Imaging prices at Speare Memorial Hospital
Plymouth, NH · every code in this section with a posted price and a Medicare benchmark.
266 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) range across 4 matching MRF lines |
$119.04–$248 | $192–$400 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$125.24–$260.40 | $202–$420 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,201 | $3,550 | 5.2× |
| Ankle 2 views (73600) range across 6 matching MRF lines |
$131.44–$409.20 | $212–$660 | varies |
| Arthrogram ankle (73615) | $943.64 | $1,522 | 2.5× |
| Arthrogram hip (73525) range across 6 matching MRF lines |
$454.46–$946.12 | $733–$1,526 | varies |
| Arthrogram Wrist (73115) range across 6 matching MRF lines |
$469.96–$978.98 | $758–$1,579 | varies |
| Bone age studies (77072) | $173.60 | $280 | 1.6× |
| Bone Imaging 3 Phase (78315) | $2,170 | $3,500 | 5.1× |
| Bone Imaging Limited Area (78300) | $1,457 | $2,350 | 3.4× |
| Bone Imaging Whole Body (78306) | $1,891 | $3,050 | 4.4× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$297.60–$620 | $480–$1,000 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) | $3,871.28 | $6,244 | 2.5× |
| Cat Scan Follow-Up Study (76380) | $868 | $1,400 | 9.3× |
| Chest 1 view (71045) range across 7 matching MRF lines |
$98.58–$204.60 | $159–$330 | varies |
| Chest 2 views (71046) range across 6 matching MRF lines |
$104.16–$325.50 | $168–$525 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$124.62–$259.16 | $201–$418 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$133.30–$277.14 | $215–$447 | varies |
| Cholecystography Oral Contrast (74290) | $620 | $1,000 | 3.3× |
| Clavicle complete (73000) range across 6 matching MRF lines |
$110.36–$344.10 | $178–$555 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,178 | $1,900 | 10.6× |
| Contrast X-Ray Bladder (74430) | $378.20 | $610 | 1.0× |
| Contrast X-Ray Of Elbow (73085) range across 6 matching MRF lines |
$366.42–$763.84 | $591–$1,232 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $1,070.12 | $1,726 | 2.9× |
| Contrast Xray Throat/Cerv Esopha (74210) | $585.90 | $945 | 3.1× |
| CT abdomen and pelvis without and with contrast (74178) | $2,604 | $4,200 | 7.0× |
| CT abdomen and pelvis without contrast (74176) | $2,244.40 | $3,620 | 8.8× |
| CT abdomen w contrast (74160) | $1,488 | $2,400 | 7.9× |
| CT abdomen w wo contrast (74170) | $1,922 | $3,100 | 10.3× |
| CT abdomen w/o contrast (74150) | $1,054 | $1,700 | 9.4× |
| CT Angio Abdomen and Pelvis (74174) | $2,356 | $3,800 | 6.3× |
| CT Angio Chest (71275) | $1,760.80 | $2,840 | 9.4× |
| CT Angio Head (70496) | $1,553.72 | $2,506 | 8.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,922 | $3,100 | 10.3× |
| CT Angio Neck (70498) | $1,553.72 | $2,506 | 8.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,364 | $2,200 | 7.3× |
| CT cervical spine w/ contrast (72126) | $1,519 | $2,450 | 4.1× |
| CT cervical spine w/o contrast (72125) | $1,426 | $2,300 | 12.8× |
| CT cervical spine w/wo cont (72127) | $1,612 | $2,600 | 8.6× |
| CT chest w contrast (71260) | $1,333 | $2,150 | 7.1× |
| CT chest w/wo contrast (71270) | $1,426 | $2,300 | 7.6× |
| CT head/brain with contrast (70460) | $1,100.50 | $1,775 | 5.9× |
| CT head/brain without and with contrast (70470) | $1,193.50 | $1,925 | 6.4× |
| CT iac w contrast (70481) | $1,333 | $2,150 | 7.1× |
| CT l-spine w&w/o contrast (72133) | $1,426 | $2,300 | 7.6× |
| CT lower ext w/o (73700) | $1,283.40 | $2,070 | 11.5× |
| CT lower extremity w/contrast material (73701) | $1,531.40 | $2,470 | 8.2× |
| CT lumbar spine w contrast (72132) | $1,333 | $2,150 | 3.6× |
| CT lumbar spine w/o contrast (72131) | $1,116 | $1,800 | 10.0× |
| CT maxillofacial w contrast (70487) | $1,333 | $2,150 | 7.1× |
| CT maxillofacial wo contrast (70486) | $1,240 | $2,000 | 11.1× |
| CT neck tissue combo (70492) | $1,426 | $2,300 | 7.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,426 | $2,300 | 7.6× |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$1,240–$1,333 | $2,000–$2,150 | varies |
| CT pelvis w&w/o contrast (72194) | $1,953 | $3,150 | 10.4× |
| CT pelvis w/o contrast (72192) | $1,178 | $1,900 | 10.6× |
| CT scan of leg combo (73702) | $1,655.40 | $2,670 | 8.8× |
| CT scans face/jaw combo (70488) | $1,426 | $2,300 | 7.6× |
| CT soft tissue neck w contrast (70491) | $1,333 | $2,150 | 7.1× |
| CT soft tissue neck w/o contrast (70490) | $1,240 | $2,000 | 11.1× |
| CT thoracic spine w contrast (72129) | $1,333 | $2,150 | 7.1× |
| CT thoracic spine w/o contrast (72128) | $1,240 | $2,000 | 11.1× |
| CT thoracic spine w/wo cont (72130) | $1,426 | $2,300 | 7.6× |
| CT thorax w/o contrast (71250) | $1,240 | $2,000 | 11.1× |
| CT upper ext wo (73200) | $1,041.60 | $1,680 | 9.3× |
| CT upper extremity w/o & w/contrast material (73202) | $1,599.60 | $2,580 | 8.5× |
| CT upper extremity with contrast (73201) | $1,413.60 | $2,280 | 3.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,418 | $3,900 | 12.9× |
| Cta Abdomen (74175) | $1,860 | $3,000 | 9.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,768.24 | $2,852 | 4.7× |
| CTA pelvis (72191) | $1,581 | $2,550 | 8.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $489.18 | $789 | 4.4× |
| Dxa Bone Density Axial (77080) | $393.70 | $635 | 3.5× |
| Dxa bone density study (77085) | $399.90 | $645 | 3.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $167.40 | $270 | 1.8× |
| Echo exam of fetal heart (76825) range across 2 matching MRF lines |
$291.40–$1,457 | $470–$2,350 | varies |
| Echo exam uterus (76831) | $682 | $1,100 | 2.7× |
| Esophagram (74220) range across 2 matching MRF lines |
$281.48–$585.90 | $454–$945 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$252.96–$527 | $408–$850 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 5 matching MRF lines |
$193.44–$403 | $312–$650 | varies |
| Fluoroscopy up to 1 hr (76000) | $372 | $600 | 1.5× |
| Foot 2 views (73620) range across 6 matching MRF lines |
$110.36–$344.10 | $178–$555 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$106.02–$330.46 | $171–$533 | varies |
| Gastric emptying imaging study (78264) | $2,139 | $3,450 | 5.0× |
| Gated Heart Planar Single (78472) | $1,508.46 | $2,433 | 3.5× |
| Hand 2 views (73120) range across 6 matching MRF lines |
$108.50–$337.90 | $175–$545 | varies |
| Hepatobil Syst Image W/Drug (78227) | $2,883 | $4,650 | 5.0× |
| Hepatobiliary System Imaging (78226) | $2,108 | $3,400 | 4.9× |
| Ht Muscle Image Spect Sing (78451) | $2,277.88 | $3,674 | 1.6× |
| Hysterosalpingogram (74740) | $682 | $1,100 | 2.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $651 | $1,050 | 7.0× |
| K Flow/Funct Image Multiple (78709) | $2,232 | $3,600 | 3.8× |
| K Flow/Funct Image W/Drug (78708) | $1,426 | $2,300 | 2.5× |
| K Flow/Funct Image W/O Drug (78707) | $1,364 | $2,200 | 2.4× |
| Knee 3 Views (73562) range across 6 matching MRF lines |
$131.44–$409.20 | $212–$660 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,612 | $2,600 | 3.8× |
| Lung perfusion differential (78597) | $1,240 | $2,000 | 2.9× |
| Lung Ventilat&Perfus Imaging (78582) | $2,046 | $3,300 | 3.5× |
| Lung Ventilation Imaging (78579) | $1,364 | $2,200 | 3.2× |
| Lymph System Imaging (78195) | $2,170 | $3,500 | 3.7× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,130.88–$2,356 | $1,824–$3,800 | varies |
| Meckels Divert Exam (78290) | $2,170 | $3,500 | 5.1× |
| Mra Head W/O & W/Contrast Material (70546) | $2,480 | $4,000 | 6.7× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$744–$1,550 | $1,200–$2,500 | varies |
| MRA head with contrast (70545) | $2,015 | $3,250 | 5.4× |
| MRA neck w contrast (70548) | $2,015 | $3,250 | 5.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,480 | $4,000 | 6.7× |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$744–$1,550 | $1,200–$2,500 | varies |
| MRI abdomen w contrast (74182) | $2,325 | $3,750 | 6.2× |
| MRI abdomen w/o contrast (74181) range across 4 matching MRF lines |
$892.80–$1,860 | $1,440–$3,000 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $2,356 | $3,800 | 2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,728 | $4,400 | 7.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,312.60 | $3,730 | 2.8× |
| MRI cervical spine w contrast (72142) | $2,294 | $3,700 | 6.2× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$892.80–$1,860 | $1,440–$3,000 | varies |
| MRI chest w/o contrast (71550) range across 4 matching MRF lines |
$967.20–$2,015 | $1,560–$3,250 | varies |
| MRI chest with contrast (71551) | $2,821 | $4,550 | 3.4× |
| MRI chest wo w contrast (71552) | $3,224 | $5,200 | 8.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,356 | $3,800 | 6.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,728 | $4,400 | 7.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 12 matching MRF lines |
$922.56–$1,922 | $1,488–$3,100 | varies |
| MRI lumbar spine w contrast (72149) | $2,294 | $3,700 | 6.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,480 | $4,000 | 6.7× |
| MRI orbit face &/neck w/o contrast (70540) range across 4 matching MRF lines |
$744–$1,550 | $1,200–$2,500 | varies |
| MRI orbit face neck w contrast (70542) | $2,015 | $3,250 | 5.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,480 | $4,000 | 6.7× |
| MRI pelvis w contrast (72196) | $2,015 | $3,250 | 5.4× |
| MRI pelvis w/o & w contrast (72197) | $2,170 | $3,500 | 5.8× |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$930–$1,550 | $1,500–$2,500 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$892.80–$1,860 | $1,440–$3,000 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,337.40 | $3,770 | 6.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 16 matching MRF lines |
$913.88–$1,903.40 | $1,474–$3,070 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,957.40 | $4,770 | 7.9× |
| MRI, abdomen, combo (74183) | $2,604 | $4,200 | 7.0× |
| MRI, dorsal spine combo (72157) | $2,480 | $4,000 | 6.7× |
| MRI, dorsal spine contrast (72147) | $2,294 | $3,700 | 6.2× |
| MRI, joint upper extrem (73221) range across 12 matching MRF lines |
$902.10–$1,878.60 | $1,455–$3,030 | varies |
| MRI, joint upper extrem combo (73223) | $2,746.60 | $4,430 | 7.4× |
| MRI, lumbar spine combo (72158) | $2,666 | $4,300 | 7.2× |
| Myocardial Spect Multiple Studies (78452) | $2,914 | $4,700 | 2.1× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$96.10–$200.26 | $155–$323 | varies |
| Nonvascular Shunt X-Ray (75809) | $589 | $950 | 5.3× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) range across 2 matching MRF lines |
$102.30–$212.04 | $165–$342 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $164.92 | $266 | 1.5× |
| Optic foramina (70190) range across 4 matching MRF lines |
$115.94–$241.80 | $187–$390 | varies |
| Parathyroid Planar Imaging (78070) | $1,860 | $3,000 | 4.4× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$125.24–$260.40 | $202–$420 | varies |
| Pet Image W/Ct Lmtd (78814) | $3,871.28 | $6,244 | 2.5× |
| PET image w/CT, full body (78816) | $3,871.28 | $6,244 | 2.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,871.28 | $6,244 | 2.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,232 | $3,600 | 5.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$164.30–$341.62 | $265–$551 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$190.96–$396.80 | $308–$640 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 6 matching MRF lines |
$137.02–$427.80 | $221–$690 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 6 matching MRF lines |
$114.70–$358.36 | $185–$578 | varies |
| Radex elbow complete minimum 3 views (73080) range across 6 matching MRF lines |
$137.02–$427.80 | $221–$690 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 4 matching MRF lines |
$148.80–$309.38 | $240–$499 | varies |
| Radex fingr minimum 2 views (73140) range across 20 matching MRF lines |
$130.20–$270.94 | $210–$437 | varies |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$125.24–$390.60 | $202–$630 | varies |
| Radex Hand Minimum 3 Views (73130) range across 6 matching MRF lines |
$143.22–$446.40 | $231–$720 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 6 matching MRF lines |
$129.58–$404.86 | $209–$653 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$197.16–$409.82 | $318–$661 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$125.86–$262.26 | $203–$423 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$110.36–$230.02 | $178–$371 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$116.56–$362.70 | $188–$585 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$102.30–$212.04 | $165–$342 | varies |
| Radex Spine 1 View Specify Level (72020) range across 10 matching MRF lines |
$72.54–$150.66 | $117–$243 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$103.54–$215.14 | $167–$347 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$178.56–$371.38 | $288–$599 | varies |
| Radex Toe Minimum 2 Views (73660) range across 20 matching MRF lines |
$89.28–$186 | $144–$300 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 6 matching MRF lines |
$110.36–$344.10 | $178–$555 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$137.64–$429.04 | $222–$692 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$332.94–$692.54 | $537–$1,117 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$135.78–$282.72 | $219–$456 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$169.88–$353.40 | $274–$570 | varies |
| Radiologic exam colon double contrast study (74280) | $1,333 | $2,150 | 7.1× |
| Radiologic exam colon single contrast study (74270) | $868 | $1,400 | 4.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $651 | $1,050 | 3.5× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$151.90–$474.30 | $245–$765 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$142.60–$296.36 | $230–$478 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $713 | $1,150 | 3.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $837 | $1,350 | 4.5× |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$99.82–$207.70 | $161–$335 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 10 matching MRF lines |
$110.36–$344.10 | $178–$555 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$113.46–$353.40 | $183–$570 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$178.56–$372 | $288–$600 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$129.58–$269.70 | $209–$435 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$161.20–$334.80 | $260–$540 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,643 | $2,650 | 3.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,015 | $3,250 | 3.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,418 | $3,900 | 4.2× |
| Scapula (73010) range across 4 matching MRF lines |
$86.80–$179.80 | $140–$290 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $186 | $300 | 8.0× |
| Sella turcica (70240) range across 2 matching MRF lines |
$102.30–$212.04 | $165–$342 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$80.60–$167.40 | $130–$270 | varies |
| Shoulder Arthrography (73040) range across 6 matching MRF lines |
$450.12–$937.44 | $726–$1,512 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$114.70–$238.70 | $185–$385 | varies |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$131.44–$274.04 | $212–$442 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$97.96–$203.36 | $158–$328 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$121.52–$252.34 | $196–$407 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$104.78–$218.24 | $169–$352 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $1,302 | $2,100 | 3.1× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$434–$651 | $700–$1,050 | varies |
| Ultrasound Exam Aaa Screen (76706) | $682 | $1,100 | 6.1× |
| Ultrasound, abdomen limited (76705) | $496 | $800 | 4.4× |
| Umbilical-artery Doppler (OB) (76820) | $283.96 | $458 | 2.5× |
| Upper gi w/o kub (74240) | $682 | $1,100 | 3.6× |
| Urethrocystogram voiding (74455) | $725.40 | $1,170 | 2.8× |
| Urethrocystography retrograde (74450) | $1,798 | $2,900 | 7.1× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$558–$837 | $900–$1,350 | varies |
| Us chest (76604) | $373.86 | $603 | 3.3× |
| Us exam, pelvic, limited (76857) range across 6 matching MRF lines |
$150.04–$312.48 | $242–$504 | varies |
| Us head (76506) | $899 | $1,450 | 8.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 6 matching MRF lines |
$158.72–$494.76 | $256–$798 | varies |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$461.28–$961 | $744–$1,550 | varies |
| Us ob limited 1 or more fetuses (76815) range across 7 matching MRF lines |
$327.36–$682 | $528–$1,100 | varies |
| Us ob transvaginal (76817) range across 7 matching MRF lines |
$238.08–$496 | $384–$800 | varies |
| Us pelvic non ob complete (76856) | $620 | $1,000 | 5.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$282.72–$589 | $456–$950 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $558 | $900 | 5.0× |
| Us retroperitoneal complete (76770) | $620 | $1,000 | 5.6× |
| Us retroperitoneal limited (76775) range across 6 matching MRF lines |
$208.32–$434 | $336–$700 | varies |
| Us scrotum and contents (76870) | $589 | $950 | 5.3× |
| Us spinal canal and contents (76800) | $713 | $1,150 | 6.4× |
| Us thyroid (76536) range across 3 matching MRF lines |
$327.36–$682 | $528–$1,100 | varies |
| Us transrectal (76872) | $868 | $1,400 | 7.8× |
| Vertebral fracture assessment via dxa (77086) | $189.72 | $306 | 2.0× |
| Wrist 2 views (73100) range across 10 matching MRF lines |
$117.80–$367.66 | $190–$593 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$89.28–$186 | $144–$300 | varies |
| X-ray antegrade pyelogram tube (74425) | $930 | $1,500 | 2.5× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$127.72–$265.36 | $206–$428 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 6 matching MRF lines |
$101.68–$316.20 | $164–$510 | varies |
| X-Ray Exam Breast Specimen (76098) | $229.40 | $370 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$127.72–$265.36 | $206–$428 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$233.74–$486.70 | $377–$785 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$260.40–$542.50 | $420–$875 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$106.64–$221.96 | $172–$358 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$137.02–$285.20 | $221–$460 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 4 matching MRF lines |
$178.56–$372 | $288–$600 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$146.32–$304.42 | $236–$491 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$191.58–$398.04 | $309–$642 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$212.66–$442.06 | $343–$713 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$200.88–$418.50 | $324–$675 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$121.52–$252.34 | $196–$407 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$202.74–$421.60 | $327–$680 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 4 matching MRF lines |
$147.56–$306.90 | $238–$495 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$100.44–$209.56 | $162–$338 | varies |
| X-ray humerus (73060) range across 10 matching MRF lines |
$110.36–$344.10 | $178–$555 | varies |
| X-ray IV pyelogram (ivp) (74400) | $930 | $1,500 | 5.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$125.86–$262.26 | $203–$423 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$132.68–$275.90 | $214–$445 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$123.38–$256.68 | $199–$414 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$86.80–$179.80 | $140–$290 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$178.56–$372 | $288–$600 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$120.28–$250.48 | $194–$404 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$113.46–$235.60 | $183–$380 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$110.36–$229.40 | $178–$370 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$115.94–$241.80 | $187–$390 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$133.30–$277.14 | $215–$447 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$169.88–$354.02 | $274–$571 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $693.78 | $1,119 | 1.9× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$282.72–$704.32 | $456–$1,136 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$297.60–$620 | $480–$1,000 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$169.88–$354.02 | $274–$571 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$94.86–$197.78 | $153–$319 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$161.82–$336.04 | $261–$542 | 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.