine combo (72157) | $3,465.80 | $5,332 | 8.0× |
| MRI, dorsal spine contrast (72147) | $3,237 | $4,980 | 7.4× |
| MRI, joint upper extrem (73221) range across 6 matching MRF lines |
$2,376.40–$3,563.95 | $3,656–$5,483 | varies |
| MRI, joint upper extrem combo (73223) range across 6 matching MRF lines |
$3,312.40–$4,969.90 | $5,096–$7,646 | varies |
| MRI, lumbar spine combo (72158) | $3,342.95 | $5,143 | 7.7× |
| Myelogram cervical (72240) | $796.90 | $1,226 | 0.8× |
| Myelogram Lumbar (72265) | $857.35 | $1,319 | 0.9× |
| Myelography thoracic (72255) | $666.90 | $1,026 | 0.7× |
| Myelograpy 2/more regions rs&i (72270) | $1,340.30 | $2,062 | 1.4× |
| Myocardial Spect Multiple Studies (78452) | $3,211.65 | $4,941 | 2.0× |
| Neck soft tissue (70360) | $313.30 | $482 | 2.9× |
| Nonvascular Shunt X-Ray (75809) | $389.35 | $599 | 3.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,913 | $6,020 | 2.3× |
| Ob us nuchal meas 1 gest (76813) | $89.05 | $137 | 0.7× |
| Parathyroid Planar Imaging (78070) | $764.40 | $1,176 | 1.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $862.55 | $1,327 | 1.7× |
| Pelvis 1 or 2 views (72170) | $812.50 | — | 6.2× |
| PET image w/CT, full body (78816) | $4,457.70 | $6,858 | 2.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,457.70 | $6,858 | 2.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $779.35 | $1,199 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $308.75 | $475 | 2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $643.50 | $990 | 0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$461.50–$1,451.45 | — | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 9 matching MRF lines |
$285.35–$427.70 | $439–$658 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$645.45–$4,309.50 | — | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $508.30 | $782 | 3.9× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$208–$312 | — | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$420.55–$726.70 | — | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$300.95–$1,102.40 | — | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 9 matching MRF lines |
$270.40–$404.95 | $416–$623 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $364 | $560 | 3.4× |
| Radex Ribs Unilateral 2 Views (71100) | $521.95 | $803 | 4.8× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$356.85–$1,647.75 | — | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $289.25 | $445 | 2.7× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$10,437.59–$13,959.80 | — | varies |
| Radex Sternum Minimum 2 Views (71120) | $454.35 | $699 | 4.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $358.80 | $552 | 3.3× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$226.85–$341.90 | — | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 6 matching MRF lines |
$279.50–$418.60 | $430–$644 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$522.60–$2,422.55 | — | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $208 | $320 | 1.6× |
| Radiation treatment delivery level 1 (77402) | $317.20 | $488 | 2.5× |
| Radiation treatment delivery level 2 (77407) | $1,116.05 | $1,717 | 2.3× |
| Radiation treatment delivery level 3 (77412) | $819 | $1,260 | 1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $510.25 | $785 | 3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $447.20 | $688 | 3.4× |
| Radiologic exam colon double contrast study (74280) | $941.20 | $1,448 | 4.3× |
| Radiologic exam colon single contrast study (74270) | $709.15 | $1,091 | 3.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $323.70 | $498 | 1.5× |
| Radiologic exam knee complete 4/more views (73564) range across 15 matching MRF lines |
$353.60–$530.40 | $544–$816 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $401.70 | $618 | 3.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $703.95 | $1,083 | 3.2× |
| Radiologic exam swallow function contrast study (74230) | $778.70 | $1,198 | 3.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $504.40 | $776 | 2.3× |
| Radiologic examination femur 1 view (73551) range across 6 matching MRF lines |
$107.25–$161.85 | $165–$249 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 9 matching MRF lines |
$372.45–$559.65 | $573–$861 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$204.10–$1,040.65 | — | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $426.40 | $656 | 3.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$473.20–$646.10 | — | varies |
| Ribs bilateral 3 views (71110) | $585.65 | $901 | 4.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,550.25 | $2,385 | 3.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,760.20 | $2,708 | 2.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,276.30 | $3,502 | 3.4× |
| Scapula (73010) range across 9 matching MRF lines |
$375.70–$563.55 | $578–$867 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 9 matching MRF lines |
$181.35–$272.35 | $279–$419 | varies |
| Shoulder 1 view (73020) | $151.45 | — | 1.4× |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$748.15–$1,123.20 | $1,151–$1,728 | varies |
| Skull less than 4 views (70250) | $308.75 | $475 | 2.4× |
| Special dosimetry (77331) | $329.55 | $507 | 2.0× |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$13,741.65–$34,370.11 | — | varies |
| Special teletherapy port plan (77321) | $540.15 | $831 | 1.2× |
| Special treatment procedure (77470) | $1,443.65 | $2,221 | 2.1× |
| Stereotactic Body Radiation Delivery (77373) | $3,216.85 | $4,949 | 1.4× |
| Sternoclavicular joints (71130) | $488.80 | $752 | 4.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $852.15 | $1,311 | 1.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $847.60 | $1,304 | 1.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,407.90 | $2,166 | 3.0× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $707.20 | $1,088 | 1.5× |
| Ther rad simulaj-aided field setting simple (77280) | $393.90 | $606 | 2.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $362.05 | $557 | 1.7× |
| Thoracic spine 2 views (72070) | $278.20 | $428 | 2.1× |
| Thoracic spine 3 views (72072) | $332.15 | $511 | 2.5× |
| Thoracolumbar 2 views (72080) | $267.80 | $412 | 2.5× |
| Thyroid Imaging With Vascular Flow (78013) | $700.05 | $1,077 | 1.4× |
| Thyroid Uptake Measurement (78012) | $312.65 | $481 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $761.15 | $1,171 | 1.5× |
| Tx Devices Design & Construction Complex (77334) | $1,219.40 | $1,876 | 2.6× |
| Tx devices design & construction intermediate (77333) | $642.85 | $989 | 3.8× |
| Tx devices design & construction simple (77332) | $317.20 | $488 | 1.9× |
| Ultrasound Breast Limited (76642) range across 9 matching MRF lines |
$231.40–$346.45 | $356–$533 | varies |
| Ultrasound Exam Aaa Screen (76706) | $600.60 | $924 | 4.6× |
| Ultrasound, abdomen limited (76705) | $668.85 | — | 5.1× |
| Umbilical-artery Doppler (OB) (76820) | $202.15 | $311 | 1.5× |
| Upper gi w/o kub (74240) | $957.45 | $1,473 | 4.4× |
| Urethrocystogram voiding (74455) | $725.40 | $1,116 | 2.4× |
| Urethrocystography retrograde (74450) | $692.25 | $1,065 | 2.3× |
| Us breast unilateral complete (76641) range across 12 matching MRF lines |
$386.75–$579.80 | $595–$892 | varies |
| Us chest (76604) | $438.10 | $674 | 3.4× |
| Us complete joint (76881) | $456.30 | $702 | 3.5× |
| Us exam, pelvic, limited (76857) | $498.55 | — | 3.8× |
| Us head (76506) | $828.10 | $1,274 | 6.3× |
| Us kidney transplant (76776) | $618.15 | $951 | 4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $388.05 | — | 3.0× |
| Us ob detailed single fetus (76811) | $837.85 | $1,289 | 2.8× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$405.60–$531.70 | — | varies |
| Us ob transvaginal (76817) | $966.55 | $1,487 | 7.4× |
| Us pelvic non ob complete (76856) | $896.35 | $1,379 | 6.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $774.15 | $1,191 | 5.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $92.95 | $143 | 0.7× |
| Us retroperitoneal complete (76770) | $1,214.85 | — | 9.3× |
| Us retroperitoneal limited (76775) | $654.55 | — | 5.0× |
| Us scrotum and contents (76870) | $708.50 | $1,090 | 5.4× |
| Us spinal canal and contents (76800) | $371.15 | $571 | 2.8× |
| Us thyroid (76536) | $555.75 | $855 | 4.3× |
| Vein X-Ray Chest (75827) | $2,618.85 | $4,029 | 1.3× |
| Venogram Sinus/Jugular (75860) | $1,864.85 | $2,869 | 0.5× |
| Venography caval inferior serialography rs&i (75825) | $5,958.55 | $9,167 | 1.5× |
| Venography extremity bilateral rs&i (75822) | $2,061.15 | $3,171 | 1.0× |
| Venography extremity unilateral rs&i (75820) | $1,695.20 | $2,608 | 0.9× |
| Venography Renal Bilateral (75833) | $1,846.65 | $2,841 | 0.5× |
| Venography Renal Unilateral (75831) | $33,611.65 | — | 8.5× |
| Venous sampling by catheter (75893) | $6,336.85 | $9,749 | 0.9× |
| Vertebral fracture assessment via dxa (77086) | $165.10 | $254 | 1.5× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$520–$2,050.75 | — | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $442.65 | $681 | 4.1× |
| X-Ray Aorta Leg Arteries (75630) | $5,229.90 | $8,046 | 1.3× |
| X-Ray Bend Only L-S Spine (72120) | $367.90 | $566 | 2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 12 matching MRF lines |
$199.55–$299.65 | $307–$461 | varies |
| X-Ray Exam Breast Specimen (76098) | $330.20 | $508 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $592.15 | $911 | 5.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $603.85 | $929 | 4.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $709.15 | $1,091 | 5.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $150.80 | $232 | 1.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $766.35 | — | 7.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $618.80 | $952 | 4.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $231.40 | $356 | 1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $386.10 | $594 | 3.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $529.10 | $814 | 4.1× |
| X-Ray Exam L-S Spine Bending (72114) | $260 | $400 | 2.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $358.80 | $552 | 3.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $540.80 | $832 | 4.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $334.75 | $515 | 2.6× |
| X-ray eye for foreign body (70030) range across 6 matching MRF lines |
$433.55–$649.35 | $667–$999 | varies |
| X-ray humerus (73060) | $248.95 | $383 | 2.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $165.10 | $254 | 1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $332.15 | $511 | 3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $681.85 | — | 5.2× |
| X-ray nose-rectum child f.b. (76010) | $436.80 | $672 | 4.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $355.55 | $547 | 2.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $501.80 | $772 | 3.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $448.50 | $690 | 3.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $359.45 | $553 | 3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $443.95 | $683 | 4.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $521.95 | $803 | 4.0× |
| X-ray thoracic spine 4 vw (72074) | $390 | $600 | 3.0× |
| X-Ray Tmj Unilat (70328) | $239.20 | $368 | 2.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $578.50 | $890 | 1.3× |
| X-Rays Bone Length Studies (77073) | $469.95 | $723 | 3.6× |
| X-Rays Bone Survey Complete (77075) | $909.35 | $1,399 | 7.0× |
| Xr c-spine 4 or 5 views (72050) | $472.55 | $727 | 3.6× |
| Xr facial bones less than 3 views (70140) | $463.45 | $713 | 4.3× |
| Xr orbits complete 4 views (70200) | $781.95 | $1,203 | 6.0× |
| Xr Tomogram Single Plane (76100) | $529.10 | $814 | 4.1× |
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.