Imaging prices at St. John's Episcopal Hospital at South Shore
Far Rockaway, NY · every code in this section with a posted price and a Medicare benchmark.
261 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) | $255.99 | $255.99 | 2.4× |
| Abdomen 2 views (74019) | $461.89 | $461.89 | 3.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,716.25 | $1,716.25 | 3.4× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| Bone age studies (77072) | $461.89 | $461.89 | 3.5× |
| Bone Imaging 3 Phase (78315) | $2,782.50 | $2,782.50 | 5.6× |
| Bone Imaging Limited Area (78300) | $1,513.68 | $1,513.68 | 3.0× |
| Bone Imaging Multiple Areas (78305) | $1,669.50 | $1,669.50 | 3.3× |
| Bone Imaging Whole Body (78306) | $2,448.60 | $2,448.60 | 4.9× |
| Bone survey infant (77076) | $461.89 | $461.89 | 3.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,276.09 | $2,276.09 | 3.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,200 | $5,200 | 2.9× |
| Chest 1 view (71045) | $255.99 | $255.99 | 2.4× |
| Chest 2 views (71046) | $278.25 | $278.25 | 2.6× |
| Chest 3 views (71047) | $267.12 | $267.12 | 2.5× |
| Chest 4 or more views (71048) | $473.02 | $473.02 | 3.6× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$250.43–$361.73 | $250.43–$361.73 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $445.20 | $445.20 | 3.4× |
| Contrast X-Ray Bladder (74430) | $1,012.83 | $1,012.83 | 2.3× |
| CT abdomen and pelvis without and with contrast (74178) | $2,893.80 | $2,893.80 | 6.6× |
| CT abdomen and pelvis without contrast (74176) | $1,346.73 | $1,346.73 | 4.5× |
| CT abdomen w contrast (74160) | $2,136.96 | $2,136.96 | 9.8× |
| CT abdomen w wo contrast (74170) | $2,587.72 | $2,587.72 | 11.8× |
| CT abdomen w/o contrast (74150) | $1,808.63 | $1,808.63 | 13.9× |
| CT Angio Abdomen and Pelvis (74174) | $2,782.50 | $2,782.50 | 6.4× |
| CT Angio Chest (71275) | $2,671.20 | $2,671.20 | 12.2× |
| CT Angio Head (70496) | $2,448.60 | $2,448.60 | 11.2× |
| CT angio hrt w/3d image (75574) | $2,782.50 | $2,782.50 | 6.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,135.26–$1,797.49 | $1,135.26–$1,797.49 | varies |
| CT Angio Neck (70498) | $2,114.70 | $2,114.70 | 9.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,257.69 | $1,257.69 | 5.7× |
| CT cervical spine w/ contrast (72126) | $2,175.91 | $2,175.91 | 5.0× |
| CT cervical spine w/o contrast (72125) | $1,864.28 | $1,864.28 | 14.3× |
| CT cervical spine w/wo cont (72127) | $2,604.42 | $2,604.42 | 11.9× |
| CT chest w contrast (71260) | $2,187.05 | $2,187.05 | 10.0× |
| CT chest w/wo contrast (71270) | $2,671.20 | $2,671.20 | 12.2× |
| CT head/brain with contrast (70460) | $1,791.93 | $1,791.93 | 8.2× |
| CT head/brain without and with contrast (70470) | $2,782.50 | $2,782.50 | 12.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $2,114.70 | $2,114.70 | 19.5× |
| CT iac w contrast (70481) | $1,875.40 | $1,875.40 | 8.6× |
| CT l-spine w&w/o contrast (72133) | $2,604.42 | $2,604.42 | 11.9× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$890.40–$1,563.77 | $890.40–$1,563.77 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,012.83–$1,819.76 | $1,012.83–$1,819.76 | varies |
| CT lumbar spine w contrast (72132) | $2,175.91 | $2,175.91 | 5.0× |
| CT lumbar spine w/o contrast (72131) | $1,864.28 | $1,864.28 | 14.3× |
| CT maxillofacial w contrast (70487) | $1,847.58 | $1,847.58 | 8.4× |
| CT maxillofacial wo contrast (70486) | $1,558.20 | $1,558.20 | 11.9× |
| CT neck tissue combo (70492) | $2,253.82 | $2,253.82 | 10.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,424.11 | $2,424.11 | 11.1× |
| CT orbits w/o contrast (70480) | $1,608.29 | $1,608.29 | 12.3× |
| CT pelvis w&w/o contrast (72194) | $2,520.95 | $2,520.95 | 11.5× |
| CT pelvis w/o contrast (72192) | $1,842.02 | $1,842.02 | 14.1× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,135.26–$1,797.49 | $1,135.26–$1,797.49 | varies |
| CT scans face/jaw combo (70488) | $2,253.82 | $2,253.82 | 10.3× |
| CT soft tissue neck w contrast (70491) | $1,875.40 | $1,875.40 | 8.6× |
| CT soft tissue neck w/o contrast (70490) | $1,608.29 | $1,608.29 | 12.3× |
| CT thoracic spine w contrast (72129) | $2,175.91 | $2,175.91 | 9.9× |
| CT thoracic spine w/o contrast (72128) | $1,864.28 | $1,864.28 | 14.3× |
| CT thoracic spine w/wo cont (72130) | $2,604.42 | $2,604.42 | 11.9× |
| CT thorax w/o contrast (71250) | $1,864.28 | $1,864.28 | 14.3× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$901.53–$1,524.81 | $901.53–$1,524.81 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,135.26–$1,797.49 | $1,135.26–$1,797.49 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,012.83–$1,819.76 | $1,012.83–$1,819.76 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,063.50 | $2,063.50 | 9.4× |
| Cta Abdomen (74175) | $2,587.72 | $2,587.72 | 11.8× |
| CTA pelvis (72191) | $2,604.42 | $2,604.42 | 11.9× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $660.01 | $660.01 | 5.1× |
| Doppler Fetal Mid Cerebral Artery (76821) | $461.89 | $461.89 | 3.5× |
| Dxa Bone Density Axial (77080) | $877.04 | $877.04 | 6.7× |
| Echo exam uterus (76831) | $960.52 | $960.52 | 3.2× |
| Esophagram (74220) | $1,012.83 | $1,012.83 | 4.6× |
| Fetal Biophys Profile W/Nst (76818) | $660.01 | $660.01 | 5.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $660.01 | $660.01 | 5.1× |
| Fluoroscopy up to 1 hr (76000) | $960.52 | $960.52 | 3.2× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| Gastric emptying imaging study (78264) | $1,402.38 | $1,402.38 | 2.8× |
| Gated Heart Planar Single (78472) | $1,716.25 | $1,716.25 | 3.4× |
| Gated Heart, Multiple (78473) | $2,551 | $2,551 | 5.1× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$461.89–$573.20 | $461.89–$573.20 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,816.42 | $1,816.42 | 2.7× |
| Hepatobiliary System Imaging (78226) | $1,402.38 | $1,402.38 | 2.8× |
| Ht Musc Image Planar Mult (78454) | $4,952.85 | $4,952.85 | 3.1× |
| Ht Muscle Image Spect Sing (78451) | $4,824.85 | $4,824.85 | 3.0× |
| Hysterosalpingogram (74740) | $996.13 | $996.13 | 3.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $637.75 | $637.75 | 5.9× |
| K Flow/Funct Image Multiple (78709) | $2,039.02 | $2,039.02 | 3.0× |
| K Flow/Funct Image W/O Drug (78707) | $1,816.42 | $1,816.42 | 2.7× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$250.43–$456.33 | $250.43–$456.33 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,636.11 | $1,636.11 | 3.3× |
| Liver imaging static only (78201) | $4,824.85 | $4,824.85 | 7.1× |
| Lung Perf&Ventilat Diferentl (78598) | $1,816.42 | $1,816.42 | 2.7× |
| Lung perfusion differential (78597) | $1,402.38 | $1,402.38 | 2.8× |
| Lung Ventilat&Perfus Imaging (78582) | $1,816.42 | $1,816.42 | 2.7× |
| Lung Ventilation Imaging (78579) | $1,402.38 | $1,402.38 | 2.8× |
| Lymph System Imaging (78195) | $2,114.70 | $2,114.70 | 3.1× |
| Mammary ductogram or galactogram multiple (77054) | $1,068.48 | $1,068.48 | 3.6× |
| Mammary ductogram or galactogram single (77053) | $940.49 | $940.49 | 3.2× |
| Meckels Divert Exam (78290) | $1,402.38 | $1,402.38 | 2.8× |
| Mra Head W/O & W/Contrast Material (70546) | $4,535.48 | $4,535.48 | 10.4× |
| MRA head w/o contrast (70544) | $3,305.61 | $3,305.61 | 11.1× |
| MRA head with contrast (70545) | $4,045.76 | $4,045.76 | 9.3× |
| MRA neck w contrast (70548) | $4,045.76 | $4,045.76 | 9.3× |
| Mra Neck W/O &W/Contrast Material (70549) | $4,535.48 | $4,535.48 | 10.4× |
| MRA neck w/o contrast (70547) | $3,305.61 | $3,305.61 | 11.1× |
| MRI abdomen w contrast (74182) | $3,522.64 | $3,522.64 | 8.1× |
| MRI abdomen w/o contrast (74181) | $3,339 | $3,339 | 11.2× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,892.10–$3,149.79 | $1,892.10–$3,149.79 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,997.84–$3,216.57 | $1,997.84–$3,216.57 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$2,726.85–$4,897.20 | $2,726.85–$4,897.20 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $3,737.45 | $3,737.45 | 12.5× |
| MRI Breast Without Contrast Material Unilateral (77046) | $3,277.78 | $3,277.78 | 11.0× |
| MRI cervical spine w contrast (72142) | $1,830.88 | $1,830.88 | 4.2× |
| MRI cervical spine w/o cont (72141) | $3,339 | $3,339 | 11.2× |
| MRI chest w/o contrast (71550) | $3,339 | $3,339 | 11.2× |
| MRI chest with contrast (71551) | $3,867.68 | $3,867.68 | 4.0× |
| MRI chest wo w contrast (71552) | $6,861.65 | $6,861.65 | 15.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$1,892.10–$3,283.35 | $1,892.10–$3,283.35 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$2,320.61–$3,216.57 | $2,320.61–$3,216.57 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,892.10–$3,283.35 | $1,892.10–$3,283.35 | varies |
| MRI lumbar spine w contrast (72149) | $1,830.88 | $1,830.88 | 4.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $7,100.94 | $7,100.94 | 16.3× |
| MRI orbit face &/neck w/o contrast (70540) | $3,300.05 | $3,300.05 | 11.1× |
| MRI orbit face neck w contrast (70542) | $1,830.88 | $1,830.88 | 4.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $3,238.83 | $3,238.83 | 7.4× |
| MRI pelvis w contrast (72196) | $3,784.20 | $3,784.20 | 8.7× |
| MRI pelvis w/o & w contrast (72197) | $6,538.88 | $6,538.88 | 15.0× |
| MRI pelvis w/o contrast (72195) | $3,339 | $3,339 | 11.2× |
| MRI thoracic spine w/o contrast (72146) | $3,650.64 | $3,650.64 | 12.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$2,203.74–$3,561.60 | $2,203.74–$3,561.60 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,970.01–$3,283.35 | $1,970.01–$3,283.35 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$2,860.41–$4,084.71 | $2,860.41–$4,084.71 | varies |
| MRI, abdomen, combo (74183) | $3,717.42 | $3,717.42 | 8.5× |
| MRI, dorsal spine combo (72157) | $7,100.94 | $7,100.94 | 16.3× |
| MRI, dorsal spine contrast (72147) | $4,006.80 | $4,006.80 | 9.2× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,914.36–$2,955.01 | $1,914.36–$2,955.01 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$2,481.99–$3,517.08 | $2,481.99–$3,517.08 | varies |
| MRI, lumbar spine combo (72158) | $7,034.16 | $7,034.16 | 16.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,402.38 | $1,402.38 | 2.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $4,824.85 | $4,824.85 | 3.0× |
| Myocardial Spect Multiple Studies (78452) | $4,952.85 | $4,952.85 | 3.1× |
| Neck soft tissue (70360) | $250.43 | $250.43 | 2.3× |
| Nuclear Rx Oral Admin (79005) | $957.18 | $957.18 | 3.3× |
| Ob us nuchal meas 1 gest (76813) | $461.89 | $461.89 | 3.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,337.30 | $2,337.30 | 3.4× |
| Parathyroid Planar Imaging (78070) | $1,446.90 | $1,446.90 | 2.9× |
| Parathyroid planar imaging w/wo subtraction (78071) | $2,187.05 | $2,187.05 | 4.4× |
| Pelvis 1 or 2 views (72170) | $461.89 | $461.89 | 3.5× |
| PET image w/CT, full body (78816) | $5,200 | $5,200 | 2.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $5,200 | $5,200 | 2.9× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $4,700 | $4,700 | 2.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,580.46 | $1,580.46 | 3.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $550.93 | $550.93 | 4.2× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $461.89 | $461.89 | 3.5× |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $250.43 | $250.43 | 2.3× |
| Radex Ribs Unilateral 2 Views (71100) | $255.99 | $255.99 | 2.4× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| Radex Sternum Minimum 2 Views (71120) | $250.43 | $250.43 | 2.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $361.73 | $361.73 | 3.3× |
| Radex Toe Minimum 2 Views (73660) | $250.43 | $250.43 | 2.3× |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$461.89–$573.20 | $461.89–$573.20 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $862.58 | $862.58 | 6.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $461.89 | $461.89 | 3.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $506.42 | $506.42 | 3.9× |
| Radiologic exam colon double contrast study (74280) | $1,282.18 | $1,282.18 | 5.9× |
| Radiologic exam colon single contrast study (74270) | $660.01 | $660.01 | 3.0× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$461.89–$773.53 | $461.89–$773.53 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $478.59 | $478.59 | 3.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $483.04 | $483.04 | 2.2× |
| Radiologic exam swallow function contrast study (74230) | $506.42 | $506.42 | 2.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $740.14 | $740.14 | 3.4× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$261.56–$383.99 | $261.56–$383.99 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$261.56–$383.99 | $261.56–$383.99 | varies |
| Radiologic examination knee 1/2 views (73560) | $250.43 | $250.43 | 2.3× |
| Radiologic Examination Osseous Survey Limited (77074) | $461.89 | $461.89 | 3.5× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $940.49 | $940.49 | 1.4× |
| Ribs bilateral 3 views (71110) | $445.20 | $445.20 | 3.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,402.38 | $1,402.38 | 2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,558.20 | $1,558.20 | 3.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $4,824.85 | $4,824.85 | 7.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $4,824.85 | $4,824.85 | 7.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,276.09 | $2,276.09 | 3.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $4,750 | $4,750 | 2.9× |
| Scapula (73010) range across 2 matching MRF lines |
$461.89–$573.20 | $461.89–$573.20 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $111.30 | $111.30 | 4.8× |
| Sialogram (70390) | $934.92 | $934.92 | 3.1× |
| Skull less than 4 views (70250) | $461.89 | $461.89 | 3.5× |
| Speech evaluation, complex (70371) | $934.92 | $934.92 | 3.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $1,116.34 | $1,116.34 | 5.1× |
| Thoracic spine 2 views (72070) | $428.50 | $428.50 | 3.3× |
| Thoracic spine 3 views (72072) | $445.20 | $445.20 | 3.4× |
| Thoracolumbar 2 views (72080) | $267.12 | $267.12 | 2.5× |
| Thyroid Imaging With Vascular Flow (78013) | $1,402.38 | $1,402.38 | 2.8× |
| Thyroid Uptake Measurement (78012) | $1,402.38 | $1,402.38 | 2.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,446.90 | $1,446.90 | 2.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$250.43–$361.73 | $250.43–$361.73 | varies |
| Ultrasound, abdomen limited (76705) | $552.05 | $552.05 | 4.2× |
| Umbilical-artery Doppler (OB) (76820) | $461.89 | $461.89 | 3.5× |
| Upper gi w/o kub (74240) | $612.15 | $612.15 | 2.8× |
| Urethrocystogram voiding (74455) | $932.69 | $932.69 | 3.1× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$461.89–$684.50 | $461.89–$684.50 | varies |
| Us chest (76604) | $514.21 | $514.21 | 3.9× |
| Us complete joint (76881) | $473.02 | $473.02 | 3.6× |
| Us exam, pelvic, limited (76857) | $461.89 | $461.89 | 3.5× |
| Us head (76506) | $931.58 | $931.58 | 7.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $441.86 | $441.86 | 3.4× |
| Us ob detailed single fetus (76811) | $564.29 | $564.29 | 1.9× |
| Us ob limited 1 or more fetuses (76815) | $461.89 | $461.89 | 3.5× |
| Us ob transvaginal (76817) | $461.89 | $461.89 | 3.5× |
| Us pelvic non ob complete (76856) | $598.79 | $598.79 | 4.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $461.89 | $461.89 | 3.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $461.89 | $461.89 | 3.5× |
| Us retroperitoneal complete (76770) | $1,116.34 | $1,116.34 | 8.6× |
| Us retroperitoneal limited (76775) | $782.44 | $782.44 | 6.0× |
| Us scrotum and contents (76870) | $593.23 | $593.23 | 4.5× |
| Us spinal canal and contents (76800) | $539.80 | $539.80 | 4.1× |
| Us thyroid (76536) range across 2 matching MRF lines |
$490–$545.37 | $490–$545.37 | varies |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $422.94 | $422.94 | 3.9× |
| X-ray antegrade pyelogram tube (74425) | $1,830.88 | $1,830.88 | 4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,953.32 | $1,953.32 | 2.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $267.12 | $267.12 | 2.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $461.89 | $461.89 | 3.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $834.75 | $834.75 | 6.4× |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$261.56–$383.99 | $261.56–$383.99 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$261.56–$383.99 | $261.56–$383.99 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$461.89–$573.20 | $461.89–$573.20 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $461.89 | $461.89 | 3.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $489.72 | $489.72 | 3.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $517.54 | $517.54 | 4.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $250.43 | $250.43 | 2.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $317.20 | $317.20 | 2.4× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$250.43–$417.38 | $250.43–$417.38 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$250.43–$383.99 | $250.43–$383.99 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $250.43 | $250.43 | 2.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $461.89 | $461.89 | 3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $556.50 | $556.50 | 4.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $556.50 | $556.50 | 4.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $461.89 | $461.89 | 3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $250.43 | $250.43 | 2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $250.43 | $250.43 | 2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $461.89 | $461.89 | 3.5× |
| X-Ray Stress View (77071) | $250.43 | $250.43 | 2.3× |
| X-Ray Tmj Unilat (70328) | $250.43 | $250.43 | 2.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,830.88 | $1,830.88 | 4.2× |
| X-Rays Bone Length Studies (77073) | $461.89 | $461.89 | 3.5× |
| X-Rays Bone Survey Complete (77075) | $667.80 | $667.80 | 5.1× |
| Xr c-spine 4 or 5 views (72050) | $461.89 | $461.89 | 3.5× |
| Xr facial bones less than 3 views (70140) | $250.43 | $250.43 | 2.3× |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$461.89–$612.15 | $461.89–$612.15 | varies |
| Xr orbits complete 4 views (70200) | $461.89 | $461.89 | 3.5× |
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.