Imaging prices at Schneck Medical Center
Seymour, IN · every code in this section with a posted price and a Medicare benchmark.
281 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) range across 2 matching MRF lines |
$578.20–$3,661 | $826–$5,230 | varies |
| Abdomen 1 View (74018) | $60.90 | $87 | 0.7× |
| Abdomen 2 views (74019) | $66.50 | $95 | 0.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $572.60 | $818 | 1.4× |
| Ankle 2 views (73600) range across 10 matching MRF lines |
$70–$202.65 | $100–$289.50 | varies |
| Arthrogram hip (73525) | $718.20 | $1,026 | 1.9× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$101.50–$368.90 | $145–$527 | varies |
| Bone age studies (77072) | $70 | $100 | 0.6× |
| Bone Imaging 3 Phase (78315) | $751.80 | $1,074 | 1.8× |
| Bone Imaging Limited Area (78300) | $484.40 | $692 | 1.1× |
| Bone Imaging Multiple Areas (78305) | $684.60 | $978 | 1.6× |
| Bone Imaging Whole Body (78306) | $704.90 | $1,007 | 1.7× |
| Bone survey infant (77076) | $542.50 | $775 | 4.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $982.10 | $1,403 | 1.7× |
| Cat Scan Follow-Up Study (76380) | $623.70 | $891 | 6.8× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$60.90–$135.10 | $87–$193 | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$87.50–$220.50 | $125–$315 | varies |
| Chest 3 views (71047) | $98 | $140 | 1.1× |
| Chest 4 or more views (71048) | $108.50 | $155 | 1.0× |
| Clavicle complete (73000) range across 5 matching MRF lines |
$71.40–$250.95 | $102–$358.50 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $18.20 | $26 | 0.2× |
| Continuing medical physics consltj pr wk (77336) | $618.10 | $883 | 4.3× |
| Contrast X-Ray Bladder (74430) | $336 | $480 | 0.9× |
| Contrast X-Ray Of Elbow (73085) | $638.40 | $912 | 1.7× |
| CT abdomen and pelvis without and with contrast (74178) | $2,725.10 | $3,893 | 7.4× |
| CT abdomen and pelvis without contrast (74176) | $2,011.80 | $2,874 | 8.0× |
| CT abdomen w contrast (74160) | $1,218 | $1,740 | 6.6× |
| CT abdomen w wo contrast (74170) | $1,607.20 | $2,296 | 8.7× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$627.20–$1,124.90 | $896–$1,607 | varies |
| CT Angio Abdomen and Pelvis (74174) | $1,856.40 | $2,652 | 5.0× |
| CT Angio Chest (71275) | $1,710.80 | $2,444 | 9.2× |
| CT Angio Head (70496) | $1,710.80 | $2,444 | 9.2× |
| CT angio hrt w/3d image (75574) | $1,162 | $1,660 | 3.1× |
| CT Angio Neck (70498) | $1,528.10 | $2,183 | 8.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,616.30 | $2,309 | 8.7× |
| CT cervical spine w/ contrast (72126) | $1,507.80 | $2,154 | 4.1× |
| CT cervical spine w/o contrast (72125) | $1,235.50 | $1,765 | 11.2× |
| CT cervical spine w/wo cont (72127) | $2,457 | $3,510 | 13.2× |
| CT chest w contrast (71260) | $1,219.40 | $1,742 | 6.6× |
| CT chest w/wo contrast (71270) | $1,515.50 | $2,165 | 8.2× |
| CT head/brain with contrast (70460) | $980.70 | $1,401 | 5.3× |
| CT head/brain without and with contrast (70470) | $1,407 | $2,010 | 7.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $35 | $50 | 0.4× |
| CT iac w contrast (70481) range across 4 matching MRF lines |
$1,272.60–$1,735.30 | $1,818–$2,479 | varies |
| CT l-spine w&w/o contrast (72133) | $1,894.90 | $2,707 | 10.2× |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$584.50–$1,069.60 | $835–$1,528 | varies |
| CT lower extremity w/contrast material (73701) | $1,130.50 | $1,615 | 6.1× |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$49.70–$1,130.50 | $71–$1,615 | varies |
| CT lumbar spine w/o contrast (72131) | $1,176.70 | $1,681 | 10.6× |
| CT maxillofacial w contrast (70487) | $1,213.10 | $1,733 | 6.5× |
| CT maxillofacial wo contrast (70486) | $1,164.10 | $1,663 | 10.5× |
| CT neck tissue combo (70492) | $1,463.70 | $2,091 | 7.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 4 matching MRF lines |
$1,326.50–$2,457 | $1,895–$3,510 | varies |
| CT orbits w/o contrast (70480) range across 4 matching MRF lines |
$1,101.10–$1,353.10 | $1,573–$1,933 | varies |
| CT pelvis w&w/o contrast (72194) | $1,445.50 | $2,065 | 7.8× |
| CT pelvis w/o contrast (72192) | $1,014.30 | $1,449 | 9.2× |
| CT scan of leg combo (73702) | $2,457 | $3,510 | 13.2× |
| CT scans face/jaw combo (70488) | $1,570.80 | $2,244 | 8.5× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$49.70–$1,257.20 | $71–$1,796 | varies |
| CT soft tissue neck w/o contrast (70490) | $1,031.10 | $1,473 | 9.3× |
| CT thoracic spine w contrast (72129) | $1,099 | $1,570 | 5.9× |
| CT thoracic spine w/o contrast (72128) | $1,140.30 | $1,629 | 10.3× |
| CT thoracic spine w/wo cont (72130) | $2,457 | $3,510 | 13.2× |
| CT thorax w/o contrast (71250) | $1,124.90 | $1,607 | 10.2× |
| CT upper ext wo (73200) | $1,069.60 | $1,528 | 9.7× |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,621.20–$2,457 | $2,316–$3,510 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,426.60–$1,710.80 | $2,038–$2,444 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,960 | $2,800 | 10.6× |
| Cta Abdomen (74175) | $1,337.70 | $1,911 | 7.2× |
| CTA pelvis (72191) | $2,457 | $3,510 | 13.2× |
| Diskography lumbar (72295) | $126 | $180 | 0.1× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 3 matching MRF lines |
$70–$198.10 | $100–$283 | varies |
| Dxa Bone Density Axial (77080) | $245 | $350 | 2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $70 | $100 | 0.8× |
| Echo exam uterus (76831) range across 3 matching MRF lines |
$29.40–$188.30 | $42–$269 | varies |
| Esophagram (74220) | $368.90 | $527 | 2.0× |
| Fetal Biophys Profile W/Nst (76818) range across 3 matching MRF lines |
$44.10–$278.60 | $63–$398 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$29.40–$202.30 | $42–$289 | varies |
| Fluoroscopy up to 1 hr (76000) range across 7 matching MRF lines |
$63–$203 | $90–$290 | varies |
| Foot 2 views (73620) range across 10 matching MRF lines |
$63–$118.65 | $90–$169.50 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$70–$253.05 | $100–$361.50 | varies |
| Gastric emptying imaging study (78264) | $577.50 | $825 | 1.4× |
| Gated Heart Planar Single (78472) | $838.60 | $1,198 | 2.0× |
| Hand 2 views (73120) range across 8 matching MRF lines |
$91.70–$241.50 | $131–$345 | varies |
| Hepatobil Syst Image W/Drug (78227) | $767.90 | $1,097 | 1.3× |
| Hepatobiliary System Imaging (78226) | $767.90 | $1,097 | 1.8× |
| Hysterosalpingogram (74740) | $817.60 | $1,168 | 3.2× |
| Infant hip ultrasound, limited static exam (76886) | $337.40 | $482 | 3.7× |
| Joint Survey Single View (77077) | $42 | $60 | 0.4× |
| K Flow/Funct Image Multiple (78709) | $2,475.90 | $3,537 | 4.3× |
| K Flow/Funct Image W/Drug (78708) | $1,353.80 | $1,934 | 2.4× |
| K Flow/Funct Image W/O Drug (78707) | $1,056.30 | $1,509 | 1.8× |
| Knee 3 Views (73562) range across 11 matching MRF lines |
$83.30–$291.90 | $119–$417 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $726.60 | $1,038 | 1.7× |
| Lung Ventilat&Perfus Imaging (78582) | $916.30 | $1,309 | 1.6× |
| Lymph System Imaging (78195) | $1,135.40 | $1,622 | 2.0× |
| Meckels Divert Exam (78290) | $536.20 | $766 | 1.3× |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$543.20–$956.20 | $776–$1,366 | varies |
| Mra Head W/O & W/Contrast Material (70546) | $2,107.70 | $3,011 | 5.7× |
| MRA head w/o contrast (70544) | $1,652 | $2,360 | 6.5× |
| MRA head with contrast (70545) | $2,726.50 | $3,895 | 7.4× |
| MRA neck w contrast (70548) | $2,726.50 | $3,895 | 7.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,107.70 | $3,011 | 5.7× |
| MRA neck w/o contrast (70547) | $1,709.40 | $2,442 | 6.8× |
| MRI abdomen w contrast (74182) | $2,606.10 | $3,723 | 7.1× |
| MRI abdomen w/o contrast (74181) | $1,622.60 | $2,318 | 6.4× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,829.10–$2,606.10 | $2,613–$3,723 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,242.80 | $3,204 | 6.1× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,930.60–$2,606.10 | $2,758–$3,723 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,686.30 | $2,409 | 6.7× |
| MRI cervical spine w contrast (72142) | $2,220.40 | $3,172 | 6.0× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$49.70–$1,883.70 | $71–$2,691 | varies |
| MRI chest w/o contrast (71550) | $2,606.10 | $3,723 | 10.3× |
| MRI chest with contrast (71551) | $2,606.10 | $3,723 | 3.1× |
| MRI chest wo w contrast (71552) | $3,103.10 | $4,433 | 8.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,158.80–$3,103.10 | $3,084–$4,433 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,775.20 | $2,536 | 7.0× |
| MRI lumbar spine w contrast (72149) | $2,220.40 | $3,172 | 6.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,268.70 | $3,241 | 6.1× |
| MRI orbit face &/neck w/o contrast (70540) | $1,558.90 | $2,227 | 6.2× |
| MRI orbit face neck w contrast (70542) | $2,606.10 | $3,723 | 7.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,129.40 | $3,042 | 5.8× |
| MRI pelvis w contrast (72196) | $2,919 | $4,170 | 7.9× |
| MRI pelvis w/o & w contrast (72197) | $2,467.50 | $3,525 | 6.7× |
| MRI pelvis w/o contrast (72195) | $1,821.40 | $2,602 | 7.2× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$49.70–$1,877.40 | $71–$2,682 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,783.60–$2,606.10 | $2,548–$3,723 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,873.90–$3,103.10 | $2,677–$4,433 | varies |
| MRI, abdomen, combo (74183) | $2,129.40 | $3,042 | 5.8× |
| MRI, dorsal spine combo (72157) | $2,419.20 | $3,456 | 6.6× |
| MRI, dorsal spine contrast (72147) | $2,606.10 | $3,723 | 7.1× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$49.70–$1,751.40 | $71–$2,502 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$49.70–$3,103.10 | $71–$4,433 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$49.70–$2,445.80 | $71–$3,494 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $632.80 | $904 | 1.5× |
| Myocardial Spect Multiple Studies (78452) | $3,066 | $4,380 | 2.2× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$63–$67.20 | $90–$96 | varies |
| Nonvascular Shunt X-Ray (75809) | $42 | $60 | 0.4× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$997.50–$3,661 | $1,425–$5,230 | varies |
| Nuclear Rx Oral Admin (79005) | $1,199.80 | $1,714 | 4.9× |
| Parathyroid Planar Imaging (78070) | $872.90 | $1,247 | 2.1× |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$70–$168.70 | $100–$241 | varies |
| Pet Image W/Ct Lmtd (78814) | $8,590.40 | $12,272 | 5.7× |
| PET image w/CT, full body (78816) | $4,733.40 | $6,762 | 3.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,455.50 | $6,365 | 2.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $665.70 | $951 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $116.20 | $166 | 1.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $411.60 | $588 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 13 matching MRF lines |
$77–$255.15 | $110–$364.50 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 10 matching MRF lines |
$77–$250.95 | $110–$358.50 | varies |
| Radex elbow complete minimum 3 views (73080) range across 8 matching MRF lines |
$80.50–$253.05 | $115–$361.50 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $86.10 | $123 | 0.8× |
| Radex fingr minimum 2 views (73140) range across 7 matching MRF lines |
$44.80–$202.65 | $64–$289.50 | varies |
| Radex foot complete minimum 3 views (73630) range across 13 matching MRF lines |
$65.10–$258.30 | $93–$369 | varies |
| Radex Hand Minimum 3 Views (73130) range across 8 matching MRF lines |
$98–$258.30 | $140–$369 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$67.20–$100.80 | $96–$144 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$107.80–$161.70 | $154–$231 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 4 matching MRF lines |
$45.50–$53.90 | $65–$77 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$79.80–$221.20 | $114–$316 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 7 matching MRF lines |
$112–$253.05 | $160–$361.50 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$60.20–$70 | $86–$100 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$33.60–$120.40 | $48–$172 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 4 matching MRF lines |
$77–$198.10 | $110–$283 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $130.20 | $186 | 1.4× |
| Radex Toe Minimum 2 Views (73660) range across 10 matching MRF lines |
$49.70–$202.65 | $71–$289.50 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$60.90–$91.35 | $87–$130.50 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 9 matching MRF lines |
$63–$258.30 | $90–$369 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 2 matching MRF lines |
$2,583–$18,418.40 | $3,690–$26,312 | varies |
| Radiation treatment delivery level 1 (77402) | $377.30 | $539 | 3.5× |
| Radiation treatment delivery level 2 (77407) | $455.70 | $651 | 1.1× |
| Radiation treatment delivery level 3 (77412) | $618.10 | $883 | 1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$82.60–$101.50 | $118–$145 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $80.50 | $115 | 0.7× |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$319.90–$620.90 | $457–$887 | varies |
| Radiologic exam colon single contrast study (74270) | $611.10 | $873 | 3.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $481.60 | $688 | 2.6× |
| Radiologic exam knee complete 4/more views (73564) range across 7 matching MRF lines |
$83.30–$291.90 | $119–$417 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$81.90–$213.50 | $117–$305 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $406 | $580 | 2.2× |
| Radiologic exam swallow function contrast study (74230) | $353.50 | $505 | 1.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $529.90 | $757 | 2.9× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$70.70–$106.05 | $101–$151.50 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 8 matching MRF lines |
$70.70–$280.35 | $101–$400.50 | varies |
| Radiologic examination knee 1/2 views (73560) range across 9 matching MRF lines |
$69.30–$258.30 | $99–$369 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $568.40 | $812 | 5.1× |
| Radiologic Examination Salivary Gland Calculus (70380) | $214.90 | $307 | 2.3× |
| Radiologic examination tibia & fibula 2 views (73590) range across 10 matching MRF lines |
$67.20–$321.30 | $96–$459 | varies |
| Ribs bilateral 3 views (71110) | $97.30 | $139 | 0.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,142 | $3,060 | 3.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,296.40 | $1,852 | 2.3× |
| Scapula (73010) range across 5 matching MRF lines |
$74.90–$253.05 | $107–$361.50 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $50.40 | $72 | 2.2× |
| Sella turcica (70240) | $246.40 | $352 | 2.7× |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$62.30–$202.65 | $89–$289.50 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$784–$1,564.50 | $1,120–$2,235 | varies |
| Sialogram (70390) | $501.90 | $717 | 2.0× |
| Skull less than 4 views (70250) | $70.70 | $101 | 0.6× |
| Special dosimetry (77331) range across 2 matching MRF lines |
$166.60–$333.90 | $238–$477 | varies |
| Special Physics Consult (77370) | $763 | $1,090 | 5.4× |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$192.50–$809.90 | $275–$1,157 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$424.20–$1,556.10 | $606–$2,223 | varies |
| Stereotactic Body Radiation Delivery (77373) | $14,289.10 | $20,413 | 7.6× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$84–$208.60 | $120–$298 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$341.60–$1,248.10 | $488–$1,783 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$263.20–$958.30 | $376–$1,369 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$368.90–$1,356.60 | $527–$1,938 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$200.20–$894.60 | $286–$1,278 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$134.40–$735 | $192–$1,050 | varies |
| Thoracic spine 2 views (72070) range across 4 matching MRF lines |
$81.20–$222.60 | $116–$318 | varies |
| Thoracic spine 3 views (72072) | $85.40 | $122 | 0.8× |
| Thoracolumbar 2 views (72080) | $269.50 | $385 | 2.9× |
| Thyroid Imaging With Vascular Flow (78013) | $375.90 | $537 | 0.9× |
| Thyroid Met Imaging Body (78018) | $830.90 | $1,187 | 1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $275.80 | $394 | 0.7× |
| Tx Devices Design & Construction Complex (77334) range across 4 matching MRF lines |
$231–$845.60 | $330–$1,208 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$161.70–$590.10 | $231–$843 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$147–$532 | $210–$760 | varies |
| Ultrasound Breast Limited (76642) | $322.70 | $461 | 3.5× |
| Ultrasound Exam Aaa Screen (76706) | $607.60 | $868 | 5.5× |
| Ultrasound, abdomen limited (76705) | $379.40 | $542 | 3.4× |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$44.10–$176.40 | $63–$252 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$110.60–$319.90 | $158–$457 | varies |
| Unlisted us procedure (76999) range across 4 matching MRF lines |
$226.80–$337.40 | $324–$482 | varies |
| Upper gi w/o kub (74240) | $529.90 | $757 | 2.9× |
| Urethrocystogram voiding (74455) | $485.10 | $693 | 1.9× |
| Urethrocystography retrograde (74450) | $44.10 | $63 | 0.2× |
| Us chest (76604) | $498.40 | $712 | 4.5× |
| Us complete joint (76881) | $305.90 | $437 | 2.8× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$18.20–$152.60 | $26–$218 | varies |
| Us kidney transplant (76776) | $609 | $870 | 5.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $112 | $160 | 1.0× |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$73.50–$392 | $105–$560 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$29.40–$158.90 | $42–$227 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$29.40–$222.60 | $42–$318 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$29.40–$230.30 | $42–$329 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$37.10–$213.50 | $53–$305 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$32.90–$135.10 | $47–$193 | varies |
| Us retroperitoneal complete (76770) | $609 | $870 | 5.5× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$598.50–$609 | $855–$870 | varies |
| Us scrotum and contents (76870) | $667.10 | $953 | 6.0× |
| Us thyroid (76536) | $312.20 | $446 | 2.8× |
| Us transrectal (76872) | $102.90 | $147 | 0.9× |
| Vertebral fracture assessment via dxa (77086) | $235.90 | $337 | 2.6× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$53.20–$202.65 | $76–$289.50 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 4 matching MRF lines |
$71.40–$212.10 | $102–$303 | varies |
| X-ray antegrade pyelogram tube (74425) | $392 | $560 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$147–$382.90 | $210–$547 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 9 matching MRF lines |
$60.20–$202.65 | $86–$289.50 | varies |
| X-Ray Exam Breast Specimen (76098) | $354.20 | $506 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$14–$298.20 | $20–$426 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$156.10–$235.20 | $223–$336 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$63–$114.80 | $90–$164 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$84–$172.20 | $120–$246 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 4 matching MRF lines |
$105–$184.80 | $150–$264 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$84–$201.60 | $120–$288 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$137.90–$154.70 | $197–$221 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$82.60–$234.50 | $118–$335 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$125.30–$437.50 | $179–$625 | varies |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$14–$422.80 | $20–$604 | varies |
| X-ray humerus (73060) range across 4 matching MRF lines |
$80.50–$168.70 | $115–$241 | varies |
| X-ray IV pyelogram (ivp) (74400) | $485.10 | $693 | 2.6× |
| X-ray IV pyelogram+tomography (74415) | $542.50 | $775 | 2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $53.90 | $77 | 0.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 4 matching MRF lines |
$52.50–$196.70 | $75–$281 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 6 matching MRF lines |
$105–$275.80 | $150–$394 | varies |
| X-ray nose-rectum child f.b. (76010) | $60.90 | $87 | 0.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $83.30 | $119 | 0.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$81.20–$238.70 | $116–$341 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $68.60 | $98 | 0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$114.80–$198.10 | $164–$283 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$92.40–$97.30 | $132–$139 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $115.50 | $165 | 1.0× |
| X-ray thoracic spine 4 vw (72074) | $133 | $190 | 1.2× |
| X-Ray Tmj Unilat (70328) | $89.60 | $128 | 1.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $58.80 | $84 | 0.2× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$198.10–$272.30 | $283–$389 | varies |
| X-Rays Bone Survey Complete (77075) | $542.50 | $775 | 4.9× |
| Xr c-spine 4 or 5 views (72050) range across 4 matching MRF lines |
$123.20–$367.50 | $176–$525 | varies |
| Xr facial bones less than 3 views (70140) | $70.70 | $101 | 0.8× |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$70–$105 | $100–$150 | varies |
| Xr orbits complete 4 views (70200) | $87.50 | $125 | 0.8× |
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.