Imaging prices at St. Luke's Patients Medical Center
Pasadena, TX · every code in this section with a posted price and a Medicare benchmark.
304 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) range across 2 matching MRF lines |
$470.40–$472.15 | $1,344–$1,349 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$568.68–$568.75 | $1,624.79–$1,625 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $768.25 | $2,195 | 1.9× |
| Angio internal mammary (75756) | $1,020.60 | $2,916 | 0.3× |
| Angio pulmonary bilat (75743) | $1,612.17 | $4,606.20 | 0.5× |
| Angiography extremity bilateral rs&i (75716) | $3,162.03 | $9,034.37 | 1.0× |
| Angiography extremity unilateral rs&i (75710) | $2,909.20 | $8,312 | 0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $1,173.69 | $3,353.40 | 0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,064.35 | $3,041 | 0.3× |
| Ankle 2 views (73600) | $368.90 | $1,054 | 4.2× |
| Aortography thoracic serialography rs&i (75605) | $5,244.26 | $14,983.58 | 0.9× |
| Aortography thoracic w/o serialography rs&i (75600) | $1,415.93 | $4,045.50 | 0.4× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$2,816.06–$2,816.10 | $8,045.88–$8,046 | varies |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$1,608.71 | $4,596.30 | 0.3× |
| Artery X-Rays Spine (75705) unusually low: confirm this is the full procedure |
$1,910.48 | $5,458.50 | 0.3× |
| Arthrogram ankle (73615) | $372.65 | $1,064.70 | 1.1× |
| Arthrogram Wrist (73115) | $275.31 | $786.60 | 0.8× |
| Bone age studies (77072) | $163.49 | $467.10 | 1.6× |
| Bone Imaging 3 Phase (78315) | $2,335.55 | $6,673 | 5.8× |
| Bone Imaging Limited Area (78300) | $1,523.90 | $4,354 | 3.8× |
| Bone Imaging Whole Body (78306) | $1,978.99 | $5,654.25 | 4.9× |
| Bone marrow imaging; whole body (78104) | $761.36 | $2,175.30 | 1.9× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,242.05 | $3,548.70 | 2.3× |
| Brain Imaging Minimum 4 Static Views (78605) | $952.88 | $2,722.50 | 1.7× |
| Cerebrospinal Fluid Scan (78630) | $773.01 | $2,208.60 | 1.4× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$417.90–$466.20 | $1,194–$1,332 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$514.85–$549.85 | $1,471–$1,571 | varies |
| Chest 3 views (71047) | $232.05 | $663 | 2.7× |
| Chest 4 or more views (71048) | $747.95 | $2,137 | 7.1× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$397.25–$397.28 | $1,135–$1,135.07 | varies |
| Contrast Exam Abdominl Aorta (75625) | $3,162.03 | $9,034.37 | 1.0× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$354.06–$354.20 | $1,011.60–$1,012 | varies |
| Contrast X-Ray Of Elbow (73085) | $261.10 | $746 | 0.7× |
| Contrast X-Ray Of Knee Joint (73580) | $643.86 | $1,839.60 | 1.8× |
| Corpora cavernosography (74445) | $115.92 | $331.20 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) | $5,050.85 | $14,431 | 14.4× |
| CT abdomen and pelvis without contrast (74176) | $4,700.85 | $13,431 | 19.6× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$4,032.35–$4,032.44 | $11,521–$11,521.24 | varies |
| CT abdomen w wo contrast (74170) | $4,556.65 | $13,019 | 25.9× |
| CT abdomen w/o contrast (74150) | $2,339.05 | $6,683 | 22.3× |
| CT Angio Abdomen and Pelvis (74174) | $4,118.80 | $11,768 | 11.8× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$2,087.05–$3,421.25 | $5,963–$9,775 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$3,731–$3,731.16 | $10,660–$10,660.44 | varies |
| CT angio hrt w/3d image (75574) | $1,619.80 | $4,628 | 4.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 4 matching MRF lines |
$3,286.15–$3,286.50 | $9,389–$9,390 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$3,731–$3,731.16 | $10,660–$10,660.44 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $3,546.82 | $10,133.75 | 20.1× |
| CT cervical spine w/ contrast (72126) | $4,160.45 | $11,887 | 11.9× |
| CT cervical spine w/o contrast (72125) | $3,200.40 | $9,144 | 30.5× |
| CT cervical spine w/wo cont (72127) | $4,864.65 | $13,899 | 27.6× |
| CT chest w contrast (71260) | $3,760.40 | $10,744 | 21.3× |
| CT chest w/wo contrast (71270) | $4,399.50 | $12,570 | 25.0× |
| CT head/brain with contrast (70460) | $3,462.20 | $9,892 | 19.6× |
| CT head/brain without and with contrast (70470) | $4,055.45 | $11,587 | 23.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $291.90 | $834 | 3.3× |
| CT hrt w/3d image congen (75573) | $923.30 | $2,638 | 2.6× |
| CT iac w contrast (70481) | $1,533.70 | $4,382 | 8.7× |
| CT l-spine w&w/o contrast (72133) | $5,881.05 | $16,803 | 33.4× |
| CT lower ext w/o (73700) | $1,890.70 | $5,402 | 18.0× |
| CT lower extremity w/contrast material (73701) | $2,439.15 | $6,969 | 13.8× |
| CT lumbar spine w contrast (72132) | $5,002.90 | $14,294 | 14.3× |
| CT lumbar spine w/o contrast (72131) | $3,818.85 | $10,911 | 36.4× |
| CT maxillofacial w contrast (70487) | $2,685.55 | $7,673 | 15.2× |
| CT maxillofacial wo contrast (70486) | $2,256.63 | $6,447.50 | 21.5× |
| CT neck tissue combo (70492) | $2,943.50 | $8,410 | 16.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,789.20 | $5,112 | 10.2× |
| CT orbits w/o contrast (70480) | $1,345.05 | $3,843 | 12.8× |
| CT pelvis w&w/o contrast (72194) | $5,436.55 | $15,533 | 30.9× |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$2,846.20–$3,818.85 | $8,132–$10,911 | varies |
| CT scan of leg combo (73702) | $2,855.30 | $8,158 | 16.2× |
| CT scans face/jaw combo (70488) | $3,249.75 | $9,285 | 18.4× |
| CT soft tissue neck w contrast (70491) | $2,452.79 | $7,007.97 | 13.9× |
| CT soft tissue neck w/o contrast (70490) | $1,986.95 | $5,677 | 18.9× |
| CT thoracic spine w contrast (72129) | $4,767.35 | $13,621 | 27.1× |
| CT thoracic spine w/o contrast (72128) | $3,639.30 | $10,398 | 34.7× |
| CT thoracic spine w/wo cont (72130) | $5,604.55 | $16,013 | 31.8× |
| CT thorax w/o contrast (71250) | $2,970.80 | $8,488 | 28.3× |
| CT upper ext wo (73200) | $1,375.55 | $3,930.12 | 13.1× |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$1,719.55–$2,132.20 | $4,913–$6,092 | varies |
| CT upper extremity with contrast (73201) | $1,719.55 | $4,913 | 4.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,346.12 | $6,703.20 | 13.3× |
| Cta Abdomen (74175) | $3,294.90 | $9,414 | 18.7× |
| CTA pelvis (72191) | $727.97 | $2,079.90 | 4.1× |
| Dilation ureters/urethra rs&i (74485) | $589.37 | $1,683.90 | 0.3× |
| Discography Cerv/Thor Spine (72285) | $969.89 | $2,771.10 | 0.5× |
| Dxa Bone Density Axial (77080) | $405.30 | $1,158 | 3.9× |
| Dxa bone density study (77085) | $182.35 | $521 | 1.7× |
| Echo exam uterus (76831) | $1,240.75 | $3,545 | 5.2× |
| Esophagram (74220) | $887.95 | $2,537 | 5.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $362.25 | $1,035 | 3.4× |
| Fluoroscopy up to 1 hr (76000) | $484.74 | $1,384.95 | 2.0× |
| Follow-Up Angiography (75898) | $334.85 | $956.70 | 0.1× |
| Foot 2 views (73620) | $515.55 | $1,473 | 5.9× |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$473.50–$473.55 | $1,352.85–$1,353 | varies |
| Gastric emptying imaging study (78264) | $1,699.25 | $4,855 | 4.2× |
| Gated Heart Planar Single (78472) | $523.53 | $1,495.80 | 1.3× |
| Hand 2 views (73120) | $347.90 | $994 | 3.3× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $1,239.53 | $3,541.50 | 0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,064.35 | $3,041 | 0.3× |
| Hepatobil Syst Image W/Drug (78227) | $1,864.45 | $5,327 | 3.4× |
| Hepatobiliary System Imaging (78226) | $1,752.80 | $5,008 | 4.4× |
| Ht Musc Image Planar Mult (78454) | $5,327.35 | $15,221 | 4.1× |
| Ht Muscle Image Spect Sing (78451) | $4,421.90 | $12,634 | 3.4× |
| Hysterosalpingogram (74740) | $501.20 | $1,432 | 2.1× |
| K Flow/Funct Image W/Drug (78708) | $1,286.62 | $3,676.05 | 2.4× |
| K Flow/Funct Image W/O Drug (78707) | $1,595.65 | $4,559 | 2.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $1,531.25 | $4,375 | 3.8× |
| Knee 3 Views (73562) | $595.35 | $1,701 | 6.8× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $288.54 | $824.40 | 0.7× |
| Leveen/Shunt Patency Exam (78291) | $641.66 | $1,833.30 | 1.6× |
| Liver & Spleen Imaging Static Only (78215) | $445.22 | $1,272.03 | 1.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $957.60 | $2,736 | 2.4× |
| Lung Perf&Ventilat Diferentl (78598) | $779.63 | $2,227.50 | 1.4× |
| Lung perfusion differential (78597) | $721.98 | $2,062.80 | 1.8× |
| Lung Ventilat&Perfus Imaging (78582) | $1,009.05 | $2,883 | 1.8× |
| Lung Ventilation Imaging (78579) | $569.45 | $1,627 | 1.4× |
| Lymph System Imaging (78195) | $1,315.65 | $3,759 | 2.4× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$714–$714.11 | $2,040–$2,040.30 | varies |
| Mammary ductogram or galactogram multiple (77054) | $669.06 | $1,911.60 | 2.8× |
| Mammary ductogram or galactogram single (77053) | $319.10 | $911.70 | 1.3× |
| Meckels Divert Exam (78290) | $586.85 | $1,676.70 | 1.5× |
| Mr safety determination physician/other qhp (76016) | $92.40 | $264 | 1.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $25.55 | $73 | 0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $96.25 | $275 | 1.0× |
| Mr safety implt pos&/immoblj (76019) | $62.30 | $178 | 1.1× |
| Mr safety med physics xm customization plng&mntr (76017) | $218.75 | $625 | 0.9× |
| Mra Head W/O & W/Contrast Material (70546) | $2,331 | $6,660 | 6.7× |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,523.40–$1,523.55 | $4,352.55–$4,353 | varies |
| MRA head with contrast (70545) | $1,599.85 | $4,571 | 4.6× |
| MRA neck w contrast (70548) | $3,743.60 | $10,696 | 10.7× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,254.20 | $15,012 | 15.0× |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$3,283.69–$3,283.70 | $9,381.95–$9,382 | varies |
| MRI abdomen w contrast (74182) | $4,442.55 | $12,693 | 12.7× |
| MRI abdomen w/o contrast (74181) | $2,863 | $8,180 | 11.9× |
| MRI any jt lower extrem w/contrast material (73722) | $5,275.90 | $15,074 | 6.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $5,673.15 | $16,209 | 16.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $5,163.55 | $14,753 | 6.6× |
| MRI bone marrow blood supply (77084) | $995.40 | $2,844 | 4.2× |
| MRI cervical spine w contrast (72142) | $4,857.65 | $13,879 | 13.9× |
| MRI cervical spine w/o cont (72141) | $3,492.65 | $9,979 | 14.6× |
| MRI chest w/o contrast (71550) | $1,717.07 | $4,905.90 | 7.2× |
| MRI chest with contrast (71551) | $1,337.81 | $3,822.30 | 1.7× |
| MRI chest wo w contrast (71552) | $1,904.49 | $5,441.40 | 5.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$2,965.90–$5,163.55 | $8,474–$14,753 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,795.05 | $10,843 | 10.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$2,513.19–$4,105.50 | $7,180.53–$11,730 | varies |
| MRI lumbar spine w contrast (72149) | $4,100.25 | $11,715 | 11.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,597.90 | $15,994 | 16.0× |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,463.35–$1,463.49 | $4,181–$4,181.38 | varies |
| MRI orbit face neck w contrast (70542) | $908.15 | $2,594.70 | 2.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$2,321.90–$2,321.99 | $6,634–$6,634.25 | varies |
| MRI pelvis w contrast (72196) | $3,948.70 | $11,282 | 11.3× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$4,935.88–$4,936.05 | $14,102.50–$14,103 | varies |
| MRI pelvis w/o contrast (72195) | $3,356.50 | $9,590 | 14.0× |
| MRI thoracic spine w/o contrast (72146) | $2,391.20 | $6,832 | 10.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$1,901.90–$5,163.55 | $5,434–$14,753 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,744.75–$4,105.50 | $4,985–$11,730 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,355.50 | $6,730 | 6.7× |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$4,935.88–$4,936.05 | $14,102.50–$14,103 | varies |
| MRI, dorsal spine combo (72157) | $4,041.45 | $11,547 | 11.5× |
| MRI, dorsal spine contrast (72147) | $3,443.65 | $9,839 | 9.8× |
| MRI, joint upper extrem (73221) | $4,105.50 | $11,730 | 17.1× |
| MRI, joint upper extrem combo (73223) | $6,378.75 | $18,225 | 18.2× |
| MRI, lumbar spine combo (72158) | $4,822.30 | $13,778 | 13.8× |
| Myelogram cervical (72240) | $985.32 | $2,815.20 | 1.3× |
| Myelogram Lumbar (72265) | $1,036.67 | $2,961.90 | 1.3× |
| Myelography thoracic (72255) | $518.18 | $1,480.50 | 0.7× |
| Myelograpy 2/more regions rs&i (72270) | $1,209.29 | $3,455.10 | 1.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $4,421.90 | $12,634 | 3.4× |
| Myocardial Spect Multiple Studies (78452) | $5,327.35 | $15,221 | 4.1× |
| N-invas est c ffr sw aly CTA (75580) | $1,381.44 | $3,946.95 | 1.6× |
| Neck soft tissue (70360) | $347.55 | $993 | 4.0× |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$131.36–$145.95 | $375.30–$417 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,261.58 | $3,604.50 | 2.3× |
| Parathyroid Planar Imaging (78070) | $547 | $1,562.85 | 1.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $889.93 | $2,542.65 | 2.2× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$457.45–$457.46 | $1,307–$1,307.02 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $720.67 | $2,059.05 | 1.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $568.75 | $1,625 | 5.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$345.10–$345.24 | $986–$986.40 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) | $614.95 | $1,757 | 7.0× |
| Radex Calcaneus Minimum 2 Views (73650) | $356.46 | $1,018.44 | 4.1× |
| Radex elbow complete minimum 3 views (73080) | $535.99 | $1,531.38 | 6.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $488.10 | $1,394.56 | 4.6× |
| Radex fingr minimum 2 views (73140) | $388.50 | $1,110 | 4.4× |
| Radex foot complete minimum 3 views (73630) | $620.90 | $1,774 | 7.1× |
| Radex Hand Minimum 3 Views (73130) | $535.15 | $1,529 | 6.1× |
| Radex lower extremity infant minimum 2 views (73592) | $167.58 | $478.80 | 1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $169.16 | $483.30 | 1.9× |
| Radex shoulder complete minimum 2 views (73030) | $634.90 | $1,814 | 7.3× |
| Radex Sinuses Paransl < 3 Views (70210) | $66.73 | $190.65 | 0.8× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $2,303.70 | $6,582 | 13.1× |
| Radex Spine 1 View Specify Level (72020) | $314.65 | $899 | 3.6× |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$106.16–$336.35 | $303.30–$961 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $493.15 | $1,409 | 5.6× |
| Radex Toe Minimum 2 Views (73660) | $278.25 | $795 | 3.2× |
| Radex upper extremity infant minimum 2 views (73092) | $41.27 | $117.90 | 0.4× |
| Radex Wrist Complete Minimum 3 Views (73110) | $539 | $1,540 | 6.2× |
| Radiolog exam mandible compl minimum 4 views (70110) | $586.50 | $1,675.69 | 5.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$373.10–$568.75 | $1,066–$1,625 | varies |
| Radiologic exam colon double contrast study (74280) | $1,710.45 | $4,887 | 9.7× |
| Radiologic exam colon single contrast study (74270) | $872.55 | $2,493 | 5.0× |
| Radiologic exam knee complete 4/more views (73564) | $684.95 | $1,957 | 6.5× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $690.90 | $1,974 | 6.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $770.70 | $2,202 | 4.4× |
| Radiologic exam swallow function contrast study (74230) | $986.30 | $2,818 | 5.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,054.20 | $3,012 | 6.0× |
| Radiologic examination femur 1 view (73551) | $393.75 | $1,125 | 4.5× |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$479.77–$479.85 | $1,370.75–$1,371 | varies |
| Radiologic examination knee 1/2 views (73560) | $494.20 | $1,412 | 5.7× |
| Radiologic examination tibia & fibula 2 views (73590) | $583.96 | $1,668.45 | 6.7× |
| Renal Cyst Study (74470) | $563.24 | $1,609.25 | 1.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $465.26 | $1,329.30 | 1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $769.86 | $2,199.60 | 1.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $1,622.57 | $4,635.90 | 3.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,279.53 | $3,655.80 | 2.3× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$1,697.15–$1,748.25 | $4,849–$4,995 | varies |
| Rp Therapy Intravenous Administration (79101) | $1,040.13 | $2,971.80 | 4.4× |
| Salivary Gland Imaging (78230) | $641.66 | $1,833.30 | 1.6× |
| Scapula (73010) range across 2 matching MRF lines |
$222.60–$222.71 | $636–$636.30 | varies |
| Sella turcica (70240) | $63.32 | $180.90 | 0.7× |
| Shoulder 1 view (73020) | $355.60 | $1,016 | 4.1× |
| Shoulder Arthrography (73040) | $737.86 | $2,108.16 | 2.1× |
| Sialogram (70390) | $349.34 | $998.10 | 1.5× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$234.36–$234.50 | $669.60–$670 | varies |
| Spleen Imaging (78185) | $541.17 | $1,546.20 | 1.3× |
| Sternoclavicular joints (71130) | $142.89 | $408.25 | 1.6× |
| Superior sagittal sinus venogram (75870) | $1,064.35 | $3,041 | 0.3× |
| Testicular Imaging W/Flow (78761) | $916.65 | $2,619 | 2.3× |
| Thoracic spine 2 views (72070) | $424.90 | $1,214 | 4.0× |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$744.80–$744.92 | $2,128–$2,128.34 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $841.37 | $2,403.90 | 2.1× |
| Thyroid Imaging With Vascular Flow (78013) | $568.40 | $1,624 | 1.4× |
| Thyroid Uptake Measurement (78012) | $308.07 | $880.20 | 0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,159.61 | $3,313.15 | 2.9× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$733.95–$1,101.10 | $2,097–$3,146 | varies |
| Ultrasound Exam Aaa Screen (76706) | $274.37 | $783.90 | 2.6× |
| Ultrasound, abdomen limited (76705) | $926.45 | $2,647 | 8.8× |
| Unlisted fluoroscopic procedure (76496) | $185.54 | $530.10 | 2.1× |
| Unlisted us procedure (76999) | $105 | $300 | 1.2× |
| Upper gi w/o kub (74240) | $446.42 | $1,275.48 | 2.5× |
| Ureteral Reflux Study (78740) | $826.25 | $2,360.70 | 2.1× |
| Urethrocystogram voiding (74455) | $467.78 | $1,336.50 | 2.0× |
| Urethrocystography retrograde (74450) | $567.88 | $1,622.50 | 2.4× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$925.75–$1,388.45 | $2,645–$3,967 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$196.35–$530.67 | $561–$1,516.20 | varies |
| Us exam, pelvic, limited (76857) | $489.65 | $1,399 | 4.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $980.54 | $2,801.52 | 9.3× |
| Us ob limited 1 or more fetuses (76815) | $581.70 | $1,662 | 5.5× |
| Us ob transvaginal (76817) | $668.50 | $1,910 | 6.4× |
| Us pelvic non ob complete (76856) | $1,041.43 | $2,975.50 | 9.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$938.22–$938.35 | $2,680.61–$2,681 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$1,183.18–$1,183.35 | $3,380.50–$3,381 | varies |
| Us retroperitoneal limited (76775) | $473.55 | $1,353 | 4.5× |
| Us scrotum and contents (76870) | $908.17 | $2,594.75 | 8.6× |
| Us thyroid (76536) range across 2 matching MRF lines |
$1,026.13–$1,026.20 | $2,931.78–$2,932 | varies |
| Us transrectal (76872) | $1,034.15 | $2,954.70 | 9.8× |
| Vascular Flow Imaging (78445) | $630 | $1,800 | 1.6× |
| Vein X-Ray Chest (75827) | $1,115.73 | $3,187.80 | 0.7× |
| Vein X-Ray Skull Epidural (75872) | $430.29 | $1,229.40 | 0.7× |
| Vein X-Ray Spleen/Liver (75810) | $1,340.33 | $3,829.50 | 0.4× |
| Venogram Sinus/Jugular (75860) | $1,064.35 | $3,041 | 0.3× |
| Venography Adrenal Unilateral (75840) | $316.58 | $904.50 | 0.1× |
| Venography caval inferior serialography rs&i (75825) | $3,491.33 | $9,975.21 | 1.1× |
| Venography extremity bilateral rs&i (75822) | $899.50 | $2,570 | 0.6× |
| Venography extremity unilateral rs&i (75820) | $719.42 | $2,055.46 | 0.5× |
| Venography Orbital Rs&I (75880) | $316.58 | $904.50 | 0.5× |
| Venography Renal Bilateral (75833) | $1,411.83 | $4,033.80 | 0.4× |
| Venography Renal Unilateral (75831) | $2,034.59 | $5,813.10 | 0.6× |
| Venous thrombosis imaging (78457) | $699.30 | $1,998 | 1.3× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $1,361.75 | $3,890.70 | 3.4× |
| Vertebral fracture assessment via dxa (77086) | $109.31 | $312.30 | 1.3× |
| Wrist 2 views (73100) | $442.05 | $1,263 | 5.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $249.17 | $711.90 | 2.9× |
| X-ray antegrade pyelogram tube (74425) | $1,772.40 | $5,064 | 5.1× |
| X-Ray Aorta Leg Arteries (75630) | $3,921.05 | $11,203 | 1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $471.80 | $1,348 | 5.4× |
| X-Ray Exam Breast Specimen (76098) | $580.30 | $1,658 | 1.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $387.10 | $1,106 | 4.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $560.70 | $1,602 | 6.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $706.65 | $2,019 | 6.7× |
| X-Ray Exam Hips Bi 2 Views (73521) | $482.30 | $1,378 | 4.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $633.85 | $1,811 | 6.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $729.05 | $2,083 | 6.9× |
| X-Ray Exam L-S Spine Bending (72114) | $1,093.75 | $3,125 | 10.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $513.10 | $1,466 | 5.9× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $811.30 | $2,318 | 7.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $566.30 | $1,618 | 5.4× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$445.55–$445.60 | $1,273–$1,273.14 | varies |
| X-ray IV pyelogram (ivp) (74400) | $850.85 | $2,431 | 4.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $583.45 | $1,667 | 6.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $714 | $2,040 | 6.8× |
| X-ray nose-rectum child f.b. (76010) | $95.45 | $272.70 | 1.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $889 | $2,540 | 8.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $494.55 | $1,413 | 4.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $420.35 | $1,201 | 4.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $411.95 | $1,177 | 4.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$783.13–$783.30 | $2,237.50–$2,238 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $458.15 | $1,309 | 4.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,772.09 | $5,063.10 | 5.1× |
| X-Rays Bone Survey Complete (77075) | $519.75 | $1,485 | 4.9× |
| Xr c-spine 4 or 5 views (72050) | $693.35 | $1,981 | 6.6× |
| Xr facial bones less than 3 views (70140) | $136.40 | $389.70 | 1.6× |
| Xr orbits complete 4 views (70200) | $148.68 | $424.80 | 1.4× |
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.