Imaging prices at SGMC Health Main
Valdosta, GA · every code in this section with a posted price and a Medicare benchmark.
313 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) | $6,486 | $8,648 | 5.3× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$402.75–$403.50 | $537–$538 | varies |
| Abdomen 2 views (74019) | $302.25 | $403 | 3.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $668.25 | $891 | 1.9× |
| Angio internal mammary (75756) | $5,867.25 | $7,823 | 2.1× |
| Angio pulmonary bilat (75743) | $7,082.25 | $9,443 | 2.6× |
| Angiography extremity bilateral rs&i (75716) | $4,853.25 | $6,471 | 1.8× |
| Angiography extremity unilateral rs&i (75710) | $1,979.25 | $2,639 | 0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $7,051.50 | $9,402 | 2.5× |
| Ankle 2 views (73600) | $351.75 | $469 | 4.6× |
| Aortography thoracic serialography rs&i (75605) | $6,786.75 | $9,049 | 1.4× |
| Artery X-Rays Abdomen (75726) | $5,429.25 | $7,239 | 1.1× |
| Artery X-Rays Pelvis (75736) | $6,786.75 | $9,049 | 1.4× |
| Arthrogram ankle (73615) | $513.75 | $685 | 1.7× |
| Arthrogram hip (73525) | $402.75 | $537 | 1.3× |
| Arthrogram Wrist (73115) | $400.50 | $534 | 1.3× |
| Basic radiation dosimetry calculation (77300) | $295.50 | $394 | 2.5× |
| Bone age studies (77072) | $368.25 | $491 | 4.0× |
| Bone Imaging 3 Phase (78315) | $1,166.25 | $1,555 | 3.3× |
| Bone Imaging Limited Area (78300) | $1,307.25 | $1,743 | 3.7× |
| Bone Imaging Multiple Areas (78305) | $930 | $1,240 | 2.7× |
| Bone Imaging Whole Body (78306) | $747.75 | $997 | 2.1× |
| Bone survey infant (77076) | $305.25 | $407 | 3.3× |
| Brain Flow Imaging Only (78610) | $426.75 | $569 | 0.9× |
| Chest 1 view (71045) | $178.50 | $238 | 2.3× |
| Chest 2 views (71046) | $123 | $164 | 1.6× |
| Chest 3 views (71047) | $174.75 | $233 | 2.3× |
| Chest 4 or more views (71048) | $161.25 | $215 | 1.8× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$181.50–$208.50 | $242–$278 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $122.25 | $163 | 1.3× |
| Continuing medical physics consltj pr wk (77336) | $276 | $368 | 2.3× |
| Contrast Exam Abdominl Aorta (75625) | $4,067.25 | $5,423 | 1.5× |
| Contrast X-Ray Bladder (74430) | $495 | $660 | 1.6× |
| Contrast X-Ray Of Elbow (73085) | $392.25 | $523 | 1.3× |
| Contrast X-Ray Of Knee Joint (73580) | $385.50 | $514 | 1.3× |
| CT abdomen and pelvis without and with contrast (74178) | $7,065 | $9,420 | 23.1× |
| CT abdomen and pelvis without contrast (74176) | $4,152.75 | $5,537 | 19.9× |
| CT abdomen w contrast (74160) | $3,319.50 | $4,426 | 21.6× |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$3,749.25–$3,750 | $4,999–$5,000 | varies |
| CT abdomen w/o contrast (74150) | $1,005.75 | $1,341 | 11.0× |
| CT Angio Abdomen and Pelvis (74174) | $606 | $808 | 2.0× |
| CT Angio Chest (71275) | $4,387.50 | $5,850 | 28.5× |
| CT Angio Head (70496) | $4,492.50 | $5,990 | 29.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $5,042.25 | $6,723 | 32.8× |
| CT Angio Neck (70498) | $2,361.75 | $3,149 | 15.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,839.75 | $2,453 | 12.0× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $288 | $384 | 1.9× |
| CT cervical spine w/ contrast (72126) | $2,286 | $3,048 | 7.5× |
| CT cervical spine w/o contrast (72125) | $562.50 | $750 | 6.1× |
| CT cervical spine w/wo cont (72127) | $1,931.25 | $2,575 | 12.6× |
| CT chest w contrast (71260) | $1,848 | $2,464 | 12.0× |
| CT chest w/wo contrast (71270) | $2,372.25 | $3,163 | 15.4× |
| CT head/brain with contrast (70460) | $1,915.50 | $2,554 | 12.5× |
| CT head/brain without and with contrast (70470) | $2,816.25 | $3,755 | 18.3× |
| CT heart contrast eval cardiac structure&morph (75572) | $367.50 | $490 | 1.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $185.25 | $247 | 2.4× |
| CT iac w contrast (70481) | $1,570.50 | $2,094 | 10.2× |
| CT l-spine w&w/o contrast (72133) | $1,974.75 | $2,633 | 12.8× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$888.75–$1,022.25 | $1,185–$1,363 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$348.75–$401.25 | $465–$535 | varies |
| CT lumbar spine w contrast (72132) | $1,867.50 | $2,490 | 6.1× |
| CT lumbar spine w/o contrast (72131) | $506.25 | $675 | 5.5× |
| CT maxillofacial w contrast (70487) | $2,055 | $2,740 | 13.4× |
| CT maxillofacial wo contrast (70486) | $996 | $1,328 | 10.9× |
| CT neck tissue combo (70492) | $2,410.50 | $3,214 | 15.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,157.25 | $1,543 | 7.5× |
| CT orbits w/o contrast (70480) | $1,272 | $1,696 | 13.9× |
| CT pelvis w&w/o contrast (72194) | $2,574.75 | $3,433 | 16.8× |
| CT pelvis w/o contrast (72192) | $597 | $796 | 6.5× |
| CT scan of leg combo (73702) | $1,321.50 | $1,762 | 8.6× |
| CT scans face/jaw combo (70488) | $1,493.25 | $1,991 | 9.7× |
| CT soft tissue neck w contrast (70491) | $1,712.25 | $2,283 | 11.1× |
| CT soft tissue neck w/o contrast (70490) | $1,583.25 | $2,111 | 17.3× |
| CT thoracic spine w contrast (72129) | $844.50 | $1,126 | 5.5× |
| CT thoracic spine w/o contrast (72128) | $610.50 | $814 | 6.7× |
| CT thoracic spine w/wo cont (72130) | $1,958.25 | $2,611 | 12.7× |
| CT thorax w/o contrast (71250) | $429.75 | $573 | 4.7× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$869.25–$999.75 | $1,159–$1,333 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $1,321.50 | $1,762 | 8.6× |
| CT upper extremity with contrast (73201) | $1,445.25 | $1,927 | 4.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $522.75 | $697 | 3.4× |
| Cta Abdomen (74175) | $2,299.50 | $3,066 | 15.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $6,816.75 | $9,089 | 22.3× |
| CTA pelvis (72191) | $2,232 | $2,976 | 14.5× |
| Discography Cerv/Thor Spine (72285) | $3,449.25 | $4,599 | 2.0× |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$3,606–$4,705.50 | $4,808–$6,274 | varies |
| Dxa Bone Density Axial (77080) | $114 | $152 | 1.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $162 | $216 | 2.1× |
| Echo Guide For Artery Repair (76936) | $777.75 | $1,037 | 4.1× |
| Esophagram (74220) | $206.25 | $275 | 1.3× |
| Fetal Biophys Profile W/Nst (76818) | $628.50 | $838 | 6.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $632.25 | $843 | 6.9× |
| Fluoroscopy up to 1 hr (76000) | $613.50 | $818 | 2.9× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$187.50–$216 | $250–$288 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$216.75–$249 | $289–$332 | varies |
| Gastric emptying imaging study (78264) | $2,373.75 | $3,165 | 6.8× |
| Gated Heart Planar Single (78472) | $470.25 | $627 | 1.3× |
| GI Endoscopic US S&I (76975) | $418.50 | $558 | 2.0× |
| Hand 2 views (73120) | $351 | $468 | 3.8× |
| Hepatobil Syst Image W/Drug (78227) | $1,720.50 | $2,294 | 3.6× |
| Hepatobiliary System Imaging (78226) | $1,499.25 | $1,999 | 4.3× |
| Ht Muscle Image Spect Sing (78451) | $2,580.75 | $3,441 | 2.3× |
| Hysterosalpingogram (74740) | $603.75 | $805 | 2.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $327 | $436 | 4.3× |
| Infant hip ultrasound, limited static exam (76886) | $279.75 | $373 | 3.7× |
| K Flow/Funct Image W/Drug (78708) | $768 | $1,024 | 1.6× |
| K Flow/Funct Image W/O Drug (78707) | $946.50 | $1,262 | 2.0× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $510.75 | $681 | 1.5× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$239.25–$275.25 | $319–$367 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,021.50 | $1,362 | 2.9× |
| Lung Perf&Ventilat Diferentl (78598) | $1,002 | $1,336 | 2.1× |
| Lung Ventilat&Perfus Imaging (78582) | $854.25 | $1,139 | 1.8× |
| Lymph System Imaging (78195) | $1,728.75 | $2,305 | 3.6× |
| Magnetic Image Jaw Joint (70336) | $1,525.50 | $2,034 | 7.3× |
| Mammary ductogram or galactogram multiple (77054) | $278.25 | $371 | 1.3× |
| Mammary ductogram or galactogram single (77053) | $278.25 | $371 | 1.3× |
| Meckels Divert Exam (78290) | $1,006.50 | $1,342 | 2.9× |
| Mlc imrt design & construction per imrt plan (77338) | $743.25 | $991 | 2.3× |
| Mra Head W/O & W/Contrast Material (70546) | $3,267.75 | $4,357 | 10.7× |
| MRA head w/o contrast (70544) | $1,896 | $2,528 | 9.1× |
| MRA head with contrast (70545) | $2,056.50 | $2,742 | 6.7× |
| MRA neck w contrast (70548) | $2,252.25 | $3,003 | 7.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,511 | $3,348 | 8.2× |
| MRA neck w/o contrast (70547) | $1,692 | $2,256 | 8.1× |
| MRI abdomen w contrast (74182) | $2,869.50 | $3,826 | 9.4× |
| MRI abdomen w/o contrast (74181) | $4,334.25 | $5,779 | 20.7× |
| MRI any jt lower extrem w/contrast material (73722) | $2,342.25 | $3,123 | 3.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,017.25 | $4,023 | 9.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,672.25 | $3,563 | 3.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $543.75 | $725 | 2.6× |
| MRI Breast Without Contrast Material Unilateral (77046) | $519.75 | $693 | 2.5× |
| MRI cervical spine w contrast (72142) | $2,025 | $2,700 | 6.6× |
| MRI cervical spine w/o cont (72141) | $1,622.25 | $2,163 | 7.8× |
| MRI chest w/o contrast (71550) | $1,709.25 | $2,279 | 8.2× |
| MRI chest with contrast (71551) | $2,601 | $3,468 | 3.8× |
| MRI chest wo w contrast (71552) | $2,262 | $3,016 | 7.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,081.25 | $2,775 | 6.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,769.50 | $5,026 | 12.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,342 | $4,456 | 16.0× |
| MRI lumbar spine w contrast (72149) | $2,507.25 | $3,343 | 8.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,658.25 | $6,211 | 15.2× |
| MRI orbit face &/neck w/o contrast (70540) | $1,857.75 | $2,477 | 8.9× |
| MRI orbit face neck w contrast (70542) | $1,776.75 | $2,369 | 5.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,535.75 | $3,381 | 8.3× |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$2,517–$2,670 | $3,356–$3,560 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$4,958.25–$4,959 | $6,611–$6,612 | varies |
| MRI pelvis w/o contrast (72195) | $3,881.25 | $5,175 | 18.6× |
| MRI spectroscopy (76390) | $155.25 | $207 | 2.0× |
| MRI thoracic spine w/o contrast (72146) | $1,781.25 | $2,375 | 8.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,289 | $3,052 | 7.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $849 | $1,132 | 4.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,886.75 | $3,849 | 9.4× |
| MRI, abdomen, combo (74183) | $4,347 | $5,796 | 14.2× |
| MRI, dorsal spine combo (72157) | $5,241 | $6,988 | 17.1× |
| MRI, dorsal spine contrast (72147) | $2,480.25 | $3,307 | 8.1× |
| MRI, joint upper extrem (73221) | $679.50 | $906 | 3.2× |
| MRI, joint upper extrem combo (73223) | $3,018.75 | $4,025 | 9.9× |
| MRI, lumbar spine combo (72158) | $4,722 | $6,296 | 15.4× |
| Myelogram cervical (72240) | $1,026 | $1,368 | 1.5× |
| Myelogram Lumbar (72265) | $1,032.75 | $1,377 | 1.5× |
| Myelograpy 2/more regions rs&i (72270) | $1,123.50 | $1,498 | 1.6× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$4,773.75–$4,774.50 | $6,365–$6,366 | varies |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $3,834.75 | $5,113 | 2.0× |
| Neck soft tissue (70360) | $267 | $356 | 3.5× |
| Nonvascular Shunt X-Ray (75809) | $80.25 | $107 | 0.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,400.25 | $5,867 | 3.6× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$800.25–$835.50 | $1,067–$1,114 | varies |
| Panoramic X-ray of jaws (70355) | $109.50 | $146 | 1.4× |
| Parathyroid Planar Imaging (78070) | $816 | $1,088 | 2.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $975 | $1,300 | 2.8× |
| Pelvis 1 or 2 views (72170) | $81.75 | $109 | 0.9× |
| Pet Image Skull-Thigh (78812) | $2,802 | $3,736 | 2.2× |
| Pet Image W/Ct Lmtd (78814) | $6,033.75 | $8,045 | 4.8× |
| PET image w/CT, full body (78816) | $2,207.25 | $2,943 | 1.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $1,884 | $2,512 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $563.25 | $751 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $532.50 | $710 | 5.8× |
| Radex Ankle Complete Minimum 3 Views (73610) | $405 | $540 | 5.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $177 | $236 | 2.3× |
| Radex elbow complete minimum 3 views (73080) | $405 | $540 | 5.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$272.25–$470.25 | $363–$627 | varies |
| Radex fingr minimum 2 views (73140) | $302.25 | $403 | 4.0× |
| Radex foot complete minimum 3 views (73630) | $507.75 | $677 | 6.7× |
| Radex Hand Minimum 3 Views (73130) | $374.25 | $499 | 4.9× |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$180–$198 | $240–$264 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $366 | $488 | 4.8× |
| Radex Ribs Unilateral 2 Views (71100) | $103.50 | $138 | 1.4× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$192.75–$222 | $257–$296 | varies |
| Radex Sternum Minimum 2 Views (71120) | $210.75 | $281 | 2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $192 | $256 | 2.5× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$181.50–$208.50 | $242–$278 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $142.50 | $190 | 1.6× |
| Radex Wrist Complete Minimum 3 Views (73110) | $372.75 | $497 | 4.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $14,966.25 | $19,955 | 2.3× |
| Radiation treatment delivery level 1 (77402) | $176.25 | $235 | 2.0× |
| Radiation treatment delivery level 2 (77407) | $516 | $688 | 1.5× |
| Radiation treatment delivery level 3 (77412) | $2,351.25 | $3,135 | 4.9× |
| Radiolog exam mandible compl minimum 4 views (70110) | $269.25 | $359 | 2.9× |
| Radiologic exam colon single contrast study (74270) | $636.75 | $849 | 4.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $378.75 | $505 | 2.5× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$195.75–$225 | $261–$300 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $206.25 | $275 | 2.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $387 | $516 | 2.5× |
| Radiologic exam swallow function contrast study (74230) | $222 | $296 | 1.4× |
| Radiologic exam teeth complete full mouth (70320) | $156.75 | $209 | 0.7× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $440.25 | $587 | 2.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $483.75 | $645 | 3.1× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$167.25–$192 | $223–$256 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$171.75–$197.25 | $229–$263 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $219.75 | $293 | 2.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$168.75–$194.25 | $225–$259 | varies |
| Radiologic examination, teeth; single view Non-Facility (70300) | $164.25 | $219 | 2.2× |
| Ribs bilateral 3 views (71110) | $369 | $492 | 4.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $903 | $1,204 | 2.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $949.50 | $1,266 | 2.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,514 | $3,352 | 5.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,307.25 | $1,743 | 2.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,376 | $3,168 | 2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,808 | $3,744 | 2.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,719.75 | $2,293 | 1.5× |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$378.75–$440.25 | $505–$587 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$186–$213.75 | $248–$285 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$147–$173.25 | $196–$231 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$96.75–$111 | $129–$148 | varies |
| Shoulder Arthrography (73040) | $402.75 | $537 | 1.3× |
| Skull less than 4 views (70250) | $413.25 | $551 | 4.5× |
| Special dosimetry (77331) | $818.25 | $1,091 | 6.9× |
| Special Physics Consult (77370) | $400.50 | $534 | 3.4× |
| Special teletherapy port plan (77321) | $849.75 | $1,133 | 2.6× |
| Special treatment procedure (77470) | $2,100 | $2,800 | 4.3× |
| Stereotactic Body Radiation Delivery (77373) | $2,853 | $3,804 | 1.8× |
| Sternoclavicular joints (71130) | $150.75 | $201 | 2.0× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $288 | $384 | 3.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,462.50 | $1,950 | 4.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $656.25 | $875 | 2.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $766.50 | $1,022 | 2.3× |
| Ther rad simulaj-aided field setting simple (77280) | $1,006.50 | $1,342 | 8.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $370.50 | $494 | 2.4× |
| Thoracic spine 2 views (72070) | $598.50 | $798 | 6.5× |
| Thoracic spine 3 views (72072) | $408 | $544 | 4.5× |
| Thyroid Imaging With Vascular Flow (78013) | $730.50 | $974 | 2.1× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$684.75–$714.75 | $913–$953 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,308 | $1,744 | 3.7× |
| Tx Devices Design & Construction Complex (77334) | $651.75 | $869 | 2.0× |
| Tx devices design & construction intermediate (77333) | $568.50 | $758 | 4.8× |
| Tx devices design & construction simple (77332) | $867 | $1,156 | 7.4× |
| Ultrasound Breast Limited (76642) | $459 | $612 | 6.0× |
| Ultrasound Elastography Parenchyma (76981) | $1,181.25 | $1,575 | 12.9× |
| Ultrasound Exam Aaa Screen (76706) | $188.25 | $251 | 2.1× |
| Ultrasound, abdomen limited (76705) | $846.75 | $1,129 | 9.2× |
| Umbilical-artery Doppler (OB) (76820) | $346.50 | $462 | 3.8× |
| Upper gi w/o kub (74240) | $789.75 | $1,053 | 5.1× |
| Urethrocystogram voiding (74455) | $579 | $772 | 2.8× |
| Urethrocystography retrograde (74450) | $557.25 | $743 | 2.7× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$462–$531 | $616–$708 | varies |
| Us chest (76604) | $744 | $992 | 8.1× |
| Us complete joint (76881) | $494.25 | $659 | 5.4× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$355.50–$744 | $474–$992 | varies |
| Us head (76506) | $310.50 | $414 | 3.4× |
| Us kidney transplant (76776) | $566.25 | $755 | 6.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $489.75 | $653 | 5.3× |
| Us ob limited 1 or more fetuses (76815) | $744 | $992 | 8.1× |
| Us ob transvaginal (76817) | $831 | $1,108 | 9.1× |
| Us pelvic non ob complete (76856) | $973.50 | $1,298 | 10.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $853.50 | $1,138 | 9.3× |
| Us retroperitoneal complete (76770) | $516.75 | $689 | 5.6× |
| Us retroperitoneal limited (76775) | $931.50 | $1,242 | 10.2× |
| Us scrotum and contents (76870) | $976.50 | $1,302 | 10.7× |
| Us spinal canal and contents (76800) | $368.25 | $491 | 4.0× |
| Us thyroid (76536) | $970.50 | $1,294 | 10.6× |
| Us transrectal (76872) | $1,149.75 | $1,533 | 12.5× |
| Vein X-Ray Chest (75827) | $1,335 | $1,780 | 1.0× |
| Venogram Sinus/Jugular (75860) | $5,631.75 | $7,509 | 2.0× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$4,847.25–$5,058 | $6,463–$6,744 | varies |
| Venography extremity bilateral rs&i (75822) | $1,335 | $1,780 | 1.0× |
| Venography extremity unilateral rs&i (75820) | $1,241.25 | $1,655 | 0.9× |
| Venography Renal Bilateral (75833) | $6,745.50 | $8,994 | 2.4× |
| Venography Renal Unilateral (75831) | $5,310.75 | $7,081 | 1.9× |
| Venous sampling by catheter (75893) | $9,184.50 | $12,246 | 1.9× |
| Wrist 2 views (73100) | $308.25 | $411 | 4.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $242.25 | $323 | 3.2× |
| X-ray antegrade pyelogram tube (74425) | $334.50 | $446 | 1.1× |
| X-Ray Aorta Leg Arteries (75630) | $3,801 | $5,068 | 1.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$153–$176.25 | $204–$235 | varies |
| X-Ray Exam Breast Specimen (76098) | $837 | $1,116 | 1.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $296.25 | $395 | 3.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $561 | $748 | 6.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $366 | $488 | 4.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $136.50 | $182 | 1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $80.25 | $107 | 1.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $279.75 | $373 | 3.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $270.75 | $361 | 3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $331.50 | $442 | 3.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $504 | $672 | 5.5× |
| X-Ray Exam L-S Spine Bending (72114) | $450 | $600 | 4.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $507.75 | $677 | 6.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $732 | $976 | 8.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $247.50 | $330 | 2.7× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$141–$162 | $188–$216 | varies |
| X-ray IV pyelogram (ivp) (74400) | $822.75 | $1,097 | 5.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $154.50 | $206 | 2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$267.75–$308.25 | $357–$411 | varies |
| X-ray nose-rectum child f.b. (76010) | $353.25 | $471 | 4.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $320.25 | $427 | 3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $174 | $232 | 1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $398.25 | $531 | 5.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $344.25 | $459 | 4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $372.75 | $497 | 4.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $513.75 | $685 | 1.7× |
| X-Rays Bone Length Studies (77073) | $194.25 | $259 | 2.1× |
| X-Rays Bone Survey Complete (77075) | $414.75 | $553 | 4.5× |
| Xr c-spine 4 or 5 views (72050) | $597 | $796 | 6.5× |
| Xr orbits complete 4 views (70200) | $273.75 | $365 | 3.0× |
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.