Imaging prices at Shannon Medical Center
San Angelo, TX · every code in this section with a posted price and a Medicare benchmark.
350 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) | $2,362.50 | $4,725 | 1.7× |
| Abdomen 1 View (74018) | $363 | $726 | 4.2× |
| Abdomen 2 views (74019) | $378.50 | $757 | 3.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,359 | $2,718 | 3.4× |
| Adrenal Cortex & Medulla Img (78075) | $553 | $1,106 | 0.4× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$3,141–$6,282 | $6,282–$12,564 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$1,943.50–$6,282 | $3,887–$12,564 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,639 | $3,278 | 0.5× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$266–$269.50 | $532–$539 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$1,216.50 | $2,433 | 0.2× |
| Artery X-Rays Abdomen (75726) | $5,436.50 | $10,873 | 1.0× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,620.50 | $5,241 | 0.5× |
| Artery X-Rays Spine (75705) | $7,981 | $15,962 | 1.4× |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$833.50–$837 | $1,667–$1,674 | varies |
| Arthrogram hip (73525) | $813 | $1,626 | 2.3× |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$444–$444.50 | $888–$889 | varies |
| Basic radiation dosimetry calculation (77300) | $117.50 | $235 | 0.9× |
| Bone age studies (77072) | $334 | $668 | 3.2× |
| Bone Imaging 3 Phase (78315) | $1,638.50 | $3,277 | 4.1× |
| Bone Imaging Limited Area (78300) | $1,622.50 | $3,245 | 4.0× |
| Bone Imaging Whole Body (78306) | $2,200 | $4,400 | 5.5× |
| Bone marrow imaging limited area (78102) | $631.50 | $1,263 | 1.6× |
| Bone survey infant (77076) | $594 | $1,188 | 5.7× |
| Brachytx isodose complex (77318) | $1,854 | $3,708 | 4.9× |
| Brachytx isodose intermed (77317) | $2,369.50 | $4,739 | 6.3× |
| Brachytx Isodose Plan Simple (77316) | $474 | $948 | 1.3× |
| Brain Image W/Flow < 4 Views (78601) | $613 | $1,226 | 1.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,825.50 | $5,651 | 2.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,939.50 | $3,879 | 5.5× |
| Cat Scan Follow-Up Study (76380) | $1,094 | $2,188 | 12.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $953 | $1,906 | 1.7× |
| Cerebrospinal Fluid Scan (78630) | $953 | $1,906 | 1.7× |
| Chest 1 view (71045) | $298.50 | $597 | 3.4× |
| Chest 2 views (71046) | $370 | $740 | 4.2× |
| Chest 3 views (71047) | $385 | $770 | 4.4× |
| Chest 4 or more views (71048) | $522 | $1,044 | 5.0× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$390.50–$392 | $781–$784 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $160.50 | $321 | 1.5× |
| Continuing medical physics consltj pr wk (77336) | $244.50 | $489 | 1.8× |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$2,900–$5,549.50 | $5,800–$11,099 | varies |
| Contrast X-Ray Bladder (74430) | $552.50 | $1,105 | 1.6× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$833.50–$837 | $1,667–$1,674 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$1,041–$1,042 | $2,082–$2,084 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $3,154.50 | $6,309 | 9.0× |
| CT abdomen and pelvis without contrast (74176) | $2,626.50 | $5,253 | 11.0× |
| CT abdomen w contrast (74160) | $2,531.50 | $5,063 | 14.4× |
| CT abdomen w wo contrast (74170) | $3,139.50 | $6,279 | 17.8× |
| CT abdomen w/o contrast (74150) | $2,352 | $4,704 | 22.4× |
| CT Angio Abdomen and Pelvis (74174) | $4,674 | $9,348 | 13.3× |
| CT Angio Chest (71275) | $2,615 | $5,230 | 14.8× |
| CT Angio Head (70496) | $2,272 | $4,544 | 12.9× |
| CT angio hrt w/3d image (75574) | $2,569 | $5,138 | 7.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$2,900–$2,904.50 | $5,800–$5,809 | varies |
| CT Angio Neck (70498) | $2,272 | $4,544 | 12.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$2,037.50–$2,041 | $4,075–$4,082 | varies |
| CT bone density (77078) | $579.50 | $1,159 | 6.6× |
| CT cervical spine w/ contrast (72126) | $2,746 | $5,492 | 7.8× |
| CT cervical spine w/o contrast (72125) | $2,614.50 | $5,229 | 24.9× |
| CT cervical spine w/wo cont (72127) | $3,802 | $7,604 | 21.6× |
| CT chest w contrast (71260) | $2,746 | $5,492 | 15.6× |
| CT chest w/wo contrast (71270) | $3,430 | $6,860 | 19.5× |
| CT head/brain with contrast (70460) | $2,130 | $4,260 | 12.1× |
| CT head/brain without and with contrast (70470) | $2,746.50 | $5,493 | 15.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $160.50 | $321 | 1.8× |
| CT iac w contrast (70481) range across 4 matching MRF lines |
$1,616–$1,617 | $3,232–$3,234 | varies |
| CT l-spine w&w/o contrast (72133) | $4,326.50 | $8,653 | 24.6× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$2,223–$2,224.50 | $4,446–$4,449 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$2,898–$2,900.50 | $5,796–$5,801 | varies |
| CT lumbar spine w contrast (72132) | $3,117.50 | $6,235 | 8.9× |
| CT lumbar spine w/o contrast (72131) | $2,964.50 | $5,929 | 28.2× |
| CT maxillofacial w contrast (70487) | $3,106 | $6,212 | 17.6× |
| CT maxillofacial wo contrast (70486) | $2,221 | $4,442 | 21.1× |
| CT neck tissue combo (70492) | $4,493.50 | $8,987 | 25.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 4 matching MRF lines |
$3,105.50–$3,106 | $6,211–$6,212 | varies |
| CT orbits w/o contrast (70480) range across 4 matching MRF lines |
$2,219.50–$2,221 | $4,439–$4,442 | varies |
| CT pelvis w&w/o contrast (72194) | $3,035.50 | $6,071 | 17.2× |
| CT pelvis w/o contrast (72192) | $2,179 | $4,358 | 20.7× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$2,900–$2,900.50 | $5,800–$5,801 | varies |
| CT scans face/jaw combo (70488) | $3,551.50 | $7,103 | 20.2× |
| CT soft tissue neck w contrast (70491) | $2,762 | $5,524 | 15.7× |
| CT soft tissue neck w/o contrast (70490) | $2,591 | $5,182 | 24.7× |
| CT thoracic spine w contrast (72129) | $2,450.50 | $4,901 | 13.9× |
| CT thoracic spine w/o contrast (72128) | $2,330.50 | $4,661 | 22.2× |
| CT thoracic spine w/wo cont (72130) | $3,408.50 | $6,817 | 19.3× |
| CT thorax w/o contrast (71250) | $2,564.50 | $5,129 | 24.4× |
| CT upper ext wo (73200) | $1,874.50 | $3,749 | 17.8× |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,665–$2,668.50 | $5,330–$5,337 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$2,450.50–$2,451 | $4,901–$4,902 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,973 | $5,946 | 16.9× |
| Cta Abdomen (74175) | $2,718 | $5,436 | 15.4× |
| CTA pelvis (72191) | $2,532 | $5,064 | 14.4× |
| Dilation ureters/urethra rs&i (74485) | $641.50 | $1,283 | 0.3× |
| Discography Cerv/Thor Spine (72285) | $1,510 | $3,020 | 0.8× |
| Diskography lumbar (72295) | $1,510 | $3,020 | 0.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $302.50 | $605 | 2.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $374 | $748 | 3.6× |
| Doppler Fetal Mid Cerebral Artery (76821) | $340 | $680 | 3.2× |
| Dxa Bone Density Axial (77080) | $568.50 | $1,137 | 5.4× |
| Dxa bone density study (77085) | $211 | $422 | 2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $568.50 | $1,137 | 6.5× |
| Echo exam of fetal heart (76825) | $1,189 | $2,378 | 2.2× |
| Echo exam uterus (76831) | $674 | $1,348 | 2.8× |
| Echo Guide For Artery Repair (76936) | $696.50 | $1,393 | 3.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $527 | $1,054 | 2.2× |
| Esophagram (74220) | $525.50 | $1,051 | 3.0× |
| Fetal Biophys Profile W/Nst (76818) | $193.50 | $387 | 1.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $805 | $1,610 | 7.7× |
| Fluoroscopy up to 1 hr (76000) | $58.50 | $117 | 0.2× |
| Follow-Up Angiography (75898) | $568.50 | $1,137 | 0.2× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$242.50–$245 | $485–$490 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$359–$363 | $718–$726 | varies |
| Gastric emptying imaging study (78264) | $1,797 | $3,594 | 4.5× |
| Gated Heart Planar Single (78472) | $1,741 | $3,482 | 4.3× |
| Gated Heart, Multiple (78473) | $1,501 | $3,002 | 3.7× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$234.50–$235 | $469–$470 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $6,040.50 | $12,081 | 1.9× |
| Hepatobil Syst Image W/Drug (78227) | $1,843 | $3,686 | 3.4× |
| Hepatobiliary System Imaging (78226) | $650.50 | $1,301 | 1.6× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$1,981.50–$2,826 | $3,963–$5,652 | varies |
| Hysterosalpingogram (74740) | $796.50 | $1,593 | 3.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $304 | $608 | 3.5× |
| Infant hip ultrasound, limited static exam (76886) | $132.50 | $265 | 1.5× |
| K Flow/Funct Image W/Drug (78708) range across 3 matching MRF lines |
$1,268.50–$2,402.50 | $2,537–$4,805 | varies |
| K Flow/Funct Image W/O Drug (78707) | $1,708 | $3,416 | 3.1× |
| Kidney Imaging Morphol (78700) | $957 | $1,914 | 2.4× |
| Knee 3 Views (73562) | $333.50 | $667 | 3.8× |
| Liver & Spleen Imaging Static Only (78215) | $1,733 | $3,466 | 4.3× |
| Liver imaging static only (78201) | $1,672 | $3,344 | 3.1× |
| Lung Perf&Ventilat Diferentl (78598) | $2,242 | $4,484 | 4.1× |
| Lung Ventilat&Perfus Imaging (78582) | $1,711 | $3,422 | 3.1× |
| Lung Ventilation Imaging (78579) | $1,554.50 | $3,109 | 3.9× |
| Lymph System Imaging (78195) | $1,365.50 | $2,731 | 2.5× |
| Magnetic Image Jaw Joint (70336) | $572.50 | $1,145 | 2.4× |
| Meckels Divert Exam (78290) | $1,359 | $2,718 | 3.4× |
| Mlc imrt design & construction per imrt plan (77338) | $2,600 | $5,200 | 6.9× |
| Mra Head W/O & W/Contrast Material (70546) | $2,414 | $4,828 | 6.9× |
| MRA head w/o contrast (70544) | $3,879 | $7,758 | 16.2× |
| MRA head with contrast (70545) | $4,210 | $8,420 | 12.0× |
| MRA neck w contrast (70548) | $4,210 | $8,420 | 12.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,413.50 | $10,827 | 15.4× |
| MRA neck w/o contrast (70547) | $3,879 | $7,758 | 16.2× |
| MRI abdomen w contrast (74182) | $2,964.50 | $5,929 | 8.5× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$2,454.50–$4,195.50 | $4,909–$8,391 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$3,546.50–$3,550.50 | $7,093–$7,101 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$4,361.50–$4,365.50 | $8,723–$8,731 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$3,327–$6,646 | $6,654–$13,292 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $431.50 | $863 | 1.8× |
| MRI Breast Without Contrast Material Unilateral (77046) | $403 | $806 | 1.7× |
| MRI cardiac w/o contrast (75557) | $1,566 | $3,132 | 6.5× |
| MRI cervical spine w contrast (72142) | $3,251.50 | $6,503 | 9.3× |
| MRI cervical spine w/o cont (72141) | $2,733.50 | $5,467 | 11.4× |
| MRI chest w/o contrast (71550) | $1,898.50 | $3,797 | 7.9× |
| MRI chest with contrast (71551) | $4,273.50 | $8,547 | 5.4× |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$2,565–$4,007 | $5,130–$8,014 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$3,546.50–$3,550.50 | $7,093–$7,101 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$4,348–$4,365.50 | $8,696–$8,731 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$2,973.50–$2,975.50 | $5,947–$5,951 | varies |
| MRI lumbar spine w contrast (72149) | $3,801.50 | $7,603 | 10.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,777.50 | $7,555 | 10.8× |
| MRI orbit face &/neck w/o contrast (70540) | $3,319.50 | $6,639 | 13.8× |
| MRI orbit face neck w contrast (70542) | $4,502 | $9,004 | 12.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,536.50 | $11,073 | 15.8× |
| MRI pelvis w contrast (72196) | $3,298.50 | $6,597 | 9.4× |
| MRI pelvis w/o & w contrast (72197) | $4,621.50 | $9,243 | 13.2× |
| MRI pelvis w/o contrast (72195) | $2,777.50 | $5,555 | 11.6× |
| MRI spectroscopy (76390) | $1,261 | $2,522 | 14.4× |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,902–$2,831 | $3,804–$5,662 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 7 matching MRF lines |
$2,786.50–$3,327 | $5,573–$6,654 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$2,785.50–$2,786.50 | $5,571–$5,573 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$4,087–$8,172 | $8,174–$16,344 | varies |
| MRI, abdomen, combo (74183) | $4,405.50 | $8,811 | 12.6× |
| MRI, dorsal spine combo (72157) | $4,180.50 | $8,361 | 11.9× |
| MRI, dorsal spine contrast (72147) | $3,407.50 | $6,815 | 9.7× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$2,785.50–$2,786.50 | $5,571–$5,573 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$2,964.50–$4,088.50 | $5,929–$8,177 | varies |
| MRI, lumbar spine combo (72158) | $4,489.50 | $8,979 | 12.8× |
| Myelogram cervical (72240) | $1,513.50 | $3,027 | 1.9× |
| Myelogram Lumbar (72265) | $1,513.50 | $3,027 | 1.9× |
| Myelography thoracic (72255) | $1,606.50 | $3,213 | 2.0× |
| Myelograpy 2/more regions rs&i (72270) | $1,513.50 | $3,027 | 1.9× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,162.50 | $2,325 | 2.9× |
| Myocardial Spect Multiple Studies (78452) | $3,397 | $6,794 | 2.6× |
| N-invas est c ffr sw aly CTA (75580) | $3,553.50 | $7,107 | 4.1× |
| Neck soft tissue (70360) | $351 | $702 | 4.0× |
| Nm csf leak detection (78650) | $1,111.50 | $2,223 | 0.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,088.50 | $8,177 | 2.9× |
| Nuclear medicine study of endocrine organs (78099) | $843.50 | $1,687 | 2.1× |
| Nuclear Rx Oral Admin (79005) | $1,127 | $2,254 | 4.8× |
| Ob us nuchal meas 1 gest (76813) | $370.50 | $741 | 3.5× |
| Optic foramina (70190) | $588.50 | $1,177 | 6.7× |
| Parathyroid Planar Imaging (78070) | $757.50 | $1,515 | 1.9× |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$1,100–$2,131.50 | $2,200–$4,263 | varies |
| Pelvis 1 or 2 views (72170) | $481 | $962 | 4.6× |
| Perineogram (74775) | $899.50 | $1,799 | 3.8× |
| PET image w/CT, full body (78816) | $3,249 | $6,498 | 2.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 9 matching MRF lines |
$2,153.50–$3,548.50 | $4,307–$7,097 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,187.50 | $2,375 | 3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $379.50 | $759 | 3.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,375 | $2,750 | 2.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$391.50–$392 | $783–$784 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $323.50 | $647 | 3.7× |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$406–$407 | $812–$814 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $495 | $990 | 4.7× |
| Radex fingr minimum 2 views (73140) range across 13 matching MRF lines |
$169.50–$302.50 | $339–$605 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$357–$358.50 | $714–$717 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$327–$331 | $654–$662 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$310–$313.50 | $620–$627 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $216 | $432 | 2.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $392 | $784 | 4.5× |
| Radex Ribs Unilateral 2 Views (71100) | $366 | $732 | 4.2× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$276.50–$427 | $553–$854 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $277.50 | $555 | 3.2× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $490 | $980 | 2.8× |
| Radex Spine 1 View Specify Level (72020) | $357.50 | $715 | 4.1× |
| Radex Sternum Minimum 2 Views (71120) | $439.50 | $879 | 5.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $132 | $264 | 1.5× |
| Radex Toe Minimum 2 Views (73660) | $291.50 | $583 | 3.3× |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$168–$169 | $336–$338 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$343.50–$514.50 | $687–$1,029 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $610.50 | $1,221 | 5.8× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $13,696.50 | $27,393 | 1.9× |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$168–$343 | $336–$686 | varies |
| Radiation treatment delivery level 2 (77407) | $508 | $1,016 | 1.3× |
| Radiation treatment delivery level 3 (77412) range across 3 matching MRF lines |
$367.50–$419 | $735–$838 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $539 | $1,078 | 5.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $378.50 | $757 | 3.6× |
| Radiologic exam colon double contrast study (74280) | $1,107 | $2,214 | 6.3× |
| Radiologic exam colon single contrast study (74270) | $906.50 | $1,813 | 5.1× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$464–$469.50 | $928–$939 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $514 | $1,028 | 4.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $791.50 | $1,583 | 4.5× |
| Radiologic exam swallow function contrast study (74230) | $640 | $1,280 | 3.6× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$808.50–$1,231 | $1,617–$2,462 | varies |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$117.50–$357.50 | $235–$715 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$426–$427 | $852–$854 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$349–$349.50 | $698–$699 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $838.50 | $1,677 | 8.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$366.50–$368 | $733–$736 | varies |
| Ribs bilateral 3 views (71110) | $390.50 | $781 | 3.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $895 | $1,790 | 2.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $9,159 | $18,318 | 22.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$2,569–$2,753 | $5,138–$5,506 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,075 | $2,150 | 2.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 5 matching MRF lines |
$659.50–$2,652 | $1,319–$5,304 | varies |
| Scapula (73010) range across 3 matching MRF lines |
$371.50–$373 | $743–$746 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $59 | $118 | 2.5× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$224.50–$228 | $449–$456 | varies |
| Shoulder Arthrography (73040) | $1,090.50 | $2,181 | 3.1× |
| Skull less than 4 views (70250) | $404.50 | $809 | 3.9× |
| Special dosimetry (77331) | $638 | $1,276 | 4.7× |
| Special Physics Consult (77370) | $319.50 | $639 | 2.4× |
| Special teletherapy port plan (77321) | $638.50 | $1,277 | 1.7× |
| Special treatment procedure (77470) | $780 | $1,560 | 1.4× |
| Stereotactic Body Radiation Delivery (77373) | $3,675 | $7,350 | 2.0× |
| Sternoclavicular joints (71130) | $289.50 | $579 | 3.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $336.50 | $673 | 0.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $184.50 | $369 | 0.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $901.50 | $1,803 | 2.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $933.50 | $1,867 | 2.5× |
| Ther rad simulaj-aided field setting simple (77280) | $588 | $1,176 | 4.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $690 | $1,380 | 3.9× |
| Thoracic spine 2 views (72070) | $299.50 | $599 | 2.9× |
| Thoracic spine 3 views (72072) | $527.50 | $1,055 | 5.0× |
| Thoracolumbar 2 views (72080) | $123 | $246 | 1.4× |
| Thyroid Imaging With Vascular Flow (78013) | $927.50 | $1,855 | 2.3× |
| Thyroid Met Imaging Body (78018) | $1,125.50 | $2,251 | 2.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $927.50 | $1,855 | 2.3× |
| Tx Devices Design & Construction Complex (77334) | $273.50 | $547 | 0.7× |
| Tx devices design & construction intermediate (77333) | $184.50 | $369 | 1.4× |
| Tx devices design & construction simple (77332) | $143 | $286 | 1.1× |
| Ultrasound Breast Limited (76642) | $218 | $436 | 2.5× |
| Ultrasound Elastography Parenchyma (76981) | $468 | $936 | 4.5× |
| Ultrasound Exam Aaa Screen (76706) | $151.50 | $303 | 1.4× |
| Ultrasound, abdomen limited (76705) | $802 | $1,604 | 7.6× |
| Umbilical-artery Doppler (OB) (76820) | $421 | $842 | 4.0× |
| Unlisted us procedure (76999) | $327.50 | $655 | 3.7× |
| Upper gi w/o kub (74240) | $501 | $1,002 | 2.8× |
| Ureteral Reflux Study (78740) | $1,079.50 | $2,159 | 2.7× |
| Urethrocystogram voiding (74455) | $707.50 | $1,415 | 3.0× |
| Urethrocystography retrograde (74450) | $707.50 | $1,415 | 3.0× |
| Us breast unilateral complete (76641) | $218 | $436 | 2.1× |
| Us chest (76604) | $401 | $802 | 3.8× |
| Us complete joint (76881) | $434.50 | $869 | 4.1× |
| Us exam, pelvic, limited (76857) | $407.50 | $815 | 3.9× |
| Us head (76506) | $337.50 | $675 | 3.2× |
| Us kidney transplant (76776) | $269 | $538 | 2.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $346 | $692 | 3.3× |
| Us ob detailed single fetus (76811) | $1,300.50 | $2,601 | 5.4× |
| Us ob limited 1 or more fetuses (76815) | $885.50 | $1,771 | 8.4× |
| Us ob transvaginal (76817) | $547 | $1,094 | 5.2× |
| Us pelvic non ob complete (76856) | $786 | $1,572 | 7.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $547 | $1,094 | 5.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $885.50 | $1,771 | 8.4× |
| Us retroperitoneal complete (76770) | $905 | $1,810 | 8.6× |
| Us retroperitoneal limited (76775) | $434.50 | $869 | 4.1× |
| Us scrotum and contents (76870) | $710 | $1,420 | 6.8× |
| Us spinal canal and contents (76800) | $323 | $646 | 3.1× |
| Us thyroid (76536) | $752.50 | $1,505 | 7.2× |
| Us transrectal (76872) | $332 | $664 | 3.2× |
| Vascular Flow Imaging (78445) | $842 | $1,684 | 2.1× |
| Vein X-Ray Chest (75827) | $2,440 | $4,880 | 1.5× |
| Venogram Sinus/Jugular (75860) | $2,141.50 | $4,283 | 0.7× |
| Venography caval inferior serialography rs&i (75825) | $2,490.50 | $4,981 | 0.8× |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$1,071.50–$1,543.50 | $2,143–$3,087 | varies |
| Venography extremity unilateral rs&i (75820) | $2,141.50 | $4,283 | 1.4× |
| Venography Renal Bilateral (75833) | $3,051 | $6,102 | 1.0× |
| Venous sampling by catheter (75893) | $8,389 | $16,778 | 1.5× |
| Vertebral fracture assessment via dxa (77086) | $117.50 | $235 | 1.3× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$285.50–$286.50 | $571–$573 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $202.50 | $405 | 2.3× |
| X-ray antegrade pyelogram tube (74425) | $690 | $1,380 | 2.0× |
| X-Ray Aorta Leg Arteries (75630) | $2,900 | $5,800 | 0.9× |
| X-Ray Bend Only L-S Spine (72120) | $365 | $730 | 3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$333–$334.50 | $666–$669 | varies |
| X-Ray Exam Breast Specimen (76098) | $265.50 | $531 | 0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $611 | $1,222 | 7.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $611 | $1,222 | 5.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $610.50 | $1,221 | 5.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $313.50 | $627 | 3.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$186–$370 | $372–$740 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $307.50 | $615 | 2.9× |
| X-Ray Exam Hips Bi 2 Views (73521) | $331 | $662 | 3.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $331 | $662 | 3.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $211 | $422 | 2.0× |
| X-Ray Exam L-S Spine Bending (72114) | $895.50 | $1,791 | 8.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $439.50 | $879 | 5.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $687 | $1,374 | 6.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$201–$311.50 | $402–$623 | varies |
| X-ray eye for foreign body (70030) | $373 | $746 | 4.3× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$374.50–$392 | $749–$784 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,037.50 | $2,075 | 5.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $256 | $512 | 2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $255 | $510 | 2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $481.50 | $963 | 4.6× |
| X-ray nose-rectum child f.b. (76010) | $131.50 | $263 | 1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $569 | $1,138 | 5.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $216 | $432 | 2.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $211.50 | $423 | 2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $411 | $822 | 4.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $640 | $1,280 | 7.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $728 | $1,456 | 6.9× |
| X-Ray Stress View (77071) | $224 | $448 | 2.6× |
| X-Ray Tmj Unilat (70328) | $186 | $372 | 2.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $846.50 | $1,693 | 2.4× |
| X-Rays Bone Length Studies (77073) | $372 | $744 | 3.5× |
| X-Rays Bone Survey Complete (77075) | $500 | $1,000 | 4.8× |
| Xr c-spine 4 or 5 views (72050) | $553.50 | $1,107 | 5.3× |
| Xr facial bones less than 3 views (70140) | $216.50 | $433 | 2.5× |
| Xr orbits complete 4 views (70200) | $562 | $1,124 | 5.4× |
| Xr Tomogram Single Plane (76100) | $264.50 | $529 | 2.5× |
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.