Imaging prices at Upson Regional Medical Center
Thomaston, GA · every code in this section with a posted price and a Medicare benchmark.
331 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 3 matching MRF lines |
$84–$199.20 | $140–$332 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$93.60–$199.20 | $156–$332 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,213.40 | $3,689 | 5.6× |
| Angio pulmonary bilat (75743) | $5,296.20 | $8,827 | 1.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $2,300.40 | $3,834 | 0.7× |
| Angiography extremity bilateral rs&i (75716) | $2,131.80 | $3,553 | 0.7× |
| Angiography extremity unilateral rs&i (75710) range across 4 matching MRF lines |
$2,131.80–$2,532.60 | $3,553–$4,221 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,296.20 | $8,827 | 1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $2,300.40 | $3,834 | 0.7× |
| Ankle 2 views (73600) | $312 | $520 | 3.6× |
| Aortography thoracic serialography rs&i (75605) | $3,831.60 | $6,386 | 0.7× |
| Aortography thoracic w/o serialography rs&i (75600) | $2,734.20 | $4,557 | 0.9× |
| Artery X-Rays Abdomen (75726) range across 3 matching MRF lines |
$3,831.60–$8,823 | $6,386–$14,705 | varies |
| Artery X-Rays Adrenal Gland (75731) | $2,734.20 | $4,557 | 0.9× |
| Artery X-Rays Pelvis (75736) | $3,831.60 | $6,386 | 0.7× |
| Artery X-Rays Spine (75705) | $3,831.60 | $6,386 | 0.7× |
| Arthrogram ankle (73615) | $492.60 | $821 | 1.4× |
| Arthrogram hip (73525) | $402 | $670 | 1.2× |
| Arthrogram Wrist (73115) range across 3 matching MRF lines |
$223.20–$492.60 | $372–$821 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$88.20–$186.60 | $147–$311 | varies |
| Bone Imaging 3 Phase (78315) | $2,256.60 | $3,761 | 5.7× |
| Bone Imaging Limited Area (78300) | $1,493.40 | $2,489 | 3.8× |
| Bone Imaging Multiple Areas (78305) | $1,039.80 | $1,733 | 2.6× |
| Bone Imaging Whole Body (78306) | $2,661 | $4,435 | 6.8× |
| Bone marrow imaging limited area (78102) | $820.20 | $1,367 | 2.1× |
| Bone survey infant (77076) | $256.80 | $428 | 2.5× |
| Brain Image W/Flow < 4 Views (78601) | $1,630.80 | $2,718 | 4.1× |
| Brain imaging < 4 static views (78600) | $1,087.80 | $1,813 | 2.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$320.40–$1,570.80 | $534–$2,618 | varies |
| Brain Imaging Minimum 4 Static Views (78605) | $910.80 | $1,518 | 1.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $2,988 | $4,980 | 2.1× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) | $1,248 | $2,080 | 2.3× |
| Cat Scan Follow-Up Study (76380) range across 3 matching MRF lines |
$525–$1,469.40 | $875–$2,449 | varies |
| Chest 1 view (71045) | $355.80 | $593 | 4.2× |
| Chest 2 views (71046) range across 4 matching MRF lines |
$132.60–$355.80 | $221–$593 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$180–$355.80 | $300–$593 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$392.40–$465.60 | $654–$776 | varies |
| Clavicle complete (73000) range across 5 matching MRF lines |
$108–$288 | $180–$480 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$154.80–$155.40 | $258–$259 | varies |
| Contrast Exam Abdominl Aorta (75625) | $2,300.40 | $3,834 | 0.7× |
| Contrast X-Ray Bladder (74430) | $268.80 | $448 | 0.8× |
| Contrast X-Ray Of Elbow (73085) | $369.60 | $616 | 1.1× |
| Contrast X-Ray Of Knee Joint (73580) | $630.60 | $1,051 | 1.8× |
| Contrast Xray Throat/Cerv Esopha (74210) | $190.20 | $317 | 1.1× |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$525–$6,601.80 | $875–$11,003 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$525–$4,597.20 | $875–$7,662 | varies |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$525–$3,397.20 | $875–$5,662 | varies |
| CT abdomen w wo contrast (74170) range across 3 matching MRF lines |
$525–$4,134.60 | $875–$6,891 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$525–$3,152.40 | $875–$5,254 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 3 matching MRF lines |
$525–$2,613 | $875–$4,355 | varies |
| CT Angio Chest (71275) range across 6 matching MRF lines |
$525–$5,697.60 | $875–$9,496 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$525–$2,552.40 | $875–$4,254 | varies |
| CT angio hrt w/3d image (75574) range across 3 matching MRF lines |
$525–$652.80 | $875–$1,088 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 9 matching MRF lines |
$525–$4,947 | $875–$8,245 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$525–$2,761.20 | $875–$4,602 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 9 matching MRF lines |
$525–$2,845.80 | $875–$4,743 | varies |
| CT bone density (77078) range across 3 matching MRF lines |
$525–$703.80 | $875–$1,173 | varies |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$525–$6,327.60 | $875–$10,546 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$525–$5,991 | $875–$9,985 | varies |
| CT cervical spine w/wo cont (72127) range across 3 matching MRF lines |
$525–$7,548.60 | $875–$12,581 | varies |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$525–$3,353.40 | $875–$5,589 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$525–$4,164.60 | $875–$6,941 | varies |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$525–$2,355.60 | $875–$3,926 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$525–$2,364.60 | $875–$3,941 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 3 matching MRF lines |
$525–$652.80 | $875–$1,088 | varies |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$525–$5,047.80 | $875–$8,413 | varies |
| CT l-spine w&w/o contrast (72133) range across 3 matching MRF lines |
$525–$3,890.40 | $875–$6,484 | varies |
| CT lower ext w/o (73700) range across 36 matching MRF lines |
$525–$4,947 | $875–$8,245 | varies |
| CT lower extremity w/contrast material (73701) range across 30 matching MRF lines |
$525–$3,034.20 | $875–$5,057 | varies |
| CT lumbar spine w contrast (72132) range across 3 matching MRF lines |
$525–$3,405.60 | $875–$5,676 | varies |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$525–$3,156 | $875–$5,260 | varies |
| CT maxillofacial w contrast (70487) range across 6 matching MRF lines |
$525–$5,934.60 | $875–$9,891 | varies |
| CT maxillofacial wo contrast (70486) range across 6 matching MRF lines |
$525–$2,025.60 | $875–$3,376 | varies |
| CT neck tissue combo (70492) range across 3 matching MRF lines |
$525–$2,451 | $875–$4,085 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$525–$5,754.60 | $875–$9,591 | varies |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$525–$1,805.40 | $875–$3,009 | varies |
| CT pelvis w&w/o contrast (72194) range across 3 matching MRF lines |
$525–$4,401 | $875–$7,335 | varies |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$525–$1,169.40 | $875–$1,949 | varies |
| CT scan of leg combo (73702) range across 27 matching MRF lines |
$525–$4,947 | $875–$8,245 | varies |
| CT scans face/jaw combo (70488) range across 6 matching MRF lines |
$525–$6,643.80 | $875–$11,073 | varies |
| CT soft tissue neck w contrast (70491) range across 3 matching MRF lines |
$525–$2,061 | $875–$3,435 | varies |
| CT soft tissue neck w/o contrast (70490) range across 3 matching MRF lines |
$525–$1,792.20 | $875–$2,987 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$525–$2,763 | $875–$4,605 | varies |
| CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines |
$525–$2,871.60 | $875–$4,786 | varies |
| CT thoracic spine w/wo cont (72130) range across 3 matching MRF lines |
$525–$3,956.40 | $875–$6,594 | varies |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$525–$3,067.20 | $875–$5,112 | varies |
| CT unlisted procedure (76497) range across 3 matching MRF lines |
$509.40–$525 | $849–$875 | varies |
| CT upper ext wo (73200) range across 36 matching MRF lines |
$525–$3,034.20 | $875–$5,057 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 45 matching MRF lines |
$525–$4,947 | $875–$8,245 | varies |
| CT upper extremity with contrast (73201) range across 33 matching MRF lines |
$525–$3,034.20 | $875–$5,057 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$525–$6,013.20 | $875–$10,022 | varies |
| Cta Abdomen (74175) range across 3 matching MRF lines |
$525–$4,764.60 | $875–$7,941 | varies |
| CTA pelvis (72191) range across 3 matching MRF lines |
$525–$4,779 | $875–$7,965 | varies |
| Dilation ureters/urethra rs&i (74485) | $1,439.40 | $2,399 | 0.7× |
| Diskography lumbar (72295) | $3,858 | $6,430 | 2.0× |
| Doppler Fetal Mid Cerebral Artery (76821) | $217.80 | $363 | 2.1× |
| Dxa Bone Density Axial (77080) | $606.60 | $1,011 | 5.9× |
| Dxa bone density study (77085) | $165.60 | $276 | 1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $606.60 | $1,011 | 7.1× |
| Echo exam uterus (76831) | $645 | $1,075 | 2.7× |
| Echo Guide For Artery Repair (76936) | $591 | $985 | 2.8× |
| Esophagram (74220) | $308.40 | $514 | 1.8× |
| Fetal Biophys Profile W/Nst (76818) | $324 | $540 | 3.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$324–$599.40 | $540–$999 | varies |
| Fluoroscopy up to 1 hr (76000) range across 6 matching MRF lines |
$142.80–$645 | $238–$1,075 | varies |
| Follow-Up Angiography (75898) | $2,300.40 | $3,834 | 0.7× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$108–$283.20 | $180–$472 | varies |
| Forearm 2 views (73090) range across 4 matching MRF lines |
$136.80–$366.60 | $228–$611 | varies |
| Gastric emptying imaging study (78264) | $2,594.40 | $4,324 | 6.6× |
| Gated Heart, Multiple (78473) | $1,614 | $2,690 | 4.1× |
| Hand 2 views (73120) | $320.40 | $534 | 3.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $2,300.40 | $3,834 | 0.7× |
| Hepatobil Syst Image W/Drug (78227) | $2,193 | $3,655 | 4.1× |
| Hepatobiliary System Imaging (78226) | $1,579.20 | $2,632 | 4.0× |
| Ht Muscle Image Spect Sing (78451) | $3,274.20 | $5,457 | 2.6× |
| Hysterosalpingogram (74740) | $465.60 | $776 | 2.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $467.40 | $779 | 5.5× |
| Infant hip ultrasound, limited static exam (76886) | $365.40 | $609 | 4.3× |
| Infusion Ivp (74410) | $342 | $570 | 2.0× |
| Joint Survey Single View (77077) | $149.40 | $249 | 1.5× |
| K Flow/Funct Image Multiple (78709) | $1,725 | $2,875 | 3.2× |
| K Flow/Funct Image W/Drug (78708) | $1,942.80 | $3,238 | 3.6× |
| K Flow/Funct Image W/O Drug (78707) | $1,942.80 | $3,238 | 3.6× |
| Knee 3 Views (73562) | $145.20 | $242 | 1.7× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) | $1,401.60 | $2,336 | 3.6× |
| Liver & Spleen Imaging Static Only (78215) | $1,542 | $2,570 | 3.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $1,397.40 | $2,329 | 3.6× |
| Liver imaging static only (78201) | $1,010.40 | $1,684 | 1.9× |
| Liver imaging w/vascular flow (78202) | $1,038.60 | $1,731 | 1.9× |
| Lung Perf&Ventilat Diferentl (78598) | $1,287.60 | $2,146 | 2.4× |
| Lung perfusion differential (78597) | $795 | $1,325 | 2.0× |
| Lung Ventilat&Perfus Imaging (78582) | $1,331.40 | $2,219 | 2.5× |
| Lung Ventilation Imaging (78579) | $742.80 | $1,238 | 1.9× |
| Lymph System Imaging (78195) | $1,733.40 | $2,889 | 3.2× |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,080–$6,238.80 | $1,800–$10,398 | varies |
| Mammary ductogram or galactogram multiple (77054) | $790.80 | $1,318 | 3.4× |
| Mammary ductogram or galactogram single (77053) | $592.80 | $988 | 2.5× |
| Meckels Divert Exam (78290) | $1,510.80 | $2,518 | 3.8× |
| Mra Head W/O & W/Contrast Material (70546) range across 3 matching MRF lines |
$1,080–$6,415.80 | $1,800–$10,693 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,080–$5,199 | $1,800–$8,665 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$1,080–$5,412.60 | $1,800–$9,021 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$1,080–$4,808.40 | $1,800–$8,014 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$1,080–$5,457 | $1,800–$9,095 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$1,080–$4,345.20 | $1,800–$7,242 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$1,080–$12,321.60 | $1,800–$20,536 | varies |
| MRI abdomen w/o contrast (74181) range across 4 matching MRF lines |
$1,080–$10,266.60 | $1,800–$17,111 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 12 matching MRF lines |
$1,080–$11,473.80 | $1,800–$19,123 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 12 matching MRF lines |
$1,080–$12,853.80 | $1,800–$21,423 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 12 matching MRF lines |
$1,080–$11,473.80 | $1,800–$19,123 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$1,080–$5,710.80 | $1,800–$9,518 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,080–$4,889.40 | $1,800–$8,149 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$1,080–$6,381.60 | $1,800–$10,636 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$1,080–$6,826.80 | $1,800–$11,378 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$1,080–$14,610.60 | $1,800–$24,351 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 16 matching MRF lines |
$1,080–$7,786.20 | $1,800–$12,977 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 18 matching MRF lines |
$1,080–$9,663.60 | $1,800–$16,106 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 16 matching MRF lines |
$1,080–$7,306.80 | $1,800–$12,178 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$1,080–$10,412.40 | $1,800–$17,354 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$1,080–$6,570.60 | $1,800–$10,951 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,080–$5,263.20 | $1,800–$8,772 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$1,080–$6,315.60 | $1,800–$10,526 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$1,080–$7,777.80 | $1,800–$12,963 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$1,080–$9,555.60 | $1,800–$15,926 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,080–$12,159.60 | $1,800–$20,266 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,080–$9,183 | $1,800–$15,305 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,080–$9,941.40 | $1,800–$16,569 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 14 matching MRF lines |
$1,080–$10,078.80 | $1,800–$16,798 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 12 matching MRF lines |
$1,080–$10,078.80 | $1,800–$16,798 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 12 matching MRF lines |
$1,080–$13,327.80 | $1,800–$22,213 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,080–$13,798.20 | $1,800–$22,997 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,080–$9,660 | $1,800–$16,100 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$1,080–$10,494 | $1,800–$17,490 | varies |
| MRI, joint upper extrem (73221) range across 12 matching MRF lines |
$1,080–$8,955 | $1,800–$14,925 | varies |
| MRI, joint upper extrem combo (73223) range across 12 matching MRF lines |
$1,080–$13,794 | $1,800–$22,990 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,080–$9,660 | $1,800–$16,100 | varies |
| Myelogram cervical (72240) | $1,704 | $2,840 | 2.2× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $1,180.80 | $1,968 | 3.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) range across 2 matching MRF lines |
$2,583.60–$3,571.20 | $4,306–$5,952 | varies |
| Myocardial Spect Multiple Studies (78452) | $4,887.60 | $8,146 | 3.8× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$71.40–$186 | $119–$310 | varies |
| Nonvascular Shunt X-Ray (75809) | $243 | $405 | 2.4× |
| Optic foramina (70190) range across 2 matching MRF lines |
$97.80–$111.60 | $163–$186 | varies |
| Parathyroid imaging w/tomographic spect & CT (78072) | $1,713 | $2,855 | 3.2× |
| Parathyroid Planar Imaging (78070) | $1,786.20 | $2,977 | 4.5× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,659.60 | $2,766 | 4.2× |
| Pelvis 1 or 2 views (72170) | $300 | $500 | 2.9× |
| Pet Image Skull-Thigh (78812) range across 2 matching MRF lines |
$1,080–$7,519.20 | $1,800–$12,532 | varies |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$1,080–$8,519.40 | $1,800–$14,199 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$1,080–$8,494.80 | $1,800–$14,158 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$1,080–$9,150.60 | $1,800–$15,251 | varies |
| Pet Imaging Limited Area Chest Head/Neck (78811) range across 3 matching MRF lines |
$3,641.40–$7,746 | $6,069–$12,910 | varies |
| PET whole body (78813) range across 40 matching MRF lines |
$1,080–$8,789.40 | $1,800–$14,649 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,708.20 | $2,847 | 4.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $199.20 | $332 | 1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $388.80 | $648 | 0.7× |
| Radex Ankle Complete Minimum 3 Views (73610) | $361.20 | $602 | 4.2× |
| Radex Calcaneus Minimum 2 Views (73650) range across 4 matching MRF lines |
$130.20–$382.20 | $217–$637 | varies |
| Radex elbow complete minimum 3 views (73080) range across 4 matching MRF lines |
$142.80–$385.20 | $238–$642 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$158.40–$432 | $264–$720 | varies |
| Radex fingr minimum 2 views (73140) range across 20 matching MRF lines |
$103.20–$306.60 | $172–$511 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$136.80–$358.20 | $228–$597 | varies |
| Radex Hand Minimum 3 Views (73130) range across 4 matching MRF lines |
$127.80–$347.40 | $213–$579 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $144 | $240 | 1.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $176.40 | $294 | 1.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$160.20–$427.20 | $267–$712 | varies |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) | $188.40 | $314 | 2.2× |
| Radex Ribs Unilateral 2 Views (71100) range across 4 matching MRF lines |
$137.40–$405.60 | $229–$676 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 4 matching MRF lines |
$117–$385.20 | $195–$642 | varies |
| Radex Sinuses Paransl < 3 Views (70210) | $268.20 | $447 | 3.1× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $949.80 | $1,583 | 5.5× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$65.40–$166.80 | $109–$278 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$160.20–$429 | $267–$715 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $452.40 | $754 | 5.3× |
| Radex Toe Minimum 2 Views (73660) range across 19 matching MRF lines |
$103.20–$306.60 | $172–$511 | varies |
| Radex upper extremity infant minimum 2 views (73092) | $141.60 | $236 | 1.4× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 4 matching MRF lines |
$141.60–$374.40 | $236–$624 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$178.20–$487.80 | $297–$813 | varies |
| Radiologic exam colon double contrast study (74280) | $518.40 | $864 | 3.0× |
| Radiologic exam colon single contrast study (74270) | $512.40 | $854 | 3.0× |
| Radiologic exam knee complete 4/more views (73564) range across 8 matching MRF lines |
$127.80–$378 | $213–$630 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$145.20–$429.60 | $242–$716 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $357.60 | $596 | 2.1× |
| Radiologic exam swallow function contrast study (74230) range across 3 matching MRF lines |
$105–$329.40 | $175–$549 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 5 matching MRF lines |
$499.80–$752.40 | $833–$1,254 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$141.60–$380.40 | $236–$634 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$111–$296.40 | $185–$494 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $465 | $775 | 4.5× |
| Radiologic Examination Salivary Gland Calculus (70380) | $87 | $145 | 1.0× |
| Radiologic examination tibia & fibula 2 views (73590) range across 4 matching MRF lines |
$126.60–$339 | $211–$565 | varies |
| Renal Cyst Study (74470) | $429 | $715 | 0.8× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$196.20–$528.60 | $327–$881 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $670.80 | $1,118 | 1.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $3,156.60 | $5,261 | 5.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 4 matching MRF lines |
$49.80–$2,674.20 | $83–$4,457 | varies |
| Scapula (73010) range across 4 matching MRF lines |
$144–$375 | $240–$625 | varies |
| Sella turcica (70240) | $178.20 | $297 | 2.1× |
| Shoulder 1 view (73020) | $300 | $500 | 3.5× |
| Shoulder Arthrography (73040) | $444 | $740 | 1.3× |
| Sialogram (70390) | $345 | $575 | 1.5× |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$115.20–$339 | $192–$565 | varies |
| Speech evaluation, complex (70371) | $290.40 | $484 | 1.2× |
| Spleen Imaging (78185) | $964.20 | $1,607 | 2.5× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$102.60–$127.80 | $171–$213 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $694.80 | $1,158 | 4.0× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$165–$440.40 | $275–$734 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$168.60–$452.40 | $281–$754 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$111–$301.80 | $185–$503 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $1,182.60 | $1,971 | 3.0× |
| Thyroid Imaging With Vascular Flow (78013) | $1,035 | $1,725 | 2.6× |
| Thyroid Uptake Measurement (78012) | $881.40 | $1,469 | 2.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,285.80 | $2,143 | 3.3× |
| Ultrasound Breast Limited (76642) | $740.40 | $1,234 | 8.6× |
| Ultrasound Exam Aaa Screen (76706) | $369 | $615 | 3.6× |
| Ultrasound, abdomen limited (76705) | $938.40 | $1,564 | 9.1× |
| Umbilical-artery Doppler (OB) (76820) | $223.80 | $373 | 2.2× |
| Unlisted Dx Radiographic Procedure (76499) | $753 | $1,255 | 8.8× |
| Unlisted magnetic resonance procedure (76498) range across 2 matching MRF lines |
$1,080–$5,203.80 | $1,800–$8,673 | varies |
| Unlisted us procedure (76999) | $273 | $455 | 3.2× |
| Upper gi w/o kub (74240) | $414 | $690 | 2.4× |
| Urethrocystogram voiding (74455) | $439.80 | $733 | 1.9× |
| Urethrocystography retrograde (74450) | $325.80 | $543 | 1.4× |
| Us breast unilateral complete (76641) range across 3 matching MRF lines |
$370.80–$740.40 | $618–$1,234 | varies |
| Us chest (76604) | $424.20 | $707 | 4.1× |
| Us complete joint (76881) | $776.40 | $1,294 | 7.5× |
| Us exam, pelvic, limited (76857) | $677.40 | $1,129 | 6.6× |
| Us head (76506) | $378 | $630 | 3.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $947.40 | $1,579 | 9.2× |
| Us ob detailed single fetus (76811) | $592.80 | $988 | 2.5× |
| Us ob limited 1 or more fetuses (76815) | $572.40 | $954 | 5.6× |
| Us ob transvaginal (76817) | $666.60 | $1,111 | 6.5× |
| Us pelvic non ob complete (76856) | $960.60 | $1,601 | 9.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $790.80 | $1,318 | 7.7× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $423.60 | $706 | 4.1× |
| Us retroperitoneal complete (76770) | $885.60 | $1,476 | 8.6× |
| Us retroperitoneal limited (76775) | $878.40 | $1,464 | 8.5× |
| Us scrotum and contents (76870) | $892.20 | $1,487 | 8.7× |
| Us spinal canal and contents (76800) | $373.80 | $623 | 3.6× |
| Us thyroid (76536) | $969.60 | $1,616 | 9.4× |
| Us transrectal (76872) | $775.80 | $1,293 | 7.5× |
| Vascular Flow Imaging (78445) | $952.20 | $1,587 | 2.4× |
| Vasogram (74440) | $243 | $405 | 1.0× |
| Vein X-Ray Chest (75827) | $1,558.20 | $2,597 | 1.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $2,300.40 | $3,834 | 0.7× |
| Venography Adrenal Unilateral (75840) | $2,300.40 | $3,834 | 0.7× |
| Venography caval inferior serialography rs&i (75825) | $2,073.60 | $3,456 | 0.7× |
| Venography extremity bilateral rs&i (75822) | $2,636.40 | $4,394 | 1.7× |
| Venography extremity unilateral rs&i (75820) | $1,130.40 | $1,884 | 0.7× |
| Venography Renal Bilateral (75833) | $2,300.40 | $3,834 | 0.7× |
| Venography Renal Unilateral (75831) | $2,300.40 | $3,834 | 0.7× |
| Venous sampling by catheter (75893) | $3,831.60 | $6,386 | 0.7× |
| Vertebral fracture assessment via dxa (77086) | $209.40 | $349 | 2.4× |
| Wrist 2 views (73100) range across 4 matching MRF lines |
$102–$301.80 | $170–$503 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $238.80 | $398 | 2.8× |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$303–$501 | $505–$835 | varies |
| X-Ray Aorta Leg Arteries (75630) | $2,284.20 | $3,807 | 0.7× |
| X-Ray Bend Only L-S Spine (72120) | $357.60 | $596 | 3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 4 matching MRF lines |
$106.20–$282 | $177–$470 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$145.20–$388.80 | $242–$648 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 4 matching MRF lines |
$88.20–$186 | $147–$310 | varies |
| X-Ray Exam Hip Uni 1 View (73501) | $413.40 | $689 | 4.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 5 matching MRF lines |
$136.80–$367.20 | $228–$612 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) | $107.40 | $179 | 1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $508.80 | $848 | 4.9× |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$216–$639 | $360–$1,065 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$183.60–$489 | $306–$815 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$209.40–$563.40 | $349–$939 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 4 matching MRF lines |
$169.80–$460.20 | $283–$767 | varies |
| X-ray eye for foreign body (70030) | $158.40 | $264 | 1.8× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$124.80–$310.20 | $208–$517 | varies |
| X-ray IV pyelogram (ivp) (74400) | $640.20 | $1,067 | 3.7× |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$125.40–$457.20 | $209–$762 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $153 | $255 | 1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$94.20–$231 | $157–$385 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$198.60–$534 | $331–$890 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$106.80–$130.80 | $178–$218 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$212.40–$574.80 | $354–$958 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $320.40 | $534 | 3.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $338.40 | $564 | 3.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$158.40–$421.80 | $264–$703 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$201.60–$540 | $336–$900 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$181.20–$484.80 | $302–$808 | varies |
| X-Ray Stress View (77071) | $127.80 | $213 | 1.5× |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$136.80–$361.80 | $228–$603 | varies |
| X-Ray Tmj Unilat (70328) | $146.40 | $244 | 1.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $457.20 | $762 | 1.3× |
| X-Rays Bone Length Studies (77073) | $193.20 | $322 | 1.9× |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$357.60–$961.20 | $596–$1,602 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$209.40–$560.40 | $349–$934 | varies |
| Xr facial bones less than 3 views (70140) | $222 | $370 | 2.6× |
| Xr orbits complete 4 views (70200) range across 4 matching MRF lines |
$174–$510 | $290–$850 | varies |
| Xr Tomogram Single Plane (76100) | $268.20 | $447 | 2.6× |
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.