Imaging prices at T.J. Samson Community Hospital
Glasgow, KY · every code in this section with a posted price and a Medicare benchmark.
287 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 2 matching MRF lines |
$14.30–$146.25 | $22–$225 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$18.20–$200.20 | $28–$308 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$75.40–$1,043.25 | $116–$1,605 | varies |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$3,355.30 | $240–$5,162 | 1.1× |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$3,625.05 | $215–$5,577 | 1.2× |
| Ankle 2 views (73600) range across 4 matching MRF lines |
$13–$239.20 | $20–$368 | varies |
| Aortography thoracic serialography rs&i (75605) | $5,913.05 | $9,097 | 1.1× |
| Artery X-Rays Abdomen (75726) | $5,913.05 | $9,097 | 1.1× |
| Arthrogram ankle (73615) range across 4 matching MRF lines |
$41.60–$763.10 | $64–$1,174 | varies |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$44.20–$510.90 | $68–$786 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$14.95–$117 | $23–$180 | varies |
| Bone Imaging 3 Phase (78315) range across 3 matching MRF lines |
$77.35–$1,170 | $119–$1,800 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$48.10–$780 | $74–$1,200 | varies |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$63.05–$665.93 | $97–$1,024.50 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$65–$955.50 | $100–$1,470 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$53.95–$460.20 | $83–$708 | varies |
| Brain Flow Imaging Only (78610) range across 2 matching MRF lines |
$577.20 | $34–$888 | 1.1× |
| Brain Imaging Minimum 4 Static Views (78605) range across 2 matching MRF lines |
$40.95–$577.20 | $63–$888 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,985.13 | $4,592.50 | 2.2× |
| Cat Scan Follow-Up Study (76380) | $74.10 | $114 | 0.9× |
| Chest 1 view (71045) range across 2 matching MRF lines |
$14.30–$115.70 | $22–$178 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$16.90–$167.70 | $26–$258 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$21.45–$195 | $33–$300 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$24.70–$247 | $38–$380 | varies |
| Clavicle complete (73000) range across 4 matching MRF lines |
$13–$234 | $20–$360 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$83.20–$115.70 | $128–$178 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$3,355.30 | $173–$5,162 | 1.1× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$26–$393.25 | $40–$605 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$45.50–$499.85 | $70–$769 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$46.80–$499.85 | $72–$769 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) range across 2 matching MRF lines |
$46.15–$252.20 | $71–$388 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$154.05–$3,445.65 | $237–$5,301 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$134.55–$2,559.05 | $207–$3,937 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$97.50–$1,279.53 | $150–$1,968.50 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$107.25–$1,657.50 | $165–$2,550 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$91–$1,279.53 | $140–$1,968.50 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$167.70–$2,559.05 | $258–$3,937 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$139.75–$1,279.85 | $215–$1,969 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$146.25–$1,225.90 | $225–$1,886 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$144.30–$1,816.10 | $222–$2,794 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$146.25–$1,114.75 | $225–$1,715 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$137.80–$367.90 | $212–$566 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$93.60–$1,086.15 | $144–$1,671 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$77.35–$1,069.90 | $119–$1,646 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$96.85–$1,102.40 | $149–$1,696 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$89.70–$1,279.85 | $138–$1,969 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$95.55–$1,657.50 | $147–$2,550 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$94.25–$1,086.15 | $145–$1,671 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$102.05–$1,749.15 | $157–$2,691 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$45.50–$92.95 | $70–$143 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$87.10–$1,086.15 | $134–$1,671 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$96.85–$1,549.60 | $149–$2,384 | varies |
| CT lower ext w/o (73700) range across 4 matching MRF lines |
$77.35–$1,816.10 | $119–$2,794 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$89.05–$1,816.10 | $137–$2,794 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$93.60–$1,676.35 | $144–$2,579 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$77.35–$1,077.70 | $119–$1,658 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$86.45–$1,133.60 | $133–$1,744 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$65.65–$1,023.75 | $101–$1,575 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$124.80–$1,639.30 | $192–$2,522 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$96.85–$1,549.60 | $149–$2,384 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$98.15–$826.15 | $151–$1,271 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$93.60–$1,825.20 | $144–$2,808 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$83.85–$993.20 | $129–$1,528 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$92.95–$1,259.70 | $143–$1,938 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$97.50–$1,437.15 | $150–$2,211 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$105.30–$1,188.20 | $162–$1,828 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$98.15–$868.40 | $151–$1,336 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$93.60–$252.20 | $144–$388 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$77.35–$980.85 | $119–$1,509 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$96.85–$495.30 | $149–$762 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$83.20–$1,073.15 | $128–$1,651 | varies |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$77.35–$1,639.30 | $119–$2,522 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$93.60–$189.80 | $144–$292 | varies |
| CT upper extremity with contrast (73201) range across 4 matching MRF lines |
$89.05–$1,587.30 | $137–$2,442 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$182.65–$1,069.90 | $281–$1,646 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$139.10–$1,279.85 | $214–$1,969 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$138.45–$1,038.70 | $213–$1,598 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$15.60–$117 | $24–$180 | varies |
| Dxa bone density study (77085) range across 2 matching MRF lines |
$23.40–$139.10 | $36–$214 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$16.25–$92.95 | $25–$143 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$46.80–$252.20 | $72–$388 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$87.10–$129.35 | $134–$199 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$63.05–$138.45 | $97–$213 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$26–$533.65 | $40–$821 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$12.35–$250.90 | $19–$386 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$13–$304.20 | $20–$468 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$60.45–$793.65 | $93–$1,221 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) range across 2 matching MRF lines |
$74.10–$425.10 | $114–$654 | varies |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$77.35–$1,564.55 | $119–$2,407 | varies |
| Hand 2 views (73120) range across 4 matching MRF lines |
$13–$304.20 | $20–$468 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$68.25–$1,014.33 | $105–$1,560.50 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$56.55–$538.20 | $87–$828 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$110.50–$1,408.55 | $170–$2,167 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$29.90–$358.80 | $46–$552 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$57.20–$436.80 | $88–$672 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$47.45–$92.95 | $73–$143 | varies |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$105.30–$577.20 | $162–$888 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$91–$577.20 | $140–$888 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$72.15–$839.80 | $111–$1,292 | varies |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$14.95–$304.20 | $23–$468 | varies |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) range across 2 matching MRF lines |
$38.35–$425.10 | $59–$654 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$37.70–$793.65 | $58–$1,221 | varies |
| Liver imaging static only (78201) range across 2 matching MRF lines |
$33.15–$577.20 | $51–$888 | varies |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$63.70–$577.20 | $98–$888 | varies |
| Lung perfusion differential (78597) range across 2 matching MRF lines |
$55.25–$438.75 | $85–$675 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$80.60–$1,020.18 | $124–$1,569.50 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$37.05–$438.75 | $57–$675 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$89.70–$1,010.10 | $138–$1,554 | varies |
| Magnetic Image Jaw Joint (70336) | $113.75 | $175 | 0.5× |
| Mammary ductogram or galactogram multiple (77054) | $34.45 | $53 | 0.2× |
| Mammary ductogram or galactogram single (77053) | $27.95 | $43 | 0.1× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$52–$425.10 | $80–$654 | varies |
| Mr safety determination physician/other qhp (76016) range across 2 matching MRF lines |
$42.90–$92.95 | $66–$143 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $31.20 | $48 | 1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) range across 2 matching MRF lines |
$53.95–$101.40 | $83–$156 | varies |
| Mr safety implt pos&/immoblj (76019) range across 2 matching MRF lines |
$42.25–$63.05 | $65–$97 | varies |
| Mr safety med physics xm customization plng&mntr (76017) range across 2 matching MRF lines |
$54.60–$254.15 | $84–$391 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$118.95–$2,738.78 | $183–$4,213.50 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$97.50–$1,532.70 | $150–$2,358 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$97.50–$1,533.03 | $150–$2,358.50 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$123.50–$1,533.35 | $190–$2,359 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$146.25–$2,739.10 | $225–$4,214 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$97.50–$1,314.95 | $150–$2,023 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$133.25–$1,795.95 | $205–$2,763 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$111.80–$1,652.30 | $172–$2,542 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$126.10–$3,484 | $194–$5,360 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 4 matching MRF lines |
$165.10–$4,134 | $254–$6,360 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$126.10–$3,484 | $194–$5,360 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$143.65–$1,652.30 | $221–$2,542 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$120.25–$1,621.75 | $185–$2,495 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$111.80–$1,417.33 | $172–$2,180.50 | varies |
| MRI chest with contrast (71551) | $133.25 | $205 | 0.2× |
| MRI chest wo w contrast (71552) | $172.90 | $266 | 0.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 4 matching MRF lines |
$125.45–$3,484 | $193–$5,360 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 4 matching MRF lines |
$165.10–$4,134 | $254–$6,360 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$103.35–$2,834 | $159–$4,360 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$143.65–$1,652.30 | $221–$2,542 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$185.25–$3,377.40 | $285–$5,196 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$102.70–$1,314.95 | $158–$2,023 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$125.45–$1,533.35 | $193–$2,359 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$172.25–$2,739.10 | $265–$4,214 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$133.90–$1,652.30 | $206–$2,542 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$168.35–$2,952.30 | $259–$4,542 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$111.80–$1,621.75 | $172–$2,495 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$120.25–$1,652.30 | $185–$2,542 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 4 matching MRF lines |
$125.45–$3,484 | $193–$5,360 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 4 matching MRF lines |
$104–$2,834 | $160–$4,360 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$165.10–$4,134 | $254–$6,360 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$168.35–$1,950 | $259–$3,000 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$185.25–$1,885 | $285–$2,900 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$143.65–$1,755.65 | $221–$2,701 | varies |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$104.65–$3,243.50 | $161–$4,990 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$165.75–$4,134 | $255–$6,360 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$185.25–$3,377.40 | $285–$5,196 | varies |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $117.65 | $181 | 0.1× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$130–$2,405 | $200–$3,700 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$14.30–$152.10 | $22–$234 | varies |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$39–$117 | $60–$180 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$135.20–$668.85 | $208–$1,029 | varies |
| Panoramic X-ray of jaws (70355) range across 2 matching MRF lines |
$16.25–$92.95 | $25–$143 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$118.30–$577.20 | $182–$888 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$61.10–$594.75 | $94–$915 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$90.35–$581.10 | $139–$894 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$13.65–$152.10 | $21–$234 | varies |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$163.15–$3,770 | $251–$5,800 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$184.60–$3,770 | $284–$5,800 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$183.30–$3,770 | $282–$5,800 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$56.55–$705.25 | $87–$1,085 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$24.70–$358.80 | $38–$552 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$40.95–$581.10 | $63–$894 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 4 matching MRF lines |
$13.65–$304.20 | $21–$468 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$13–$234 | $20–$360 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$13.65–$304.20 | $21–$468 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$20.15–$188.50 | $31–$290 | varies |
| Radex fingr minimum 2 views (73140) range across 4 matching MRF lines |
$11.05–$304.20 | $17–$468 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$13.65–$304.20 | $21–$468 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$13.65–$304.20 | $21–$468 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$13–$373.10 | $20–$574 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$26.65–$53.30 | $41–$82 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$13.65–$92.95 | $21–$143 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$17.55–$169 | $27–$260 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$14.95–$304.20 | $23–$468 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$13.65–$135.85 | $21–$209 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$89.70–$317.20 | $138–$488 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$15.60–$117 | $24–$180 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$18.85–$179.40 | $29–$276 | varies |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$10.40–$247 | $16–$380 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 4 matching MRF lines |
$13–$373.10 | $20–$574 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$13.65–$304.20 | $21–$468 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$19.50–$135.85 | $30–$209 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$20.80–$254.15 | $32–$391 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$96.20–$486.85 | $148–$749 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$79.95–$372.45 | $123–$573 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$53.95–$189.80 | $83–$292 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$17.55–$353.60 | $27–$544 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$20.15–$228.15 | $31–$351 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$62.40–$279.50 | $96–$430 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$41.60–$373.75 | $64–$575 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$68.90–$384.80 | $106–$592 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$14.30–$304.20 | $22–$468 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$13–$244.40 | $20–$376 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$33.80–$494 | $52–$760 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$13–$304.20 | $20–$468 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$22.75–$191.75 | $35–$295 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$75.40–$1,408.55 | $116–$2,167 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$60.45–$1,408.55 | $93–$2,167 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$80.60–$1,408.55 | $124–$2,167 | varies |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) | $134.55 | $207 | 0.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 2 matching MRF lines |
$157.95–$1,573 | $243–$2,420 | varies |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) range across 2 matching MRF lines |
$110.50–$1,408.55 | $170–$2,167 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$150.80–$269.10 | $232–$414 | varies |
| Scapula (73010) range across 4 matching MRF lines |
$14.30–$234 | $22–$360 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 3 matching MRF lines |
$24.70–$48.75 | $38–$75 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$43.55–$499.85 | $67–$769 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$14.30–$135.85 | $22–$209 | varies |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$16.90–$123.50 | $26–$190 | varies |
| Testicular Imaging W/Flow (78761) | $425.10 | $654 | 1.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$160.55–$770.25 | $247–$1,185 | varies |
| Thoracic spine 2 views (72070) | $16.25 | $25 | 0.2× |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$17.55–$234.65 | $27–$361 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$16.90–$92.95 | $26–$143 | varies |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$27.95–$425.10 | $43–$654 | varies |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$64.35–$910.65 | $99–$1,401 | varies |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$425.10 | $22–$654 | 1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$37.70–$455.65 | $58–$701 | varies |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$53.30–$375.70 | $82–$578 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 2 matching MRF lines |
$43.55–$111.15 | $67–$171 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$43.55–$117 | $67–$180 | varies |
| Ultrasound, abdomen limited (76705) range across 4 matching MRF lines |
$46.15–$594.10 | $71–$914 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$39–$144.95 | $60–$223 | varies |
| Unlisted us procedure (76999) | $103.35 | $159 | 1.3× |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$61.75–$363.35 | $95–$559 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$24.70–$331.50 | $38–$510 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$26.65–$254.15 | $41–$391 | varies |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$56.55–$600.60 | $87–$924 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$44.85–$144.95 | $69–$223 | varies |
| Us complete joint (76881) range across 4 matching MRF lines |
$65–$190.45 | $100–$293 | varies |
| Us exam, pelvic, limited (76857) range across 4 matching MRF lines |
$37.70–$386.75 | $58–$595 | varies |
| Us head (76506) range across 2 matching MRF lines |
$49.40–$336.38 | $76–$517.50 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$49.40–$117 | $76–$180 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$156.65–$361.40 | $241–$556 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$53.30–$315.90 | $82–$486 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$61.10–$182.65 | $94–$281 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$55.90–$510.25 | $86–$785 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$81.25–$159.25 | $125–$245 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$70.85–$188.50 | $109–$290 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$57.20–$612.95 | $88–$943 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$45.50–$610.35 | $70–$939 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$50.05–$363.35 | $77–$559 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$92.30–$336.38 | $142–$517.50 | varies |
| Us thyroid (76536) range across 4 matching MRF lines |
$44.20–$409.50 | $68–$630 | varies |
| Us transrectal (76872) | $55.25 | $85 | 0.6× |
| Vascular Flow Imaging (78445) range across 2 matching MRF lines |
$39.65–$425.10 | $61–$654 | varies |
| Venography caval inferior serialography rs&i (75825) | $3,355.30 | $5,162 | 1.1× |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$1,673.10 | $120–$2,574 | 1.1× |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$13.65–$92.95 | $21–$143 | varies |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$13–$224.90 | $20–$346 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$14.95–$131.30 | $23–$202 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$39–$419.90 | $60–$646 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$3,355.30 | $245–$5,162 | 1.1× |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$17.55–$243.75 | $27–$375 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$13–$278.20 | $20–$428 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$581.10 | $38–$894 | 1.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$24.05–$332.80 | $37–$512 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$14.95–$108.55 | $23–$167 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$17.55–$209.95 | $27–$323 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$17.55–$420.55 | $27–$647 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$23.40–$345.15 | $36–$531 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$17.55–$171.60 | $27–$264 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$23.40–$458.25 | $36–$705 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$20.80–$202.15 | $32–$311 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$13–$152.10 | $20–$234 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$37.70–$293.80 | $58–$452 | varies |
| X-ray IV pyelogram+tomography (74415) | $523.90 | $806 | 3.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$17.55–$194.35 | $27–$299 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$14.30–$123.50 | $22–$190 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$24.70–$299.65 | $38–$461 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$13.65–$187.20 | $21–$288 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$13.65–$152.10 | $21–$234 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$16.90–$187.20 | $26–$288 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$22.10–$241.80 | $34–$372 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$42.25–$455 | $65–$700 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$21.45–$117 | $33–$180 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$43.55–$460.20 | $67–$708 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$21.45–$378.95 | $33–$583 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$14.30–$28.60 | $22–$44 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$26–$123.50 | $40–$190 | 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.