Imaging prices at Uintah Basin Medical Center
Roosevelt, UT · every code in this section with a posted price and a Medicare benchmark.
222 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 |
$292.73–$332.33 | $325.25–$369.25 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$405–$444.60 | $450–$494 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $1,818.90 | $2,021 | 4.5× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$579.15–$623.48 | $643.50–$692.75 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$717.98–$816.30 | $797.75–$907 | varies |
| Bone age studies (77072) | $258.75 | $287.50 | 2.4× |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,302.53–$1,570.50 | $1,447.25–$1,745 | varies |
| Bone Imaging Limited Area (78300) | $1,537.20 | $1,708 | 3.8× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,486.13–$1,742.40 | $1,651.25–$1,936 | varies |
| Bone survey infant (77076) | $418.28 | $464.75 | 4.0× |
| Cat Scan Follow-Up Study (76380) | $961.20 | $1,068 | 10.9× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$294.30–$324.23 | $327–$360.25 | varies |
| Chest 2 views (71046) range across 4 matching MRF lines |
$362.70–$405 | $403–$450 | varies |
| Chest 3 views (71047) | $344.03 | $382.25 | 3.9× |
| Chest 4 or more views (71048) | $361.35 | $401.50 | 3.4× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$317.70–$348.98 | $353–$387.75 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 3 matching MRF lines |
$632.03–$907.20 | $702.25–$1,008 | varies |
| Contrast X-Ray Bladder (74430) | $549.90 | $611 | 1.6× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$4,504.28–$4,949.10 | $5,004.75–$5,499 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$3,406.05–$3,878.10 | $3,784.50–$4,309 | varies |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$1,805.18–$2,135.70 | $2,005.75–$2,373 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,979.55–$2,297.70 | $2,199.50–$2,553 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$1,586.48–$1,899.90 | $1,762.75–$2,111 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 3 matching MRF lines |
$729.45–$1,139.40 | $810.50–$1,266 | varies |
| CT Angio Chest (71275) range across 4 matching MRF lines |
$1,810.13–$2,305.80 | $2,011.25–$2,562 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$1,703.48–$2,196 | $1,892.75–$2,440 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$675–$1,983.60 | $750–$2,204 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$2,108.70–$2,596.50 | $2,343–$2,885 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $2,198.70 | $2,443 | 12.4× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$2,144.25–$2,246.40 | $2,382.50–$2,496 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$2,006.55–$2,358 | $2,229.50–$2,620 | varies |
| CT cervical spine w/wo cont (72127) | $2,452.50 | $2,725 | 13.8× |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$1,750.73–$2,136.60 | $1,945.25–$2,374 | varies |
| CT chest w/wo contrast (71270) | $2,218.50 | $2,465 | 12.5× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,712.93–$2,073.60 | $1,903.25–$2,304 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$2,083.95–$2,498.40 | $2,315.50–$2,776 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $352.80 | $392 | 4.0× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,444.05–$1,848.60 | $1,604.50–$2,054 | varies |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$1,708.43–$1,994.40 | $1,898.25–$2,216 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,752.30–$2,052.90 | $1,947–$2,281 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$2,248.65–$2,619.90 | $2,498.50–$2,911 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,997.55–$2,347.20 | $2,219.50–$2,608 | varies |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$1,612.35–$2,024.10 | $1,791.50–$2,249 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$1,612.35–$1,979.10 | $1,791.50–$2,199 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$2,016–$2,462.40 | $2,240–$2,736 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $2,074.50 | $2,305 | 11.7× |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,671.98–$1,749.60 | $1,857.75–$1,944 | varies |
| CT pelvis w&w/o contrast (72194) | $2,219.40 | $2,466 | 12.5× |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,731.83–$2,026.80 | $1,924.25–$2,252 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,866.83–$2,324.70 | $2,074.25–$2,583 | varies |
| CT soft tissue neck w contrast (70491) range across 3 matching MRF lines |
$2,009.48–$2,438.10 | $2,232.75–$2,709 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,448.78–$1,843.20 | $1,609.75–$2,048 | varies |
| CT thoracic spine w contrast (72129) | $2,403.90 | $2,671 | 13.5× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,959.98–$2,309.40 | $2,177.75–$2,566 | varies |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$1,260.23–$1,605.60 | $1,400.25–$1,784 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$1,562.85–$1,914.30 | $1,736.50–$2,127 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$1,695.83–$2,079.90 | $1,884.25–$2,311 | varies |
| Cta Abdomen (74175) | $2,596.50 | $2,885 | 14.6× |
| Dxa Bone Density Axial (77080) range across 4 matching MRF lines |
$270.90–$513.90 | $301–$571 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $270.90 | $301 | 3.1× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$574.43–$737.10 | $638.25–$819 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$519.75–$602.78 | $577.50–$669.75 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$387.45–$568.80 | $430.50–$632 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$548.78–$641.03 | $609.75–$712.25 | varies |
| Foot 2 views (73620) range across 4 matching MRF lines |
$280.58–$615.15 | $311.75–$683.50 | varies |
| Forearm 2 views (73090) | $353.03 | $392.25 | 4.0× |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,215.23–$1,700.10 | $1,350.25–$1,889 | varies |
| Gastroesophageal Reflux Exam (78262) | $1,142.10 | $1,269 | 2.8× |
| Gated Heart Planar Single (78472) | $1,875.60 | $2,084 | 4.6× |
| Gated Heart, Multiple (78473) | $1,709.10 | $1,899 | 4.2× |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$2,012.40–$2,106 | $2,236–$2,340 | varies |
| Ht Musc Image Planar Mult (78454) | $2,634.30 | $2,927 | 2.0× |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$575.55–$654.98 | $639.50–$727.75 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$372.15–$514.80 | $413.50–$572 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$348.08–$457.43 | $386.75–$508.25 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$1,325.03–$1,587.60 | $1,472.25–$1,764 | varies |
| Kidney Imaging Morphol (78700) | $999 | $1,110 | 2.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 2 matching MRF lines |
$1,045.80–$1,201.50 | $1,162–$1,335 | varies |
| Knee 3 Views (73562) range across 4 matching MRF lines |
$373.50–$747 | $415–$830 | varies |
| Liver & Spleen Imaging Static Only (78215) | $1,422 | $1,580 | 3.5× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$1,538.10–$1,733.40 | $1,709–$1,926 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,449–$1,725.30 | $1,610–$1,917 | varies |
| Magnetic Image Jaw Joint (70336) | $5,220 | $5,800 | 21.6× |
| Mammary ductogram or galactogram multiple (77054) | $559.80 | $622 | 2.3× |
| Meckels Divert Exam (78290) | $1,468.80 | $1,632 | 3.6× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$2,953.80–$3,592.80 | $3,282–$3,992 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,979.55–$2,452.50 | $2,199.50–$2,725 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$3,117.83–$3,764.70 | $3,464.25–$4,183 | varies |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$2,448.90–$2,985.30 | $2,721–$3,317 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,059.30–$1,176.30 | $1,177–$1,307 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,224–$1,378.80 | $1,360–$1,532 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 4 matching MRF lines |
$927–$1,124.10 | $1,030–$1,249 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,691.10 | $1,879 | 7.0× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,037.70 | $1,153 | 4.3× |
| MRI cervical spine w contrast (72142) | $3,274.20 | $3,638 | 9.3× |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$729.90–$838.80 | $811–$932 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$2,582.55–$2,701.80 | $2,869.50–$3,002 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 3 matching MRF lines |
$3,332.48–$4,123.80 | $3,702.75–$4,582 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 4 matching MRF lines |
$2,717.33–$3,284.10 | $3,019.25–$3,649 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$2,820.83–$3,377.70 | $3,134.25–$3,753 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$1,180.80–$1,350 | $1,312–$1,500 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$2,270.03–$2,938.50 | $2,522.25–$3,265 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$3,252.38–$3,932.10 | $3,613.75–$4,369 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$3,360.15–$4,205.70 | $3,733.50–$4,673 | varies |
| MRI pelvis w/o contrast (72195) range across 3 matching MRF lines |
$2,188.80–$2,844.90 | $2,432–$3,161 | varies |
| MRI spectroscopy (76390) | $1,239.30 | $1,377 | 14.1× |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$729.90–$838.80 | $811–$932 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$2,558.25–$3,117.60 | $2,842.50–$3,464 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$3,304.35–$4,093.20 | $3,671.50–$4,548 | varies |
| MRI, abdomen, combo (74183) range across 4 matching MRF lines |
$3,386.70–$4,194 | $3,763–$4,660 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,180.80–$1,350 | $1,312–$1,500 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$2,551.73–$3,137.40 | $2,835.25–$3,486 | varies |
| MRI, joint upper extrem (73221) range across 3 matching MRF lines |
$729–$827.10 | $810–$919 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,219.50–$1,374.30 | $1,355–$1,527 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,180.80–$1,350 | $1,312–$1,500 | varies |
| Myelogram Lumbar (72265) | $1,378.58 | $1,531.75 | 1.7× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $2,521.80 | $2,802 | 1.9× |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$3,425.85–$3,597.30 | $3,806.50–$3,997 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$327.38–$369.68 | $363.75–$410.75 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $83.70 | $93 | 0.8× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $196.20 | $218 | 1.9× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) | $36 | $40 | 1.2× |
| Parathyroid imaging w/tomographic spect & CT (78072) range across 2 matching MRF lines |
$972.23–$1,158.30 | $1,080.25–$1,287 | varies |
| Parathyroid Planar Imaging (78070) | $1,353.60 | $1,504 | 3.3× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$265.73–$308.70 | $295.25–$343 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$1,092.83–$1,320.30 | $1,214.25–$1,467 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$459.45–$508.05 | $510.50–$564.50 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $712.13 | $791.25 | 1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$384.53–$416.93 | $427.25–$463.25 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$324.45–$353.25 | $360.50–$392.50 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$389.48–$843.75 | $432.75–$937.50 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $470.25 | $522.50 | 4.4× |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$306–$329.63 | $340–$366.25 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$380.70–$411.98 | $423–$457.75 | varies |
| Radex Hand Minimum 3 Views (73130) range across 7 matching MRF lines |
$409.50–$883.80 | $455–$982 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$211.73–$240.53 | $235.25–$267.25 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $299.48 | $332.75 | 2.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$323.33–$353.48 | $359.25–$392.75 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$354.38–$397.80 | $393.75–$442 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$399.60–$436.95 | $444–$485.50 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $266.63 | $296.25 | 3.0× |
| Radex Sternum Minimum 2 Views (71120) | $376.88 | $418.75 | 4.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $432 | $480 | 4.9× |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$276.98–$302.63 | $307.75–$336.25 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $258.75 | $287.50 | 2.4× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$363.60–$793.80 | $404–$882 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $549 | $610 | 5.2× |
| Radiologic exam colon double contrast study (74280) | $917.10 | $1,019 | 5.2× |
| Radiologic exam colon single contrast study (74270) | $881.33 | $979.25 | 5.0× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$486.68–$528.98 | $540.75–$587.75 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) | $352.13 | $391.25 | 3.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $781.65 | $868.50 | 4.4× |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$678.15–$776.48 | $753.50–$862.75 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$1,072.35–$1,075.05 | $1,191.50–$1,194.50 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$328.73–$360 | $365.25–$400 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$350.55–$381.83 | $389.50–$424.25 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$345.83–$377.10 | $384.25–$419 | varies |
| Ribs bilateral 3 views (71110) | $513.23 | $570.25 | 4.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 3 matching MRF lines |
$1,492.20–$1,698.30 | $1,658–$1,887 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,573.20 | $1,748 | 1.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $2,056.50 | $2,285 | 1.6× |
| Scapula (73010) range across 3 matching MRF lines |
$322.88–$360.23 | $358.75–$400.25 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 4 matching MRF lines |
$79.65–$284.85 | $88.50–$316.50 | varies |
| Shoulder Arthrography (73040) range across 3 matching MRF lines |
$820.80–$907.88 | $912–$1,008.75 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$405–$452.48 | $450–$502.75 | varies |
| Sternoclavicular joints (71130) | $421.65 | $468.50 | 4.8× |
| Testicular Imaging W/Flow (78761) | $944.10 | $1,049 | 2.3× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$344.03–$381.38 | $382.25–$423.75 | varies |
| Thoracic spine 3 views (72072) | $499.05 | $554.50 | 4.7× |
| Thyroid Imaging With Vascular Flow (78013) | $953.10 | $1,059 | 2.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$1,085.18–$1,235.70 | $1,205.75–$1,373 | varies |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$168.75–$584.10 | $187.50–$649 | varies |
| Ultrasound Elastography Parenchyma (76981) | $285.98 | $317.75 | 2.7× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$683.78–$864 | $759.75–$960 | varies |
| Ultrasound, abdomen limited (76705) range across 7 matching MRF lines |
$255.15–$799.20 | $283.50–$888 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$261.90–$328.50 | $291–$365 | varies |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$503.33–$639.90 | $559.25–$711 | varies |
| Ureteral Reflux Study (78740) | $941.40 | $1,046 | 2.3× |
| Urethrocystography retrograde (74450) | $529.88 | $588.75 | 2.2× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$436.50–$594 | $485–$660 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$273.60–$591.75 | $304–$657.50 | varies |
| Us complete joint (76881) | $291.83 | $324.25 | 2.8× |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$487.35–$587.70 | $541.50–$653 | varies |
| Us head (76506) | $354.15 | $393.50 | 3.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 5 matching MRF lines |
$216.68–$413.78 | $240.75–$459.75 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$303.53–$416.70 | $337.25–$463 | varies |
| Us ob transvaginal (76817) range across 4 matching MRF lines |
$264.15–$355.50 | $293.50–$395 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$685.58–$813.60 | $761.75–$904 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$495–$650.03 | $550–$722.25 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 4 matching MRF lines |
$438.30–$547.20 | $487–$608 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$683.78–$825.53 | $759.75–$917.25 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$509.85–$625.05 | $566.50–$694.50 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$160.65–$705.38 | $178.50–$783.75 | varies |
| Us transrectal (76872) | $680.18 | $755.75 | 6.4× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$254.03–$282.83 | $282.25–$314.25 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $324.23 | $360.25 | 3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$301.50–$330.30 | $335–$367 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$540–$567 | $600–$630 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 3 matching MRF lines |
$152.33–$198 | $169.25–$220 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$208.35–$239.63 | $231.50–$266.25 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$295.43–$333.68 | $328.25–$370.75 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$489.83–$539.78 | $544.25–$599.75 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$562.73–$627.08 | $625.25–$696.75 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$390.83–$451.58 | $434.25–$501.75 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$474.98–$527.18 | $527.75–$585.75 | varies |
| X-ray eye for foreign body (70030) | $172.80 | $192 | 2.0× |
| X-ray humerus (73060) range across 2 matching MRF lines |
$354.15–$387.45 | $393.50–$430.50 | varies |
| X-ray IV pyelogram (ivp) (74400) | $828 | $920 | 4.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $261.90 | $291 | 3.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$419.40–$456.75 | $466–$507.50 | varies |
| X-ray nose-rectum child f.b. (76010) range across 3 matching MRF lines |
$468.90–$511.20 | $521–$568 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $553.05 | $614.50 | 5.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $452.93 | $503.25 | 4.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $449.78 | $499.75 | 5.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $247.73 | $275.25 | 2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $521.78 | $579.75 | 4.9× |
| X-Ray Tmj Unilat (70328) | $195.30 | $217 | 2.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $869.63 | $966.25 | 2.5× |
| X-Rays Bone Survey Complete (77075) | $885.15 | $983.50 | 8.4× |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$513.68–$567.23 | $570.75–$630.25 | varies |
| Xr facial bones less than 3 views (70140) | $300.60 | $334 | 3.4× |
| Xr orbits complete 4 views (70200) | $495 | $550 | 4.7× |
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.