Imaging prices at St. Anthony Summit Medical Center
Frisco, CO · every code in this section with a posted price and a Medicare benchmark.
306 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) | $212.53 | $531.32 | 2.3× |
| Abdomen 2 views (74019) | $203.46 | $508.64 | 1.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $666.70 | $1,666.74 | 1.6× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$573.47–$745.53 | $1,433.66–$1,863.81 | varies |
| Bone age studies (77072) | $171.74 | $429.33 | 1.6× |
| Bone Imaging 3 Phase (78315) | $901.36 | $2,253.40 | 2.1× |
| Bone Imaging Limited Area (78300) | $698.16 | $1,745.40 | 1.7× |
| Bone Imaging Multiple Areas (78305) | $679.67 | $1,699.16 | 1.6× |
| Bone Imaging Whole Body (78306) | $790.96 | $1,977.40 | 1.9× |
| Bone marrow imaging limited area (78102) | $534.36 | $1,335.90 | 1.3× |
| Bone survey infant (77076) | $286.26 | $715.63 | 2.6× |
| Brain Image W/Flow < 4 Views (78601) | $544.10 | $1,360.24 | 1.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $611.46 | $1,528.65 | 1.1× |
| Cat Scan Follow-Up Study (76380) | $1,533.77 | $3,834.41 | 16.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $617.50 | $1,543.74 | 1.1× |
| Cerebrospinal Fluid Scan (78630) | $659.74 | $1,649.33 | 1.2× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$195.36–$231.28 | $488.39–$578.19 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$121.92–$273.07 | $304.79–$682.67 | varies |
| Chest 3 views (71047) | $240.82 | $602.03 | 2.6× |
| Chest 4 or more views (71048) | $336.18 | $840.43 | 3.0× |
| Cholecystography Oral Contrast (74290) | $429.53 | $1,073.82 | 2.3× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$222.27–$287.56 | $555.67–$718.88 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $256.25 | $640.61 | 2.3× |
| Contrast X-Ray Bladder (74430) | $720.91 | $1,802.26 | 2.0× |
| CT abdomen and pelvis without and with contrast (74178) | $2,470.81 | $6,177.01 | 6.7× |
| CT abdomen and pelvis without contrast (74176) | $1,482.49 | $3,706.21 | 5.9× |
| CT abdomen w contrast (74160) | $2,255.22 | $5,638.04 | 12.2× |
| CT abdomen w wo contrast (74170) | $2,347.28 | $5,868.18 | 12.7× |
| CT abdomen w/o contrast (74150) | $1,439.65 | $3,599.11 | 13.1× |
| CT Angio Abdomen and Pelvis (74174) | $5,347.22 | $13,368.03 | 14.5× |
| CT Angio Chest (71275) | $2,673.62 | $6,684.04 | 14.4× |
| CT Angio Head (70496) | $1,876.49 | $4,691.22 | 10.1× |
| CT angio hrt w/3d image (75574) | $2,335.07 | $5,837.66 | 6.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$2,673.62–$3,475.69 | $6,684.04–$8,689.22 | varies |
| CT Angio Neck (70498) | $1,876.49 | $4,691.22 | 10.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,673.62 | $6,684.04 | 14.4× |
| CT cervical spine w/ contrast (72126) | $2,333.29 | $5,833.21 | 6.3× |
| CT cervical spine w/o contrast (72125) | $1,533.77 | $3,834.41 | 13.9× |
| CT cervical spine w/wo cont (72127) | $2,618.84 | $6,547.09 | 14.2× |
| CT chest w contrast (71260) | $2,333.29 | $5,833.21 | 12.6× |
| CT chest w/wo contrast (71270) | $1,879.61 | $4,699.01 | 10.2× |
| CT head/brain with contrast (70460) | $1,637.63 | $4,094.06 | 8.9× |
| CT head/brain without and with contrast (70470) | $1,838.04 | $4,595.08 | 9.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,279.96 | $3,199.89 | 3.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $465.68 | $1,164.20 | 5.1× |
| CT iac w contrast (70481) | $1,637.63 | $4,094.06 | 8.9× |
| CT l-spine w&w/o contrast (72133) | $2,618.84 | $6,547.09 | 14.2× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,533.77–$1,993.90 | $3,834.41–$4,984.73 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,968.03–$2,333.29 | $4,920.06–$5,833.21 | varies |
| CT lumbar spine w contrast (72132) | $2,333.29 | $5,833.21 | 6.3× |
| CT lumbar spine w/o contrast (72131) | $1,533.77 | $3,834.41 | 13.9× |
| CT maxillofacial w contrast (70487) | $1,637.63 | $4,094.06 | 8.9× |
| CT maxillofacial wo contrast (70486) | $1,076.48 | $2,691.20 | 9.8× |
| CT neck tissue combo (70492) | $1,838.04 | $4,595.08 | 9.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,446.36–$1,838.04 | $3,615.88–$4,595.08 | varies |
| CT orbits w/o contrast (70480) | $1,076.48 | $2,691.20 | 9.8× |
| CT pelvis w&w/o contrast (72194) | $2,618.84 | $6,547.09 | 14.2× |
| CT pelvis w/o contrast (72192) | $1,458.74 | $3,646.83 | 13.2× |
| CT scan of leg combo (73702) | $1,238.65 | $3,096.61 | 6.7× |
| CT scans face/jaw combo (70488) | $1,318.94 | $3,297.34 | 7.1× |
| CT soft tissue neck w contrast (70491) | $1,637.63 | $4,094.06 | 8.9× |
| CT soft tissue neck w/o contrast (70490) | $1,076.48 | $2,691.20 | 9.8× |
| CT thoracic spine w contrast (72129) | $2,462.64 | $6,156.60 | 13.3× |
| CT thoracic spine w/o contrast (72128) | $1,533.77 | $3,834.41 | 13.9× |
| CT thoracic spine w/wo cont (72130) | $2,618.84 | $6,547.09 | 14.2× |
| CT thorax w/o contrast (71250) | $1,533.77 | $3,834.41 | 13.9× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,533.77–$1,993.90 | $3,834.41–$4,984.73 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $2,781.22 | $6,953.04 | 15.0× |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$2,333.29–$3,033.28 | $5,833.21–$7,583.19 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,673.62 | $6,684.04 | 14.4× |
| Cta Abdomen (74175) | $2,673.62 | $6,684.04 | 14.4× |
| CTA pelvis (72191) | $2,673.62 | $6,684.04 | 14.4× |
| Diskography lumbar (72295) | $969.08 | $2,422.68 | 0.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $362.52 | $906.29 | 3.3× |
| Dxa Bone Density Axial (77080) | $411.20 | $1,027.98 | 3.7× |
| Dxa bone density study (77085) | $494.94 | $1,237.34 | 4.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $344.08 | $860.20 | 3.7× |
| Esophagram (74220) | $459.75 | $1,149.36 | 2.5× |
| Fetal Biophys Profile W/Nst (76818) | $167.79 | $419.47 | 1.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $548.95 | $1,372.36 | 5.0× |
| Fluoroscopy up to 1 hr (76000) | $237.17 | $592.91 | 0.9× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Gastric emptying imaging study (78264) | $646.95 | $1,617.37 | 1.5× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $776.35 | $1,940.86 | 1.8× |
| Gated Heart Planar Single (78472) | $1,110.64 | $2,776.58 | 2.6× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $970.43 | $2,426.07 | 1.7× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Hepatobil Syst Image W/Drug (78227) | $978.59 | $2,446.46 | 1.7× |
| Hepatobiliary System Imaging (78226) | $889.63 | $2,224.06 | 2.1× |
| Ht Muscle Image Spect Sing (78451) | $2,224.92 | $5,562.28 | 1.6× |
| Hysterosalpingogram (74740) | $502.29 | $1,255.71 | 2.0× |
| K Flow/Funct Image Multiple (78709) | $552.24 | $1,380.58 | 1.0× |
| K Flow/Funct Image W/Drug (78708) | $892.30 | $2,230.74 | 1.6× |
| K Flow/Funct Image W/O Drug (78707) | $1,009.63 | $2,524.06 | 1.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $540.29 | $1,350.71 | 1.3× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Leveen/Shunt Patency Exam (78291) | $680.64 | $1,701.59 | 1.6× |
| Liver & Spleen Imaging Static Only (78215) | $600.55 | $1,501.37 | 1.4× |
| Liver imaging static only (78201) | $696.47 | $1,741.17 | 1.2× |
| Lung Perf&Ventilat Diferentl (78598) | $1,080.47 | $2,701.16 | 1.9× |
| Lung perfusion differential (78597) | $954.70 | $2,386.75 | 2.3× |
| Lung Ventilat&Perfus Imaging (78582) | $954.70 | $2,386.75 | 1.7× |
| Lung Ventilation Imaging (78579) | $675.44 | $1,688.59 | 1.6× |
| Lymph System Imaging (78195) | $646.95 | $1,617.37 | 1.1× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$2,469.82–$4,939.64 | $6,174.55–$12,349.09 | varies |
| Mammary ductogram or galactogram multiple (77054) | $536.85 | $1,342.11 | 2.1× |
| Mammary ductogram or galactogram single (77053) | $466.92 | $1,167.28 | 1.9× |
| Meckels Divert Exam (78290) | $646.95 | $1,617.37 | 1.5× |
| Mr safety determination physician/other qhp (76016) | $551.20 | $1,378 | 6.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $551.20 | $1,378 | 18.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $551.20 | $1,378 | 5.5× |
| Mr safety implt pos&/immoblj (76019) | $551.20 | $1,378 | 8.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $551.20 | $1,378 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) | $3,329.81 | $8,324.52 | 9.0× |
| MRA head w/o contrast (70544) | $2,647.03 | $6,617.57 | 10.5× |
| MRA head with contrast (70545) | $2,343.21 | $5,858.01 | 6.4× |
| MRA neck w contrast (70548) | $2,939.34 | $7,348.33 | 8.0× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,235.99 | $8,089.96 | 8.8× |
| MRA neck w/o contrast (70547) | $1,675.84 | $4,189.59 | 6.7× |
| MRI abdomen w contrast (74182) | $2,742.54 | $6,856.33 | 7.5× |
| MRI abdomen w/o contrast (74181) | $2,469.82 | $6,174.55 | 9.8× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,742.54–$5,485.07 | $6,856.33–$13,712.66 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$3,019.34–$6,038.68 | $7,548.34–$15,096.68 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,742.54–$5,485.07 | $6,856.33–$13,712.66 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $2,589.93 | $6,474.82 | 10.3× |
| MRI Breast Without Contrast Material Unilateral (77046) | $458.86 | $1,147.14 | 1.8× |
| MRI cervical spine w contrast (72142) | $2,443.84 | $6,109.59 | 6.6× |
| MRI cervical spine w/o cont (72141) | $2,469.82 | $6,174.55 | 9.8× |
| MRI chest w/o contrast (71550) | $2,469.82 | $6,174.55 | 9.8× |
| MRI chest with contrast (71551) | $2,742.54 | $6,856.33 | 3.3× |
| MRI chest wo w contrast (71552) | $3,019.34 | $7,548.34 | 8.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,952.77 | $7,381.91 | 8.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,952.77–$6,038.68 | $7,381.91–$15,096.68 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$2,469.82–$4,939.64 | $6,174.55–$12,349.09 | varies |
| MRI lumbar spine w contrast (72149) | $2,742.54 | $6,856.33 | 7.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $3,019.34 | $7,548.34 | 8.2× |
| MRI orbit face &/neck w/o contrast (70540) | $2,277.06 | $5,692.65 | 9.0× |
| MRI orbit face neck w contrast (70542) | $2,343.21 | $5,858.01 | 6.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,628.45 | $6,571.12 | 7.1× |
| MRI pelvis w contrast (72196) | $2,742.54 | $6,856.33 | 7.5× |
| MRI pelvis w/o & w contrast (72197) | $3,019.34 | $7,548.34 | 8.2× |
| MRI pelvis w/o contrast (72195) | $2,469.82 | $6,174.55 | 9.8× |
| MRI thoracic spine w/o contrast (72146) | $2,469.82 | $6,174.55 | 9.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $646.42 | $1,616.03 | 1.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$2,469.82–$4,939.64 | $6,174.55–$12,349.09 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$2,952.77–$6,038.68 | $7,381.91–$15,096.68 | varies |
| MRI, abdomen, combo (74183) | $3,019.34 | $7,548.34 | 8.2× |
| MRI, dorsal spine combo (72157) | $3,019.34 | $7,548.34 | 8.2× |
| MRI, dorsal spine contrast (72147) | $2,186.34 | $5,465.85 | 5.9× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,695.90–$4,939.64 | $4,239.74–$12,349.09 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$3,019.34–$6,038.68 | $7,548.34–$15,096.68 | varies |
| MRI, lumbar spine combo (72158) | $3,019.34 | $7,548.34 | 8.2× |
| Myelogram cervical (72240) | $686.58 | $1,716.44 | 0.8× |
| Myelogram Lumbar (72265) | $686.58 | $1,716.44 | 0.8× |
| Myelography thoracic (72255) | $686.58 | $1,716.44 | 0.8× |
| Myelograpy 2/more regions rs&i (72270) | $762.49 | $1,906.21 | 0.9× |
| Myocardial Spect Multiple Studies (78452) | $1,959.52 | $4,898.79 | 1.4× |
| N-invas est c ffr sw aly CTA (75580) | $6,749.14 | $16,872.83 | 7.5× |
| Neck soft tissue (70360) | $268.81 | $672.02 | 2.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $388.61 | $971.52 | 0.9× |
| Nm csf leak detection (78650) | $728.66 | $1,821.63 | 0.5× |
| Nonvascular Shunt X-Ray (75809) | $465.48 | $1,163.70 | 4.2× |
| Nuclear Rx Intra-Arterial (79445) | $1,183.08 | $2,957.70 | 4.8× |
| Nuclear Rx Oral Admin (79005) | $1,144.14 | $2,860.34 | 4.6× |
| Ob us nuchal meas 1 gest (76813) | $345 | $862.49 | 3.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) range across 2 matching MRF lines |
$473.46–$946.92 | $1,183.64–$2,367.28 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,805.51 | $4,513.77 | 3.2× |
| Parathyroid Planar Imaging (78070) | $513.08 | $1,282.69 | 1.2× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,978.59 | $4,946.47 | 4.7× |
| Pelvis 1 or 2 views (72170) | $222.27 | $555.67 | 2.0× |
| Peritoneogram Rs&I (74190) | $511.56 | $1,278.89 | 0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $596.82 | $1,492.05 | 1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $374.64 | $936.59 | 3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $462.68 | $1,156.69 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $222.27 | $555.67 | 2.0× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$213.72–$288.94 | $534.28–$722.35 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$288.94–$327.39 | $722.35–$818.46 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $245.81 | $614.51 | 2.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $222.27 | $555.67 | 2.4× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$222.27–$309.87 | $555.67–$774.67 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $222.27 | $555.67 | 2.4× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $354.10 | $885.24 | 1.9× |
| Radex Spine 1 View Specify Level (72020) | $222.27 | $555.67 | 2.4× |
| Radex Sternum Minimum 2 Views (71120) | $208.01 | $520.02 | 2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $202.06 | $505.14 | 2.2× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$221.20–$288.94 | $552.98–$722.35 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $438.52 | $1,096.28 | 4.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $391.19 | $977.96 | 3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $212.53 | $531.32 | 1.9× |
| Radiologic exam colon double contrast study (74280) | $672.02 | $1,680.03 | 3.6× |
| Radiologic exam colon single contrast study (74270) | $459.75 | $1,149.36 | 2.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $449.25 | $1,123.12 | 2.4× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$347.54–$391.19 | $868.83–$977.96 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $222.27 | $555.67 | 2.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $569.61 | $1,424.02 | 3.1× |
| Radiologic exam swallow function contrast study (74230) | $459.75 | $1,149.36 | 2.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $459.75 | $1,149.36 | 2.5× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$157.78–$185.23 | $394.43–$463.06 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$206.57–$268.56 | $516.42–$671.38 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$222.27–$251.88 | $555.67–$629.70 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Ribs bilateral 3 views (71110) | $333.41 | $833.52 | 3.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $841.98 | $2,104.94 | 2.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,111.41 | $2,778.51 | 2.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,680.59 | $4,201.46 | 2.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,672 | $4,179.98 | 2.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,136.67 | $2,841.67 | 2.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $1,500.41 | $3,751.01 | 1.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,650.44 | $4,126.09 | 1.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,250.34 | $3,125.84 | 0.9× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $724.26 | $1,810.65 | 2.9× |
| Rp Therapy Intravenous Administration (79101) | $712.75 | $1,781.86 | 2.9× |
| Scapula (73010) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $16 | $40 | 0.7× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$165.16–$185.23 | $412.89–$463.06 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$519.23–$675 | $1,298.07–$1,687.49 | varies |
| Sialogram (70390) | $722.87 | $1,807.17 | 2.9× |
| Skull less than 4 views (70250) | $222.27 | $555.67 | 2.0× |
| Sternoclavicular joints (71130) | $222.27 | $555.67 | 2.4× |
| Testicular Imaging W/Flow (78761) | $480.17 | $1,200.42 | 1.1× |
| Thoracic spine 2 views (72070) | $222.27 | $555.67 | 2.0× |
| Thoracic spine 3 views (72072) | $222.27 | $555.67 | 2.0× |
| Thoracolumbar 2 views (72080) | $222.27 | $555.67 | 2.4× |
| Thyroid Imaging With Vascular Flow (78013) | $645.76 | $1,614.40 | 1.5× |
| Thyroid Met Imaging Body (78018) | $1,128.90 | $2,822.23 | 2.0× |
| Thyroid Uptake Measurement (78012) | $282.74 | $706.83 | 0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $724.33 | $1,810.82 | 1.7× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$262.94–$923.65 | $657.35–$2,309.12 | varies |
| Ultrasound Exam Aaa Screen (76706) | $215.35 | $538.37 | 2.0× |
| Ultrasound, abdomen limited (76705) | $548.80 | $1,371.99 | 5.0× |
| Umbilical-artery Doppler (OB) (76820) | $362.52 | $906.29 | 3.3× |
| Unlisted Dx Radiographic Procedure (76499) | $3,717.26 | $9,293.15 | 40.5× |
| Upper gi w/o kub (74240) | $413.77 | $1,034.42 | 2.2× |
| Ureteral Reflux Study (78740) | $555.94 | $1,389.83 | 1.3× |
| Urethrocystogram voiding (74455) | $720.91 | $1,802.26 | 2.9× |
| Urethrocystography retrograde (74450) | $720.91 | $1,802.26 | 2.9× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$262.94–$525.88 | $657.35–$1,314.69 | varies |
| Us chest (76604) | $547.78 | $1,369.44 | 5.0× |
| Us complete joint (76881) range across 2 matching MRF lines |
$331.81–$663.63 | $829.52–$1,659.07 | varies |
| Us exam, pelvic, limited (76857) | $340.33 | $850.81 | 3.1× |
| Us head (76506) | $547.78 | $1,369.44 | 5.0× |
| Us kidney transplant (76776) | $604.34 | $1,510.84 | 5.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $355.47 | $888.66 | 3.2× |
| Us ob detailed single fetus (76811) | $521.80 | $1,304.49 | 2.1× |
| Us ob limited 1 or more fetuses (76815) | $340.33 | $850.81 | 3.1× |
| Us ob transvaginal (76817) | $462.36 | $1,155.89 | 4.2× |
| Us pelvic non ob complete (76856) | $714.44 | $1,786.08 | 6.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $340.33 | $850.81 | 3.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $340.33 | $850.81 | 3.1× |
| Us retroperitoneal complete (76770) | $631.70 | $1,579.25 | 5.7× |
| Us retroperitoneal limited (76775) | $548.95 | $1,372.36 | 5.0× |
| Us scrotum and contents (76870) | $548.95 | $1,372.36 | 5.0× |
| Us thyroid (76536) | $685.30 | $1,713.24 | 6.2× |
| Venography extremity bilateral rs&i (75822) | $966.77 | $2,416.91 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $768.35 | $1,920.87 | 0.5× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$222.27–$288.94 | $555.67–$722.35 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $440.92 | $1,102.30 | 4.8× |
| X-ray antegrade pyelogram tube (74425) | $678.84 | $1,697.10 | 1.8× |
| X-Ray Bend Only L-S Spine (72120) | $348.64 | $871.58 | 3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$215.88–$222.27 | $539.70–$555.67 | varies |
| X-Ray Exam Breast Specimen (76098) | $423.08 | $1,057.69 | 0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $185.23 | $463.06 | 2.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $222.27 | $555.67 | 2.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $308.74 | $771.84 | 2.8× |
| X-Ray Exam Hip Uni 1 View (73501) | $222.27 | $555.67 | 2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $277.84 | $694.58 | 3.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $325.99 | $814.97 | 3.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $426.54 | $1,066.35 | 3.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $302.99 | $757.46 | 2.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $614.21 | $1,535.52 | 5.6× |
| X-Ray Exam L-S Spine Bending (72114) | $384.89 | $962.22 | 3.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $280.87 | $702.16 | 3.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $341.78 | $854.43 | 3.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $222.27 | $555.67 | 2.0× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$225.76–$291.21 | $564.39–$728.02 | varies |
| X-ray humerus (73060) | $222.27 | $555.67 | 2.4× |
| X-ray IV pyelogram (ivp) (74400) | $720.91 | $1,802.26 | 3.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $222.27 | $555.67 | 2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $333.41 | $833.52 | 3.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $309.53 | $773.82 | 2.8× |
| X-ray nose-rectum child f.b. (76010) | $246.61 | $616.51 | 2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $488.99 | $1,222.46 | 4.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $222.27 | $555.67 | 2.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $222.27 | $555.67 | 2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $222.27 | $555.67 | 2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $222.27 | $555.67 | 2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $391.19 | $977.96 | 3.5× |
| X-Ray Stress View (77071) | $165.63 | $414.07 | 1.8× |
| X-ray thoracic spine 4 vw (72074) | $372.07 | $930.17 | 3.4× |
| X-Ray Tmj Unilat (70328) | $146.70 | $366.73 | 1.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $720.91 | $1,802.26 | 2.0× |
| X-Rays Bone Length Studies (77073) | $149.96 | $374.90 | 1.4× |
| X-Rays Bone Survey Complete (77075) | $400.59 | $1,001.46 | 3.6× |
| Xr c-spine 4 or 5 views (72050) | $325.99 | $814.97 | 3.0× |
| Xr facial bones less than 3 views (70140) | $205.82 | $514.55 | 2.2× |
| Xr orbits complete 4 views (70200) | $334.47 | $836.16 | 3.0× |
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.