Imaging prices at Sisters of Charity Hospital
Buffalo, NY · every code in this section with a posted price and a Medicare benchmark.
326 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $176 | $176 | 1.6× |
| Abdomen 2 views (74019) | $9 | $235 | 0.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $830 | $830 | 1.7× |
| Angio pulmonary bilat (75743) | $5,862 | $5,862 | 1.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $5,862 | $5,862 | 1.5× |
| Angiography extremity bilateral rs&i (75716) | $5,862 | $5,862 | 1.5× |
| Angiography extremity unilateral rs&i (75710) | $5,862 | $5,862 | 1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,862 | $5,862 | 1.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $5,862 | $5,862 | 1.5× |
| Ankle 2 views (73600) range across 12 matching MRF lines |
$174–$261 | $174–$261 | varies |
| Aortography thoracic serialography rs&i (75605) | $9,765 | $9,765 | 1.4× |
| Aortography thoracic w/o serialography rs&i (75600) | $5,862 | $5,862 | 1.5× |
| Artery X-Rays Abdomen (75726) | $9,765 | $9,765 | 1.4× |
| Artery X-Rays Pelvis (75736) | $9,765 | $9,765 | 1.4× |
| Artery X-Rays Spine (75705) | $9,765 | $9,765 | 1.4× |
| Arthrogram hip (73525) | $791 | $791 | 1.8× |
| Bone age studies (77072) | $232 | $232 | 1.8× |
| Bone Imaging 3 Phase (78315) | $48 | $833 | 0.1× |
| Bone Imaging Limited Area (78300) | $799 | $799 | 1.6× |
| Bone Imaging Whole Body (78306) | $818 | $818 | 1.6× |
| Bone marrow imaging limited area (78102) | $792 | $792 | 1.6× |
| Bone survey infant (77076) | $276 | $276 | 2.1× |
| Brain Flow Imaging Only (78610) | $1,002 | $1,002 | 1.5× |
| Brain Image W/Flow < 4 Views (78601) | $790 | $790 | 1.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,237 | $1,237 | 2.8× |
| Cat Scan Follow-Up Study (76380) | $45 | $409 | 0.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,016 | $1,016 | 1.5× |
| Cerebrospinal Fluid Scan (78630) | $1,027 | $1,027 | 1.5× |
| Chest 1 view (71045) | $175 | $175 | 1.6× |
| Chest 2 views (71046) range across 8 matching MRF lines |
$9–$179 | $179 | varies |
| Chest 3 views (71047) | $183 | $183 | 1.7× |
| Chest 4 or more views (71048) | $243 | $243 | 1.9× |
| Clavicle complete (73000) range across 24 matching MRF lines |
$175–$262.50 | $175–$262.50 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $253 | $253 | 1.9× |
| Contrast Exam Abdominl Aorta (75625) | $5,862 | $5,862 | 1.5× |
| Contrast X-Ray Bladder (74430) | $756 | $756 | 1.7× |
| Contrast X-Ray Of Knee Joint (73580) | $790 | $790 | 1.8× |
| CT abdomen and pelvis without and with contrast (74178) | $82.04 | $901 | 0.2× |
| CT abdomen and pelvis without contrast (74176) | $41.21 | $605 | 0.1× |
| CT abdomen w contrast (74160) | $102 | $802 | 0.5× |
| CT abdomen w wo contrast (74170) | $152.40 | $993 | 0.7× |
| CT abdomen w/o contrast (74150) | $84 | $663 | 0.6× |
| CT Angio Abdomen and Pelvis (74174) | $916 | $916 | 2.1× |
| CT Angio Chest (71275) | $84 | $1,030 | 0.4× |
| CT Angio Head (70496) | $844 | $844 | 3.9× |
| CT angio hrt w/3d image (75574) | $787 | $787 | 1.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $869 | $869 | 4.0× |
| CT Angio Neck (70498) | $844 | $844 | 3.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $869 | $869 | 4.0× |
| CT cervical spine w/ contrast (72126) | $102 | $834 | 0.2× |
| CT cervical spine w/o contrast (72125) | $84 | $692 | 0.6× |
| CT cervical spine w/wo cont (72127) | $1,036 | $1,036 | 4.7× |
| CT chest w contrast (71260) | $102 | $828 | 0.5× |
| CT chest w/wo contrast (71270) | $152.40 | $1,036 | 0.7× |
| CT head/brain with contrast (70460) | $87 | $663 | 0.4× |
| CT head/brain without and with contrast (70470) | $130.20 | $828 | 0.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $622 | $622 | 1.4× |
| CT heart no contrast quant eval coronry calcium (75571) | $210 | $210 | 1.9× |
| CT iac w contrast (70481) | $87 | $663 | 0.4× |
| CT l-spine w&w/o contrast (72133) | $1,036 | $1,036 | 4.7× |
| CT lower ext w/o (73700) range across 12 matching MRF lines |
$84–$1,306.50 | $580–$1,306.50 | varies |
| CT lower extremity w/contrast material (73701) range across 9 matching MRF lines |
$102–$1,038 | $692–$1,557 | varies |
| CT lumbar spine w contrast (72132) | $833 | $833 | 1.9× |
| CT lumbar spine w/o contrast (72131) | $692 | $692 | 5.3× |
| CT maxillofacial w contrast (70487) | $87 | $663 | 0.4× |
| CT maxillofacial wo contrast (70486) | $72 | $553 | 0.6× |
| CT neck tissue combo (70492) | $828 | $828 | 3.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $828 | $828 | 3.8× |
| CT orbits w/o contrast (70480) | $72 | $553 | 0.6× |
| CT pelvis w&w/o contrast (72194) | $152.40 | $993 | 0.7× |
| CT pelvis w/o contrast (72192) | $84 | $692 | 0.6× |
| CT scan of leg combo (73702) | $869 | $869 | 4.0× |
| CT scans face/jaw combo (70488) | $828 | $828 | 3.8× |
| CT soft tissue neck w contrast (70491) | $102 | $663 | 0.5× |
| CT soft tissue neck w/o contrast (70490) | $84 | $553 | 0.6× |
| CT thoracic spine w contrast (72129) | $102 | $828 | 0.5× |
| CT thoracic spine w/o contrast (72128) | $84 | $692 | 0.6× |
| CT thoracic spine w/wo cont (72130) | $152.40 | $1,036 | 0.7× |
| CT thorax w/o contrast (71250) | $84 | $692 | 0.6× |
| CT upper ext wo (73200) range across 6 matching MRF lines |
$84–$580 | $580 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $869 | $869 | 4.0× |
| CT upper extremity with contrast (73201) | $828 | $828 | 1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $989 | $989 | 4.5× |
| Cta Abdomen (74175) | $989 | $989 | 4.5× |
| CTA pelvis (72191) | $989 | $989 | 4.5× |
| Dilation ureters/urethra rs&i (74485) | $3,666 | $3,666 | 1.4× |
| Discography Cerv/Thor Spine (72285) | $3,596 | $3,596 | 1.5× |
| Diskography lumbar (72295) | $3,596 | $3,596 | 1.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $265 | $265 | 2.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $421 | $421 | 3.2× |
| Doppler Fetal Mid Cerebral Artery (76821) | $277 | $277 | 2.1× |
| Dxa Bone Density Axial (77080) | $60 | $233 | 0.5× |
| Dxa bone density study (77085) | $242 | $242 | 1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $178 | $178 | 1.6× |
| Echo exam of fetal heart (76825) | $1,101 | $1,101 | 1.6× |
| Echo exam uterus (76831) | $519 | $519 | 1.7× |
| Echo Guide For Artery Repair (76936) | $738 | $738 | 2.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $527 | $527 | 1.8× |
| Echograp Trans R Pros Study (76873) | $352 | $352 | 2.7× |
| Esophagram (74220) | $12 | $405 | 0.1× |
| Fetal Biophys Profile W/Nst (76818) | $308 | $308 | 2.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $283 | $283 | 2.2× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $775 | $775 | 2.6× |
| Fluoroscopy up to 1 hr (76000) | — | $482 | — |
| Follow-Up Angiography (75898) | $5,862 | $5,862 | 1.5× |
| Foot 2 views (73620) range across 24 matching MRF lines |
$174–$261 | $174–$261 | varies |
| Forearm 2 views (73090) range across 20 matching MRF lines |
$174–$261 | $174–$261 | varies |
| Gastric emptying imaging study (78264) | $24 | $813 | 0.0× |
| Gated Heart Planar Single (78472) | $829 | $829 | 1.7× |
| Hand 2 views (73120) range across 20 matching MRF lines |
$230–$345 | $230–$345 | varies |
| Heart first pass single,planar (78481) | $1,053 | $1,053 | 1.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $4,516 | $4,516 | 1.1× |
| Hepatobil Syst Image W/Drug (78227) | $85.21 | $1,045 | 0.1× |
| Hepatobiliary System Imaging (78226) | $809 | $809 | 1.6× |
| Ht Muscle Image Spect Sing (78451) | $2,702 | $2,702 | 1.7× |
| Hysterosalpingogram (74740) | $15 | $489 | 0.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $223 | $223 | 2.1× |
| Infant hip ultrasound, limited static exam (76886) | $235 | $235 | 2.2× |
| Infusion Ivp (74410) | $414 | $414 | 1.9× |
| Joint Survey Single View (77077) | $245 | $245 | 1.9× |
| K Flow/Funct Image Multiple (78709) | $1,086 | $1,086 | 1.6× |
| K Flow/Funct Image W/Drug (78708) | $1,070 | $1,070 | 1.6× |
| K Flow/Funct Image W/O Drug (78707) | $1,049 | $1,049 | 1.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $788 | $788 | 1.6× |
| Knee 3 Views (73562) range across 20 matching MRF lines |
$177–$265.50 | $177–$265.50 | varies |
| Liver & Spleen Imaging Static Only (78215) | $788 | $788 | 1.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $793 | $793 | 1.6× |
| Liver imaging w/vascular flow (78202) | $1,925 | $1,925 | 2.8× |
| Lung perfusion differential (78597) | $808 | $808 | 1.6× |
| Lung Ventilat&Perfus Imaging (78582) | $1,059 | $1,059 | 1.6× |
| Lung Ventilation Imaging (78579) | $788 | $788 | 1.6× |
| Lymph System Imaging (78195) | $1,069 | $1,069 | 1.6× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $5,862 | $5,862 | 1.5× |
| Mammary ductogram or galactogram multiple (77054) | $494 | $494 | 1.7× |
| Meckels Divert Exam (78290) | $804 | $804 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) | $300 | $2,579 | 0.7× |
| MRA head w/o contrast (70544) | $300 | $1,313 | 1.0× |
| MRA head with contrast (70545) | $300 | $1,313 | 0.7× |
| MRA neck w contrast (70548) | $1,313 | $1,313 | 3.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,579 | $2,579 | 5.9× |
| MRA neck w/o contrast (70547) | $1,313 | $1,313 | 4.4× |
| MRI abdomen w contrast (74182) | $300 | $1,559 | 0.7× |
| MRI abdomen w/o contrast (74181) | $300 | $1,301 | 1.0× |
| MRI any jt lower extrem w/contrast material (73722) | $1,556 | $1,556 | 1.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 6 matching MRF lines |
$2,879–$4,318 | $2,879–$4,318 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,556 | $1,556 | 1.6× |
| MRI Breast W/O Contrast Bilateral (77047) | $705 | $705 | 2.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $470 | $470 | 1.6× |
| MRI cardiac w/o contrast (75557) | $870 | $870 | 2.9× |
| MRI cervical spine w contrast (72142) | $300 | $1,573 | 0.7× |
| MRI cervical spine w/o cont (72141) | $300 | $1,313 | 1.0× |
| MRI chest w/o contrast (71550) | $1,301 | $1,301 | 4.4× |
| MRI chest wo w contrast (71552) | $2,865 | $2,865 | 6.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 12 matching MRF lines |
$2,879–$6,477 | $2,879–$6,477 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,296 | $1,296 | 4.4× |
| MRI lumbar spine w contrast (72149) | $300 | $1,573 | 0.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $300 | $2,916 | 0.7× |
| MRI orbit face &/neck w/o contrast (70540) | $1,296 | $1,296 | 4.4× |
| MRI orbit face neck w contrast (70542) | $1,555 | $1,555 | 3.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,879 | $2,879 | 6.6× |
| MRI pelvis w contrast (72196) | $300 | $1,559 | 0.7× |
| MRI pelvis w/o & w contrast (72197) | $300 | $2,885 | 0.7× |
| MRI pelvis w/o contrast (72195) | $300 | $1,301 | 1.0× |
| MRI spectroscopy (76390) | $1,313 | $1,313 | 12.1× |
| MRI thoracic spine w/o contrast (72146) | $300 | $1,457 | 1.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,555 | $1,555 | 3.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,296 | $1,296 | 4.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,879 | $2,879 | 6.6× |
| MRI, abdomen, combo (74183) | $300 | $2,885 | 0.7× |
| MRI, dorsal spine combo (72157) | $300 | $2,916 | 0.7× |
| MRI, dorsal spine contrast (72147) | $300 | $1,573 | 0.7× |
| MRI, joint upper extrem (73221) | $1,296 | $1,296 | 4.4× |
| MRI, joint upper extrem combo (73223) | $2,879 | $2,879 | 6.6× |
| MRI, lumbar spine combo (72158) | $300 | $2,916 | 0.7× |
| Myocardial Spect Multiple Studies (78452) | $143.24 | $2,724 | 0.1× |
| Neck soft tissue (70360) | $176 | $176 | 1.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $772 | $772 | 1.5× |
| Nuclear Rx Oral Admin (79005) | $646 | $646 | 2.2× |
| Ob us nuchal meas 1 gest (76813) | $320 | $320 | 2.5× |
| Parathyroid Planar Imaging (78070) | $814 | $814 | 1.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $847 | $847 | 1.7× |
| Pelvis 1 or 2 views (72170) | $231 | $231 | 1.8× |
| Peritoneogram Rs&I (74190) | $625 | $625 | 0.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $5,988 | $5,988 | 1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $809 | $809 | 1.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $243 | $243 | 1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,001 | $1,001 | 1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 20 matching MRF lines |
$7.50–$262.50 | $175–$262.50 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $174 | $174 | 1.6× |
| Radex elbow complete minimum 3 views (73080) range across 16 matching MRF lines |
$175–$262.50 | $175–$262.50 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $238 | $238 | 1.8× |
| Radex fingr minimum 2 views (73140) | $172 | $172 | 1.6× |
| Radex foot complete minimum 3 views (73630) range across 24 matching MRF lines |
$7.50–$262.50 | $175–$262.50 | varies |
| Radex Hand Minimum 3 Views (73130) range across 24 matching MRF lines |
$7.50–$262.50 | $175–$262.50 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 9 matching MRF lines |
$174–$261 | $174–$261 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $245 | $245 | 1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $175 | $175 | 1.6× |
| Radex Ribs Unilateral 2 Views (71100) | $179 | $179 | 1.6× |
| Radex shoulder complete minimum 2 views (73030) range across 28 matching MRF lines |
$9–$264 | $176–$264 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $175 | $175 | 1.6× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $454 | $454 | 2.1× |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$6–$174 | $174 | varies |
| Radex Sternum Minimum 2 Views (71120) | $177 | $177 | 1.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $181 | $181 | 1.7× |
| Radex Toe Minimum 2 Views (73660) range across 16 matching MRF lines |
$172–$258 | $172–$258 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $230 | $230 | 1.8× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 20 matching MRF lines |
$175–$262.50 | $175–$262.50 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $407 | $407 | 3.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $237 | $237 | 1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $12 | $239 | 0.1× |
| Radiologic exam colon double contrast study (74280) | $462 | $462 | 2.1× |
| Radiologic exam colon single contrast study (74270) | $442 | $442 | 2.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $413 | $413 | 1.9× |
| Radiologic exam knee complete 4/more views (73564) range across 20 matching MRF lines |
$12–$352.50 | $235–$352.50 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $238 | $238 | 1.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $18 | $423 | 0.1× |
| Radiologic exam swallow function contrast study (74230) | $12 | $399 | 0.1× |
| Radiologic exam upr gi trc double contrast study (74246) | $430 | $430 | 2.0× |
| Radiologic examination femur 1 view (73551) | $175 | $175 | 1.6× |
| Radiologic examination femur minimum 2 views (73552) range across 20 matching MRF lines |
$176–$264 | $176–$264 | varies |
| Radiologic examination knee 1/2 views (73560) range across 24 matching MRF lines |
$175–$262.50 | $175–$262.50 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $201 | $201 | 1.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 24 matching MRF lines |
$174–$261 | $174–$261 | varies |
| Ribs bilateral 3 views (71110) | $241 | $241 | 1.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $801 | $801 | 1.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $808 | $808 | 1.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,676 | $2,676 | 3.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,676 | $2,676 | 3.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,676 | $2,676 | 3.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,736 | $2,736 | 1.7× |
| Scapula (73010) | $232 | $232 | 1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $96 | $96 | 4.1× |
| Shoulder 1 view (73020) range across 16 matching MRF lines |
$174–$261 | $174–$261 | varies |
| Shoulder Arthrography (73040) | $776 | $776 | 1.8× |
| Skull less than 4 views (70250) | $232 | $232 | 1.8× |
| Sternoclavicular joints (71130) | $179 | $179 | 1.6× |
| Superior sagittal sinus venogram (75870) | $5,862 | $5,862 | 1.5× |
| Testicular Imaging W/Flow (78761) | $807 | $807 | 1.6× |
| Thoracic spine 2 views (72070) range across 6 matching MRF lines |
$9–$233 | $233 | varies |
| Thoracic spine 3 views (72072) | $235 | $235 | 1.8× |
| Thoracolumbar 2 views (72080) | $179 | $179 | 1.6× |
| Thyroid Imaging With Vascular Flow (78013) | $778 | $778 | 1.6× |
| Thyroid Met Imaging Body (78018) | $1,040 | $1,040 | 1.5× |
| Thyroid Uptake Measurement (78012) | $772 | $772 | 1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $49.67 | $788 | 0.1× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$16–$218 | $218 | varies |
| Ultrasound Exam Aaa Screen (76706) | $263 | $263 | 2.0× |
| Ultrasound, abdomen limited (76705) | $266 | $266 | 2.0× |
| Umbilical-artery Doppler (OB) (76820) | $260 | $260 | 2.0× |
| Unlisted Dx Radiographic Procedure (76499) | $166 | $166 | 1.5× |
| Upper gi w/o kub (74240) | $423 | $423 | 1.9× |
| Urethrocystogram voiding (74455) | $484 | $484 | 1.6× |
| Urethrocystography retrograde (74450) | $484 | $484 | 1.6× |
| Us breast unilateral complete (76641) range across 9 matching MRF lines |
$19.48–$417 | $278–$417 | varies |
| Us chest (76604) | $265 | $265 | 2.0× |
| Us complete joint (76881) | $270 | $270 | 2.1× |
| Us exam, pelvic, limited (76857) | $259 | $259 | 2.0× |
| Us head (76506) | $271 | $271 | 2.1× |
| Us kidney transplant (76776) | $281 | $281 | 2.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $5.92 | $257 | 0.0× |
| Us ob detailed single fetus (76811) | $799 | $799 | 2.7× |
| Us ob limited 1 or more fetuses (76815) | $272 | $272 | 2.1× |
| Us ob transvaginal (76817) | $36 | $319 | 0.3× |
| Us pelvic non ob complete (76856) | $33 | $275 | 0.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $33 | $309 | 0.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $290 | $290 | 2.2× |
| Us retroperitoneal complete (76770) | $36 | $279 | 0.3× |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$36–$265 | $265 | varies |
| Us scrotum and contents (76870) | $18 | $270 | 0.1× |
| Us spinal canal and contents (76800) | $319 | $319 | 2.4× |
| Us thyroid (76536) | $18 | $264 | 0.1× |
| Us transrectal (76872) | $275 | $275 | 2.1× |
| Vascular Flow Imaging (78445) | $790 | $790 | 1.6× |
| Vein X-Ray Chest (75827) | $2,880 | $2,880 | 1.5× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $5,862 | $5,862 | 1.5× |
| Vein X-Ray Spleen/Liver (75810) | $3,176 | $3,176 | 0.8× |
| Venogram Sinus/Jugular (75860) | $5,862 | $5,862 | 1.5× |
| Venography Adrenal Unilateral (75840) | $5,862 | $5,862 | 1.5× |
| Venography caval inferior serialography rs&i (75825) | $5,862 | $5,862 | 1.5× |
| Venography extremity bilateral rs&i (75822) | $2,908 | $2,908 | 1.5× |
| Venography extremity unilateral rs&i (75820) | $2,879 | $2,879 | 1.5× |
| Venography Renal Bilateral (75833) | $5,862 | $5,862 | 1.5× |
| Venography Renal Unilateral (75831) | $5,862 | $5,862 | 1.5× |
| Venous sampling by catheter (75893) | $9,765 | $9,765 | 1.4× |
| Vertebral fracture assessment via dxa (77086) | $175 | $175 | 1.6× |
| Wrist 2 views (73100) range across 20 matching MRF lines |
$6–$262.50 | $175–$262.50 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $177 | $177 | 1.6× |
| X-ray antegrade pyelogram tube (74425) | $773 | $773 | 1.8× |
| X-Ray Aorta Leg Arteries (75630) | $5,862 | $5,862 | 1.5× |
| X-Ray Bend Only L-S Spine (72120) | $235 | $235 | 1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 16 matching MRF lines |
$175–$262.50 | $175–$262.50 | varies |
| X-Ray Exam Breast Specimen (76098) | $989 | $989 | 1.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $183 | $183 | 1.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $243 | $243 | 1.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $403 | $403 | 3.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $176 | $176 | 1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 12 matching MRF lines |
$7.48–$180 | $180 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) | $240 | $240 | 1.8× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 6 matching MRF lines |
$7.22–$235 | $235 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $242 | $242 | 1.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $400 | $400 | 3.1× |
| X-Ray Exam L-S Spine Bending (72114) | $242 | $242 | 1.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 6 matching MRF lines |
$9–$180 | $180 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $242 | $242 | 1.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $239 | $239 | 1.8× |
| X-ray eye for foreign body (70030) range across 9 matching MRF lines |
$175–$262.50 | $175–$262.50 | varies |
| X-ray humerus (73060) range across 20 matching MRF lines |
$174–$261 | $174–$261 | varies |
| X-ray IV pyelogram (ivp) (74400) | $414 | $414 | 1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $176 | $176 | 1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $175 | $175 | 1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 6 matching MRF lines |
$9–$235 | $235 | varies |
| X-ray nose-rectum child f.b. (76010) | $175 | $175 | 1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $243 | $243 | 1.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $235 | $235 | 1.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $230 | $230 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $175 | $175 | 1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $12 | $179 | 0.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $240 | $240 | 1.8× |
| X-ray thoracic spine 4 vw (72074) | $237 | $237 | 1.8× |
| X-Ray Tmj Unilat (70328) | $176 | $176 | 1.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $774 | $774 | 1.8× |
| X-Rays Bone Length Studies (77073) | $240 | $240 | 1.8× |
| X-Rays Bone Survey Complete (77075) | $263 | $263 | 2.0× |
| Xr c-spine 4 or 5 views (72050) | $12 | $239 | 0.1× |
| Xr facial bones less than 3 views (70140) | $177 | $177 | 1.6× |
| Xr orbits complete 4 views (70200) | $240 | $240 | 1.8× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.