Imaging prices at St. Bernards Medical Center
Jonesboro, AR · every code in this section with a posted price and a Medicare benchmark.
363 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) range across 2 matching MRF lines |
$347.75–$1,644.50 | $535–$2,530 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$22.75–$113.75 | $35–$175 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$27.30–$136.50 | $42–$210 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $513.50 | $790 | 1.4× |
| Angio internal mammary (75756) | $3,948.75 | $6,075 | 1.3× |
| Angio pulmonary bilat (75743) range across 3 matching MRF lines |
$168.35–$4,091.75 | $259–$6,295 | varies |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $3,948.75 | $6,075 | 1.3× |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$3,068–$4,091.75 | $4,720–$6,295 | varies |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$3,068–$4,091.75 | $4,720–$6,295 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,948.75 | $6,075 | 1.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,721.25 | $5,725 | 1.3× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$35.75–$113.75 | $55–$175 | varies |
| Aortography thoracic serialography rs&i (75605) range across 3 matching MRF lines |
$5,102.50–$7,026.50 | $7,850–$10,810 | varies |
| Artery X-Rays Abdomen (75726) | $6,805.50 | $10,470 | 1.3× |
| Artery X-Rays Adrenal Gland (75731) | $3,948.75 | $6,075 | 1.3× |
| Artery X-Rays Pelvis (75736) range across 3 matching MRF lines |
$6,201–$7,026.50 | $9,540–$10,810 | varies |
| Artery X-Rays Spine (75705) range across 2 matching MRF lines |
$347.75–$7,026.50 | $535–$10,810 | varies |
| Arthrogram ankle (73615) | $438.75 | $675 | 1.3× |
| Arthrogram hip (73525) | $438.75 | $675 | 1.3× |
| Arthrogram Wrist (73115) | $438.75 | $675 | 1.3× |
| Basic radiation dosimetry calculation (77300) range across 3 matching MRF lines |
$146.25–$165.75 | $225–$255 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$14.95–$136.50 | $23–$210 | varies |
| Bone Imaging 3 Phase (78315) | $513.50 | $790 | 1.4× |
| Bone Imaging Limited Area (78300) | $513.50 | $790 | 1.4× |
| Bone Imaging Multiple Areas (78305) | $513.50 | $790 | 1.4× |
| Bone Imaging Whole Body (78306) | $513.50 | $790 | 1.4× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$91–$136.50 | $140–$210 | varies |
| Brachytx isodose complex (77318) | $533 | $820 | 1.5× |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$130–$442 | $200–$680 | varies |
| Brachytx Isodose Plan Simple (77316) range across 2 matching MRF lines |
$97.50–$442 | $150–$680 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $669.50 | $1,030 | 1.3× |
| Brain Imaging Minimum 4 Static Views (78605) | $669.50 | $1,030 | 1.3× |
| Cat Scan Follow-Up Study (76380) | $78 | $120 | 1.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $669.50 | $1,030 | 1.3× |
| Cerebrospinal Fluid Scan (78630) | $669.50 | $1,030 | 1.3× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$11.70–$113.75 | $18–$175 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$20.80–$113.75 | $32–$175 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$29.25–$113.75 | $45–$175 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$28.60–$136.50 | $44–$210 | varies |
| Cholecystography Oral Contrast (74290) | $227.50 | $350 | 1.4× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$21.45–$113.75 | $33–$175 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$136.50–$195 | $210–$300 | varies |
| Continuing medical physics consltj pr wk (77336) | $159.25 | $245 | 1.3× |
| Contrast Exam Abdominl Aorta (75625) range across 3 matching MRF lines |
$3,068–$4,091.75 | $4,720–$6,295 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$45.50–$438.75 | $70–$675 | varies |
| Contrast X-Ray Of Elbow (73085) | $438.75 | $675 | 1.3× |
| Contrast X-Ray Of Knee Joint (73580) | $438.75 | $675 | 1.3× |
| Corpora cavernosography (74445) | $136.50 | $210 | 1.4× |
| CT abdomen and pelvis without and with contrast (74178) | $477.75 | $735 | 1.5× |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$111.80–$302.25 | $172–$465 | varies |
| CT abdomen w contrast (74160) | $227.50 | $350 | 1.4× |
| CT abdomen w wo contrast (74170) | $227.50 | $350 | 1.4× |
| CT abdomen w/o contrast (74150) | $136.50 | $210 | 1.4× |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$123.50–$477.75 | $190–$735 | varies |
| CT Angio Chest (71275) | $227.50 | $350 | 1.4× |
| CT Angio Head (70496) range across 2 matching MRF lines |
$227.50–$552.50 | $350–$850 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$133.25–$227.50 | $205–$350 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $227.50 | $350 | 1.4× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$107.25–$227.50 | $165–$350 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$107.25–$227.50 | $165–$350 | varies |
| CT cervical spine w/ contrast (72126) | $477.75 | $735 | 1.5× |
| CT cervical spine w/o contrast (72125) | $136.50 | $210 | 1.4× |
| CT cervical spine w/wo cont (72127) | $227.50 | $350 | 1.4× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$131.95–$227.50 | $203–$350 | varies |
| CT chest w/wo contrast (71270) | $227.50 | $350 | 1.4× |
| CT head/brain with contrast (70460) | $227.50 | $350 | 1.4× |
| CT head/brain without and with contrast (70470) | $227.50 | $350 | 1.4× |
| CT heart contrast eval cardiac structure&morph (75572) range across 3 matching MRF lines |
$94.25–$464.75 | $145–$715 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $48.75 | $75 | 0.6× |
| CT iac w contrast (70481) | $227.50 | $350 | 1.4× |
| CT l-spine w&w/o contrast (72133) | $227.50 | $350 | 1.4× |
| CT lower ext w/o (73700) | $136.50 | $210 | 1.4× |
| CT lower extremity w/contrast material (73701) | $227.50 | $350 | 1.4× |
| CT lumbar spine w contrast (72132) | $477.75 | $735 | 1.5× |
| CT lumbar spine w/o contrast (72131) | $136.50 | $210 | 1.4× |
| CT maxillofacial w contrast (70487) | $227.50 | $350 | 1.4× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$94.90–$136.50 | $146–$210 | varies |
| CT neck tissue combo (70492) | $227.50 | $350 | 1.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $227.50 | $350 | 1.4× |
| CT orbits w/o contrast (70480) | $136.50 | $210 | 1.4× |
| CT pelvis w&w/o contrast (72194) | $227.50 | $350 | 1.4× |
| CT pelvis w/o contrast (72192) | $136.50 | $210 | 1.4× |
| CT scan of leg combo (73702) | $227.50 | $350 | 1.4× |
| CT scans face/jaw combo (70488) | $227.50 | $350 | 1.4× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$131.95–$227.50 | $203–$350 | varies |
| CT soft tissue neck w/o contrast (70490) | $136.50 | $210 | 1.4× |
| CT thoracic spine w contrast (72129) | $227.50 | $350 | 1.4× |
| CT thoracic spine w/o contrast (72128) | $136.50 | $210 | 1.4× |
| CT thoracic spine w/wo cont (72130) | $227.50 | $350 | 1.4× |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$102.70–$136.50 | $158–$210 | varies |
| CT upper ext wo (73200) | $136.50 | $210 | 1.4× |
| CT upper extremity w/o & w/contrast material (73202) | $227.50 | $350 | 1.4× |
| CT upper extremity with contrast (73201) | $477.75 | $735 | 1.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$143–$227.50 | $220–$350 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$113.75–$227.50 | $175–$350 | varies |
| CTA pelvis (72191) | $227.50 | $350 | 1.4× |
| Dilation ureters/urethra rs&i (74485) | $2,522 | $3,880 | 1.3× |
| Dxa Bone Density Axial (77080) range across 4 matching MRF lines |
$136.50–$195 | $210–$300 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$58.50–$143 | $90–$220 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $45.50 | $70 | 0.6× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$126.75–$302.25 | $195–$465 | varies |
| Echo Guide For Artery Repair (76936) range across 4 matching MRF lines |
$370.50–$425.75 | $570–$655 | varies |
| Esophagram (74220) | $227.50 | $350 | 1.4× |
| Fetal Biophys Profile W/Nst (76818) | $149.50 | $230 | 1.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$130–$146.25 | $200–$225 | varies |
| Fluoroscopy up to 1 hr (76000) range across 6 matching MRF lines |
$292.50–$315.25 | $15–$485 | varies |
| Follow-Up Angiography (75898) range across 6 matching MRF lines |
$3,721.25–$4,091.75 | $210–$6,295 | varies |
| Foot 2 views (73620) range across 3 matching MRF lines |
$23.40–$113.75 | $36–$175 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$24.70–$113.75 | $38–$175 | varies |
| Gastric emptying imaging study (78264) | $513.50 | $790 | 1.4× |
| Gastroesophageal Reflux Exam (78262) | $513.50 | $790 | 1.4× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$58.50–$507 | $90–$780 | varies |
| Hand 2 views (73120) range across 3 matching MRF lines |
$35.75–$136.50 | $55–$210 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,222 | $1,880 | 1.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$247–$962 | $380–$1,480 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 2 matching MRF lines |
$110.50–$962 | $170–$1,480 | varies |
| Heart first pass single,planar (78481) | $669.50 | $1,030 | 1.3× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,948.75 | $6,075 | 1.3× |
| Hepatobil Syst Image W/Drug (78227) | $669.50 | $1,030 | 1.3× |
| Hepatobiliary System Imaging (78226) | $513.50 | $790 | 1.4× |
| Ht Muscle Image Spect Sing (78451) range across 6 matching MRF lines |
$81.25–$1,761.50 | $125–$2,710 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$289.25–$302.25 | $445–$465 | varies |
| Infant hip ultrasound, limited static exam (76886) | $113.75 | $175 | 1.4× |
| Infusion Ivp (74410) | $227.50 | $350 | 1.4× |
| Interstitial radiation source applic complex (77778) | $1,313 | $2,020 | 2.0× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,066 | $1,640 | 1.6× |
| Intracavitary Radiation Source Applic Intermed (77762) | $796.25 | $1,225 | 1.5× |
| Intracavitary radiation source applic simple (77761) | $705.25 | $1,085 | 1.4× |
| Joint Survey Single View (77077) | $23.40 | $36 | 0.2× |
| K Flow/Funct Image Multiple (78709) | $669.50 | $1,030 | 1.3× |
| K Flow/Funct Image W/Drug (78708) | $669.50 | $1,030 | 1.3× |
| K Flow/Funct Image W/O Drug (78707) | $669.50 | $1,030 | 1.3× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$30.55–$113.75 | $47–$175 | varies |
| Leveen/Shunt Patency Exam (78291) | $490.75 | $755 | 1.3× |
| Liver & Spleen Imaging Static Only (78215) | $513.50 | $790 | 1.4× |
| Lung Perf&Ventilat Diferentl (78598) | $669.50 | $1,030 | 1.3× |
| Lung Ventilat&Perfus Imaging (78582) | $669.50 | $1,030 | 1.3× |
| Lung Ventilation Imaging (78579) | $513.50 | $790 | 1.4× |
| Lymph System Imaging (78195) | $669.50 | $1,030 | 1.3× |
| Magnetic Image Jaw Joint (70336) | $302.25 | $465 | 1.4× |
| Mammary ductogram or galactogram multiple (77054) | $302.25 | $465 | 1.4× |
| Mammary ductogram or galactogram single (77053) | $302.25 | $465 | 1.4× |
| Meckels Divert Exam (78290) | $513.50 | $790 | 1.4× |
| Mlc imrt design & construction per imrt plan (77338) range across 3 matching MRF lines |
$325–$698.75 | $500–$1,075 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $32.50 | $50 | 1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $120.25 | $185 | 1.3× |
| MRA head w/o contrast (70544) | $302.25 | $465 | 1.4× |
| MRA head with contrast (70545) | $497.25 | $765 | 1.5× |
| MRA neck w contrast (70548) | $477.75 | $735 | 1.5× |
| Mra Neck W/O &W/Contrast Material (70549) | $477.75 | $735 | 1.5× |
| MRA neck w/o contrast (70547) | $302.25 | $465 | 1.4× |
| MRI abdomen w contrast (74182) | $477.75 | $735 | 1.5× |
| MRI abdomen w/o contrast (74181) | $302.25 | $465 | 1.4× |
| MRI any jt lower extrem w/contrast material (73722) | $991.25 | $1,525 | 1.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $477.75 | $735 | 1.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $991.25 | $1,525 | 1.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $302.25 | $465 | 1.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $302.25 | $465 | 1.4× |
| MRI cardiac w/o contrast (75557) | $302.25 | $465 | 1.4× |
| MRI cervical spine w contrast (72142) | $477.75 | $735 | 1.5× |
| MRI cervical spine w/o cont (72141) | $302.25 | $465 | 1.4× |
| MRI chest w/o contrast (71550) | $302.25 | $465 | 1.4× |
| MRI chest with contrast (71551) | $991.25 | $1,525 | 1.3× |
| MRI chest wo w contrast (71552) | $477.75 | $735 | 1.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $477.75 | $735 | 1.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $477.75 | $735 | 1.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $302.25 | $465 | 1.4× |
| MRI lumbar spine w contrast (72149) | $477.75 | $735 | 1.5× |
| Mri Neck Spine W/O & W/Dye (72156) | $477.75 | $735 | 1.5× |
| MRI orbit face &/neck w/o contrast (70540) | $302.25 | $465 | 1.4× |
| MRI orbit face neck w contrast (70542) | $477.75 | $735 | 1.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $477.75 | $735 | 1.5× |
| MRI pelvis w contrast (72196) | $477.75 | $735 | 1.5× |
| MRI pelvis w/o & w contrast (72197) | $487.50 | $750 | 1.5× |
| MRI pelvis w/o contrast (72195) | $302.25 | $465 | 1.4× |
| MRI thoracic spine w/o contrast (72146) | $302.25 | $465 | 1.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $477.75 | $735 | 1.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $302.25 | $465 | 1.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $477.75 | $735 | 1.5× |
| MRI, abdomen, combo (74183) | $477.75 | $735 | 1.5× |
| MRI, dorsal spine combo (72157) | $477.75 | $735 | 1.5× |
| MRI, dorsal spine contrast (72147) | $477.75 | $735 | 1.5× |
| MRI, joint upper extrem (73221) | $302.25 | $465 | 1.4× |
| MRI, joint upper extrem combo (73223) | $477.75 | $735 | 1.5× |
| MRI, lumbar spine combo (72158) | $477.75 | $735 | 1.5× |
| Myocardial Spect Multiple Studies (78452) range across 7 matching MRF lines |
$94.25–$1,761.50 | $145–$2,710 | varies |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $97.50 | $150 | 0.0× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$22.10–$113.75 | $34–$175 | varies |
| Nm csf leak detection (78650) | $1,761.50 | $2,710 | 1.5× |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$617.50–$2,044.25 | $950–$3,145 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$162.50–$338 | $250–$520 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $669.50 | $1,030 | 1.3× |
| Parathyroid Planar Imaging (78070) | $513.50 | $790 | 1.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $513.50 | $790 | 1.4× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$23.40–$136.50 | $36–$210 | varies |
| Peritoneogram Rs&I (74190) | $682.50 | $1,050 | 1.3× |
| PET whole body (78813) | $1,618.50 | $2,490 | 1.2× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $1,758.25 | $2,705 | 1.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,948.75 | $6,075 | 1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $513.50 | $790 | 1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$39–$136.50 | $60–$210 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $682.50 | $1,050 | 1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$27.30–$113.75 | $42–$175 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$23.40–$113.75 | $36–$175 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$31.20–$113.75 | $48–$175 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$31.85–$136.50 | $49–$210 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$31.20–$113.75 | $48–$175 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$27.30–$113.75 | $42–$175 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$27.30–$113.75 | $42–$175 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $136.50 | $210 | 1.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$27.95–$113.75 | $43–$175 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$22.75–$113.75 | $35–$175 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$26.65–$113.75 | $41–$175 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$28.60–$113.75 | $44–$175 | varies |
| Radex Spine 1 View Specify Level (72020) range across 4 matching MRF lines |
$22.75–$113.75 | $35–$175 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$29.90–$113.75 | $46–$175 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $113.75 | $175 | 1.4× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$24.70–$113.75 | $38–$175 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $136.50 | $210 | 1.4× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$29.90–$113.75 | $46–$175 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$45.50–$136.50 | $70–$210 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $11,722.75 | $18,035 | 1.7× |
| Radiation treatment delivery level 1 (77402) | $156 | $240 | 1.6× |
| Radiation treatment delivery level 2 (77407) | $315.25 | $485 | 0.9× |
| Radiation treatment delivery level 3 (77412) | $315.25 | $485 | 0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$27.30–$136.50 | $42–$210 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$45.50–$136.50 | $70–$210 | varies |
| Radiologic exam colon double contrast study (74280) | $227.50 | $350 | 1.4× |
| Radiologic exam colon single contrast study (74270) | $227.50 | $350 | 1.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $227.50 | $350 | 1.4× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$52–$136.50 | $80–$210 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$42.25–$159.25 | $65–$245 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $227.50 | $350 | 1.4× |
| Radiologic exam swallow function contrast study (74230) | $227.50 | $350 | 1.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $227.50 | $350 | 1.4× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$19.50–$113.75 | $30–$175 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$30.55–$113.75 | $47–$175 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$24.70–$113.75 | $38–$175 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $139.75 | $215 | 1.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$24.05–$113.75 | $37–$175 | varies |
| Red Cell Volume Determination Spx Mult Samplings (78121) range across 3 matching MRF lines |
$107.25–$669.50 | $30–$1,030 | varies |
| Renal Cyst Study (74470) | $682.50 | $1,050 | 1.3× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$36.40–$136.50 | $56–$210 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $513.50 | $790 | 1.4× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,725.75 | $2,655 | 3.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,761.50 | $2,710 | 3.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 9 matching MRF lines |
$61.75–$1,940.25 | $95–$2,985 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,940.25 | $2,985 | 1.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $81.25 | $125 | 0.1× |
| Rp Therapy Intravenous Administration (79101) range across 4 matching MRF lines |
$162.50–$338 | $250–$520 | varies |
| Scapula (73010) range across 3 matching MRF lines |
$25.35–$136.50 | $39–$210 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $42.25 | $65 | 1.8× |
| Sella turcica (70240) | $113.75 | $175 | 1.4× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$32.50–$113.75 | $50–$175 | varies |
| Shoulder Arthrography (73040) | $438.75 | $675 | 1.3× |
| Sialogram (70390) | $302.25 | $465 | 1.4× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$30.55–$136.50 | $47–$210 | varies |
| Special dosimetry (77331) range across 3 matching MRF lines |
$68.25–$165.75 | $105–$255 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$165.75–$169 | $255–$260 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$74.75–$442 | $115–$680 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$159.25–$705.25 | $245–$1,085 | varies |
| Spleen Imaging (78185) | $432.25 | $665 | 1.2× |
| Stereotactic Body Radiation Delivery (77373) | $6,214 | $9,560 | 3.7× |
| Sternoclavicular joints (71130) | $113.75 | $175 | 1.4× |
| Superior sagittal sinus venogram (75870) | $4,091.75 | $6,295 | 1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 4 matching MRF lines |
$201.50–$442 | $310–$680 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) range across 4 matching MRF lines |
$97.50–$442 | $150–$680 | varies |
| Temporomandble Jt Arthrography Rs&I (70332) range across 3 matching MRF lines |
$221–$302.25 | $340–$465 | varies |
| Testicular Imaging W/Flow (78761) | $513.50 | $790 | 1.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$126.75–$695.50 | $195–$1,070 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $624 | $960 | 1.8× |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$55.25–$377 | $85–$580 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $227.50 | $350 | 1.4× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$29.90–$136.50 | $46–$210 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$25.35–$136.50 | $39–$210 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$46.80–$113.75 | $72–$175 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $513.50 | $790 | 1.4× |
| Thyroid Met Imaging Body (78018) | $669.50 | $1,030 | 1.3× |
| Thyroid Uptake Measurement (78012) | $513.50 | $790 | 1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $513.50 | $790 | 1.4× |
| Tx Devices Design & Construction Complex (77334) range across 3 matching MRF lines |
$191.75–$442 | $295–$680 | varies |
| Tx devices design & construction intermediate (77333) | $165.75 | $255 | 1.3× |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$42.25–$165.75 | $65–$255 | varies |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$113.75–$214.50 | $175–$330 | varies |
| Ultrasound Exam Aaa Screen (76706) | $136.50 | $210 | 1.4× |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$65.65–$139.75 | $101–$215 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 4 matching MRF lines |
$65–$139.75 | $100–$215 | varies |
| Unlisted Procedure Clinical Brachytherapy (77799) | $156 | $240 | 1.6× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$113.75–$130 | $175–$200 | varies |
| Upper gi w/o kub (74240) | $227.50 | $350 | 1.4× |
| Ureteral Reflux Study (78740) | $432.25 | $665 | 1.2× |
| Urethrocystogram voiding (74455) | $302.25 | $465 | 1.4× |
| Urethrocystography retrograde (74450) | $302.25 | $465 | 1.4× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$136.50–$292.50 | $210–$450 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$65–$136.50 | $100–$210 | varies |
| Us complete joint (76881) | $136.50 | $210 | 1.4× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$26–$146.25 | $40–$225 | varies |
| Us head (76506) | $136.50 | $210 | 1.4× |
| Us kidney transplant (76776) | $136.50 | $210 | 1.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $136.50 | $210 | 1.4× |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$113.75–$146.25 | $175–$225 | varies |
| Us ob transvaginal (76817) | $136.50 | $210 | 1.4× |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$75.40–$136.50 | $116–$210 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $136.50 | $210 | 1.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$120.25–$136.50 | $185–$210 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$76.05–$139.75 | $117–$215 | varies |
| Us retroperitoneal limited (76775) range across 7 matching MRF lines |
$81.25–$139.75 | $125–$215 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$35.75–$136.50 | $55–$210 | varies |
| Us spinal canal and contents (76800) | $136.50 | $210 | 1.4× |
| Us thyroid (76536) range across 3 matching MRF lines |
$87.75–$139.75 | $135–$215 | varies |
| Us transrectal (76872) | $162.50 | $250 | 1.7× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$1,982.50–$2,018.25 | $3,050–$3,105 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,948.75 | $6,075 | 1.3× |
| Venogram Sinus/Jugular (75860) | $3,948.75 | $6,075 | 1.3× |
| Venography Adrenal Unilateral (75840) | $3,948.75 | $6,075 | 1.3× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$3,948.75–$4,091.75 | $6,075–$6,295 | varies |
| Venography extremity bilateral rs&i (75822) range across 4 matching MRF lines |
$1,982.50–$2,018.25 | $100–$3,105 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$1,982.50–$2,018.25 | $3,050–$3,105 | varies |
| Venography Renal Bilateral (75833) | $3,948.75 | $6,075 | 1.3× |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$3,948.75–$4,091.75 | $6,075–$6,295 | varies |
| Venous sampling by catheter (75893) range across 2 matching MRF lines |
$6,201–$6,805.50 | $9,540–$10,470 | varies |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$39–$107.25 | $60–$165 | varies |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$23.40–$113.75 | $36–$175 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$42.90–$113.75 | $66–$175 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$52–$438.75 | $80–$675 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 4 matching MRF lines |
$3,068–$4,091.75 | $170–$6,295 | varies |
| X-Ray Bend Only L-S Spine (72120) | $32.50 | $50 | 0.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$24.70–$113.75 | $38–$175 | varies |
| X-Ray Exam Breast Specimen (76098) | $682.50 | $1,050 | 1.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$18.20–$113.75 | $28–$175 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$31.85–$136.50 | $49–$210 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$52.65–$136.50 | $81–$210 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$19.50–$113.75 | $30–$175 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$31.85–$113.75 | $49–$175 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$65–$136.50 | $100–$210 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$31.85–$136.50 | $49–$210 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$36.40–$136.50 | $56–$210 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$89.70–$136.50 | $138–$210 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$80.60–$136.50 | $124–$210 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$31.85–$113.75 | $49–$175 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$42.25–$136.50 | $65–$210 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$26–$136.50 | $40–$210 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$26.65–$113.75 | $41–$175 | varies |
| X-ray IV pyelogram (ivp) (74400) | $227.50 | $350 | 1.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$25.35–$117 | $39–$180 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$42.25–$113.75 | $65–$175 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$34.45–$136.50 | $53–$210 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$19.50–$48.10 | $30–$74 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $34.45 | $53 | 0.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $136.50 | $210 | 1.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $35.75 | $55 | 0.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$26–$113.75 | $40–$175 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$35.75–$113.75 | $55–$175 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$65–$136.50 | $100–$210 | varies |
| X-Ray Stress View (77071) | $113.75 | $175 | 1.4× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$45.50–$136.50 | $70–$210 | varies |
| X-Ray Tmj Unilat (70328) | $113.75 | $175 | 1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$26–$438.75 | $40–$675 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$53.95–$136.50 | $83–$210 | varies |
| X-Rays Bone Survey Complete (77075) | $136.50 | $210 | 1.4× |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$32.50–$136.50 | $50–$210 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$26–$55.25 | $40–$85 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$29.25–$136.50 | $45–$210 | 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.