Imaging prices at Stephens Memorial Hospital
Breckenridge, TX · every code in this section with a posted price and a Medicare benchmark.
244 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$62.52–$113.20 | $89.31–$161.72 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$76.57–$113.20 | $109.38–$161.72 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$733.82–$770.52 | $1,048.32–$1,100.74 | varies |
| Ankle 2 views (73600) range across 12 matching MRF lines |
$100.25–$207.27 | $143.22–$296.10 | varies |
| Bone Imaging 3 Phase (78315) | $759.75 | $1,085.36 | 1.9× |
| Bone Imaging Limited Area (78300) | $506.44 | $723.49 | 1.3× |
| Bone Imaging Multiple Areas (78305) | $618.79 | $883.98 | 1.5× |
| Bone Imaging Whole Body (78306) | $666 | $951.43 | 1.7× |
| Bone marrow imaging limited area (78102) range across 2 matching MRF lines |
$733.82–$770.52 | $1,048.32–$1,100.74 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$166.35–$171.34 | $237.64–$244.77 | varies |
| Chest 1 view (71045) range across 4 matching MRF lines |
$118.56–$238.14 | $169.37–$340.20 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$130.03–$136.54 | $185.76–$195.05 | varies |
| Chest 3 views (71047) | $143.04 | $204.34 | 1.6× |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$224.70–$235.94 | $321–$337.05 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$195.72–$201.59 | $279.60–$287.99 | varies |
| Clavicle complete (73000) range across 12 matching MRF lines |
$100.25–$207.27 | $143.22–$296.10 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,534.68 | $2,192.40 | 14.6× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$565.60–$593.88 | $808–$848.40 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 6 matching MRF lines |
$2,005.10–$3,534.62 | $2,864.43–$5,049.45 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$1,856.58–$2,940 | $2,652.25–$4,200 | varies |
| CT abdomen w contrast (74160) range across 4 matching MRF lines |
$928.29–$1,958.78 | $1,326.13–$2,798.25 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,485.26–$2,490.92 | $2,121.80–$3,558.45 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$928.29–$1,655.96 | $1,326.13–$2,365.65 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 4 matching MRF lines |
$2,100–$3,193.58 | $3,000–$4,562.25 | varies |
| CT Angio Chest (71275) range across 5 matching MRF lines |
$1,206.77–$2,199.86 | $1,723.96–$3,142.65 | varies |
| CT Angio Head (70496) range across 6 matching MRF lines |
$1,206.77–$2,181.48 | $1,723.96–$3,116.40 | varies |
| CT angio hrt w/3d image (75574) range across 4 matching MRF lines |
$2,100–$2,497.60 | $3,000–$3,568 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$1,741.60–$1,946.70 | $2,488–$2,781 | varies |
| CT Angio Neck (70498) range across 6 matching MRF lines |
$1,206.77–$2,230.73 | $1,723.96–$3,186.75 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,946.70–$2,005.10 | $2,781–$2,864.43 | varies |
| CT cervical spine w/ contrast (72126) | $1,120 | $1,600 | 3.2× |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$928.29–$1,560.30 | $1,326.13–$2,229 | varies |
| CT cervical spine w/wo cont (72127) | $1,680 | $2,400 | 9.5× |
| CT chest w contrast (71260) range across 4 matching MRF lines |
$1,206.77–$1,806.70 | $1,723.96–$2,581 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$1,299.61–$2,485.04 | $1,856.58–$3,550.05 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,206.77–$2,130.10 | $1,723.96–$3,043 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,485.26–$2,423.40 | $2,121.80–$3,462 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,002.55–$1,785 | $1,432.22–$2,550 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$1,299.61–$3,283.70 | $1,856.58–$4,691 | varies |
| CT lower ext w/o (73700) range across 8 matching MRF lines |
$928.29–$1,559.67 | $1,326.13–$2,228.10 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$1,642.20–$1,724.31 | $2,346–$2,463.30 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,206.77–$2,712.89 | $1,723.96–$3,875.55 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,076.82–$1,613.33 | $1,538.31–$2,304.75 | varies |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$1,002.55–$2,535.75 | $1,432.22–$3,622.50 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$928.29–$1,489.85 | $1,326.13–$2,128.35 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,299.61–$2,122.40 | $1,856.58–$3,032 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,299.61–$2,170 | $1,856.58–$3,100 | varies |
| CT orbits w/o contrast (70480) range across 4 matching MRF lines |
$928.29–$1,816.92 | $1,326.13–$2,595.60 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,299.61–$2,940 | $1,856.58–$4,200 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$928.29–$1,680.21 | $1,326.13–$2,400.30 | varies |
| CT scan of leg combo (73702) range across 4 matching MRF lines |
$1,782.20–$1,871.31 | $2,546–$2,673.30 | varies |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$1,299.61–$3,115 | $1,856.58–$4,450 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,206.77–$2,073.40 | $1,723.96–$2,962 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$928.29–$1,812.51 | $1,326.13–$2,589.30 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,206.77–$3,575.78 | $1,723.96–$5,108.25 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,076.82–$1,880.13 | $1,538.31–$2,685.90 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$1,299.61–$3,640 | $1,856.58–$5,200 | varies |
| CT thorax w/o contrast (71250) range across 7 matching MRF lines |
$928.29–$1,534.68 | $1,326.13–$2,192.40 | varies |
| CT upper ext wo (73200) range across 10 matching MRF lines |
$928.29–$1,871.31 | $1,326.13–$2,673.30 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 6 matching MRF lines |
$1,206.77–$1,782.20 | $1,723.96–$2,546 | varies |
| CT upper extremity with contrast (73201) range across 6 matching MRF lines |
$1,072.13–$1,642.20 | $1,531.61–$2,346 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$1,946.70–$2,479.16 | $2,781–$3,541.65 | varies |
| Cta Abdomen (74175) range across 5 matching MRF lines |
$1,946.70–$2,299.82 | $2,781–$3,285.45 | varies |
| Dxa Bone Density Axial (77080) range across 4 matching MRF lines |
$324.10–$340.31 | $463–$486.15 | varies |
| Esophagram (74220) range across 3 matching MRF lines |
$196.06–$398.37 | $280.08–$569.10 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$218.33–$224.88 | $311.90–$321.26 | varies |
| Fluoroscopy up to 1 hr (76000) range across 5 matching MRF lines |
$185.66–$584.33 | $265.23–$834.75 | varies |
| Foot 2 views (73620) range across 12 matching MRF lines |
$100.25–$233.73 | $143.22–$333.90 | varies |
| Forearm 2 views (73090) range across 24 matching MRF lines |
$96.68–$378.53 | $138.12–$540.75 | varies |
| Gastric emptying imaging study (78264) | $736.41 | $1,052.01 | 1.8× |
| Gated Heart Planar Single (78472) | $503.53 | $719.33 | 1.3× |
| Hand 2 views (73120) range across 14 matching MRF lines |
$100.25–$279.30 | $143.22–$399 | varies |
| Heart first pass single,planar (78481) range across 2 matching MRF lines |
$951.47–$999.04 | $1,359.24–$1,427.20 | varies |
| Hepatobil Syst Image W/Drug (78227) | $983.16 | $1,404.52 | 1.8× |
| Hepatobiliary System Imaging (78226) | $725.73 | $1,036.76 | 1.8× |
| Ht Musc Image Planar Mult (78454) | $959.04 | $1,370.06 | 0.7× |
| Ht Muscle Image Spect Sing (78451) | $748.76 | $1,069.65 | 0.6× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$444.49–$466.71 | $634.98–$666.73 | varies |
| Infusion Ivp (74410) range across 2 matching MRF lines |
$387.65–$399.28 | $553.79–$570.40 | varies |
| K Flow/Funct Image Multiple (78709) | $805.38 | $1,150.54 | 1.5× |
| K Flow/Funct Image W/Drug (78708) | $386.80 | $552.57 | 0.7× |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$486.55–$510.87 | $695.07–$729.82 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 2 matching MRF lines |
$447.80–$470.20 | $639.72–$671.71 | varies |
| Knee 3 Views (73562) range across 8 matching MRF lines |
$132.19–$283.50 | $188.84–$405 | varies |
| Leveen/Shunt Patency Exam (78291) range across 2 matching MRF lines |
$525.87–$541.65 | $751.24–$773.78 | varies |
| Liver & Spleen Imaging Static Only (78215) | $426.14 | $608.77 | 1.1× |
| Lung Perf&Ventilat Diferentl (78598) | $668.93 | $955.62 | 1.2× |
| Lung Ventilat&Perfus Imaging (78582) | $733.38 | $1,047.69 | 1.3× |
| Lung Ventilation Imaging (78579) | $409.86 | $585.52 | 1.0× |
| Lymph System Imaging (78195) | $782.01 | $1,117.15 | 1.4× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,113.95–$2,114.60 | $1,591.35–$3,020.85 | varies |
| Meckels Divert Exam (78290) range across 3 matching MRF lines |
$525.87–$725.42 | $751.24–$1,036.32 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$1,856.58–$4,348.26 | $2,652.25–$6,211.80 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,113.95–$2,067.56 | $1,591.35–$2,953.65 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$1,299.61–$2,025.10 | $1,856.58–$2,893 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$1,299.61–$2,025.10 | $1,856.58–$2,893 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$1,856.58–$3,777.90 | $2,652.25–$5,397 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,113.95–$2,754.78 | $1,591.35–$3,935.40 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$1,299.61–$2,030 | $1,856.58–$2,900 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$1,856.58–$2,167.90 | $2,652.25–$3,097 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$1,299.61–$2,415 | $1,856.58–$3,450 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,113.95–$2,127.09 | $1,591.35–$3,038.70 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$1,113.95–$1,321.60 | $1,591.35–$1,888 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$1,856.58–$2,936.50 | $2,652.25–$4,195 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 4 matching MRF lines |
$1,856.58–$2,276.30 | $2,652.25–$3,251.85 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$1,113.95–$1,934.80 | $1,591.35–$2,764 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$1,299.61–$2,535.75 | $1,856.58–$3,622.50 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$1,856.58–$3,534.30 | $2,652.25–$5,049 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 3 matching MRF lines |
$1,113.95–$2,030 | $1,591.35–$2,900 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$1,856.58–$4,248.30 | $2,652.25–$6,069 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$1,299.61–$3,307.50 | $1,856.58–$4,725 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,856.58–$3,670.10 | $2,652.25–$5,243 | varies |
| MRI pelvis w/o contrast (72195) range across 4 matching MRF lines |
$1,113.95–$2,711.80 | $1,591.35–$3,874 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,113.95–$2,013.90 | $1,591.35–$2,877 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 5 matching MRF lines |
$1,113.95–$2,031.54 | $1,591.35–$2,902.20 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$1,856.58–$2,276.30 | $2,652.25–$3,251.85 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,856.58–$3,536.09 | $2,652.25–$5,051.55 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,856.58–$3,490.20 | $2,652.25–$4,986 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$1,299.61–$2,829.75 | $1,856.58–$4,042.50 | varies |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$1,113.95–$2,077.60 | $1,591.35–$2,968 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$1,856.58–$2,725.10 | $2,652.25–$3,893 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,856.58–$2,877.70 | $2,652.25–$4,111 | varies |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) range across 2 matching MRF lines |
$675.72–$696 | $965.32–$994.28 | varies |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) range across 2 matching MRF lines |
$675.72–$696 | $965.32–$994.28 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) range across 2 matching MRF lines |
$913.37–$959.04 | $1,304.82–$1,370.06 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$991.87–$2,603.75 | $1,416.96–$3,719.64 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$100.25–$400.58 | $143.22–$572.25 | varies |
| Nm myocard infarct spect (78469) range across 2 matching MRF lines |
$675.72–$696 | $965.32–$994.28 | varies |
| Ob us nuchal meas 1 gest (76813) | $236.27 | $337.53 | 2.2× |
| Optic foramina (70190) range across 2 matching MRF lines |
$99.58–$104.56 | $142.26–$149.37 | varies |
| Parathyroid Planar Imaging (78070) range across 3 matching MRF lines |
$479.99–$1,295 | $685.70–$1,850 | varies |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$100.25–$310.91 | $143.22–$444.15 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $524.06 | $748.66 | 1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$385.70–$404.99 | $551–$578.55 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$444.49–$466.71 | $634.98–$666.73 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 6 matching MRF lines |
$132.19–$292.53 | $188.84–$417.90 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 6 matching MRF lines |
$107.68–$127.89 | $153.83–$182.70 | varies |
| Radex elbow complete minimum 3 views (73080) range across 6 matching MRF lines |
$132.19–$351.33 | $188.84–$501.90 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 5 matching MRF lines |
$100.25–$134.93 | $143.22–$192.76 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$107.68–$252.84 | $153.83–$361.20 | varies |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$132.19–$276.36 | $188.84–$394.80 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$132.19–$287.39 | $188.84–$410.55 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $192.38 | $274.83 | 2.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 9 matching MRF lines |
$100.25–$179.91 | $143.22–$257.01 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$100.25–$108.43 | $143.22–$154.90 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 6 matching MRF lines |
$112.14–$283.71 | $160.20–$405.30 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 15 matching MRF lines |
$107.68–$331.49 | $153.83–$473.55 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 6 matching MRF lines |
$69.09–$110.25 | $98.70–$157.50 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$100.25–$108.78 | $143.22–$155.40 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$609.64–$640.12 | $870.91–$914.46 | varies |
| Radex Toe Minimum 2 Views (73660) range across 6 matching MRF lines |
$112.14–$222.71 | $160.20–$318.15 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $233.47 | $333.53 | 2.2× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$132.19–$271.95 | $188.84–$388.50 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$305.90–$321.20 | $437–$458.85 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$112.14–$121.28 | $160.20–$173.26 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $240.10 | $343 | 2.3× |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$347.20–$364.56 | $496–$520.80 | varies |
| Radiologic exam colon single contrast study (74270) range across 4 matching MRF lines |
$612.50–$643.13 | $875–$918.75 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 7 matching MRF lines |
$102.58–$399.11 | $146.54–$570.15 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$99.58–$404.25 | $142.26–$577.50 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$200.51–$518.18 | $286.44–$740.25 | varies |
| Radiologic examination femur 1 view (73551) range across 8 matching MRF lines |
$100.25–$137.45 | $143.22–$196.35 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 10 matching MRF lines |
$107.68–$273.70 | $153.83–$391 | varies |
| Radiologic examination knee 1/2 views (73560) range across 13 matching MRF lines |
$100.25–$253.58 | $143.22–$362.25 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 12 matching MRF lines |
$100.25–$297.68 | $143.22–$425.25 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) range across 2 matching MRF lines |
$165.84–$174.14 | $236.92–$248.77 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$1,219.95–$1,256.55 | $1,742.79–$1,795.07 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$2,171.33–$2,236.47 | $3,101.90–$3,194.96 | varies |
| Salivary Gland Imaging (78230) range across 2 matching MRF lines |
$525.87–$541.65 | $751.24–$773.78 | varies |
| Salivary Gland Imaging Serial Images (78231) range across 2 matching MRF lines |
$525.87–$541.65 | $751.24–$773.78 | varies |
| Scapula (73010) range across 12 matching MRF lines |
$100.25–$207.27 | $143.22–$296.10 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $113.10 | $161.57 | 4.8× |
| Sella turcica (70240) range across 4 matching MRF lines |
$99.58–$104.56 | $142.26–$149.37 | varies |
| Shoulder 1 view (73020) range across 6 matching MRF lines |
$100.25–$246.23 | $143.22–$351.75 | varies |
| Skull less than 4 views (70250) range across 6 matching MRF lines |
$69.09–$242.55 | $98.70–$346.50 | varies |
| Spleen Imaging (78185) range across 2 matching MRF lines |
$175.20–$180.46 | $250.29–$257.80 | varies |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$99.58–$173.48 | $142.26–$247.83 | varies |
| Temporomandble Jt Arthrography Rs&I (70332) | $591.88 | $845.54 | 2.5× |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$711.61–$732.96 | $1,016.58–$1,047.08 | varies |
| Thoracic spine 2 views (72070) range across 6 matching MRF lines |
$100.25–$330.75 | $143.22–$472.50 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$166.35–$354.27 | $237.64–$506.10 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $420.45 | $600.64 | 1.0× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$647.11–$666.52 | $924.44–$952.17 | varies |
| Thyroid Uptake Measurement (78012) | $177.07 | $252.95 | 0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $528.93 | $755.62 | 1.3× |
| Ultrasound Breast Limited (76642) range across 5 matching MRF lines |
$139.62–$363.09 | $199.45–$518.70 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$344.58–$809.24 | $492.26–$1,156.05 | varies |
| Ultrasound, abdomen limited (76705) range across 5 matching MRF lines |
$218.33–$645.33 | $311.90–$921.90 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $182.45 | $260.64 | 2.1× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$196.06–$620.34 | $280.08–$886.20 | varies |
| Ureteral Reflux Study (78740) range across 2 matching MRF lines |
$711.61–$732.96 | $1,016.58–$1,047.08 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$540.40–$567.42 | $772–$810.60 | varies |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$139.62–$438.06 | $199.45–$625.80 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$139.62–$143.80 | $199.45–$205.43 | varies |
| Us complete joint (76881) range across 6 matching MRF lines |
$218.33–$424.10 | $311.90–$605.85 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$139.62–$327.08 | $199.45–$467.25 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$342.90–$370.85 | $489.85–$529.78 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 3 matching MRF lines |
$233.93–$423.36 | $334.18–$604.80 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$224.88–$236.12 | $321.26–$337.32 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$300.02–$641.66 | $428.60–$916.65 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$139.62–$150.99 | $199.45–$215.70 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$218.33–$639.45 | $311.90–$913.50 | varies |
| Us retroperitoneal limited (76775) | $224.45 | $320.64 | 2.1× |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$218.33–$809.24 | $311.90–$1,156.05 | varies |
| Us spinal canal and contents (76800) range across 3 matching MRF lines |
$222.79–$240.95 | $318.27–$344.21 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$218.33–$551.25 | $311.90–$787.50 | varies |
| Vascular Flow Imaging (78445) range across 2 matching MRF lines |
$404.33–$416.46 | $577.61–$594.94 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$1,302–$1,367.10 | $1,860–$1,953 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$1,476.75–$1,859.55 | $2,109.64–$2,656.50 | varies |
| Venous thrombosis imaging (78457) range across 2 matching MRF lines |
$404.33–$416.46 | $577.61–$594.94 | varies |
| Venous Thrombosis Imaging Venogram Bilateral (78458) range across 2 matching MRF lines |
$404.33–$416.46 | $577.61–$594.94 | varies |
| Wrist 2 views (73100) range across 12 matching MRF lines |
$100.25–$227.85 | $143.22–$325.50 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$103.60–$108.78 | $148–$155.40 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 12 matching MRF lines |
$100.25–$219.03 | $143.22–$312.90 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$555.80–$583.59 | $794–$833.70 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 4 matching MRF lines |
$103.60–$280.77 | $148–$401.10 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$151.90–$171.50 | $217–$245 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$296.10–$310.91 | $423–$444.15 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 6 matching MRF lines |
$100.25–$224.91 | $143.22–$321.30 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 6 matching MRF lines |
$107.68–$236.67 | $153.83–$338.10 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$166.35–$490.98 | $237.64–$701.40 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$297.05–$908.46 | $424.36–$1,297.80 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 4 matching MRF lines |
$151.90–$180.08 | $217–$257.25 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 8 matching MRF lines |
$100.25–$370.44 | $143.22–$529.20 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$99.58–$104.56 | $142.26–$149.37 | varies |
| X-ray humerus (73060) range across 8 matching MRF lines |
$123.90–$378.53 | $177–$540.75 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 4 matching MRF lines |
$387.65–$1,059.87 | $553.79–$1,514.10 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 5 matching MRF lines |
$99.58–$116.45 | $142.26–$166.36 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$185.66–$297.68 | $265.23–$425.25 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 10 matching MRF lines |
$96.68–$460.85 | $138.12–$658.35 | varies |
| X-ray nose-rectum child f.b. (76010) | $173.48 | $247.83 | 2.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$166.35–$796.74 | $237.64–$1,138.20 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$81.90–$233.50 | $117–$333.57 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 4 matching MRF lines |
$194.60–$204.33 | $278–$291.90 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 7 matching MRF lines |
$100.25–$299.88 | $143.22–$428.40 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 4 matching MRF lines |
$100.25–$404.25 | $143.22–$577.50 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 4 matching MRF lines |
$166.35–$404.25 | $237.64–$577.50 | varies |
| X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines |
$287.36–$370.44 | $410.51–$529.20 | varies |
| X-Ray Tmj Unilat (70328) range across 6 matching MRF lines |
$96.68–$104.37 | $138.12–$149.10 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$40.53–$1,051.79 | $57.90–$1,502.55 | varies |
| X-Rays Bone Survey Complete (77075) range across 4 matching MRF lines |
$340.90–$891.16 | $487–$1,273.08 | varies |
| Xr c-spine 4 or 5 views (72050) | $261.86 | $374.08 | 2.5× |
| Xr facial bones less than 3 views (70140) range across 6 matching MRF lines |
$100.25–$108.43 | $143.22–$154.90 | varies |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$100.25–$108.43 | $143.22–$154.90 | varies |
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.