Imaging prices at Tippah County Hospital
Ripley, MS · every code in this section with a posted price and a Medicare benchmark.
277 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 |
$24–$200.73 | $24–$200.73 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$30–$211.37 | $30–$211.37 | varies |
| Angio internal mammary (75756) | $411 | $411 | 0.2× |
| Angio pulmonary bilat (75743) | $428 | $428 | 0.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $458 | $458 | 0.2× |
| Angiography extremity bilateral rs&i (75716) | $471 | $471 | 0.2× |
| Angiography extremity unilateral rs&i (75710) | $395 | $395 | 0.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $368 | $368 | 0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $380 | $380 | 0.1× |
| Ankle 2 views (73600) | $65 | $65 | 0.9× |
| Aortography thoracic serialography rs&i (75605) | $344 | $344 | 0.1× |
| Aortography thoracic w/o serialography rs&i (75600) | $464 | $464 | 0.2× |
| Artery X-Rays Abdomen (75726) | $369 | $369 | 0.1× |
| Artery X-Rays Adrenal Gland (75731) | $409 | $409 | 0.2× |
| Artery X-Rays Pelvis (75736) | $389 | $389 | 0.1× |
| Artery X-Rays Spine (75705) | $565 | $565 | 0.1× |
| Arthrogram ankle (73615) | $233 | $233 | 0.8× |
| Arthrogram hip (73525) | $255 | $255 | 0.8× |
| Arthrogram Wrist (73115) | $251 | $251 | 0.8× |
| Bone age studies (77072) range across 2 matching MRF lines |
$24–$200.73 | $24–$200.73 | varies |
| Bone survey infant (77076) | $267 | $267 | 3.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $975 | $975 | 3.2× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,149 | $1,149 | 1.7× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$24–$211.37 | $24–$211.37 | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$29–$247.23 | $29–$247.23 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$35–$211.05 | $35–$211.05 | varies |
| Cholecystography Oral Contrast (74290) | $158 | $158 | 1.0× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $208 | $208 | 2.3× |
| Cisternography Positive Contrast Rs&I (70015) | $348 | $348 | 0.5× |
| Clavicle complete (73000) range across 5 matching MRF lines |
$21–$200.73 | $21–$200.73 | varies |
| Contrast Exam Abdominl Aorta (75625) | $343 | $343 | 0.1× |
| Contrast X-Ray Bladder (74430) | $94 | $94 | 0.3× |
| Contrast X-Ray Of Elbow (73085) | $231 | $231 | 0.8× |
| Contrast X-Ray Of Knee Joint (73580) | $285 | $285 | 0.9× |
| Contrast Xray Throat/Cerv Esopha (74210) | $178 | $178 | 1.2× |
| Corpora cavernosography (74445) | $138 | $138 | 1.5× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$257–$4,174 | $257–$4,174 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$221–$3,853 | $221–$3,853 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$146–$1,761.38 | $146–$1,761.38 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$160–$2,113.65 | $160–$2,113.65 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$136–$1,694 | $136–$1,694 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$623–$916 | $623–$916 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$164–$1,864 | $164–$1,864 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$240–$1,864 | $240–$1,864 | varies |
| CT angio hrt w/3d image (75574) | $944 | $944 | 3.1× |
| CT Angio Neck (70498) range across 4 matching MRF lines |
$233–$1,864 | $233–$1,864 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$161–$1,761.38 | $161–$1,761.38 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$128–$1,690.92 | $128–$1,690.92 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$171–$2,113.65 | $171–$2,113.65 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$142–$1,761.38 | $142–$1,761.38 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$158–$2,113.65 | $158–$2,113.65 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,181 | $1,181 | 7.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $1,077 | $1,077 | 11.9× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$149–$1,761.38 | $149–$1,761.38 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$146–$1,823 | $146–$1,823 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $648 | $648 | 2.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $237 | $237 | 3.2× |
| CT hrt w/3d image congen (75573) | $892 | $892 | 3.0× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$182–$1,409.10 | $182–$1,409.10 | varies |
| CT lower ext w/o (73700) range across 5 matching MRF lines |
$120–$1,500 | $120–$1,500 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$156–$1,317 | $156–$1,317 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$125–$1,761.38 | $125–$1,761.38 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$141–$1,600 | $141–$1,600 | varies |
| CT maxillofacial wo contrast (70486) range across 4 matching MRF lines |
$117–$1,573 | $117–$1,573 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$170–$1,127.28 | $170–$1,127.28 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$161–$2,113.65 | $161–$2,113.65 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$124–$1,694 | $124–$1,694 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$158–$1,721 | $158–$1,721 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$148–$1,381 | $148–$1,381 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$125–$1,761.38 | $125–$1,761.38 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$133–$1,694 | $133–$1,694 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$121–$1,217 | $121–$1,217 | varies |
| CT upper extremity with contrast (73201) range across 4 matching MRF lines |
$156–$1,317 | $156–$1,317 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 4 matching MRF lines |
$267–$1,864 | $267–$1,864 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$248–$1,864 | $248–$1,864 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$250–$1,026 | $250–$1,026 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $37 | $37 | 0.2× |
| Dilation ureters/urethra rs&i (74485) | $218 | $218 | 0.1× |
| Diskography lumbar (72295) | $228 | $228 | 0.1× |
| Dxa Bone Density Axial (77080) range across 3 matching MRF lines |
$140.91–$247.23 | $140.91–$247.23 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $209.51 | $209.51 | 2.8× |
| Esophagram (74220) range across 3 matching MRF lines |
$208–$211.37 | $208–$211.37 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$102–$204.96 | $102–$204.96 | varies |
| Fluoroscopy up to 1 hr (76000) | $113 | $113 | 0.5× |
| Follow-Up Angiography (75898) | $203 | $203 | 0.1× |
| Foot 2 views (73620) | $62 | $62 | 0.8× |
| Forearm 2 views (73090) range across 5 matching MRF lines |
$21–$200.73 | $21–$200.73 | varies |
| Hand 2 views (73120) range across 5 matching MRF lines |
$21–$200.73 | $21–$200.73 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $352 | $352 | 0.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $354 | $354 | 0.1× |
| Hysterosalpingogram (74740) | $175 | $175 | 0.9× |
| Infusion Ivp (74410) | $251 | $251 | 1.7× |
| Knee 3 Views (73562) range across 9 matching MRF lines |
$23–$211.37 | $23–$211.37 | varies |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) | $144 | $144 | 0.1× |
| Lymphangiography extremity only unilateral rs&i (75801) | $105 | $105 | 0.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $144 | $144 | 0.1× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $100 | $100 | 0.0× |
| Magnetic Image Jaw Joint (70336) range across 5 matching MRF lines |
$195–$5,000 | $195–$5,000 | varies |
| Mammary ductogram or galactogram multiple (77054) | $181 | $181 | 0.9× |
| Mammary ductogram or galactogram single (77053) | $134 | $134 | 0.7× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$237–$4,600 | $237–$4,600 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$137–$2,800 | $137–$2,800 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$162–$3,600 | $162–$3,600 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$162–$3,600 | $162–$3,600 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$237–$4,600 | $237–$4,600 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$138–$2,800 | $138–$2,800 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$224–$3,600 | $224–$3,600 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$180–$2,800 | $180–$2,800 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$185–$7,500 | $185–$7,500 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 16 matching MRF lines |
$312–$9,000 | $312–$9,000 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$184–$7,600 | $184–$7,600 | varies |
| MRI cardiac w/o cont stress (75559) | $1,004 | $1,004 | 2.1× |
| MRI cardiac w/o contrast (75557) | $744 | $744 | 3.6× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$254–$3,600 | $254–$3,600 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$178–$2,800 | $178–$2,800 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$207–$2,800 | $207–$2,800 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$224–$3,600 | $224–$3,600 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$291–$4,600 | $291–$4,600 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 4 matching MRF lines |
$209–$7,600 | $209–$7,600 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 18 matching MRF lines |
$243–$9,000 | $243–$9,000 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 18 matching MRF lines |
$153–$5,800 | $153–$5,800 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$237–$3,200 | $237–$3,200 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$360–$4,600 | $360–$4,600 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$185–$2,800 | $185–$2,800 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$209–$3,600 | $209–$3,600 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$243–$4,600 | $243–$4,600 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$228–$3,600 | $228–$3,600 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$253–$4,600 | $253–$4,600 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$166–$2,800 | $166–$2,800 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$178–$2,800 | $178–$2,800 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 4 matching MRF lines |
$158–$7,000 | $158–$7,000 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 18 matching MRF lines |
$153–$5,800 | $153–$5,800 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 18 matching MRF lines |
$244–$8,000 | $244–$8,000 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$253–$4,600 | $253–$4,600 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$257–$4,600 | $257–$4,600 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$252–$3,600 | $252–$3,600 | varies |
| MRI, joint upper extrem (73221) range across 18 matching MRF lines |
$156–$5,600 | $156–$5,600 | varies |
| MRI, joint upper extrem combo (73223) range across 16 matching MRF lines |
$311–$8,000 | $311–$8,000 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$343–$4,600 | $343–$4,600 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$259.04–$3,595.80 | $259.04–$3,595.80 | varies |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$21–$200.73 | $21–$200.73 | varies |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$231–$267 | $231–$267 | varies |
| Optic foramina (70190) | $83 | $83 | 1.1× |
| Panoramic X-ray of jaws (70355) | $48 | $48 | 0.6× |
| Pelvis 1 or 2 views (72170) range across 4 matching MRF lines |
$21–$200.73 | $21–$200.73 | varies |
| Perineogram (74775) | $76 | $76 | 0.4× |
| Peritoneogram Rs&I (74190) | $58 | $58 | 0.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $386 | $386 | 0.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 4 matching MRF lines |
$42–$394.55 | $42–$394.55 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $139 | $139 | 0.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 11 matching MRF lines |
$21–$200.73 | $21–$200.73 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 5 matching MRF lines |
$21–$200.73 | $21–$200.73 | varies |
| Radex elbow complete minimum 3 views (73080) range across 5 matching MRF lines |
$21–$211.05 | $21–$211.05 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 7 matching MRF lines |
$35–$318.42 | $35–$318.42 | varies |
| Radex fingr minimum 2 views (73140) range across 21 matching MRF lines |
$17–$209.51 | $17–$209.51 | varies |
| Radex foot complete minimum 3 views (73630) range across 5 matching MRF lines |
$21–$211.05 | $21–$211.05 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$21–$211.05 | $21–$211.05 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $64 | $64 | 0.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $132 | $132 | 1.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$21–$211.05 | $21–$211.05 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $181 | $181 | 2.4× |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$24–$200.73 | $24–$200.73 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $70 | $70 | 0.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $924 | $924 | 6.1× |
| Radex Spine 1 View Specify Level (72020) | $53 | $53 | 0.7× |
| Radex Sternum Minimum 2 Views (71120) | $247.23 | $247.23 | 3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $111 | $111 | 1.5× |
| Radex Toe Minimum 2 Views (73660) range across 21 matching MRF lines |
$17–$200.73 | $17–$200.73 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$64–$159 | $64–$159 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 5 matching MRF lines |
$21–$211.05 | $21–$211.05 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$35–$318.15 | $35–$318.15 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$422.73–$499 | $422.73–$499 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$352.28–$357 | $352.28–$357 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$98–$159 | $98–$159 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $97 | $97 | 1.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$245–$352.28 | $245–$352.28 | varies |
| Radiologic exam swallow function contrast study (74230) | $209 | $209 | 1.4× |
| Radiologic exam teeth complete full mouth (70320) | $119 | $119 | 0.6× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) | $86 | $86 | 0.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $293 | $293 | 1.9× |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$21–$200.73 | $21–$200.73 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$70–$159 | $70–$159 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $318.12 | $318.12 | 3.5× |
| Radiologic Examination Salivary Gland Calculus (70380) | $86 | $86 | 1.1× |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$21–$200.73 | $21–$200.73 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $126 | $126 | 0.3× |
| Radiologic examination, teeth; single view Non-Facility (70300) | $34 | $34 | 0.5× |
| Renal Cyst Study (74470) | $65 | $65 | 0.1× |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$36–$318.15 | $36–$318.15 | varies |
| Scapula (73010) range across 5 matching MRF lines |
$21–$200.73 | $21–$200.73 | varies |
| Sella turcica (70240) | $70 | $70 | 0.9× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$54–$159 | $54–$159 | varies |
| Shoulder Arthrography (73040) | $238 | $238 | 0.8× |
| Sialogram (70390) | $227 | $227 | 1.1× |
| Skull less than 4 views (70250) range across 4 matching MRF lines |
$33–$204.75 | $33–$204.75 | varies |
| Speech evaluation, complex (70371) | $213 | $213 | 1.0× |
| Superior sagittal sinus venogram (75870) | $356 | $356 | 0.1× |
| Temporomandble Jt Arthrography Rs&I (70332) | $189 | $189 | 0.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $473 | $473 | 3.1× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$29–$200.73 | $29–$200.73 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$29–$318.12 | $29–$318.12 | varies |
| Thoracolumbar 2 views (72080) | $83 | $83 | 1.1× |
| Ultrasound Breast Limited (76642) | $213 | $213 | 2.8× |
| Ultrasound, abdomen limited (76705) range across 8 matching MRF lines |
$77–$471 | $77–$471 | varies |
| Upper gi w/o kub (74240) | $262 | $262 | 1.7× |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$188–$901.60 | $188–$901.60 | varies |
| Urethrocystography retrograde (74450) | $41 | $41 | 0.2× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$72–$213 | $72–$213 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$72–$471 | $72–$471 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$49.50–$471 | $49.50–$471 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$51–$315 | $51–$315 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$86–$281.82 | $86–$281.82 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$102–$471 | $102–$471 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$90–$471 | $90–$471 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$116–$471 | $116–$471 | varies |
| Us retroperitoneal complete (76770) range across 4 matching MRF lines |
$98–$810.87 | $98–$810.87 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$77–$247.23 | $77–$247.23 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$84–$471 | $84–$471 | varies |
| Us thyroid (76536) range across 4 matching MRF lines |
$74–$471 | $74–$471 | varies |
| Vasogram (74440) | $185 | $185 | 0.9× |
| Vein X-Ray Chest (75827) | $336 | $336 | 0.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $384 | $384 | 0.1× |
| Vein X-Ray Skull Epidural (75872) | $342 | $342 | 0.6× |
| Vein X-Ray Spleen/Liver (75810) | $141 | $141 | 0.1× |
| Venogram Sinus/Jugular (75860) | $348 | $348 | 0.1× |
| Venography Adrenal Unilateral (75840) | $367 | $367 | 0.1× |
| Venography caval inferior serialography rs&i (75825) | $332 | $332 | 0.1× |
| Venography extremity bilateral rs&i (75822) | $352 | $352 | 0.3× |
| Venography extremity unilateral rs&i (75820) | $280 | $280 | 0.2× |
| Venography Orbital Rs&I (75880) | $304 | $304 | 0.6× |
| Venography Renal Bilateral (75833) | $409 | $409 | 0.2× |
| Venography Renal Unilateral (75831) | $355 | $355 | 0.1× |
| Venous sampling by catheter (75893) | $283 | $283 | 0.1× |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$71–$159 | $71–$159 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $90 | $90 | 1.2× |
| X-ray antegrade pyelogram tube (74425) | $43 | $43 | 0.1× |
| X-Ray Aorta Leg Arteries (75630) | $417 | $417 | 0.2× |
| X-Ray Bend Only L-S Spine (72120) | $92 | $92 | 1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$64–$159 | $64–$159 | varies |
| X-Ray Exam Breast Specimen (76098) | $43 | $43 | 0.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $493.19 | $493.19 | 5.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$45–$493.90 | $45–$493.90 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 6 matching MRF lines |
$21–$200.73 | $21–$200.73 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$29–$200.73 | $29–$200.73 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 4 matching MRF lines |
$36–$200.73 | $36–$200.73 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$30–$317.69 | $30–$317.69 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$39–$317.69 | $39–$317.69 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$41–$317.69 | $41–$317.69 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $146 | $146 | 1.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$29–$211.37 | $29–$211.37 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$48–$352.28 | $48–$352.28 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 4 matching MRF lines |
$36–$318.12 | $36–$318.12 | varies |
| X-ray eye for foreign body (70030) | $67 | $67 | 0.9× |
| X-ray head for orthodontia (70350) | $49 | $49 | 0.7× |
| X-ray humerus (73060) range across 5 matching MRF lines |
$21–$200.73 | $21–$200.73 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$256–$901.60 | $256–$901.60 | varies |
| X-ray IV pyelogram+tomography (74415) | $311 | $311 | 2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $79 | $79 | 1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 4 matching MRF lines |
$24–$200.73 | $24–$200.73 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$30–$211.37 | $30–$211.37 | varies |
| X-ray nose-rectum child f.b. (76010) | $62 | $62 | 0.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $267 | $267 | 3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$24–$247.23 | $24–$247.23 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$24–$176.78 | $24–$176.78 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$21–$200.73 | $21–$200.73 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 5 matching MRF lines |
$35–$318.15 | $35–$318.15 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$45–$318.15 | $45–$318.15 | varies |
| X-ray thoracic spine 4 vw (72074) | $101 | $101 | 1.1× |
| X-Ray Tmj Unilat (70328) range across 3 matching MRF lines |
$24–$200.73 | $24–$200.73 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $44 | $44 | 0.1× |
| X-Rays Bone Survey Complete (77075) | $267 | $267 | 3.0× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$111–$318.15 | $111–$318.15 | varies |
| Xr facial bones less than 3 views (70140) | $69 | $69 | 0.9× |
| XR Mastoids < 3 Views Bilateral (70120) | $82 | $82 | 0.9× |
| Xr myelogram posterior fossa (70010) | $154 | $154 | 0.5× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$38–$318.15 | $38–$318.15 | varies |
| Xr Tomogram Single Plane (76100) | $228 | $228 | 2.5× |
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.