Imaging prices at St. Tammany Parish Hospital
Covington, LA · every code in this section with a posted price and a Medicare benchmark.
384 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) | $3,048.60 | $5,081 | 2.4× |
| Abdomen 1 View (74018) | $118.88 | $198.14 | 1.5× |
| Abdomen 2 views (74019) | $219.03 | $365.05 | 2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $668.71 | $1,114.51 | 1.8× |
| Angio internal mammary (75756) | $4,770.22 | $7,950.36 | 1.7× |
| Angio pulmonary bilat (75743) | $4,770.22 | $7,950.36 | 1.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $5,625 | $9,375 | 2.0× |
| Angiography extremity bilateral rs&i (75716) | $4,770.22 | $7,950.36 | 1.7× |
| Angiography extremity unilateral rs&i (75710) | $4,770.22 | $7,950.36 | 1.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $4,770.22 | $7,950.36 | 1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $1,881.05 | $3,135.09 | 0.7× |
| Ankle 2 views (73600) | $118.88 | $198.14 | 1.5× |
| Aortography thoracic serialography rs&i (75605) | $8,161.63 | $13,602.72 | 1.6× |
| Artery X-Rays Abdomen (75726) | $8,161.63 | $13,602.72 | 1.6× |
| Artery X-Rays Adrenal Gland (75731) | $5,790 | $9,650 | 2.0× |
| Artery X-Rays Pelvis (75736) | $8,161.63 | $13,602.72 | 1.6× |
| Artery X-Rays Spine (75705) | $9,720 | $16,200 | 1.9× |
| Arthrogram ankle (73615) | $873.33 | $1,455.55 | 2.8× |
| Arthrogram hip (73525) | $873.33 | $1,455.55 | 2.8× |
| Arthrogram Wrist (73115) | $483.65 | $806.09 | 1.5× |
| Basic radiation dosimetry calculation (77300) | $280.80 | $468 | 2.3× |
| Bone age studies (77072) | $219.03 | $365.05 | 2.3× |
| Bone Imaging 3 Phase (78315) | $1,251.60 | $2,086 | 3.4× |
| Bone Imaging Limited Area (78300) | $1,251.60 | $2,086 | 3.4× |
| Bone Imaging Whole Body (78306) | $1,251.60 | $2,086 | 3.4× |
| Bone marrow imaging limited area (78102) | $720 | $1,200 | 2.0× |
| Brachytx isodose complex (77318) | $888.60 | $1,481 | 2.6× |
| Brachytx isodose intermed (77317) | $774 | $1,290 | 2.3× |
| Brachytx Isodose Plan Simple (77316) | $774 | $1,290 | 2.3× |
| Brain Flow Imaging Only (78610) | $1,005 | $1,675 | 2.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $867.03 | $1,445.05 | 1.8× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $573.60 | $956 | 1.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $750 | $1,250 | 2.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,118.40 | $1,864 | 1.6× |
| Cat Scan Follow-Up Study (76380) | $127.87 | $213.12 | 1.6× |
| Cerebrospinal Fluid Scan (78630) | $867.03 | $1,445.05 | 1.8× |
| Chest 1 view (71045) | $186 | $310 | 2.4× |
| Chest 2 views (71046) | $180 | $300 | 2.3× |
| Chest 3 views (71047) | $118.88 | $198.14 | 1.5× |
| Chest 4 or more views (71048) | $219.03 | $365.05 | 2.3× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$173.40–$346.80 | $289–$578 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $195 | $325 | 2.1× |
| Continuing medical physics consltj pr wk (77336) | $260.40 | $434 | 2.1× |
| Contrast Exam Abdominl Aorta (75625) | $4,770.22 | $7,950.36 | 1.7× |
| Contrast X-Ray Bladder (74430) | $483.65 | $806.09 | 1.5× |
| Contrast X-Ray Of Elbow (73085) | $873.33 | $1,455.55 | 2.8× |
| Contrast X-Ray Of Knee Joint (73580) | $873.33 | $1,455.55 | 2.8× |
| Contrast Xray Throat/Cerv Esopha (74210) | $483.65 | $806.09 | 3.0× |
| CT abdomen and pelvis without and with contrast (74178) | $3,293.40 | $5,489 | 10.4× |
| CT abdomen and pelvis without contrast (74176) | $2,662.80 | $4,438 | 12.3× |
| CT abdomen w contrast (74160) | $1,735.80 | $2,893 | 10.9× |
| CT abdomen w wo contrast (74170) | $1,915.80 | $3,193 | 12.0× |
| CT abdomen w/o contrast (74150) | $1,386.60 | $2,311 | 14.6× |
| CT Angio Abdomen and Pelvis (74174) | $1,712.40 | $2,854 | 5.4× |
| CT Angio Chest (71275) | $2,082 | $3,470 | 13.1× |
| CT Angio Head (70496) | $808.20 | $1,347 | 5.1× |
| CT angio hrt w/3d image (75574) | $754.80 | $1,258 | 2.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $736.20 | $1,227 | 4.6× |
| CT Angio Neck (70498) | $1,048.80 | $1,748 | 6.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $729 | $1,215 | 4.6× |
| CT cervical spine w/ contrast (72126) | $1,371 | $2,285 | 4.3× |
| CT cervical spine w/o contrast (72125) | $1,191 | $1,985 | 12.5× |
| CT cervical spine w/wo cont (72127) | $1,560.60 | $2,601 | 9.8× |
| CT chest w contrast (71260) | $1,139.40 | $1,899 | 7.2× |
| CT chest w/wo contrast (71270) | $1,139.40 | $1,899 | 7.2× |
| CT head/brain with contrast (70460) | $1,203 | $2,005 | 7.6× |
| CT head/brain without and with contrast (70470) | $1,203 | $2,005 | 7.6× |
| CT heart contrast eval cardiac structure&morph (75572) | $537 | $895 | 1.7× |
| CT heart no contrast quant eval coronry calcium (75571) | $118.80 | $198 | 1.5× |
| CT hrt w/3d image congen (75573) | $537 | $895 | 1.7× |
| CT iac w contrast (70481) | $1,233.60 | $2,056 | 7.7× |
| CT l-spine w&w/o contrast (72133) | $1,560.60 | $2,601 | 9.8× |
| CT lower ext w/o (73700) | $1,057.20 | $1,762 | 11.1× |
| CT lower extremity w/contrast material (73701) | $1,059 | $1,765 | 6.6× |
| CT lumbar spine w contrast (72132) | $1,824 | $3,040 | 5.8× |
| CT lumbar spine w/o contrast (72131) | $1,171.20 | $1,952 | 12.3× |
| CT maxillofacial w contrast (70487) | $1,122 | $1,870 | 7.0× |
| CT maxillofacial wo contrast (70486) | $1,077.60 | $1,796 | 11.4× |
| CT neck tissue combo (70492) | $1,125.60 | $1,876 | 7.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,099.20 | $1,832 | 6.9× |
| CT orbits w/o contrast (70480) | $1,099.20 | $1,832 | 11.6× |
| CT pelvis w&w/o contrast (72194) | $1,407.60 | $2,346 | 8.8× |
| CT pelvis w/o contrast (72192) | $1,246.20 | $2,077 | 13.1× |
| CT scan of leg combo (73702) | $1,059 | $1,765 | 6.6× |
| CT scans face/jaw combo (70488) | $1,236 | $2,060 | 7.8× |
| CT soft tissue neck w contrast (70491) | $1,125.60 | $1,876 | 7.1× |
| CT soft tissue neck w/o contrast (70490) | $1,125.60 | $1,876 | 11.9× |
| CT thoracic spine w contrast (72129) | $1,824 | $3,040 | 11.5× |
| CT thoracic spine w/o contrast (72128) | $1,171.20 | $1,952 | 12.3× |
| CT thoracic spine w/wo cont (72130) | $1,560.60 | $2,601 | 9.8× |
| CT thorax w/o contrast (71250) | $1,139.40 | $1,899 | 12.0× |
| CT upper ext wo (73200) | $1,059 | $1,765 | 11.2× |
| CT upper extremity w/o & w/contrast material (73202) | $1,059 | $1,765 | 6.6× |
| CT upper extremity with contrast (73201) | $1,096.20 | $1,827 | 3.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,430.40 | $2,384 | 9.0× |
| Cta Abdomen (74175) | $1,567.20 | $2,612 | 9.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $729.60 | $1,216 | 2.3× |
| CTA pelvis (72191) | $801 | $1,335 | 5.0× |
| Dilation ureters/urethra rs&i (74485) | $3,244.94 | $5,408.24 | 1.7× |
| Discography Cerv/Thor Spine (72285) | $3,081.92 | $5,136.53 | 1.7× |
| Diskography lumbar (72295) | $3,081.92 | $5,136.53 | 1.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $225 | $375 | 2.4× |
| Doppler Fetal Mid Cerebral Artery (76821) | $219.03 | $365.05 | 2.3× |
| Dxa Bone Density Axial (77080) | $309 | $515 | 3.3× |
| Dxa bone density study (77085) | $219.03 | $365.05 | 2.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $153 | $255 | 1.9× |
| Echo Guide For Artery Repair (76936) | $476.18 | $793.63 | 2.4× |
| Esophagram (74220) | $483.65 | $806.09 | 3.0× |
| Fetal Biophys Profile W/Nst (76818) | $255 | $425 | 2.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $255 | $425 | 2.7× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $451.20 | $752 | 2.1× |
| Fluoroscopy up to 1 hr (76000) | $444.55 | $740.92 | 2.1× |
| Follow-Up Angiography (75898) | $1,881.05 | $3,135.09 | 0.7× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$165–$237.60 | $275–$396 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$165–$330 | $275–$550 | varies |
| Gastric emptying imaging study (78264) | $1,206.60 | $2,011 | 3.3× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $668.71 | $1,114.51 | 1.8× |
| Gated Heart Planar Single (78472) | $1,134.60 | $1,891 | 3.1× |
| Gated Heart, Multiple (78473) | $672 | $1,120 | 1.9× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $867.03 | $1,445.05 | 1.8× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$219–$438 | $365–$730 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $1,366.55 | $2,277.59 | 2.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $1,366.55 | $2,277.59 | 2.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $1,366.55 | $2,277.59 | 2.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $4,770.22 | $7,950.36 | 1.7× |
| Hepatobil Syst Image W/Drug (78227) | $867.03 | $1,445.05 | 1.8× |
| Hepatobiliary System Imaging (78226) | $668.71 | $1,114.51 | 1.8× |
| Ht Musc Image Planar Mult (78454) | $2,301.50 | $3,835.83 | 2.0× |
| Ht Muscle Image Spect Sing (78451) | $2,301.50 | $3,835.83 | 2.0× |
| Hysterosalpingogram (74740) | $444.55 | $740.92 | 2.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $148.80 | $248 | 1.9× |
| Infant hip ultrasound, limited static exam (76886) | $118.88 | $198.14 | 1.5× |
| Infusion Ivp (74410) | $483.65 | $806.09 | 3.0× |
| Interstitial radiation source applic complex (77778) | $2,418.60 | $4,031 | 3.8× |
| Intracavitary Radiation Source Applic Complex (77763) | $1,914 | $3,190 | 3.0× |
| Intracavitary Radiation Source Applic Intermed (77762) | $1,333.20 | $2,222 | 2.7× |
| Intracavitary radiation source applic simple (77761) | $1,222.80 | $2,038 | 2.4× |
| Joint Survey Single View (77077) | $228.60 | $381 | 2.4× |
| K Flow/Funct Image Multiple (78709) | $867.03 | $1,445.05 | 1.8× |
| K Flow/Funct Image W/Drug (78708) | $1,721.40 | $2,869 | 3.5× |
| K Flow/Funct Image W/O Drug (78707) | $1,257 | $2,095 | 2.5× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$195–$294 | $325–$490 | varies |
| Leveen/Shunt Patency Exam (78291) | $676.20 | $1,127 | 1.9× |
| Liver & Spleen Imaging Static Only (78215) | $668.71 | $1,114.51 | 1.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $668.71 | $1,114.51 | 1.8× |
| Liver imaging static only (78201) | $2,301.50 | $3,835.83 | 4.7× |
| Lung perfusion differential (78597) | $668.71 | $1,114.51 | 1.8× |
| Lung Ventilat&Perfus Imaging (78582) | $1,137.60 | $1,896 | 2.3× |
| Lung Ventilation Imaging (78579) | $668.71 | $1,114.51 | 1.8× |
| Lymph System Imaging (78195) | $945 | $1,575 | 1.9× |
| Lymphangiography extremity only unilateral rs&i (75801) | $1,172.24 | $1,953.74 | 2.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $5,310 | $8,850 | 1.9× |
| Magnetic Image Jaw Joint (70336) | $969 | $1,615 | 4.5× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) | $930 | $1,550 | 1.9× |
| Mammary ductogram or galactogram multiple (77054) | $444.60 | $741 | 2.1× |
| Meckels Divert Exam (78290) | $668.71 | $1,114.51 | 1.8× |
| Mlc imrt design & construction per imrt plan (77338) | $774 | $1,290 | 2.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $51 | $85 | 1.9× |
| Mra Head W/O & W/Contrast Material (70546) | $2,667 | $4,445 | 8.4× |
| MRA head w/o contrast (70544) | $1,675.80 | $2,793 | 7.7× |
| MRA head with contrast (70545) | $1,768.20 | $2,947 | 5.6× |
| MRA neck w contrast (70548) | $1,779 | $2,965 | 5.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $2,824.20 | $4,707 | 8.9× |
| MRA neck w/o contrast (70547) | $1,496.40 | $2,494 | 6.9× |
| MRI abdomen w contrast (74182) | $1,275 | $2,125 | 4.0× |
| MRI abdomen w/o contrast (74181) | $1,116 | $1,860 | 5.2× |
| MRI any jt lower extrem w/contrast material (73722) | $1,759.20 | $2,932 | 2.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $2,006.40 | $3,344 | 6.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,759.20 | $2,932 | 2.5× |
| MRI Breast W/O Contrast Bilateral (77047) | $498 | $830 | 2.3× |
| MRI Breast Without Contrast Material Unilateral (77046) | $498 | $830 | 2.3× |
| MRI cardiac w/o contrast (75557) | $465 | $775 | 2.1× |
| MRI cervical spine w contrast (72142) | $2,079 | $3,465 | 6.6× |
| MRI cervical spine w/o cont (72141) | $1,823.40 | $3,039 | 8.4× |
| MRI chest w/o contrast (71550) | $1,398 | $2,330 | 6.5× |
| MRI chest wo w contrast (71552) | $2,402.40 | $4,004 | 7.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,660.20 | $2,767 | 5.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,893.60 | $3,156 | 6.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,456.20 | $2,427 | 6.7× |
| MRI lumbar spine w contrast (72149) | $1,961.40 | $3,269 | 6.2× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,370.60 | $3,951 | 7.5× |
| MRI orbit face &/neck w/o contrast (70540) | $2,137.20 | $3,562 | 9.9× |
| MRI orbit face neck w contrast (70542) | $2,443.20 | $4,072 | 7.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,776.20 | $4,627 | 8.8× |
| MRI pelvis w contrast (72196) | $1,398 | $2,330 | 4.4× |
| MRI pelvis w/o & w contrast (72197) | $1,896 | $3,160 | 6.0× |
| MRI pelvis w/o contrast (72195) | $1,457.40 | $2,429 | 6.7× |
| MRI spectroscopy (76390) | $939 | $1,565 | 11.9× |
| MRI thoracic spine w/o contrast (72146) | $1,562.40 | $2,604 | 7.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,811.40 | $3,019 | 5.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,456.20 | $2,427 | 6.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,893.60 | $3,156 | 6.0× |
| MRI, abdomen, combo (74183) | $1,449 | $2,415 | 4.6× |
| MRI, dorsal spine combo (72157) | $2,266.20 | $3,777 | 7.2× |
| MRI, dorsal spine contrast (72147) | $1,782 | $2,970 | 5.6× |
| MRI, joint upper extrem (73221) | $1,543.20 | $2,572 | 7.1× |
| MRI, joint upper extrem combo (73223) | $2,006.40 | $3,344 | 6.3× |
| MRI, lumbar spine combo (72158) | $2,274.60 | $3,791 | 7.2× |
| Myelogram Lumbar (72265) | $1,304.88 | $2,174.80 | 1.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,301.50 | $3,835.83 | 2.0× |
| Myocardial Spect Multiple Studies (78452) | $2,759.40 | $4,599 | 2.3× |
| Neck soft tissue (70360) | $155.40 | $259 | 2.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $705 | $1,175 | 1.9× |
| Nonvascular Shunt X-Ray (75809) | $219.03 | $365.05 | 2.3× |
| Ntsty modul radthx pln dose-vol histos (77301) | $4,393.80 | $7,323 | 3.5× |
| Nuclear Rx Intra-Arterial (79445) | $456.37 | $760.62 | 2.2× |
| Nuclear Rx Oral Admin (79005) | $456.37 | $760.62 | 2.2× |
| Ob us nuchal meas 1 gest (76813) | $219.03 | $365.05 | 2.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,230 | $2,050 | 2.5× |
| Parathyroid Planar Imaging (78070) | $832.80 | $1,388 | 2.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,242 | $2,070 | 3.4× |
| Pelvis 1 or 2 views (72170) | $219.03 | $365.05 | 2.3× |
| Perineogram (74775) | $316.80 | $528 | 1.5× |
| Peritoneogram Rs&I (74190) | $931.35 | $1,552.25 | 1.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $710.40 | $1,184 | 2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $232.20 | $387 | 2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $444.55 | $740.92 | 0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$177–$354 | $295–$590 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$177–$354 | $295–$590 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$175.80–$351.60 | $293–$586 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $253.20 | $422 | 2.7× |
| Radex fingr minimum 2 views (73140) | $177 | $295 | 2.2× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$177–$354 | $295–$590 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$177–$354 | $295–$590 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $118.88 | $198.14 | 1.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $227.40 | $379 | 2.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $164.40 | $274 | 2.1× |
| Radex Ribs Unilateral 2 Views (71100) | $217.80 | $363 | 2.8× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$188.40–$376.80 | $314–$628 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $138.60 | $231 | 1.8× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $315 | $525 | 2.0× |
| Radex Spine 1 View Specify Level (72020) | $121.80 | $203 | 1.5× |
| Radex Sternum Minimum 2 Views (71120) | $231.60 | $386 | 2.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $256.80 | $428 | 3.2× |
| Radex Toe Minimum 2 Views (73660) | $165 | $275 | 2.1× |
| Radex upper extremity infant minimum 2 views (73092) | $219.03 | $365.05 | 2.3× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$177–$354 | $295–$590 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $316.80 | $528 | 3.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $14,520 | $24,200 | 2.2× |
| Radiation treatment delivery level 1 (77402) | $238.69 | $397.81 | 2.6× |
| Radiation treatment delivery level 2 (77407) | $555.60 | $926 | 1.6× |
| Radiation treatment delivery level 3 (77412) | $555.60 | $926 | 1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $256.20 | $427 | 2.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $225 | $375 | 2.4× |
| Radiologic exam colon double contrast study (74280) | $529.80 | $883 | 3.3× |
| Radiologic exam colon single contrast study (74270) | $483.65 | $806.09 | 3.0× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$219–$438 | $365–$730 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $229.80 | $383 | 2.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $474.60 | $791 | 3.0× |
| Radiologic exam swallow function contrast study (74230) | $247.20 | $412 | 1.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $315 | $525 | 2.0× |
| Radiologic examination femur 1 view (73551) | $118.88 | $198.14 | 1.5× |
| Radiologic examination femur minimum 2 views (73552) | $118.88 | $198.14 | 1.5× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$147–$294 | $245–$490 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $464.40 | $774 | 4.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$177–$354 | $295–$590 | varies |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $420.67 | $701.12 | 1.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $555.60 | $926 | 1.6× |
| Ribs bilateral 3 views (71110) | $219.03 | $365.05 | 2.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $735 | $1,225 | 2.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,301.50 | $3,835.83 | 4.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,301.50 | $3,835.83 | 4.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $2,400 | $4,000 | 4.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,400 | $4,000 | 2.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,730 | $4,550 | 2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,400 | $4,000 | 2.0× |
| Scapula (73010) | $249.60 | $416 | 2.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $42 | $70 | 1.8× |
| Sella turcica (70240) | $118.88 | $198.14 | 1.5× |
| Shoulder 1 view (73020) | $118.88 | $198.14 | 1.5× |
| Shoulder Arthrography (73040) | $873.33 | $1,455.55 | 2.8× |
| Sialogram (70390) | $444.55 | $740.92 | 2.1× |
| Skull less than 4 views (70250) | $219.03 | $365.05 | 2.3× |
| Special dosimetry (77331) | $280.80 | $468 | 2.3× |
| Special Physics Consult (77370) | $380.40 | $634 | 3.1× |
| Special teletherapy port plan (77321) | $774 | $1,290 | 2.3× |
| Special treatment procedure (77470) | $1,252.20 | $2,087 | 2.5× |
| Stereotactic Body Radiation Delivery (77373) | $3,711.60 | $6,186 | 2.3× |
| Sternoclavicular joints (71130) | $177.60 | $296 | 2.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $238.69 | $397.81 | 2.6× |
| Tbs technical calculation only (77091) | $180 | $300 | 2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $774 | $1,290 | 2.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $774 | $1,290 | 2.3× |
| Testicular Imaging W/Flow (78761) | $668.71 | $1,114.51 | 1.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $775.80 | $1,293 | 2.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $783.60 | $1,306 | 2.3× |
| Ther rad simulaj-aided field setting simple (77280) | $396 | $660 | 3.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $789 | $1,315 | 5.0× |
| Thoracic spine 2 views (72070) | $229.20 | $382 | 2.4× |
| Thoracic spine 3 views (72072) | $208.80 | $348 | 2.2× |
| Thoracolumbar 2 views (72080) | $297.60 | $496 | 3.8× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $668.71 | $1,114.51 | 1.8× |
| Thyroid Imaging With Vascular Flow (78013) | $687 | $1,145 | 1.9× |
| Thyroid Met Imaging Body (78018) | $995.40 | $1,659 | 2.0× |
| Thyroid Uptake Measurement (78012) | $668.71 | $1,114.51 | 1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $892.80 | $1,488 | 2.5× |
| Tx Devices Design & Construction Complex (77334) | $680.40 | $1,134 | 2.0× |
| Tx devices design & construction intermediate (77333) | $347.40 | $579 | 2.8× |
| Tx devices design & construction simple (77332) | $280.80 | $468 | 2.3× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$255–$510 | $425–$850 | varies |
| Ultrasound Elastography Parenchyma (76981) | $216 | $360 | 2.3× |
| Ultrasound Exam Aaa Screen (76706) | $219.03 | $365.05 | 2.3× |
| Ultrasound, abdomen limited (76705) | $502.20 | $837 | 5.3× |
| Umbilical-artery Doppler (OB) (76820) | $219.03 | $365.05 | 2.3× |
| Unlisted Dx Radiographic Procedure (76499) | $118.88 | $198.14 | 1.5× |
| Unlisted fluoroscopic procedure (76496) | $135 | $225 | 1.7× |
| Unlisted us procedure (76999) | $165 | $275 | 2.1× |
| Upper gi w/o kub (74240) | $465 | $775 | 2.9× |
| Urethrocystogram voiding (74455) | $444.55 | $740.92 | 2.1× |
| Urethrocystography retrograde (74450) | $444.55 | $740.92 | 2.1× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$255–$510 | $425–$850 | varies |
| Us chest (76604) | $219.03 | $365.05 | 2.3× |
| Us complete joint (76881) | $502.20 | $837 | 5.3× |
| Us exam, pelvic, limited (76857) | $271.20 | $452 | 2.9× |
| Us head (76506) | $219.03 | $365.05 | 2.3× |
| Us kidney transplant (76776) | $358.20 | $597 | 3.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$502.20–$1,004.40 | $837–$1,674 | varies |
| Us ob detailed single fetus (76811) | $450 | $750 | 2.1× |
| Us ob limited 1 or more fetuses (76815) | $310.80 | $518 | 3.3× |
| Us ob transvaginal (76817) | $277.20 | $462 | 2.9× |
| Us pelvic non ob complete (76856) | $479.40 | $799 | 5.0× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $285 | $475 | 3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $294 | $490 | 3.1× |
| Us retroperitoneal complete (76770) | $358.20 | $597 | 3.8× |
| Us retroperitoneal limited (76775) | $276 | $460 | 2.9× |
| Us scrotum and contents (76870) | $466.20 | $777 | 4.9× |
| Us spinal canal and contents (76800) | $466.20 | $777 | 4.9× |
| Us thyroid (76536) | $466.20 | $777 | 4.9× |
| Us transrectal (76872) | $237 | $395 | 2.5× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$1,005–$1,589.49 | $1,675–$2,649.15 | varies |
| Vein X-Ray Liver W/O Hemodyn (75887) | $6,652.80 | $11,088 | 2.3× |
| Venogram Sinus/Jugular (75860) | $4,770.22 | $7,950.36 | 1.7× |
| Venography caval inferior serialography rs&i (75825) | $4,770.22 | $7,950.36 | 1.7× |
| Venography extremity bilateral rs&i (75822) | $1,881.05 | $3,135.09 | 1.3× |
| Venography extremity unilateral rs&i (75820) | $1,172.24 | $1,953.74 | 0.8× |
| Venography Renal Bilateral (75833) | $4,770.22 | $7,950.36 | 1.7× |
| Venography Renal Unilateral (75831) | $4,770.22 | $7,950.36 | 1.7× |
| Venous sampling by catheter (75893) | $8,161.63 | $13,602.72 | 1.6× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $735 | $1,225 | 2.0× |
| Vertebral fracture assessment via dxa (77086) | $118.88 | $198.14 | 1.5× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$180–$210 | $300–$350 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $151.20 | $252 | 1.9× |
| X-ray antegrade pyelogram tube (74425) | $580.20 | $967 | 1.8× |
| X-Ray Aorta Leg Arteries (75630) | $4,770.22 | $7,950.36 | 1.7× |
| X-Ray Bend Only L-S Spine (72120) | $219.03 | $365.05 | 2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$118.80–$226.80 | $198–$378 | varies |
| X-Ray Exam Breast Specimen (76098) | $931.35 | $1,552.25 | 1.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $118.88 | $198.14 | 1.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $219.03 | $365.05 | 2.3× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $316.80 | $528 | 3.3× |
| X-Ray Exam Hip Uni 1 View (73501) | $118.88 | $198.14 | 1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $180 | $300 | 2.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $219.03 | $365.05 | 2.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $219.03 | $365.05 | 2.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $219.03 | $365.05 | 2.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $316.80 | $528 | 3.3× |
| X-Ray Exam L-S Spine Bending (72114) | $237.60 | $396 | 2.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $297.60 | $496 | 3.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $297.60 | $496 | 3.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $219.03 | $365.05 | 2.3× |
| X-ray eye for foreign body (70030) | $118.88 | $198.14 | 1.5× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$174.60–$349.20 | $291–$582 | varies |
| X-ray IV pyelogram (ivp) (74400) | $483.65 | $806.09 | 3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $248.40 | $414 | 3.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $147 | $245 | 1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $219.03 | $365.05 | 2.3× |
| X-ray nose-rectum child f.b. (76010) | $129.60 | $216 | 1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $219.03 | $365.05 | 2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $249.60 | $416 | 2.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $219.03 | $365.05 | 2.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $231.60 | $386 | 2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $256.20 | $427 | 3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $295.20 | $492 | 3.1× |
| X-Ray Stress View (77071) | $168.60 | $281 | 2.1× |
| X-ray thoracic spine 4 vw (72074) | $297.60 | $496 | 3.1× |
| X-Ray Tmj Unilat (70328) | $118.88 | $198.14 | 1.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $873.33 | $1,455.55 | 2.8× |
| X-Rays Bone Length Studies (77073) | $219.03 | $365.05 | 2.3× |
| X-Rays Bone Survey Complete (77075) | $492 | $820 | 5.2× |
| Xr c-spine 4 or 5 views (72050) | $219.03 | $365.05 | 2.3× |
| Xr facial bones less than 3 views (70140) | $214.80 | $358 | 2.7× |
| XR Mastoids < 3 Views Bilateral (70120) | $237 | $395 | 2.5× |
| Xr orbits complete 4 views (70200) | $256.20 | $427 | 2.7× |
| Xr Tomogram Single Plane (76100) | $347.40 | $579 | 3.7× |
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.