Imaging prices at Samaritan North Lincoln Hospital
Lincoln City, OR · every code in this section with a posted price and a Medicare benchmark.
371 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) | $6,744 | $8,430 | 4.4× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$53.60–$240 | $67–$300 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$65.60–$256 | $82–$320 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,144 | $1,430 | 2.6× |
| Angio internal mammary (75756) | $6,384 | $7,980 | 1.8× |
| Angio pulmonary bilat (75743) | $3,784 | $4,730 | 1.1× |
| Angiography extremity bilateral rs&i (75716) | $5,768 | $7,210 | 1.6× |
| Angiography extremity unilateral rs&i (75710) | $4,480 | $5,600 | 1.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,376 | $6,720 | 1.5× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$62.40–$280 | $78–$350 | varies |
| Aortography thoracic serialography rs&i (75605) | $6,440 | $8,050 | 1.0× |
| Aortography thoracic w/o serialography rs&i (75600) | $4,078.40 | $5,098 | 1.2× |
| Artery X-Rays Abdomen (75726) | $7,712 | $9,640 | 1.2× |
| Artery X-Rays Pelvis (75736) | $7,712 | $9,640 | 1.2× |
| Artery X-Rays Spine (75705) | $7,408 | $9,260 | 1.2× |
| Arthrogram ankle (73615) | $696 | $870 | 1.8× |
| Arthrogram hip (73525) | $728 | $910 | 1.9× |
| Arthrogram Wrist (73115) | $696 | $870 | 1.8× |
| Basic radiation dosimetry calculation (77300) | $568 | $710 | 3.8× |
| Bone age studies (77072) | $264 | $330 | 2.3× |
| Bone Imaging 3 Phase (78315) | $1,240 | $1,550 | 2.8× |
| Bone Imaging Limited Area (78300) | $880 | $1,100 | 2.0× |
| Bone Imaging Multiple Areas (78305) | $968 | $1,210 | 2.2× |
| Bone Imaging Whole Body (78306) | $1,144 | $1,430 | 2.6× |
| Bone survey infant (77076) | $408 | $510 | 3.5× |
| Brachytx isodose complex (77318) | $1,088 | $1,360 | 2.6× |
| Brain Image W/Flow < 4 Views (78601) | $848 | $1,060 | 1.9× |
| Brain imaging < 4 static views (78600) | $648 | $810 | 1.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 4 matching MRF lines |
$5,200–$5,528 | $6,500–$6,910 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,224 | $2,780 | 5.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $2,224 | $2,780 | 2.6× |
| Cat Scan Follow-Up Study (76380) | $552 | $690 | 5.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $800 | $1,000 | 1.3× |
| Cerebrospinal Fluid Scan (78630) | $1,240 | $1,550 | 2.1× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$43.20–$264 | $54–$330 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$58.40–$296 | $73–$370 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$73.60–$320 | $92–$400 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$80–$416 | $100–$520 | varies |
| Cholecystography Oral Contrast (74290) | $504 | $630 | 2.6× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$61.60–$216 | $77–$270 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $264 | $330 | 2.3× |
| Continuing medical physics consltj pr wk (77336) | $680 | $850 | 4.6× |
| Contrast Exam Abdominl Aorta (75625) | $5,256 | $6,570 | 1.5× |
| Contrast X-Ray Bladder (74430) | $576 | $720 | 1.5× |
| Contrast X-Ray Of Elbow (73085) | $704 | $880 | 1.8× |
| Contrast X-Ray Of Knee Joint (73580) | $664 | $830 | 1.7× |
| CT abdomen and pelvis without and with contrast (74178) | $2,304 | $2,880 | 5.9× |
| CT abdomen and pelvis without contrast (74176) | $1,536 | $1,920 | 5.8× |
| CT abdomen w contrast (74160) | $1,152 | $1,440 | 5.9× |
| CT abdomen w wo contrast (74170) | $1,376 | $1,720 | 7.1× |
| CT abdomen w/o contrast (74150) | $920 | $1,150 | 7.9× |
| CT Angio Abdomen and Pelvis (74174) | $1,608 | $2,010 | 4.1× |
| CT Angio Chest (71275) | $1,376 | $1,720 | 7.1× |
| CT Angio Head (70496) | $1,376 | $1,720 | 7.1× |
| CT angio hrt w/3d image (75574) | $1,392 | $1,740 | 3.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,392 | $1,740 | 7.1× |
| CT Angio Neck (70498) | $1,376 | $1,720 | 7.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,640 | $2,050 | 8.4× |
| CT cervical spine w/ contrast (72126) | $1,640 | $2,050 | 4.2× |
| CT cervical spine w/o contrast (72125) | $920 | $1,150 | 7.9× |
| CT cervical spine w/wo cont (72127) | $2,040 | $2,550 | 10.5× |
| CT chest w contrast (71260) | $1,152 | $1,440 | 5.9× |
| CT chest w/wo contrast (71270) | $1,376 | $1,720 | 7.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,792 | $2,240 | 15.4× |
| CT head/brain with contrast (70460) | $1,152 | $1,440 | 5.9× |
| CT head/brain without and with contrast (70470) | $1,376 | $1,720 | 7.1× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,152 | $1,440 | 3.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $352 | $440 | 3.6× |
| CT hrt w/3d image congen (75573) | $992 | $1,240 | 2.6× |
| CT iac w contrast (70481) | $1,152 | $1,440 | 5.9× |
| CT l-spine w&w/o contrast (72133) | $2,040 | $2,550 | 10.5× |
| CT lower ext w/o (73700) | $920 | $1,150 | 7.9× |
| CT lower extremity w/contrast material (73701) | $1,152 | $1,440 | 5.9× |
| CT lumbar spine w contrast (72132) | $1,536 | $1,920 | 4.0× |
| CT lumbar spine w/o contrast (72131) | $920 | $1,150 | 7.9× |
| CT maxillofacial w contrast (70487) | $1,152 | $1,440 | 5.9× |
| CT maxillofacial wo contrast (70486) | $920 | $1,150 | 7.9× |
| CT neck tissue combo (70492) | $1,376 | $1,720 | 7.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,376 | $1,720 | 7.1× |
| CT orbits w/o contrast (70480) | $920 | $1,150 | 7.9× |
| CT pelvis w&w/o contrast (72194) | $1,376 | $1,720 | 7.1× |
| CT pelvis w/o contrast (72192) | $920 | $1,150 | 7.9× |
| CT scan of leg combo (73702) | $1,376 | $1,720 | 7.1× |
| CT scans face/jaw combo (70488) | $1,376 | $1,720 | 7.1× |
| CT soft tissue neck w contrast (70491) | $1,152 | $1,440 | 5.9× |
| CT soft tissue neck w/o contrast (70490) | $920 | $1,150 | 7.9× |
| CT thoracic spine w contrast (72129) | $1,152 | $1,440 | 5.9× |
| CT thoracic spine w/o contrast (72128) | $920 | $1,150 | 7.9× |
| CT thoracic spine w/wo cont (72130) | $1,080 | $1,350 | 5.5× |
| CT thorax w/o contrast (71250) | $920 | $1,150 | 7.9× |
| CT unlisted procedure (76497) | $216 | $270 | 2.2× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$349.60–$920 | $437–$1,150 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,160 | $1,450 | 5.9× |
| CT upper extremity with contrast (73201) | $1,392 | $1,740 | 3.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,568 | $1,960 | 8.0× |
| Cta Abdomen (74175) | $1,376 | $1,720 | 7.1× |
| CTA pelvis (72191) | $1,376 | $1,720 | 7.1× |
| Dilation ureters/urethra rs&i (74485) | $2,528 | $3,160 | 1.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $232 | $290 | 2.0× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$76.80–$384 | $96–$480 | varies |
| Dxa bone density study (77085) | $224 | $280 | 1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$57.60–$256 | $72–$320 | varies |
| Echo exam uterus (76831) | $696 | $870 | 2.6× |
| Echo Guide For Artery Repair (76936) | $1,056 | $1,320 | 4.4× |
| Esophagram (74220) | $640 | $800 | 3.3× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$218.40–$528 | $273–$660 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $528 | $660 | 4.5× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$79.20–$704 | $99–$880 | varies |
| Follow-Up Angiography (75898) | $3,784 | $4,730 | 1.1× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$52.80–$224 | $66–$280 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$54.40–$264 | $68–$330 | varies |
| Gastric emptying imaging study (78264) | $1,144 | $1,430 | 2.6× |
| Gated Heart Planar Single (78472) | $1,144 | $1,430 | 2.6× |
| Hand 2 views (73120) range across 5 matching MRF lines |
$58.40–$368 | $73–$460 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $5,376 | $6,720 | 1.5× |
| Hepatobil Syst Image W/Drug (78227) | $1,408 | $1,760 | 2.3× |
| Hepatobiliary System Imaging (78226) | $1,320 | $1,650 | 3.0× |
| Ht Muscle Image Spect Sing (78451) | $2,120 | $2,650 | 1.5× |
| Hysterosalpingogram (74740) | $728 | $910 | 2.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$328.80–$416 | $411–$520 | varies |
| Infant hip ultrasound, limited static exam (76886) | $328 | $410 | 3.4× |
| Infusion Ivp (74410) | $680 | $850 | 3.5× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$80–$139.20 | $100–$174 | varies |
| K Flow/Funct Image Multiple (78709) | $1,016 | $1,270 | 1.7× |
| K Flow/Funct Image W/Drug (78708) | $1,408 | $1,760 | 2.3× |
| K Flow/Funct Image W/O Drug (78707) | $1,240 | $1,550 | 2.1× |
| Kidney Imaging Morphol (78700) | $752 | $940 | 1.7× |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$80–$304 | $100–$380 | varies |
| Leveen/Shunt Patency Exam (78291) | $424 | $530 | 1.0× |
| Liver & Spleen Imaging Static Only (78215) | $864 | $1,080 | 1.9× |
| Liver imaging static only (78201) | $712 | $890 | 1.2× |
| Lung Perf&Ventilat Diferentl (78598) | $1,320 | $1,650 | 2.2× |
| Lung perfusion differential (78597) | $880 | $1,100 | 2.0× |
| Lung Ventilat&Perfus Imaging (78582) | $1,504 | $1,880 | 2.5× |
| Lung Ventilation Imaging (78579) | $648 | $810 | 1.5× |
| Lymph System Imaging (78195) | $1,240 | $1,550 | 2.1× |
| Magnetic Image Jaw Joint (70336) | $1,424 | $1,780 | 5.4× |
| Mammary ductogram or galactogram single (77053) | $656 | $820 | 2.5× |
| Meckels Divert Exam (78290) | $1,144 | $1,430 | 2.6× |
| Mlc imrt design & construction per imrt plan (77338) | $1,288 | $1,610 | 3.1× |
| Mr safety determination physician/other qhp (76016) | $117.60 | $147 | 1.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $32.80 | $41 | 1.0× |
| Mra Head W/O & W/Contrast Material (70546) | $2,760 | $3,450 | 7.1× |
| MRA head w/o contrast (70544) | $1,872 | $2,340 | 7.1× |
| MRA head with contrast (70545) | $2,312 | $2,890 | 6.0× |
| MRA neck w contrast (70548) | $2,224 | $2,780 | 5.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,672 | $3,340 | 6.9× |
| MRA neck w/o contrast (70547) | $1,776 | $2,220 | 6.7× |
| MRI abdomen w contrast (74182) | $2,224 | $2,780 | 5.7× |
| MRI abdomen w/o contrast (74181) | $1,776 | $2,220 | 6.7× |
| MRI any jt lower extrem w/contrast material (73722) | $2,224 | $2,780 | 2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,672 | $3,340 | 6.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,224 | $2,780 | 2.6× |
| MRI bone marrow blood supply (77084) | $1,872 | $2,340 | 7.1× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,776 | $2,220 | 6.7× |
| MRI Breast Without Contrast Material Unilateral (77046) | $888 | $1,110 | 3.3× |
| MRI cardiac w/o contrast (75557) | $1,776 | $2,220 | 6.7× |
| MRI cervical spine w contrast (72142) | $2,224 | $2,780 | 5.7× |
| MRI cervical spine w/o cont (72141) | $1,776 | $2,220 | 6.7× |
| MRI chest w/o contrast (71550) | $1,776 | $2,220 | 6.7× |
| MRI chest with contrast (71551) | $3,160 | $3,950 | 3.6× |
| MRI chest wo w contrast (71552) | $2,760 | $3,450 | 7.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,224 | $2,780 | 5.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,672 | $3,340 | 6.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,776 | $2,220 | 6.7× |
| MRI lumbar spine w contrast (72149) | $2,224 | $2,780 | 5.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,672 | $3,340 | 6.9× |
| MRI orbit face &/neck w/o contrast (70540) | $1,776 | $2,220 | 6.7× |
| MRI orbit face neck w contrast (70542) | $2,224 | $2,780 | 5.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,672 | $3,340 | 6.9× |
| MRI pelvis w contrast (72196) | $2,224 | $2,780 | 5.7× |
| MRI pelvis w/o & w contrast (72197) | $2,672 | $3,340 | 6.9× |
| MRI pelvis w/o contrast (72195) | $1,776 | $2,220 | 6.7× |
| MRI spectroscopy (76390) | $1,200 | $1,500 | 12.4× |
| MRI thoracic spine w/o contrast (72146) | $1,776 | $2,220 | 6.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,224 | $2,780 | 5.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,776 | $2,220 | 6.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,672 | $3,340 | 6.9× |
| MRI, abdomen, combo (74183) | $2,672 | $3,340 | 6.9× |
| MRI, dorsal spine combo (72157) | $2,672 | $3,340 | 6.9× |
| MRI, dorsal spine contrast (72147) | $2,104 | $2,630 | 5.4× |
| MRI, joint upper extrem (73221) | $1,776 | $2,220 | 6.7× |
| MRI, joint upper extrem combo (73223) | $2,672 | $3,340 | 6.9× |
| MRI, lumbar spine combo (72158) | $2,672 | $3,340 | 6.9× |
| Myelogram cervical (72240) | $1,280 | $1,600 | 1.5× |
| Myelogram Lumbar (72265) | $1,256 | $1,570 | 1.4× |
| Myelography thoracic (72255) | $1,280 | $1,600 | 1.5× |
| Myelograpy 2/more regions rs&i (72270) | $1,544 | $1,930 | 1.8× |
| Myocardial Spect Multiple Studies (78452) | $2,800 | $3,500 | 1.9× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$57.60–$264 | $72–$330 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $432 | $540 | 1.0× |
| Nm csf leak detection (78650) | $1,456 | $1,820 | 1.0× |
| Nonvascular Shunt X-Ray (75809) | $416 | $520 | 3.6× |
| Ntsty modul radthx pln dose-vol histos (77301) | $7,200 | $9,000 | 4.7× |
| Nuclear Rx Intra-Arterial (79445) | $480 | $600 | 1.9× |
| Nuclear Rx Oral Admin (79005) | $728 | $910 | 2.8× |
| Ob us nuchal meas 1 gest (76813) | $392 | $490 | 3.4× |
| Ophthalmic us dx quantitative a-scan only (76511) | $168 | $210 | 1.4× |
| Optic foramina (70190) range across 2 matching MRF lines |
$68–$136 | $85–$170 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,320 | $1,650 | 2.2× |
| Parathyroid Planar Imaging (78070) | $1,144 | $1,430 | 2.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $960 | $1,200 | 2.2× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$49.60–$424 | $62–$530 | varies |
| Pet Image W/Ct Lmtd (78814) | $5,312 | $6,640 | 3.3× |
| PET image w/CT, full body (78816) range across 4 matching MRF lines |
$5,504–$5,744 | $6,880–$7,180 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 4 matching MRF lines |
$5,976–$6,408 | $7,470–$8,010 | varies |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $5,376 | $6,720 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,144 | $1,430 | 2.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$87.20–$360 | $109–$450 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $816 | $1,020 | 1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$72–$312 | $90–$390 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$52.80–$248 | $66–$310 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$61.60–$240 | $77–$300 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$87.20–$368 | $109–$460 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$79.20–$256 | $99–$320 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$66.40–$336 | $83–$420 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$72–$336 | $90–$420 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $296 | $370 | 3.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$75.20–$216 | $94–$270 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$66.40–$264 | $83–$330 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$64.80–$280 | $81–$350 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$60–$168 | $75–$210 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$42.40–$264 | $53–$330 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$61.60–$224 | $77–$280 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $296 | $370 | 3.1× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$57.60–$184 | $72–$230 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$60–$184 | $75–$230 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$82.40–$376 | $103–$470 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$200–$416 | $250–$520 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $11,464 | $14,330 | 1.4× |
| Radiation treatment delivery level 1 (77402) | $480 | $600 | 4.2× |
| Radiation treatment delivery level 2 (77407) | $728 | $910 | 1.7× |
| Radiation treatment delivery level 3 (77412) | $800 | $1,000 | 1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$80–$376 | $100–$470 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$76.80–$264 | $96–$330 | varies |
| Radiologic exam colon double contrast study (74280) | $584 | $730 | 3.0× |
| Radiologic exam colon single contrast study (74270) | $568 | $710 | 2.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $680 | $850 | 3.5× |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$89.60–$400 | $112–$500 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$76.80–$376 | $96–$470 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $416 | $520 | 2.1× |
| Radiologic exam swallow function contrast study (74230) | $752 | $940 | 3.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $640 | $800 | 3.3× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$53.60–$248 | $67–$310 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$68–$304 | $85–$380 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$66.40–$264 | $83–$330 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $416 | $520 | 3.6× |
| Radiologic Examination Salivary Gland Calculus (70380) | $136 | $170 | 1.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$60–$296 | $75–$370 | varies |
| Renal Cyst Study (74470) | $784 | $980 | 1.3× |
| Ribs bilateral 3 views (71110) | $368 | $460 | 3.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,144 | $1,430 | 2.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,128 | $1,410 | 2.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,760 | $2,200 | 2.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,760 | $2,200 | 2.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,680 | $2,100 | 2.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,808 | $2,260 | 1.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,944 | $2,430 | 1.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,680 | $2,100 | 1.2× |
| Rp Therapy Intravenous Administration (79101) | $480 | $600 | 1.9× |
| Scapula (73010) range across 4 matching MRF lines |
$37.60–$280 | $47–$350 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $120 | $150 | 5.1× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$36–$248 | $45–$310 | varies |
| Shoulder Arthrography (73040) | $728 | $910 | 1.9× |
| Sialogram (70390) | $560 | $700 | 2.1× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$68.80–$280 | $86–$350 | varies |
| Special dosimetry (77331) | $400 | $500 | 2.7× |
| Special Physics Consult (77370) | $1,016 | $1,270 | 6.8× |
| Special teletherapy port plan (77321) | $1,248 | $1,560 | 3.0× |
| Special treatment procedure (77470) | $1,712 | $2,140 | 2.8× |
| Stereotactic Body Radiation Delivery (77373) | $7,384 | $9,230 | 3.7× |
| Sternoclavicular joints (71130) | $224 | $280 | 2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,928 | $2,410 | 4.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $952 | $1,190 | 2.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,608 | $2,010 | 3.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,024 | $1,280 | 2.5× |
| Ther rad simulaj-aided field setting simple (77280) | $760 | $950 | 5.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $232.80 | $291 | 1.2× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$58.40–$320 | $73–$400 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$72–$376 | $90–$470 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$62.40–$376 | $78–$470 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $448 | $560 | 1.0× |
| Thyroid Met Imaging Body (78018) | $1,408 | $1,760 | 2.3× |
| Thyroid Uptake Measurement (78012) | $432 | $540 | 1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $864 | $1,080 | 1.9× |
| Tx Devices Design & Construction Complex (77334) | $1,384 | $1,730 | 3.3× |
| Tx devices design & construction intermediate (77333) | $880 | $1,100 | 5.9× |
| Tx devices design & construction simple (77332) | $824 | $1,030 | 5.5× |
| Ultrasound Breast Limited (76642) | $304 | $380 | 3.1× |
| Ultrasound elastography first target lesion (76982) | $480 | $600 | 4.1× |
| Ultrasound Elastography Parenchyma (76981) | $480 | $600 | 4.1× |
| Ultrasound Exam Aaa Screen (76706) | $456 | $570 | 3.9× |
| Ultrasound, abdomen limited (76705) | $528 | $660 | 4.5× |
| Umbilical-artery Doppler (OB) (76820) | $208 | $260 | 1.8× |
| Unlisted Dx Radiographic Procedure (76499) | $112 | $140 | 1.2× |
| Unlisted us procedure (76999) | $272 | $340 | 2.8× |
| Upper gi w/o kub (74240) | $520 | $650 | 2.7× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $408 | $510 | 36.9× |
| Urea breath test c-14 isotopic analysis (78268) | $168 | $210 | 1.8× |
| Urethrocystogram voiding (74455) | $480 | $600 | 1.8× |
| Urethrocystography retrograde (74450) | $672 | $840 | 2.5× |
| Us breast unilateral complete (76641) | $360 | $450 | 3.1× |
| Us chest (76604) range across 3 matching MRF lines |
$93.60–$360 | $117–$450 | varies |
| Us complete joint (76881) | $528 | $660 | 4.5× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$80.80–$440 | $101–$550 | varies |
| Us head (76506) | $464 | $580 | 4.0× |
| Us kidney transplant (76776) | $760 | $950 | 6.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$32–$256 | $40–$320 | varies |
| Us ob detailed single fetus (76811) | $944 | $1,180 | 3.6× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$156.80–$400 | $196–$500 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$180–$400 | $225–$500 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$234.40–$592 | $293–$740 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$225.60–$592 | $282–$740 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$224–$472 | $280–$590 | varies |
| Us retroperitoneal complete (76770) | $704 | $880 | 6.1× |
| Us retroperitoneal limited (76775) | $464 | $580 | 4.0× |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$221.60–$640 | $277–$800 | varies |
| Us spinal canal and contents (76800) | $616 | $770 | 5.3× |
| Us thyroid (76536) | $528 | $660 | 4.5× |
| Us transrectal (76872) range across 2 matching MRF lines |
$336–$548.80 | $420–$686 | varies |
| Vein X-Ray Chest (75827) | $2,104 | $2,630 | 1.2× |
| Venography caval inferior serialography rs&i (75825) | $4,624 | $5,780 | 1.3× |
| Venography extremity bilateral rs&i (75822) | $2,384 | $2,980 | 1.4× |
| Venography extremity unilateral rs&i (75820) | $1,960 | $2,450 | 1.1× |
| Venography Renal Bilateral (75833) | $5,264 | $6,580 | 1.5× |
| Venography Renal Unilateral (75831) | $5,376 | $6,720 | 1.5× |
| Vertebral fracture assessment via dxa (77086) | $112 | $140 | 1.2× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$65.60–$264 | $82–$330 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$49.60–$296 | $62–$370 | varies |
| X-ray antegrade pyelogram tube (74425) | $968 | $1,210 | 2.5× |
| X-Ray Aorta Leg Arteries (75630) | $4,056 | $5,070 | 1.2× |
| X-Ray Bend Only L-S Spine (72120) | $184 | $230 | 1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$53.60–$384 | $67–$480 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,784 | $2,230 | 2.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$76.80–$168 | $96–$210 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$140–$384 | $175–$480 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$156.80–$400 | $196–$500 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$60–$232 | $75–$290 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$91.20–$272 | $114–$340 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$114.40–$288 | $143–$360 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$77.60–$376 | $97–$470 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$100–$456 | $125–$570 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$120–$504 | $150–$630 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$119.20–$336 | $149–$420 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$72.80–$256 | $91–$320 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$120.80–$408 | $151–$510 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 4 matching MRF lines |
$74.40–$328 | $93–$410 | varies |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$60–$296 | $75–$370 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$61.60–$360 | $77–$450 | varies |
| X-ray IV pyelogram (ivp) (74400) | $680 | $850 | 3.5× |
| X-ray IV pyelogram+tomography (74415) | $680 | $850 | 3.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$75.20–$224 | $94–$280 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$80–$216 | $100–$270 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$73.60–$320 | $92–$400 | varies |
| X-ray nose-rectum child f.b. (76010) | $224 | $280 | 2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$94.40–$440 | $118–$550 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$72–$408 | $90–$510 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $63.20 | $79 | 0.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$61.60–$280 | $77–$350 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$68.80–$288 | $86–$360 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$79.20–$336 | $99–$420 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$80–$472 | $100–$590 | varies |
| X-Ray Tmj Unilat (70328) | $152 | $190 | 1.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $808 | $1,010 | 2.1× |
| X-Rays Bone Length Studies (77073) | $392 | $490 | 3.4× |
| X-Rays Bone Survey Complete (77075) | $512 | $640 | 4.4× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$101.60–$376 | $127–$470 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$56.80–$184 | $71–$230 | varies |
| Xr myelogram posterior fossa (70010) | $856 | $1,070 | 2.2× |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$87.20–$304 | $109–$380 | varies |
| Xr Tomogram Single Plane (76100) | $488 | $610 | 4.2× |
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.