Imaging prices at St. Louis Children’s Hospital
St. Louis, MO · every code in this section with a posted price and a Medicare benchmark.
311 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) | $257.40 | $429 | 3.0× |
| Abdomen 2 views (74019) | $273 | $455 | 2.6× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $703.80 | $1,173 | 1.8× |
| Angio internal mammary (75756) | $3,307.20 | $5,512 | 1.0× |
| Angio pulmonary bilat (75743) | $3,745.80 | $6,243 | 1.2× |
| Angiography extremity bilateral rs&i (75716) | $3,614.40 | $6,024 | 1.1× |
| Angiography extremity unilateral rs&i (75710) | $3,307.20 | $5,512 | 1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,307.20 | $5,512 | 1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,307.20 | $5,512 | 1.0× |
| Ankle 2 views (73600) | $330.60 | $551 | 3.8× |
| Aortography thoracic serialography rs&i (75605) | $5,748 | $9,580 | 1.0× |
| Artery X-Rays Abdomen (75726) | $5,748 | $9,580 | 1.0× |
| Artery X-Rays Pelvis (75736) | $5,748 | $9,580 | 1.0× |
| Arthrogram ankle (73615) | $468 | $780 | 1.3× |
| Arthrogram hip (73525) | $587.40 | $979 | 1.7× |
| Arthrogram Wrist (73115) | $521.40 | $869 | 1.5× |
| Bone age studies (77072) | $366.60 | $611 | 3.5× |
| Bone Imaging 3 Phase (78315) | $3,410.40 | $5,684 | 8.5× |
| Bone Imaging Limited Area (78300) | $864 | $1,440 | 2.2× |
| Bone Imaging Multiple Areas (78305) | $1,036.20 | $1,727 | 2.6× |
| Bone Imaging Whole Body (78306) | $2,868 | $4,780 | 7.2× |
| Bone survey infant (77076) | $178.80 | $298 | 1.7× |
| Brain Image W/Flow < 4 Views (78601) | $625.80 | $1,043 | 1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $5,118 | $8,530 | 3.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,709.80 | $6,183 | 10.6× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,810.60 | $6,351 | 4.9× |
| Cat Scan Follow-Up Study (76380) | $440.40 | $734 | 5.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $705.60 | $1,176 | 1.3× |
| Chest 1 view (71045) | $249 | $415 | 2.9× |
| Chest 2 views (71046) | $340.80 | $568 | 3.9× |
| Chest 3 views (71047) | $360 | $600 | 4.1× |
| Chest 4 or more views (71048) | $385.20 | $642 | 3.7× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $388.80 | $648 | 3.7× |
| Clavicle complete (73000) | $411.60 | $686 | 4.7× |
| Contrast Exam Abdominl Aorta (75625) | $3,307.20 | $5,512 | 1.0× |
| Contrast X-Ray Bladder (74430) | $468 | $780 | 1.3× |
| Contrast X-Ray Of Elbow (73085) | $468 | $780 | 1.3× |
| Contrast X-Ray Of Knee Joint (73580) | $504 | $840 | 1.4× |
| CT abdomen and pelvis without and with contrast (74178) | $2,223.60 | $3,706 | 6.4× |
| CT abdomen and pelvis without contrast (74176) | $1,420.20 | $2,367 | 5.9× |
| CT abdomen w contrast (74160) | $1,617.60 | $2,696 | 9.2× |
| CT abdomen w wo contrast (74170) | $1,828.80 | $3,048 | 10.4× |
| CT abdomen w/o contrast (74150) | $707.40 | $1,179 | 6.8× |
| CT Angio Abdomen and Pelvis (74174) | $2,446.20 | $4,077 | 7.0× |
| CT Angio Chest (71275) | $1,165.20 | $1,942 | 6.6× |
| CT Angio Head (70496) | $1,060.20 | $1,767 | 6.0× |
| CT angio hrt w/3d image (75574) | $2,382 | $3,970 | 6.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $2,040 | $3,400 | 11.6× |
| CT Angio Neck (70498) | $1,141.20 | $1,902 | 6.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,921.20 | $3,202 | 10.9× |
| CT cervical spine w/ contrast (72126) | $1,093.20 | $1,822 | 3.1× |
| CT cervical spine w/o contrast (72125) | $693 | $1,155 | 6.6× |
| CT cervical spine w/wo cont (72127) | $1,270.20 | $2,117 | 7.2× |
| CT chest w contrast (71260) | $916.80 | $1,528 | 5.2× |
| CT chest w/wo contrast (71270) | $1,059 | $1,765 | 6.0× |
| CT head/brain with contrast (70460) | $866.40 | $1,444 | 4.9× |
| CT head/brain without and with contrast (70470) | $963.60 | $1,606 | 5.5× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,063.80 | $1,773 | 3.0× |
| CT hrt w/3d image congen (75573) | $2,165.40 | $3,609 | 6.2× |
| CT iac w contrast (70481) | $2,291.40 | $3,819 | 13.0× |
| CT l-spine w&w/o contrast (72133) | $1,597.80 | $2,663 | 9.1× |
| CT lower ext w/o (73700) | $1,123.20 | $1,872 | 10.7× |
| CT lower extremity w/contrast material (73701) | $1,190.40 | $1,984 | 6.8× |
| CT lumbar spine w contrast (72132) | $1,293.60 | $2,156 | 3.7× |
| CT lumbar spine w/o contrast (72131) | $1,288.80 | $2,148 | 12.3× |
| CT maxillofacial w contrast (70487) | $861 | $1,435 | 4.9× |
| CT maxillofacial wo contrast (70486) | $675 | $1,125 | 6.4× |
| CT neck tissue combo (70492) | $1,037.40 | $1,729 | 5.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,718.60 | $4,531 | 15.5× |
| CT orbits w/o contrast (70480) | $2,091.60 | $3,486 | 20.0× |
| CT pelvis w&w/o contrast (72194) | $1,508.40 | $2,514 | 8.6× |
| CT pelvis w/o contrast (72192) | $696.60 | $1,161 | 6.7× |
| CT scan of leg combo (73702) | $1,854.60 | $3,091 | 10.6× |
| CT scans face/jaw combo (70488) | $1,029.60 | $1,716 | 5.9× |
| CT soft tissue neck w contrast (70491) | $817.20 | $1,362 | 4.7× |
| CT soft tissue neck w/o contrast (70490) | $717.60 | $1,196 | 6.9× |
| CT thoracic spine w contrast (72129) | $937.80 | $1,563 | 5.3× |
| CT thoracic spine w/o contrast (72128) | $916.20 | $1,527 | 8.7× |
| CT thoracic spine w/wo cont (72130) | $1,728 | $2,880 | 9.8× |
| CT thorax w/o contrast (71250) | $816.60 | $1,361 | 7.8× |
| CT unlisted procedure (76497) | $670.80 | $1,118 | 7.7× |
| CT upper ext wo (73200) | $1,342.20 | $2,237 | 12.8× |
| CT upper extremity with contrast (73201) | $1,715.40 | $2,859 | 4.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $864 | $1,440 | 4.9× |
| Cta Abdomen (74175) | $2,011.80 | $3,353 | 11.5× |
| CTA pelvis (72191) | $1,659 | $2,765 | 9.4× |
| Echo Guide For Artery Repair (76936) | $742.80 | $1,238 | 3.4× |
| Esophagram (74220) | $793.80 | $1,323 | 4.5× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,338 | $2,230 | 5.6× |
| Fluoroscopy up to 1 hr (76000) | $346.20 | $577 | 1.4× |
| Foot 2 views (73620) | $369.60 | $616 | 4.2× |
| Forearm 2 views (73090) | $348.60 | $581 | 4.0× |
| Gastric emptying imaging study (78264) | $2,472.60 | $4,121 | 6.2× |
| Gastroesophageal Reflux Exam (78262) | $874.80 | $1,458 | 2.2× |
| Hand 2 views (73120) | $421.20 | $702 | 4.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $3,734.40 | $6,224 | 1.2× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $3,555.60 | $5,926 | 1.1× |
| Hepatobil Syst Image W/Drug (78227) | $2,926.80 | $4,878 | 5.4× |
| Hepatobiliary System Imaging (78226) | $818.40 | $1,364 | 2.0× |
| Ht Muscle Image Spect Sing (78451) | $1,710 | $2,850 | 1.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $580.80 | $968 | 6.7× |
| Infant hip ultrasound, limited static exam (76886) | $553.20 | $922 | 6.3× |
| Joint Survey Single View (77077) | $247.20 | $412 | 2.4× |
| K Flow/Funct Image W/Drug (78708) | $2,276.40 | $3,794 | 4.2× |
| K Flow/Funct Image W/O Drug (78707) | $2,168.40 | $3,614 | 4.0× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $628.80 | $1,048 | 1.6× |
| Kidney Imaging Morphol (78700) | $862.20 | $1,437 | 2.2× |
| Knee 3 Views (73562) | $447 | $745 | 5.1× |
| Lung Perf&Ventilat Diferentl (78598) | $1,026 | $1,710 | 1.9× |
| Lung perfusion differential (78597) | $696 | $1,160 | 1.7× |
| Lung Ventilat&Perfus Imaging (78582) | $1,987.20 | $3,312 | 3.7× |
| Lung Ventilation Imaging (78579) | $526.80 | $878 | 1.3× |
| Lymph System Imaging (78195) | $1,648.80 | $2,748 | 3.0× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $3,307.20 | $5,512 | 1.0× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $3,035.40 | $5,059 | 1.0× |
| Magnetic Image Jaw Joint (70336) | $3,916.80 | $6,528 | 16.4× |
| Magnetic Resonance Elastography (76391) | $2,154.60 | $3,591 | 9.0× |
| Meckels Divert Exam (78290) | $992.40 | $1,654 | 2.5× |
| Medical physics dose eval radiation expos w/rprt (76145) | $316.20 | $527 | 0.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $35.40 | $59 | 1.2× |
| Mra Head W/O & W/Contrast Material (70546) | $1,684.80 | $2,808 | 4.8× |
| MRA head w/o contrast (70544) | $1,045.80 | $1,743 | 4.4× |
| MRA head with contrast (70545) | $1,329.60 | $2,216 | 3.8× |
| MRA neck w contrast (70548) | $2,514 | $4,190 | 7.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,679.60 | $4,466 | 7.7× |
| MRA neck w/o contrast (70547) | $2,280.60 | $3,801 | 9.5× |
| MRI abdomen w contrast (74182) | $2,223 | $3,705 | 6.4× |
| MRI abdomen w/o contrast (74181) | $2,167.20 | $3,612 | 9.1× |
| MRI any jt lower extrem w/contrast material (73722) | $4,143.60 | $6,906 | 5.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,602.60 | $7,671 | 13.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,898.20 | $6,497 | 5.0× |
| MRI bone marrow blood supply (77084) | $358.80 | $598 | 1.5× |
| MRI brain functional w/o physician admnistration (70554) | $2,720.40 | $4,534 | 11.4× |
| MRI brain functional w/physician admnistration (70555) | $2,750.40 | $4,584 | 11.5× |
| MRI cardiac w/o cont stress (75559) | $2,944.80 | $4,908 | 5.4× |
| MRI cardiac w/o contrast (75557) | $2,804.40 | $4,674 | 11.7× |
| MRI cervical spine w contrast (72142) | $3,720.60 | $6,201 | 10.6× |
| MRI cervical spine w/o cont (72141) | $3,543.60 | $5,906 | 14.8× |
| MRI chest w/o contrast (71550) | $3,730.80 | $6,218 | 15.6× |
| MRI chest wo w contrast (71552) | $4,158.60 | $6,931 | 11.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$3,933.60–$7,867.20 | $6,556–$13,112 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $4,420.80 | $7,368 | 12.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$3,361.80–$6,723.60 | $5,603–$11,206 | varies |
| MRI lumbar spine w contrast (72149) | $3,650.40 | $6,084 | 10.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $4,679.40 | $7,799 | 13.4× |
| MRI orbit face &/neck w/o contrast (70540) | $1,821 | $3,035 | 7.6× |
| MRI orbit face neck w contrast (70542) | $2,151 | $3,585 | 6.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,200 | $7,000 | 12.0× |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$4,003.20–$8,006.40 | $6,672–$13,344 | varies |
| MRI pelvis w/o & w contrast (72197) | $4,915.80 | $8,193 | 14.1× |
| MRI pelvis w/o contrast (72195) | $3,422.40 | $5,704 | 14.3× |
| MRI spectroscopy (76390) | $1,312.80 | $2,188 | 15.1× |
| MRI thoracic spine w/o contrast (72146) | $3,445.20 | $5,742 | 14.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,003.60 | $5,006 | 8.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,172.80 | $5,288 | 13.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $4,095.60 | $6,826 | 11.7× |
| MRI, abdomen, combo (74183) | $5,211.60 | $8,686 | 14.9× |
| MRI, dorsal spine combo (72157) | $4,683 | $7,805 | 13.4× |
| MRI, dorsal spine contrast (72147) | $3,617.40 | $6,029 | 10.4× |
| MRI, joint upper extrem (73221) | $3,712.80 | $6,188 | 15.5× |
| MRI, joint upper extrem combo (73223) | $4,093.20 | $6,822 | 11.7× |
| MRI, lumbar spine combo (72158) | $4,690.80 | $7,818 | 13.4× |
| Myocardial Spect Multiple Studies (78452) | $2,377.80 | $3,963 | 1.8× |
| Neck soft tissue (70360) | $115.80 | $193 | 1.3× |
| Nervous system nuclear exam (78699) | $557.40 | $929 | 1.4× |
| Nm unlisted gi procedure (78299) | $401.40 | $669 | 1.0× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $115.80 | $193 | 1.3× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $241.20 | $402 | 2.3× |
| Panoramic X-ray of jaws (70355) | $116.40 | $194 | 1.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $939.60 | $1,566 | 1.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $767.40 | $1,279 | 1.9× |
| Pelvis 1 or 2 views (72170) | $421.80 | $703 | 4.0× |
| Perineogram (74775) | $511.20 | $852 | 2.1× |
| Pet Image Skull-Thigh (78812) | $3,160.20 | $5,267 | 2.2× |
| Pet Image W/Ct Lmtd (78814) | $2,674.80 | $4,458 | 1.9× |
| PET image w/CT, full body (78816) | $4,395.60 | $7,326 | 3.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,396.60 | $5,661 | 2.4× |
| Pet Imaging Limited Area Chest Head/Neck (78811) | $1,875 | $3,125 | 1.4× |
| PET whole body (78813) | $3,475.20 | $5,792 | 2.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $4,075.20 | $6,792 | 1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $683.40 | $1,139 | 1.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $260.40 | $434 | 2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $689.40 | $1,149 | 1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) | $367.20 | $612 | 4.2× |
| Radex Calcaneus Minimum 2 Views (73650) | $391.20 | $652 | 4.5× |
| Radex elbow complete minimum 3 views (73080) | $403.20 | $672 | 4.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $273 | $455 | 2.6× |
| Radex fingr minimum 2 views (73140) | $326.40 | $544 | 3.7× |
| Radex foot complete minimum 3 views (73630) | $382.80 | $638 | 4.4× |
| Radex Hand Minimum 3 Views (73130) | $523.20 | $872 | 6.0× |
| Radex lower extremity infant minimum 2 views (73592) | $143.40 | $239 | 1.6× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $255 | $425 | 2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $459.60 | $766 | 5.3× |
| Radex Ribs Unilateral 2 Views (71100) | $226.80 | $378 | 2.6× |
| Radex shoulder complete minimum 2 views (73030) | $432.60 | $721 | 5.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $166.80 | $278 | 1.9× |
| Radex Spine 1 View Specify Level (72020) | $157.80 | $263 | 1.8× |
| Radex Sternum Minimum 2 Views (71120) range across 4 matching MRF lines |
$200.40–$267 | $334–$445 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $314.40 | $524 | 3.6× |
| Radex Toe Minimum 2 Views (73660) | $429 | $715 | 4.9× |
| Radex upper extremity infant minimum 2 views (73092) | $280.20 | $467 | 2.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $407.40 | $679 | 4.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $387.60 | $646 | 3.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $285 | $475 | 2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $304.80 | $508 | 2.9× |
| Radiologic exam colon double contrast study (74280) | $504 | $840 | 2.9× |
| Radiologic exam colon single contrast study (74270) | $372 | $620 | 2.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $879.60 | $1,466 | 5.0× |
| Radiologic exam knee complete 4/more views (73564) | $512.40 | $854 | 4.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $451.80 | $753 | 4.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $334.20 | $557 | 1.9× |
| Radiologic exam swallow function contrast study (74230) | $261 | $435 | 1.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $660 | $1,100 | 3.8× |
| Radiologic examination femur 1 view (73551) | $116.40 | $194 | 1.3× |
| Radiologic examination femur minimum 2 views (73552) | $148.80 | $248 | 1.7× |
| Radiologic examination knee 1/2 views (73560) range across 17 matching MRF lines |
$348.60–$697.20 | $581–$1,162 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $263.40 | $439 | 2.5× |
| Radiologic examination tibia & fibula 2 views (73590) | $365.40 | $609 | 4.2× |
| Ribs bilateral 3 views (71110) | $321.60 | $536 | 3.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,849.20 | $3,082 | 4.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,031.20 | $5,052 | 5.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,989 | $3,315 | 3.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,254.20 | $3,757 | 1.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $5,579.40 | $9,299 | 3.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,936.60 | $6,561 | 3.0× |
| Rp Therapy Intravenous Administration (79101) | $651 | $1,085 | 2.8× |
| Scapula (73010) | $354.60 | $591 | 3.4× |
| Shoulder 1 view (73020) | $150 | $250 | 1.7× |
| Shoulder Arthrography (73040) | $566.40 | $944 | 1.6× |
| Skull less than 4 views (70250) | $146.40 | $244 | 1.4× |
| Speech evaluation, complex (70371) | $440.40 | $734 | 1.8× |
| Spleen Imaging (78185) | $526.80 | $878 | 1.3× |
| Sternoclavicular joints (71130) | $264.60 | $441 | 3.0× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $619.80 | $1,033 | 3.5× |
| Thoracic spine 2 views (72070) | $187.80 | $313 | 1.8× |
| Thoracic spine 3 views (72072) | $303.60 | $506 | 2.9× |
| Thoracolumbar 2 views (72080) | $190.80 | $318 | 2.2× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$334.80–$669.60 | $558–$1,116 | varies |
| Ultrasound elastography first target lesion (76982) | $639 | $1,065 | 6.1× |
| Ultrasound Elastography Parenchyma (76981) | $999 | $1,665 | 9.5× |
| Ultrasound Exam Aaa Screen (76706) | $240.60 | $401 | 2.3× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) | $359.40 | $599 | 1.0× |
| Ultrasound, abdomen limited (76705) | $285 | $475 | 2.7× |
| Unlisted Dx Radiographic Procedure (76499) | $177 | $295 | 2.0× |
| Unlisted magnetic resonance procedure (76498) | $1,740 | $2,900 | 20.0× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$130.80–$160.80 | $218–$268 | varies |
| Upper gi w/o kub (74240) | $567.60 | $946 | 3.2× |
| Urethrocystogram voiding (74455) | $997.80 | $1,663 | 4.2× |
| Urethrocystography retrograde (74450) | $446.40 | $744 | 1.9× |
| Us breast unilateral complete (76641) | $429 | $715 | 4.1× |
| Us chest (76604) | $214.80 | $358 | 2.1× |
| Us complete joint (76881) | $324.60 | $541 | 3.1× |
| Us exam, pelvic, limited (76857) | $282 | $470 | 2.7× |
| Us head (76506) | $283.20 | $472 | 2.7× |
| Us kidney transplant (76776) | $358.80 | $598 | 3.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $270.60 | $451 | 2.6× |
| Us ob limited 1 or more fetuses (76815) | $258 | $430 | 2.5× |
| Us ob transvaginal (76817) | $262.80 | $438 | 2.5× |
| Us pelvic non ob complete (76856) | $309 | $515 | 3.0× |
| Us retroperitoneal complete (76770) | $1,189.80 | $1,983 | 11.4× |
| Us retroperitoneal limited (76775) | $254.40 | $424 | 2.4× |
| Us scrotum and contents (76870) | $460.80 | $768 | 4.4× |
| Us spinal canal and contents (76800) | $700.20 | $1,167 | 6.7× |
| Us thyroid (76536) | $1,118.40 | $1,864 | 10.7× |
| Vein X-Ray Chest (75827) | $1,660.20 | $2,767 | 1.1× |
| Vein X-Ray Spleen/Liver (75810) | $3,307.20 | $5,512 | 1.0× |
| Venogram Sinus/Jugular (75860) | $3,307.20 | $5,512 | 1.0× |
| Venography caval inferior serialography rs&i (75825) | $3,307.20 | $5,512 | 1.0× |
| Venography extremity bilateral rs&i (75822) | $1,660.20 | $2,767 | 1.1× |
| Venography extremity unilateral rs&i (75820) | $1,363.20 | $2,272 | 0.9× |
| Venography Renal Unilateral (75831) | $4,204.80 | $7,008 | 1.3× |
| Wrist 2 views (73100) | $319.80 | $533 | 3.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 4 matching MRF lines |
$249.60–$333 | $416–$555 | varies |
| X-ray antegrade pyelogram tube (74425) | $468 | $780 | 1.3× |
| X-Ray Aorta Leg Arteries (75630) | $3,685.20 | $6,142 | 1.2× |
| X-Ray Bend Only L-S Spine (72120) | $343.80 | $573 | 3.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 8 matching MRF lines |
$313.80–$627.60 | $523–$1,046 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $193.20 | $322 | 2.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $241.20 | $402 | 2.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $312 | $520 | 3.0× |
| X-Ray Exam Hip Uni 1 View (73501) | $117.60 | $196 | 1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $179.40 | $299 | 2.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $400.80 | $668 | 3.8× |
| X-Ray Exam Hips Bi 2 Views (73521) | $220.20 | $367 | 2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $392.40 | $654 | 3.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $462 | $770 | 4.4× |
| X-Ray Exam L-S Spine Bending (72114) | $544.80 | $908 | 5.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $181.20 | $302 | 2.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $807 | $1,345 | 7.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 6 matching MRF lines |
$192–$255.60 | $320–$426 | varies |
| X-ray eye for foreign body (70030) | $123 | $205 | 1.4× |
| X-ray head for orthodontia (70350) | $115.80 | $193 | 1.3× |
| X-ray humerus (73060) | $118.80 | $198 | 1.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $205.80 | $343 | 2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $290.40 | $484 | 3.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $426.60 | $711 | 4.1× |
| X-ray nose-rectum child f.b. (76010) | $136.20 | $227 | 1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $392.40 | $654 | 3.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $439.80 | $733 | 4.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $348.60 | $581 | 3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 4 matching MRF lines |
$358.80–$478.20 | $598–$797 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $348 | $580 | 4.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $670.80 | $1,118 | 6.4× |
| X-Ray Stress View (77071) | $115.80 | $193 | 1.3× |
| X-ray thoracic spine 4 vw (72074) | $349.20 | $582 | 3.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $468 | $780 | 1.3× |
| X-Rays Bone Length Studies (77073) | $402 | $670 | 3.8× |
| X-Rays Bone Survey Complete (77075) | $354.60 | $591 | 3.4× |
| Xr c-spine 4 or 5 views (72050) | $694.20 | $1,157 | 6.6× |
| Xr facial bones less than 3 views (70140) | $209.40 | $349 | 2.4× |
| Xr orbits complete 4 views (70200) | $468 | $780 | 4.5× |
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.