Imaging prices at St. Patrick Hospital
Missoula, MT · every code in this section with a posted price and a Medicare benchmark.
325 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) | $4,655.20 | $5,819 | 3.3× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$189.60–$236 | $237–$295 | varies |
| Abdomen 2 views (74019) | $267.20 | $334 | 2.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,272 | $1,590 | 3.1× |
| Adrenal Cortex & Medulla Img (78075) | $1,850.40 | $2,313 | 1.4× |
| Angio internal mammary (75756) | $6,295.20 | $7,869 | 2.0× |
| Angio pulmonary bilat (75743) | $1,520 | $1,900 | 0.5× |
| Angiography extremity bilateral rs&i (75716) | $4,636.80 | $5,796 | 1.4× |
| Angiography extremity unilateral rs&i (75710) | $4,171.20 | $5,214 | 1.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $6,074.40 | $7,593 | 1.9× |
| Ankle 2 views (73600) | $182.40 | $228 | 2.1× |
| Aortography thoracic serialography rs&i (75605) unusually low: confirm this is the full procedure |
$1,976.80 | $2,471 | 0.3× |
| Aortography thoracic w/o serialography rs&i (75600) | $6,295.20 | $7,869 | 2.0× |
| Artery X-Rays Abdomen (75726) unusually low: confirm this is the full procedure |
$1,960 | $2,450 | 0.3× |
| Artery X-Rays Pelvis (75736) unusually low: confirm this is the full procedure |
$2,456.80 | $3,071 | 0.4× |
| Arthrogram hip (73525) | $482.40 | $603 | 1.4× |
| Basic radiation dosimetry calculation (77300) | $515.20 | $644 | 3.8× |
| Bone age studies (77072) | $252.80 | $316 | 2.4× |
| Bone Imaging 3 Phase (78315) | $1,796.80 | $2,246 | 4.4× |
| Bone Imaging Limited Area (78300) | $1,186.40 | $1,483 | 2.9× |
| Bone Imaging Multiple Areas (78305) | $1,320 | $1,650 | 3.2× |
| Bone Imaging Whole Body (78306) | $1,540 | $1,925 | 3.8× |
| Bone marrow imaging; multiple areas (78103) | $913.60 | $1,142 | 2.2× |
| Bone survey infant (77076) | $191.20 | $239 | 1.8× |
| Brachytx isodose complex (77318) | $623.20 | $779 | 1.6× |
| Brachytx isodose intermed (77317) | $623.20 | $779 | 1.6× |
| Brachytx Isodose Plan Simple (77316) | $224 | $280 | 0.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $2,496.80 | $3,121 | 7.0× |
| Chest 1 view (71045) | $230.40 | $288 | 2.6× |
| Chest 2 views (71046) | $230.40 | $288 | 2.6× |
| Chest 3 views (71047) | $284.80 | $356 | 3.2× |
| Chest 4 or more views (71048) | $378.40 | $473 | 3.5× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) | $238.40 | $298 | 2.2× |
| Cholecystography Oral Contrast (74290) | $432.80 | $541 | 2.4× |
| Clavicle complete (73000) | $196 | $245 | 2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $394.40 | $493 | 3.7× |
| Continuing medical physics consltj pr wk (77336) | $515.20 | $644 | 3.8× |
| Contrast Exam Abdominl Aorta (75625) | $2,803.20 | $3,504 | 0.9× |
| Contrast X-Ray Bladder (74430) | $538.40 | $673 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) | $3,617.60 | $4,522 | 10.1× |
| CT abdomen and pelvis without contrast (74176) | $1,791.20 | $2,239 | 7.3× |
| CT abdomen w contrast (74160) | $1,400.80 | $1,751 | 7.8× |
| CT abdomen w wo contrast (74170) | $1,629.60 | $2,037 | 9.1× |
| CT abdomen w/o contrast (74150) | $1,148.80 | $1,436 | 10.8× |
| CT Angio Abdomen and Pelvis (74174) | $2,934.40 | $3,668 | 8.2× |
| CT Angio Chest (71275) | $1,866.40 | $2,333 | 10.4× |
| CT Angio Head (70496) | $1,218.40 | $1,523 | 6.8× |
| CT angio hrt w/3d image (75574) | $1,400.80 | $1,751 | 3.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $3,385.60 | $4,232 | 18.9× |
| CT Angio Neck (70498) | $1,218.40 | $1,523 | 6.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $3,385.60 | $4,232 | 18.9× |
| CT cervical spine w/ contrast (72126) | $2,128 | $2,660 | 6.0× |
| CT cervical spine w/o contrast (72125) | $999.20 | $1,249 | 9.4× |
| CT cervical spine w/wo cont (72127) | $2,552 | $3,190 | 14.2× |
| CT chest w contrast (71260) | $1,866.40 | $2,333 | 10.4× |
| CT chest w/wo contrast (71270) | $2,622.40 | $3,278 | 14.6× |
| CT colonography screening (74263) | $1,405.60 | $1,757 | 5.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,864.80 | $2,331 | 17.5× |
| CT head/brain with contrast (70460) | $1,218.40 | $1,523 | 6.8× |
| CT head/brain without and with contrast (70470) | $2,944 | $3,680 | 16.4× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,400.80 | $1,751 | 3.9× |
| CT heart no contrast quant eval coronry calcium (75571) | $443.20 | $554 | 5.0× |
| CT iac w contrast (70481) | $1,980.80 | $2,476 | 11.1× |
| CT l-spine w&w/o contrast (72133) | $2,934.40 | $3,668 | 16.4× |
| CT lower ext w/o (73700) | $1,148.80 | $1,436 | 10.8× |
| CT lower extremity w/contrast material (73701) | $2,200.80 | $2,751 | 12.3× |
| CT lumbar spine w contrast (72132) | $1,828 | $2,285 | 5.1× |
| CT lumbar spine w/o contrast (72131) | $1,148.80 | $1,436 | 10.8× |
| CT maxillofacial w contrast (70487) | $1,218.40 | $1,523 | 6.8× |
| CT maxillofacial wo contrast (70486) | $999.20 | $1,249 | 9.4× |
| CT neck tissue combo (70492) | $2,944 | $3,680 | 16.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,944 | $3,680 | 16.4× |
| CT orbits w/o contrast (70480) | $999.20 | $1,249 | 9.4× |
| CT pelvis w&w/o contrast (72194) | $3,385.60 | $4,232 | 18.9× |
| CT pelvis w/o contrast (72192) | $1,148.80 | $1,436 | 10.8× |
| CT scan of leg combo (73702) | $3,385.60 | $4,232 | 18.9× |
| CT scans face/jaw combo (70488) | $1,292 | $1,615 | 7.2× |
| CT soft tissue neck w contrast (70491) | $1,621.60 | $2,027 | 9.0× |
| CT soft tissue neck w/o contrast (70490) | $1,218.40 | $1,523 | 11.4× |
| CT thoracic spine w contrast (72129) | $3,385.60 | $4,232 | 18.9× |
| CT thoracic spine w/o contrast (72128) | $1,148.80 | $1,436 | 10.8× |
| CT thorax w/o contrast (71250) | $1,148.80 | $1,436 | 10.8× |
| CT upper ext wo (73200) | $1,148.80 | $1,436 | 10.8× |
| CT upper extremity w/o & w/contrast material (73202) | $3,385.60 | $4,232 | 18.9× |
| CT upper extremity with contrast (73201) | $1,882.40 | $2,353 | 5.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,400.80 | $1,751 | 7.8× |
| Cta Abdomen (74175) | $1,400.80 | $1,751 | 7.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $1,640.80 | $2,051 | 4.6× |
| CTA pelvis (72191) | $3,385.60 | $4,232 | 18.9× |
| Dilation ureters/urethra rs&i (74485) | $1,013.60 | $1,267 | 0.5× |
| Doppler Fetal Mid Cerebral Artery (76821) | $215.20 | $269 | 2.0× |
| Dxa Bone Density Axial (77080) | $344 | $430 | 3.2× |
| Dxa bone density study (77085) | $171.20 | $214 | 1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $136 | $170 | 1.5× |
| Echo exam uterus (76831) | $451.20 | $564 | 1.9× |
| Echo Guide For Artery Repair (76936) | $568.80 | $711 | 2.6× |
| Esophagram (74220) | $657.60 | $822 | 3.7× |
| Fetal Biophys Profile W/Nst (76818) | $532 | $665 | 5.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $327.20 | $409 | 3.1× |
| Fluoroscopy up to 1 hr (76000) | $562.40 | $703 | 2.3× |
| Follow-Up Angiography (75898) | $1,760 | $2,200 | 0.5× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$145.60–$182.40 | $182–$228 | varies |
| Forearm 2 views (73090) | $182.40 | $228 | 2.1× |
| Gastric emptying imaging study (78264) | $1,213.60 | $1,517 | 3.0× |
| Gated Heart Planar Single (78472) | $1,360 | $1,700 | 3.3× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$124–$256 | $155–$320 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,379.20 | $1,724 | 1.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,379.20 | $1,724 | 1.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $1,911.20 | $2,389 | 0.6× |
| Hepatobil Syst Image W/Drug (78227) | $1,071.20 | $1,339 | 1.9× |
| Hepatobiliary System Imaging (78226) | $1,071.20 | $1,339 | 2.6× |
| Ht Muscle Image Spect Sing (78451) | $2,088 | $2,610 | 1.6× |
| Hysterosalpingogram (74740) | $480.80 | $601 | 2.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $491.20 | $614 | 5.5× |
| Infant hip ultrasound, limited static exam (76886) | $192.80 | $241 | 2.2× |
| Intracavitary Radiation Source Applic Intermed (77762) | $5,219.20 | $6,524 | 9.2× |
| Joint Survey Single View (77077) | $256 | $320 | 2.4× |
| K Flow/Funct Image W/Drug (78708) | $1,340 | $1,675 | 2.4× |
| K Flow/Funct Image W/O Drug (78707) | $1,282.40 | $1,603 | 2.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $844.80 | $1,056 | 2.1× |
| Knee 3 Views (73562) | $182.40 | $228 | 2.1× |
| Lung Perf&Ventilat Diferentl (78598) | $1,857.60 | $2,322 | 3.3× |
| Lung perfusion differential (78597) | $864.80 | $1,081 | 2.1× |
| Lung Ventilat&Perfus Imaging (78582) | $1,654.40 | $2,068 | 3.0× |
| Lymph System Imaging (78195) | $1,448 | $1,810 | 2.6× |
| Magnetic Image Jaw Joint (70336) | $1,788.80 | $2,236 | 7.3× |
| Magnetic Resonance Elastography (76391) | $1,729.60 | $2,162 | 7.1× |
| Meckels Divert Exam (78290) | $956 | $1,195 | 2.3× |
| Mlc imrt design & construction per imrt plan (77338) | $1,398.40 | $1,748 | 3.7× |
| Mr safety determination physician/other qhp (76016) | $362.40 | $453 | 4.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $101.60 | $127 | 3.4× |
| Mr safety med physics xm customization plng&mntr (76017) | $992.80 | $1,241 | 4.1× |
| Mra Head W/O & W/Contrast Material (70546) | $3,552 | $4,440 | 10.0× |
| MRA head w/o contrast (70544) | $1,004 | $1,255 | 4.1× |
| MRA head with contrast (70545) | $1,644 | $2,055 | 4.6× |
| MRA neck w contrast (70548) | $1,644 | $2,055 | 4.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,200.80 | $2,751 | 6.2× |
| MRA neck w/o contrast (70547) | $1,556.80 | $1,946 | 6.4× |
| MRI abdomen w contrast (74182) | $2,183.20 | $2,729 | 6.1× |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,158.40–$1,331.20 | $1,448–$1,664 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $2,183.20 | $2,729 | 2.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,905.60 | $3,632 | 8.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $2,183.20 | $2,729 | 2.7× |
| MRI bone marrow blood supply (77084) | $2,944.80 | $3,681 | 12.1× |
| MRI brain functional w/o physician admnistration (70554) | $737.60 | $922 | 3.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $1,729.60 | $2,162 | 7.1× |
| MRI cardiac w/o contrast (75557) | $1,873.60 | $2,342 | 7.7× |
| MRI cervical spine w contrast (72142) | $2,200.80 | $2,751 | 6.2× |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$747.20–$1,342.40 | $934–$1,678 | varies |
| MRI chest w/o contrast (71550) | $2,183.20 | $2,729 | 9.0× |
| MRI chest wo w contrast (71552) | $2,367.20 | $2,959 | 6.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $2,183.20 | $2,729 | 6.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,331.20 | $1,664 | 5.5× |
| MRI lumbar spine w contrast (72149) | $2,183.20 | $2,729 | 6.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,744 | $3,430 | 7.7× |
| MRI orbit face &/neck w/o contrast (70540) | $1,560 | $1,950 | 6.4× |
| MRI orbit face neck w contrast (70542) | $1,516.80 | $1,896 | 4.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,200.80 | $2,751 | 6.2× |
| MRI pelvis w/o & w contrast (72197) | $2,183.20 | $2,729 | 6.1× |
| MRI pelvis w/o contrast (72195) | $1,331.20 | $1,664 | 5.5× |
| MRI thoracic spine w/o contrast (72146) | $1,331.20 | $1,664 | 5.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,331.20 | $1,664 | 5.5× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $2,183.20 | $2,729 | 6.1× |
| MRI, abdomen, combo (74183) | $2,892 | $3,615 | 8.1× |
| MRI, dorsal spine combo (72157) | $2,860.80 | $3,576 | 8.0× |
| MRI, dorsal spine contrast (72147) | $2,183.20 | $2,729 | 6.1× |
| MRI, joint upper extrem (73221) | $1,331.20 | $1,664 | 5.5× |
| MRI, joint upper extrem combo (73223) | $2,905.60 | $3,632 | 8.2× |
| MRI, lumbar spine combo (72158) | $2,504 | $3,130 | 7.0× |
| Myocardial Spect Multiple Studies (78452) | $2,088 | $2,610 | 1.6× |
| N-invas est c ffr sw aly CTA (75580) | $2,636 | $3,295 | 3.0× |
| Neck soft tissue (70360) | $207.20 | $259 | 2.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $786.40 | $983 | 1.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,655.20 | $5,819 | 3.3× |
| Nuclear Rx Intra-Arterial (79445) | $575.20 | $719 | 2.4× |
| Nuclear Rx Oral Admin (79005) | $821.60 | $1,027 | 3.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,122.40 | $2,653 | 3.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,016 | $1,270 | 2.5× |
| Pelvis 1 or 2 views (72170) | $256 | $320 | 2.4× |
| PET image w/CT, full body (78816) | $6,243.20 | $7,804 | 4.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,060 | $7,575 | 4.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $1,473.60 | $1,842 | 0.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $991.20 | $1,239 | 2.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $355.20 | $444 | 3.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $445.60 | $557 | 0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) | $182.40 | $228 | 2.1× |
| Radex Calcaneus Minimum 2 Views (73650) | $192 | $240 | 2.2× |
| Radex elbow complete minimum 3 views (73080) | $182.40 | $228 | 2.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $318.40 | $398 | 3.0× |
| Radex fingr minimum 2 views (73140) | $182.40 | $228 | 2.1× |
| Radex foot complete minimum 3 views (73630) | $182.40 | $228 | 2.1× |
| Radex Hand Minimum 3 Views (73130) | $304 | $380 | 3.4× |
| Radex lower extremity infant minimum 2 views (73592) | $171.20 | $214 | 1.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $210.40 | $263 | 2.4× |
| Radex Ribs Unilateral 2 Views (71100) | $216 | $270 | 2.4× |
| Radex shoulder complete minimum 2 views (73030) | $182.40 | $228 | 2.1× |
| Radex Sinuses Paransl < 3 Views (70210) | $192 | $240 | 2.2× |
| Radex Spine 1 View Specify Level (72020) | $182.40 | $228 | 2.1× |
| Radex Sternum Minimum 2 Views (71120) | $234.40 | $293 | 2.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $333.60 | $417 | 3.8× |
| Radex Toe Minimum 2 Views (73660) | $184 | $230 | 2.1× |
| Radex upper extremity infant minimum 2 views (73092) | $171.20 | $214 | 1.6× |
| Radex Wrist Complete Minimum 3 Views (73110) | $202.40 | $253 | 2.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $436.80 | $546 | 4.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $14,454.40 | $18,068 | 1.9× |
| Radiation treatment delivery level 1 (77402) | $198.40 | $248 | 1.9× |
| Radiation treatment delivery level 2 (77407) | $226.40 | $283 | 0.6× |
| Radiation treatment delivery level 3 (77412) | $382.40 | $478 | 0.7× |
| Radiolog exam mandible compl minimum 4 views (70110) | $345.60 | $432 | 3.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $312.80 | $391 | 2.9× |
| Radiologic exam colon double contrast study (74280) | $636 | $795 | 3.5× |
| Radiologic exam colon single contrast study (74270) | $480.80 | $601 | 2.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $711.20 | $889 | 4.0× |
| Radiologic exam knee complete 4/more views (73564) | $256 | $320 | 2.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $277.60 | $347 | 2.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $473.60 | $592 | 2.6× |
| Radiologic exam swallow function contrast study (74230) | $432.80 | $541 | 2.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $432.80 | $541 | 2.4× |
| Radiologic examination femur 1 view (73551) | $139.20 | $174 | 1.6× |
| Radiologic examination femur minimum 2 views (73552) | $182.40 | $228 | 2.1× |
| Radiologic examination knee 1/2 views (73560) | $182.40 | $228 | 2.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $182.40 | $228 | 2.1× |
| Ribs bilateral 3 views (71110) | $342.40 | $428 | 3.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,011.20 | $2,514 | 3.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,024 | $2,530 | 3.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $3,492.80 | $4,366 | 2.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $3,080 | $3,850 | 2.3× |
| Rp Therapy Intravenous Administration (79101) | $863.20 | $1,079 | 3.6× |
| Scapula (73010) | $198.40 | $248 | 1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $74.40 | $93 | 3.2× |
| Shoulder 1 view (73020) | $172.80 | $216 | 1.9× |
| Shoulder Arthrography (73040) | $468.80 | $586 | 1.3× |
| Sialogram (70390) | $142.40 | $178 | 0.6× |
| Skull less than 4 views (70250) | $212.80 | $266 | 2.0× |
| Special Physics Consult (77370) | $515.20 | $644 | 3.8× |
| Special teletherapy port plan (77321) | $713.60 | $892 | 1.9× |
| Special treatment procedure (77470) | $2,492.80 | $3,116 | 4.4× |
| Stereotactic Body Radiation Delivery (77373) | $3,956.80 | $4,946 | 2.2× |
| Sternoclavicular joints (71130) | $174.40 | $218 | 2.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $224 | $280 | 0.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $224 | $280 | 0.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,398.40 | $1,748 | 3.7× |
| Ther rad simulaj-aided field setting simple (77280) | $515.20 | $644 | 3.8× |
| Thoracic spine 2 views (72070) | $256 | $320 | 2.4× |
| Thoracic spine 3 views (72072) | $256 | $320 | 2.4× |
| Thoracolumbar 2 views (72080) | $228.80 | $286 | 2.6× |
| Thyroid Met Imaging Body (78018) | $1,313.60 | $1,642 | 2.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $924 | $1,155 | 2.3× |
| Tx Devices Design & Construction Complex (77334) | $959.20 | $1,199 | 2.5× |
| Tx devices design & construction simple (77332) | $959.20 | $1,199 | 7.0× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$261.60–$275.20 | $327–$344 | varies |
| Ultrasound Elastography Parenchyma (76981) | $827.20 | $1,034 | 7.7× |
| Ultrasound Exam Aaa Screen (76706) | $338.40 | $423 | 3.2× |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$431.20–$453.60 | $539–$567 | varies |
| Umbilical-artery Doppler (OB) (76820) | $95.20 | $119 | 0.9× |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$402.40–$462.40 | $503–$578 | varies |
| Unlisted us procedure (76999) | $182.40 | $228 | 2.1× |
| Upper gi w/o kub (74240) | $519.20 | $649 | 2.9× |
| Urethrocystogram voiding (74455) | $602.40 | $753 | 2.5× |
| Urethrocystography retrograde (74450) | $436.80 | $546 | 1.8× |
| Us breast unilateral complete (76641) | $453.60 | $567 | 4.2× |
| Us chest (76604) range across 2 matching MRF lines |
$552–$580.80 | $690–$726 | varies |
| Us complete joint (76881) | $500.80 | $626 | 4.7× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$316.80–$333.60 | $396–$417 | varies |
| Us head (76506) | $253.60 | $317 | 2.4× |
| Us kidney transplant (76776) | $601.60 | $752 | 5.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$428–$450.40 | $535–$563 | varies |
| Us ob detailed single fetus (76811) | $844 | $1,055 | 3.5× |
| Us ob limited 1 or more fetuses (76815) | $394.40 | $493 | 3.7× |
| Us ob transvaginal (76817) | $436 | $545 | 4.1× |
| Us pelvic non ob complete (76856) | $481.60 | $602 | 4.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $644.80 | $806 | 6.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $374.40 | $468 | 3.5× |
| Us retroperitoneal complete (76770) | $591.20 | $739 | 5.5× |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$446.40–$469.60 | $558–$587 | varies |
| Us scrotum and contents (76870) | $450.40 | $563 | 4.2× |
| Us spinal canal and contents (76800) | $892 | $1,115 | 8.4× |
| Us thyroid (76536) range across 2 matching MRF lines |
$431.20–$453.60 | $539–$567 | varies |
| Vein X-Ray Chest (75827) | $2,502.40 | $3,128 | 1.6× |
| Venogram Sinus/Jugular (75860) | $1,084.80 | $1,356 | 0.3× |
| Venography Adrenal Unilateral (75840) | $6,074.40 | $7,593 | 1.9× |
| Venography caval inferior serialography rs&i (75825) | $2,587.20 | $3,234 | 0.8× |
| Venography extremity bilateral rs&i (75822) | $1,180 | $1,475 | 0.7× |
| Venography extremity unilateral rs&i (75820) | $613.60 | $767 | 0.4× |
| Venography Renal Unilateral (75831) | $1,282.40 | $1,603 | 0.4× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$141.60–$188.80 | $177–$236 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $263.20 | $329 | 3.0× |
| X-ray antegrade pyelogram tube (74425) | $492 | $615 | 1.4× |
| X-Ray Aorta Leg Arteries (75630) | $2,803.20 | $3,504 | 0.9× |
| X-Ray Bend Only L-S Spine (72120) | $256 | $320 | 2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$147.20–$182.40 | $184–$228 | varies |
| X-Ray Exam Breast Specimen (76098) | $224.80 | $281 | 0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $139.20 | $174 | 1.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $230.40 | $288 | 2.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $436.80 | $546 | 4.1× |
| X-Ray Exam Hip Uni 1 View (73501) | $202.40 | $253 | 2.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $222.40 | $278 | 2.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $249.60 | $312 | 2.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $230.40 | $288 | 2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $230.40 | $288 | 2.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $436.80 | $546 | 4.1× |
| X-Ray Exam L-S Spine Bending (72114) | $473.60 | $592 | 4.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $182.40 | $228 | 2.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $394.40 | $493 | 3.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $256 | $320 | 2.4× |
| X-ray humerus (73060) | $182.40 | $228 | 2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $176.80 | $221 | 2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $155.20 | $194 | 1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $256 | $320 | 2.4× |
| X-ray nose-rectum child f.b. (76010) | $118.40 | $148 | 1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $356.80 | $446 | 3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $256 | $320 | 2.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $141.60 | $177 | 1.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $237.60 | $297 | 2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $219.20 | $274 | 2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $282.40 | $353 | 2.6× |
| X-Ray Stress View (77071) | $97.60 | $122 | 1.1× |
| X-ray thoracic spine 4 vw (72074) | $268.80 | $336 | 2.5× |
| X-Ray Tmj Unilat (70328) | $133.60 | $167 | 1.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $512 | $640 | 1.4× |
| X-Rays Bone Length Studies (77073) | $384.80 | $481 | 3.6× |
| X-Rays Bone Survey Complete (77075) | $552 | $690 | 5.2× |
| Xr c-spine 4 or 5 views (72050) | $256 | $320 | 2.4× |
| Xr facial bones less than 3 views (70140) | $214.40 | $268 | 2.4× |
| Xr orbits complete 4 views (70200) | $282.40 | $353 | 2.6× |
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.