Imaging prices at Sarah D Culbertson Memorial Hospital
Rushville, IL · every code in this section with a posted price and a Medicare benchmark.
216 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 |
$78.30–$416.70 | $87–$463 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$97.20–$578.70 | $108–$643 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$421.20–$1,483.20 | $468–$1,648 | varies |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$69.30–$324 | $77–$360 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$82.80–$259.20 | $92–$288 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$430.20–$2,247.30 | $478–$2,497 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$263.70–$1,436.40 | $293–$1,596 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$360.90–$2,205.90 | $401–$2,451 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$300.60–$592.20 | $334–$658 | varies |
| Brain Image W/Flow < 4 Views (78601) range across 2 matching MRF lines |
$212.40–$4,008.60 | $236–$4,454 | varies |
| Chest 1 view (71045) range across 2 matching MRF lines |
$73.80–$347.40 | $82–$386 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$92.70–$425.70 | $103–$473 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$119.70–$518.40 | $133–$576 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$129.60–$625.50 | $144–$695 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$73.80–$351.90 | $82–$391 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$463.50–$2,154.60 | $515–$2,394 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$138.60–$954 | $154–$1,060 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) range across 2 matching MRF lines |
$250.20–$571.50 | $278–$635 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$861.30–$6,338.70 | $957–$7,043 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$746.10–$4,329 | $829–$4,810 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$546.30–$3,012.30 | $607–$3,347 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$597.60–$3,442.50 | $664–$3,825 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$509.40–$2,410.20 | $566–$2,678 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$940.50–$5,227.20 | $1,045–$5,808 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$783–$4,899.60 | $870–$5,444 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$750.60–$4,055.40 | $834–$4,506 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$810.90–$4,194.90 | $901–$4,661 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$750.60–$3,942.90 | $834–$4,381 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$843.30–$2,950.20 | $937–$3,278 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$522.90–$2,919.60 | $581–$3,244 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$425.70–$2,943 | $473–$3,270 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$546.30–$3,462.30 | $607–$3,847 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$500.40–$2,924.10 | $556–$3,249 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$532.80–$3,447.90 | $592–$3,831 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$486–$2,275.20 | $540–$2,528 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$546.30–$2,988.90 | $607–$3,321 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$244.80–$2,210.40 | $272–$2,456 | varies |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$486–$2,395.80 | $540–$2,662 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$546.30–$2,887.20 | $607–$3,208 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$425.70–$2,354.40 | $473–$2,616 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$500.40–$2,456.10 | $556–$2,729 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$522.90–$2,766.60 | $581–$3,074 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$425.70–$2,710.80 | $473–$3,012 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$481.50–$2,757.60 | $535–$3,064 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$365.40–$2,410.20 | $406–$2,678 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$690.30–$3,129.30 | $767–$3,477 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$546.30–$2,576.70 | $607–$2,863 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$550.80–$2,376.90 | $612–$2,641 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$518.40–$2,557.80 | $576–$2,842 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$468–$2,117.70 | $520–$2,353 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$518.40–$2,766.60 | $576–$3,074 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$546.30–$3,012.30 | $607–$3,347 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$593.10–$2,656.80 | $659–$2,952 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$550.80–$2,247.30 | $612–$2,497 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$528.30–$2,641.50 | $587–$2,935 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$425.70–$2,664.90 | $473–$2,961 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$546.30–$3,165.30 | $607–$3,517 | varies |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$463.50–$2,307.60 | $515–$2,564 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$425.70–$2,132.10 | $473–$2,369 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$518.40–$2,475 | $576–$2,750 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$500.40–$2,331 | $556–$2,590 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$1,019.70–$4,194.90 | $1,133–$4,661 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$778.50–$5,237.10 | $865–$5,819 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$138.60–$440.10 | $154–$489 | varies |
| Foot 2 views (73620) range across 2 matching MRF lines |
$69.30–$324 | $77–$360 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$69.30–$421.20 | $77–$468 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$333–$1,089 | $370–$1,210 | varies |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$412.20–$2,113.20 | $458–$2,348 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$73.80–$324 | $82–$360 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$379.80–$2,178 | $422–$2,420 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$574.20–$2,772 | $638–$3,080 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$504.90–$1,783.80 | $561–$1,982 | varies |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$82.80–$486 | $92–$540 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$203.40–$1,367.10 | $226–$1,519 | varies |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$347.40–$2,071.80 | $386–$2,302 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$634.50–$2,294.10 | $705–$2,549 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$282.60–$1,251 | $314–$1,390 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$634.50–$3,767.40 | $705–$4,186 | varies |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$556.20–$2,965.50 | $618–$3,295 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$513.90–$3,016.80 | $571–$3,352 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$643.50–$2,850.30 | $715–$3,167 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$768.60–$3,743.10 | $854–$4,159 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$513.90–$2,826.90 | $571–$3,141 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$741.60–$2,826.90 | $824–$3,141 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$621–$3,568.50 | $690–$3,965 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$694.80–$2,743.20 | $772–$3,048 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$921.60–$3,640.50 | $1,024–$4,045 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$699.30–$2,747.70 | $777–$3,053 | varies |
| MRI bone marrow blood supply (77084) range across 2 matching MRF lines |
$685.80–$2,363.40 | $762–$2,626 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$774–$2,820.60 | $860–$3,134 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$634.50–$3,568.50 | $705–$3,965 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$621–$2,376.90 | $690–$2,641 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$741.60–$2,813.40 | $824–$3,126 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$968.40–$3,722.40 | $1,076–$4,136 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$694.80–$2,794.50 | $772–$3,105 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$921.60–$4,613.40 | $1,024–$5,126 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$578.70–$3,420 | $643–$3,800 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$768.60–$2,942.10 | $854–$3,269 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$986.40–$4,686.30 | $1,096–$5,207 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$578.70–$2,363.40 | $643–$2,626 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$694.80–$2,145.60 | $772–$2,384 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$921.60–$4,059 | $1,024–$4,510 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$741.60–$2,817.90 | $824–$3,131 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$940.50–$4,653 | $1,045–$5,170 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$630–$3,549.60 | $700–$3,944 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$634.50–$3,244.50 | $705–$3,605 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$694.80–$2,803.50 | $772–$3,115 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$583.20–$3,522.60 | $648–$3,914 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$921.60–$2,880 | $1,024–$3,200 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$940.50–$4,362.30 | $1,045–$4,847 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$986.40–$4,686.30 | $1,096–$5,207 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$764.10–$2,820.60 | $849–$3,134 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$583.20–$3,429.90 | $648–$3,811 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$927–$4,551.30 | $1,030–$5,057 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$986.40–$4,771.80 | $1,096–$5,302 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$681.30–$4,927.50 | $757–$5,475 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$78.30–$425.70 | $87–$473 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$337.50–$1,621.80 | $375–$1,802 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$73.80–$384.30 | $82–$427 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$315–$1,946.70 | $350–$2,163 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$138.60–$690.30 | $154–$767 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$73.80–$440.10 | $82–$489 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$69.30–$384.30 | $77–$427 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$73.80–$532.80 | $82–$592 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$110.70–$588.60 | $123–$654 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$59.40–$315 | $66–$350 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$73.80–$440.10 | $82–$489 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$73.80–$440.10 | $82–$489 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$69.30–$365.40 | $77–$406 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$147.60–$486 | $164–$540 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$73.80–$365.40 | $82–$406 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$92.70–$430.20 | $103–$478 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$82.80–$463.50 | $92–$515 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$73.80–$263.70 | $82–$293 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$500.40–$815.40 | $556–$906 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$69.30–$296.10 | $77–$329 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$82.80–$416.70 | $92–$463 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$101.70–$486 | $113–$540 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$59.40–$356.40 | $66–$396 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$69.30–$305.10 | $77–$339 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$73.80–$440.10 | $82–$489 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$106.20–$486 | $118–$540 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$115.20–$518.40 | $128–$576 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$444.60–$1,030.50 | $494–$1,145 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$101.70–$583.20 | $113–$648 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$110.70–$463.50 | $123–$515 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$231.30–$700.20 | $257–$778 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$384.30–$1,011.60 | $427–$1,124 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$73.80–$421.20 | $82–$468 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$78.30–$518.40 | $87–$576 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$73.80–$351.90 | $82–$391 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$189.90–$871.20 | $211–$968 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$69.30–$425.70 | $77–$473 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$78.30–$463.50 | $87–$515 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$44.10–$87.30 | $49–$97 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$69.30–$268.20 | $77–$298 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$78.30–$449.10 | $87–$499 | varies |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$92.70–$416.70 | $103–$463 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$899.10–$1,030.50 | $999–$1,145 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$87.30–$324 | $97–$360 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$97.20–$556.20 | $108–$618 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$92.70–$416.70 | $103–$463 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $441.90 | $491 | 1.0× |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$78.30–$764.10 | $87–$849 | varies |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$296.10–$741.60 | $329–$824 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$235.80–$871.20 | $262–$968 | varies |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$250.20–$917.10 | $278–$1,019 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$347.40–$690.30 | $386–$767 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$138.60–$671.40 | $154–$746 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$138.60–$856.80 | $154–$952 | varies |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$315–$393.30 | $350–$437 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$244.80–$611.10 | $272–$679 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$388.80–$787.50 | $432–$875 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$207.90–$703.80 | $231–$782 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$324–$927 | $360–$1,030 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$296.10–$532.80 | $329–$592 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$278.10–$648.90 | $309–$721 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$324–$792 | $360–$880 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$291.60–$741.60 | $324–$824 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$425.70–$569.70 | $473–$633 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$319.50–$1,112.40 | $355–$1,236 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$250.20–$703.80 | $278–$782 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$272.70–$963.90 | $303–$1,071 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$240.30–$959.40 | $267–$1,066 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$291.60–$602.10 | $324–$669 | varies |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$73.80–$347.40 | $82–$386 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$82.80–$370.80 | $92–$412 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$97.20–$449.10 | $108–$499 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$73.80–$384.30 | $82–$427 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$138.60–$625.50 | $154–$695 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$110.70–$430.20 | $123–$478 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$138.60–$578.70 | $154–$643 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$82.80–$468 | $92–$520 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$97.20–$463.50 | $108–$515 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$97.20–$611.10 | $108–$679 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$129.60–$671.40 | $144–$746 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$138.60–$787.50 | $154–$875 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$129.60–$996.30 | $144–$1,107 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$97.20–$449.10 | $108–$499 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$129.60–$694.80 | $144–$772 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$115.20–$615.60 | $128–$684 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$69.30–$425.70 | $77–$473 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$212.40–$939.60 | $236–$1,044 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$78.30–$449.10 | $87–$499 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$73.80–$384.30 | $82–$427 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$97.20–$509.40 | $108–$566 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$138.60–$778.50 | $154–$865 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$97.20–$393.30 | $108–$437 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$73.80–$518.40 | $82–$576 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$92.70–$528.30 | $103–$587 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$119.70–$634.50 | $133–$705 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$217.80–$791.10 | $242–$879 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$240.30–$2,704.50 | $267–$3,005 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$115.20–$694.80 | $128–$772 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$82.80–$421.20 | $92–$468 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$119.70–$425.70 | $133–$473 | 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.