Imaging prices at St. Thomas More Hospital
Canon City, CO · every code in this section with a posted price and a Medicare benchmark.
283 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) | $239.14 | $597.83 | 2.6× |
| Abdomen 2 views (74019) | $486.19 | $1,215.47 | 4.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,041.73 | $2,604.31 | 2.5× |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$230.22–$299.30 | $575.55–$748.25 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$521.54–$678 | $1,303.84–$1,694.99 | varies |
| Bone age studies (77072) | $291.08 | $727.69 | 2.6× |
| Bone Imaging 3 Phase (78315) | $1,789.35 | $4,473.37 | 4.2× |
| Bone Imaging Limited Area (78300) | $854.35 | $2,135.86 | 2.0× |
| Bone Imaging Multiple Areas (78305) | $1,231.34 | $3,078.34 | 2.9× |
| Bone Imaging Whole Body (78306) | $1,466.72 | $3,666.80 | 3.5× |
| Bone survey infant (77076) | $498.51 | $1,246.26 | 4.5× |
| Brain Image W/Flow < 4 Views (78601) | $534.53 | $1,336.31 | 1.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $838.82 | $2,097.04 | 1.5× |
| Cat Scan Follow-Up Study (76380) | $672.26 | $1,680.65 | 7.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $1,148.85 | $2,872.12 | 2.0× |
| Cerebrospinal Fluid Scan (78630) | $1,455.87 | $3,639.66 | 2.5× |
| Chest 1 view (71045) | $172.70 | $431.74 | 1.9× |
| Chest 2 views (71046) | $184.23 | $460.56 | 2.0× |
| Chest 3 views (71047) | $373.91 | $934.77 | 4.1× |
| Chest 4 or more views (71048) | $373.91 | $934.77 | 3.4× |
| Cholecystography Oral Contrast (74290) | $194.77 | $486.92 | 1.1× |
| Clavicle complete (73000) range across 2 matching MRF lines |
$249.27–$324.04 | $623.16–$810.08 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $214.50 | $536.25 | 1.9× |
| Contrast X-Ray Bladder (74430) | $501.41 | $1,253.52 | 1.4× |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$383.68–$498.78 | $959.19–$1,246.95 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $3,992.05 | $9,980.12 | 10.8× |
| CT abdomen and pelvis without contrast (74176) | $1,570.64 | $3,926.58 | 6.2× |
| CT abdomen w contrast (74160) | $1,214.53 | $3,036.32 | 6.6× |
| CT abdomen w wo contrast (74170) | $1,682.32 | $4,205.78 | 9.1× |
| CT abdomen w/o contrast (74150) | $1,104.12 | $2,760.30 | 10.0× |
| CT Angio Abdomen and Pelvis (74174) | $3,419.01 | $8,547.52 | 9.3× |
| CT Angio Chest (71275) | $2,167.22 | $5,418.05 | 11.7× |
| CT Angio Head (70496) | $1,886.43 | $4,716.06 | 10.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$735.80–$1,103.69 | $1,839.50–$2,759.22 | varies |
| CT Angio Neck (70498) | $2,331.05 | $5,827.61 | 12.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,880.45 | $4,701.12 | 10.2× |
| CT cervical spine w/ contrast (72126) | $1,504.70 | $3,761.73 | 4.1× |
| CT cervical spine w/o contrast (72125) | $1,423.87 | $3,559.66 | 12.9× |
| CT cervical spine w/wo cont (72127) | $1,601.60 | $4,003.99 | 8.7× |
| CT chest w contrast (71260) | $1,529.95 | $3,824.86 | 8.3× |
| CT chest w/wo contrast (71270) | $2,285.67 | $5,714.17 | 12.4× |
| CT head/brain with contrast (70460) | $1,458.54 | $3,646.33 | 7.9× |
| CT head/brain without and with contrast (70470) | $2,002.35 | $5,005.87 | 10.8× |
| CT heart no contrast quant eval coronry calcium (75571) | $915.92 | $2,289.79 | 10.0× |
| CT iac w contrast (70481) | $1,534.80 | $3,837 | 8.3× |
| CT l-spine w&w/o contrast (72133) | $1,770.20 | $4,425.50 | 9.6× |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,043.16–$1,356.10 | $2,607.89–$3,390.25 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,338.72–$1,740.34 | $3,346.79–$4,350.85 | varies |
| CT lumbar spine w contrast (72132) | $1,608.03 | $4,020.06 | 4.4× |
| CT lumbar spine w/o contrast (72131) | $1,473.16 | $3,682.90 | 13.4× |
| CT maxillofacial w contrast (70487) | $1,186 | $2,964.98 | 6.4× |
| CT maxillofacial wo contrast (70486) | $936.28 | $2,340.70 | 8.5× |
| CT neck tissue combo (70492) | $2,232.45 | $5,581.12 | 12.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,849.22 | $4,623.04 | 10.0× |
| CT orbits w/o contrast (70480) | $1,232.50 | $3,081.25 | 11.2× |
| CT pelvis w&w/o contrast (72194) | $1,320.77 | $3,301.91 | 7.1× |
| CT pelvis w/o contrast (72192) | $1,119.84 | $2,799.58 | 10.2× |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,782.17–$2,316.82 | $4,455.42–$5,792.05 | varies |
| CT scans face/jaw combo (70488) | $1,901.30 | $4,753.24 | 10.3× |
| CT soft tissue neck w contrast (70491) | $1,277.67 | $3,194.16 | 6.9× |
| CT soft tissue neck w/o contrast (70490) | $951.93 | $2,379.82 | 8.6× |
| CT thoracic spine w contrast (72129) | $1,576.31 | $3,940.77 | 8.5× |
| CT thoracic spine w/o contrast (72128) | $1,431.47 | $3,578.66 | 13.0× |
| CT thoracic spine w/wo cont (72130) | $1,685.90 | $4,214.74 | 9.1× |
| CT thorax w/o contrast (71250) | $1,159.05 | $2,897.61 | 10.5× |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,081.68–$1,406.18 | $2,704.19–$3,515.44 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,782.17–$2,316.82 | $4,455.42–$5,792.05 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,452.52–$1,888.29 | $3,631.30–$4,720.71 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,383.94 | $5,959.83 | 12.9× |
| Cta Abdomen (74175) | $1,880.45 | $4,701.12 | 10.2× |
| CTA pelvis (72191) | $1,880.45 | $4,701.12 | 10.2× |
| Dxa Bone Density Axial (77080) | $333.79 | $834.47 | 3.0× |
| Dxa bone density study (77085) | $533.57 | $1,333.91 | 4.8× |
| Echo exam uterus (76831) | $386.19 | $965.47 | 1.5× |
| Esophagram (74220) | $433.13 | $1,082.81 | 2.3× |
| Fetal Biophys Profile W/Nst (76818) | $203.64 | $509.10 | 1.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $325.53 | $813.82 | 3.0× |
| Fluoroscopy up to 1 hr (76000) | $239.81 | $599.51 | 1.0× |
| Foot 2 views (73620) range across 2 matching MRF lines |
$102.39–$133.11 | $255.97–$332.76 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$265.86–$345.64 | $664.65–$864.09 | varies |
| Gastric emptying imaging study (78264) | $944.16 | $2,360.40 | 2.2× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $1,084.92 | $2,712.28 | 2.6× |
| Gated Heart Planar Single (78472) | $1,846.08 | $4,615.18 | 4.4× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,356.14 | $3,390.35 | 2.4× |
| Hand 2 views (73120) range across 2 matching MRF lines |
$312.86–$406.72 | $782.14–$1,016.78 | varies |
| Hepatobil Syst Image W/Drug (78227) | $1,234.68 | $3,086.68 | 2.2× |
| Hepatobiliary System Imaging (78226) | $1,122.44 | $2,806.09 | 2.7× |
| Ht Muscle Image Spect Sing (78451) | $1,010.36 | $2,525.89 | 0.7× |
| Hysterosalpingogram (74740) | $498.27 | $1,245.67 | 2.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $498.51 | $1,246.26 | 5.4× |
| K Flow/Funct Image Multiple (78709) | $1,071.29 | $2,678.21 | 1.9× |
| K Flow/Funct Image W/Drug (78708) | $1,014.47 | $2,536.17 | 1.8× |
| K Flow/Funct Image W/O Drug (78707) | $852.10 | $2,130.25 | 1.5× |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$228.06–$296.47 | $570.14–$741.16 | varies |
| Leveen/Shunt Patency Exam (78291) | $876.70 | $2,191.73 | 2.1× |
| Liver & Spleen Imaging Static Only (78215) | $1,011.90 | $2,529.74 | 2.4× |
| Liver imaging static only (78201) | $758.45 | $1,896.11 | 1.3× |
| Lung Perf&Ventilat Diferentl (78598) | $1,804.86 | $4,512.13 | 3.2× |
| Lung perfusion differential (78597) | $1,254.43 | $3,136.07 | 3.0× |
| Lung Ventilat&Perfus Imaging (78582) | $2,043.83 | $5,109.57 | 3.6× |
| Lung Ventilation Imaging (78579) | $1,254.43 | $3,136.07 | 3.0× |
| Lymph System Imaging (78195) | $961.28 | $2,403.20 | 1.7× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,819.81–$3,639.61 | $4,549.52–$9,099.02 | varies |
| Meckels Divert Exam (78290) | $995.13 | $2,487.82 | 2.4× |
| Mr safety determination physician/other qhp (76016) | $551.20 | $1,378 | 6.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $551.20 | $1,378 | 18.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $551.20 | $1,378 | 5.5× |
| Mr safety implt pos&/immoblj (76019) | $551.20 | $1,378 | 8.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $551.20 | $1,378 | 2.2× |
| Mra Head W/O & W/Contrast Material (70546) | $3,222.24 | $8,055.60 | 8.8× |
| MRA head w/o contrast (70544) | $1,210.07 | $3,025.16 | 4.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,039.56 | $7,598.90 | 8.3× |
| MRA neck w/o contrast (70547) | $1,210.07 | $3,025.16 | 4.8× |
| MRI abdomen w contrast (74182) | $1,697.99 | $4,244.97 | 4.6× |
| MRI abdomen w/o contrast (74181) | $1,442.40 | $3,605.99 | 5.7× |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,451.58–$2,903.17 | $3,628.94–$7,257.91 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,598.60–$3,197.20 | $3,996.49–$7,992.99 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,529.50–$3,059 | $3,823.73–$7,647.49 | varies |
| MRI cervical spine w contrast (72142) | $1,700.35 | $4,250.87 | 4.6× |
| MRI cervical spine w/o cont (72141) | $1,280.41 | $3,201.02 | 5.1× |
| MRI chest w/o contrast (71550) | $1,613.28 | $4,033.20 | 6.4× |
| MRI chest wo w contrast (71552) | $2,092.38 | $5,230.95 | 5.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$1,381.40–$2,762.79 | $3,453.49–$6,906.97 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,685–$3,369.99 | $4,212.48–$8,424.96 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$1,279.93–$2,559.85 | $3,199.81–$6,399.62 | varies |
| MRI lumbar spine w contrast (72149) | $1,775.74 | $4,439.35 | 4.8× |
| Mri Neck Spine W/O & W/Dye (72156) | $2,173.77 | $5,434.41 | 5.9× |
| MRI orbit face &/neck w/o contrast (70540) | $1,439.80 | $3,599.48 | 5.7× |
| MRI orbit face neck w contrast (70542) | $2,130.26 | $5,325.64 | 5.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $2,820.72 | $7,051.78 | 7.7× |
| MRI pelvis w contrast (72196) | $1,538.11 | $3,845.27 | 4.2× |
| MRI pelvis w/o & w contrast (72197) | $1,854.94 | $4,637.33 | 5.0× |
| MRI pelvis w/o contrast (72195) | $1,356.72 | $3,391.80 | 5.4× |
| MRI thoracic spine w/o contrast (72146) | $1,415.66 | $3,539.14 | 5.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$1,543.98–$3,087.94 | $3,859.93–$7,719.84 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,382.58–$2,765.17 | $3,456.45–$6,912.91 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,720.50–$3,441 | $4,301.24–$8,602.49 | varies |
| MRI, abdomen, combo (74183) | $2,222.58 | $5,556.43 | 6.0× |
| MRI, dorsal spine combo (72157) | $2,173.77 | $5,434.41 | 5.9× |
| MRI, dorsal spine contrast (72147) | $1,775.74 | $4,439.35 | 4.8× |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,465.23–$2,930.46 | $3,663.07–$7,326.15 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,803.06–$3,606.09 | $4,507.63–$9,015.22 | varies |
| MRI, lumbar spine combo (72158) | $2,173.77 | $5,434.41 | 5.9× |
| Myelogram cervical (72240) | $1,019.31 | $2,548.27 | 1.2× |
| Myelogram Lumbar (72265) | $1,019.31 | $2,548.27 | 1.2× |
| Myelography thoracic (72255) | $1,019.31 | $2,548.27 | 1.2× |
| Myelograpy 2/more regions rs&i (72270) | $1,151.03 | $2,877.56 | 1.4× |
| Myocardial Spect Multiple Studies (78452) | $1,434.77 | $3,586.92 | 1.1× |
| N-invas est c ffr sw aly CTA (75580) | $6,748.04 | $16,870.10 | 7.4× |
| Neck soft tissue (70360) | $284 | $709.99 | 3.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $649.36 | $1,623.38 | 5.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $2,229.99 | $5,574.96 | 3.9× |
| Parathyroid Planar Imaging (78070) | $994.49 | $2,486.22 | 2.4× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,833.30 | $4,583.25 | 4.3× |
| Pelvis 1 or 2 views (72170) | $239.46 | $598.63 | 2.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,254.43 | $3,136.07 | 3.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $508.11 | $1,270.27 | 4.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $335.75 | $839.37 | 0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$241.53–$313.99 | $603.82–$784.96 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$228.06–$296.48 | $570.14–$741.18 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$279.16–$362.92 | $697.90–$907.29 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $456.97 | $1,142.42 | 4.1× |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$208.56–$271.15 | $521.40–$677.87 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$260.14–$338.19 | $650.35–$845.46 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$208.56–$271.16 | $521.40–$677.88 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$249.27–$324.04 | $623.16–$810.08 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$447.39–$581.59 | $1,118.46–$1,453.96 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $332.34 | $830.85 | 3.6× |
| Radex Ribs Unilateral 2 Views (71100) | $239.46 | $598.63 | 2.6× |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$250.86–$326.11 | $627.13–$815.26 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $166.18 | $415.43 | 1.8× |
| Radex Spine 1 View Specify Level (72020) | $249.27 | $623.16 | 2.7× |
| Radex Sternum Minimum 2 Views (71120) | $309.42 | $773.53 | 3.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $343.80 | $859.49 | 3.7× |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$208.56–$271.15 | $521.40–$677.87 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$286.66–$372.64 | $716.65–$931.60 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$230.22–$299.30 | $575.55–$748.25 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $425.88 | $1,064.68 | 3.9× |
| Radiolog exam mandible compl minimum 4 views (70110) | $412.56 | $1,031.38 | 3.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $382.31 | $955.76 | 3.5× |
| Radiologic exam colon double contrast study (74280) | $811.42 | $2,028.54 | 4.4× |
| Radiologic exam colon single contrast study (74270) | $811.42 | $2,028.54 | 4.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $414.20 | $1,035.50 | 2.2× |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$253.68–$329.80 | $634.20–$824.48 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $342.65 | $856.62 | 3.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $486.85 | $1,217.12 | 2.6× |
| Radiologic exam swallow function contrast study (74230) | $413.26 | $1,033.15 | 2.2× |
| Radiologic exam upr gi trc double contrast study (74246) | $597.66 | $1,494.14 | 3.2× |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$190.72–$247.94 | $476.79–$619.84 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$289.71–$376.62 | $724.27–$941.53 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$216.81–$281.84 | $542.02–$704.60 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $575.86 | $1,439.63 | 5.2× |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$250.97–$326.26 | $627.42–$815.63 | varies |
| Ribs bilateral 3 views (71110) | $726.76 | $1,816.90 | 6.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,280.34 | $3,200.85 | 3.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $1,687.78 | $4,219.44 | 4.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,272.23 | $8,180.56 | 5.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,055.87 | $5,139.66 | 3.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,728.46 | $4,321.14 | 3.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $2,311.09 | $5,777.72 | 1.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,542.20 | $6,355.49 | 1.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,901.31 | $4,753.26 | 1.4× |
| Scapula (73010) range across 2 matching MRF lines |
$290.80–$378.05 | $726.99–$945.12 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $16 | $40 | 0.7× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$199.18–$258.92 | $497.93–$647.30 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$521.54–$678 | $1,303.84–$1,694.99 | varies |
| Skull less than 4 views (70250) | $332.34 | $830.85 | 3.0× |
| Sternoclavicular joints (71130) | $332.34 | $830.85 | 3.6× |
| Testicular Imaging W/Flow (78761) | $651.67 | $1,629.16 | 1.5× |
| Thoracic spine 2 views (72070) | $503.51 | $1,258.77 | 4.6× |
| Thoracic spine 3 views (72072) | $342.65 | $856.62 | 3.1× |
| Thoracolumbar 2 views (72080) | $114.04 | $285.09 | 1.2× |
| Thyroid Imaging With Vascular Flow (78013) | $889.28 | $2,223.18 | 2.1× |
| Thyroid Met Imaging Body (78018) | $2,749.50 | $6,873.74 | 4.8× |
| Thyroid Uptake Measurement (78012) | $634.84 | $1,587.10 | 1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,199.94 | $2,999.83 | 2.8× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$271.96–$543.92 | $679.89–$1,359.80 | varies |
| Ultrasound Exam Aaa Screen (76706) | $239.29 | $598.22 | 2.2× |
| Ultrasound, abdomen limited (76705) | $439.98 | $1,099.95 | 4.0× |
| Umbilical-artery Doppler (OB) (76820) | $176.46 | $441.14 | 1.6× |
| Unlisted Dx Radiographic Procedure (76499) | $4,385.03 | $10,962.57 | 47.8× |
| Upper gi w/o kub (74240) | $203.33 | $508.32 | 1.1× |
| Urethrocystogram voiding (74455) | $399.71 | $999.27 | 1.6× |
| Urethrocystography retrograde (74450) | $1,353.63 | $3,384.06 | 5.4× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$299.17–$598.32 | $747.91–$1,495.78 | varies |
| Us chest (76604) | $370.92 | $927.29 | 3.4× |
| Us complete joint (76881) range across 2 matching MRF lines |
$347.24–$694.46 | $868.10–$1,736.13 | varies |
| Us exam, pelvic, limited (76857) | $255.80 | $639.49 | 2.3× |
| Us head (76506) | $415.42 | $1,038.53 | 3.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $347.24 | $868.10 | 3.1× |
| Us ob detailed single fetus (76811) | $695.53 | $1,738.81 | 2.8× |
| Us ob limited 1 or more fetuses (76815) | $278.20 | $695.48 | 2.5× |
| Us ob transvaginal (76817) | $352.39 | $880.96 | 3.2× |
| Us pelvic non ob complete (76856) | $543.32 | $1,358.30 | 4.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $455.82 | $1,139.54 | 4.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $407.71 | $1,019.27 | 3.7× |
| Us retroperitoneal complete (76770) | $658.45 | $1,646.11 | 6.0× |
| Us retroperitoneal limited (76775) | $506.48 | $1,266.19 | 4.6× |
| Us scrotum and contents (76870) | $408.25 | $1,020.62 | 3.7× |
| Us spinal canal and contents (76800) | $445.10 | $1,112.74 | 4.0× |
| Us thyroid (76536) | $395.62 | $989.03 | 3.6× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$200.30–$260.38 | $500.74–$650.95 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $309.42 | $773.53 | 3.4× |
| X-ray antegrade pyelogram tube (74425) | $579.59 | $1,448.97 | 1.6× |
| X-Ray Bend Only L-S Spine (72120) | $401.34 | $1,003.33 | 3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$257.85–$335.21 | $644.62–$838.02 | varies |
| X-Ray Exam Breast Specimen (76098) | $363.83 | $909.56 | 0.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $274.18 | $685.44 | 3.0× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $328.12 | $820.30 | 3.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $384.08 | $960.18 | 3.5× |
| X-Ray Exam Hip Uni 1 View (73501) | $159.12 | $397.80 | 1.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $301.13 | $752.81 | 3.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $384.08 | $960.18 | 3.5× |
| X-Ray Exam Hips Bi 2 Views (73521) | $377.34 | $943.33 | 3.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $441.70 | $1,104.24 | 4.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $485.87 | $1,214.66 | 4.4× |
| X-Ray Exam L-S Spine Bending (72114) | $444.75 | $1,111.86 | 4.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $342.65 | $856.62 | 3.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $465.27 | $1,163.16 | 4.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $457.27 | $1,143.16 | 4.1× |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$146.40–$190.32 | $365.99–$475.80 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$257.85–$335.21 | $644.62–$838.02 | varies |
| X-ray IV pyelogram (ivp) (74400) | $537.23 | $1,343.06 | 2.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $108.14 | $270.33 | 1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $108.08 | $270.19 | 1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $312.79 | $781.96 | 2.8× |
| X-ray nose-rectum child f.b. (76010) | $324.57 | $811.41 | 3.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $519.28 | $1,298.19 | 4.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $343.80 | $859.49 | 3.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $203.64 | $509.10 | 1.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $286.51 | $716.26 | 3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $415.42 | $1,038.53 | 4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $498.51 | $1,246.26 | 4.5× |
| X-Ray Stress View (77071) | $166.18 | $415.43 | 1.8× |
| X-ray thoracic spine 4 vw (72074) | $797.53 | $1,993.82 | 7.2× |
| X-Ray Tmj Unilat (70328) | $108.14 | $270.33 | 1.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $294.80 | $736.99 | 0.8× |
| X-Rays Bone Length Studies (77073) | $358.13 | $895.32 | 3.2× |
| X-Rays Bone Survey Complete (77075) | $700.45 | $1,751.12 | 6.4× |
| Xr c-spine 4 or 5 views (72050) | $426.32 | $1,065.78 | 3.9× |
| Xr facial bones less than 3 views (70140) | $249.27 | $623.16 | 2.7× |
| Xr orbits complete 4 views (70200) | $408 | $1,020 | 3.7× |
| Xr Tomogram Single Plane (76100) | $486.85 | $1,217.12 | 4.4× |
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.