Imaging prices at Stillwater Medical - Perry
Perry, OK · every code in this section with a posted price and a Medicare benchmark.
315 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) | $3,436.80 | $4,296 | 2.6× |
| Abdomen 1 View (74018) | $498.40 | $623 | 6.0× |
| Abdomen 2 views (74019) | $540 | $675 | 5.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,468.80 | $1,836 | 3.8× |
| Angio pulmonary bilat (75743) | $6,888 | $8,610 | 2.3× |
| Angiography extremity bilateral rs&i (75716) | $6,888 | $8,610 | 2.3× |
| Angiography extremity unilateral rs&i (75710) | $6,888 | $8,610 | 2.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $6,888 | $8,610 | 2.3× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$447.20–$888.80 | $559–$1,111 | varies |
| Aortography thoracic serialography rs&i (75605) | $10,367.20 | $12,959 | 1.9× |
| Artery X-Rays Pelvis (75736) | $10,367.20 | $12,959 | 1.9× |
| Arthrogram hip (73525) | $951.20 | $1,189 | 2.8× |
| Arthrogram Wrist (73115) | $704.80 | $881 | 2.1× |
| Basic radiation dosimetry calculation (77300) | $447.20 | $559 | 3.5× |
| Bone age studies (77072) | $273.60 | $342 | 2.7× |
| Bone Imaging 3 Phase (78315) | $2,545.60 | $3,182 | 6.6× |
| Bone Imaging Limited Area (78300) | $1,099.20 | $1,374 | 2.9× |
| Bone Imaging Multiple Areas (78305) | $1,260 | $1,575 | 3.3× |
| Bone Imaging Whole Body (78306) | $2,665.60 | $3,332 | 6.9× |
| Bone marrow imaging limited area (78102) | $1,031.20 | $1,289 | 2.7× |
| Bone marrow imaging; multiple areas (78103) | $904 | $1,130 | 2.4× |
| Bone marrow imaging; whole body (78104) | $1,222.40 | $1,528 | 3.2× |
| Bone survey infant (77076) | $323.20 | $404 | 3.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,007.20 | $1,259 | 1.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,318.40 | $1,648 | 3.9× |
| Cat Scan Follow-Up Study (76380) | $940.80 | $1,176 | 11.2× |
| Cerebrospinal Fluid Scan (78630) | $2,171.20 | $2,714 | 4.2× |
| Chest 1 view (71045) | $486.40 | $608 | 5.8× |
| Chest 2 views (71046) range across 2 matching MRF lines |
$72–$621.60 | $90–$777 | varies |
| Chest 3 views (71047) | $467.20 | $584 | 5.6× |
| Chest 4 or more views (71048) | $516 | $645 | 5.1× |
| Cholecystography Oral Contrast (74290) | $459.20 | $574 | 2.7× |
| Clavicle complete (73000) range across 4 matching MRF lines |
$524–$971.20 | $655–$1,214 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $1,336 | $1,670 | 13.3× |
| Continuing medical physics consltj pr wk (77336) | $534.40 | $668 | 4.1× |
| Contrast Exam Abdominl Aorta (75625) | $6,888 | $8,610 | 2.3× |
| Contrast X-Ray Bladder (74430) | $912 | $1,140 | 2.7× |
| Contrast X-Ray Of Elbow (73085) | $725.60 | $907 | 2.2× |
| Contrast X-Ray Of Knee Joint (73580) | $828.80 | $1,036 | 2.5× |
| CT abdomen and pelvis without and with contrast (74178) | $7,183.20 | $8,979 | 21.4× |
| CT abdomen and pelvis without contrast (74176) | $4,910.40 | $6,138 | 21.4× |
| CT abdomen w contrast (74160) | $3,392.80 | $4,241 | 20.1× |
| CT abdomen w wo contrast (74170) | $4,542.40 | $5,678 | 26.9× |
| CT abdomen w/o contrast (74150) | $3,371.20 | $4,214 | 33.5× |
| CT Angio Abdomen and Pelvis (74174) | $4,057.60 | $5,072 | 12.1× |
| CT Angio Chest (71275) | $3,772 | $4,715 | 22.4× |
| CT Angio Head (70496) | $2,840.80 | $3,551 | 16.8× |
| CT angio hrt w/3d image (75574) | $3,584 | $4,480 | 10.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,085.60 | $1,357 | 6.4× |
| CT Angio Neck (70498) | $2,764 | $3,455 | 16.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,548.80 | $3,186 | 15.1× |
| CT cervical spine w/ contrast (72126) | $3,530.40 | $4,413 | 10.5× |
| CT cervical spine w/o contrast (72125) | $3,291.20 | $4,114 | 32.7× |
| CT cervical spine w/wo cont (72127) | $4,135.20 | $5,169 | 24.5× |
| CT chest w contrast (71260) | $3,214.40 | $4,018 | 19.1× |
| CT chest w/wo contrast (71270) | $4,356.80 | $5,446 | 25.8× |
| CT head/brain with contrast (70460) | $2,647.20 | $3,309 | 15.7× |
| CT head/brain without and with contrast (70470) | $4,084 | $5,105 | 24.2× |
| CT heart contrast eval cardiac structure&morph (75572) | $998.40 | $1,248 | 3.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $1,092 | $1,365 | 13.0× |
| CT iac w contrast (70481) | $2,653.60 | $3,317 | 15.7× |
| CT l-spine w&w/o contrast (72133) | $3,966.40 | $4,958 | 23.5× |
| CT lower ext w/o (73700) | $2,836.80 | $3,546 | 28.2× |
| CT lower extremity w/contrast material (73701) | $3,144.80 | $3,931 | 18.6× |
| CT lumbar spine w contrast (72132) | $3,825.60 | $4,782 | 11.4× |
| CT lumbar spine w/o contrast (72131) | $3,282.40 | $4,103 | 32.6× |
| CT maxillofacial w contrast (70487) | $3,583.20 | $4,479 | 21.2× |
| CT maxillofacial wo contrast (70486) | $2,776 | $3,470 | 27.6× |
| CT neck tissue combo (70492) | $3,828 | $4,785 | 22.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $3,207.20 | $4,009 | 19.0× |
| CT orbits w/o contrast (70480) | $2,387.20 | $2,984 | 23.7× |
| CT pelvis w&w/o contrast (72194) | $3,607.20 | $4,509 | 21.4× |
| CT pelvis w/o contrast (72192) | $2,495.20 | $3,119 | 24.8× |
| CT scan of leg combo (73702) | $3,396 | $4,245 | 20.1× |
| CT scans face/jaw combo (70488) | $4,084.80 | $5,106 | 24.2× |
| CT soft tissue neck w contrast (70491) | $3,179.20 | $3,974 | 18.8× |
| CT soft tissue neck w/o contrast (70490) | $2,032.80 | $2,541 | 20.2× |
| CT thoracic spine w contrast (72129) | $3,460 | $4,325 | 20.5× |
| CT thoracic spine w/o contrast (72128) | $2,914.40 | $3,643 | 29.0× |
| CT thoracic spine w/wo cont (72130) | $3,336 | $4,170 | 19.8× |
| CT thorax w/o contrast (71250) | $2,889.60 | $3,612 | 28.7× |
| CT upper ext wo (73200) | $2,583.20 | $3,229 | 25.7× |
| CT upper extremity w/o & w/contrast material (73202) | $2,942.40 | $3,678 | 17.4× |
| CT upper extremity with contrast (73201) | $2,759.20 | $3,449 | 8.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $4,062.40 | $5,078 | 24.1× |
| Cta Abdomen (74175) | $3,514.40 | $4,393 | 20.8× |
| CTA pelvis (72191) | $2,531.20 | $3,164 | 15.0× |
| Diskography lumbar (72295) | $3,643.20 | $4,554 | 1.9× |
| Dxa Bone Density Axial (77080) | $698.40 | $873 | 6.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $223.20 | $279 | 2.7× |
| Echo Guide For Artery Repair (76936) | $964 | $1,205 | 4.6× |
| Esophagram (74220) | $917.60 | $1,147 | 5.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $633.60 | $792 | 6.3× |
| Fluoroscopy up to 1 hr (76000) | $985.60 | $1,232 | 4.3× |
| Follow-Up Angiography (75898) | $5,345.60 | $6,682 | 1.8× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$440–$920 | $550–$1,150 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$524–$905.60 | $655–$1,132 | varies |
| Gastric emptying imaging study (78264) | $2,548 | $3,185 | 6.6× |
| Gated Heart Planar Single (78472) | $2,423.20 | $3,029 | 6.3× |
| Hand 2 views (73120) range across 4 matching MRF lines |
$441.60–$711.20 | $552–$889 | varies |
| Hepatobil Syst Image W/Drug (78227) | $3,002.40 | $3,753 | 5.7× |
| Hepatobiliary System Imaging (78226) | $2,292.80 | $2,866 | 6.0× |
| Ht Muscle Image Spect Sing (78451) | $2,827.20 | $3,534 | 2.3× |
| Hysterosalpingogram (74740) | $772.80 | $966 | 3.4× |
| Image fusion (77399) | $294.40 | $368 | 2.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $449.60 | $562 | 5.4× |
| Infusion Ivp (74410) | $1,136 | $1,420 | 6.7× |
| Joint Survey Single View (77077) | $247.20 | $309 | 2.5× |
| K Flow/Funct Image W/Drug (78708) | $2,197.60 | $2,747 | 4.2× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$668–$1,132.80 | $835–$1,416 | varies |
| Lung Perf&Ventilat Diferentl (78598) | $1,556.80 | $1,946 | 3.0× |
| Lung perfusion differential (78597) | $2,108 | $2,635 | 5.5× |
| Lung Ventilat&Perfus Imaging (78582) | $1,924 | $2,405 | 3.7× |
| Lymph System Imaging (78195) | $2,120.80 | $2,651 | 4.1× |
| Magnetic Image Jaw Joint (70336) | $2,125.60 | $2,657 | 9.3× |
| Meckels Divert Exam (78290) | $1,100.80 | $1,376 | 2.9× |
| Mlc imrt design & construction per imrt plan (77338) | $1,136 | $1,420 | 3.2× |
| Mra Head W/O & W/Contrast Material (70546) | $3,789.60 | $4,737 | 11.3× |
| MRA head w/o contrast (70544) | $2,968.80 | $3,711 | 12.9× |
| MRA neck w contrast (70548) | $3,232 | $4,040 | 9.6× |
| Mra Neck W/O &W/Contrast Material (70549) | $3,152.80 | $3,941 | 9.4× |
| MRA neck w/o contrast (70547) | $2,741.60 | $3,427 | 11.9× |
| MRI abdomen w contrast (74182) | $3,835.20 | $4,794 | 11.4× |
| MRI abdomen w/o contrast (74181) | $3,328.80 | $4,161 | 14.5× |
| MRI any jt lower extrem w/contrast material (73722) | $3,902.40 | $4,878 | 5.2× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $4,761.60 | $5,952 | 14.2× |
| MRI any jt upper extremity w/contrast matrl (73222) | $3,656 | $4,570 | 4.8× |
| MRI cardiac w/o contrast (75557) | $1,318.40 | $1,648 | 5.7× |
| MRI cervical spine w/o cont (72141) | $3,950.40 | $4,938 | 17.2× |
| MRI chest w/o contrast (71550) | $2,908.80 | $3,636 | 12.7× |
| MRI chest with contrast (71551) | $3,136 | $3,920 | 4.2× |
| MRI chest wo w contrast (71552) | $3,533.60 | $4,417 | 10.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $3,236.80 | $4,046 | 9.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,871.20 | $4,839 | 11.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,296.80 | $4,121 | 14.4× |
| MRI lumbar spine w contrast (72149) | $4,404 | $5,505 | 13.1× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,170.40 | $6,463 | 15.4× |
| MRI orbit face &/neck w/o contrast (70540) | $3,078.40 | $3,848 | 13.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $4,764 | $5,955 | 14.2× |
| MRI pelvis w contrast (72196) | $3,336.80 | $4,171 | 9.9× |
| MRI pelvis w/o & w contrast (72197) | $4,971.20 | $6,214 | 14.8× |
| MRI pelvis w/o contrast (72195) | $2,932 | $3,665 | 12.8× |
| MRI thoracic spine w/o contrast (72146) | $3,904 | $4,880 | 17.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $3,013.60 | $3,767 | 9.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $3,244.80 | $4,056 | 14.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,947.20 | $4,934 | 11.8× |
| MRI, abdomen, combo (74183) | $5,296.80 | $6,621 | 15.8× |
| MRI, dorsal spine combo (72157) | $5,584.80 | $6,981 | 16.6× |
| MRI, joint upper extrem (73221) | $3,773.60 | $4,717 | 16.4× |
| MRI, joint upper extrem combo (73223) | $4,131.20 | $5,164 | 12.3× |
| MRI, lumbar spine combo (72158) | $5,604 | $7,005 | 16.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $856.80 | $1,071 | 2.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $4,325.60 | $5,407 | 3.5× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $1,020 | $1,275 | 2.0× |
| Myocardial Spect Multiple Studies (78452) | $4,931.20 | $6,164 | 4.0× |
| N-invas est c ffr sw aly CTA (75580) | $2,940 | $3,675 | 3.6× |
| Neck soft tissue (70360) | $450.40 | $563 | 5.4× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) | $1,260 | $1,575 | 3.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $3,488 | $4,360 | 2.6× |
| Nuclear Rx Oral Admin (79005) | $1,568 | $1,960 | 7.0× |
| Ob us nuchal meas 1 gest (76813) | $396.80 | $496 | 3.9× |
| Optic foramina (70190) | $183.20 | $229 | 2.2× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,523.20 | $1,904 | 4.0× |
| Pelvis 1 or 2 views (72170) | $544.80 | $681 | 5.4× |
| Perineogram (74775) | $664 | $830 | 2.9× |
| PET image w/CT, full body (78816) | $7,224 | $9,030 | 5.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $6,814.40 | $8,518 | 5.0× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,686.40 | $2,108 | 4.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $775.20 | $969 | 7.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,040.80 | $1,301 | 2.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$610.40–$1,055.20 | $763–$1,319 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$499.20–$924 | $624–$1,155 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$546.40–$1,062.40 | $683–$1,328 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $728 | $910 | 7.2× |
| Radex fingr minimum 2 views (73140) range across 5 matching MRF lines |
$464.80–$726.40 | $581–$908 | varies |
| Radex foot complete minimum 3 views (73630) range across 5 matching MRF lines |
$648.80–$1,094.40 | $811–$1,368 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$575.20–$964.80 | $719–$1,206 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $216.80 | $271 | 2.6× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $312 | $390 | 3.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $445.60 | $557 | 5.3× |
| Radex Ribs Unilateral 2 Views (71100) | $549.60 | $687 | 6.6× |
| Radex shoulder complete minimum 2 views (73030) | $659.20 | $824 | 7.9× |
| Radex Sinuses Paransl < 3 Views (70210) | $312 | $390 | 3.7× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $1,247.20 | $1,559 | 7.4× |
| Radex Spine 1 View Specify Level (72020) | $388.80 | $486 | 4.6× |
| Radex Sternum Minimum 2 Views (71120) | $405.60 | $507 | 4.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $359.20 | $449 | 4.3× |
| Radex Toe Minimum 2 Views (73660) | $450.40 | $563 | 5.4× |
| Radex upper extremity infant minimum 2 views (73092) | $247.20 | $309 | 2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) | $574.40 | $718 | 6.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $20,264.80 | $25,331 | 2.9× |
| Radiation treatment delivery level 1 (77402) | $940 | $1,175 | 9.6× |
| Radiation treatment delivery level 2 (77407) | $804 | $1,005 | 2.2× |
| Radiation treatment delivery level 3 (77412) | $1,136 | $1,420 | 2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) | $644.80 | $806 | 6.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $599.20 | $749 | 6.0× |
| Radiologic exam colon double contrast study (74280) | $1,517.60 | $1,897 | 9.0× |
| Radiologic exam colon single contrast study (74270) | $1,116 | $1,395 | 6.6× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$816.80–$1,224.80 | $1,021–$1,531 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $238.40 | $298 | 2.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,079.20 | $1,349 | 6.4× |
| Radiologic exam swallow function contrast study (74230) | $1,114.40 | $1,393 | 6.6× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,022.40 | $1,278 | 6.1× |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$446.40–$939.20 | $558–$1,174 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$648–$1,353.60 | $810–$1,692 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$493.60–$952.80 | $617–$1,191 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $445.60 | $557 | 4.4× |
| Radiologic examination tibia & fibula 2 views (73590) | $580 | $725 | 6.9× |
| Ribs bilateral 3 views (71110) | $688 | $860 | 6.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $1,512 | $1,890 | 3.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,704 | $4,630 | 7.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $2,984 | $3,730 | 5.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $3,068.80 | $3,836 | 5.9× |
| Rp Therapy Intravenous Administration (79101) | $980 | $1,225 | 4.4× |
| Scapula (73010) | $438.40 | $548 | 4.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $181.60 | $227 | 7.8× |
| Sella turcica (70240) | $183.20 | $229 | 2.2× |
| Shoulder 1 view (73020) | $476 | $595 | 5.7× |
| Shoulder Arthrography (73040) range across 4 matching MRF lines |
$1,803.20–$2,824.80 | $2,254–$3,531 | varies |
| Skull less than 4 views (70250) | $399.20 | $499 | 4.0× |
| Special dosimetry (77331) | $390.40 | $488 | 3.0× |
| Special Physics Consult (77370) | $562.40 | $703 | 4.4× |
| Special teletherapy port plan (77321) | $2,120 | $2,650 | 5.9× |
| Special treatment procedure (77470) | $1,848 | $2,310 | 3.5× |
| Spleen Imaging (78185) | $2,622.40 | $3,278 | 6.8× |
| Stereotactic Body Radiation Delivery (77373) | $4,280 | $5,350 | 2.5× |
| Sternoclavicular joints (71130) | $253.60 | $317 | 3.0× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) range across 2 matching MRF lines |
$215.20–$2,220 | $269–$2,775 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $2,120 | $2,650 | 5.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $2,120 | $2,650 | 5.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $1,629.60 | $2,037 | 4.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $1,314.40 | $1,643 | 3.6× |
| Ther rad simulaj-aided field setting simple (77280) | $875.20 | $1,094 | 6.8× |
| Thoracic spine 2 views (72070) | $635.20 | $794 | 6.3× |
| Thoracic spine 3 views (72072) | $655.20 | $819 | 6.5× |
| Thoracolumbar 2 views (72080) | $445.60 | $557 | 5.3× |
| Thyroid Met Imaging Body (78018) | $1,932 | $2,415 | 3.7× |
| Thyroid Uptake Measurement (78012) | $1,052.80 | $1,316 | 2.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,688.80 | $2,111 | 4.4× |
| Tx Devices Design & Construction Complex (77334) | $1,116.80 | $1,396 | 3.1× |
| Tx devices design & construction intermediate (77333) | $975.20 | $1,219 | 7.5× |
| Tx devices design & construction simple (77332) | $1,004 | $1,255 | 7.8× |
| Ultrasound Breast Limited (76642) | $602.40 | $753 | 7.2× |
| Ultrasound Elastography Parenchyma (76981) | $280 | $350 | 2.8× |
| Ultrasound Exam Aaa Screen (76706) | $452.80 | $566 | 4.5× |
| Ultrasound, abdomen limited (76705) | $1,034.40 | $1,293 | 10.3× |
| Umbilical-artery Doppler (OB) (76820) | $296.80 | $371 | 3.0× |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$871.20–$2,474.40 | $1,089–$3,093 | varies |
| Unlisted us procedure (76999) | $420 | $525 | 5.0× |
| Upper gi w/o kub (74240) | $989.60 | $1,237 | 5.9× |
| Ureteral Reflux Study (78740) | $904 | $1,130 | 2.4× |
| Urethrocystography retrograde (74450) | $789.60 | $987 | 3.4× |
| Us breast unilateral complete (76641) | $674.40 | $843 | 6.7× |
| Us chest (76604) | $752 | $940 | 7.5× |
| Us complete joint (76881) | $820.80 | $1,026 | 8.2× |
| Us exam, pelvic, limited (76857) | $637.60 | $797 | 6.3× |
| Us head (76506) | $442.40 | $553 | 4.4× |
| Us kidney transplant (76776) | $884.80 | $1,106 | 8.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $599.20 | $749 | 6.0× |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$289.60–$887.20 | $362–$1,109 | varies |
| Us ob transvaginal (76817) | $715.20 | $894 | 7.1× |
| Us pelvic non ob complete (76856) | $1,148.80 | $1,436 | 11.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $920.80 | $1,151 | 9.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $592.80 | $741 | 5.9× |
| Us retroperitoneal complete (76770) | $674.40 | $843 | 6.7× |
| Us retroperitoneal limited (76775) | $651.20 | $814 | 6.5× |
| Us scrotum and contents (76870) | $1,129.60 | $1,412 | 11.2× |
| Us spinal canal and contents (76800) | $385.60 | $482 | 3.8× |
| Us thyroid (76536) | $1,075.20 | $1,344 | 10.7× |
| Us transrectal (76872) | $309.60 | $387 | 3.1× |
| Vein X-Ray Chest (75827) | $3,158.40 | $3,948 | 2.1× |
| Venogram Sinus/Jugular (75860) | $6,888 | $8,610 | 2.3× |
| Venography caval inferior serialography rs&i (75825) | $6,888 | $8,610 | 2.3× |
| Venography extremity bilateral rs&i (75822) | $3,440 | $4,300 | 2.3× |
| Venography extremity unilateral rs&i (75820) | $3,440 | $4,300 | 2.3× |
| Venography Renal Unilateral (75831) | $6,013.60 | $7,517 | 2.0× |
| Wrist 2 views (73100) | $492.80 | $616 | 5.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $308.80 | $386 | 3.7× |
| X-ray antegrade pyelogram tube (74425) | $871.20 | $1,089 | 2.6× |
| X-Ray Aorta Leg Arteries (75630) | $6,888 | $8,610 | 2.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$508.80–$833.60 | $636–$1,042 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,164 | $1,455 | 2.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $172 | $215 | 2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $564.80 | $706 | 5.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $380.80 | $476 | 4.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $492.80 | $616 | 5.9× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $231.20 | $289 | 2.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $559.20 | $699 | 5.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $231.20 | $289 | 2.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $418.40 | $523 | 4.2× |
| X-Ray Exam L-S Spine Bending (72114) | $852 | $1,065 | 8.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $560 | $700 | 6.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $762.40 | $953 | 7.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $693.60 | $867 | 6.9× |
| X-ray humerus (73060) | $541.60 | $677 | 6.5× |
| X-ray IV pyelogram+tomography (74415) | $971.20 | $1,214 | 5.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $428 | $535 | 5.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $296 | $370 | 3.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $584.80 | $731 | 5.8× |
| X-ray nose-rectum child f.b. (76010) | $222.40 | $278 | 2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $860 | $1,075 | 8.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $452 | $565 | 4.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $319.20 | $399 | 3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $463.20 | $579 | 5.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $781.60 | $977 | 9.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $671.20 | $839 | 6.7× |
| X-Ray Tmj Unilat (70328) | $201.60 | $252 | 2.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $1,316 | $1,645 | 3.9× |
| X-Rays Bone Length Studies (77073) | $321.60 | $402 | 3.2× |
| X-Rays Bone Survey Complete (77075) | $1,080.80 | $1,351 | 10.7× |
| Xr c-spine 4 or 5 views (72050) | $780.80 | $976 | 7.8× |
| Xr facial bones less than 3 views (70140) | $360.80 | $451 | 4.3× |
| XR Mastoids < 3 Views Bilateral (70120) | $235.20 | $294 | 2.3× |
| Xr orbits complete 4 views (70200) | $532.80 | $666 | 5.3× |
| Xr Tomogram Single Plane (76100) | $338.40 | $423 | 3.4× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.