Imaging prices at Sheridan Memorial Hospital
Sheridan, WY · every code in this section with a posted price and a Medicare benchmark.
323 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 |
$1,460.80–$3,486.40 | $1,826–$4,358 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$42.40–$163.20 | $53–$204 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$62.40–$170.40 | $78–$213 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$220.80–$859.20 | $276–$1,074 | varies |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$497.60–$3,703.20 | $622–$4,629 | varies |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$1,350.40–$4,157.60 | $1,688–$5,197 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$676–$3,703.20 | $845–$4,629 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$789.60–$2,887.20 | $987–$3,609 | varies |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$36.80–$200 | $46–$250 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$530.40–$6,134.40 | $663–$7,668 | varies |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$568–$6,134.40 | $710–$7,668 | varies |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$625.60–$6,134.40 | $782–$7,668 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$121.60–$540.80 | $152–$676 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$128–$901.60 | $160–$1,127 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$144–$901.60 | $180–$1,127 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$196–$199.20 | $245–$249 | varies |
| Bone age studies (77072) range across 3 matching MRF lines |
$20–$163.20 | $25–$204 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$227.20–$981.60 | $284–$1,227 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$140.80–$575.20 | $176–$719 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$190.40–$993.60 | $238–$1,242 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$158.40–$186.40 | $198–$233 | varies |
| Brain Imaging Minimum 4 Static Views (78605) range across 2 matching MRF lines |
$69.60–$481.60 | $87–$602 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$216–$3,070.40 | $270–$3,838 | varies |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) range across 2 matching MRF lines |
$163.20–$474.40 | $204–$593 | varies |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$222.40–$1,076.80 | $278–$1,346 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) range across 2 matching MRF lines |
$126.40–$705.60 | $158–$882 | varies |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$152.80–$1,094.40 | $191–$1,368 | varies |
| Chest 1 view (71045) range across 4 matching MRF lines |
$20–$157.60 | $25–$197 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$20–$170.40 | $25–$213 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$62.40–$186.40 | $78–$233 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$68.80–$186.40 | $86–$233 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$26.40–$392.80 | $33–$491 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$32–$163.20 | $40–$204 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$98.40–$384.80 | $123–$481 | varies |
| Continuing medical physics consltj pr wk (77336) | $425.60 | $532 | 3.1× |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$194.40–$3,703.20 | $243–$4,629 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$92–$682.40 | $115–$853 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$121.60–$600.80 | $152–$751 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$104.80–$901.60 | $131–$1,127 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$356.80–$2,352 | $446–$2,940 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$315.20–$1,932 | $394–$2,415 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$288.80–$1,289.60 | $361–$1,612 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$318.40–$1,487.20 | $398–$1,859 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$269.60–$1,144 | $337–$1,430 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$497.60–$2,904 | $622–$3,630 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$413.60–$1,554.40 | $517–$1,943 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$397.60–$1,439.20 | $497–$1,799 | varies |
| CT angio hrt w/3d image (75574) range across 3 matching MRF lines |
$433.60–$1,628.80 | $542–$2,036 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$429.60–$1,698.40 | $537–$2,123 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$397.60–$1,439.20 | $497–$1,799 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$405.60–$1,698.40 | $507–$2,123 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$275.20–$1,316 | $344–$1,645 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$242.40–$1,176 | $303–$1,470 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$287.20–$1,530.40 | $359–$1,913 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$282.40–$1,344 | $353–$1,680 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$313.60–$1,530.40 | $392–$1,913 | varies |
| CT colonography screening (74263) range across 2 matching MRF lines |
$262.40–$2,003.20 | $328–$2,504 | varies |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 2 matching MRF lines |
$204–$1,148.80 | $255–$1,436 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$255.20–$1,144 | $319–$1,430 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$288.80–$1,316 | $361–$1,645 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$336–$1,804.80 | $420–$2,256 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $97.60 | $122 | 1.1× |
| CT hrt w/3d image congen (75573) range across 2 matching MRF lines |
$570.40–$2,129.60 | $713–$2,662 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$313.60–$1,144 | $392–$1,430 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$287.20–$1,530.40 | $359–$1,913 | varies |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$228–$1,324 | $285–$1,655 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$264–$1,470.40 | $330–$1,838 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$275.20–$1,316 | $344–$1,645 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$228–$1,176 | $285–$1,470 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$255.20–$1,144 | $319–$1,430 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$193.60–$1,031.20 | $242–$1,289 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$328.80–$1,316 | $411–$1,645 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$326.40–$1,316 | $408–$1,645 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$289.60–$1,031.20 | $362–$1,289 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$275.20–$1,487.20 | $344–$1,859 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$248–$1,176 | $310–$1,470 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$275.20–$1,358.40 | $344–$1,698 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$287.20–$1,316 | $359–$1,645 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$314.40–$1,248.80 | $393–$1,561 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$289.60–$1,031.20 | $362–$1,289 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$275.20–$1,316 | $344–$1,645 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$228–$1,176 | $285–$1,470 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$287.20–$1,530.40 | $359–$1,913 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$232–$1,176 | $290–$1,470 | varies |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$228–$1,324 | $285–$1,655 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 4 matching MRF lines |
$275.20–$1,698.40 | $344–$2,123 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$264–$1,176 | $330–$1,470 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$540–$1,480.80 | $675–$1,851 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$409.60–$1,535.20 | $512–$1,919 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$409.60–$1,480.80 | $512–$1,851 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) range across 2 matching MRF lines |
$74.40–$386.40 | $93–$483 | varies |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$150.40–$692 | $188–$865 | varies |
| Discography Cerv/Thor Spine (72285) range across 2 matching MRF lines |
$225.60–$2,286.40 | $282–$2,858 | varies |
| Diskography lumbar (72295) range across 2 matching MRF lines |
$168–$2,286.40 | $210–$2,858 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 2 matching MRF lines |
$87.20–$135.20 | $109–$169 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 3 matching MRF lines |
$104.80–$294.40 | $131–$368 | varies |
| Doppler Fetal Mid Cerebral Artery (76821) range across 4 matching MRF lines |
$166.40–$451.20 | $208–$564 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$64–$360 | $80–$450 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $131.20 | $164 | 1.5× |
| Echo exam of fetal heart (76825) | $476.80 | $596 | 0.9× |
| Echo exam uterus (76831) range across 4 matching MRF lines |
$116.80–$440.80 | $146–$551 | varies |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$452–$550.40 | $565–$688 | varies |
| Esophagram (74220) | $268.80 | $336 | 1.5× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$254.40–$560 | $318–$700 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$181.60–$439.20 | $227–$549 | varies |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$38.40–$351.20 | $48–$439 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$473.60–$1,534.40 | $592–$1,918 | varies |
| Foot 2 views (73620) range across 5 matching MRF lines |
$20–$200 | $25–$250 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$33.60–$163.20 | $42–$204 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$176.80–$972 | $221–$1,215 | varies |
| Gastroesophageal Reflux Exam (78262) range across 2 matching MRF lines |
$149.60–$793.60 | $187–$992 | varies |
| Gated Heart Planar Single (78472) range across 3 matching MRF lines |
$134.40–$984.80 | $168–$1,231 | varies |
| Hand 2 views (73120) range across 4 matching MRF lines |
$36.80–$200 | $46–$250 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$253.60–$1,728 | $317–$2,160 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$202.40–$1,528.80 | $253–$1,911 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$165.60–$1,139.20 | $207–$1,424 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$302.40–$774.40 | $378–$968 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$180–$539.20 | $225–$674 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$96–$220 | $120–$275 | varies |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$308.80–$910.40 | $386–$1,138 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$268–$745.60 | $335–$932 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) range across 2 matching MRF lines |
$138.40–$630.40 | $173–$788 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$111.20–$575.20 | $139–$719 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) range across 2 matching MRF lines |
$111.20–$575.20 | $139–$719 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$240–$920 | $300–$1,150 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$267.20–$968 | $334–$1,210 | varies |
| Mammary ductogram or galactogram multiple (77054) range across 4 matching MRF lines |
$104–$676 | $130–$845 | varies |
| Mammary ductogram or galactogram single (77053) range across 4 matching MRF lines |
$82.40–$535.20 | $103–$669 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$152.80–$662.40 | $191–$828 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$529.60–$1,186.40 | $662–$1,483 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$408–$2,214.40 | $510–$2,768 | varies |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$97.60–$1,393.60 | $122–$1,742 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 3 matching MRF lines |
$97.60–$2,214.40 | $122–$2,768 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$393.60–$1,731.20 | $492–$2,164 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$330.40–$1,342.40 | $413–$1,678 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$368.80–$1,593.60 | $461–$1,992 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$97.60–$1,980 | $122–$2,475 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$368.80–$1,554.40 | $461–$1,943 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$404.80–$1,456.80 | $506–$1,821 | varies |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$97.60–$1,334.40 | $122–$1,668 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$97.60–$330.40 | $122–$413 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$513.60–$1,856.80 | $642–$2,321 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$97.60–$1,980 | $122–$2,475 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$306.40–$1,507.20 | $383–$1,884 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$407.20–$1,456.80 | $509–$1,821 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 3 matching MRF lines |
$97.60–$2,015.20 | $122–$2,519 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 3 matching MRF lines |
$97.60–$1,300 | $122–$1,625 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$97.60–$1,980 | $122–$2,475 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$393.60–$1,456.80 | $492–$1,821 | varies |
| MRI pelvis w/o & w contrast (72197) range across 3 matching MRF lines |
$97.60–$1,985.60 | $122–$2,482 | varies |
| MRI pelvis w/o contrast (72195) range across 3 matching MRF lines |
$97.60–$1,507.20 | $122–$1,884 | varies |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$97.60–$1,386.40 | $122–$1,733 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$97.60–$1,507.20 | $122–$1,884 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$487.20–$1,979.20 | $609–$2,474 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$513.60–$1,985.60 | $642–$2,482 | varies |
| MRI, dorsal spine combo (72157) range across 3 matching MRF lines |
$97.60–$2,015.20 | $122–$2,519 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$404.80–$1,293.60 | $506–$1,617 | varies |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$97.60–$1,455.20 | $122–$1,819 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$97.60–$1,980 | $122–$2,475 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$97.60–$2,015.20 | $122–$2,519 | varies |
| Myocardial Spect Multiple Studies (78452) range across 3 matching MRF lines |
$353.60–$2,020.80 | $80–$2,526 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$37.60–$149.60 | $47–$187 | varies |
| Nm myocard infarct spect (78469) range across 2 matching MRF lines |
$76–$1,512 | $95–$1,890 | varies |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$112.80–$284.80 | $141–$356 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$2,181.60–$4,158.40 | $2,727–$5,198 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$396–$620 | $495–$775 | varies |
| Ob us nuchal meas 1 gest (76813) range across 3 matching MRF lines |
$254.40–$332.80 | $318–$416 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$178.40–$1,119.20 | $223–$1,399 | varies |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$20–$163.20 | $25–$204 | varies |
| Perineogram (74775) range across 2 matching MRF lines |
$166.40–$612 | $208–$765 | varies |
| Peritoneogram Rs&I (74190) range across 2 matching MRF lines |
$185.60–$260 | $232–$325 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$398.40–$4,395.20 | $498–$5,494 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$396–$4,332.80 | $495–$5,416 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$165.60–$660.80 | $207–$826 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$70.40–$186.40 | $88–$233 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$124.80–$268 | $156–$335 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$20–$204.80 | $25–$256 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$36.80–$157.60 | $46–$197 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$26.40–$166.40 | $33–$208 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$57.60–$191.20 | $72–$239 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$28–$187.20 | $35–$234 | varies |
| Radex foot complete minimum 3 views (73630) range across 5 matching MRF lines |
$20–$204.80 | $25–$256 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$20–$250.40 | $25–$313 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$31.20–$162.40 | $39–$203 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$79.20–$174.40 | $99–$218 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$34.40–$163.20 | $43–$204 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) range across 2 matching MRF lines |
$51.20–$172 | $64–$215 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$20–$152 | $25–$190 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$43.20–$208 | $54–$260 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$40–$170.40 | $50–$213 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$157.60–$661.60 | $197–$827 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$20–$149.60 | $25–$187 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$47.20–$173.60 | $59–$217 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$71.20–$230.40 | $89–$288 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$20–$149.60 | $25–$187 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$31.20–$162.40 | $39–$203 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$20–$164 | $25–$205 | varies |
| Radiation treatment delivery level 1 (77402) | $577.60 | $722 | 5.5× |
| Radiation treatment delivery level 2 (77407) | $616.80 | $771 | 1.6× |
| Radiation treatment delivery level 3 (77412) | $778.40 | $973 | 1.4× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$56.80–$170.40 | $71–$213 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$224.80–$384.80 | $281–$481 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$157.60–$328 | $197–$410 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$91.20–$304 | $114–$380 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 5 matching MRF lines |
$20–$213.60 | $25–$267 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$49.60–$177.60 | $62–$222 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$106.40–$281.60 | $133–$352 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$120.80–$281.60 | $151–$352 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 5 matching MRF lines |
$20–$200 | $25–$250 | varies |
| Radiologic examination knee 1/2 views (73560) range across 5 matching MRF lines |
$20–$204 | $25–$255 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$104–$179.20 | $130–$224 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$34.40–$163.20 | $43–$204 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$77.60–$211.20 | $97–$264 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 3 matching MRF lines |
$88.80–$774.40 | $111–$968 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$183.20–$997.60 | $229–$1,247 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$234.40–$1,052 | $293–$1,315 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$188.80–$1,079.20 | $236–$1,349 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$234.40–$1,299.20 | $293–$1,624 | varies |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $936 | $1,170 | 3.9× |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$431.20–$620 | $539–$775 | varies |
| Salivary Gland Imaging Serial Images (78231) range across 2 matching MRF lines |
$118.40–$744 | $148–$930 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$34.40–$163.20 | $43–$204 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$96.80–$101.60 | $121–$127 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$36–$157.60 | $45–$197 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$128–$1,373.60 | $160–$1,717 | varies |
| Sialogram (70390) range across 4 matching MRF lines |
$86.40–$418.40 | $108–$523 | varies |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$20–$170.40 | $25–$213 | varies |
| Special dosimetry (77331) range across 2 matching MRF lines |
$252.80–$455.20 | $316–$569 | varies |
| Special Physics Consult (77370) | $810.40 | $1,013 | 5.9× |
| Special teletherapy port plan (77321) | $507.20 | $634 | 1.3× |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$1,317.60–$1,392 | $1,647–$1,740 | varies |
| Spleen Imaging (78185) range across 2 matching MRF lines |
$32–$653.60 | $40–$817 | varies |
| Sternoclavicular joints (71130) range across 4 matching MRF lines |
$47.20–$228.80 | $59–$286 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$440–$560 | $550–$700 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 2 matching MRF lines |
$184.80–$813.60 | $231–$1,017 | varies |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$163.20–$751.20 | $204–$939 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$777.60–$1,016.80 | $972–$1,271 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$532–$1,420 | $665–$1,775 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$340–$541.60 | $425–$677 | varies |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$20–$173.60 | $25–$217 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$20–$186.40 | $25–$233 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$49.60–$177.60 | $62–$222 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) range across 2 matching MRF lines |
$53.60–$668.80 | $67–$836 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$82.40–$589.60 | $103–$737 | varies |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$186.40–$1,145.60 | $233–$1,432 | varies |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$43.20–$521.60 | $54–$652 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$113.60–$963.20 | $142–$1,204 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$393.60–$682.40 | $492–$853 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$271.20–$787.20 | $339–$984 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$153.60–$628.80 | $192–$786 | varies |
| Ultrasound Breast Limited (76642) range across 5 matching MRF lines |
$130.40–$404.80 | $163–$506 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$126.40–$376.80 | $158–$471 | varies |
| Ultrasound, abdomen limited (76705) range across 5 matching MRF lines |
$124.80–$904.80 | $156–$1,131 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$244–$336 | $305–$420 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $80 | $100 | 0.9× |
| Unlisted fluoroscopic procedure (76496) | $178.40 | $223 | 2.0× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$205.60–$302.40 | $257–$378 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$74.40–$312.80 | $93–$391 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$74.40–$300.80 | $93–$376 | varies |
| Us bone density measurement (76977) | $255.20 | $319 | 2.4× |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$165.60–$422.40 | $207–$528 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$121.60–$346.40 | $152–$433 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$96–$332 | $120–$415 | varies |
| Us head (76506) range across 2 matching MRF lines |
$147.20–$331.20 | $184–$414 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$160.80–$393.60 | $201–$492 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$74.40–$224.80 | $93–$281 | varies |
| Us ob detailed single fetus (76811) range across 4 matching MRF lines |
$448–$765.60 | $560–$957 | varies |
| Us ob limited 1 or more fetuses (76815) range across 4 matching MRF lines |
$150.40–$378.40 | $188–$473 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$172.80–$434.40 | $216–$543 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$157.60–$443.20 | $197–$554 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 4 matching MRF lines |
$228–$456.80 | $285–$571 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$138.40–$424.80 | $173–$531 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$164.80–$452.80 | $206–$566 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$131.20–$336.80 | $164–$421 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$146.40–$391.20 | $183–$489 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$278.40–$391.20 | $348–$489 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$126.40–$546.40 | $158–$683 | varies |
| Us transrectal (76872) range across 3 matching MRF lines |
$144–$710.40 | $180–$888 | varies |
| Vein X-Ray Chest (75827) range across 3 matching MRF lines |
$204–$1,451.20 | $255–$1,814 | varies |
| Venogram Sinus/Jugular (75860) range across 2 matching MRF lines |
$204–$3,703.20 | $255–$4,629 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$211.20–$3,703.20 | $264–$4,629 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$284.80–$1,534.40 | $356–$1,918 | varies |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$228–$1,086.40 | $285–$1,358 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$268–$3,703.20 | $335–$4,629 | varies |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$36.80–$200 | $46–$250 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$60–$216.80 | $75–$271 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$95.20–$641.60 | $119–$802 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 3 matching MRF lines |
$271.20–$4,120 | $339–$5,150 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$50.40–$202.40 | $63–$253 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$20–$163.20 | $25–$204 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$36.80–$157.60 | $46–$197 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$52.80–$160 | $66–$200 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$65.60–$208 | $82–$260 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$43.20–$157.60 | $54–$197 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$20–$247.20 | $25–$309 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$64.80–$212.80 | $81–$266 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$77.60–$221.60 | $97–$277 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$89.60–$256 | $112–$320 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$74.40–$235.20 | $93–$294 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$20–$169.60 | $25–$212 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$82.40–$229.60 | $103–$287 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$20–$177.60 | $25–$222 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$20–$124.80 | $25–$156 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$37.60–$166.40 | $47–$208 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$112–$325.60 | $140–$407 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$42.40–$140.80 | $53–$176 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$49.60–$200 | $62–$250 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$20–$178.40 | $25–$223 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$42.40–$164 | $53–$205 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$20–$252.80 | $25–$316 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$43.20–$170.40 | $54–$213 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$34.40–$163.20 | $43–$204 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$40–$166.40 | $50–$208 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$56.80–$191.20 | $71–$239 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$80–$202.40 | $100–$253 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$42.40–$160 | $53–$200 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$105.60–$521.60 | $132–$652 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$60.80–$189.60 | $76–$237 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$120–$264 | $150–$330 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$20–$202.40 | $25–$253 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$46.40–$170.40 | $58–$213 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$42.40–$166.40 | $53–$208 | varies |
| Xr orbits complete 4 views (70200) range across 4 matching MRF lines |
$63.20–$212 | $79–$265 | varies |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.