Imaging prices at Southwestern Medical Center
Lawton, OK · every code in this section with a posted price and a Medicare benchmark.
335 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) | $2,765.21 | $6,913.02 | 2.1× |
| Abdomen 1 View (74018) | $206.64 | $516.59 | 2.5× |
| Abdomen 2 views (74019) | $228.54 | $571.35 | 2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,892.10 | $4,730.26 | 4.9× |
| Adrenal Cortex & Medulla Img (78075) range across 2 matching MRF lines |
$2,489.36–$2,862.76 | $6,223.39–$7,156.91 | varies |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$1,181.10–$1,648.33 | $2,952.76–$4,120.82 | varies |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$2,070.47–$5,190.18 | $5,176.17–$12,975.44 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $946.80 | $2,367 | 0.3× |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$384.12–$5,190.18 | $960.31–$12,975.44 | varies |
| Angiography extremity unilateral rs&i (75710) range across 4 matching MRF lines |
$1,742.06–$5,190.18 | $4,355.15–$12,975.44 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 4 matching MRF lines |
$1,855.20–$5,190.18 | $4,638.01–$12,975.44 | varies |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $946.80 | $2,367 | 0.3× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$164.48–$328.96 | $411.21–$822.41 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$946.80–$2,618.98 | $2,367–$6,547.45 | varies |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$1,291.86–$2,473.04 | $3,229.66–$6,182.61 | varies |
| Artery X-Rays Adrenal Gland (75731) range across 2 matching MRF lines |
$752.46–$865.33 | $1,881.14–$2,163.32 | varies |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$1,286.54 | $3,216.35 | 0.2× |
| Artery X-Rays Spine (75705) likely a partial charge, not the full procedure |
$993.13 | $2,482.82 | 0.2× |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$419.47–$838.94 | $1,048.68–$2,097.36 | varies |
| Arthrogram hip (73525) range across 4 matching MRF lines |
$1,118.27–$2,570.33 | $2,795.67–$6,425.83 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$419.89–$838.94 | $1,049.72–$2,097.36 | varies |
| Basic radiation dosimetry calculation (77300) | $320.70 | $801.75 | 2.5× |
| Bone age studies (77072) range across 2 matching MRF lines |
$250.86–$295.12 | $627.14–$737.81 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,134.24–$2,873.38 | $2,835.61–$7,183.46 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$945.20–$2,446.76 | $2,363–$6,116.91 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$945.20–$2,897.98 | $2,363–$7,244.96 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$292.18–$343.74 | $730.46–$859.36 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,337.74 | $5,844.34 | 4.5× |
| Brain Imaging Minimum 4 Static Views (78605) | $2,154.90 | $5,387.26 | 4.1× |
| Cat Scan Follow-Up Study (76380) | $655.45 | $1,638.63 | 7.8× |
| Cerebrospinal Fluid Scan (78630) | $2,045.87 | $5,114.67 | 3.9× |
| Chest 1 view (71045) | $281.80 | $704.51 | 3.4× |
| Chest 2 views (71046) range across 3 matching MRF lines |
$333.80–$449.54 | $834.51–$1,123.86 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$334.36–$399.78 | $835.91–$999.45 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$391.39–$523.91 | $978.48–$1,309.77 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$311.61–$366.60 | $779.03–$916.49 | varies |
| Clavicle complete (73000) range across 3 matching MRF lines |
$238.46–$476.09 | $596.15–$1,190.23 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$62.51–$62.82 | $156.28–$157.04 | varies |
| Continuing medical physics consltj pr wk (77336) | $362.44 | $906.10 | 2.8× |
| Contrast Exam Abdominl Aorta (75625) range across 4 matching MRF lines |
$384.12–$5,190.18 | $960.31–$12,975.44 | varies |
| Contrast X-Ray Bladder (74430) range across 3 matching MRF lines |
$340.95–$417.65 | $852.38–$1,044.12 | varies |
| Contrast X-Ray Of Elbow (73085) range across 4 matching MRF lines |
$469.67–$1,078 | $1,174.18–$2,695.01 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$497.58–$995.16 | $1,243.96–$2,487.90 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$2,585.43–$3,041.68 | $6,463.57–$7,604.21 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$2,049–$2,410.60 | $5,122.51–$6,026.49 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$360.14–$2,493.73 | $900.34–$6,234.33 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$580.55–$2,493.73 | $1,451.37–$6,234.33 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$220.41–$2,493.73 | $551.03–$6,234.33 | varies |
| CT Angio Abdomen and Pelvis (74174) | $3,477.80 | $8,694.51 | 10.4× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,116.25–$1,391.02 | $2,790.62–$3,477.56 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,116.25–$1,391.02 | $2,790.62–$3,477.56 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$2,546.59–$5,090.69 | $6,366.47–$12,726.72 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,116.25–$1,391.02 | $2,790.62–$3,477.56 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$1,345.20–$2,850.75 | $3,363–$7,126.88 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$739.96–$1,520.84 | $1,849.89–$3,802.10 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$220.41–$1,520.84 | $551.03–$3,802.10 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$960.37–$3,041.68 | $2,400.92–$7,604.21 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,215.43–$1,429.92 | $3,038.57–$3,574.80 | varies |
| CT chest w/wo contrast (71270) | $1,468.77 | $3,671.93 | 8.7× |
| CT colonography screening (74263) range across 2 matching MRF lines |
$960.86–$1,198 | $2,402.14–$2,995.01 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$334.56–$1,258.29 | $836.39–$3,145.73 | varies |
| CT head/brain without and with contrast (70470) | $537.25 | $1,343.13 | 3.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $269.87 | $674.67 | 3.2× |
| CT iac w contrast (70481) | $360.14 | $900.34 | 2.1× |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$2,585.43–$3,041.68 | $6,463.57–$7,604.21 | varies |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$220.41–$440.82 | $551.03–$1,102.06 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$360.14–$1,658.44 | $900.34–$4,146.09 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,467.94–$1,726.99 | $3,669.86–$4,317.47 | varies |
| CT lumbar spine w/o contrast (72131) | $1,292.72 | $3,231.80 | 12.9× |
| CT maxillofacial w contrast (70487) | $360.14 | $900.34 | 2.1× |
| CT maxillofacial wo contrast (70486) | $220.41 | $551.03 | 2.2× |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,292.72–$1,520.84 | $3,231.80–$3,802.10 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$580.55–$1,520.84 | $1,451.37–$3,802.10 | varies |
| CT orbits w/o contrast (70480) | $220.41 | $551.03 | 2.2× |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,292.72–$1,520.84 | $3,231.80–$3,802.10 | varies |
| CT pelvis w/o contrast (72192) | $1,024.51 | $2,561.27 | 10.2× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$580.55–$1,161.10 | $1,451.37–$2,902.75 | varies |
| CT scans face/jaw combo (70488) | $580.55 | $1,451.37 | 3.4× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,215.43–$1,429.92 | $3,038.57–$3,574.80 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,024.51–$1,205.30 | $2,561.27–$3,013.25 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$360.14–$1,520.84 | $900.34–$3,802.10 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$220.41–$1,520.84 | $551.03–$3,802.10 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$580.55–$3,041.68 | $1,451.37–$7,604.21 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,141.04–$1,342.40 | $2,852.61–$3,356.01 | varies |
| CT upper ext wo (73200) range across 6 matching MRF lines |
$1,323.71–$3,115.10 | $3,309.27–$7,787.76 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$2,546.59–$5,090.69 | $6,366.47–$12,726.72 | varies |
| CT upper extremity with contrast (73201) range across 4 matching MRF lines |
$1,629.12–$3,258.24 | $4,072.80–$8,145.59 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$1,394.80–$1,738.66 | $3,486.99–$4,346.65 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,394.80–$1,738.66 | $3,486.99–$4,346.65 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$1,394.80–$1,738.66 | $3,486.99–$4,346.65 | varies |
| Dilation ureters/urethra rs&i (74485) range across 3 matching MRF lines |
$316.84–$811.96 | $792.10–$2,029.90 | varies |
| Diskography lumbar (72295) | $482.55 | $1,206.37 | 0.3× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$189.28–$222.68 | $473.20–$556.71 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$167.63–$237.27 | $419.07–$593.17 | varies |
| Echo exam of fetal heart (76825) | $320.70 | $801.75 | 0.6× |
| Esophagram (74220) range across 2 matching MRF lines |
$549.24–$646.16 | $1,373.10–$1,615.40 | varies |
| Fetal Biophys Profile W/Nst (76818) | $246.31 | $615.78 | 2.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $246.31 | $615.78 | 2.4× |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$341.34–$539 | $853.35–$1,347.51 | varies |
| Follow-Up Angiography (75898) range across 4 matching MRF lines |
$345.06–$2,842.63 | $862.66–$7,106.58 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$199.20–$398.40 | $498–$995.99 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$219.63–$459.97 | $549.07–$1,149.93 | varies |
| Gastric emptying imaging study (78264) | $2,511.06 | $6,277.66 | 6.5× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $2,647.50 | $6,618.74 | 6.9× |
| Gated Heart Planar Single (78472) | $2,116.32 | $5,290.80 | 5.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $2,786.16 | $6,965.40 | 5.3× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$181.02–$360.37 | $452.54–$900.93 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$2,147.07–$2,469.13 | $5,367.67–$6,172.83 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$1,588.42–$1,826.69 | $3,971.06–$4,566.72 | varies |
| Ht Musc Image Planar Mult (78454) | $2,283.50 | $5,708.75 | 1.8× |
| Ht Muscle Image Spect Sing (78451) | $2,789.52 | $6,973.79 | 2.2× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$442.20–$520.24 | $1,105.51–$1,300.59 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$523.62–$616.02 | $1,309.05–$1,540.05 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$414.92–$488.15 | $1,037.31–$1,220.37 | varies |
| Joint Survey Single View (77077) | $88.44 | $221.11 | 0.9× |
| K Flow/Funct Image Multiple (78709) | $5,004.80 | $12,512 | 9.6× |
| K Flow/Funct Image W/Drug (78708) | $2,579.28 | $6,448.21 | 4.9× |
| K Flow/Funct Image W/O Drug (78707) | $2,424.96 | $6,062.41 | 4.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$232.67–$464.52 | $581.68–$1,161.30 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,717.10 | $4,292.74 | 4.5× |
| Liver imaging static only (78201) | $2,066 | $5,164.99 | 4.0× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$3,013.49–$3,465.50 | $7,533.72–$8,663.76 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$1,966.69–$2,261.70 | $4,916.72–$5,654.24 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$697.80–$1,074.10 | $1,744.50–$2,685.24 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) range across 2 matching MRF lines |
$901.42–$1,036.64 | $2,253.55–$2,591.59 | varies |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) range across 2 matching MRF lines |
$901.42–$1,036.64 | $2,253.55–$2,591.59 | varies |
| Lymphangiography, pelvic/abdominal, unilateral (75805) range across 2 matching MRF lines |
$676.31–$777.75 | $1,690.77–$1,944.38 | varies |
| Magnetic Image Jaw Joint (70336) | $2,026.68 | $5,066.71 | 8.8× |
| Mammary ductogram or galactogram multiple (77054) range across 2 matching MRF lines |
$359.79–$399.38 | $899.47–$998.46 | varies |
| Mammary ductogram or galactogram single (77053) range across 2 matching MRF lines |
$359.79–$399.38 | $899.47–$998.46 | varies |
| Meckels Divert Exam (78290) | $1,672.36 | $4,180.91 | 4.3× |
| Mlc imrt design & construction per imrt plan (77338) | $1,422.06 | $3,555.16 | 3.9× |
| Mra Head W/O & W/Contrast Material (70546) | $2,482.12 | $6,205.29 | 7.4× |
| MRA head w/o contrast (70544) | $1,903.12 | $4,757.79 | 8.3× |
| MRA head with contrast (70545) | $2,134.14 | $5,335.34 | 6.4× |
| MRA neck w contrast (70548) | $2,134.14 | $5,335.34 | 6.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,482.12 | $6,205.29 | 7.4× |
| MRA neck w/o contrast (70547) | $1,903.12 | $4,757.79 | 8.3× |
| MRI abdomen w contrast (74182) | $2,522.20 | $6,305.50 | 7.5× |
| MRI abdomen w/o contrast (74181) | $2,026.68 | $5,066.71 | 8.8× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$1,438.58–$2,877.16 | $3,596.45–$7,192.91 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$1,901.06–$3,802.10 | $4,752.64–$9,505.26 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$2,553.20–$4,823.71 | $6,382.99–$12,059.28 | varies |
| MRI cervical spine w contrast (72142) | $2,522.20 | $6,305.50 | 7.5× |
| MRI cervical spine w/o cont (72141) | $2,270.10 | $5,675.26 | 9.9× |
| MRI chest w/o contrast (71550) | $2,026.68 | $5,066.71 | 8.8× |
| MRI chest with contrast (71551) | $2,257.71 | $5,644.28 | 3.0× |
| MRI chest wo w contrast (71552) | $2,899.93 | $7,249.82 | 8.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$2,553.20–$4,823.71 | $6,382.99–$12,059.28 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,899.93–$5,520.08 | $7,249.82–$13,800.19 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$2,040.32–$4,362.09 | $5,100.81–$10,905.23 | varies |
| MRI lumbar spine w contrast (72149) | $2,522.20 | $6,305.50 | 7.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,222.28 | $8,055.71 | 9.6× |
| MRI orbit face &/neck w/o contrast (70540) | $462.47 | $1,156.18 | 2.0× |
| MRI orbit face neck w contrast (70542) | $739.96 | $1,849.89 | 2.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,202.43 | $3,006.07 | 3.6× |
| MRI pelvis w contrast (72196) | $2,257.71 | $5,644.28 | 6.7× |
| MRI pelvis w/o & w contrast (72197) | $2,604.44 | $6,511.11 | 7.8× |
| MRI pelvis w/o contrast (72195) | $2,026.68 | $5,066.71 | 8.8× |
| MRI thoracic spine w/o contrast (72146) | $2,270.10 | $5,675.26 | 9.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 4 matching MRF lines |
$2,466.41–$4,691.88 | $6,166.02–$11,729.70 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,234.98–$2,460.21 | $5,587.44–$6,150.52 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$2,532.53–$5,064.24 | $6,331.33–$12,660.61 | varies |
| MRI, abdomen, combo (74183) | $2,899.52 | $7,248.79 | 8.6× |
| MRI, dorsal spine combo (72157) | $2,899.93 | $7,249.82 | 8.6× |
| MRI, dorsal spine contrast (72147) | $2,522.20 | $6,305.50 | 7.5× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,040.32–$4,080.23 | $5,100.81–$10,200.58 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$2,899.93–$5,520.08 | $7,249.82–$13,800.19 | varies |
| MRI, lumbar spine combo (72158) | $2,899.93 | $7,249.82 | 8.6× |
| Myelogram cervical (72240) | $1,027.69 | $2,569.22 | 1.4× |
| Myelogram Lumbar (72265) | $1,168.03 | $2,920.07 | 1.5× |
| Myelography thoracic (72255) | $1,027.69 | $2,569.22 | 1.4× |
| Myelograpy 2/more regions rs&i (72270) | $2,947.75 | $7,369.37 | 3.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) range across 2 matching MRF lines |
$1,955.90–$2,053.70 | $4,889.76–$5,134.25 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$3,308.95–$3,506.32 | $8,272.37–$8,765.80 | varies |
| Neck soft tissue (70360) | $210.35 | $525.88 | 2.5× |
| Nm csf leak detection (78650) | $2,045.87 | $5,114.67 | 1.6× |
| Nonvascular Shunt X-Ray (75809) range across 3 matching MRF lines |
$108.63–$839.19 | $271.58–$2,097.97 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,284.28 | $8,210.70 | 2.5× |
| Nuclear Rx Oral Admin (79005) range across 3 matching MRF lines |
$1,346.39–$2,110.17 | $3,365.97–$5,275.43 | varies |
| Optic foramina (70190) range across 3 matching MRF lines |
$166.14–$199.20 | $415.35–$498 | varies |
| Parathyroid Planar Imaging (78070) | $2,804.05 | $7,010.13 | 7.3× |
| Pelvis 1 or 2 views (72170) | $219.45 | $548.63 | 2.2× |
| Peritoneogram Rs&I (74190) | $713.72 | $1,784.31 | 1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,237.09 | $5,592.73 | 5.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$611.65–$719.58 | $1,529.12–$1,798.95 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 4 matching MRF lines |
$373.19–$583.96 | $932.97–$1,459.89 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$293.42–$588.09 | $733.56–$1,470.22 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$138.86–$278.96 | $347.14–$697.40 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$243.42–$455.57 | $608.54–$1,138.92 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $350.04 | $875.11 | 3.5× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$169.44–$337.64 | $423.61–$844.11 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$259.95–$519.90 | $649.87–$1,299.75 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$258.30–$517.01 | $645.74–$1,292.52 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$242.60–$484.36 | $606.49–$1,210.89 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $246.31 | $615.78 | 2.9× |
| Radex Ribs Unilateral 2 Views (71100) | $277.30 | $693.26 | 3.3× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$257.06–$508.33 | $642.65–$1,270.82 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $266.56 | $666.39 | 3.2× |
| Radex Spine 1 View Specify Level (72020) | $179.77 | $449.43 | 2.1× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$226.71–$238.04 | $566.77–$595.11 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $292.18 | $730.46 | 3.5× |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$189.69–$380.62 | $474.23–$951.55 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$243.42–$486.01 | $608.54–$1,215.02 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$240.11–$481.46 | $600.27–$1,203.66 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $615.78 | $1,539.45 | 6.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $291.36 | $728.39 | 2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $412.03 | $1,030.08 | 4.1× |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$1,033.18–$1,215.50 | $2,582.95–$3,038.76 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$867.46–$1,020.54 | $2,168.65–$2,551.35 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$239.70–$477.74 | $599.25–$1,194.36 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $257.06 | $642.65 | 2.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$523.62–$616.02 | $1,309.05–$1,540.05 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$451.30–$530.94 | $1,128.24–$1,327.34 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$935.65–$975.32 | $2,339.12–$2,438.31 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$274.83–$550.07 | $687.07–$1,375.17 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$428.98–$857.95 | $1,072.45–$2,144.88 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$159.11–$318.22 | $397.77–$795.55 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $511 | $1,277.50 | 5.1× |
| Radiologic Examination Salivary Gland Calculus (70380) | $173.99 | $434.97 | 2.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$242.60–$484.36 | $606.49–$1,210.89 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $184.74 | $461.84 | 0.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,471.37 | $6,178.42 | 6.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,477.79 | $3,694.47 | 3.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,131.99 | $10,329.98 | 7.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$2,904.14–$3,151.27 | $7,260.35–$7,878.18 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$2,384.14–$3,308.95 | $5,960.36–$8,272.37 | varies |
| Rp Therapy Intravenous Administration (79101) range across 3 matching MRF lines |
$635.74–$2,904.14 | $1,589.34–$7,260.35 | varies |
| Salivary Gland Imaging Serial Images (78231) | $2,239.89 | $5,599.72 | 5.8× |
| Scapula (73010) range across 3 matching MRF lines |
$277.30–$552.54 | $693.26–$1,381.36 | varies |
| Sella turcica (70240) | $88.44 | $221.11 | 1.1× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$140.10–$277.30 | $350.25–$693.26 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$1,176.98–$2,317.61 | $2,942.44–$5,794.02 | varies |
| Sialogram (70390) | $288.05 | $720.12 | 1.3× |
| Skull less than 4 views (70250) | $207.46 | $518.66 | 2.1× |
| Special dosimetry (77331) | $332.27 | $830.68 | 2.6× |
| Special Physics Consult (77370) | $517.01 | $1,292.52 | 4.0× |
| Special teletherapy port plan (77321) | $563.70 | $1,409.26 | 1.6× |
| Special treatment procedure (77470) | $886.88 | $2,217.21 | 1.7× |
| Spleen Imaging (78185) | $1,449.27 | $3,623.18 | 3.8× |
| Sternoclavicular joints (71130) | $173.99 | $434.97 | 2.1× |
| Superior sagittal sinus venogram (75870) | $1,082.59 | $2,706.47 | 0.4× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $212.42 | $531.06 | 2.2× |
| Testicular Imaging W/Flow (78761) | $2,012.32 | $5,030.79 | 5.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $922.01 | $2,305.03 | 2.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $692.23 | $1,730.58 | 1.9× |
| Ther rad simulaj-aided field setting simple (77280) | $462.86 | $1,157.16 | 3.6× |
| Thoracic spine 2 views (72070) | $306.65 | $766.63 | 3.0× |
| Thoracic spine 3 views (72072) | $329.38 | $823.44 | 3.3× |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$293.42–$345.21 | $733.56–$863.02 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) range across 2 matching MRF lines |
$1,831.04–$2,105.70 | $4,577.60–$5,264.24 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $1,817.74 | $4,544.35 | 4.7× |
| Thyroid Met Imaging Body (78018) | $2,237.65 | $5,594.13 | 4.3× |
| Thyroid Uptake Measurement (78012) | $1,280.42 | $3,201.04 | 3.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,175.03 | $5,437.57 | 5.7× |
| Tx Devices Design & Construction Complex (77334) | $538.08 | $1,345.21 | 1.5× |
| Tx devices design & construction intermediate (77333) | $358.31 | $895.77 | 2.8× |
| Tx devices design & construction simple (77332) | $246.72 | $616.80 | 1.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$322.36–$643.05 | $805.89–$1,607.63 | varies |
| Ultrasound, abdomen limited (76705) | $439.31 | $1,098.28 | 4.4× |
| Unlisted Dx Radiographic Procedure (76499) range across 4 matching MRF lines |
$353.47–$423.82 | $883.68–$1,059.56 | varies |
| Unlisted us procedure (76999) | $345.91 | $864.77 | 4.1× |
| Upper gi w/o kub (74240) range across 4 matching MRF lines |
$530.64–$975.32 | $1,326.60–$2,438.31 | varies |
| Ureteral Reflux Study (78740) | $1,617.01 | $4,042.52 | 4.2× |
| Urethrocystogram voiding (74455) range across 3 matching MRF lines |
$277.30–$524.61 | $693.26–$1,311.53 | varies |
| Urethrocystography retrograde (74450) range across 3 matching MRF lines |
$277.30–$338.88 | $693.26–$847.20 | varies |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$322.36–$643.05 | $805.89–$1,607.63 | varies |
| Us chest (76604) | $276.07 | $690.17 | 2.7× |
| Us complete joint (76881) | $522.79 | $1,306.97 | 5.2× |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$219.98–$326.07 | $549.94–$815.18 | varies |
| Us head (76506) | $441.37 | $1,103.43 | 4.4× |
| Us kidney transplant (76776) | $1,110.46 | $2,776.16 | 11.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $481.88 | $1,204.69 | 4.8× |
| Us ob detailed single fetus (76811) | $419.89 | $1,049.72 | 1.8× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$270.70–$318.46 | $676.74–$796.16 | varies |
| Us ob transvaginal (76817) | $209.94 | $524.85 | 2.1× |
| Us pelvic non ob complete (76856) | $440.55 | $1,101.38 | 4.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $419.89 | $1,049.72 | 4.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$270.70–$318.46 | $676.74–$796.16 | varies |
| Us retroperitoneal complete (76770) | $542.62 | $1,356.56 | 5.4× |
| Us retroperitoneal limited (76775) | $439.31 | $1,098.28 | 4.4× |
| Us scrotum and contents (76870) | $387.65 | $969.13 | 3.9× |
| Us spinal canal and contents (76800) | $639.34 | $1,598.34 | 6.4× |
| Us thyroid (76536) | $434.76 | $1,086.91 | 4.3× |
| Us transrectal (76872) | $628.17 | $1,570.43 | 6.2× |
| Vascular Flow Imaging (78445) | $1,715.98 | $4,289.95 | 4.5× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$985.20–$1,517.12 | $2,462.99–$3,792.79 | varies |
| Venogram Sinus/Jugular (75860) | $1,193.35 | $2,983.38 | 0.4× |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$1,282.28–$3,123.88 | $3,205.69–$7,809.69 | varies |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$3,641.34–$3,823.40 | $9,103.34–$9,558.51 | varies |
| Venography extremity unilateral rs&i (75820) range across 5 matching MRF lines |
$3,641.34–$3,823.40 | $9,103.34–$9,558.51 | varies |
| Venography Renal Bilateral (75833) | $5,190.18 | $12,975.44 | 1.7× |
| Venography Renal Unilateral (75831) range across 4 matching MRF lines |
$5,190.18–$5,449.68 | $12,975.44–$13,624.21 | varies |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$1,225.83 | $3,064.58 | 0.2× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$182.67–$364.92 | $456.67–$912.29 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $259.95 | $649.87 | 3.1× |
| X-ray antegrade pyelogram tube (74425) range across 7 matching MRF lines |
$233.80–$719.10 | $584.49–$1,797.74 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 4 matching MRF lines |
$384.12–$5,190.18 | $960.31–$12,975.44 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$197.13–$393.85 | $492.83–$984.62 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$272.76–$313.67 | $681.90–$784.18 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $179.77 | $449.43 | 2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $307.47 | $768.68 | 3.1× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $461.63 | $1,154.07 | 4.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $179.77 | $449.43 | 2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $333.51 | $833.77 | 4.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $454.60 | $1,136.50 | 4.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $255.41 | $638.52 | 2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $509.56 | $1,273.90 | 5.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $637.27 | $1,593.17 | 6.3× |
| X-Ray Exam L-S Spine Bending (72114) | $390.13 | $975.32 | 3.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $288.05 | $720.12 | 3.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $416.99 | $1,042.48 | 4.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $284.33 | $710.83 | 2.8× |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$166.14–$207.46 | $415.35–$518.66 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$235.15–$468.66 | $587.87–$1,171.64 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$1,124.10–$1,322.47 | $2,810.25–$3,306.18 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $259.54 | $648.84 | 3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$159.11–$187.18 | $397.77–$467.96 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $362.44 | $906.10 | 3.6× |
| X-ray nose-rectum child f.b. (76010) | $218.62 | $546.56 | 2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $414.10 | $1,035.25 | 4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $254.58 | $636.44 | 2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $235.15 | $587.87 | 2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $338.06 | $845.15 | 4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $367.82 | $919.54 | 3.7× |
| X-Ray Stress View (77071) | $353.96 | $884.89 | 4.2× |
| X-Ray Tmj Unilat (70328) | $266.15 | $665.37 | 3.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$871.59–$1,025.40 | $2,178.97–$2,563.50 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$244.66–$287.83 | $611.65–$719.58 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$991.44–$1,166.40 | $2,478.61–$2,916.01 | varies |
| Xr c-spine 4 or 5 views (72050) | $369.88 | $924.70 | 3.7× |
| Xr facial bones less than 3 views (70140) | $228.96 | $572.39 | 2.7× |
| XR Mastoids < 3 Views Bilateral (70120) | $334.34 | $835.84 | 3.3× |
| Xr orbits complete 4 views (70200) | $255.41 | $638.52 | 2.5× |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$507.91–$597.54 | $1,269.78–$1,493.86 | 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.