Imaging prices at South Coast Global Medical Center
Santa Ana, CA · every code in this section with a posted price and a Medicare benchmark.
389 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) | $6,699 | $6,699 | 3.8× |
| Abdomen 1 View (74018) | $484 | $484 | 4.3× |
| Abdomen 2 views (74019) | $652 | $652 | 4.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,820 | $1,820 | 3.5× |
| Angio internal mammary (75756) | $17,145 | $17,145 | 4.2× |
| Angio pulmonary bilat (75743) | $17,145 | $17,145 | 4.2× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$17,145–$25,718 | $17,145–$25,718 | varies |
| Angiography extremity unilateral rs&i (75710) | $17,145 | $17,145 | 4.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $17,145 | $17,145 | 4.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $17,145 | $17,145 | 4.2× |
| Ankle 2 views (73600) | $484 | $484 | 4.3× |
| Aortography thoracic serialography rs&i (75605) | $28,561 | $28,561 | 4.0× |
| Aortography thoracic w/o serialography rs&i (75600) | $17,145 | $17,145 | 4.2× |
| Artery X-Rays Abdomen (75726) | $28,561 | $28,561 | 4.0× |
| Artery X-Rays Pelvis (75736) | $28,561 | $28,561 | 4.0× |
| Artery X-Rays Spine (75705) | $28,561 | $28,561 | 4.0× |
| Arthrogram ankle (73615) | $2,206 | $2,206 | 4.9× |
| Arthrogram hip (73525) | $2,206 | $2,206 | 4.9× |
| Arthrogram Wrist (73115) | $2,206 | $2,206 | 4.9× |
| Basic radiation dosimetry calculation (77300) | $673 | $673 | 3.9× |
| Bone age studies (77072) | $652 | $652 | 4.8× |
| Bone Imaging 3 Phase (78315) | $1,838 | $1,838 | 3.6× |
| Bone Imaging Limited Area (78300) | $1,135 | $1,135 | 2.2× |
| Bone Imaging Multiple Areas (78305) | $1,583 | $1,583 | 3.1× |
| Bone Imaging Whole Body (78306) | $1,977 | $1,977 | 3.8× |
| Bone marrow imaging limited area (78102) | $1,308 | $1,308 | 2.5× |
| Bone survey infant (77076) | $652 | $652 | 4.8× |
| Brain Flow Imaging Only (78610) | $564 | $564 | 0.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,232 | $2,232 | 3.2× |
| Brain Imaging Minimum 4 Static Views (78605) | $1,881 | $1,881 | 2.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $2,944 | $2,944 | 5.7× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $3,093 | $3,093 | 4.4× |
| Cat Scan Follow-Up Study (76380) | $1,688 | $1,688 | 15.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,094 | $2,094 | 3.0× |
| Cerebrospinal Fluid Scan (78630) | $2,372 | $2,372 | 3.4× |
| Chest 1 view (71045) | $598 | $598 | 5.3× |
| Chest 2 views (71046) | $484 | $484 | 4.3× |
| Chest 3 views (71047) | $484 | $484 | 4.3× |
| Chest 4 or more views (71048) | $652 | $652 | 4.8× |
| Cholecystography Oral Contrast (74290) | $1,070 | $1,070 | 4.7× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $652 | $652 | 4.8× |
| Cisternography Positive Contrast Rs&I (70015) | $4,285 | $4,285 | 4.2× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$484–$727 | $484–$727 | varies |
| Continuing medical physics consltj pr wk (77336) | $673 | $673 | 3.9× |
| Contrast Exam Abdominl Aorta (75625) | $17,145 | $17,145 | 4.2× |
| Contrast X-Ray Bladder (74430) | $2,206 | $2,206 | 4.9× |
| Contrast X-Ray Of Elbow (73085) | $2,206 | $2,206 | 4.9× |
| Contrast X-Ray Of Knee Joint (73580) | $2,206 | $2,206 | 4.9× |
| Contrast Xray Throat/Cerv Esopha (74210) | $1,070 | $1,070 | 4.7× |
| CT abdomen and pelvis without and with contrast (74178) | $7,682 | $7,682 | 17.1× |
| CT abdomen and pelvis without contrast (74176) | $5,653 | $5,653 | 18.4× |
| CT abdomen w contrast (74160) | $3,727 | $3,727 | 16.5× |
| CT abdomen w wo contrast (74170) | $3,727 | $3,727 | 16.5× |
| CT abdomen w/o contrast (74150) | $2,271 | $2,271 | 16.9× |
| CT Angio Abdomen and Pelvis (74174) | $7,682 | $7,682 | 17.1× |
| CT Angio Chest (71275) | $3,727 | $3,727 | 16.5× |
| CT Angio Head (70496) | $3,727 | $3,727 | 16.5× |
| CT angio hrt w/3d image (75574) | $3,727 | $3,727 | 8.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$3,727–$5,590 | $3,727–$5,590 | varies |
| CT Angio Neck (70498) | $3,727 | $3,727 | 16.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $3,727 | $3,727 | 16.5× |
| CT bone density (77078) | $3,095 | $3,095 | 27.7× |
| CT cervical spine w/ contrast (72126) | $7,682 | $7,682 | 17.1× |
| CT cervical spine w/o contrast (72125) | $2,785 | $2,785 | 20.7× |
| CT cervical spine w/wo cont (72127) | $3,727 | $3,727 | 16.5× |
| CT chest w contrast (71260) | $4,558 | $4,558 | 20.2× |
| CT chest w/wo contrast (71270) | $3,727 | $3,727 | 16.5× |
| CT head/brain with contrast (70460) | $3,727 | $3,727 | 16.5× |
| CT head/brain without and with contrast (70470) | $3,727 | $3,727 | 16.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $1,688 | $1,688 | 15.1× |
| CT iac w contrast (70481) | $3,727 | $3,727 | 16.5× |
| CT l-spine w&w/o contrast (72133) | $3,727 | $3,727 | 16.5× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$2,271–$3,407 | $2,271–$3,407 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$3,727–$5,590 | $3,727–$5,590 | varies |
| CT lumbar spine w contrast (72132) | $7,682 | $7,682 | 17.1× |
| CT lumbar spine w/o contrast (72131) | $2,785 | $2,785 | 20.7× |
| CT maxillofacial w contrast (70487) | $3,727 | $3,727 | 16.5× |
| CT maxillofacial wo contrast (70486) | $2,271 | $2,271 | 16.9× |
| CT neck tissue combo (70492) | $3,727 | $3,727 | 16.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,727 | $3,727 | 16.5× |
| CT orbits w/o contrast (70480) | $2,271 | $2,271 | 16.9× |
| CT pelvis w&w/o contrast (72194) | $3,727 | $3,727 | 16.5× |
| CT pelvis w/o contrast (72192) | $2,271 | $2,271 | 16.9× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$3,727–$5,590 | $3,727–$5,590 | varies |
| CT scans face/jaw combo (70488) | $3,727 | $3,727 | 16.5× |
| CT soft tissue neck w contrast (70491) | $3,727 | $3,727 | 16.5× |
| CT soft tissue neck w/o contrast (70490) | $2,271 | $2,271 | 16.9× |
| CT thoracic spine w contrast (72129) | $3,727 | $3,727 | 16.5× |
| CT thoracic spine w/o contrast (72128) | $2,785 | $2,785 | 20.7× |
| CT thoracic spine w/wo cont (72130) | $3,727 | $3,727 | 16.5× |
| CT thorax w/o contrast (71250) | $2,785 | $2,785 | 20.7× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$2,271–$3,407 | $2,271–$3,407 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$3,727–$5,590 | $3,727–$5,590 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$7,682–$11,524 | $7,682–$11,524 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,727 | $3,727 | 16.5× |
| Cta Abdomen (74175) | $3,727 | $3,727 | 16.5× |
| CTA pelvis (72191) | $3,727 | $3,727 | 16.5× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $1,378 | $1,378 | 4.5× |
| Dilation ureters/urethra rs&i (74485) | $10,724 | $10,724 | 4.0× |
| Discography Cerv/Thor Spine (72285) | $10,517 | $10,517 | 4.2× |
| Diskography lumbar (72295) | $10,517 | $10,517 | 4.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $583 | $583 | 4.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $988 | $988 | 7.3× |
| Dxa Bone Density Axial (77080) | $652 | $652 | 4.8× |
| Dxa bone density study (77085) | $652 | $652 | 4.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $484 | $484 | 4.3× |
| Echo exam of fetal heart (76825) | $1,398 | $1,398 | 2.0× |
| Echo exam uterus (76831) | $1,296 | $1,296 | 4.2× |
| Echo Guide For Artery Repair (76936) | $1,032 | $1,032 | 3.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,022 | $1,022 | 3.3× |
| Esophagram (74220) | $1,070 | $1,070 | 4.7× |
| Fetal Biophys Profile W/Nst (76818) | $1,345 | $1,345 | 10.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,345 | $1,345 | 10.0× |
| Fluoroscopy up to 1 hr (76000) | $1,378 | $1,378 | 4.5× |
| Follow-Up Angiography (75898) | $17,145 | $17,145 | 4.2× |
| Foot 2 views (73620) | $484 | $484 | 4.3× |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$484–$727 | $484–$727 | varies |
| Gastric emptying imaging study (78264) | $4,359 | $4,359 | 8.5× |
| Gastric Mucosa Imaging (78261) | $1,516 | $1,516 | 2.9× |
| Gastroesophageal Reflux Exam (78262) | $1,516 | $1,516 | 2.9× |
| Gastrointestinal Protein Loss (78282) | $728 | $728 | 1.4× |
| Gated Heart Planar Single (78472) | $2,352 | $2,352 | 4.6× |
| Gated Heart, Multiple (78473) | $3,517 | $3,517 | 6.8× |
| Hand 2 views (73120) | $652 | $652 | 4.8× |
| Heart first pass single,planar (78481) | $2,254 | $2,254 | 3.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $17,145 | $17,145 | 4.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $17,145 | $17,145 | 4.2× |
| Hepatobil Syst Image W/Drug (78227) | $5,728 | $5,728 | 8.2× |
| Hepatobiliary System Imaging (78226) | $4,179 | $4,179 | 8.1× |
| Ht Musc Image Planar Mult (78454) | $2,360 | $2,360 | 1.4× |
| Ht Muscle Image Spect Sing (78451) | $2,831 | $2,831 | 1.7× |
| Hysterosalpingogram (74740) | $1,378 | $1,378 | 4.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,305 | $1,305 | 11.7× |
| Infant hip ultrasound, limited static exam (76886) | $1,163 | $1,163 | 10.4× |
| Infusion Ivp (74410) | $1,070 | $1,070 | 4.7× |
| Joint Survey Single View (77077) | $652 | $652 | 4.8× |
| K Flow/Funct Image Multiple (78709) | $2,561 | $2,561 | 3.7× |
| K Flow/Funct Image W/Drug (78708) | $2,182 | $2,182 | 3.1× |
| K Flow/Funct Image W/O Drug (78707) | $2,706 | $2,706 | 3.9× |
| Kidney Imaging Morphol (78700) | $1,092 | $1,092 | 2.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,680 | $1,680 | 3.3× |
| Knee 3 Views (73562) | $484 | $484 | 4.3× |
| Liver & Spleen Imaging Static Only (78215) | $1,213 | $1,213 | 2.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,596 | $1,596 | 3.1× |
| Liver imaging static only (78201) | $1,092 | $1,092 | 1.6× |
| Liver imaging w/vascular flow (78202) | $1,685 | $1,685 | 2.4× |
| Lung Perf&Ventilat Diferentl (78598) | $3,839 | $3,839 | 5.5× |
| Lung perfusion differential (78597) | $2,490 | $2,490 | 4.8× |
| Lung Ventilat&Perfus Imaging (78582) | $4,079 | $4,079 | 5.8× |
| Lung Ventilation Imaging (78579) | $2,215 | $2,215 | 4.3× |
| Lymph System Imaging (78195) | $2,658 | $2,658 | 3.8× |
| Lymphangiography extremity only unilateral rs&i (75801) | $3,237 | $3,237 | 4.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $17,145 | $17,145 | 4.2× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $17,145 | $17,145 | 4.2× |
| Magnetic Image Jaw Joint (70336) range across 3 matching MRF lines |
$4,690–$7,034 | $4,690–$7,034 | varies |
| Mammary ductogram or galactogram multiple (77054) | $1,378 | $1,378 | 4.5× |
| Mammary ductogram or galactogram single (77053) | $1,378 | $1,378 | 4.5× |
| Meckels Divert Exam (78290) | $1,516 | $1,516 | 2.9× |
| Mlc imrt design & construction per imrt plan (77338) | $1,796 | $1,796 | 3.7× |
| Mra Head W/O & W/Contrast Material (70546) | $7,505 | $7,505 | 16.7× |
| MRA head w/o contrast (70544) | $4,690 | $4,690 | 15.3× |
| MRA head with contrast (70545) | $7,505 | $7,505 | 16.7× |
| MRA neck w contrast (70548) | $7,505 | $7,505 | 16.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $7,505 | $7,505 | 16.7× |
| MRA neck w/o contrast (70547) | $4,690 | $4,690 | 15.3× |
| MRI abdomen w contrast (74182) | $7,505 | $7,505 | 16.7× |
| MRI abdomen w/o contrast (74181) | $4,690 | $4,690 | 15.3× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$14,581–$21,872 | $14,581–$21,872 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$7,505–$11,258 | $7,505–$11,258 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$14,581–$21,872 | $14,581–$21,872 | varies |
| MRI cervical spine w contrast (72142) | $7,505 | $7,505 | 16.7× |
| MRI cervical spine w/o cont (72141) | $5,253 | $5,253 | 17.1× |
| MRI chest w/o contrast (71550) | $4,690 | $4,690 | 15.3× |
| MRI chest with contrast (71551) | $14,581 | $14,581 | 14.5× |
| MRI chest wo w contrast (71552) | $7,505 | $7,505 | 16.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$7,505–$11,258 | $7,505–$11,258 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$7,505–$11,258 | $7,505–$11,258 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$4,690–$7,034 | $4,690–$7,034 | varies |
| MRI lumbar spine w contrast (72149) | $7,505 | $7,505 | 16.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $7,505 | $7,505 | 16.7× |
| MRI orbit face &/neck w/o contrast (70540) | $4,690 | $4,690 | 15.3× |
| MRI orbit face neck w contrast (70542) | $7,505 | $7,505 | 16.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $7,505 | $7,505 | 16.7× |
| MRI pelvis w contrast (72196) | $7,505 | $7,505 | 16.7× |
| MRI pelvis w/o & w contrast (72197) | $7,505 | $7,505 | 16.7× |
| MRI pelvis w/o contrast (72195) | $4,690 | $4,690 | 15.3× |
| MRI thoracic spine w/o contrast (72146) | $4,690 | $4,690 | 15.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$7,505–$11,258 | $7,505–$11,258 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$4,690–$7,034 | $4,690–$7,034 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$7,505–$11,258 | $7,505–$11,258 | varies |
| MRI, abdomen, combo (74183) | $7,505 | $7,505 | 16.7× |
| MRI, dorsal spine combo (72157) | $7,505 | $7,505 | 16.7× |
| MRI, dorsal spine contrast (72147) | $7,505 | $7,505 | 16.7× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$4,690–$7,034 | $4,690–$7,034 | varies |
| MRI, joint upper extrem combo (73223) range across 5 matching MRF lines |
$1,804–$16,887 | $1,804–$16,887 | varies |
| MRI, lumbar spine combo (72158) | $7,505 | $7,505 | 16.7× |
| Myelogram cervical (72240) | $4,285 | $4,285 | 4.2× |
| Myelogram Lumbar (72265) | $4,285 | $4,285 | 4.2× |
| Myelography thoracic (72255) | $4,285 | $4,285 | 4.2× |
| Myelograpy 2/more regions rs&i (72270) | $4,285 | $4,285 | 4.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,227 | $1,227 | 2.4× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $1,626 | $1,626 | 2.3× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,476 | $2,476 | 1.5× |
| Myocardial Spect Multiple Studies (78452) | $6,414 | $6,414 | 3.9× |
| Neck soft tissue (70360) | $484 | $484 | 4.3× |
| Nm csf leak detection (78650) | $2,075 | $2,075 | 1.2× |
| Nm myocard infarct spect (78469) | $1,626 | $1,626 | 2.3× |
| Ntsty modul radthx pln dose-vol histos (77301) | $6,699 | $6,699 | 3.8× |
| Nuclear Rx Oral Admin (79005) | $1,670 | $1,670 | 5.6× |
| Ob us nuchal meas 1 gest (76813) | $1,868 | $1,868 | 13.9× |
| Optic foramina (70190) | $484 | $484 | 4.3× |
| Panoramic X-ray of jaws (70355) | $484 | $484 | 4.3× |
| Parathyroid Planar Imaging (78070) | $1,348 | $1,348 | 2.6× |
| Pelvis 1 or 2 views (72170) | $652 | $652 | 4.8× |
| Peritoneogram Rs&I (74190) | $2,894 | $2,894 | 4.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,577 | $1,577 | 3.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $652 | $652 | 4.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,894 | $2,894 | 4.1× |
| Radex Ankle Complete Minimum 3 Views (73610) | $484 | $484 | 4.3× |
| Radex Calcaneus Minimum 2 Views (73650) | $484 | $484 | 4.3× |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$484–$727 | $484–$727 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $652 | $652 | 4.8× |
| Radex fingr minimum 2 views (73140) | $484 | $484 | 4.3× |
| Radex foot complete minimum 3 views (73630) | $484 | $484 | 4.3× |
| Radex Hand Minimum 3 Views (73130) | $484 | $484 | 4.3× |
| Radex lower extremity infant minimum 2 views (73592) | $484 | $484 | 4.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $652 | $652 | 4.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $484 | $484 | 4.3× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $484 | $484 | 4.3× |
| Radex Ribs Unilateral 2 Views (71100) | $484 | $484 | 4.3× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$484–$727 | $484–$727 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $484 | $484 | 4.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,070 | $1,070 | 4.7× |
| Radex Spine 1 View Specify Level (72020) | $484 | $484 | 4.3× |
| Radex Sternum Minimum 2 Views (71120) | $484 | $484 | 4.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $484 | $484 | 4.3× |
| Radex Toe Minimum 2 Views (73660) | $484 | $484 | 4.3× |
| Radex upper extremity infant minimum 2 views (73092) | $652 | $652 | 4.8× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$484–$727 | $484–$727 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $652 | $652 | 4.8× |
| Radiation treatment delivery level 1 (77402) | $635 | $635 | 4.8× |
| Radiation treatment delivery level 2 (77407) | $1,282 | $1,282 | 2.6× |
| Radiation treatment delivery level 3 (77412) | $1,282 | $1,282 | 1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) | $652 | $652 | 4.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $652 | $652 | 4.8× |
| Radiologic exam colon double contrast study (74280) | $1,070 | $1,070 | 4.7× |
| Radiologic exam colon single contrast study (74270) | $1,070 | $1,070 | 4.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,070 | $1,070 | 4.7× |
| Radiologic exam knee complete 4/more views (73564) | $652 | $652 | 4.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $652 | $652 | 4.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,070 | $1,070 | 4.7× |
| Radiologic exam swallow function contrast study (74230) | $1,070 | $1,070 | 4.7× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $1,378 | $1,378 | 4.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,070 | $1,070 | 4.7× |
| Radiologic examination femur 1 view (73551) | $484 | $484 | 4.3× |
| Radiologic examination femur minimum 2 views (73552) | $484 | $484 | 4.3× |
| Radiologic examination knee 1/2 views (73560) | $484 | $484 | 4.3× |
| Radiologic Examination Osseous Survey Limited (77074) | $652 | $652 | 4.8× |
| Radiologic Examination Salivary Gland Calculus (70380) | $484 | $484 | 4.3× |
| Radiologic examination tibia & fibula 2 views (73590) | $484 | $484 | 4.3× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $2,894 | $2,894 | 4.1× |
| Renal Cyst Study (74470) | $2,894 | $2,894 | 4.1× |
| Ribs bilateral 3 views (71110) | $652 | $652 | 4.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,250 | $1,250 | 2.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,856 | $1,856 | 3.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,660 | $2,660 | 3.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,172 | $2,172 | 3.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,172 | $2,172 | 3.1× |
| Salivary Gland Imaging (78230) | $850 | $850 | 1.7× |
| Salivary Gland Imaging Serial Images (78231) | $984 | $984 | 1.9× |
| Scapula (73010) | $652 | $652 | 4.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $810 | $810 | 34.6× |
| Sella turcica (70240) | $484 | $484 | 4.3× |
| Shoulder 1 view (73020) | $484 | $484 | 4.3× |
| Shoulder Arthrography (73040) | $2,206 | $2,206 | 4.9× |
| Sialogram (70390) | $1,378 | $1,378 | 4.5× |
| Skull less than 4 views (70250) | $652 | $652 | 4.8× |
| Special dosimetry (77331) | $673 | $673 | 3.9× |
| Special Physics Consult (77370) | $673 | $673 | 3.9× |
| Special teletherapy port plan (77321) | $1,796 | $1,796 | 3.7× |
| Special treatment procedure (77470) | $2,878 | $2,878 | 4.0× |
| Spleen Imaging (78185) | $1,213 | $1,213 | 2.4× |
| Sternoclavicular joints (71130) | $484 | $484 | 4.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,796 | $1,796 | 3.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,796 | $1,796 | 3.7× |
| Testicular Imaging W/Flow (78761) | $1,213 | $1,213 | 2.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,796 | $1,796 | 3.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,796 | $1,796 | 3.7× |
| Ther rad simulaj-aided field setting simple (77280) | $673 | $673 | 3.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,070 | $1,070 | 4.7× |
| Thoracic spine 2 views (72070) | $652 | $652 | 4.8× |
| Thoracic spine 3 views (72072) | $652 | $652 | 4.8× |
| Thoracolumbar 2 views (72080) | $484 | $484 | 4.3× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,135 | $1,135 | 2.2× |
| Thyroid Imaging With Vascular Flow (78013) | $2,533 | $2,533 | 4.9× |
| Thyroid Met Imaging Body (78018) | $1,820 | $1,820 | 2.6× |
| Thyroid Uptake Measurement (78012) | $2,533 | $2,533 | 4.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $3,086 | $3,086 | 6.0× |
| Tx Devices Design & Construction Complex (77334) | $1,796 | $1,796 | 3.7× |
| Tx devices design & construction intermediate (77333) | $673 | $673 | 3.9× |
| Tx devices design & construction simple (77332) | $673 | $673 | 3.9× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$1,355–$2,032 | $1,355–$2,032 | varies |
| Ultrasound Exam Aaa Screen (76706) | $1,466 | $1,466 | 10.9× |
| Ultrasound, abdomen limited (76705) | $1,546 | $1,546 | 11.5× |
| Umbilical-artery Doppler (OB) (76820) | $664 | $664 | 4.9× |
| Unlisted Dx Radiographic Procedure (76499) | $484 | $484 | 4.3× |
| Unlisted magnetic resonance procedure (76498) | $1,649 | $1,649 | 14.7× |
| Upper gi w/o kub (74240) | $1,070 | $1,070 | 4.7× |
| Ureteral Reflux Study (78740) | $946 | $946 | 1.8× |
| Urethrocystogram voiding (74455) | $1,378 | $1,378 | 4.5× |
| Urethrocystography retrograde (74450) | $1,378 | $1,378 | 4.5× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$1,665–$2,497 | $1,665–$2,497 | varies |
| Us chest (76604) | $1,040 | $1,040 | 7.7× |
| Us complete joint (76881) | $1,032 | $1,032 | 7.7× |
| Us exam, pelvic, limited (76857) | $723 | $723 | 5.4× |
| Us head (76506) | $1,068 | $1,068 | 7.9× |
| Us kidney transplant (76776) | $1,894 | $1,894 | 14.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $450 | $450 | 3.3× |
| Us ob detailed single fetus (76811) | $2,728 | $2,728 | 8.9× |
| Us ob limited 1 or more fetuses (76815) | $1,080 | $1,080 | 8.0× |
| Us ob transvaginal (76817) | $1,410 | $1,410 | 10.5× |
| Us pelvic non ob complete (76856) | $1,161 | $1,161 | 8.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,345 | $1,345 | 10.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $889 | $889 | 6.6× |
| Us retroperitoneal complete (76770) | $1,385 | $1,385 | 10.3× |
| Us retroperitoneal limited (76775) | $881 | $881 | 6.6× |
| Us scrotum and contents (76870) | $1,026 | $1,026 | 7.6× |
| Us spinal canal and contents (76800) | $1,389 | $1,389 | 10.3× |
| Us thyroid (76536) | $1,025 | $1,025 | 7.6× |
| Us transrectal (76872) | $1,161 | $1,161 | 8.6× |
| Vascular Flow Imaging (78445) | $1,694 | $1,694 | 3.3× |
| Vasogram (74440) | $1,378 | $1,378 | 4.5× |
| Vein X-Ray Chest (75827) | $8,422 | $8,422 | 4.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $17,145 | $17,145 | 4.2× |
| Vein X-Ray Skull Epidural (75872) | $3,237 | $3,237 | 4.0× |
| Vein X-Ray Spleen/Liver (75810) | $17,145 | $17,145 | 4.2× |
| Venogram Sinus/Jugular (75860) | $17,145 | $17,145 | 4.2× |
| Venography Adrenal Unilateral (75840) | $17,145 | $17,145 | 4.2× |
| Venography caval inferior serialography rs&i (75825) | $17,145 | $17,145 | 4.2× |
| Venography extremity bilateral rs&i (75822) | $8,422 | $8,422 | 4.2× |
| Venography extremity unilateral rs&i (75820) | $8,422 | $8,422 | 4.2× |
| Venography Renal Bilateral (75833) | $17,145 | $17,145 | 4.2× |
| Venography Renal Unilateral (75831) | $17,145 | $17,145 | 4.2× |
| Venous sampling by catheter (75893) | $28,561 | $28,561 | 4.0× |
| Vertebral fracture assessment via dxa (77086) | $484 | $484 | 4.3× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$484–$727 | $484–$727 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $484 | $484 | 4.3× |
| X-ray antegrade pyelogram tube (74425) | $2,206 | $2,206 | 4.9× |
| X-Ray Aorta Leg Arteries (75630) | $17,145 | $17,145 | 4.2× |
| X-Ray Bend Only L-S Spine (72120) | $652 | $652 | 4.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $484 | $484 | 4.3× |
| X-Ray Exam Breast Specimen (76098) | $2,894 | $2,894 | 4.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $484 | $484 | 4.3× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $652 | $652 | 4.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $652 | $652 | 4.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $484 | $484 | 4.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $484 | $484 | 4.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $652 | $652 | 4.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $652 | $652 | 4.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $652 | $652 | 4.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $652 | $652 | 4.8× |
| X-Ray Exam L-S Spine Bending (72114) | $652 | $652 | 4.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $484 | $484 | 4.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $652 | $652 | 4.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $652 | $652 | 4.8× |
| X-ray eye for foreign body (70030) | $484 | $484 | 4.3× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$484–$727 | $484–$727 | varies |
| X-ray IV pyelogram (ivp) (74400) | $1,070 | $1,070 | 4.7× |
| X-ray IV pyelogram+tomography (74415) | $1,070 | $1,070 | 4.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $484 | $484 | 4.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $484 | $484 | 4.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $652 | $652 | 4.8× |
| X-ray nose-rectum child f.b. (76010) | $484 | $484 | 4.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $652 | $652 | 4.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $652 | $652 | 4.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $652 | $652 | 4.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $484 | $484 | 4.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $484 | $484 | 4.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $652 | $652 | 4.8× |
| X-ray thoracic spine 4 vw (72074) | $652 | $652 | 4.8× |
| X-Ray Tmj Unilat (70328) | $484 | $484 | 4.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,206 | $2,206 | 4.9× |
| X-Rays Bone Length Studies (77073) | $652 | $652 | 4.8× |
| X-Rays Bone Survey Complete (77075) | $652 | $652 | 4.8× |
| Xr c-spine 4 or 5 views (72050) | $652 | $652 | 4.8× |
| Xr facial bones less than 3 views (70140) | $484 | $484 | 4.3× |
| XR Mastoids < 3 Views Bilateral (70120) | $652 | $652 | 4.8× |
| Xr orbits complete 4 views (70200) | $652 | $652 | 4.8× |
| Xr Tomogram Single Plane (76100) | $652 | $652 | 4.8× |
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.