Imaging prices at Slidell Memorial Hospital
Slidell, LA · every code in this section with a posted price and a Medicare benchmark.
347 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) | $476.77 | $2,979.80 | 0.4× |
| Abdomen 1 View (74018) | $44.96 | $281 | 0.6× |
| Abdomen 2 views (74019) | $58.72 | $367 | 0.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $275.68 | $1,723 | 0.8× |
| Angio internal mammary (75756) | $566.56 | $3,541 | 0.2× |
| Angio pulmonary bilat (75743) | $1,056.48 | $6,603 | 0.4× |
| Angiography extremity bilateral rs&i (75716) | $1,280 | $8,000 | 0.4× |
| Angiography extremity unilateral rs&i (75710) | $1,041.44 | $6,509 | 0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,056.80 | $6,605 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $374.72 | $2,342 | 0.1× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$47.36–$94.72 | $296–$592 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$956.32 | $5,977 | 0.2× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$682.72 | $4,267 | 0.1× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$921.60 | $5,760 | 0.2× |
| Arthrogram ankle (73615) | $94.08 | $588 | 0.3× |
| Arthrogram hip (73525) | $112.64 | $704 | 0.4× |
| Arthrogram Wrist (73115) | $94.08 | $588 | 0.3× |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$49.44–$49.51 | $309–$309.43 | varies |
| Bone age studies (77072) | $35.68 | $223 | 0.4× |
| Bone Imaging 3 Phase (78315) | $304 | $1,900 | 0.8× |
| Bone Imaging Limited Area (78300) | $251.04 | $1,569 | 0.7× |
| Bone Imaging Multiple Areas (78305) | $342.56 | $2,141 | 0.9× |
| Bone Imaging Whole Body (78306) | $301.28 | $1,883 | 0.8× |
| Bone marrow imaging limited area (78102) | $141.28 | $883 | 0.4× |
| Bone survey infant (77076) | $67.20 | $420 | 0.7× |
| Brachytx isodose complex (77318) | $128.73 | $804.55 | 0.4× |
| Brachytx isodose intermed (77317) | $128.73 | $804.55 | 0.4× |
| Brachytx Isodose Plan Simple (77316) | $128.73 | $804.55 | 0.4× |
| Brain Flow Imaging Only (78610) | $179.04 | $1,119 | 0.4× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $166.88 | $1,043 | 0.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $550.24 | $3,439 | 0.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $172.96 | $1,081 | 0.4× |
| Cerebrospinal Fluid Scan (78630) | $211.84 | $1,324 | 0.4× |
| Chest 1 view (71045) | $47.36 | $296 | 0.6× |
| Chest 2 views (71046) | $58.72 | $367 | 0.7× |
| Chest 3 views (71047) | $67.68 | $423 | 0.9× |
| Chest 4 or more views (71048) | $99.04 | $619 | 1.0× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $45.28 | $283 | 0.5× |
| Cisternography Positive Contrast Rs&I (70015) | $288 | $1,800 | 0.4× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$47.36–$69.44 | $296–$434 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $32.48 | $203 | 0.3× |
| Continuing medical physics consltj pr wk (77336) | $49.51 | $309.43 | 0.4× |
| Contrast Exam Abdominl Aorta (75625) | $1,041.44 | $6,509 | 0.4× |
| Contrast X-Ray Bladder (74430) | $58.88 | $368 | 0.2× |
| Contrast X-Ray Of Elbow (73085) | $94.08 | $588 | 0.3× |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$94.08–$188.16 | $588–$1,176 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $72.16 | $451 | 0.5× |
| CT abdomen and pelvis without and with contrast (74178) | $773.28 | $4,833 | 2.4× |
| CT abdomen and pelvis without contrast (74176) | $615.04 | $3,844 | 2.8× |
| CT abdomen w contrast (74160) | $355.04 | $2,219 | 2.2× |
| CT abdomen w wo contrast (74170) | $425.28 | $2,658 | 2.7× |
| CT abdomen w/o contrast (74150) | $306.08 | $1,913 | 3.2× |
| CT Angio Abdomen and Pelvis (74174) | $702.88 | $4,393 | 2.2× |
| CT Angio Chest (71275) | $476.16 | $2,976 | 3.0× |
| CT Angio Head (70496) | $476.16 | $2,976 | 3.0× |
| CT angio hrt w/3d image (75574) | $218.24 | $1,364 | 0.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $396.80 | $2,480 | 2.5× |
| CT Angio Neck (70498) | $453.76 | $2,836 | 2.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $396.80 | $2,480 | 2.5× |
| CT cervical spine w/ contrast (72126) | $362.08 | $2,263 | 1.1× |
| CT cervical spine w/o contrast (72125) | $314.40 | $1,965 | 3.3× |
| CT cervical spine w/wo cont (72127) | $367.68 | $2,298 | 2.3× |
| CT chest w contrast (71260) | $360.96 | $2,256 | 2.3× |
| CT chest w/wo contrast (71270) | $440.96 | $2,756 | 2.8× |
| CT head/brain with contrast (70460) | $352.32 | $2,202 | 2.2× |
| CT head/brain without and with contrast (70470) | $395.68 | $2,473 | 2.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $60 | $375 | 0.8× |
| CT hrt w/3d image congen (75573) | $115.84 | $724 | 0.4× |
| CT iac w contrast (70481) | $310.40 | $1,940 | 1.9× |
| CT l-spine w&w/o contrast (72133) | $367.68 | $2,298 | 2.3× |
| CT lower ext w/o (73700) | $254.56 | $1,591 | 2.7× |
| CT lower extremity w/contrast material (73701) | $288.96 | $1,806 | 1.8× |
| CT lumbar spine w contrast (72132) | $362.08 | $2,263 | 1.1× |
| CT lumbar spine w/o contrast (72131) | $315.20 | $1,970 | 3.3× |
| CT maxillofacial w contrast (70487) | $310.40 | $1,940 | 1.9× |
| CT maxillofacial wo contrast (70486) | $268.16 | $1,676 | 2.8× |
| CT neck tissue combo (70492) | $361.12 | $2,257 | 2.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $402.56 | $2,516 | 2.5× |
| CT orbits w/o contrast (70480) | $274.88 | $1,718 | 2.9× |
| CT pelvis w&w/o contrast (72194) | $413.60 | $2,585 | 2.6× |
| CT pelvis w/o contrast (72192) | $308.80 | $1,930 | 3.3× |
| CT scan of leg combo (73702) | $315.04 | $1,969 | 2.0× |
| CT scans face/jaw combo (70488) | $402.56 | $2,516 | 2.5× |
| CT soft tissue neck w contrast (70491) | $320.80 | $2,005 | 2.0× |
| CT soft tissue neck w/o contrast (70490) | $274.88 | $1,718 | 2.9× |
| CT thoracic spine w contrast (72129) | $362.08 | $2,263 | 2.3× |
| CT thoracic spine w/o contrast (72128) | $315.20 | $1,970 | 3.3× |
| CT thoracic spine w/wo cont (72130) | $367.68 | $2,298 | 2.3× |
| CT thorax w/o contrast (71250) | $317.60 | $1,985 | 3.3× |
| CT upper ext wo (73200) | $254.56 | $1,591 | 2.7× |
| CT upper extremity w/o & w/contrast material (73202) | $315.04 | $1,969 | 2.0× |
| CT upper extremity with contrast (73201) | $288.96 | $1,806 | 0.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $587.52 | $3,672 | 3.7× |
| Cta Abdomen (74175) | $476.16 | $2,976 | 3.0× |
| CTA pelvis (72191) | $396.80 | $2,480 | 2.5× |
| Dilation ureters/urethra rs&i (74485) | $394.72 | $2,467 | 0.2× |
| Diskography lumbar (72295) | $323.84 | $2,024 | 0.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $45.28 | $283 | 0.5× |
| Dxa Bone Density Axial (77080) | $76.80 | $480 | 0.8× |
| Dxa bone density study (77085) | $44.96 | $281 | 0.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $30.56 | $191 | 0.4× |
| Echo exam uterus (76831) | $161.76 | $1,011 | 0.7× |
| Echo Guide For Artery Repair (76936) | $162.56 | $1,016 | 0.8× |
| Esophagram (74220) | $69.60 | $435 | 0.4× |
| Fetal Biophys Profile W/Nst (76818) | $45.28 | $283 | 0.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $97.60 | $610 | 1.0× |
| Fluoroscopy up to 1 hr (76000) | $57.28 | $358 | 0.3× |
| Follow-Up Angiography (75898) | $164.16 | $1,026 | 0.1× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$47.36–$94.72 | $296–$592 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$47.36–$94.72 | $296–$592 | varies |
| Gastric emptying imaging study (78264) | $278.24 | $1,739 | 0.8× |
| Gastroesophageal Reflux Exam (78262) | $252.64 | $1,579 | 0.7× |
| Gated Heart Planar Single (78472) | $284 | $1,775 | 0.8× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$47.36–$94.72 | $296–$592 | varies |
| Hepatobil Syst Image W/Drug (78227) | $336 | $2,100 | 0.7× |
| Hepatobiliary System Imaging (78226) | $285.28 | $1,783 | 0.8× |
| Ht Muscle Image Spect Sing (78451) | $506.40 | $3,165 | 0.4× |
| Hysterosalpingogram (74740) | $88.16 | $551 | 0.4× |
| Image fusion (77399) | $49.51 | $309.43 | 0.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $82.56 | $516 | 1.0× |
| Infant hip ultrasound, limited static exam (76886) | $24.80 | $155 | 0.3× |
| Infusion Ivp (74410) | $156 | $975 | 1.0× |
| Joint Survey Single View (77077) | $67.20 | $420 | 0.7× |
| K Flow/Funct Image Multiple (78709) | $423.36 | $2,646 | 0.9× |
| K Flow/Funct Image W/Drug (78708) | $314.72 | $1,967 | 0.6× |
| K Flow/Funct Image W/O Drug (78707) | $282.72 | $1,767 | 0.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$47.36–$94.72 | $296–$592 | varies |
| Leveen/Shunt Patency Exam (78291) | $174.24 | $1,089 | 0.5× |
| Liver & Spleen Imaging Static Only (78215) | $182.72 | $1,142 | 0.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $228.64 | $1,429 | 0.6× |
| Lung perfusion differential (78597) | $196.48 | $1,228 | 0.5× |
| Lung Ventilat&Perfus Imaging (78582) | $307.52 | $1,922 | 0.6× |
| Lung Ventilation Imaging (78579) | $196.48 | $1,228 | 0.5× |
| Lymph System Imaging (78195) | $225.76 | $1,411 | 0.5× |
| Magnetic Image Jaw Joint (70336) | $799.04 | $4,994 | 3.7× |
| Meckels Divert Exam (78290) | $221.76 | $1,386 | 0.6× |
| Mlc imrt design & construction per imrt plan (77338) | $128.73 | $804.55 | 0.4× |
| Mra Head W/O & W/Contrast Material (70546) | $845.44 | $5,284 | 2.7× |
| MRA head w/o contrast (70544) | $488.64 | $3,054 | 2.3× |
| MRA head with contrast (70545) | $552.80 | $3,455 | 1.7× |
| MRA neck w contrast (70548) | $552.80 | $3,455 | 1.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $845.44 | $5,284 | 2.7× |
| MRA neck w/o contrast (70547) | $488.64 | $3,054 | 2.3× |
| MRI abdomen w contrast (74182) | $463.20 | $2,895 | 1.5× |
| MRI abdomen w/o contrast (74181) | $458.56 | $2,866 | 2.1× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$463.20–$926.40 | $2,895–$5,790 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $907.04 | $5,669 | 2.9× |
| MRI any jt upper extremity w/contrast matrl (73222) | $463.20 | $2,895 | 0.7× |
| MRI Breast W/O Contrast Bilateral (77047) | $668.64 | $4,179 | 3.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $334.24 | $2,089 | 1.5× |
| MRI cervical spine w contrast (72142) | $524.64 | $3,279 | 1.7× |
| MRI cervical spine w/o cont (72141) | $477.28 | $2,983 | 2.2× |
| MRI chest w/o contrast (71550) | $458.56 | $2,866 | 2.1× |
| MRI chest with contrast (71551) | $463.20 | $2,895 | 0.7× |
| MRI chest wo w contrast (71552) | $907.04 | $5,669 | 2.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $463.20 | $2,895 | 1.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $831.52 | $5,197 | 2.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$453.60–$907.20 | $2,835–$5,670 | varies |
| MRI lumbar spine w contrast (72149) | $524.64 | $3,279 | 1.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $907.04 | $5,669 | 2.9× |
| MRI orbit face &/neck w/o contrast (70540) | $399.36 | $2,496 | 1.8× |
| MRI orbit face neck w contrast (70542) | $463.20 | $2,895 | 1.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $907.04 | $5,669 | 2.9× |
| MRI pelvis w contrast (72196) | $463.20 | $2,895 | 1.5× |
| MRI pelvis w/o & w contrast (72197) | $786.24 | $4,914 | 2.5× |
| MRI pelvis w/o contrast (72195) | $415.04 | $2,594 | 1.9× |
| MRI thoracic spine w/o contrast (72146) | $477.28 | $2,983 | 2.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $463.20 | $2,895 | 1.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $453.60 | $2,835 | 2.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $907.04 | $5,669 | 2.9× |
| MRI, abdomen, combo (74183) | $907.04 | $5,669 | 2.9× |
| MRI, dorsal spine combo (72157) | $907.04 | $5,669 | 2.9× |
| MRI, dorsal spine contrast (72147) | $524.64 | $3,279 | 1.7× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$453.60–$907.20 | $2,835–$5,670 | varies |
| MRI, joint upper extrem combo (73223) | $907.04 | $5,669 | 2.9× |
| MRI, lumbar spine combo (72158) | $907.04 | $5,669 | 2.9× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $185.60 | $1,160 | 0.5× |
| Myocardial Spect Multiple Studies (78452) | $686.56 | $4,291 | 0.6× |
| Neck soft tissue (70360) | $32.32 | $202 | 0.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $161.92 | $1,012 | 0.4× |
| Nm csf leak detection (78650) | $273.28 | $1,708 | 0.2× |
| Nm myocard infarct spect (78469) | $273.28 | $1,708 | 0.6× |
| Ntsty modul radthx pln dose-vol histos (77301) | $476.77 | $2,979.80 | 0.4× |
| Nuclear Rx Oral Admin (79005) | $87.04 | $544 | 0.4× |
| Parathyroid Planar Imaging (78070) | $233.92 | $1,462 | 0.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $290.08 | $1,813 | 0.8× |
| Pelvis 1 or 2 views (72170) | $35.84 | $224 | 0.4× |
| PET image w/CT, full body (78816) | $766.24 | $4,789 | 0.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $736.80 | $4,605 | 0.6× |
| PET whole body (78813) | $736.80 | $4,605 | 0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $244.80 | $1,530 | 0.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $80.32 | $502 | 0.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $136.64 | $854 | 0.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$47.36–$94.72 | $296–$592 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$47.36–$94.72 | $296–$592 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$47.36–$94.72 | $296–$592 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $47.36 | $296 | 0.5× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$30.24–$60.48 | $189–$378 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$47.36–$94.72 | $296–$592 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$47.36–$94.72 | $296–$592 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$28.32–$56.64 | $177–$354 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $54.24 | $339 | 0.7× |
| Radex Ribs Unilateral 2 Views (71100) | $58.72 | $367 | 0.7× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$37.28–$74.56 | $233–$466 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $39.20 | $245 | 0.5× |
| Radex Spine 1 View Specify Level (72020) | $44.96 | $281 | 0.6× |
| Radex Sternum Minimum 2 Views (71120) | $40.32 | $252 | 0.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $40.32 | $252 | 0.5× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$30.24–$60.48 | $189–$378 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$32.64–$65.28 | $204–$408 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$47.36–$94.72 | $296–$592 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) unusually low: confirm this is the full procedure |
$3,057.70 | $19,110.60 | 0.5× |
| Radiation treatment delivery level 1 (77402) | $46.80 | $292.48 | 0.5× |
| Radiation treatment delivery level 2 (77407) | $89.78 | $561.15 | 0.3× |
| Radiation treatment delivery level 3 (77412) | $89.78 | $561.15 | 0.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $54.24 | $339 | 0.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $80.32 | $502 | 0.8× |
| Radiologic exam colon double contrast study (74280) | $125.28 | $783 | 0.8× |
| Radiologic exam colon single contrast study (74270) | $98.88 | $618 | 0.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $72.96 | $456 | 0.5× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$81.92–$94.72 | $512–$592 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $42.40 | $265 | 0.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $74.72 | $467 | 0.5× |
| Radiologic exam swallow function contrast study (74230) | $95.36 | $596 | 0.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $91.68 | $573 | 0.6× |
| Radiologic examination femur 1 view (73551) | $47.36 | $296 | 0.6× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$38.88–$77.76 | $243–$486 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$38.88–$69.76 | $243–$436 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $67.20 | $420 | 0.7× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$47.36–$94.72 | $296–$592 | varies |
| Ribs bilateral 3 views (71110) | $80.32 | $502 | 0.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $178.24 | $1,114 | 0.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $236.64 | $1,479 | 0.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $507.20 | $3,170 | 1.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $236.64 | $1,479 | 0.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $238.24 | $1,489 | 0.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $508.80 | $3,180 | 0.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $577.28 | $3,608 | 0.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $508.80 | $3,180 | 0.4× |
| Rp Therapy Intravenous Administration (79101) | $221.44 | $1,384 | 1.0× |
| Scapula (73010) | $47.36 | $296 | 0.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $40 | $250 | 1.7× |
| Sella turcica (70240) | $39.20 | $245 | 0.5× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$32.64–$65.28 | $204–$408 | varies |
| Shoulder Arthrography (73040) | $102.88 | $643 | 0.3× |
| Sialogram (70390) | $66.24 | $414 | 0.3× |
| Skull less than 4 views (70250) | $39.20 | $245 | 0.4× |
| Special dosimetry (77331) | $49.51 | $309.43 | 0.4× |
| Special Physics Consult (77370) | $49.51 | $309.43 | 0.4× |
| Special teletherapy port plan (77321) | $128.73 | $804.55 | 0.4× |
| Special treatment procedure (77470) | $207.94 | $1,299.63 | 0.4× |
| Stereotactic Body Radiation Delivery (77373) | $676.23 | $4,226.43 | 0.4× |
| Sternoclavicular joints (71130) | $35.84 | $224 | 0.5× |
| Tbs technical calculation only (77091) | $29.60 | $185 | 0.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $128.73 | $804.55 | 0.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $128.73 | $804.55 | 0.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $128.73 | $804.55 | 0.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $128.73 | $804.55 | 0.4× |
| Ther rad simulaj-aided field setting simple (77280) | $49.51 | $309.43 | 0.4× |
| Thoracic spine 2 views (72070) | $56 | $350 | 0.6× |
| Thoracic spine 3 views (72072) | $72.64 | $454 | 0.8× |
| Thoracolumbar 2 views (72080) | $56 | $350 | 0.7× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $203.68 | $1,273 | 0.6× |
| Thyroid Imaging With Vascular Flow (78013) | $230.24 | $1,439 | 0.6× |
| Thyroid Met Imaging Body (78018) | $288.64 | $1,804 | 0.6× |
| Thyroid Uptake Measurement (78012) | $178.24 | $1,114 | 0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $276.48 | $1,728 | 0.8× |
| Tx Devices Design & Construction Complex (77334) | $128.73 | $804.55 | 0.4× |
| Tx devices design & construction intermediate (77333) | $49.51 | $309.43 | 0.4× |
| Tx devices design & construction simple (77332) | $49.51 | $309.43 | 0.4× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$69.28–$138.56 | $433–$866 | varies |
| Ultrasound Exam Aaa Screen (76706) | $70.08 | $438 | 0.7× |
| Ultrasound, abdomen limited (76705) | $84.48 | $528 | 0.9× |
| Umbilical-artery Doppler (OB) (76820) | $56.48 | $353 | 0.6× |
| Unlisted Dx Radiographic Procedure (76499) | $24.80 | $155 | 0.3× |
| Unlisted us procedure (76999) | $83.36 | $521 | 1.1× |
| Upper gi w/o kub (74240) | $80.64 | $504 | 0.5× |
| Urethrocystogram voiding (74455) | $73.12 | $457 | 0.3× |
| Urethrocystography retrograde (74450) | $57.92 | $362 | 0.3× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$116.16–$232.32 | $726–$1,452 | varies |
| Us chest (76604) | $102.08 | $638 | 1.1× |
| Us complete joint (76881) | $84.48 | $528 | 0.9× |
| Us exam, pelvic, limited (76857) | $75.04 | $469 | 0.8× |
| Us head (76506) | $113.92 | $712 | 1.2× |
| Us kidney transplant (76776) | $122.56 | $766 | 1.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $70.24 | $439 | 0.7× |
| Us ob detailed single fetus (76811) | $220 | $1,375 | 1.0× |
| Us ob limited 1 or more fetuses (76815) | $89.76 | $561 | 0.9× |
| Us ob transvaginal (76817) | $91.68 | $573 | 1.0× |
| Us pelvic non ob complete (76856) | $117.92 | $737 | 1.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $169.92 | $1,062 | 1.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $74.72 | $467 | 0.8× |
| Us retroperitoneal complete (76770) | $135.68 | $848 | 1.4× |
| Us retroperitoneal limited (76775) | $108.80 | $680 | 1.1× |
| Us scrotum and contents (76870) | $89.60 | $560 | 0.9× |
| Us spinal canal and contents (76800) | $70.40 | $440 | 0.7× |
| Us thyroid (76536) | $83.36 | $521 | 0.9× |
| Us transrectal (76872) | $139.52 | $872 | 1.5× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$248–$468.80 | $1,550–$2,930 | varies |
| Venogram Sinus/Jugular (75860) | $1,056.64 | $6,604 | 0.4× |
| Venography caval inferior serialography rs&i (75825) | $517.76 | $3,236 | 0.2× |
| Venography extremity bilateral rs&i (75822) | $369.12 | $2,307 | 0.3× |
| Venography extremity unilateral rs&i (75820) | $369.12 | $2,307 | 0.3× |
| Venography Renal Bilateral (75833) | $524.48 | $3,278 | 0.2× |
| Venography Renal Unilateral (75831) | $1,310.88 | $8,193 | 0.5× |
| Venous sampling by catheter (75893) unusually low: confirm this is the full procedure |
$1,750.40 | $10,940 | 0.3× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$47.36–$94.72 | $296–$592 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $36.32 | $227 | 0.5× |
| X-ray antegrade pyelogram tube (74425) | $108 | $675 | 0.3× |
| X-Ray Aorta Leg Arteries (75630) | $576 | $3,600 | 0.2× |
| X-Ray Bend Only L-S Spine (72120) | $72.64 | $454 | 0.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$33.92–$67.84 | $212–$424 | varies |
| X-Ray Exam Breast Specimen (76098) | $108 | $675 | 0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $24.80 | $155 | 0.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $45.28 | $283 | 0.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $45.28 | $283 | 0.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $33.92 | $212 | 0.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $47.36 | $296 | 0.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $47.36 | $296 | 0.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $47.36 | $296 | 0.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $47.36 | $296 | 0.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $94.72 | $592 | 1.0× |
| X-Ray Exam L-S Spine Bending (72114) | $79.04 | $494 | 0.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $61.12 | $382 | 0.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $141.60 | $885 | 1.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $80.32 | $502 | 0.8× |
| X-ray eye for foreign body (70030) | $26.88 | $168 | 0.3× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$38.88–$77.76 | $243–$486 | varies |
| X-ray IV pyelogram (ivp) (74400) | $156 | $975 | 1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $54.24 | $339 | 0.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $32.64 | $204 | 0.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $72.64 | $454 | 0.8× |
| X-ray nose-rectum child f.b. (76010) | $29.44 | $184 | 0.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $102.08 | $638 | 1.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $72.64 | $454 | 0.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $47.36 | $296 | 0.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $51.52 | $322 | 0.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $54.24 | $339 | 0.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $54.24 | $339 | 0.6× |
| X-ray thoracic spine 4 vw (72074) | $61.12 | $382 | 0.6× |
| X-Ray Tmj Unilat (70328) | $24.80 | $155 | 0.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$134.56–$314.40 | $841–$1,965 | varies |
| X-Rays Bone Length Studies (77073) | $40.64 | $254 | 0.4× |
| X-Rays Bone Survey Complete (77075) | $144 | $900 | 1.5× |
| Xr c-spine 4 or 5 views (72050) | $101.28 | $633 | 1.1× |
| Xr facial bones less than 3 views (70140) | $32.16 | $201 | 0.4× |
| Xr orbits complete 4 views (70200) | $54.24 | $339 | 0.6× |
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.