Imaging prices at Sutter Delta Medical Center
Antioch, CA · every code in this section with a posted price and a Medicare benchmark.
336 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) | $666 | $666 | 5.4× |
| Abdomen 2 views (74019) | $921 | $921 | 6.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $3,945 | $3,945 | 7.0× |
| Angio internal mammary (75756) | $9,292 | $9,292 | 2.1× |
| Angio pulmonary bilat (75743) | $8,381 | $8,381 | 1.9× |
| Angiography extremity bilateral rs&i (75716) | $11,739 | $11,739 | 2.6× |
| Angiography extremity unilateral rs&i (75710) | $10,621 | $10,621 | 2.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $3,793 | $3,793 | 0.9× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$743–$1,115 | $743–$1,115 | varies |
| Aortography thoracic serialography rs&i (75605) | $10,840 | $10,840 | 1.4× |
| Aortography thoracic w/o serialography rs&i (75600) | $5,504 | $5,504 | 1.2× |
| Artery X-Rays Abdomen (75726) | $13,544 | $13,544 | 1.7× |
| Artery X-Rays Pelvis (75736) | $14,417 | $14,417 | 1.8× |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$7,309–$10,964 | $7,309–$10,964 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$2,090–$3,135 | $2,090–$3,135 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$1,063–$1,594 | $1,063–$1,594 | varies |
| Basic radiation dosimetry calculation (77300) | $1,523 | $1,523 | 8.0× |
| Bone age studies (77072) | $458 | $458 | 3.1× |
| Bone Imaging 3 Phase (78315) | $4,874 | $4,874 | 8.6× |
| Bone Imaging Limited Area (78300) | $2,432 | $2,432 | 4.3× |
| Bone Imaging Multiple Areas (78305) | $3,347 | $3,347 | 5.9× |
| Bone Imaging Whole Body (78306) | $4,342 | $4,342 | 7.7× |
| Bone marrow imaging limited area (78102) | $2,576 | $2,576 | 4.6× |
| Bone survey infant (77076) | $1,786 | $1,786 | 12.1× |
| Brachytx isodose complex (77318) | $7,059 | $7,059 | 13.4× |
| Brain Flow Imaging Only (78610) | $3,603 | $3,603 | 4.7× |
| Brain Imaging Minimum 4 Static Views (78605) | $3,704 | $3,704 | 4.8× |
| Cat Scan Follow-Up Study (76380) | $1,807 | $1,807 | 14.7× |
| Cerebrospinal Fluid Scan (78630) | $2,044 | $2,044 | 2.7× |
| Chest 1 view (71045) | $738 | $738 | 6.0× |
| Chest 2 views (71046) | $804 | $804 | 6.5× |
| Chest 3 views (71047) | $723 | $723 | 5.9× |
| Chest 4 or more views (71048) | $832 | $832 | 5.6× |
| Cholecystography Oral Contrast (74290) | $2,009 | $2,009 | 8.1× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$769–$1,154 | $769–$1,154 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $304 | $304 | 2.1× |
| Contrast Exam Abdominl Aorta (75625) | $10,950 | $10,950 | 2.5× |
| Contrast X-Ray Bladder (74430) | $1,268 | $1,268 | 2.6× |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$5,056–$7,584 | $5,056–$7,584 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$1,892–$2,838 | $1,892–$2,838 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $370 | $370 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) | $8,994 | $8,994 | 18.3× |
| CT abdomen and pelvis without contrast (74176) | $6,374 | $6,374 | 18.9× |
| CT abdomen w contrast (74160) | $4,755 | $4,755 | 19.2× |
| CT abdomen w wo contrast (74170) | $4,989 | $4,989 | 20.1× |
| CT abdomen w/o contrast (74150) | $4,058 | $4,058 | 27.5× |
| CT Angio Abdomen and Pelvis (74174) | $9,849 | $9,849 | 20.0× |
| CT Angio Chest (71275) | $6,885 | $6,885 | 27.8× |
| CT Angio Head (70496) | $6,173 | $6,173 | 24.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$6,840–$10,260 | $6,840–$10,260 | varies |
| CT Angio Neck (70498) | $5,871 | $5,871 | 23.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $5,928 | $5,928 | 23.9× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $6,626 | $6,626 | 26.8× |
| CT cervical spine w/ contrast (72126) | $7,056 | $7,056 | 14.3× |
| CT cervical spine w/o contrast (72125) | $5,058 | $5,058 | 34.3× |
| CT cervical spine w/wo cont (72127) | $5,699 | $5,699 | 23.0× |
| CT chest w contrast (71260) | $5,153 | $5,153 | 20.8× |
| CT chest w/wo contrast (71270) | $5,607 | $5,607 | 22.6× |
| CT head/brain with contrast (70460) | $4,869 | $4,869 | 19.7× |
| CT head/brain without and with contrast (70470) | $5,345 | $5,345 | 21.6× |
| CT iac w contrast (70481) | $5,596 | $5,596 | 22.6× |
| CT l-spine w&w/o contrast (72133) | $5,824 | $5,824 | 23.5× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$4,359–$6,538 | $4,359–$6,538 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$5,316–$7,974 | $5,316–$7,974 | varies |
| CT lumbar spine w contrast (72132) | $6,202 | $6,202 | 12.6× |
| CT lumbar spine w/o contrast (72131) | $4,803 | $4,803 | 32.5× |
| CT maxillofacial w contrast (70487) | $5,254 | $5,254 | 21.2× |
| CT maxillofacial wo contrast (70486) | $4,272 | $4,272 | 28.9× |
| CT neck tissue combo (70492) | $4,572 | $4,572 | 18.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $5,337 | $5,337 | 21.5× |
| CT orbits w/o contrast (70480) | $4,511 | $4,511 | 30.6× |
| CT pelvis w&w/o contrast (72194) | $4,196 | $4,196 | 16.9× |
| CT pelvis w/o contrast (72192) | $4,656 | $4,656 | 31.5× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$5,479–$8,218 | $5,479–$8,218 | varies |
| CT scans face/jaw combo (70488) | $4,353 | $4,353 | 17.6× |
| CT soft tissue neck w contrast (70491) | $4,995 | $4,995 | 20.2× |
| CT soft tissue neck w/o contrast (70490) | $4,177 | $4,177 | 28.3× |
| CT thoracic spine w contrast (72129) | $6,600 | $6,600 | 26.6× |
| CT thoracic spine w/o contrast (72128) | $4,811 | $4,811 | 32.6× |
| CT thoracic spine w/wo cont (72130) | $6,822 | $6,822 | 27.5× |
| CT thorax w/o contrast (71250) | $4,097 | $4,097 | 27.8× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$4,265–$6,398 | $4,265–$6,398 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$5,615–$8,422 | $5,615–$8,422 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$5,122–$7,683 | $5,122–$7,683 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $7,047 | $7,047 | 28.5× |
| Cta Abdomen (74175) | $6,496 | $6,496 | 26.2× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $12,425 | $12,425 | 25.2× |
| CTA pelvis (72191) | $5,400 | $5,400 | 21.8× |
| Dilation ureters/urethra rs&i (74485) | $4,933 | $4,933 | 1.7× |
| Dxa Bone Density Axial (77080) | $913 | $913 | 6.2× |
| Dxa bone density study (77085) | $794 | $794 | 5.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $474 | $474 | 3.9× |
| Echo exam uterus (76831) | $1,463 | $1,463 | 4.3× |
| Echograp Trans R Pros Study (76873) | $1,316 | $1,316 | 8.9× |
| Esophagram (74220) | $1,422 | $1,422 | 5.7× |
| Fetal Biophys Profile W/Nst (76818) | $1,705 | $1,705 | 11.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,579 | $1,579 | 10.7× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) | $1,508 | $1,508 | 4.5× |
| Fluoroscopy up to 1 hr (76000) | $1,733 | $1,733 | 5.1× |
| Follow-Up Angiography (75898) | $6,169 | $6,169 | 1.4× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$698–$1,046 | $698–$1,046 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$912–$1,368 | $912–$1,368 | varies |
| Gastric emptying imaging study (78264) | $4,274 | $4,274 | 7.6× |
| Gated Heart Planar Single (78472) | $3,159 | $3,159 | 5.6× |
| Gated Heart, Multiple (78473) | $3,565 | $3,565 | 6.3× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$801–$1,202 | $801–$1,202 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $10,261 | $10,261 | 2.3× |
| Hepatobil Syst Image W/Drug (78227) | $4,107 | $4,107 | 5.4× |
| Hepatobiliary System Imaging (78226) | $3,581 | $3,581 | 6.3× |
| Ht Musc Image Planar Mult (78454) | $7,173 | $7,173 | 3.9× |
| Ht Muscle Image Spect Sing (78451) | $7,176 | $7,176 | 3.9× |
| Hysterosalpingogram (74740) | $1,432 | $1,432 | 4.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $2,292 | $2,292 | 18.7× |
| Infant hip ultrasound, limited static exam (76886) | $872 | $872 | 7.1× |
| Infusion Ivp (74410) | $2,636 | $2,636 | 10.6× |
| Interstitial radiation source applic complex (77778) | $8,023 | $8,023 | 8.2× |
| Joint Survey Single View (77077) | $618 | $618 | 4.2× |
| K Flow/Funct Image Multiple (78709) | $6,538 | $6,538 | 8.5× |
| K Flow/Funct Image W/Drug (78708) | $4,467 | $4,467 | 5.8× |
| K Flow/Funct Image W/O Drug (78707) | $4,147 | $4,147 | 5.4× |
| Kidney Imaging Morphol (78700) | $3,635 | $3,635 | 6.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $3,153 | $3,153 | 5.6× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$954–$1,431 | $954–$1,431 | varies |
| Liver & Spleen Imaging Static Only (78215) | $3,380 | $3,380 | 6.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $2,209 | $2,209 | 3.9× |
| Lung Perf&Ventilat Diferentl (78598) | $4,083 | $4,083 | 5.3× |
| Lung perfusion differential (78597) | $2,153 | $2,153 | 3.8× |
| Lung Ventilat&Perfus Imaging (78582) | $4,562 | $4,562 | 6.0× |
| Lung Ventilation Imaging (78579) | $2,310 | $2,310 | 4.1× |
| Lymph System Imaging (78195) | $4,428 | $4,428 | 5.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $11,329 | $11,329 | 5.1× |
| Lymphangiography extremity only unilateral rs&i (75801) | $9,693 | $9,693 | 10.9× |
| Magnetic Image Jaw Joint (70336) | $4,939 | $4,939 | 14.7× |
| Mammary ductogram or galactogram multiple (77054) | $2,822 | $2,822 | 8.4× |
| Mammary ductogram or galactogram single (77053) | $998 | $998 | 3.0× |
| Meckels Divert Exam (78290) | $4,328 | $4,328 | 7.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $94 | $94 | 2.3× |
| Mra Head W/O & W/Contrast Material (70546) | $7,839 | $7,839 | 15.9× |
| MRA head w/o contrast (70544) | $5,677 | $5,677 | 16.8× |
| MRA head with contrast (70545) | $6,437 | $6,437 | 13.1× |
| MRA neck w contrast (70548) | $5,978 | $5,978 | 12.1× |
| Mra Neck W/O &W/Contrast Material (70549) | $8,824 | $8,824 | 17.9× |
| MRA neck w/o contrast (70547) | $5,464 | $5,464 | 16.2× |
| MRI abdomen w contrast (74182) | $5,386 | $5,386 | 10.9× |
| MRI abdomen w/o contrast (74181) | $5,540 | $5,540 | 16.4× |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$5,118–$7,678 | $5,118–$7,678 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$7,534–$11,300 | $7,534–$11,300 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$5,051–$7,576 | $5,051–$7,576 | varies |
| MRI bone marrow blood supply (77084) | $5,084 | $5,084 | 15.1× |
| MRI Breast W/O Contrast Bilateral (77047) | $4,205 | $4,205 | 12.5× |
| MRI cardiac w/o contrast (75557) | $5,936 | $5,936 | 17.6× |
| MRI cervical spine w contrast (72142) | $6,480 | $6,480 | 13.2× |
| MRI cervical spine w/o cont (72141) | $5,265 | $5,265 | 15.6× |
| MRI chest w/o contrast (71550) | $4,588 | $4,588 | 13.6× |
| MRI chest wo w contrast (71552) | $8,053 | $8,053 | 16.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$6,749–$10,124 | $6,749–$10,124 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$6,693–$10,040 | $6,693–$10,040 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$4,496–$6,744 | $4,496–$6,744 | varies |
| MRI lumbar spine w contrast (72149) | $8,076 | $8,076 | 16.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $8,560 | $8,560 | 17.4× |
| MRI orbit face &/neck w/o contrast (70540) | $4,351 | $4,351 | 12.9× |
| MRI orbit face neck w contrast (70542) | $8,245 | $8,245 | 16.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $7,992 | $7,992 | 16.2× |
| MRI pelvis w contrast (72196) | $5,220 | $5,220 | 10.6× |
| MRI pelvis w/o & w contrast (72197) | $8,535 | $8,535 | 17.3× |
| MRI pelvis w/o contrast (72195) | $5,735 | $5,735 | 17.0× |
| MRI thoracic spine w/o contrast (72146) | $5,458 | $5,458 | 16.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$3,921–$5,882 | $3,921–$5,882 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$4,456–$6,684 | $4,456–$6,684 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$6,867–$10,300 | $6,867–$10,300 | varies |
| MRI, abdomen, combo (74183) | $7,712 | $7,712 | 15.7× |
| MRI, dorsal spine combo (72157) | $8,406 | $8,406 | 17.1× |
| MRI, dorsal spine contrast (72147) | $6,508 | $6,508 | 13.2× |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$4,860–$7,291 | $4,860–$7,291 | varies |
| MRI, joint upper extrem combo (73223) range across 3 matching MRF lines |
$7,159–$10,739 | $7,159–$10,739 | varies |
| MRI, lumbar spine combo (72158) | $8,441 | $8,441 | 17.1× |
| Myelogram cervical (72240) | $2,690 | $2,690 | 2.4× |
| Myelogram Lumbar (72265) | $4,112 | $4,112 | 3.7× |
| Myelography thoracic (72255) | $3,075 | $3,075 | 2.8× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $3,319 | $3,319 | 5.9× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) | $2,676 | $2,676 | 3.5× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $5,394 | $5,394 | 3.0× |
| Myocardial Spect Multiple Studies (78452) | $9,698 | $9,698 | 5.3× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $6,919 | $6,919 | 3.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) | $6,609 | $6,609 | 3.3× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) | $10,308 | $10,308 | 3.3× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $13,244 | $13,244 | 4.3× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) | $13,244 | $13,244 | 6.2× |
| Neck soft tissue (70360) | $744 | $744 | 6.1× |
| Nm myocard infarct spect (78469) | $4,795 | $4,795 | 6.3× |
| Nonvascular Shunt X-Ray (75809) | $927 | $927 | 6.3× |
| Ob us nuchal meas 1 gest (76813) | $769 | $769 | 5.2× |
| Optic foramina (70190) | $437 | $437 | 3.6× |
| Parathyroid Planar Imaging (78070) | $2,563 | $2,563 | 4.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $4,163 | $4,163 | 7.4× |
| Pelvis 1 or 2 views (72170) | $770 | $770 | 5.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $3,215 | $3,215 | 5.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,179 | $1,179 | 8.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,934 | $1,934 | 2.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$866–$1,300 | $866–$1,300 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$642–$963 | $642–$963 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$844–$1,265 | $844–$1,265 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $915 | $915 | 6.2× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$681–$1,022 | $681–$1,022 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$918–$1,377 | $918–$1,377 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$886–$1,329 | $886–$1,329 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$647–$970 | $647–$970 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $1,021 | $1,021 | 6.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $869 | $869 | 7.1× |
| Radex Ribs Unilateral 2 Views (71100) | $803 | $803 | 6.5× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$890–$1,335 | $890–$1,335 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $607 | $607 | 4.9× |
| Radex Spine 1 View Specify Level (72020) | $729 | $729 | 5.9× |
| Radex Sternum Minimum 2 Views (71120) | $728 | $728 | 5.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $704 | $704 | 5.7× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$662–$994 | $662–$994 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$649–$974 | $649–$974 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$862–$1,294 | $862–$1,294 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $1,244 | $1,244 | 8.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $938 | $938 | 6.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $879 | $879 | 6.0× |
| Radiologic exam colon double contrast study (74280) | $2,003 | $2,003 | 8.1× |
| Radiologic exam colon single contrast study (74270) | $1,630 | $1,630 | 6.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,225 | $1,225 | 4.9× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$1,025–$1,537 | $1,025–$1,537 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $890 | $890 | 6.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,744 | $1,744 | 7.0× |
| Radiologic exam swallow function contrast study (74230) | $1,571 | $1,571 | 6.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,643 | $1,643 | 6.6× |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$714–$1,071 | $714–$1,071 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$797–$1,195 | $797–$1,195 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$709–$1,064 | $709–$1,064 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) | $936 | $936 | 7.6× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$810–$1,215 | $810–$1,215 | varies |
| Ribs bilateral 3 views (71110) | $1,049 | $1,049 | 7.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,555 | $2,555 | 4.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,716 | $2,716 | 4.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,601 | $5,601 | 7.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $6,051 | $6,051 | 7.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $5,048 | $5,048 | 6.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $3,885 | $3,885 | 2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $8,841 | $8,841 | 4.4× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $6,242 | $6,242 | 3.4× |
| Salivary Gland Imaging Serial Images (78231) | $1,959 | $1,959 | 3.5× |
| Scapula (73010) range across 3 matching MRF lines |
$840–$1,260 | $840–$1,260 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $183 | $183 | 7.8× |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$693–$1,040 | $693–$1,040 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$1,838–$2,757 | $1,838–$2,757 | varies |
| Sialogram (70390) | $2,952 | $2,952 | 8.8× |
| Skull less than 4 views (70250) | $967 | $967 | 6.6× |
| Special Physics Consult (77370) | $2,476 | $2,476 | 13.0× |
| Sternoclavicular joints (71130) | $589 | $589 | 4.8× |
| Testicular Imaging W/Flow (78761) | $2,156 | $2,156 | 3.8× |
| Thoracic spine 2 views (72070) | $932 | $932 | 6.3× |
| Thoracic spine 3 views (72072) | $980 | $980 | 6.6× |
| Thoracolumbar 2 views (72080) | $805 | $805 | 6.6× |
| Thyroid Imaging With Vascular Flow (78013) | $175 | $175 | 0.3× |
| Thyroid Uptake Measurement (78012) | $1,895 | $1,895 | 3.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,319 | $2,319 | 4.1× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$865–$1,298 | $865–$1,298 | varies |
| Ultrasound Exam Aaa Screen (76706) | $1,021 | $1,021 | 6.9× |
| Ultrasound, abdomen limited (76705) | $1,656 | $1,656 | 11.2× |
| Umbilical-artery Doppler (OB) (76820) | $742 | $742 | 5.0× |
| Upper gi w/o kub (74240) | $1,658 | $1,658 | 6.7× |
| Urethrocystogram voiding (74455) | $1,633 | $1,633 | 4.8× |
| Urethrocystography retrograde (74450) | $1,911 | $1,911 | 5.7× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$1,092–$1,637 | $1,092–$1,637 | varies |
| Us chest (76604) | $1,377 | $1,377 | 9.3× |
| Us complete joint (76881) | $1,299 | $1,299 | 8.8× |
| Us exam, pelvic, limited (76857) | $944 | $944 | 6.4× |
| Us head (76506) | $1,788 | $1,788 | 12.1× |
| Us kidney transplant (76776) | $1,984 | $1,984 | 13.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $847 | $847 | 5.7× |
| Us ob detailed single fetus (76811) | $1,665 | $1,665 | 4.9× |
| Us ob limited 1 or more fetuses (76815) | $1,194 | $1,194 | 8.1× |
| Us ob transvaginal (76817) | $1,457 | $1,457 | 9.9× |
| Us pelvic non ob complete (76856) | $1,596 | $1,596 | 10.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,625 | $1,625 | 11.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $894 | $894 | 6.1× |
| Us retroperitoneal complete (76770) | $1,666 | $1,666 | 11.3× |
| Us retroperitoneal limited (76775) | $1,330 | $1,330 | 9.0× |
| Us scrotum and contents (76870) | $1,538 | $1,538 | 10.4× |
| Us spinal canal and contents (76800) | $1,641 | $1,641 | 11.1× |
| Us thyroid (76536) | $1,368 | $1,368 | 9.3× |
| Us transrectal (76872) | $1,088 | $1,088 | 7.4× |
| Vascular Flow Imaging (78445) | $3,538 | $3,538 | 6.3× |
| Vein X-Ray Chest (75827) | $5,360 | $5,360 | 2.4× |
| Venography caval inferior serialography rs&i (75825) | $9,070 | $9,070 | 2.0× |
| Venography extremity bilateral rs&i (75822) | $4,966 | $4,966 | 2.2× |
| Venography extremity unilateral rs&i (75820) | $3,907 | $3,907 | 1.8× |
| Venography Renal Bilateral (75833) | $6,237 | $6,237 | 1.4× |
| Venography Renal Unilateral (75831) | $5,147 | $5,147 | 1.2× |
| Venous sampling by catheter (75893) | $9,044 | $9,044 | 1.2× |
| Vertebral fracture assessment via dxa (77086) | $389 | $389 | 3.2× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$675–$1,012 | $675–$1,012 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $733 | $733 | 6.0× |
| X-ray antegrade pyelogram tube (74425) | $2,106 | $2,106 | 4.3× |
| X-Ray Aorta Leg Arteries (75630) | $12,702 | $12,702 | 2.8× |
| X-Ray Bend Only L-S Spine (72120) | $836 | $836 | 5.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$752–$1,128 | $752–$1,128 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,281 | $1,281 | 1.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $575 | $575 | 4.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $820 | $820 | 5.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $972 | $972 | 6.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $685 | $685 | 5.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $768 | $768 | 6.2× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,048 | $1,048 | 7.1× |
| X-Ray Exam Hips Bi 2 Views (73521) | $959 | $959 | 6.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,136 | $1,136 | 7.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,337 | $1,337 | 9.1× |
| X-Ray Exam L-S Spine Bending (72114) | $1,169 | $1,169 | 7.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $864 | $864 | 7.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,308 | $1,308 | 8.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,074 | $1,074 | 7.3× |
| X-ray eye for foreign body (70030) | $609 | $609 | 5.0× |
| X-ray humerus (73060) | $919 | $919 | 7.5× |
| X-ray IV pyelogram (ivp) (74400) | $1,236 | $1,236 | 5.0× |
| X-ray IV pyelogram+tomography (74415) | $3,033 | $3,033 | 12.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $585 | $585 | 4.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $622 | $622 | 5.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $966 | $966 | 6.5× |
| X-ray nose-rectum child f.b. (76010) | $503 | $503 | 4.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,276 | $1,276 | 8.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $816 | $816 | 5.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $571 | $571 | 3.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $928 | $928 | 7.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $740 | $740 | 6.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,071 | $1,071 | 7.3× |
| X-ray thoracic spine 4 vw (72074) | $912 | $912 | 6.2× |
| X-Rays Bone Length Studies (77073) | $842 | $842 | 5.7× |
| X-Rays Bone Survey Complete (77075) | $1,521 | $1,521 | 10.3× |
| Xr c-spine 4 or 5 views (72050) | $1,175 | $1,175 | 8.0× |
| Xr facial bones less than 3 views (70140) | $764 | $764 | 6.2× |
| XR Mastoids < 3 Views Bilateral (70120) | $828 | $828 | 5.6× |
| Xr orbits complete 4 views (70200) | $757 | $757 | 5.1× |
| Xr Tomogram Single Plane (76100) | $2,355 | $2,355 | 16.0× |
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.