Imaging prices at UP Health System - Portage
Hancock, MI · every code in this section with a posted price and a Medicare benchmark.
271 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 |
$174.92–$190.66 | $291.53–$317.77 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$215.25–$234.62 | $358.75–$391.04 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 3 matching MRF lines |
$1,486.60–$1,679.94 | $2,477.66–$2,799.90 | varies |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$172.47–$187.99 | $287.45–$313.32 | varies |
| Arthrogram ankle (73615) | $2,055.92 | $3,426.53 | 5.9× |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$638.53–$695.99 | $1,064.21–$1,159.99 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$193.27–$210.67 | $322.12–$351.11 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,338.17–$1,458.61 | $2,230.29–$2,431.02 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$703.34–$766.64 | $1,172.23–$1,277.73 | varies |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$1,190.17–$1,297.29 | $1,983.62–$2,162.15 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,190.17–$1,297.29 | $1,983.62–$2,162.15 | varies |
| Bone survey infant (77076) | $230.65 | $384.41 | 2.2× |
| Chest 1 view (71045) range across 4 matching MRF lines |
$73.92–$287.99 | $123.20–$479.98 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$157.33–$224 | $262.22–$373.33 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$260.54–$283.99 | $434.24–$473.32 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$174.92–$190.66 | $291.53–$317.77 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$262.09–$285.67 | $436.81–$476.12 | varies |
| Contrast X-Ray Bladder (74430) range across 3 matching MRF lines |
$502.64–$1,203.96 | $837.73–$2,006.60 | varies |
| Contrast X-Ray Of Elbow (73085) range across 3 matching MRF lines |
$739.97–$1,198.64 | $1,233.29–$1,997.73 | varies |
| Contrast X-Ray Of Knee Joint (73580) | $1,109.44 | $1,849.06 | 3.2× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$5,897.02–$6,427.75 | $9,828.36–$10,712.91 | varies |
| CT abdomen and pelvis without contrast (74176) | $3,537.19 | $5,895.32 | 14.9× |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,911.86–$2,083.93 | $3,186.43–$3,473.21 | varies |
| CT abdomen w wo contrast (74170) range across 3 matching MRF lines |
$2,143.90–$4,285.15 | $3,573.17–$7,141.92 | varies |
| CT abdomen w/o contrast (74150) | $1,591.37 | $2,652.28 | 15.3× |
| CT Angio Abdomen and Pelvis (74174) | $6,575.88 | $10,959.80 | 18.9× |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,706.36–$1,859.93 | $2,843.93–$3,099.88 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,706.36–$1,859.93 | $2,843.93–$3,099.88 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$2,075.75–$2,262.57 | $3,459.59–$3,770.95 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,859.93 | $3,099.88 | 10.6× |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,706.36–$1,859.93 | $2,843.93–$3,099.88 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $1,859.93 | $3,099.88 | 10.6× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,031.65–$1,124.50 | $1,719.42–$1,874.17 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$1,653.76–$1,802.60 | $2,756.27–$3,004.33 | varies |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$2,155.90–$6,381.08 | $3,593.17–$10,635.13 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$2,462.30–$2,683.90 | $4,103.83–$4,473.17 | varies |
| CT colonography screening (74263) range across 2 matching MRF lines |
$1,751.62–$1,909.26 | $2,919.36–$3,182.10 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) | $1,909.26 | $3,182.10 | 10.9× |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 2 matching MRF lines |
$1,751.62–$1,909.26 | $2,919.36–$3,182.10 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,591.37–$1,734.59 | $2,652.28–$2,890.99 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,977.89–$2,155.90 | $3,296.49–$3,593.17 | varies |
| CT heart no contrast quant eval coronry calcium (75571) | $63.89 | $106.49 | 0.7× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,591.37–$1,734.59 | $2,652.28–$2,890.99 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$2,145.48–$2,338.57 | $3,575.80–$3,897.62 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,390.76–$1,515.92 | $2,317.93–$2,526.54 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,653.76–$1,802.60 | $2,756.27–$3,004.33 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,917.97–$2,090.59 | $3,196.62–$3,484.32 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$1,653.76–$1,802.60 | $2,756.27–$3,004.33 | varies |
| CT maxillofacial wo contrast (70486) range across 3 matching MRF lines |
$602.64–$1,315.95 | $1,004.40–$2,193.25 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,917.97–$2,090.59 | $3,196.62–$3,484.32 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,977.89–$2,155.90 | $3,296.49–$3,593.17 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$1,323.52–$1,442.63 | $2,205.86–$2,404.39 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$2,363.21–$2,575.90 | $3,938.68–$4,293.16 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,653.76–$1,802.60 | $2,756.27–$3,004.33 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$2,076.98–$2,263.91 | $3,461.63–$3,773.18 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$763.35–$832.05 | $1,272.25–$1,386.75 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,543.68–$1,682.61 | $2,572.80–$2,804.35 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,323.52–$1,442.63 | $2,205.86–$2,404.39 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,031.65–$1,124.50 | $1,719.42–$1,874.17 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,653.76–$1,802.60 | $2,756.27–$3,004.33 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$2,502.67–$2,727.91 | $4,171.11–$4,546.51 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,653.76–$1,802.60 | $2,756.27–$3,004.33 | varies |
| CT upper ext wo (73200) | $1,515.92 | $2,526.54 | 14.6× |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$2,076.98–$2,263.91 | $3,461.63–$3,773.18 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,653.76–$1,802.60 | $2,756.27–$3,004.33 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $1,706.36 | $2,843.93 | 9.8× |
| Cta Abdomen (74175) | $1,859.93 | $3,099.88 | 10.6× |
| CTA pelvis (72191) range across 2 matching MRF lines |
$1,706.36–$1,859.93 | $2,843.93–$3,099.88 | varies |
| Dilation ureters/urethra rs&i (74485) | $4,353.15 | $7,255.25 | 2.1× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$370.64–$404 | $617.73–$673.33 | varies |
| Echo exam uterus (76831) range across 3 matching MRF lines |
$446.66–$767.98 | $744.44–$1,279.97 | varies |
| Esophagram (74220) | $419.98 | $699.97 | 2.4× |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$458.70–$499.99 | $764.50–$833.31 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 4 matching MRF lines |
$483.98–$967.97 | $806.63–$1,613.28 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$425.67–$463.98 | $709.45–$773.30 | varies |
| Follow-Up Angiography (75898) range across 2 matching MRF lines |
$3,987.61–$4,346.49 | $6,646.01–$7,244.15 | varies |
| Foot 2 views (73620) | $134.68 | $224.46 | 1.6× |
| Forearm 2 views (73090) | $190.66 | $317.77 | 2.2× |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,253.76–$1,366.60 | $2,089.60–$2,277.66 | varies |
| Gated Heart Planar Single (78472) range across 3 matching MRF lines |
$1,033.30–$1,225.29 | $1,722.16–$2,042.15 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$129.33–$134.68 | $215.55–$224.46 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,974.58–$2,583.89 | $3,290.97–$4,306.49 | varies |
| Hepatobiliary System Imaging (78226) | $2,015.92 | $3,359.87 | 5.1× |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$3,854.27–$4,201.16 | $6,423.79–$7,001.93 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$796.30–$867.97 | $1,327.17–$1,446.62 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$584.69–$637.31 | $974.49–$1,062.19 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 2 matching MRF lines |
$225.07–$245.32 | $375.11–$408.87 | varies |
| Infusion Ivp (74410) | $693.30 | $1,155.50 | 4.0× |
| K Flow/Funct Image W/Drug (78708) range across 3 matching MRF lines |
$1,481.26–$2,347.92 | $2,468.77–$3,913.20 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 3 matching MRF lines |
$1,366.60–$2,233.24 | $2,277.66–$3,722.06 | varies |
| Kidney Imaging Morphol (78700) range across 2 matching MRF lines |
$922.28–$1,005.29 | $1,537.14–$1,675.48 | varies |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$210.67–$407.98 | $351.11–$679.97 | varies |
| Leveen/Shunt Patency Exam (78291) range across 2 matching MRF lines |
$934.62–$1,329.62 | $1,557.70–$2,216.03 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 3 matching MRF lines |
$894.64–$1,138.62 | $1,491.07–$1,897.70 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) range across 2 matching MRF lines |
$1,199.95–$1,307.95 | $1,999.92–$2,179.91 | varies |
| Lung Ventilat&Perfus Imaging (78582) | $1,690.60 | $2,817.66 | 3.1× |
| Lymph System Imaging (78195) range across 3 matching MRF lines |
$602.64–$846.63 | $1,004.40–$1,411.05 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| Mammary ductogram or galactogram single (77053) range across 3 matching MRF lines |
$1,149.30–$1,406.62 | $1,915.50–$2,344.37 | varies |
| Meckels Divert Exam (78290) range across 3 matching MRF lines |
$927.98–$1,442.63 | $1,546.63–$2,404.39 | varies |
| Mr safety determination physician/other qhp (76016) range across 2 matching MRF lines |
$105.66–$115.17 | $176.10–$191.95 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $29.39 | $48.98 | 1.0× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) range across 2 matching MRF lines |
$110.15–$120.06 | $183.58–$200.10 | varies |
| Mr safety implt pos&/immoblj (76019) range across 2 matching MRF lines |
$71.28–$77.69 | $118.80–$129.49 | varies |
| Mr safety med physics xm customization plng&mntr (76017) range across 2 matching MRF lines |
$290.06–$316.17 | $483.44–$526.95 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI any jt lower extrem w/contrast material (73722) | $3,407.85 | $5,679.75 | 4.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $3,407.85 | $5,679.75 | 9.8× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$2,298.25–$2,505.10 | $3,830.42–$4,175.16 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$2,298.25–$2,505.10 | $3,830.42–$4,175.16 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$3,758.87–$4,097.17 | $6,264.79–$6,828.62 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$2,980.93–$3,249.22 | $4,968.22–$5,415.36 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $3,126.47 | $5,210.78 | 9.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$3,758.87–$4,097.17 | $6,264.79–$6,828.62 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$3,827.38–$4,171.84 | $6,378.96–$6,953.07 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$3,470.19–$3,782.51 | $5,783.65–$6,304.18 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) | $3,407.85 | $5,679.75 | 9.8× |
| MRI, abdomen, combo (74183) | $3,126.47 | $5,210.78 | 9.0× |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$3,827.38–$4,171.84 | $6,378.96–$6,953.07 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$3,758.87–$4,097.17 | $6,264.79–$6,828.62 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$3,126.47–$3,407.85 | $5,210.78–$5,679.75 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$3,827.38–$4,171.84 | $6,378.96–$6,953.07 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$5,281.13–$5,938.42 | $8,801.88–$9,897.37 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$148–$161.32 | $246.66–$268.86 | varies |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) | $227.23 | $378.71 | 2.2× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) | $113.56 | $189.26 | 1.3× |
| Parathyroid planar imaging w/wo subtraction (78071) | $681.63 | $1,136.05 | 1.7× |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$174.92–$190.66 | $291.53–$317.77 | varies |
| Pet Image Skull-Thigh (78812) range across 2 matching MRF lines |
$2,388.62–$2,603.59 | $3,981.03–$4,339.32 | varies |
| Pet Image W/Ct Lmtd (78814) range across 3 matching MRF lines |
$2,574–$2,805.66 | $4,290–$4,676.10 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$2,388.62–$2,603.59 | $3,981.03–$4,339.32 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$2,388.62–$2,603.59 | $3,981.03–$4,339.32 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) range across 2 matching MRF lines |
$2,105.73–$2,295.25 | $3,509.55–$3,825.41 | varies |
| PET whole body (78813) range across 2 matching MRF lines |
$2,388.62–$2,603.59 | $3,981.03–$4,339.32 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 3 matching MRF lines |
$1,049.29–$1,242.62 | $1,748.81–$2,071.04 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$1,149.30–$1,269.68 | $1,915.50–$2,116.14 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$176.14–$191.99 | $293.57–$319.99 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$159.04–$173.35 | $265.06–$288.92 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$116.02–$210.67 | $193.36–$351.11 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$260.54–$283.99 | $434.24–$473.32 | varies |
| Radex fingr minimum 2 views (73140) | $161.32 | $268.86 | 1.9× |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$176.14–$191.99 | $293.57–$319.99 | varies |
| Radex Hand Minimum 3 Views (73130) | $176.14 | $293.57 | 2.0× |
| Radex lower extremity infant minimum 2 views (73592) | $193.27 | $322.12 | 2.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$174.92–$190.66 | $291.53–$317.77 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$123.56–$134.68 | $205.93–$224.46 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$193.27–$210.67 | $322.12–$351.11 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$205.50–$224 | $342.50–$373.33 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$123.56–$134.68 | $205.93–$224.46 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$212.84–$232 | $354.73–$386.66 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$272.77–$297.32 | $454.62–$495.54 | varies |
| Radex Toe Minimum 2 Views (73660) | $161.32 | $268.86 | 1.9× |
| Radex upper extremity infant minimum 2 views (73092) | $329.33 | $548.88 | 3.2× |
| Radex Wrist Complete Minimum 3 Views (73110) | $191.99 | $319.99 | 2.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$447.28–$487.53 | $745.46–$812.55 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$205.50–$224 | $342.50–$373.33 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$215.25–$234.62 | $358.75–$391.04 | varies |
| Radiologic exam colon double contrast study (74280) | $726.58 | $1,210.96 | 4.2× |
| Radiologic exam colon single contrast study (74270) | $557.77 | $929.62 | 3.2× |
| Radiologic exam knee complete 4/more views (73564) | $281.31 | $468.85 | 2.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$218.95–$238.65 | $364.91–$397.75 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $426.88 | $711.47 | 2.4× |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$385.30–$419.98 | $642.17–$699.97 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$538.21–$586.65 | $897.02–$977.75 | varies |
| Radiologic examination femur 1 view (73551) range across 2 matching MRF lines |
$141.65–$154.40 | $236.09–$257.34 | varies |
| Radiologic examination femur minimum 2 views (73552) | $154.40 | $257.34 | 1.8× |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$374.30–$407.98 | $623.83–$679.97 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$174.92–$190.66 | $291.53–$317.77 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$302.14–$329.33 | $503.56–$548.88 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$929.62–$1,013.29 | $1,549.37–$1,688.81 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$1,157.15–$1,261.30 | $1,928.59–$2,102.16 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$1,552.22–$1,691.92 | $2,587.04–$2,819.87 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 6 matching MRF lines |
$1,077.29–$3,667.85 | $1,795.48–$6,113.09 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$174.92–$190.66 | $291.53–$317.77 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) | $83.80 | $139.66 | 3.6× |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$123.56–$134.68 | $205.93–$224.46 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$627.98–$1,086.64 | $1,046.64–$1,811.06 | varies |
| Sialogram (70390) range across 3 matching MRF lines |
$1,149.30–$1,530.60 | $1,915.50–$2,551 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$228.74–$249.32 | $381.23–$415.54 | varies |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$228.74–$249.32 | $381.23–$415.54 | varies |
| Testicular Imaging W/Flow (78761) range across 3 matching MRF lines |
$974.63–$1,487.95 | $1,624.39–$2,479.92 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$831.77–$906.64 | $1,386.29–$1,511.06 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$212.84–$232 | $354.73–$386.66 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$129.66–$141.33 | $216.10–$235.55 | varies |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$1,520.43–$1,657.27 | $2,534.05–$2,762.11 | varies |
| Thyroid Uptake Measurement (78012) | $1,531.94 | $2,553.24 | 3.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,211.95 | $2,019.91 | 3.0× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$336.39–$366.67 | $560.65–$611.11 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$639.74–$697.31 | $1,066.23–$1,162.19 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$400–$436 | $666.66–$726.66 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$628.72–$685.30 | $1,047.86–$1,142.17 | varies |
| Unlisted Dx Radiographic Procedure (76499) range across 2 matching MRF lines |
$54.73–$106.43 | $91.21–$177.39 | varies |
| Unlisted fluoroscopic procedure (76496) | $519.86 | $866.43 | 6.0× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$400–$436 | $666.66–$726.66 | varies |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$501.51–$546.65 | $835.85–$911.08 | varies |
| Ureteral Reflux Study (78740) range across 3 matching MRF lines |
$655.99–$1,169.27 | $1,093.31–$1,948.78 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$1,121.68–$1,222.63 | $1,869.46–$2,037.71 | varies |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$303.35–$330.65 | $505.59–$551.09 | varies |
| Us chest (76604) | $204.31 | $340.51 | 2.0× |
| Us complete joint (76881) | $1,031.96 | $1,719.94 | 9.9× |
| Us exam, pelvic, limited (76857) range across 5 matching MRF lines |
$138.67–$467.99 | $231.11–$779.98 | varies |
| Us head (76506) range across 2 matching MRF lines |
$240.97–$262.65 | $401.61–$437.75 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $823.21 | $1,372.01 | 7.9× |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$382.64–$403.66 | $637.74–$672.77 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$348.49–$501.30 | $580.82–$835.50 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$119.78–$486.65 | $199.64–$811.08 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$433.01–$471.98 | $721.68–$786.63 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$496.87–$619.96 | $828.12–$1,033.27 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 4 matching MRF lines |
$237.67–$591.98 | $396.11–$986.64 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$556.56–$606.65 | $927.60–$1,011.08 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$556.56–$606.65 | $927.60–$1,011.08 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$433.01–$471.98 | $721.68–$786.63 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$230.38–$251.11 | $383.96–$418.52 | varies |
| Us thyroid (76536) | $400 | $666.66 | 3.8× |
| Us transrectal (76872) range across 2 matching MRF lines |
$433.01–$471.98 | $721.68–$786.63 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$1,247.66–$1,359.95 | $2,079.43–$2,266.58 | varies |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$2,987.89–$3,771.84 | $4,979.82–$6,286.40 | varies |
| Vertebral fracture assessment via dxa (77086) | $119.99 | $199.99 | 1.4× |
| Wrist 2 views (73100) | $123.56 | $205.93 | 1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$218.95–$238.65 | $364.91–$397.75 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$473.32–$1,598.71 | $788.87–$2,664.52 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$123.56–$134.68 | $205.93–$224.46 | varies |
| X-Ray Exam Breast Specimen (76098) | $1,149.30 | $1,915.50 | 2.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$141.65–$154.40 | $236.09–$257.34 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$234.59–$255.70 | $390.98–$426.17 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$447.28–$487.53 | $745.46–$812.55 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$141.65–$154.40 | $236.09–$257.34 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$141.65–$154.40 | $236.09–$257.34 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$234.59–$255.70 | $390.98–$426.17 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$234.59–$255.70 | $390.98–$426.17 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$447.28–$487.53 | $745.46–$812.55 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$502.74–$547.99 | $837.90–$913.31 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$369.41–$402.65 | $615.68–$671.09 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$148–$161.32 | $246.66–$268.86 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$193.27–$210.67 | $322.12–$351.11 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$692.33–$754.64 | $1,153.89–$1,257.74 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$407.98–$542.66 | $679.97–$904.43 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$151.20–$238.65 | $252–$397.75 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$292.35–$318.66 | $487.25–$531.10 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$205.50–$224 | $342.50–$373.33 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$193.27–$210.67 | $322.12–$351.11 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$292.35–$318.66 | $487.25–$531.10 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$292.35–$318.66 | $487.25–$531.10 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$853.79–$930.63 | $1,422.98–$1,551.05 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$260.54–$283.99 | $434.24–$473.32 | varies |
| X-Rays Bone Survey Complete (77075) | $517.32 | $862.20 | 5.0× |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$258.08–$281.31 | $430.14–$468.85 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$260.54–$283.99 | $434.24–$473.32 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$426.88–$465.30 | $711.47–$775.50 | 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.