Imaging prices at Shenandoah Medical Center
Shenandoah, IA · every code in this section with a posted price and a Medicare benchmark.
282 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) | $3,607.50 | $5,550 | 2.7× |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$143.65–$165.75 | $221–$255 | varies |
| Abdomen 2 views (74019) | $231.40 | $356 | 2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,160.25 | $1,785 | 3.0× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$187.20–$224.25 | $288–$345 | varies |
| Arthrogram ankle (73615) | $491.40 | $756 | 1.5× |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$516.75–$1,294.80 | $795–$1,992 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$863.20–$1,294.80 | $1,328–$1,992 | varies |
| Basic radiation dosimetry calculation (77300) | $401.05 | $617 | 3.1× |
| Bone Imaging 3 Phase (78315) | $1,267.50 | $1,950 | 3.3× |
| Bone Imaging Limited Area (78300) | $650 | $1,000 | 1.7× |
| Bone Imaging Whole Body (78306) | $1,118 | $1,720 | 2.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $7,848.10 | $12,074 | 5.7× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$162.50–$165.75 | $250–$255 | varies |
| Chest 2 views (71046) | $215.80 | $332 | 2.6× |
| Chest 3 views (71047) | $183.30 | $282 | 2.2× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$260.65–$350.35 | $401–$539 | varies |
| Cholecystography Oral Contrast (74290) | $144.30 | $222 | 0.9× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$195.65–$234.98 | $301–$361.50 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$130–$344.50 | $200–$530 | varies |
| Continuing medical physics consltj pr wk (77336) | $508.95 | $783 | 3.9× |
| Contrast X-Ray Bladder (74430) | $239.20 | $368 | 0.7× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$863.20–$1,294.80 | $1,328–$1,992 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$416–$633.75 | $640–$975 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $3,108.30 | $4,782 | 9.3× |
| CT abdomen and pelvis without contrast (74176) | $2,410.85 | $3,709 | 10.5× |
| CT abdomen w contrast (74160) | $1,485.90 | $2,286 | 8.8× |
| CT abdomen w wo contrast (74170) | $1,855.75 | $2,855 | 11.0× |
| CT abdomen w/o contrast (74150) | $1,326.65 | $2,041 | 13.2× |
| CT Angio Abdomen and Pelvis (74174) | $2,567.50 | $3,950 | 7.7× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,803.75–$1,965.60 | $2,775–$3,024 | varies |
| CT Angio Head (70496) | $1,950 | $3,000 | 11.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,966.25 | $3,025 | 11.7× |
| CT Angio Neck (70498) | $1,820 | $2,800 | 10.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,781.65 | $2,741 | 10.6× |
| CT bone density (77078) range across 2 matching MRF lines |
$259.35–$281.45 | $399–$433 | varies |
| CT cervical spine w/ contrast (72126) | $1,521 | $2,340 | 4.5× |
| CT cervical spine w/o contrast (72125) | $1,378 | $2,120 | 13.7× |
| CT chest w contrast (71260) | $1,641.25 | $2,525 | 9.7× |
| CT chest w/wo contrast (71270) | $1,730.95 | $2,663 | 10.3× |
| CT head/brain with contrast (70460) | $1,257.10 | $1,934 | 7.5× |
| CT head/brain without and with contrast (70470) | $1,482 | $2,280 | 8.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $3,010.15 | $4,631 | 36.0× |
| CT iac w contrast (70481) | $1,553.50 | $2,390 | 9.2× |
| CT l-spine w&w/o contrast (72133) | $1,722.50 | $2,650 | 10.2× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,231.10–$1,239.55 | $1,894–$1,907 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,378–$1,424.80 | $2,120–$2,192 | varies |
| CT lumbar spine w contrast (72132) | $1,495 | $2,300 | 4.5× |
| CT lumbar spine w/o contrast (72131) | $1,339.65 | $2,061 | 13.3× |
| CT maxillofacial w contrast (70487) | $1,378 | $2,120 | 8.2× |
| CT maxillofacial wo contrast (70486) | $1,147.25 | $1,765 | 11.4× |
| CT neck tissue combo (70492) | $1,514.50 | $2,330 | 9.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,378 | $2,120 | 8.2× |
| CT orbits w/o contrast (70480) | $1,127.75 | $1,735 | 11.2× |
| CT pelvis w&w/o contrast (72194) | $1,591.85 | $2,449 | 9.4× |
| CT pelvis w/o contrast (72192) | $1,313.65 | $2,021 | 13.1× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,624.35–$2,271.10 | $2,499–$3,494 | varies |
| CT scans face/jaw combo (70488) | $1,267.50 | $1,950 | 7.5× |
| CT soft tissue neck w contrast (70491) | $1,459.25 | $2,245 | 8.7× |
| CT soft tissue neck w/o contrast (70490) | $1,229.15 | $1,891 | 12.2× |
| CT thoracic spine w contrast (72129) | $1,524.25 | $2,345 | 9.0× |
| CT thoracic spine w/o contrast (72128) | $1,341.60 | $2,064 | 13.3× |
| CT thorax w/o contrast (71250) | $1,339.65 | $2,061 | 13.3× |
| CT unlisted procedure (76497) range across 2 matching MRF lines |
$78–$1,156.35 | $120–$1,779 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,118–$1,239.55 | $1,720–$1,907 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,326.65–$1,610.70 | $2,041–$2,478 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,212.90–$1,424.80 | $1,866–$2,192 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$1,683.50–$2,067 | $2,590–$3,180 | varies |
| Cta Abdomen (74175) | $1,774.50 | $2,730 | 10.5× |
| CTA pelvis (72191) | $1,787.50 | $2,750 | 10.6× |
| Doppler Fetal Mid Cerebral Artery (76821) | $209.95 | $323 | 2.1× |
| Dxa Bone Density Axial (77080) | $313.30 | $482 | 3.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $123.50 | $190 | 1.5× |
| Echo exam uterus (76831) | $336.05 | $517 | 1.5× |
| Esophagram (74220) | $330.20 | $508 | 2.0× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$253.50–$286.65 | $390–$441 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$262.60–$354.25 | $404–$545 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$195.65–$419.25 | $301–$645 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$143.65–$213.53 | $221–$328.50 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$206.70–$448.50 | $318–$690 | varies |
| Gastroesophageal Reflux Exam (78262) | $780 | $1,200 | 2.0× |
| Gated Heart Planar Single (78472) | $1,105 | $1,700 | 2.9× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$166.40–$207.35 | $256–$319 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,267.50 | $1,950 | 2.4× |
| Hepatobiliary System Imaging (78226) | $1,186.25 | $1,825 | 3.1× |
| Ht Muscle Image Spect Sing (78451) | $1,365 | $2,100 | 1.1× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$273.65–$302.25 | $421–$465 | varies |
| K Flow/Funct Image Multiple (78709) | $1,378 | $2,120 | 2.6× |
| K Flow/Funct Image W/Drug (78708) | $1,430 | $2,200 | 2.7× |
| K Flow/Funct Image W/O Drug (78707) | $1,267.50 | $1,950 | 2.4× |
| Kidney Imaging Morphol (78700) | $520 | $800 | 1.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $552.50 | $850 | 1.4× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$238.55–$353.93 | $367–$544.50 | varies |
| Liver & Spleen Imaging Static Only (78215) | $780 | $1,200 | 2.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $780 | $1,200 | 2.0× |
| Lung Ventilat&Perfus Imaging (78582) | $767 | $1,180 | 1.5× |
| Lung Ventilation Imaging (78579) | $269.10 | $414 | 0.7× |
| Lymph System Imaging (78195) | $1,186.25 | $1,825 | 2.3× |
| Magnetic Image Jaw Joint (70336) | $1,378 | $2,120 | 6.0× |
| Meckels Divert Exam (78290) | $975 | $1,500 | 2.5× |
| Mlc imrt design & construction per imrt plan (77338) | $2,827.50 | $4,350 | 7.9× |
| Mra Head W/O & W/Contrast Material (70546) | $1,953.67 | $3,005.64 | 5.8× |
| MRA head w/o contrast (70544) | $1,998.75 | $3,075 | 8.7× |
| MRA neck w contrast (70548) | $1,836.25 | $2,825 | 5.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,171 | $3,340 | 6.5× |
| MRA neck w/o contrast (70547) | $1,482 | $2,280 | 6.5× |
| MRI abdomen w/o contrast (74181) | $1,956.50 | $3,010 | 8.5× |
| MRI any jt lower extrem w/contrast material (73722) | $1,950 | $3,000 | 2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,421.25 | $3,725 | 7.2× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$1,998.75–$2,460.25 | $3,075–$3,785 | varies |
| MRI brain functional w/o physician admnistration (70554) | $1,403.36 | $2,159.01 | 6.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,324.65 | $2,037.92 | 5.8× |
| MRI cervical spine w contrast (72142) | $2,024.31 | $3,114.32 | 6.0× |
| MRI cervical spine w/o cont (72141) | $2,025.65 | $3,116.39 | 8.8× |
| MRI chest w/o contrast (71550) | $1,950 | $3,000 | 8.5× |
| MRI chest with contrast (71551) | $1,808.35 | $2,782.08 | 2.4× |
| MRI chest wo w contrast (71552) | $2,291.25 | $3,525 | 6.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,054.58–$2,596.15 | $3,160.89–$3,994.07 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,657.50 | $2,550 | 7.2× |
| MRI lumbar spine w contrast (72149) | $2,025.65 | $3,116.39 | 6.0× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,583.75 | $3,975 | 7.7× |
| MRI orbit face &/neck w/o contrast (70540) | $2,045.84 | $3,147.44 | 8.9× |
| MRI orbit face neck w contrast (70542) | $2,133.96 | $3,283.02 | 6.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,460.25 | $3,785 | 7.3× |
| MRI pelvis w contrast (72196) | $1,571.54 | $2,417.76 | 4.7× |
| MRI pelvis w/o & w contrast (72197) | $2,388.75 | $3,675 | 7.1× |
| MRI pelvis w/o contrast (72195) | $1,722.50 | $2,650 | 7.5× |
| MRI thoracic spine w/o contrast (72146) | $2,033.73 | $3,128.81 | 8.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$2,097.63–$2,502.50 | $3,227.13–$3,850 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,894.46–$2,314.94 | $2,914.56–$3,561.44 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$2,216.50–$2,388.75 | $3,410–$3,675 | varies |
| MRI, abdomen, combo (74183) | $2,671.50 | $4,110 | 8.0× |
| MRI, dorsal spine combo (72157) | $2,450.16 | $3,769.47 | 7.3× |
| MRI, dorsal spine contrast (72147) | $2,025.65 | $3,116.39 | 6.0× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,774.05–$2,117.82 | $2,729.30–$3,258.18 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$2,340–$2,460.25 | $3,600–$3,785 | varies |
| MRI, lumbar spine combo (72158) | $2,730 | $4,200 | 8.1× |
| Myelogram cervical (72240) range across 2 matching MRF lines |
$529.75–$772.20 | $815–$1,188 | varies |
| Myelogram Lumbar (72265) | $529.75 | $815 | 0.7× |
| Myelography thoracic (72255) | $529.75 | $815 | 0.7× |
| Myelograpy 2/more regions rs&i (72270) | $863.20 | $1,328 | 1.1× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$1,881.75–$2,353.65 | $2,895–$3,621 | varies |
| Neck soft tissue (70360) | $200.20 | $308 | 2.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $6,046.95 | $9,303 | 4.5× |
| Nuclear Rx Oral Admin (79005) | $1,170 | $1,800 | 5.2× |
| Ob us nuchal meas 1 gest (76813) | $115.70 | $178 | 1.2× |
| Parathyroid Planar Imaging (78070) | $926.25 | $1,425 | 2.4× |
| Pelvis 1 or 2 views (72170) | $190.45 | $293 | 1.9× |
| Pet Image W/Ct Lmtd (78814) | $7,848.10 | $12,074 | 5.7× |
| PET image w/CT, full body (78816) | $4,439.50 | $6,830 | 3.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $4,143.75 | $6,375 | 3.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $773.50 | $1,190 | 2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $301.60 | $464 | 3.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $367.25 | $565 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$223.60–$303.23 | $344–$466.50 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$185.25–$222.30 | $285–$342 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$224.25–$277.88 | $345–$427.50 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $264.55 | $407 | 2.6× |
| Radex fingr minimum 2 views (73140) | $165.75 | $255 | 2.0× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$218.40–$275.93 | $336–$424.50 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$219.05–$266.18 | $337–$409.50 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$81.90–$122.85 | $126–$189 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $182 | $280 | 1.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $224.25 | $345 | 2.7× |
| Radex Ribs Unilateral 2 Views (71100) | $208.65 | $321 | 2.5× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$215.15–$286.65 | $331–$441 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $167.70 | $258 | 2.0× |
| Radex Spine 1 View Specify Level (72020) | $180.05 | $277 | 2.2× |
| Radex Sternum Minimum 2 Views (71120) | $229.45 | $353 | 2.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $238.55 | $367 | 2.9× |
| Radex Toe Minimum 2 Views (73660) | $165.10 | $254 | 2.0× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$81.90–$122.85 | $126–$189 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$217.75–$261.30 | $335–$402 | varies |
| Radiation treatment delivery level 1 (77402) | $1,430 | $2,200 | 14.6× |
| Radiation treatment delivery level 2 (77407) | $1,950 | $3,000 | 5.3× |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$780–$837.20 | $1,200–$1,288 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $269.75 | $415 | 2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $289.25 | $445 | 2.9× |
| Radiologic exam colon double contrast study (74280) | $591.50 | $910 | 3.5× |
| Radiologic exam colon single contrast study (74270) | $487.50 | $750 | 2.9× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$247.65–$371.48 | $381–$571.50 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $189.15 | $291 | 1.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $438.75 | $675 | 2.6× |
| Radiologic exam swallow function contrast study (74230) | $383.50 | $590 | 2.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $477.75 | $735 | 2.8× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$183.30–$274.95 | $282–$423 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$143.65–$260.65 | $221–$401 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$187.20–$240.83 | $288–$370.50 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $181.35 | $279 | 1.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$197.60–$261.30 | $304–$402 | varies |
| Ribs bilateral 3 views (71110) | $267.80 | $412 | 2.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,527.50 | $2,350 | 4.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $877.50 | $1,350 | 1.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,267.50–$1,998.75 | $1,950–$3,075 | varies |
| Rp Therapy Intravenous Administration (79101) | $256.75 | $395 | 1.1× |
| Scapula (73010) range across 2 matching MRF lines |
$200.85–$273.98 | $309–$421.50 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $213.85 | $329 | 9.1× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$163.80–$207.68 | $252–$319.50 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$568.75–$675.68 | $875–$1,039.50 | varies |
| Sialogram (70390) | $299 | $460 | 1.3× |
| Skull less than 4 views (70250) | $219.05 | $337 | 2.2× |
| Special dosimetry (77331) | $350.35 | $539 | 2.7× |
| Special Physics Consult (77370) | $431.60 | $664 | 3.3× |
| Special teletherapy port plan (77321) | $975 | $1,500 | 2.7× |
| Stereotactic Body Radiation Delivery (77373) | $7,962.50 | $12,250 | 4.6× |
| Sternoclavicular joints (71130) | $131.30 | $202 | 1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,878.50 | $2,890 | 5.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,137.50 | $1,750 | 3.2× |
| Testicular Imaging W/Flow (78761) | $780 | $1,200 | 2.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,917.50 | $2,950 | 5.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,613.30 | $2,482 | 4.5× |
| Ther rad simulaj-aided field setting simple (77280) | $1,385.15 | $2,131 | 10.7× |
| Thoracic spine 2 views (72070) | $231.40 | $356 | 2.3× |
| Thoracic spine 3 views (72072) | $257.40 | $396 | 2.6× |
| Thyroid Imaging With Vascular Flow (78013) | $487.50 | $750 | 1.3× |
| Thyroid Uptake Measurement (78012) | $269.10 | $414 | 0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $585 | $900 | 1.5× |
| Tx Devices Design & Construction Complex (77334) range across 5 matching MRF lines |
$82.55–$1,626.30 | $127–$2,502 | varies |
| Tx devices design & construction intermediate (77333) range across 4 matching MRF lines |
$633.75–$20,551.05 | $975–$31,617 | varies |
| Tx devices design & construction simple (77332) | $526.50 | $810 | 4.1× |
| Ultrasound Breast Limited (76642) | $341.25 | $525 | 4.1× |
| Ultrasound Exam Aaa Screen (76706) | $498.55 | $767 | 5.0× |
| Ultrasound, abdomen limited (76705) | $408.20 | $628 | 4.1× |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$177.45–$186.55 | $273–$287 | varies |
| Unlisted fluoroscopic procedure (76496) | $631.80 | $972 | 7.6× |
| Unlisted magnetic resonance procedure (76498) | $1,868.75 | $2,875 | 22.3× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$461.50–$563.55 | $710–$867 | varies |
| Urethrocystogram voiding (74455) | $395.85 | $609 | 1.7× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$457.60–$614.25 | $704–$945 | varies |
| Us chest (76604) | $347.10 | $534 | 3.5× |
| Us complete joint (76881) range across 2 matching MRF lines |
$257.40–$487.50 | $396–$750 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$146.25–$319.15 | $225–$491 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $353.60 | $544 | 3.5× |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$187.20–$196.30 | $288–$302 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$157.95–$471.90 | $243–$726 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$234.65–$454.35 | $361–$699 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$315.25–$529.75 | $485–$815 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$245.70–$397.15 | $378–$611 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 4 matching MRF lines |
$226.85–$412.75 | $349–$635 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$533–$575.90 | $820–$886 | varies |
| Us retroperitoneal limited (76775) | $385.45 | $593 | 3.8× |
| Us scrotum and contents (76870) | $427.70 | $658 | 4.3× |
| Us thyroid (76536) | $412.10 | $634 | 4.1× |
| Us transrectal (76872) | $501.80 | $772 | 5.0× |
| Vascular Flow Imaging (78445) | $1,170 | $1,800 | 3.0× |
| Venography extremity bilateral rs&i (75822) | $1,040 | $1,600 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $1,040 | $1,600 | 0.7× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$169–$202.80 | $260–$312 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $198.90 | $306 | 2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$190.45–$233.03 | $293–$358.50 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$299.65–$425.75 | $461–$655 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $185.90 | $286 | 2.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$239.20–$338.65 | $368–$521 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$97.50–$188.50 | $150–$290 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $202.15 | $311 | 2.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $325.65 | $501 | 3.2× |
| X-Ray Exam Hips Bi 2 Views (73521) | $260.65 | $401 | 2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $260.65 | $401 | 2.6× |
| X-Ray Exam L-S Spine Bending (72114) | $428.35 | $659 | 4.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $233.35 | $359 | 2.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $358.80 | $552 | 3.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $280.15 | $431 | 2.8× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$208.65–$271.05 | $321–$417 | varies |
| X-ray IV pyelogram (ivp) (74400) | $427.70 | $658 | 2.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $213.85 | $329 | 2.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $188.50 | $290 | 2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $242.45 | $373 | 2.4× |
| X-ray nose-rectum child f.b. (76010) | $178.75 | $275 | 2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $379.60 | $584 | 3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $156 | $240 | 1.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $122.20 | $188 | 1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $195.65 | $301 | 2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $249.60 | $384 | 3.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $282.10 | $434 | 2.8× |
| X-Ray Tmj Unilat (70328) | $88.40 | $136 | 1.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $453.70 | $698 | 1.4× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$154.70–$314.60 | $238–$484 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$520–$826.15 | $800–$1,271 | varies |
| Xr c-spine 4 or 5 views (72050) | $296.40 | $456 | 2.9× |
| Xr facial bones less than 3 views (70140) | $169.65 | $261 | 2.0× |
| XR Mastoids < 3 Views Bilateral (70120) | $159.90 | $246 | 1.6× |
| Xr orbits complete 4 views (70200) | $273 | $420 | 2.7× |
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.