Imaging prices at UofL Health – Shelbyville Hospital
Shelbyville, KY · every code in this section with a posted price and a Medicare benchmark.
320 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) | $102.98 | $271 | 1.2× |
| Abdomen 2 views (74019) | $106.78 | $281 | 1.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $810.54 | $2,133 | 2.1× |
| Angiography extremity bilateral rs&i (75716) | $3,867.64 | $10,178 | 1.3× |
| Angiography extremity unilateral rs&i (75710) | $2,729.54 | $7,183 | 0.9× |
| Ankle 2 views (73600) range across 10 matching MRF lines |
$118.18–$190.76 | $311–$502 | varies |
| Arthrogram hip (73525) | $565.06 | $1,487 | 1.7× |
| Bone age studies (77072) | $190.76 | $502 | 1.9× |
| Bone Imaging 3 Phase (78315) | $1,106.94 | $2,913 | 2.9× |
| Bone Imaging Limited Area (78300) | $852.34 | $2,243 | 2.2× |
| Bone Imaging Whole Body (78306) | $1,041.58 | $2,741 | 2.7× |
| Bone marrow imaging limited area (78102) | $428.64 | $1,128 | 1.1× |
| Bone survey infant (77076) | $314.26 | $827 | 3.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $849.68 | $2,236 | 1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,678.62 | $7,049 | 1.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $1,512.40 | $3,980 | 4.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $1,281.64 | $3,372.75 | 1.7× |
| Cat Scan Follow-Up Study (76380) | $567.72 | $1,494 | 6.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $245.86 | $647 | 0.5× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) | $615.98 | $1,621 | 1.2× |
| Cerebrospinal Fluid Scan (78630) | $850.82 | $2,239 | 1.6× |
| Chest 1 view (71045) | $137.56 | $362 | 1.6× |
| Chest 2 views (71046) range across 6 matching MRF lines |
$164.54–$191.90 | $433–$505 | varies |
| Chest 3 views (71047) range across 6 matching MRF lines |
$162.64–$186.96 | $428–$492 | varies |
| Chest 4 or more views (71048) range across 4 matching MRF lines |
$108.68–$117.04 | $286–$308 | varies |
| Cholecystography Oral Contrast (74290) | $177.08 | $466 | 1.0× |
| Clavicle complete (73000) range across 6 matching MRF lines |
$194.94–$245.86 | $513–$647 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $446.12 | $1,174 | 4.4× |
| Contrast X-Ray Bladder (74430) | $462.46 | $1,217 | 1.4× |
| Contrast X-Ray Of Knee Joint (73580) | $584.06 | $1,537 | 1.7× |
| Contrast Xray Throat/Cerv Esopha (74210) | $198.74 | $523 | 1.2× |
| CT abdomen and pelvis without and with contrast (74178) | $1,248.30 | $3,285 | 3.7× |
| CT abdomen and pelvis without contrast (74176) | $976.98 | $2,571 | 4.2× |
| CT abdomen w contrast (74160) | $473.86 | $1,247 | 2.8× |
| CT abdomen w wo contrast (74170) | $612.56 | $1,612 | 3.6× |
| CT abdomen w/o contrast (74150) | $418 | $1,100 | 4.1× |
| CT Angio Abdomen and Pelvis (74174) | $1,993.86 | $5,247 | 5.9× |
| CT Angio Chest (71275) | $1,047.28 | $2,756 | 6.2× |
| CT Angio Head (70496) | $1,058.30 | $2,785 | 6.2× |
| CT angio hrt w/3d image (75574) | $2,095.68 | $5,514.94 | 6.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,349 | $3,550 | 7.9× |
| CT Angio Neck (70498) | $918.08 | $2,416 | 5.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 6 matching MRF lines |
$756.58–$1,606.73 | $1,991–$4,228.24 | varies |
| CT bone density (77078) | $240.66 | $633.31 | 2.9× |
| CT cervical spine w/ contrast (72126) | $842.84 | $2,218 | 2.5× |
| CT cervical spine w/o contrast (72125) | $807.50 | $2,125 | 8.0× |
| CT cervical spine w/wo cont (72127) | $1,144.94 | $3,013 | 6.7× |
| CT chest w contrast (71260) | $763.80 | $2,010 | 4.5× |
| CT chest w/wo contrast (71270) | $1,102 | $2,900 | 6.5× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,972.58 | $5,191 | 11.6× |
| CT colonogrphy dx image postprocess w/o contrast (74261) | $772.92 | $2,034 | 7.6× |
| CT head/brain with contrast (70460) | $705.66 | $1,857 | 4.2× |
| CT head/brain without and with contrast (70470) | $971.28 | $2,556 | 5.7× |
| CT heart no contrast quant eval coronry calcium (75571) range across 4 matching MRF lines |
$37.62–$217.74 | $99–$573 | varies |
| CT hrt w/3d image congen (75573) | $2,095.68 | $5,514.94 | 6.2× |
| CT iac w contrast (70481) | $815.86 | $2,147 | 4.8× |
| CT l-spine w&w/o contrast (72133) | $1,532.16 | $4,032 | 9.0× |
| CT lower ext w/o (73700) range across 6 matching MRF lines |
$639.54–$713.83 | $1,683–$1,878.49 | varies |
| CT lower extremity w/contrast material (73701) | $862.60 | $2,270 | 5.1× |
| CT lumbar spine w contrast (72132) | $842.84 | $2,218 | 2.5× |
| CT lumbar spine w/o contrast (72131) | $773.68 | $2,036 | 7.6× |
| CT maxillofacial w contrast (70487) | $747.84 | $1,968 | 4.4× |
| CT maxillofacial wo contrast (70486) | $676.78 | $1,781 | 6.7× |
| CT neck tissue combo (70492) | $968.62 | $2,549 | 5.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $1,696.32 | $4,464 | 10.0× |
| CT orbits w/o contrast (70480) | $759.24 | $1,998 | 7.5× |
| CT pelvis w&w/o contrast (72194) | $1,122.90 | $2,955 | 6.6× |
| CT pelvis w/o contrast (72192) | $620.92 | $1,634 | 6.1× |
| CT scan of leg combo (73702) | $1,426.52 | $3,754 | 8.4× |
| CT scans face/jaw combo (70488) | $1,052.81 | $2,770.55 | 6.2× |
| CT soft tissue neck w contrast (70491) | $933.66 | $2,457 | 5.5× |
| CT soft tissue neck w/o contrast (70490) | $690.84 | $1,818 | 6.8× |
| CT thoracic spine w contrast (72129) | $1,078.06 | $2,837 | 6.3× |
| CT thoracic spine w/o contrast (72128) | $895.66 | $2,357 | 8.9× |
| CT thoracic spine w/wo cont (72130) | $1,411.70 | $3,715 | 8.3× |
| CT thorax w/o contrast (71250) | $554.04 | $1,458 | 5.5× |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$639.54–$698.55 | $1,683–$1,838.30 | varies |
| CT upper extremity with contrast (73201) | $893 | $2,350 | 2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,549.26 | $4,077 | 9.1× |
| Cta Abdomen (74175) | $1,046.90 | $2,755 | 6.2× |
| CTA pelvis (72191) | $1,354.70 | $3,565 | 8.0× |
| Discography Cerv/Thor Spine (72285) | $1,616.14 | $4,253 | 0.9× |
| Diskography lumbar (72295) | $1,372.56 | $3,612 | 0.7× |
| Dxa Bone Density Axial (77080) | $201.40 | $530 | 2.0× |
| Echo Guide For Artery Repair (76936) | $334.78 | $881 | 1.6× |
| Esophagram (74220) | $346.56 | $912 | 2.0× |
| Fluoroscopy up to 1 hr (76000) | $198.74 | $523 | 0.9× |
| Foot 2 views (73620) range across 6 matching MRF lines |
$69.54–$153.14 | $183–$403 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$181.26–$218.88 | $477–$576 | varies |
| Gastric emptying imaging study (78264) | $1,061.72 | $2,794 | 2.7× |
| Gated Heart Planar Single (78472) | $735.68 | $1,936 | 1.9× |
| Hand 2 views (73120) | $172.52 | $454 | 1.7× |
| Hepatobil Syst Image W/Drug (78227) | $1,117.20 | $2,940 | 2.1× |
| Hepatobiliary System Imaging (78226) | $539.22 | $1,419 | 1.4× |
| Ht Muscle Image Spect Sing (78451) | $1,815.26 | $4,777 | 1.4× |
| Hysterosalpingogram (74740) range across 4 matching MRF lines |
$134.90–$446.88 | $355–$1,176 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $153.52 | $404 | 1.8× |
| Interstitial radiation source applic complex (77778) | $1,960.04 | $5,158 | 2.9× |
| Joint Survey Single View (77077) | $175.56 | $462 | 1.7× |
| K Flow/Funct Image W/Drug (78708) | $605.34 | $1,593 | 1.2× |
| K Flow/Funct Image W/O Drug (78707) | $681.72 | $1,794 | 1.3× |
| Kidney Imaging Morphol (78700) | $577.60 | $1,520 | 1.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $513 | $1,350 | 1.3× |
| Knee 3 Views (73562) range across 6 matching MRF lines |
$277.78–$379.62 | $731–$999 | varies |
| Leveen/Shunt Patency Exam (78291) | $490.58 | $1,291 | 1.3× |
| Liver & Spleen Imaging Static Only (78215) | $430.16 | $1,132 | 1.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $552.52 | $1,454 | 1.4× |
| Liver imaging static only (78201) | $926.06 | $2,437 | 1.8× |
| Lung Perf&Ventilat Diferentl (78598) | $497.42 | $1,309 | 0.9× |
| Lung perfusion differential (78597) | $349.98 | $921 | 0.9× |
| Lung Ventilat&Perfus Imaging (78582) | $649.42 | $1,709 | 1.2× |
| Lung Ventilation Imaging (78579) | $708.70 | $1,865 | 1.8× |
| Lymph System Imaging (78195) | $702.62 | $1,849 | 1.3× |
| Magnetic Image Jaw Joint (70336) | $1,944.84 | $5,118 | 8.4× |
| Mammary ductogram or galactogram multiple (77054) | $201.40 | $530 | 0.9× |
| Mammary ductogram or galactogram single (77053) | $371.26 | $977 | 1.6× |
| Meckels Divert Exam (78290) | $496.66 | $1,307 | 1.3× |
| Mr safety determination physician/other qhp (76016) | $140.98 | $371 | 1.7× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $39.14 | $103 | 1.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $147.06 | $387 | 1.6× |
| Mr safety med physics xm customization plng&mntr (76017) | $387.60 | $1,020 | 1.7× |
| Mra Head W/O & W/Contrast Material (70546) | $2,160.68 | $5,686 | 6.4× |
| MRA head w/o contrast (70544) range across 4 matching MRF lines |
$1,182.94–$1,944.46 | $3,113–$5,117 | varies |
| MRA head with contrast (70545) | $2,052 | $5,400 | 6.1× |
| MRA neck w contrast (70548) | $1,421.20 | $3,740 | 4.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,425 | $3,750 | 4.2× |
| MRA neck w/o contrast (70547) | $1,420.82 | $3,739 | 6.2× |
| MRI abdomen w contrast (74182) | $2,208.94 | $5,813 | 6.5× |
| MRI abdomen w/o contrast (74181) | $1,106.18 | $2,911 | 4.8× |
| MRI any jt lower extrem w/contrast material (73722) | $1,035.50 | $2,725 | 1.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,355.46 | $3,567 | 4.0× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,101.24 | $2,898 | 1.5× |
| MRI brain functional w/o physician admnistration (70554) | $1,092.50 | $2,875 | 4.7× |
| MRI brain functional w/physician admnistration (70555) | $1,182.18 | $3,111 | 5.1× |
| MRI Breast Without Contrast Material Unilateral (77046) range across 4 matching MRF lines |
$486.78–$1,900 | $1,281–$5,000 | varies |
| MRI cardiac w/o cont stress (75559) | $1,949.62 | $5,130.58 | 3.7× |
| MRI cardiac w/o contrast (75557) | $965.96 | $2,542 | 4.2× |
| MRI cervical spine w contrast (72142) | $1,597.52 | $4,204 | 4.7× |
| MRI cervical spine w/o cont (72141) | $1,336.84 | $3,518 | 5.8× |
| MRI chest w/o contrast (71550) | $1,322.40 | $3,480 | 5.7× |
| MRI chest with contrast (71551) | $1,429.56 | $3,762 | 1.9× |
| MRI chest wo w contrast (71552) | $1,694.42 | $4,459 | 5.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $960.64 | $2,528 | 2.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,237.28 | $3,256 | 3.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,161.28 | $3,056 | 5.0× |
| MRI lumbar spine w contrast (72149) | $1,597.52 | $4,204 | 4.7× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,425 | $3,750 | 4.2× |
| MRI orbit face &/neck w/o contrast (70540) | $1,449.32 | $3,814 | 6.3× |
| MRI orbit face neck w contrast (70542) | $2,208.94 | $5,813 | 6.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,223.98 | $3,221 | 3.6× |
| MRI pelvis w contrast (72196) | $1,944.84 | $5,118 | 5.8× |
| MRI pelvis w/o & w contrast (72197) | $1,253.62 | $3,299 | 3.7× |
| MRI pelvis w/o contrast (72195) range across 4 matching MRF lines |
$1,032.84–$2,333.76 | $2,718–$6,141.48 | varies |
| MRI spectroscopy (76390) | $1,432.60 | $3,770 | 17.0× |
| MRI thoracic spine w/o contrast (72146) | $1,336.84 | $3,518 | 5.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,616.52 | $4,254 | 4.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $820.80 | $2,160 | 3.6× |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 4 matching MRF lines |
$1,355.46–$1,657.56 | $3,567–$4,362 | varies |
| MRI, abdomen, combo (74183) | $1,440.20 | $3,790 | 4.3× |
| MRI, dorsal spine combo (72157) | $1,425 | $3,750 | 4.2× |
| MRI, dorsal spine contrast (72147) | $1,292 | $3,400 | 3.8× |
| MRI, joint upper extrem (73221) | $1,032.84 | $2,718 | 4.5× |
| MRI, joint upper extrem combo (73223) | $1,359.26 | $3,577 | 4.0× |
| MRI, lumbar spine combo (72158) | $1,336.84 | $3,518 | 4.0× |
| Musculoskeletal Nuclear Exam (78399) | $2,797.42 | $7,361.62 | 7.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $748.60 | $1,970 | 1.9× |
| Myocardial Spect Multiple Studies (78452) | $3,226.20 | $8,490 | 2.6× |
| N-invas est c ffr sw aly CTA (75580) | $869.82 | $2,289 | 1.0× |
| Neck soft tissue (70360) | $203.68 | $536 | 2.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $372.02 | $979 | 1.0× |
| Nm csf leak detection (78650) | $1,176.24 | $3,095.37 | 0.9× |
| Nonvascular Shunt X-Ray (75809) | $313.12 | $824 | 3.1× |
| Nuclear Rx Oral Admin (79005) | $1,088.32 | $2,864 | 4.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $522.88 | $1,376 | 1.0× |
| Parathyroid Planar Imaging (78070) | $433.96 | $1,142 | 1.1× |
| Pelvis 1 or 2 views (72170) | $175.94 | $463 | 1.7× |
| Perineogram (74775) | $294.50 | $775 | 1.3× |
| Pet Image W/Ct Lmtd (78814) | $2,824.92 | $7,434 | 2.0× |
| PET image w/CT, full body (78816) | $3,538.94 | $9,313 | 2.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $3,538.94 | $9,313 | 2.6× |
| Pulmonary Perfusion Imaging Particulate (78580) | $764.56 | $2,012 | 2.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $156.56 | $412 | 1.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $557.84 | $1,468 | 1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 6 matching MRF lines |
$201.40–$394.06 | $530–$1,037 | varies |
| Radex Calcaneus Minimum 2 Views (73650) | $123.88 | $326 | 1.5× |
| Radex elbow complete minimum 3 views (73080) range across 6 matching MRF lines |
$282.72–$285.76 | $744–$752 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $326.42 | $859 | 3.2× |
| Radex fingr minimum 2 views (73140) | $116.28 | $306 | 1.4× |
| Radex foot complete minimum 3 views (73630) range across 6 matching MRF lines |
$314.64–$323.38 | $828–$851 | varies |
| Radex Hand Minimum 3 Views (73130) range across 6 matching MRF lines |
$202.16–$321.48 | $532–$846 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $149.72 | $394 | 1.8× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $227.62 | $599 | 2.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $238.26 | $627 | 2.8× |
| Radex Ribs Unilateral 2 Views (71100) | $115.90 | $305 | 1.4× |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$189.62–$202.16 | $499–$532 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $166.82 | $439 | 2.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $570.38 | $1,501 | 3.4× |
| Radex Spine 1 View Specify Level (72020) | $165.68 | $436 | 2.0× |
| Radex Sternum Minimum 2 Views (71120) | $75.24 | $198 | 0.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $102.60 | $270 | 1.2× |
| Radex Toe Minimum 2 Views (73660) | $170.62 | $449 | 2.0× |
| Radex upper extremity infant minimum 2 views (73092) | $95.38 | $251 | 0.9× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$202.16–$217.74 | $532–$573 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 4 matching MRF lines |
$121.60–$138.32 | $320–$364 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) | $391.40 | $1,030 | 3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $106.78 | $281 | 1.1× |
| Radiologic exam colon double contrast study (74280) | $525.16 | $1,382 | 3.1× |
| Radiologic exam colon single contrast study (74270) | $479.18 | $1,261 | 2.8× |
| Radiologic exam knee complete 4/more views (73564) | $296.40 | $780 | 2.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $380 | $1,000 | 3.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $566.96 | $1,492 | 3.3× |
| Radiologic exam swallow function contrast study (74230) | $478.04 | $1,258 | 2.8× |
| Radiologic exam upr gi trc double contrast study (74246) range across 4 matching MRF lines |
$660.44–$887.68 | $1,738–$2,336 | varies |
| Radiologic examination femur 1 view (73551) range across 4 matching MRF lines |
$145.16–$164.92 | $382–$434 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$145.16–$156.56 | $382–$412 | varies |
| Radiologic examination knee 1/2 views (73560) | $201.40 | $530 | 2.4× |
| Radiologic Examination Osseous Survey Limited (77074) | $343.52 | $904 | 3.4× |
| Radiologic examination tibia & fibula 2 views (73590) range across 6 matching MRF lines |
$141.36–$145.54 | $372–$383 | varies |
| Ribs bilateral 3 views (71110) | $330.22 | $869 | 3.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 4 matching MRF lines |
$484.50–$733.78 | $1,275–$1,931 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $882.36 | $2,321.99 | 2.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $2,248.08 | $5,916 | 4.3× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $1,316.70 | $3,465 | 2.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $1,243.36 | $3,272 | 2.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) range across 4 matching MRF lines |
$880.84–$1,127.46 | $2,318–$2,967 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $1,279.08 | $3,366 | 0.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,127.46 | $2,967 | 0.9× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) range across 4 matching MRF lines |
$205.96–$1,394.60 | $542–$3,670 | varies |
| Rp Therapy Intravenous Administration (79101) | $662.34 | $1,743 | 2.9× |
| Scapula (73010) range across 6 matching MRF lines |
$265.24–$292.98 | $698–$771 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $55.48 | $146 | 2.4× |
| Sella turcica (70240) | $45.22 | $119 | 0.5× |
| Shoulder 1 view (73020) range across 6 matching MRF lines |
$107.16–$131.86 | $282–$347 | varies |
| Shoulder Arthrography (73040) | $584.82 | $1,539 | 1.7× |
| Sialogram (70390) | $177.46 | $467 | 0.8× |
| Skull less than 4 views (70250) | $224.58 | $591 | 2.2× |
| Speech evaluation, complex (70371) | $111.72 | $294 | 0.5× |
| Sternoclavicular joints (71130) | $194.56 | $512 | 2.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $133.76 | $352 | 0.8× |
| Thoracic spine 2 views (72070) | $115.90 | $305 | 1.1× |
| Thoracic spine 3 views (72072) | $235.60 | $620 | 2.3× |
| Thoracolumbar 2 views (72080) | $307.80 | $810 | 3.7× |
| Thyroid Imaging With Vascular Flow (78013) | $463.22 | $1,219 | 1.2× |
| Thyroid Met Imaging Body (78018) | $1,005.48 | $2,646 | 1.9× |
| Thyroid Uptake Measurement (78012) | $247 | $650 | 0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $741.76 | $1,952 | 1.9× |
| Ultrasound Breast Limited (76642) | $256.88 | $676 | 3.0× |
| Ultrasound elastography first target lesion (76982) | $263.72 | $694 | 2.6× |
| Ultrasound Elastography Parenchyma (76981) | $263.72 | $694 | 2.6× |
| Ultrasound Exam Aaa Screen (76706) | $275.50 | $725 | 2.7× |
| Ultrasound, abdomen limited (76705) | $443.46 | $1,167 | 4.4× |
| Unlisted fluoroscopic procedure (76496) | $114.38 | $301 | 1.4× |
| Unlisted magnetic resonance procedure (76498) range across 12 matching MRF lines |
$644.86–$1,733.94 | $1,697–$4,563 | varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) | $304 | $800 | 0.8× |
| Upper gi w/o kub (74240) | $417.62 | $1,099 | 2.5× |
| Urethrocystogram voiding (74455) | $351.88 | $926 | 1.5× |
| Urethrocystography retrograde (74450) | $273.60 | $720 | 1.2× |
| Us breast unilateral complete (76641) | $341.24 | $898 | 3.4× |
| Us chest (76604) | $432.44 | $1,138 | 4.3× |
| Us complete joint (76881) | $388.74 | $1,023 | 3.8× |
| Us exam, pelvic, limited (76857) | $297.54 | $783 | 2.9× |
| Us head (76506) | $254.98 | $671 | 2.5× |
| Us kidney transplant (76776) | $362.14 | $953 | 3.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $273.60 | $720 | 2.7× |
| Us ob limited 1 or more fetuses (76815) | $304 | $800 | 3.0× |
| Us ob transvaginal (76817) | $355.68 | $936 | 3.5× |
| Us pelvic non ob complete (76856) | $660.82 | $1,739 | 6.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $407.36 | $1,072 | 4.0× |
| Us retroperitoneal complete (76770) | $470.82 | $1,239 | 4.7× |
| Us retroperitoneal limited (76775) | $379.24 | $998 | 3.7× |
| Us scrotum and contents (76870) | $448.02 | $1,179 | 4.4× |
| Us spinal canal and contents (76800) | $556.32 | $1,464 | 5.5× |
| Us thyroid (76536) | $411.54 | $1,083 | 4.1× |
| Us transrectal (76872) | $1,254 | $3,300 | 12.4× |
| Venography extremity bilateral rs&i (75822) | $1,706.20 | $4,490 | 1.1× |
| Venography extremity unilateral rs&i (75820) | $1,406 | $3,700 | 0.9× |
| Vertebral fracture assessment via dxa (77086) | $65.74 | $173 | 0.8× |
| Wrist 2 views (73100) | $123.88 | $326 | 1.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $180.50 | $475 | 2.1× |
| X-ray antegrade pyelogram tube (74425) | $562.78 | $1,481 | 1.7× |
| X-Ray Bend Only L-S Spine (72120) | $367.08 | $966 | 3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 10 matching MRF lines |
$143.26–$161.50 | $377–$425 | varies |
| X-Ray Exam Breast Specimen (76098) | $258.78 | $681 | 0.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $436.24 | $1,148 | 4.3× |
| X-Ray Exam Hip Uni 1 View (73501) range across 12 matching MRF lines |
$120.08–$133.76 | $316–$352 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $193.42 | $509 | 2.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $129.96 | $342 | 1.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $199.50 | $525 | 2.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 4 matching MRF lines |
$199.50–$297.92 | $525–$784 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) | $206.34 | $543 | 2.0× |
| X-Ray Exam L-S Spine Bending (72114) | $569.24 | $1,498 | 5.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $267.52 | $704 | 3.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $460.18 | $1,211 | 4.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $256.88 | $676 | 2.5× |
| X-ray eye for foreign body (70030) | $104.88 | $276 | 1.2× |
| X-ray humerus (73060) range across 10 matching MRF lines |
$152–$170.62 | $400–$449 | varies |
| X-ray IV pyelogram (ivp) (74400) | $150.10 | $395 | 0.9× |
| X-ray IV pyelogram+tomography (74415) | $286.90 | $755 | 1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $185.82 | $489 | 2.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $160.36 | $422 | 1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $279.68 | $736 | 2.8× |
| X-ray nose-rectum child f.b. (76010) | $185.44 | $488 | 2.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $435.86 | $1,147 | 4.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $233.32 | $614 | 2.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $166.44 | $438 | 1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $193.80 | $510 | 2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $178.22 | $469 | 2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $438.90 | $1,155 | 4.3× |
| X-Ray Stress View (77071) | $65.36 | $172 | 0.8× |
| X-ray thoracic spine 4 vw (72074) | $148.20 | $390 | 1.5× |
| X-Ray Tmj Unilat (70328) | $101.46 | $267 | 1.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $393.68 | $1,036 | 1.2× |
| X-Rays Bone Length Studies (77073) range across 4 matching MRF lines |
$127.68–$232.18 | $336–$611 | varies |
| X-Rays Bone Survey Complete (77075) | $206.34 | $543 | 2.0× |
| Xr c-spine 4 or 5 views (72050) | $388.74 | $1,023 | 3.8× |
| Xr facial bones less than 3 views (70140) | $199.88 | $526 | 2.4× |
| XR Mastoids < 3 Views Bilateral (70120) | $192.28 | $506 | 1.9× |
| Xr myelogram posterior fossa (70010) | $1,230.82 | $3,239 | 3.6× |
| Xr orbits complete 4 views (70200) | $239.40 | $630 | 2.4× |
| Xr Tomogram Single Plane (76100) | $303.62 | $799 | 3.0× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.