Imaging prices at St. Charles Medical Center Prineville
Prineville, OR · every code in this section with a posted price and a Medicare benchmark.
342 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) | $8,564.98 | $10,706.22 | 5.6× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$293.57–$398.40 | $366.96–$498 | varies |
| Abdomen 2 views (74019) | $297.58 | $371.98 | 2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,875.73 | $2,344.66 | 4.2× |
| Adrenal Cortex & Medulla Img (78075) | $2,949.03 | $3,686.29 | 2.0× |
| Angio pulmonary bilat (75743) | $7,818.34 | $9,772.92 | 2.2× |
| Angiography extremity bilateral rs&i (75716) | $3,915.65 | $4,894.56 | 1.1× |
| Angiography extremity unilateral rs&i (75710) | $3,896.10 | $4,870.12 | 1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $6,325.25 | $7,906.56 | 1.8× |
| Ankle 2 views (73600) | $269.69 | $337.11 | 2.8× |
| Aortography thoracic serialography rs&i (75605) | $5,102.58 | $6,378.23 | 0.8× |
| Artery X-Rays Abdomen (75726) | $6,790.05 | $8,487.56 | 1.1× |
| Artery X-Rays Pelvis (75736) | $5,894.47 | $7,368.09 | 1.0× |
| Artery X-Rays Spine (75705) | $6,338.58 | $7,923.22 | 1.0× |
| Arthrogram hip (73525) | $1,131.15 | $1,413.94 | 2.9× |
| Arthrogram Wrist (73115) | $372.70 | $465.88 | 1.0× |
| Basic radiation dosimetry calculation (77300) | $761.86 | $952.33 | 5.1× |
| Bone age studies (77072) | $243.82 | $304.78 | 2.1× |
| Bone Imaging 3 Phase (78315) | $1,629.34 | $2,036.67 | 3.7× |
| Bone Imaging Limited Area (78300) | $1,071.31 | $1,339.14 | 2.4× |
| Bone Imaging Multiple Areas (78305) | $1,232.01 | $1,540.01 | 2.8× |
| Bone Imaging Whole Body (78306) | $1,416.81 | $1,771.01 | 3.2× |
| Bone marrow imaging limited area (78102) | $930.90 | $1,163.62 | 2.1× |
| Bone survey infant (77076) | $409.16 | $511.45 | 3.5× |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$713.66–$768.51 | $892.07–$960.64 | varies |
| Brachytx Isodose Plan Simple (77316) | $1,895.33 | $2,369.16 | 4.6× |
| Brain Flow Imaging Only (78610) | $1,339.15 | $1,673.94 | 2.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,578.66 | $3,223.32 | 6.6× |
| Cardiac Shunt Detection (78428) | $675.53 | $844.41 | 1.5× |
| Cat Scan Follow-Up Study (76380) | $1,086.83 | $1,358.54 | 11.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,433.88 | $1,792.35 | 2.4× |
| Cerebrospinal Fluid Scan (78630) | $1,249.54 | $1,561.93 | 2.1× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$65.60–$254.21 | $82–$317.76 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$100.80–$327.14 | $126–$408.92 | varies |
| Chest 3 views (71047) | $490.30 | $612.88 | 5.1× |
| Chest 4 or more views (71048) | $671.38 | $839.23 | 5.8× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $204.82 | $256.03 | 1.8× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $370.73 | $463.41 | 3.2× |
| Clavicle complete (73000) | $268.72 | $335.90 | 2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,154.61 | $1,443.26 | 9.9× |
| Continuing medical physics consltj pr wk (77336) | $971.12 | $1,213.90 | 6.5× |
| Contrast Exam Abdominl Aorta (75625) | $4,871.54 | $6,089.43 | 1.4× |
| Contrast X-Ray Bladder (74430) | $507 | $633.75 | 1.3× |
| Contrast X-Ray Of Elbow (73085) | $733.19 | $916.49 | 1.9× |
| Contrast X-Ray Of Knee Joint (73580) | $411.93 | $514.91 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) | $4,396.12 | $5,495.15 | 11.3× |
| CT abdomen and pelvis without contrast (74176) | $3,259.75 | $4,074.69 | 12.3× |
| CT abdomen w contrast (74160) | $2,066.32 | $2,582.90 | 10.6× |
| CT abdomen w wo contrast (74170) | $2,270.41 | $2,838.01 | 11.6× |
| CT abdomen w/o contrast (74150) | $1,673.48 | $2,091.85 | 14.4× |
| CT Angio Abdomen and Pelvis (74174) | $1,435.83 | $1,794.79 | 3.7× |
| CT Angio Chest (71275) | $2,311.46 | $2,889.33 | 11.9× |
| CT Angio Head (70496) | $2,687.94 | $3,359.93 | 13.8× |
| CT angio hrt w/3d image (75574) | $1,511.83 | $1,889.79 | 3.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,894.83 | $2,368.54 | 9.7× |
| CT Angio Neck (70498) | $2,562.86 | $3,203.57 | 13.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,122.72 | $2,653.40 | 10.9× |
| CT cervical spine w/ contrast (72126) | $2,231.26 | $2,789.08 | 5.8× |
| CT cervical spine w/o contrast (72125) | $1,887.31 | $2,359.14 | 16.2× |
| CT chest w contrast (71260) | $2,099.14 | $2,623.93 | 10.8× |
| CT chest w/wo contrast (71270) | $2,311.46 | $2,889.33 | 11.9× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $3,136.62 | $3,920.77 | 27.0× |
| CT head/brain with contrast (70460) | $1,779.20 | $2,224 | 9.1× |
| CT head/brain without and with contrast (70470) | $2,431.38 | $3,039.23 | 12.5× |
| CT heart contrast eval cardiac structure&morph (75572) | $822 | $1,027.50 | 2.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $167.95 | $209.94 | 1.7× |
| CT hrt w/3d image congen (75573) | $1,511.83 | $1,889.79 | 3.9× |
| CT iac w contrast (70481) | $2,170.66 | $2,713.32 | 11.1× |
| CT l-spine w&w/o contrast (72133) | $2,311.24 | $2,889.05 | 11.9× |
| CT lower ext w/o (73700) | $1,632.10 | $2,040.12 | 14.0× |
| CT lower extremity w/contrast material (73701) | $1,671.79 | $2,089.74 | 8.6× |
| CT lumbar spine w contrast (72132) | $2,108.06 | $2,635.08 | 5.4× |
| CT lumbar spine w/o contrast (72131) | $2,042.37 | $2,552.96 | 17.6× |
| CT maxillofacial w contrast (70487) | $1,941.80 | $2,427.25 | 10.0× |
| CT maxillofacial wo contrast (70486) | $1,272.74 | $1,590.93 | 11.0× |
| CT neck tissue combo (70492) | $2,057.48 | $2,571.85 | 10.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,346.02 | $2,932.52 | 12.0× |
| CT orbits w/o contrast (70480) | $1,765.38 | $2,206.72 | 15.2× |
| CT pelvis w&w/o contrast (72194) | $2,364.34 | $2,955.43 | 12.1× |
| CT pelvis w/o contrast (72192) | $1,586.28 | $1,982.85 | 13.7× |
| CT scans face/jaw combo (70488) | $2,314.86 | $2,893.58 | 11.9× |
| CT soft tissue neck w contrast (70491) | $2,134.60 | $2,668.25 | 10.9× |
| CT soft tissue neck w/o contrast (70490) | $1,711.70 | $2,139.62 | 14.7× |
| CT thoracic spine w contrast (72129) | $2,231.26 | $2,789.08 | 11.4× |
| CT thoracic spine w/o contrast (72128) | $1,806.78 | $2,258.47 | 15.5× |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$828.71–$3,147.61 | $1,035.89–$3,934.51 | varies |
| CT thorax w/o contrast (71250) | $1,866.96 | $2,333.70 | 16.1× |
| CT upper ext wo (73200) | $1,500.75 | $1,875.94 | 12.9× |
| CT upper extremity with contrast (73201) | $1,591.32 | $1,989.15 | 4.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $3,496.95 | $4,371.19 | 17.9× |
| Cta Abdomen (74175) | $1,889.78 | $2,362.22 | 9.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $637.33 | $796.66 | 1.6× |
| CTA pelvis (72191) | $1,800.92 | $2,251.15 | 9.2× |
| Diskography lumbar (72295) | $3,264.30 | $4,080.37 | 1.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $239.88 | $299.85 | 2.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $608.66 | $760.82 | 5.2× |
| Doppler Fetal Mid Cerebral Artery (76821) | $398.41 | $498.01 | 3.4× |
| Dxa Bone Density Axial (77080) | $525.70 | $657.13 | 4.5× |
| Dxa bone density study (77085) | $206.62 | $258.27 | 1.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $391.11 | $488.89 | 4.0× |
| Echo exam of fetal heart (76825) | $594.63 | $743.29 | 1.0× |
| Echo Guide For Artery Repair (76936) | $576.29 | $720.36 | 2.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $790.41 | $988.01 | 3.0× |
| Esophagram (74220) | $558.63 | $698.29 | 2.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$206.62–$513.82 | $258.27–$642.27 | varies |
| Fluoroscopy up to 1 hr (76000) | $612.30 | $765.38 | 2.3× |
| Follow-Up Angiography (75898) | $6,062.58 | $7,578.23 | 1.7× |
| Foot 2 views (73620) | $256.66 | $320.82 | 2.7× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$84–$271.74 | $105–$339.67 | varies |
| Gastric emptying imaging study (78264) | $1,442.67 | $1,803.34 | 3.2× |
| Gastroesophageal Reflux Exam (78262) | $1,154.14 | $1,442.68 | 2.6× |
| Gated Heart Planar Single (78472) | $1,193.14 | $1,491.43 | 2.7× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$84.80–$440.86 | $106–$551.08 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,546.19 | $1,932.74 | 2.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$1,386.48–$1,546.19 | $1,733.10–$1,932.74 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,425.72 | $1,782.15 | 1.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $6,407.38 | $8,009.22 | 1.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $5,571.63 | $6,964.54 | 1.6× |
| Hepatobil Syst Image W/Drug (78227) | $2,156.49 | $2,695.61 | 3.6× |
| Hepatobiliary System Imaging (78226) | $1,254.88 | $1,568.60 | 2.8× |
| Ht Muscle Image Spect Sing (78451) | $5,407.07 | $6,758.84 | 3.8× |
| Hysterosalpingogram (74740) | $663.04 | $828.80 | 2.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $167.80 | $209.75 | 1.7× |
| Infant hip ultrasound, limited static exam (76886) | $169.59 | $211.99 | 1.8× |
| Intracavitary radiation source applic simple (77761) | $2,252.06 | $2,815.07 | 3.7× |
| K Flow/Funct Image Multiple (78709) | $1,420.93 | $1,776.16 | 2.4× |
| K Flow/Funct Image W/Drug (78708) | $1,392.69 | $1,740.86 | 2.3× |
| K Flow/Funct Image W/O Drug (78707) | $1,042.03 | $1,302.54 | 1.7× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$113.60–$311.48 | $142–$389.35 | varies |
| Liver & Spleen Imaging Static Only (78215) | $982.86 | $1,228.58 | 2.2× |
| Lung perfusion differential (78597) | $1,014.73 | $1,268.41 | 2.3× |
| Lung Ventilat&Perfus Imaging (78582) | $1,808.90 | $2,261.13 | 3.0× |
| Lymph System Imaging (78195) | $1,154.14 | $1,442.68 | 1.9× |
| Magnetic Image Jaw Joint (70336) | $2,430.70 | $3,038.38 | 9.2× |
| Meckels Divert Exam (78290) | $1,442.67 | $1,803.34 | 3.2× |
| Mlc imrt design & construction per imrt plan (77338) | $979.62 | $1,224.52 | 2.4× |
| Mra Head W/O & W/Contrast Material (70546) | $3,882.78 | $4,853.48 | 10.0× |
| MRA head w/o contrast (70544) | $2,550.18 | $3,187.72 | 9.6× |
| MRA neck w contrast (70548) | $2,465.58 | $3,081.98 | 6.4× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,979.58 | $4,974.47 | 10.3× |
| MRA neck w/o contrast (70547) | $979.55 | $1,224.44 | 3.7× |
| MRI abdomen w contrast (74182) | $3,252.53 | $4,065.66 | 8.4× |
| MRI abdomen w/o contrast (74181) | $2,885.54 | $3,606.93 | 10.9× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$2,788.35–$4,182.54 | $3,485.44–$5,228.17 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,101.01–$4,748.74 | $2,626.26–$5,935.92 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,807.11 | $3,508.89 | 3.2× |
| MRI brain functional w/o physician admnistration (70554) | $1,427.37 | $1,784.21 | 5.4× |
| MRI cervical spine w contrast (72142) | $2,647.73 | $3,309.66 | 6.8× |
| MRI cervical spine w/o cont (72141) | $2,439.38 | $3,049.23 | 9.2× |
| MRI chest w/o contrast (71550) | $2,597.07 | $3,246.34 | 9.8× |
| MRI chest with contrast (71551) | $3,009.99 | $3,762.49 | 3.5× |
| MRI chest wo w contrast (71552) | $4,653.28 | $5,816.60 | 12.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $4,177.74 | $5,222.18 | 10.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,426.30 | $3,032.87 | 9.1× |
| MRI lumbar spine w contrast (72149) | $3,048.37 | $3,810.46 | 7.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,604.94 | $5,756.17 | 11.9× |
| MRI orbit face &/neck w/o contrast (70540) | $2,584.99 | $3,231.24 | 9.7× |
| MRI orbit face neck w contrast (70542) | $2,778.26 | $3,472.82 | 7.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,649.94 | $5,812.43 | 12.0× |
| MRI pelvis w contrast (72196) | $2,620.51 | $3,275.64 | 6.8× |
| MRI pelvis w/o & w contrast (72197) | $4,691.80 | $5,864.75 | 12.1× |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,013.04–$2,230.08 | $1,266.30–$2,787.60 | varies |
| MRI spectroscopy (76390) | $2,681.94 | $3,352.42 | 27.7× |
| MRI thoracic spine w/o contrast (72146) | $2,699.78 | $3,374.72 | 10.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,295.67 | $2,869.59 | 8.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $4,318.38 | $5,397.98 | 11.1× |
| MRI, abdomen, combo (74183) | $4,691.80 | $5,864.75 | 12.1× |
| MRI, dorsal spine combo (72157) | $4,743.71 | $5,929.64 | 12.2× |
| MRI, dorsal spine contrast (72147) | $2,915.77 | $3,644.71 | 7.5× |
| MRI, joint upper extrem (73221) | $2,283.46 | $2,854.32 | 8.6× |
| MRI, joint upper extrem combo (73223) | $4,693.46 | $5,866.83 | 12.1× |
| MRI, lumbar spine combo (72158) | $4,696.82 | $5,871.03 | 12.1× |
| Myocardial Spect Multiple Studies (78452) | $6,283.58 | $7,854.48 | 4.4× |
| N-invas est c ffr sw aly CTA (75580) | $3,376.77 | $4,220.96 | 3.5× |
| Neck soft tissue (70360) | $252.97 | $316.21 | 2.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $797.06 | $996.33 | 1.8× |
| Nm csf leak detection (78650) | $1,490.29 | $1,862.86 | 1.0× |
| Nonvascular Shunt X-Ray (75809) | $210.86 | $263.57 | 1.8× |
| Ntsty modul radthx pln dose-vol histos (77301) | $8,496.06 | $10,620.08 | 5.5× |
| Nuclear Rx Intra-Arterial (79445) | $539.61 | $674.51 | 2.1× |
| Nuclear Rx Oral Admin (79005) | $852.82 | $1,066.02 | 3.3× |
| Ob us nuchal meas 1 gest (76813) | $452.86 | $566.08 | 3.9× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $273.60 | $342 | 2.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $130.40 | $163 | 1.1× |
| Ophthalmic us dx quantitative a-scan only (76511) | $191.20 | $239 | 1.6× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,231.37 | $1,539.21 | 2.0× |
| Parathyroid Planar Imaging (78070) | $931.08 | $1,163.85 | 2.1× |
| Pelvis 1 or 2 views (72170) | $295.26 | $369.07 | 2.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $2,649.82 | $3,312.28 | 1.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $3,921.03 | $4,901.29 | 1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,339.15 | $1,673.94 | 3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $449.58 | $561.98 | 3.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $577.70 | $722.13 | 1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$102.40–$493.21 | $128–$616.51 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $257.09 | $321.36 | 2.7× |
| Radex elbow complete minimum 3 views (73080) | $356.26 | $445.33 | 3.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $373.32 | $466.65 | 3.2× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$101.60–$224.78 | $127–$280.98 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$92.80–$449.29 | $116–$561.61 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$98.40–$360.96 | $123–$451.20 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $167.80 | $209.75 | 1.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $288.54 | $360.68 | 3.0× |
| Radex Ribs Unilateral 2 Views (71100) | $305 | $381.25 | 3.2× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$91.20–$327.14 | $114–$408.92 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $216.41 | $270.51 | 2.2× |
| Radex Spine 1 View Specify Level (72020) | $290.22 | $362.78 | 3.0× |
| Radex Sternum Minimum 2 Views (71120) | $309.30 | $386.63 | 3.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $220.46 | $275.58 | 2.3× |
| Radex Toe Minimum 2 Views (73660) | $224.78 | $280.98 | 2.3× |
| Radex upper extremity infant minimum 2 views (73092) | $201.74 | $252.18 | 1.7× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$116–$486.14 | $145–$607.67 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $500.16 | $625.20 | 4.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $14,791.22 | $18,489.03 | 1.8× |
| Radiation treatment delivery level 1 (77402) | $660.06 | $825.08 | 5.8× |
| Radiation treatment delivery level 2 (77407) | $2,907.25 | $3,634.06 | 6.8× |
| Radiation treatment delivery level 3 (77412) | $2,915.01 | $3,643.76 | 4.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $243.82 | $304.78 | 2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $297.58 | $371.98 | 2.6× |
| Radiologic exam colon double contrast study (74280) | $845.47 | $1,056.84 | 4.3× |
| Radiologic exam colon single contrast study (74270) | $734.78 | $918.47 | 3.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $558.63 | $698.29 | 2.9× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$128.80–$358.19 | $161–$447.74 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $435.11 | $543.89 | 3.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $546.42 | $683.02 | 2.8× |
| Radiologic exam swallow function contrast study (74230) | $566.60 | $708.25 | 2.9× |
| Radiologic exam upr gi trc double contrast study (74246) | $639.12 | $798.90 | 3.3× |
| Radiologic examination femur 1 view (73551) | $158.41 | $198.01 | 1.6× |
| Radiologic examination femur minimum 2 views (73552) | $158.41 | $198.01 | 1.6× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$94.40–$270.84 | $118–$338.55 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $306.98 | $383.72 | 2.6× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$85.60–$305.30 | $107–$381.63 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $534.41 | $668.01 | 1.2× |
| Ribs bilateral 3 views (71110) | $489.56 | $611.95 | 4.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,488.60 | $1,860.75 | 3.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,711.89 | $2,139.86 | 3.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,263.95 | $2,829.94 | 3.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,603.56 | $3,254.45 | 4.3× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,443.19 | $4,303.99 | 2.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,959.67 | $4,949.59 | 2.5× |
| Scapula (73010) range across 2 matching MRF lines |
$96.80–$287.62 | $121–$359.53 | varies |
| Shoulder 1 view (73020) | $229.15 | $286.44 | 2.4× |
| Shoulder Arthrography (73040) | $830.40 | $1,038 | 2.1× |
| Skull less than 4 views (70250) | $337.19 | $421.49 | 2.9× |
| Special dosimetry (77331) | $684.62 | $855.77 | 4.6× |
| Special Physics Consult (77370) | $1,455.10 | $1,818.87 | 9.7× |
| Special treatment procedure (77470) | $3,411.82 | $4,264.77 | 5.6× |
| Spleen Imaging (78185) | $848.07 | $1,060.09 | 1.9× |
| Stereotactic Body Radiation Delivery (77373) | $7,913.09 | $9,891.36 | 4.0× |
| Sternoclavicular joints (71130) | $164.41 | $205.51 | 1.7× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $3,340.73 | $4,175.91 | 8.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,895.33 | $2,369.16 | 4.6× |
| Testicular Imaging W/Flow (78761) | $808.14 | $1,010.17 | 1.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,765.55 | $3,456.94 | 6.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,813.81 | $2,267.26 | 4.4× |
| Ther rad simulaj-aided field setting simple (77280) | $1,194.85 | $1,493.56 | 8.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $296.46 | $370.57 | 1.5× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$102.40–$367.21 | $128–$459.01 | varies |
| Thoracic spine 3 views (72072) | $414.33 | $517.91 | 3.6× |
| Thoracolumbar 2 views (72080) | $367.21 | $459.01 | 3.8× |
| Thyroid Met Imaging Body (78018) | $1,385.34 | $1,731.67 | 2.3× |
| Thyroid Uptake Measurement (78012) | $543.38 | $679.22 | 1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $947.72 | $1,184.65 | 2.1× |
| Tx Devices Design & Construction Complex (77334) | $1,647.82 | $2,059.77 | 4.0× |
| Tx devices design & construction intermediate (77333) | $1,121.82 | $1,402.27 | 7.5× |
| Tx devices design & construction simple (77332) | $853.38 | $1,066.73 | 5.7× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$293.60–$551.82 | $367–$689.78 | varies |
| Ultrasound elastography first target lesion (76982) | $735.26 | $919.07 | 6.3× |
| Ultrasound Elastography Parenchyma (76981) | $735.26 | $919.07 | 6.3× |
| Ultrasound Exam Aaa Screen (76706) | $273.12 | $341.40 | 2.4× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$300.80–$631.54 | $376–$789.43 | varies |
| Umbilical-artery Doppler (OB) (76820) | $394.66 | $493.32 | 3.4× |
| Upper gi w/o kub (74240) | $573.74 | $717.17 | 2.9× |
| Ureteral Reflux Study (78740) | $1,072.70 | $1,340.87 | 2.4× |
| Urethrocystogram voiding (74455) | $719.84 | $899.80 | 2.7× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$395.66–$593.49 | $494.58–$741.86 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$288.80–$627.19 | $361–$783.99 | varies |
| Us complete joint (76881) | $380.80 | $476 | 3.3× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$155.20–$570.31 | $194–$712.89 | varies |
| Us head (76506) | $531.23 | $664.04 | 4.6× |
| Us kidney transplant (76776) | $536.98 | $671.22 | 4.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$117.60–$381.09 | $147–$476.36 | varies |
| Us ob detailed single fetus (76811) | $632.26 | $790.33 | 2.4× |
| Us ob limited 1 or more fetuses (76815) range across 5 matching MRF lines |
$280.80–$505.10 | $351–$631.37 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$320.80–$628.89 | $401–$786.11 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$360.80–$610.56 | $451–$763.20 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$408.80–$524.85 | $511–$656.06 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $400.66 | $500.82 | 3.4× |
| Us retroperitoneal complete (76770) | $689.32 | $861.65 | 5.9× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$188–$482.86 | $235–$603.58 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$88.80–$544.08 | $111–$680.10 | varies |
| Us spinal canal and contents (76800) | $531.23 | $664.04 | 4.6× |
| Us thyroid (76536) range across 2 matching MRF lines |
$380–$631.54 | $475–$789.43 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$664.82–$677.60 | $831.02–$847 | varies |
| Vein X-Ray Chest (75827) | $2,415.86 | $3,019.82 | 1.4× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,780.42 | $3,475.53 | 0.8× |
| Venogram Sinus/Jugular (75860) | $3,116.61 | $3,895.76 | 0.9× |
| Venography caval inferior serialography rs&i (75825) | $4,213.06 | $5,266.32 | 1.2× |
| Venography extremity bilateral rs&i (75822) | $3,002.56 | $3,753.20 | 1.7× |
| Venography extremity unilateral rs&i (75820) | $1,125.15 | $1,406.44 | 0.6× |
| Venography Renal Bilateral (75833) | $4,285.17 | $5,356.46 | 1.2× |
| Venography Renal Unilateral (75831) | $3,726.23 | $4,657.79 | 1.1× |
| Venous sampling by catheter (75893) | $5,695.12 | $7,118.90 | 0.9× |
| Vertebral fracture assessment via dxa (77086) | $167.95 | $209.94 | 1.7× |
| Wrist 2 views (73100) | $281.82 | $352.27 | 2.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $359.64 | $449.55 | 3.7× |
| X-ray antegrade pyelogram tube (74425) | $543.53 | $679.41 | 1.4× |
| X-Ray Aorta Leg Arteries (75630) | $6,987.69 | $8,734.61 | 2.0× |
| X-Ray Bend Only L-S Spine (72120) | $233.22 | $291.53 | 2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$88–$263.72 | $110–$329.65 | varies |
| X-Ray Exam Breast Specimen (76098) | $674.06 | $842.57 | 1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $158.41 | $198.01 | 1.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $262.34 | $327.93 | 2.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $500.16 | $625.20 | 4.3× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$158.41–$378.40 | $198.01–$473 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $158.41 | $198.01 | 1.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$204.82–$262.34 | $256.03–$327.93 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $262.34 | $327.93 | 2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $262.34 | $327.93 | 2.3× |
| X-Ray Exam L-S Spine Bending (72114) | $944.54 | $1,180.68 | 8.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $349.68 | $437.10 | 3.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $653.41 | $816.76 | 5.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$116.80–$324.26 | $146–$405.32 | varies |
| X-ray eye for foreign body (70030) | $236.48 | $295.60 | 2.4× |
| X-ray humerus (73060) | $295.26 | $369.07 | 3.1× |
| X-ray IV pyelogram (ivp) (74400) | $716.31 | $895.39 | 3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $298.60 | $373.25 | 3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $375.77 | $469.71 | 3.2× |
| X-ray nose-rectum child f.b. (76010) | $171.98 | $214.98 | 1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $550.20 | $687.75 | 4.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $289.30 | $361.63 | 2.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $251.56 | $314.45 | 2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$89.60–$329.14 | $112–$411.43 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $526.87 | $658.59 | 5.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $558.63 | $698.29 | 4.8× |
| X-ray thoracic spine 4 vw (72074) | $509.74 | $637.18 | 4.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $649.19 | $811.49 | 1.7× |
| X-Rays Bone Length Studies (77073) | $203.02 | $253.77 | 1.7× |
| X-Rays Bone Survey Complete (77075) | $796.84 | $996.05 | 6.9× |
| Xr c-spine 4 or 5 views (72050) | $464.24 | $580.30 | 4.0× |
| Xr facial bones less than 3 views (70140) | $319.83 | $399.79 | 3.3× |
| Xr orbits complete 4 views (70200) | $348.92 | $436.15 | 3.0× |
| Xr Tomogram Single Plane (76100) | $247.61 | $309.51 | 2.1× |
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.