Imaging prices at Sutter Tracy Community Hospital
Tracy, CA · every code in this section with a posted price and a Medicare benchmark.
293 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 | 5.8× |
| Abdomen 2 views (74019) | $921 | $921 | 6.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $3,716 | $3,716 | 7.0× |
| Angiography extremity unilateral rs&i (75710) | $10,002 | $10,002 | 2.4× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$743–$1,115 | $743–$1,115 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$1,968–$2,952 | $1,968–$2,952 | varies |
| Bone age studies (77072) | $431 | $431 | 3.1× |
| Bone Imaging 3 Phase (78315) | $4,590 | $4,590 | 8.7× |
| Bone Imaging Limited Area (78300) | $2,291 | $2,291 | 4.3× |
| Bone Imaging Whole Body (78306) | $4,089 | $4,089 | 7.8× |
| Bone marrow imaging limited area (78102) | $2,426 | $2,426 | 4.6× |
| Bone marrow imaging; multiple areas (78103) | $2,593 | $2,593 | 4.9× |
| Bone survey infant (77076) | $1,689 | $1,689 | 12.2× |
| Brain Flow Imaging Only (78610) | $3,393 | $3,393 | 4.7× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $5,964 | $5,964 | 8.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$8,118–$8,280 | $8,118–$8,280 | varies |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $3,331 | $3,331 | 6.3× |
| Chest 1 view (71045) | $738 | $738 | 6.4× |
| Chest 2 views (71046) | $804 | $804 | 7.0× |
| Chest 3 views (71047) | $723 | $723 | 6.3× |
| Chest 4 or more views (71048) | $832 | $832 | 6.0× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$725–$1,088 | $725–$1,088 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $304 | $304 | 2.2× |
| Contrast X-Ray Bladder (74430) | $1,193 | $1,193 | 2.6× |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$1,782–$2,673 | $1,782–$2,673 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $8,994 | $8,994 | 19.5× |
| CT abdomen and pelvis without contrast (74176) | $6,374 | $6,374 | 20.3× |
| CT abdomen w contrast (74160) | $4,755 | $4,755 | 20.6× |
| CT abdomen w wo contrast (74170) | $4,989 | $4,989 | 21.6× |
| CT abdomen w/o contrast (74150) | $4,058 | $4,058 | 29.4× |
| CT Angio Abdomen and Pelvis (74174) | $9,276 | $9,276 | 20.2× |
| CT Angio Chest (71275) | $6,885 | $6,885 | 29.8× |
| CT Angio Head (70496) | $6,173 | $6,173 | 26.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$6,441–$9,662 | $6,441–$9,662 | varies |
| CT Angio Neck (70498) | $5,714 | $5,714 | 24.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $5,583 | $5,583 | 24.1× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $6,240 | $6,240 | 27.0× |
| CT cervical spine w/ contrast (72126) | $6,645 | $6,645 | 14.4× |
| CT cervical spine w/o contrast (72125) | $5,058 | $5,058 | 36.7× |
| CT cervical spine w/wo cont (72127) | $5,367 | $5,367 | 23.2× |
| CT chest w contrast (71260) | $5,153 | $5,153 | 22.3× |
| CT chest w/wo contrast (71270) | $5,607 | $5,607 | 24.2× |
| CT head/brain with contrast (70460) | $4,869 | $4,869 | 21.0× |
| CT head/brain without and with contrast (70470) | $5,345 | $5,345 | 23.1× |
| CT heart no contrast quant eval coronry calcium (75571) | $644 | $644 | 5.6× |
| CT iac w contrast (70481) | $5,269 | $5,269 | 22.8× |
| CT l-spine w&w/o contrast (72133) | $5,485 | $5,485 | 23.7× |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$4,106–$6,159 | $4,106–$6,159 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$5,007–$7,510 | $5,007–$7,510 | varies |
| CT lumbar spine w contrast (72132) | $5,841 | $5,841 | 12.7× |
| CT lumbar spine w/o contrast (72131) | $4,803 | $4,803 | 34.8× |
| CT maxillofacial w contrast (70487) | $5,254 | $5,254 | 22.7× |
| CT maxillofacial wo contrast (70486) | $4,272 | $4,272 | 31.0× |
| CT neck tissue combo (70492) | $4,304 | $4,304 | 18.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $5,026 | $5,026 | 21.7× |
| CT orbits w/o contrast (70480) | $4,249 | $4,249 | 30.8× |
| CT pelvis w&w/o contrast (72194) | $4,196 | $4,196 | 18.1× |
| CT pelvis w/o contrast (72192) | $4,656 | $4,656 | 33.8× |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$5,160–$7,740 | $5,160–$7,740 | varies |
| CT scans face/jaw combo (70488) | $4,353 | $4,353 | 18.8× |
| CT soft tissue neck w contrast (70491) | $4,703 | $4,703 | 20.3× |
| CT soft tissue neck w/o contrast (70490) | $3,933 | $3,933 | 28.5× |
| CT thoracic spine w contrast (72129) | $6,216 | $6,216 | 26.9× |
| CT thoracic spine w/o contrast (72128) | $4,811 | $4,811 | 34.9× |
| CT thoracic spine w/wo cont (72130) | $6,424 | $6,424 | 27.8× |
| CT thorax w/o contrast (71250) | $4,097 | $4,097 | 29.7× |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$4,016–$6,024 | $4,016–$6,024 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$5,289–$7,934 | $5,289–$7,934 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$4,824–$7,236 | $4,824–$7,236 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $6,637 | $6,637 | 28.7× |
| Cta Abdomen (74175) | $6,118 | $6,118 | 26.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $11,701 | $11,701 | 25.4× |
| CTA pelvis (72191) | $5,086 | $5,086 | 22.0× |
| Discography Cerv/Thor Spine (72285) | $2,809 | $2,809 | 1.1× |
| Diskography lumbar (72295) | $2,240 | $2,240 | 0.9× |
| Dxa Bone Density Axial (77080) | $913 | $913 | 6.6× |
| Dxa bone density study (77085) | $748 | $748 | 5.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $447 | $447 | 3.9× |
| Echo exam uterus (76831) | $1,378 | $1,378 | 4.4× |
| Echo Guide For Artery Repair (76936) | $2,163 | $2,163 | 7.6× |
| Esophagram (74220) | $1,339 | $1,339 | 5.8× |
| Fetal Biophys Profile W/Nst (76818) | $1,605 | $1,605 | 11.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $1,487 | $1,487 | 10.8× |
| Fluoroscopy up to 1 hr (76000) | $1,632 | $1,632 | 5.2× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$698–$1,046 | $698–$1,046 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$859–$1,288 | $859–$1,288 | varies |
| Gastric emptying imaging study (78264) | $4,025 | $4,025 | 7.6× |
| Gated Heart Planar Single (78472) | $2,974 | $2,974 | 5.6× |
| Gated Heart, Multiple (78473) | $3,460 | $3,460 | 6.6× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$801–$1,202 | $801–$1,202 | varies |
| Hepatobil Syst Image W/Drug (78227) | $3,868 | $3,868 | 5.4× |
| Hepatobiliary System Imaging (78226) | $3,373 | $3,373 | 6.4× |
| Ht Musc Image Planar Mult (78454) | $7,173 | $7,173 | 4.2× |
| Ht Muscle Image Spect Sing (78451) | $7,176 | $7,176 | 4.2× |
| Hysterosalpingogram (74740) | $1,347 | $1,347 | 4.3× |
| Infusion Ivp (74410) | $2,483 | $2,483 | 10.7× |
| Interstitial radiation source applic complex (77778) | $7,556 | $7,556 | 8.2× |
| K Flow/Funct Image Multiple (78709) | $6,158 | $6,158 | 8.6× |
| K Flow/Funct Image W/Drug (78708) | $4,206 | $4,206 | 5.9× |
| K Flow/Funct Image W/O Drug (78707) | $3,906 | $3,906 | 5.5× |
| Kidney Imaging Morphol (78700) | $3,423 | $3,423 | 6.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $2,968 | $2,968 | 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) | $3,183 | $3,183 | 6.0× |
| Lung Ventilat&Perfus Imaging (78582) | $4,296 | $4,296 | 6.0× |
| Lung Ventilation Imaging (78579) | $2,176 | $2,176 | 4.1× |
| Lymph System Imaging (78195) | $4,170 | $4,170 | 5.8× |
| Magnetic Image Jaw Joint (70336) | $4,652 | $4,652 | 14.8× |
| Mammary ductogram or galactogram multiple (77054) | $2,658 | $2,658 | 8.4× |
| Mammary ductogram or galactogram single (77053) | $939 | $939 | 3.0× |
| Meckels Divert Exam (78290) | $4,076 | $4,076 | 7.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $89 | $89 | 2.3× |
| Mra Head W/O & W/Contrast Material (70546) | $7,383 | $7,383 | 16.0× |
| MRA head w/o contrast (70544) | $5,677 | $5,677 | 18.0× |
| MRA head with contrast (70545) | $6,062 | $6,062 | 13.2× |
| MRA neck w contrast (70548) | $5,630 | $5,630 | 12.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $8,310 | $8,310 | 18.1× |
| MRA neck w/o contrast (70547) | $5,146 | $5,146 | 16.4× |
| MRI abdomen w contrast (74182) | $5,071 | $5,071 | 11.0× |
| MRI abdomen w/o contrast (74181) | $5,217 | $5,217 | 16.6× |
| 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 Breast W/O Contrast Bilateral (77047) | $4,205 | $4,205 | 13.4× |
| MRI Breast Without Contrast Material Unilateral (77046) | $3,889 | $3,889 | 12.4× |
| MRI cervical spine w contrast (72142) | $6,480 | $6,480 | 14.1× |
| MRI cervical spine w/o cont (72141) | $5,265 | $5,265 | 16.7× |
| MRI chest w/o contrast (71550) | $4,321 | $4,321 | 13.7× |
| MRI chest with contrast (71551) | $5,928 | $5,928 | 5.7× |
| MRI chest wo w contrast (71552) | $7,584 | $7,584 | 16.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 3 matching MRF lines |
$6,357–$9,536 | $6,357–$9,536 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$6,304–$9,456 | $6,304–$9,456 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 3 matching MRF lines |
$4,234–$6,351 | $4,234–$6,351 | varies |
| MRI lumbar spine w contrast (72149) | $8,076 | $8,076 | 17.6× |
| Mri Neck Spine W/O & W/Dye (72156) | $8,560 | $8,560 | 18.6× |
| MRI orbit face &/neck w/o contrast (70540) | $4,099 | $4,099 | 13.0× |
| MRI orbit face neck w contrast (70542) | $7,764 | $7,764 | 16.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $7,526 | $7,526 | 16.4× |
| MRI pelvis w contrast (72196) | $5,220 | $5,220 | 11.3× |
| MRI pelvis w/o & w contrast (72197) | $8,535 | $8,535 | 18.5× |
| MRI pelvis w/o contrast (72195) | $5,735 | $5,735 | 18.2× |
| MRI thoracic spine w/o contrast (72146) | $5,458 | $5,458 | 17.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$3,411–$3,692 | $3,411–$3,692 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$4,196–$6,294 | $4,196–$6,294 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$6,467–$9,700 | $6,467–$9,700 | varies |
| MRI, abdomen, combo (74183) | $7,262 | $7,262 | 15.8× |
| MRI, dorsal spine combo (72157) | $8,406 | $8,406 | 18.3× |
| MRI, dorsal spine contrast (72147) | $6,508 | $6,508 | 14.1× |
| 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 | 18.3× |
| Myelogram cervical (72240) | $2,533 | $2,533 | 2.4× |
| Myelogram Lumbar (72265) | $3,873 | $3,873 | 3.7× |
| Myelography thoracic (72255) | $2,896 | $2,896 | 2.8× |
| Myocardial Spect Multiple Studies (78452) | $9,698 | $9,698 | 5.7× |
| Neck soft tissue (70360) | $701 | $701 | 6.1× |
| Nm myocard infarct spect (78469) | $4,516 | $4,516 | 6.3× |
| Nuclear Rx Oral Admin (79005) | $2,156 | $2,156 | 7.0× |
| Parathyroid Planar Imaging (78070) | $2,414 | $2,414 | 4.6× |
| Pelvis 1 or 2 views (72170) | $770 | $770 | 5.6× |
| Pet Image Skull-Thigh (78812) | $10,614 | $10,614 | 5.6× |
| Pet Image W/Ct Lmtd (78814) | $9,293 | $9,293 | 4.9× |
| PET image w/CT, full body (78816) | $10,113 | $10,113 | 5.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $10,163 | $10,163 | 5.4× |
| PET whole body (78813) | $12,177 | $12,177 | 6.5× |
| Pulmonary Perfusion Imaging Particulate (78580) | $3,027 | $3,027 | 5.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,179 | $1,179 | 8.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,821 | $1,821 | 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) | $862 | $862 | 6.3× |
| 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 |
$609–$914 | $609–$914 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $961 | $961 | 7.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $818 | $818 | 7.1× |
| Radex Ribs Unilateral 2 Views (71100) | $756 | $756 | 6.6× |
| 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) | $571 | $571 | 5.0× |
| Radex Spine 1 View Specify Level (72020) | $729 | $729 | 6.4× |
| Radex Sternum Minimum 2 Views (71120) | $685 | $685 | 6.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $663 | $663 | 5.8× |
| 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 |
$611–$916 | $611–$916 | 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) | $1,171 | $1,171 | 8.5× |
| Radiolog exam mandible compl minimum 4 views (70110) | $883 | $883 | 6.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $879 | $879 | 6.4× |
| Radiologic exam colon double contrast study (74280) | $1,887 | $1,887 | 8.2× |
| Radiologic exam colon single contrast study (74270) | $1,535 | $1,535 | 6.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $1,154 | $1,154 | 5.0× |
| 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 | 6.5× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,642 | $1,642 | 7.1× |
| Radiologic exam swallow function contrast study (74230) | $1,480 | $1,480 | 6.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $1,547 | $1,547 | 6.7× |
| 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 Osseous Survey Limited (77074) | $818 | $818 | 5.9× |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$763–$1,144 | $763–$1,144 | varies |
| Ribs bilateral 3 views (71110) | $987 | $987 | 7.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $2,406 | $2,406 | 4.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $2,558 | $2,558 | 4.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $5,274 | $5,274 | 7.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $5,699 | $5,699 | 8.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $4,754 | $4,754 | 6.6× |
| Scapula (73010) range across 3 matching MRF lines |
$793–$1,190 | $793–$1,190 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $171 | $171 | 7.3× |
| Sella turcica (70240) | $768 | $768 | 6.7× |
| 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 |
$1,731–$2,596 | $1,731–$2,596 | varies |
| Sialogram (70390) | $2,780 | $2,780 | 8.8× |
| Skull less than 4 views (70250) | $911 | $911 | 6.6× |
| Speech evaluation, complex (70371) | $1,819 | $1,819 | 5.8× |
| Sternoclavicular joints (71130) | $554 | $554 | 4.8× |
| Thoracic spine 2 views (72070) | $932 | $932 | 6.8× |
| Thoracic spine 3 views (72072) | $980 | $980 | 7.1× |
| Thoracolumbar 2 views (72080) | $805 | $805 | 7.0× |
| Thyroid Met Imaging Body (78018) | $5,158 | $5,158 | 7.2× |
| Thyroid Uptake Measurement (78012) | $1,785 | $1,785 | 3.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,185 | $2,185 | 4.1× |
| Ultrasound Breast Limited (76642) range across 3 matching MRF lines |
$865–$1,298 | $865–$1,298 | varies |
| Ultrasound Elastography Parenchyma (76981) | $771 | $771 | 5.6× |
| Ultrasound Exam Aaa Screen (76706) | $961 | $961 | 7.0× |
| Ultrasound, abdomen limited (76705) | $1,656 | $1,656 | 12.0× |
| Upper gi w/o kub (74240) | $1,561 | $1,561 | 6.7× |
| Urethrocystogram voiding (74455) | $1,537 | $1,537 | 4.9× |
| Urethrocystography retrograde (74450) | $1,800 | $1,800 | 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) | $1,296 | $1,296 | 9.4× |
| Us complete joint (76881) | $1,224 | $1,224 | 8.9× |
| Us exam, pelvic, limited (76857) | $944 | $944 | 6.8× |
| Us head (76506) | $1,684 | $1,684 | 12.2× |
| Us kidney transplant (76776) | $1,868 | $1,868 | 13.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $798 | $798 | 5.8× |
| Us ob detailed single fetus (76811) | $1,568 | $1,568 | 5.0× |
| Us ob limited 1 or more fetuses (76815) | $1,194 | $1,194 | 8.7× |
| Us ob transvaginal (76817) | $1,457 | $1,457 | 10.6× |
| Us pelvic non ob complete (76856) | $1,596 | $1,596 | 11.6× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,625 | $1,625 | 11.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $894 | $894 | 6.5× |
| Us retroperitoneal complete (76770) | $1,568 | $1,568 | 11.4× |
| Us retroperitoneal limited (76775) | $1,253 | $1,253 | 9.1× |
| Us scrotum and contents (76870) | $1,448 | $1,448 | 10.5× |
| Us spinal canal and contents (76800) | $1,545 | $1,545 | 11.2× |
| Us thyroid (76536) | $1,368 | $1,368 | 9.9× |
| Venography extremity bilateral rs&i (75822) | $4,678 | $4,678 | 2.3× |
| Venography extremity unilateral rs&i (75820) | $3,678 | $3,678 | 1.8× |
| 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) | $691 | $691 | 6.0× |
| X-Ray Bend Only L-S Spine (72120) | $836 | $836 | 6.1× |
| 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) | $1,207 | $1,207 | 1.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $541 | $541 | 4.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $772 | $772 | 5.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $915 | $915 | 6.6× |
| X-Ray Exam Hip Uni 1 View (73501) | $685 | $685 | 6.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $768 | $768 | 6.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $1,048 | $1,048 | 7.6× |
| X-Ray Exam Hips Bi 2 Views (73521) | $904 | $904 | 6.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,070 | $1,070 | 7.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,224 | $1,224 | 8.9× |
| X-Ray Exam L-S Spine Bending (72114) | $1,169 | $1,169 | 8.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $864 | $864 | 7.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,308 | $1,308 | 9.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,011 | $1,011 | 7.3× |
| X-ray eye for foreign body (70030) | $574 | $574 | 5.0× |
| X-ray humerus (73060) | $866 | $866 | 7.5× |
| X-ray IV pyelogram (ivp) (74400) | $1,164 | $1,164 | 5.0× |
| X-ray IV pyelogram+tomography (74415) | $2,857 | $2,857 | 12.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $552 | $552 | 4.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $622 | $622 | 5.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $966 | $966 | 7.0× |
| X-ray nose-rectum child f.b. (76010) | $474 | $474 | 4.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,202 | $1,202 | 8.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $769 | $769 | 5.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $538 | $538 | 3.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $874 | $874 | 7.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $696 | $696 | 6.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,008 | $1,008 | 7.3× |
| X-Ray Stress View (77071) | $693 | $693 | 6.0× |
| X-ray thoracic spine 4 vw (72074) | $858 | $858 | 6.2× |
| X-Ray Tmj Unilat (70328) | $398 | $398 | 3.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $2,561 | $2,561 | 5.6× |
| X-Rays Bone Length Studies (77073) | $793 | $793 | 5.8× |
| X-Rays Bone Survey Complete (77075) | $1,432 | $1,432 | 10.4× |
| Xr c-spine 4 or 5 views (72050) | $1,175 | $1,175 | 8.5× |
| Xr facial bones less than 3 views (70140) | $720 | $720 | 6.3× |
| Xr orbits complete 4 views (70200) | $713 | $713 | 5.2× |
| Xr Tomogram Single Plane (76100) | $2,217 | $2,217 | 16.1× |
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.