Imaging prices at St. Catherine Hospital - Garden City
Garden City, KS · every code in this section with a posted price and a Medicare benchmark.
300 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) | $89.47 | $223.67 | 1.0× |
| Abdomen 2 views (74019) | $71.26 | $178.15 | 0.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $320.14 | $800.34 | 0.8× |
| Angiography extremity bilateral rs&i (75716) | $2,300.39 | $5,750.97 | 0.7× |
| Angiography extremity unilateral rs&i (75710) | $1,982.14 | $4,955.35 | 0.6× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$72.55–$94.31 | $181.36–$235.76 | varies |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$2,457.18 | $6,142.94 | 0.4× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$2,457.18 | $6,142.94 | 0.4× |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$397.23–$516.40 | $993.07–$1,290.99 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$365.77–$475.30 | $914.41–$1,188.25 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$251.88–$327.44 | $629.69–$818.59 | varies |
| Bone age studies (77072) | $90.18 | $225.43 | 0.9× |
| Bone Imaging 3 Phase (78315) | $547 | $1,367.48 | 1.4× |
| Bone Imaging Limited Area (78300) | $243.62 | $609.05 | 0.6× |
| Bone Imaging Multiple Areas (78305) | $249.23 | $623.06 | 0.6× |
| Bone Imaging Whole Body (78306) | $555.62 | $1,389.05 | 1.4× |
| Bone survey infant (77076) | $579.51 | $1,448.77 | 5.6× |
| Brain Flow Imaging Only (78610) | $383.10 | $957.75 | 0.7× |
| Brain Image W/Flow < 4 Views (78601) | $383.10 | $957.75 | 1.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $921.36 | $2,303.40 | 2.3× |
| Cat Scan Follow-Up Study (76380) | $847.04 | $2,117.58 | 9.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $410.20 | $1,025.50 | 0.8× |
| Cerebrospinal Fluid Scan (78630) | $525.52 | $1,313.80 | 1.0× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$46.05–$123.41 | $115.12–$308.52 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$40.82–$119.74 | $102.05–$299.35 | varies |
| Chest 4 or more views (71048) | $74.24 | $185.59 | 0.7× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$94.19–$122.44 | $235.46–$306.09 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $117.89 | $294.71 | 1.1× |
| Contrast Exam Abdominl Aorta (75625) | $2,300.39 | $5,750.97 | 0.7× |
| Contrast X-Ray Bladder (74430) | $570.22 | $1,425.54 | 1.6× |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$397.23–$516.40 | $993.07–$1,290.99 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$245.40–$319.02 | $613.50–$797.53 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $2,406.36 | $6,015.89 | 6.9× |
| CT abdomen and pelvis without contrast (74176) | $1,818.42 | $4,546.04 | 7.6× |
| CT abdomen w contrast (74160) | $1,121.86 | $2,804.64 | 6.4× |
| CT abdomen w wo contrast (74170) | $1,107.26 | $2,768.15 | 6.3× |
| CT abdomen w/o contrast (74150) | $1,093.31 | $2,733.27 | 10.5× |
| CT Angio Abdomen and Pelvis (74174) | $1,228.74 | $3,071.83 | 3.5× |
| CT Angio Chest (71275) | $989.84 | $2,474.58 | 5.7× |
| CT Angio Head (70496) | $1,116.55 | $2,791.36 | 6.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,228.74–$1,597.16 | $3,071.83–$3,992.88 | varies |
| CT Angio Neck (70498) | $750.25 | $1,875.61 | 4.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,228.74–$1,597.16 | $3,071.83–$3,992.88 | varies |
| CT cervical spine w/ contrast (72126) | $1,202.85 | $3,007.11 | 3.5× |
| CT cervical spine w/o contrast (72125) | $1,093.31 | $2,733.27 | 10.5× |
| CT cervical spine w/wo cont (72127) | $905.45 | $2,263.62 | 5.2× |
| CT chest w contrast (71260) | $1,019.85 | $2,549.61 | 5.8× |
| CT chest w/wo contrast (71270) | $1,157.55 | $2,893.87 | 6.6× |
| CT head/brain with contrast (70460) | $923.93 | $2,309.81 | 5.3× |
| CT head/brain without and with contrast (70470) | $1,192.22 | $2,980.55 | 6.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $451.08 | $1,127.68 | 5.2× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$451.08–$923.93 | $1,127.68–$2,309.81 | varies |
| CT l-spine w&w/o contrast (72133) | $802.69 | $2,006.72 | 4.6× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$898.82–$1,168.33 | $2,247.03–$2,920.82 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$919.22–$1,195.22 | $2,298.03–$2,988.04 | varies |
| CT lumbar spine w contrast (72132) | $1,202.85 | $3,007.11 | 3.5× |
| CT lumbar spine w/o contrast (72131) | $1,093.31 | $2,733.27 | 10.5× |
| CT maxillofacial w contrast (70487) | $526.39 | $1,315.96 | 3.0× |
| CT maxillofacial wo contrast (70486) | $974.19 | $2,435.46 | 9.3× |
| CT neck tissue combo (70492) | $947.28 | $2,368.18 | 5.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$451.08–$1,060.79 | $1,127.68–$2,651.97 | varies |
| CT orbits w/o contrast (70480) | $1,005.69 | $2,514.21 | 9.7× |
| CT pelvis w&w/o contrast (72194) | $1,299.11 | $3,247.76 | 7.4× |
| CT pelvis w/o contrast (72192) | $957.90 | $2,394.74 | 9.2× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$923.93–$1,201.10 | $2,309.81–$3,002.74 | varies |
| CT scans face/jaw combo (70488) | $444.01 | $1,110.02 | 2.5× |
| CT soft tissue neck w contrast (70491) | $1,042.21 | $2,605.51 | 6.0× |
| CT soft tissue neck w/o contrast (70490) | $782.10 | $1,955.24 | 7.5× |
| CT thoracic spine w contrast (72129) | $943.96 | $2,359.89 | 5.4× |
| CT thoracic spine w/o contrast (72128) | $1,182.27 | $2,955.67 | 11.3× |
| CT thoracic spine w/wo cont (72130) | $802.69 | $2,006.72 | 4.6× |
| CT thorax w/o contrast (71250) | $994.54 | $2,486.34 | 9.5× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$778.01–$1,011.67 | $1,945.01–$2,529.17 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,036.90–$1,347.96 | $2,592.23–$3,369.88 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$799.75–$1,039.68 | $1,999.37–$2,599.20 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,116.55 | $2,791.36 | 6.4× |
| Cta Abdomen (74175) | $1,228.74 | $3,071.83 | 7.0× |
| CTA pelvis (72191) | $407.82 | $1,019.55 | 2.3× |
| Doppler Fetal Mid Cerebral Artery (76821) | $69.28 | $173.20 | 0.7× |
| Dxa Bone Density Axial (77080) | $195.17 | $487.91 | 1.9× |
| Dxa bone density study (77085) | $337.25 | $843.12 | 3.2× |
| Esophagram (74220) | $304.03 | $760.07 | 1.7× |
| Fetal Biophys Profile W/Nst (76818) | $106.40 | $266 | 1.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $545.66 | $1,364.14 | 5.2× |
| Fluoroscopy up to 1 hr (76000) | $145.57 | $363.91 | 0.6× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$79.57–$103.46 | $198.92–$258.63 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$94.12–$122.36 | $235.29–$305.89 | varies |
| Gastric emptying imaging study (78264) | $481.94 | $1,204.85 | 1.2× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $504.67 | $1,261.66 | 1.3× |
| Gated Heart Planar Single (78472) | $315.42 | $788.55 | 0.8× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $630.83 | $1,577.06 | 1.2× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$70.30–$91.39 | $175.73–$228.46 | varies |
| Hepatobil Syst Image W/Drug (78227) | $342.66 | $856.65 | 0.6× |
| Hepatobiliary System Imaging (78226) | $342.66 | $856.65 | 0.9× |
| Ht Muscle Image Spect Sing (78451) | $1,652.47 | $4,131.17 | 1.3× |
| Hysterosalpingogram (74740) | $464.02 | $1,160.04 | 2.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $466.55 | $1,166.37 | 5.4× |
| K Flow/Funct Image W/Drug (78708) | $543.44 | $1,358.59 | 1.0× |
| K Flow/Funct Image W/O Drug (78707) | $424.86 | $1,062.13 | 0.8× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$112.64–$146.44 | $281.60–$366.09 | varies |
| Leveen/Shunt Patency Exam (78291) | $434.08 | $1,085.19 | 1.1× |
| Liver & Spleen Imaging Static Only (78215) | $437.24 | $1,093.10 | 1.1× |
| Liver imaging static only (78201) | $627.54 | $1,568.83 | 1.2× |
| Lung Perf&Ventilat Diferentl (78598) | $947.23 | $2,368.07 | 1.8× |
| Lung Ventilat&Perfus Imaging (78582) | $397.57 | $993.92 | 0.7× |
| Lung Ventilation Imaging (78579) | $482.56 | $1,206.39 | 1.2× |
| Lymph System Imaging (78195) | $255.76 | $639.38 | 0.5× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$452.71–$905.41 | $1,131.77–$2,263.51 | varies |
| Mammary ductogram or galactogram multiple (77054) | $150.07 | $375.16 | 0.6× |
| Mammary ductogram or galactogram single (77053) | $395.64 | $989.08 | 1.7× |
| Meckels Divert Exam (78290) | $223.88 | $559.68 | 0.6× |
| Mr safety determination physician/other qhp (76016) | $476 | $1,190 | 5.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $476 | $1,190 | 16.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $476 | $1,190 | 5.0× |
| Mr safety implt pos&/immoblj (76019) | $476 | $1,190 | 8.1× |
| Mr safety med physics xm customization plng&mntr (76017) | $476 | $1,190 | 2.0× |
| Mra Head W/O & W/Contrast Material (70546) | $1,258.33 | $3,145.81 | 3.6× |
| MRA head w/o contrast (70544) | $1,298.44 | $3,246.09 | 5.5× |
| MRA head with contrast (70545) | $1,196.39 | $2,990.96 | 3.4× |
| MRA neck w contrast (70548) | $1,196.39 | $2,990.96 | 3.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,633.67 | $4,084.17 | 4.7× |
| MRA neck w/o contrast (70547) | $1,298.44 | $3,246.09 | 5.5× |
| MRI abdomen w contrast (74182) | $1,196.39 | $2,990.96 | 3.4× |
| MRI abdomen w/o contrast (74181) | $1,298.44 | $3,246.09 | 5.5× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,349.55–$2,699.10 | $3,373.87–$6,747.73 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,633.67–$3,267.33 | $4,084.17–$8,168.31 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,349.55–$2,699.10 | $3,373.87–$6,747.73 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $518.78 | $1,296.95 | 2.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $459.91 | $1,149.77 | 1.9× |
| MRI cervical spine w contrast (72142) | $1,196.39 | $2,990.96 | 3.4× |
| MRI cervical spine w/o cont (72141) | $1,298.44 | $3,246.09 | 5.5× |
| MRI chest w/o contrast (71550) | $1,349.55 | $3,373.87 | 5.7× |
| MRI chest with contrast (71551) | $1,196.39 | $2,990.96 | 1.5× |
| MRI chest wo w contrast (71552) | $1,633.67 | $4,084.17 | 4.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$1,196.39–$2,392.78 | $2,990.96–$5,981.93 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,196.39–$2,392.78 | $2,990.96–$5,981.93 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,151.08–$2,302.16 | $2,877.70–$5,755.38 | varies |
| MRI lumbar spine w contrast (72149) | $1,196.39 | $2,990.96 | 3.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,633.67 | $4,084.17 | 4.7× |
| MRI orbit face &/neck w/o contrast (70540) | $1,349.55 | $3,373.87 | 5.7× |
| MRI orbit face neck w contrast (70542) | $1,196.39 | $2,990.96 | 3.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,633.67 | $4,084.17 | 4.7× |
| MRI pelvis w contrast (72196) | $1,196.39 | $2,990.96 | 3.4× |
| MRI pelvis w/o & w contrast (72197) | $1,633.67 | $4,084.17 | 4.7× |
| MRI pelvis w/o contrast (72195) | $524.42 | $1,311.03 | 2.2× |
| MRI thoracic spine w/o contrast (72146) | $1,298.44 | $3,246.09 | 5.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$1,196.39–$2,392.78 | $2,990.96–$5,981.95 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,298.44–$2,596.88 | $3,246.09–$6,492.18 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,633.67–$3,267.33 | $4,084.17–$8,168.32 | varies |
| MRI, abdomen, combo (74183) | $1,633.67 | $4,084.17 | 4.7× |
| MRI, dorsal spine combo (72157) | $1,448.26 | $3,620.65 | 4.2× |
| MRI, dorsal spine contrast (72147) | $1,196.39 | $2,990.96 | 3.4× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,298.44–$2,596.88 | $3,246.09–$6,492.18 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,633.67–$3,267.33 | $4,084.17–$8,168.32 | varies |
| MRI, lumbar spine combo (72158) | $1,633.67 | $4,084.17 | 4.7× |
| Myelogram cervical (72240) | $2,425.13 | $6,062.82 | 3.1× |
| Myelogram Lumbar (72265) | $2,425.13 | $6,062.82 | 3.1× |
| Myelography thoracic (72255) | $2,425.13 | $6,062.82 | 3.1× |
| Myocardial Spect Multiple Studies (78452) | $1,864.02 | $4,660.04 | 1.4× |
| N-invas est c ffr sw aly CTA (75580) | $6,755.83 | $16,889.57 | 7.9× |
| Neck soft tissue (70360) | $134.54 | $336.35 | 1.6× |
| Nonvascular Shunt X-Ray (75809) | $267.77 | $669.41 | 2.6× |
| Nuclear Rx Oral Admin (79005) | $634.39 | $1,585.97 | 2.7× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $652.07 | $1,630.16 | 1.2× |
| Parathyroid Planar Imaging (78070) | $285.72 | $714.28 | 0.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $652.07 | $1,630.16 | 1.6× |
| Pelvis 1 or 2 views (72170) | $111.79 | $279.46 | 1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $257.77 | $644.41 | 0.6× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $299.44 | $748.58 | 2.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $279.32 | $698.29 | 0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$96.06–$124.88 | $240.14–$312.20 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$84.07–$109.28 | $210.17–$273.19 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$101.18–$131.54 | $252.95–$328.85 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $247.80 | $619.50 | 2.4× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$87.78–$177.25 | $219.43–$443.11 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$87.90–$114.28 | $219.75–$285.68 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$106.16–$138.01 | $265.40–$345.02 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$86.82–$86.96 | $217.05–$217.39 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $119.17 | $297.92 | 1.4× |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$158.42–$237.62 | $396.05–$594.05 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$91.75–$119.28 | $229.36–$298.18 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $69.14 | $172.85 | 0.8× |
| Radex Spine 1 View Specify Level (72020) | $148.70 | $371.75 | 1.7× |
| Radex Sternum Minimum 2 Views (71120) | $97.82 | $244.54 | 1.1× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$95.96–$124.74 | $239.89–$311.85 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$67.05–$87.17 | $167.62–$217.91 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$115.72–$150.44 | $289.30–$376.10 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $426.37 | $1,065.91 | 4.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $147.82 | $369.54 | 1.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $111.63 | $279.06 | 1.1× |
| Radiologic exam colon double contrast study (74280) | $992.74 | $2,481.85 | 5.7× |
| Radiologic exam colon single contrast study (74270) | $992.74 | $2,481.85 | 5.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $304.03 | $760.07 | 1.7× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$140.08–$182.09 | $350.19–$455.22 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $122.48 | $306.20 | 1.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $328.59 | $821.47 | 1.9× |
| Radiologic exam swallow function contrast study (74230) | $312 | $779.99 | 1.8× |
| Radiologic exam upr gi trc double contrast study (74246) | $230.25 | $575.62 | 1.3× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$49–$63.69 | $122.48–$159.22 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$105.55–$137.20 | $263.86–$343 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$101.23–$131.59 | $253.06–$328.97 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $80.24 | $200.60 | 0.8× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$108.90–$141.56 | $272.23–$353.89 | varies |
| Ribs bilateral 3 views (71110) | $125.48 | $313.70 | 1.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $502.60 | $1,256.48 | 1.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $663.42 | $1,658.54 | 1.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $971.59 | $2,428.97 | 1.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $971.59 | $2,428.97 | 1.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $678.50 | $1,696.25 | 1.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $895.62 | $2,239.05 | 0.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $985.18 | $2,462.94 | 0.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $746.35 | $1,865.87 | 0.6× |
| Scapula (73010) range across 2 matching MRF lines |
$94.28–$122.56 | $235.69–$306.39 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $16 | $40 | 0.7× |
| Sella turcica (70240) | $114.17 | $285.42 | 1.3× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$96.04–$124.85 | $240.08–$312.11 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$284.13–$369.36 | $710.31–$923.39 | varies |
| Sialogram (70390) | $373.10 | $932.74 | 1.6× |
| Skull less than 4 views (70250) | $109.59 | $273.97 | 1.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $375.46 | $938.65 | 2.1× |
| Thoracic spine 2 views (72070) | $104.19 | $260.47 | 1.0× |
| Thoracic spine 3 views (72072) | $171.92 | $429.78 | 1.6× |
| Thoracolumbar 2 views (72080) | $91.41 | $228.52 | 1.1× |
| Thyroid Imaging With Vascular Flow (78013) | $191.86 | $479.65 | 0.5× |
| Thyroid Met Imaging Body (78018) | $622.62 | $1,556.54 | 1.2× |
| Thyroid Uptake Measurement (78012) | $198.47 | $496.17 | 0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $285.72 | $714.28 | 0.7× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$148.04–$296.08 | $370.10–$740.18 | varies |
| Ultrasound Exam Aaa Screen (76706) | $95 | $237.49 | 0.9× |
| Ultrasound, abdomen limited (76705) | $367.09 | $917.72 | 3.5× |
| Umbilical-artery Doppler (OB) (76820) | $69.28 | $173.20 | 0.7× |
| Unlisted Dx Radiographic Procedure (76499) | $2,307.73 | $5,769.31 | 26.6× |
| Upper gi w/o kub (74240) | $262.80 | $656.98 | 1.5× |
| Urethrocystogram voiding (74455) | $570.22 | $1,425.54 | 2.4× |
| Urethrocystography retrograde (74450) | $503.84 | $1,259.59 | 2.1× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$148.04–$296.08 | $370.10–$740.18 | varies |
| Us chest (76604) | $311.90 | $779.73 | 3.0× |
| Us exam, pelvic, limited (76857) | $314.66 | $786.64 | 3.0× |
| Us head (76506) | $441.37 | $1,103.42 | 4.2× |
| Us kidney transplant (76776) | $130.44 | $326.10 | 1.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$128.12–$166.56 | $320.29–$416.38 | varies |
| Us ob detailed single fetus (76811) | $205.68 | $514.18 | 0.9× |
| Us ob limited 1 or more fetuses (76815) | $175.26 | $438.13 | 1.7× |
| Us ob transvaginal (76817) | $279.48 | $698.68 | 2.7× |
| Us pelvic non ob complete (76856) | $413.57 | $1,033.92 | 4.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $339.88 | $849.69 | 3.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $69.28 | $173.20 | 0.7× |
| Us retroperitoneal complete (76770) | $432.81 | $1,082.02 | 4.2× |
| Us retroperitoneal limited (76775) | $325.43 | $813.57 | 3.1× |
| Us scrotum and contents (76870) | $387 | $967.50 | 3.7× |
| Us spinal canal and contents (76800) | $357.80 | $894.50 | 3.4× |
| Us thyroid (76536) | $497.88 | $1,244.68 | 4.8× |
| Us transrectal (76872) | $275.41 | $688.52 | 2.6× |
| Vein X-Ray Chest (75827) | $719.72 | $1,799.29 | 0.5× |
| Venography caval inferior serialography rs&i (75825) | $2,576.78 | $6,441.95 | 0.8× |
| Venography extremity bilateral rs&i (75822) | $915.80 | $2,289.48 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $396.64 | $991.60 | 0.3× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$65.60–$85.27 | $163.99–$213.17 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $111.30 | $278.23 | 1.3× |
| X-ray antegrade pyelogram tube (74425) | $215.97 | $539.92 | 0.6× |
| X-Ray Aorta Leg Arteries (75630) | $2,576.78 | $6,441.95 | 0.8× |
| X-Ray Bend Only L-S Spine (72120) | $338.38 | $845.94 | 3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$73.34–$95.35 | $183.35–$238.36 | varies |
| X-Ray Exam Breast Specimen (76098) | $315.07 | $787.67 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $56.22 | $140.53 | 0.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $102.22 | $255.53 | 1.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $50.55 | $126.36 | 0.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $101.98 | $254.93 | 1.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $205.40 | $513.50 | 2.0× |
| X-Ray Exam Hips Bi 2 Views (73521) | $78.35 | $195.86 | 0.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $218.25 | $545.62 | 2.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $122.38 | $305.95 | 1.2× |
| X-Ray Exam L-S Spine Bending (72114) | $193.58 | $483.93 | 1.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $169.79 | $424.46 | 2.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $235.44 | $588.60 | 2.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $290.58 | $726.43 | 2.8× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$54.10–$70.34 | $135.25–$175.84 | varies |
| X-ray humerus (73060) | $108.27 | $270.66 | 1.2× |
| X-ray IV pyelogram (ivp) (74400) | $530.40 | $1,326 | 3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $389.43 | $973.56 | 4.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $78.75 | $196.86 | 0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $145.18 | $362.93 | 1.4× |
| X-ray nose-rectum child f.b. (76010) | $187.20 | $467.98 | 2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $164.12 | $410.29 | 1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $172.27 | $430.67 | 1.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $91.98 | $229.95 | 0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $116.85 | $292.11 | 1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $303.37 | $758.41 | 3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $313.88 | $784.69 | 3.0× |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$64.70–$256.24 | $161.74–$640.59 | varies |
| X-ray thoracic spine 4 vw (72074) | $109.42 | $273.53 | 1.1× |
| X-Ray Tmj Unilat (70328) | $49.10 | $122.75 | 0.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $398.41 | $996.02 | 1.1× |
| X-Rays Bone Length Studies (77073) | $155.10 | $387.75 | 1.5× |
| X-Rays Bone Survey Complete (77075) | $688.39 | $1,720.96 | 6.6× |
| Xr c-spine 4 or 5 views (72050) | $280.14 | $700.33 | 2.7× |
| Xr facial bones less than 3 views (70140) | $116.02 | $290.05 | 1.3× |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$270.71–$351.93 | $676.76–$879.81 | varies |
| Xr orbits complete 4 views (70200) | $186.53 | $466.32 | 1.8× |
| Xr Tomogram Single Plane (76100) | $69.93 | $174.81 | 0.7× |
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.