Imaging prices at St. Mary's Healthcare
Amsterdam, NY · every code in this section with a posted price and a Medicare benchmark.
285 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) | $2,546.22 | $3,695 | 1.5× |
| Abdomen 1 View (74018) | $272.88 | $396 | 2.5× |
| Abdomen 2 views (74019) | $290.11 | $421 | 2.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,070.86 | $1,554 | 2.1× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$245.32–$490.64 | $356–$712 | varies |
| Arthrogram ankle (73615) | $671.87 | $975 | 1.5× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$554.04–$1,055.70 | $804–$1,532 | varies |
| Arthrogram Wrist (73115) | $618.12 | $897 | 1.4× |
| Basic radiation dosimetry calculation (77300) | $232.92 | $338 | 1.4× |
| Bone age studies (77072) | $217.07 | $315 | 1.7× |
| Bone Imaging 3 Phase (78315) | $1,321.69 | $1,918 | 2.6× |
| Bone Imaging Limited Area (78300) | $729.76 | $1,059 | 1.5× |
| Bone Imaging Whole Body (78306) | $1,246.58 | $1,809 | 2.5× |
| Bone marrow imaging limited area (78102) | $633.97 | $920 | 1.3× |
| Bone survey infant (77076) | $282.53 | $410 | 2.2× |
| Brain Image W/Flow < 4 Views (78601) | $689.10 | $1,000 | 1.4× |
| Chest 1 view (71045) | $234.29 | $340 | 2.2× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$316.30–$340.42 | $459–$494 | varies |
| Chest 3 views (71047) | $350.75 | $509 | 3.2× |
| Chest 4 or more views (71048) | $367.98 | $534 | 2.8× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$270.13–$538.19 | $392–$781 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $310.78 | $451 | 2.4× |
| Continuing medical physics consltj pr wk (77336) | $139.20 | $202 | 0.8× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$396.92–$436.89 | $576–$634 | varies |
| Contrast X-Ray Of Elbow (73085) | $724.93 | $1,052 | 1.7× |
| Contrast X-Ray Of Knee Joint (73580) | $736.65 | $1,069 | 1.7× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$2,961.06–$3,084.41 | $4,297–$4,476 | varies |
| CT abdomen and pelvis without contrast (74176) | $2,669.57 | $3,874 | 9.0× |
| CT abdomen w contrast (74160) | $1,686.92 | $2,448 | 7.7× |
| CT abdomen w wo contrast (74170) | $1,915.70 | $2,780 | 8.7× |
| CT abdomen w/o contrast (74150) | $1,441.60 | $2,092 | 11.0× |
| CT Angio Abdomen and Pelvis (74174) | $2,803.95 | $4,069 | 6.4× |
| CT Angio Chest (71275) | $1,335.48 | $1,938 | 6.1× |
| CT Angio Head (70496) | $1,666.93 | $2,419 | 7.6× |
| CT angio hrt w/3d image (75574) | $1,240.38 | $1,800 | 2.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,514.64 | $2,198 | 6.9× |
| CT Angio Neck (70498) | $1,514.64 | $2,198 | 6.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,514.64 | $2,198 | 6.9× |
| CT cervical spine w/ contrast (72126) | $1,161.13 | $1,685 | 2.7× |
| CT cervical spine w/o contrast (72125) | $1,416.79 | $2,056 | 10.9× |
| CT cervical spine w/wo cont (72127) | $1,588.38 | $2,305 | 7.3× |
| CT chest w contrast (71260) | $1,425.75 | $2,069 | 6.5× |
| CT chest w/wo contrast (71270) | $1,825.43 | $2,649 | 8.3× |
| CT colonography screening (74263) | $1,514.64 | $2,198 | 5.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,514.64 | $2,198 | 11.6× |
| CT head/brain with contrast (70460) | $1,748.94 | $2,538 | 8.0× |
| CT head/brain without and with contrast (70470) | $1,915.70 | $2,780 | 8.7× |
| CT iac w contrast (70481) | $1,533.94 | $2,226 | 7.0× |
| CT l-spine w&w/o contrast (72133) | $2,283.68 | $3,314 | 10.4× |
| CT lower ext w/o (73700) | $1,357.53 | $1,970 | 10.4× |
| CT lower extremity w/contrast material (73701) | $1,451.93 | $2,107 | 6.6× |
| CT lumbar spine w contrast (72132) | $1,495.35 | $2,170 | 3.4× |
| CT lumbar spine w/o contrast (72131) | $1,522.91 | $2,210 | 11.7× |
| CT maxillofacial w contrast (70487) | $1,451.93 | $2,107 | 6.6× |
| CT maxillofacial wo contrast (70486) | $1,267.94 | $1,840 | 9.7× |
| CT neck tissue combo (70492) | $1,904.67 | $2,764 | 8.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,904.67 | $2,764 | 8.7× |
| CT orbits w/o contrast (70480) | $1,378.89 | $2,001 | 10.6× |
| CT pelvis w&w/o contrast (72194) | $1,666.24 | $2,418 | 7.6× |
| CT pelvis w/o contrast (72192) | $1,585.62 | $2,301 | 12.2× |
| CT scan of leg combo (73702) | $1,514.64 | $2,198 | 6.9× |
| CT scans face/jaw combo (70488) | $1,904.67 | $2,764 | 8.7× |
| CT soft tissue neck w contrast (70491) | $1,518.09 | $2,203 | 6.9× |
| CT soft tissue neck w/o contrast (70490) | $1,558.06 | $2,261 | 11.9× |
| CT thoracic spine w contrast (72129) | $973.01 | $1,412 | 4.4× |
| CT thoracic spine w/o contrast (72128) | $1,592.51 | $2,311 | 12.2× |
| CT thoracic spine w/wo cont (72130) | $1,270.01 | $1,843 | 5.8× |
| CT thorax w/o contrast (71250) | $1,176.98 | $1,708 | 9.0× |
| CT upper ext wo (73200) | $1,539.45 | $2,234 | 11.8× |
| CT upper extremity w/o & w/contrast material (73202) | $1,514.64 | $2,198 | 6.9× |
| CT upper extremity with contrast (73201) | $1,219.02 | $1,769 | 2.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,514.64 | $2,198 | 6.9× |
| Cta Abdomen (74175) | $1,742.04 | $2,528 | 8.0× |
| CTA pelvis (72191) | $1,514.64 | $2,198 | 6.9× |
| Dilation ureters/urethra rs&i (74485) | $414.84 | $602 | 0.2× |
| Dxa Bone Density Axial (77080) | $476.17 | $691 | 3.6× |
| Esophagram (74220) | $465.14 | $675 | 2.1× |
| Fetal Biophys Profile W/Nst (76818) | $618.12 | $897 | 4.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $566.44 | $822 | 4.3× |
| Fluoroscopy up to 1 hr (76000) | $126.79 | $184 | 0.4× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$205.35–$410.01 | $298–$595 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$257.72–$514.76 | $374–$747 | varies |
| Gastric emptying imaging study (78264) | $1,562.88 | $2,268 | 3.1× |
| Gated Heart Planar Single (78472) | $1,544.27 | $2,241 | 3.1× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$257.72–$514.76 | $374–$747 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,316.18 | $1,910 | 1.9× |
| Hepatobiliary System Imaging (78226) | $1,562.88 | $2,268 | 3.1× |
| Ht Muscle Image Spect Sing (78451) | $1,884.69 | $2,735 | 1.2× |
| Hysterosalpingogram (74740) | $509.93 | $740 | 1.7× |
| Image fusion (77399) | $232.92 | $338 | 1.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $215 | $312 | 2.0× |
| Infant hip ultrasound, limited static exam (76886) | $146.78 | $213 | 1.4× |
| K Flow/Funct Image Multiple (78709) | $1,343.06 | $1,949 | 2.0× |
| K Flow/Funct Image W/Drug (78708) | $1,075.69 | $1,561 | 1.6× |
| K Flow/Funct Image W/O Drug (78707) | $1,544.27 | $2,241 | 2.3× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$276.33–$551.28 | $401–$800 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,043.30 | $1,514 | 2.1× |
| Lung perfusion differential (78597) | $656.71 | $953 | 1.3× |
| Lung Ventilat&Perfus Imaging (78582) | $929.60 | $1,349 | 1.4× |
| Lymph System Imaging (78195) | $929.60 | $1,349 | 1.4× |
| Magnetic Image Jaw Joint (70336) | $2,833.58 | $4,112 | 9.5× |
| Mammary ductogram or galactogram single (77053) | $320.43 | $465 | 1.1× |
| Meckels Divert Exam (78290) | $1,230.73 | $1,786 | 2.5× |
| Mlc imrt design & construction per imrt plan (77338) | $645 | $936 | 1.4× |
| MRA head w/o contrast (70544) | $2,537.27 | $3,682 | 8.5× |
| MRA neck w contrast (70548) | $2,205.81 | $3,201 | 5.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,873.55 | $4,170 | 6.6× |
| MRA neck w/o contrast (70547) | $2,205.81 | $3,201 | 7.4× |
| MRI abdomen w contrast (74182) | $2,205.81 | $3,201 | 5.1× |
| MRI abdomen w/o contrast (74181) | $2,205.81 | $3,201 | 7.4× |
| MRI any jt lower extrem w/contrast material (73722) | $2,205.81 | $3,201 | 2.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,873.55 | $4,170 | 6.6× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,205.81 | $3,201 | 2.3× |
| MRI Breast W/O Contrast Bilateral (77047) | $2,205.81 | $3,201 | 7.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $2,205.81 | $3,201 | 7.4× |
| MRI cervical spine w contrast (72142) | $2,205.81 | $3,201 | 5.1× |
| MRI cervical spine w/o cont (72141) | $2,139.66 | $3,105 | 7.2× |
| MRI chest w/o contrast (71550) | $2,205.81 | $3,201 | 7.4× |
| MRI chest with contrast (71551) | $2,205.81 | $3,201 | 2.3× |
| MRI chest wo w contrast (71552) | $3,160.90 | $4,587 | 7.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $2,205.81 | $3,201 | 5.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$2,873.55–$3,160.90 | $4,170–$4,587 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $2,426.32 | $3,521 | 8.1× |
| MRI lumbar spine w contrast (72149) | $2,205.81 | $3,201 | 5.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,914.20 | $4,229 | 6.7× |
| MRI orbit face &/neck w/o contrast (70540) | $2,316.75 | $3,362 | 7.8× |
| MRI orbit face neck w contrast (70542) | $2,205.81 | $3,201 | 5.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,914.20 | $4,229 | 6.7× |
| MRI pelvis w contrast (72196) | $2,205.81 | $3,201 | 5.1× |
| MRI pelvis w/o & w contrast (72197) | $3,304.92 | $4,796 | 7.6× |
| MRI pelvis w/o contrast (72195) | $2,537.27 | $3,682 | 8.5× |
| MRI thoracic spine w/o contrast (72146) | $2,426.32 | $3,521 | 8.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,205.81 | $3,201 | 5.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $2,205.81 | $3,201 | 7.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,873.55 | $4,170 | 6.6× |
| MRI, abdomen, combo (74183) | $2,914.20 | $4,229 | 6.7× |
| MRI, dorsal spine combo (72157) | $2,787.41 | $4,045 | 6.4× |
| MRI, dorsal spine contrast (72147) | $2,205.81 | $3,201 | 5.1× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$2,139.66–$3,889.97 | $3,105–$5,645 | varies |
| MRI, joint upper extrem combo (73223) | $2,873.55 | $4,170 | 6.6× |
| MRI, lumbar spine combo (72158) | $2,787.41 | $4,045 | 6.4× |
| Myelogram cervical (72240) | $1,264.50 | $1,835 | 1.3× |
| Myelogram Lumbar (72265) | $922.02 | $1,338 | 0.9× |
| Myelography thoracic (72255) | $554.04 | $804 | 0.6× |
| Myelograpy 2/more regions rs&i (72270) | $2,528.31 | $3,669 | 2.6× |
| Myocardial Spect Multiple Studies (78452) | $2,796.37 | $4,058 | 1.7× |
| Neck soft tissue (70360) | $293.56 | $426 | 2.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,970.71 | $4,311 | 1.7× |
| Parathyroid Planar Imaging (78070) | $863.44 | $1,253 | 1.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $633.97 | $920 | 1.3× |
| Pelvis 1 or 2 views (72170) | $272.88 | $396 | 2.1× |
| Pet Image W/Ct Lmtd (78814) range across 3 matching MRF lines |
$2,635.12–$3,160.90 | $3,824–$4,587 | varies |
| PET image w/CT, full body (78816) | $3,688.75 | $5,353 | 2.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 4 matching MRF lines |
$2,973.47–$3,252.55 | $4,315–$4,720 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $729.07 | $1,058 | 1.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $461.01 | $669 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$298.38–$596.76 | $433–$866 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$270.82–$539.57 | $393–$783 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$270.82–$539.57 | $393–$783 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $437.58 | $635 | 3.4× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$157.80–$299.76 | $229–$435 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$270.82–$539.57 | $393–$783 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$270.82–$539.57 | $393–$783 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$275.64–$551.97 | $400–$801 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $325.94 | $473 | 2.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $323.19 | $469 | 3.0× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $323.88 | $470 | 3.0× |
| Radex Ribs Unilateral 2 Views (71100) | $368.67 | $535 | 3.4× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$319.74–$639.48 | $464–$928 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $287.35 | $417 | 2.6× |
| Radex Spine 1 View Specify Level (72020) | $191.57 | $278 | 1.8× |
| Radex Sternum Minimum 2 Views (71120) | $349.37 | $507 | 3.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $437.58 | $635 | 4.0× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$150.22–$299.76 | $218–$435 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $154.36 | $224 | 1.2× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$245.32–$490.64 | $356–$712 | varies |
| Radiation treatment delivery level 1 (77402) | $205.35 | $298 | 1.6× |
| Radiation treatment delivery level 2 (77407) | $205.35 | $298 | 0.4× |
| Radiation treatment delivery level 3 (77412) | $396.23 | $575 | 0.6× |
| Radiolog exam mandible compl minimum 4 views (70110) | $400.37 | $581 | 3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$282.53–$311.47 | $410–$452 | varies |
| Radiologic exam colon double contrast study (74280) | $775.24 | $1,125 | 3.5× |
| Radiologic exam colon single contrast study (74270) | $603.65 | $876 | 2.8× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$312.16–$623.64 | $453–$905 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $398.30 | $578 | 3.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $570.57 | $828 | 2.6× |
| Radiologic exam swallow function contrast study (74230) | $580.22 | $842 | 2.7× |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$567.82–$686.34 | $824–$996 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$285.29–$570.57 | $414–$828 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$245.32–$490.64 | $356–$712 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $259.10 | $376 | 2.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$245.32–$490.64 | $356–$712 | varies |
| Ribs bilateral 3 views (71110) | $432.75 | $628 | 3.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $633.97 | $920 | 1.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,124.50 | $3,083 | 3.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$846.21–$1,437.46 | $1,228–$2,086 | varies |
| Scapula (73010) range across 3 matching MRF lines |
$362.47–$658.78 | $526–$956 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $62.71 | $91 | 2.7× |
| Sella turcica (70240) | $265.30 | $385 | 2.4× |
| Shoulder 1 view (73020) | $224.65 | $326 | 2.1× |
| Shoulder Arthrography (73040) | $619.50 | $899 | 1.4× |
| Sialogram (70390) | $604.34 | $877 | 2.0× |
| Skull less than 4 views (70250) | $197.08 | $286 | 1.5× |
| Special dosimetry (77331) | $232.92 | $338 | 1.4× |
| Special Physics Consult (77370) | $139.20 | $202 | 0.8× |
| Special teletherapy port plan (77321) | $773.86 | $1,123 | 1.7× |
| Special treatment procedure (77470) | $1,041.23 | $1,511 | 1.5× |
| Sternoclavicular joints (71130) | $385.90 | $560 | 3.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $261.86 | $380 | 0.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $232.92 | $338 | 0.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $838.63 | $1,217 | 1.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $727 | $1,055 | 1.6× |
| Ther rad simulaj-aided field setting simple (77280) | $457.56 | $664 | 2.7× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $426.55 | $619 | 1.9× |
| Thoracic spine 2 views (72070) | $257.72 | $374 | 2.0× |
| Thoracic spine 3 views (72072) | $380.38 | $552 | 2.9× |
| Thyroid Imaging With Vascular Flow (78013) | $537.50 | $780 | 1.1× |
| Thyroid Uptake Measurement (78012) | $559.55 | $812 | 1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,165.96 | $1,692 | 2.3× |
| Tx Devices Design & Construction Complex (77334) | $441.71 | $641 | 0.9× |
| Tx devices design & construction intermediate (77333) | $441.71 | $641 | 2.6× |
| Tx devices design & construction simple (77332) | $441.71 | $641 | 2.6× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$416.91–$456.87 | $605–$663 | varies |
| Ultrasound Exam Aaa Screen (76706) | $271.51 | $394 | 2.1× |
| Ultrasound, abdomen limited (76705) | $545.08 | $791 | 4.2× |
| Umbilical-artery Doppler (OB) (76820) | $150.91 | $219 | 1.2× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$638.11–$650.51 | $926–$944 | varies |
| Urethrocystogram voiding (74455) | $613.99 | $891 | 2.1× |
| Urethrocystography retrograde (74450) | $419.66 | $609 | 1.4× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$437.58–$479.61 | $635–$696 | varies |
| Us chest (76604) | $335.59 | $487 | 2.6× |
| Us complete joint (76881) | $461.70 | $670 | 3.5× |
| Us exam, pelvic, limited (76857) | $385.90 | $560 | 3.0× |
| Us head (76506) | $250.14 | $363 | 1.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $304.58 | $442 | 2.3× |
| Us ob limited 1 or more fetuses (76815) | $178.48 | $259 | 1.4× |
| Us ob transvaginal (76817) | $218.44 | $317 | 1.7× |
| Us pelvic non ob complete (76856) | $652.58 | $947 | 5.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $391.41 | $568 | 3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $243.94 | $354 | 1.9× |
| Us retroperitoneal complete (76770) | $589.87 | $856 | 4.5× |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$461.01–$562.31 | $669–$816 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$279.77–$312.85 | $406–$454 | varies |
| Us spinal canal and contents (76800) | $304.58 | $442 | 2.3× |
| Us thyroid (76536) | $563.68 | $818 | 4.3× |
| Us transrectal (76872) range across 2 matching MRF lines |
$294.93–$854.48 | $428–$1,240 | varies |
| Vein X-Ray Chest (75827) | $987.48 | $1,433 | 0.5× |
| Venography extremity bilateral rs&i (75822) | $862.06 | $1,251 | 0.4× |
| Venography extremity unilateral rs&i (75820) | $693.92 | $1,007 | 0.4× |
| Venography Renal Bilateral (75833) | $1,966 | $2,853 | 0.5× |
| Vertebral fracture assessment via dxa (77086) | $75.11 | $109 | 0.7× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$245.32–$490.64 | $356–$712 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $398.30 | $578 | 3.7× |
| X-ray antegrade pyelogram tube (74425) range across 3 matching MRF lines |
$492.02–$667.05 | $714–$968 | varies |
| X-Ray Bend Only L-S Spine (72120) | $687.03 | $997 | 5.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$270.82–$490.64 | $393–$712 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$69.60–$210.18 | $101–$305 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $525.78 | $763 | 4.8× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $466.52 | $677 | 3.6× |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$275.64–$281.84 | $400–$409 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$358.33–$387.27 | $520–$562 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $507.87 | $737 | 3.9× |
| X-Ray Exam L-S Spine Bending (72114) | $687.03 | $997 | 5.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $266.68 | $387 | 2.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $641.55 | $931 | 4.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $333.52 | $484 | 2.6× |
| X-ray eye for foreign body (70030) | $203.28 | $295 | 1.9× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$257.72–$514.76 | $374–$747 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$590.56–$693.92 | $857–$1,007 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $228.09 | $331 | 2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $281.84 | $409 | 2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $396.23 | $575 | 3.0× |
| X-ray nose-rectum child f.b. (76010) | $195.70 | $284 | 1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $529.23 | $768 | 4.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $340.42 | $494 | 2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $340.42 | $494 | 3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $383.83 | $557 | 3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $552.66 | $802 | 4.2× |
| X-Ray Stress View (77071) | $197.08 | $286 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 3 matching MRF lines |
$463.76–$587.80 | $673–$853 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$331.46–$1,161.82 | $481–$1,686 | varies |
| X-Rays Bone Survey Complete (77075) | $864.13 | $1,254 | 6.6× |
| Xr c-spine 4 or 5 views (72050) | $421.04 | $611 | 3.2× |
| Xr facial bones less than 3 views (70140) | $275.64 | $400 | 2.5× |
| Xr orbits complete 4 views (70200) | $441.71 | $641 | 3.4× |
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.