Imaging prices at Samaritan Hospital
Moses Lake, WA · every code in this section with a posted price and a Medicare benchmark.
290 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$16–$478 | $16–$478 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$20–$658 | $20–$658 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,524 | $1,524 | 3.4× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$15–$567 | $15–$567 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$201–$1,595 | $201–$1,595 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$202–$1,582 | $202–$1,582 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$46–$872 | $46–$872 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$17–$473 | $17–$473 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$86–$1,884 | $86–$1,884 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$73–$1,884 | $73–$1,884 | varies |
| Bone marrow imaging; whole body (78104) | $66 | $66 | 0.1× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$60–$378 | $60–$378 | varies |
| Cat Scan Follow-Up Study (76380) | $877 | $877 | 9.0× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$16–$401 | $16–$401 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$19–$513 | $19–$513 | varies |
| Chest 3 views (71047) | $495 | $495 | 5.1× |
| Chest 4 or more views (71048) | $783 | $783 | 6.7× |
| Cholecystography Oral Contrast (74290) | $567 | $567 | 2.9× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$15–$460 | $15–$460 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $4,269 | $4,269 | 36.6× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$28–$1,607 | $28–$1,607 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$170–$1,595 | $170–$1,595 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $1,595 | $1,595 | 4.1× |
| Contrast Xray Throat/Cerv Esopha (74210) | $525 | $525 | 2.7× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$171–$4,736 | $171–$4,736 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$149–$3,150 | $149–$3,150 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$109–$2,877 | $109–$2,877 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$119–$3,024 | $119–$3,024 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$101–$1,428 | $101–$1,428 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$185–$4,116 | $185–$4,116 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$154–$3,686 | $154–$3,686 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$149–$3,828 | $149–$3,828 | varies |
| CT angio hrt w/3d image (75574) | $2,557 | $2,557 | 6.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$161–$2,352 | $161–$2,352 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$149–$3,833 | $149–$3,833 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$153–$3,502 | $153–$3,502 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$103–$2,121 | $103–$2,121 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$91–$1,192 | $91–$1,192 | varies |
| CT cervical spine w/wo cont (72127) | $2,373 | $2,373 | 12.1× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$107–$3,208 | $107–$3,208 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$117–$3,880 | $117–$3,880 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$96–$2,704 | $96–$2,704 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$109–$3,318 | $109–$3,318 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $2,951 | $2,951 | 7.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $357 | $357 | 3.7× |
| CT hrt w/3d image congen (75573) | $3,670 | $3,670 | 9.4× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$117–$3,098 | $117–$3,098 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$108–$2,520 | $108–$2,520 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$86–$1,029 | $86–$1,029 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$99–$2,058 | $99–$2,058 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$103–$2,415 | $103–$2,415 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$86–$1,140 | $86–$1,140 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$96–$3,376 | $96–$3,376 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$69–$1,654 | $69–$1,654 | varies |
| CT neck tissue combo (70492) | $3,271 | $3,271 | 16.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$122–$3,465 | $122–$3,465 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$109–$1,696 | $109–$1,696 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$103–$2,195 | $103–$2,195 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$93–$1,670 | $93–$1,670 | varies |
| CT scan of leg combo (73702) | $2,011 | $2,011 | 10.3× |
| CT scans face/jaw combo (70488) | $3,465 | $3,465 | 17.7× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$118–$3,240 | $118–$3,240 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$109–$1,738 | $109–$1,738 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$103–$2,531 | $103–$2,531 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$86–$1,182 | $86–$1,182 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$108–$2,373 | $108–$2,373 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$96–$1,423 | $96–$1,423 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$86–$1,512 | $86–$1,512 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$413–$1,833 | $413–$1,833 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$99–$2,898 | $99–$2,898 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$202–$2,856 | $202–$2,856 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$154–$3,859 | $154–$3,859 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$154–$2,116 | $154–$2,116 | varies |
| Discography Cerv/Thor Spine (72285) | $11,449 | $11,449 | 5.3× |
| Diskography lumbar (72295) | $11,449 | $11,449 | 5.3× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$62–$418 | $62–$418 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$18–$502 | $18–$502 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$19–$447 | $19–$447 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$51–$117 | $51–$117 | varies |
| Echo exam of fetal heart (76825) | $1,889 | $1,889 | 3.1× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$63–$1,399 | $63–$1,399 | varies |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $672 | $672 | 2.5× |
| Esophagram (74220) range across 2 matching MRF lines |
$46–$556 | $46–$556 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$88–$996 | $88–$996 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$68–$982 | $68–$982 | varies |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,245 | $1,245 | 4.7× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$25–$1,055 | $25–$1,055 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$14–$493 | $14–$493 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$44–$493 | $44–$493 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$65–$1,524 | $65–$1,524 | varies |
| Gated Heart Planar Single (78472) | $1,695 | $1,695 | 3.8× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$15–$585 | $15–$585 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$76–$1,904 | $76–$1,904 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$62–$1,524 | $62–$1,524 | varies |
| Ht Muscle Image Spect Sing (78451) | $1,524 | $1,524 | 1.1× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$33–$1,595 | $33–$1,595 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$63–$418 | $63–$418 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$53–$682 | $53–$682 | varies |
| Joint Survey Single View (77077) | $28 | $28 | 0.2× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$100–$2,021 | $100–$2,021 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$80–$2,541 | $80–$2,541 | varies |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$17–$428 | $17–$428 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$90–$2,301 | $90–$2,301 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$100–$1,793 | $100–$1,793 | varies |
| Magnetic Image Jaw Joint (70336) | $1,759 | $1,759 | 6.6× |
| Mammary ductogram or galactogram multiple (77054) | $2,135 | $2,135 | 8.0× |
| Mammary ductogram or galactogram single (77053) | $2,135 | $2,135 | 8.0× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$58–$1,524 | $58–$1,524 | varies |
| Medical physics dose eval radiation expos w/rprt (76145) | $2,047 | $2,047 | 4.9× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$154–$6,342 | $154–$6,342 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$103–$2,888 | $103–$2,888 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$102–$4,032 | $102–$4,032 | varies |
| MRA neck w contrast (70548) | $4,631 | $4,631 | 11.9× |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$154–$4,704 | $154–$4,704 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$103–$2,578 | $103–$2,578 | varies |
| MRI abdomen w contrast (74182) | $3,786 | $3,786 | 9.7× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$124–$2,715 | $124–$2,715 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$139–$3,423 | $139–$3,423 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$183–$4,883 | $183–$4,883 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$139–$3,266 | $139–$3,266 | varies |
| MRI bone marrow blood supply (77084) range across 2 matching MRF lines |
$137–$2,200 | $137–$2,200 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$137–$2,825 | $137–$2,825 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,967 | $2,967 | 11.2× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$153–$3,282 | $153–$3,282 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$126–$2,258 | $126–$2,258 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$124–$2,715 | $124–$2,715 | varies |
| MRI chest with contrast (71551) | $4,048 | $4,048 | 4.6× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$193–$4,578 | $193–$4,578 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,985 | $1,985 | 5.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$183–$2,977 | $183–$2,977 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$116–$1,591 | $116–$1,591 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$153–$4,337 | $153–$4,337 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$195–$3,901 | $195–$3,901 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$112–$3,271 | $112–$3,271 | varies |
| MRI orbit face neck w contrast (70542) | $3,618 | $3,618 | 9.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$182–$4,032 | $182–$4,032 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$193–$3,712 | $193–$3,712 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$143–$2,200 | $143–$2,200 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$126–$2,342 | $126–$2,342 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,271 | $3,271 | 8.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$116–$1,470 | $116–$1,470 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$183–$4,521 | $183–$4,521 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$193–$4,883 | $193–$4,883 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$195–$4,095 | $195–$4,095 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$152–$3,250 | $152–$3,250 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$116–$1,423 | $116–$1,423 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$183–$3,686 | $183–$3,686 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$195–$3,938 | $195–$3,938 | varies |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$173–$3,180 | $173–$3,180 | varies |
| Myelogram Lumbar (72265) range across 2 matching MRF lines |
$164–$3,180 | $164–$3,180 | varies |
| Myelography thoracic (72255) range across 2 matching MRF lines |
$176–$3,180 | $176–$3,180 | varies |
| Myelograpy 2/more regions rs&i (72270) | $3,506 | $3,506 | 4.0× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$134–$1,524 | $134–$1,524 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$15–$492 | $15–$492 | varies |
| Nonvascular Shunt X-Ray (75809) | $458 | $458 | 3.9× |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$104–$418 | $104–$418 | varies |
| Optic foramina (70190) | $278 | $278 | 2.9× |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$67–$1,524 | $67–$1,524 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$100–$1,676 | $100–$1,676 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$16–$471 | $16–$471 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,524 | $1,524 | 3.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$28–$744 | $28–$744 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,190 | $2,190 | 3.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$16–$724 | $16–$724 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$15–$291 | $15–$291 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$53–$448 | $53–$448 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$24–$625 | $24–$625 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$13–$265 | $13–$265 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$15–$516 | $15–$516 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$16–$608 | $16–$608 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$15–$378 | $15–$378 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $458 | $458 | 3.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$16–$436 | $16–$436 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $279 | $279 | 2.9× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$20–$320 | $20–$320 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$33–$569 | $33–$569 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$16–$478 | $16–$478 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $809 | $809 | 4.1× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$14–$448 | $14–$448 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$18–$353 | $18–$353 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$23–$335 | $23–$335 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$12–$476 | $12–$476 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$46–$524 | $46–$524 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$16–$497 | $16–$497 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $897 | $897 | 7.7× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$54–$763 | $54–$763 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$25–$732 | $25–$732 | varies |
| Radiologic exam colon double contrast study (74280) | $229 | $229 | 1.2× |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$77–$184 | $77–$184 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$169–$1,115 | $169–$1,115 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$20–$540 | $20–$540 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$19–$493 | $19–$493 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$60–$458 | $60–$458 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$46–$534 | $46–$534 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$67–$604 | $67–$604 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$15–$362 | $15–$362 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$17–$351 | $17–$351 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$15–$314 | $15–$314 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$39–$473 | $39–$473 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $278 | $278 | 2.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$15–$480 | $15–$480 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$26–$565 | $26–$565 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$89–$5,582 | $89–$5,582 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$89–$2,775 | $89–$2,775 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$16–$330 | $16–$330 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$52–$97 | $52–$97 | varies |
| Sella turcica (70240) | $278 | $278 | 2.9× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$14–$298 | $14–$298 | varies |
| Shoulder Arthrography (73040) | $1,595 | $1,595 | 4.1× |
| Sialogram (70390) | $872 | $872 | 3.3× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$23–$541 | $23–$541 | varies |
| Speech evaluation, complex (70371) | $458 | $458 | 1.7× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$20–$296 | $20–$296 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $285 | $285 | 1.5× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$20–$298 | $20–$298 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$19–$523 | $19–$523 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$19–$296 | $19–$296 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$42–$1,676 | $42–$1,676 | varies |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$58–$587 | $58–$587 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$48–$184 | $48–$184 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$51–$974 | $51–$974 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$45–$687 | $45–$687 | varies |
| Unlisted us procedure (76999) | $518 | $518 | 5.3× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$60–$644 | $60–$644 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $19 | $19 | 1.7× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$83–$1,595 | $83–$1,595 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$29–$1,517 | $29–$1,517 | varies |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$62–$329 | $62–$329 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$47–$708 | $47–$708 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$54–$827 | $54–$827 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$44–$732 | $44–$732 | varies |
| Us head (76506) range across 2 matching MRF lines |
$55–$894 | $55–$894 | varies |
| Us kidney transplant (76776) | $698 | $698 | 6.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$42–$495 | $42–$495 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$167–$1,399 | $167–$1,399 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$56–$791 | $56–$791 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$66–$1,037 | $66–$1,037 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$59–$1,094 | $59–$1,094 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$86–$1,022 | $86–$1,022 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$75–$678 | $75–$678 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$63–$791 | $63–$791 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$50–$892 | $50–$892 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$55–$1,091 | $55–$1,091 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$103–$523 | $103–$523 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$49–$1,034 | $49–$1,034 | varies |
| Us transrectal (76872) | $381 | $381 | 3.3× |
| Venography extremity bilateral rs&i (75822) | $3,028 | $3,028 | 1.7× |
| Venography extremity unilateral rs&i (75820) | $3,028 | $3,028 | 1.7× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$15–$486 | $15–$486 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$18–$534 | $18–$534 | varies |
| X-ray antegrade pyelogram tube (74425) | $1,595 | $1,595 | 4.1× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$20–$411 | $20–$411 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$15–$426 | $15–$426 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,862 | $1,862 | 3.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$24–$262 | $24–$262 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $397 | $397 | 3.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$20–$897 | $20–$897 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$17–$348 | $17–$348 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$20–$394 | $20–$394 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$26–$566 | $26–$566 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$20–$572 | $20–$572 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$27–$424 | $27–$424 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$28–$897 | $28–$897 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$29–$448 | $29–$448 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$20–$516 | $20–$516 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $683 | $683 | 5.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$25–$565 | $25–$565 | varies |
| X-ray eye for foreign body (70030) | $278 | $278 | 2.9× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$15–$342 | $15–$342 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,400 | $1,400 | 7.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$16–$477 | $16–$477 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$16–$278 | $16–$278 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$20–$411 | $20–$411 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$16–$432 | $16–$432 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$29–$494 | $29–$494 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$17–$458 | $17–$458 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $458 | $458 | 3.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$16–$418 | $16–$418 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$23–$562 | $23–$562 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$31–$686 | $31–$686 | varies |
| X-Ray Stress View (77071) | $346 | $346 | 3.6× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$19–$637 | $19–$637 | varies |
| X-Ray Tmj Unilat (70328) | $278 | $278 | 2.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,517 | $1,517 | 3.9× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$26–$378 | $26–$378 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$47–$604 | $47–$604 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$28–$594 | $28–$594 | varies |
| Xr facial bones less than 3 views (70140) | $391 | $391 | 4.0× |
| XR Mastoids < 3 Views Bilateral (70120) | $278 | $278 | 2.4× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$25–$534 | $25–$534 | varies |
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.