Imaging prices at Walthall General Hospital

Tylertown, MS · every code in this section with a posted price and a Medicare benchmark.

345 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $119.60 $427.13 1.6×
Abdomen 2 views (74019) $151.11 $539.66 1.7×
Acute Gastrointestinal Blood Loss Imaging (78278) $467.89 $1,671.01 1.4×
Angio pulmonary bilat (75743) $986.25 $3,522.31 0.4×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $938.82 $3,352.91 0.3×
Angiography extremity bilateral rs&i (75716)
range across 2 matching MRF lines
$1,440.92–$1,441.26 $5,146.13–$5,147.34 varies
Angiography extremity unilateral rs&i (75710) $1,261.02 $4,503.62 0.5×
Angiography pulmonary unilateral slctv rs&i (75741) $1,149.21 $4,104.32 0.4×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $875.13 $3,125.43 0.3×
Ankle 2 views (73600)
range across 3 matching MRF lines
$96.56–$128.75 $344.85–$459.80 varies
Aortography thoracic serialography rs&i (75605) $1,222.73 $4,366.89 0.3×
Artery X-Rays Abdomen (75726)
range across 2 matching MRF lines
$1,440.92–$1,441.26 $5,146.13–$5,147.34 varies
Artery X-Rays Adrenal Gland (75731) $938.82 $3,352.91 0.3×
Artery X-Rays Pelvis (75736) $1,224.77 $4,374.15 0.3×
Artery X-Rays Spine (75705) $1,196.99 $4,274.93 0.2×
Arthrogram ankle (73615) $113.16 $404.14 0.4×
Arthrogram hip (73525) $117.91 $421.08 0.4×
Arthrogram Wrist (73115) $164.32 $586.85 0.5×
Bone age studies (77072) $61.33 $219.01 0.7×
Bone Imaging 3 Phase (78315) $594.60 $2,123.55 1.7×
Bone Imaging Limited Area (78300) $376.07 $1,343.10 1.1×
Bone Imaging Multiple Areas (78305) $411.65 $1,470.15 1.2×
Bone Imaging Whole Body (78306) $564.11 $2,014.65 1.6×
Bone survey infant (77076) $72.85 $260.15 0.8×
Brain Flow Imaging Only (78610) $292.73 $1,045.44 0.6×
Brain Image W/Flow < 4 Views (78601) $308.65 $1,102.31 0.9×
Brain imaging < 4 static views (78600) $256.14 $914.76 0.7×
Brain Imaging Min 4 Static Views W Vascular Flow (78606) $652.53 $2,330.46 1.4×
Brain Imaging Minimum 4 Static Views (78605) $283.92 $1,013.98 0.6×
Cardiac MRI w/w/o contrast & further seq (75561) $1,524.60 $5,445 5.1×
Cat Scan Follow-Up Study (76380) $126.72 $452.54 1.7×
Cerebrospinal Fluid Scan (78630) $505.16 $1,804.11 1.1×
Chest 1 view (71045) $99.61 $355.74 1.3×
Chest 2 views (71046) $110.11 $393.25 1.5×
Chest 3 views (71047) $127.05 $453.75 1.7×
Chest 4 or more views (71048) $135.52 $484 1.5×
Cholecystography Oral Contrast (74290) $101.64 $363 0.7×
Clavicle complete (73000) $127.05 $453.75 1.7×
Contrast Exam Abdominl Aorta (75625) $1,496.48 $5,344.57 0.5×
Contrast X-Ray Bladder (74430) $134.51 $480.37 0.4×
Contrast X-Ray Of Elbow (73085) $144.33 $515.46 0.5×
Contrast X-Ray Of Knee Joint (73580) $123.67 $441.65 0.4×
Contrast Xray Throat/Cerv Esopha (74210) $112.15 $400.51 0.7×
CT abdomen and pelvis without and with contrast (74178) $1,588.30 $5,672.48 5.3×
CT abdomen and pelvis without contrast (74176) $1,128.89 $4,031.72 5.5×
CT abdomen w contrast (74160) $795.85 $2,842.29 5.3×
CT abdomen w wo contrast (74170) $941.19 $3,361.38 6.2×
CT abdomen w/o contrast (74150) $650.16 $2,321.99 7.2×
CT Angio Abdomen and Pelvis (74174) $933.74 $3,334.76 3.1×
CT Angio Chest (71275) $618.99 $2,210.67 4.1×
CT Angio Head (70496) $618.99 $2,210.67 4.1×
CT angio hrt w/3d image (75574) $704.03 $2,514.38 2.3×
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 3 matching MRF lines
$664.39–$1,328.78 $2,372.81–$4,745.62 varies
CT Angio Neck (70498) $848.02 $3,028.63 5.6×
Ct Angio Upr Extrm W/O&W/Dye (73206)
range across 3 matching MRF lines
$618.99–$1,237.98 $2,210.67–$4,421.34 varies
CT cervical spine w/ contrast (72126) $780.26 $2,786.63 2.6×
CT cervical spine w/o contrast (72125) $719.28 $2,568.83 8.0×
CT cervical spine w/wo cont (72127) $951.36 $3,397.68 6.3×
CT chest w contrast (71260) $740.96 $2,646.27 4.9×
CT chest w/wo contrast (71270) $888.34 $3,172.62 5.9×
CT colonography screening (74263) $485.51 $1,733.93 2.4×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $562.41 $2,008.60 3.7×
CT colonogrphy dx image postprocess w/o contrast (74261) $373.70 $1,334.63 4.1×
CT head/brain with contrast (70460) $651.18 $2,325.62 4.3×
CT head/brain without and with contrast (70470) $792.46 $2,830.19 5.2×
CT heart contrast eval cardiac structure&morph (75572) $651.52 $2,326.83 2.2×
CT heart no contrast quant eval coronry calcium (75571) $30.16 $107.69 0.4×
CT hrt w/3d image congen (75573) $664.39 $2,372.81 2.2×
CT iac w contrast (70481) $651.86 $2,328.04 4.3×
CT l-spine w&w/o contrast (72133) $937.13 $3,346.86 6.2×
CT lower ext w/o (73700)
range across 3 matching MRF lines
$589.52–$1,179.03 $2,105.40–$4,210.80 varies
CT lower extremity w/contrast material (73701)
range across 3 matching MRF lines
$631.53–$1,263.05 $2,255.44–$4,510.88 varies
CT lumbar spine w contrast (72132) $797.88 $2,849.55 2.7×
CT lumbar spine w/o contrast (72131) $711.15 $2,539.79 7.9×
CT maxillofacial w contrast (70487) $660.33 $2,358.29 4.4×
CT maxillofacial wo contrast (70486) $593.24 $2,118.71 6.6×
CT neck tissue combo (70492) $837.18 $2,989.91 5.5×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $760.95 $2,717.66 5.0×
CT orbits w/o contrast (70480) $615.60 $2,198.57 6.8×
CT pelvis w&w/o contrast (72194) $901.89 $3,221.02 6.0×
CT pelvis w/o contrast (72192) $642.03 $2,292.95 7.1×
CT scan of leg combo (73702)
range across 3 matching MRF lines
$795.85–$1,591.69 $2,842.29–$5,684.58 varies
CT scans face/jaw combo (70488) $794.15 $2,836.24 5.3×
CT soft tissue neck w contrast (70491) $703.01 $2,510.75 4.6×
CT soft tissue neck w/o contrast (70490) $609.51 $2,176.79 6.8×
CT thoracic spine w contrast (72129) $609.51 $2,176.79 4.0×
CT thoracic spine w/o contrast (72128) $675.57 $2,412.74 7.5×
CT thoracic spine w/wo cont (72130) $604.42 $2,158.64 4.0×
CT thorax w/o contrast (71250) $615.60 $2,198.57 6.8×
CT upper ext wo (73200)
range across 3 matching MRF lines
$578–$1,155.99 $2,064.26–$4,128.52 varies
CT upper extremity w/o & w/contrast material (73202)
range across 3 matching MRF lines
$765.02–$1,530.03 $2,732.18–$5,464.36 varies
CT upper extremity with contrast (73201)
range across 3 matching MRF lines
$652.19–$1,304.38 $2,329.25–$4,658.50 varies
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $918.83 $3,281.52 6.1×
Cta Abdomen (74175) $1,130.24 $4,036.56 7.5×
CTA pelvis (72191) $606.80 $2,167.11 4.0×
Dilation ureters/urethra rs&i (74485) $1,079.08 $3,853.85 0.6×
Discography Cerv/Thor Spine (72285) $875.13 $3,125.43 0.5×
Diskography lumbar (72295) $893.42 $3,190.77 0.5×
Doppler Echo Fetal Spectral Display Complete (76827) $173.47 $619.52 1.9×
Dxa Bone Density Axial (77080) $132.14 $471.90 1.5×
Dxa bone density study 1/>sites appendiclr skel (77081) $116.89 $417.45 1.6×
Echo exam of fetal heart (76825) $492.28 $1,758.13 1.0×
Echo Guide For Artery Repair (76936) $326.95 $1,167.65 1.8×
Echograp Trans R Pros Study (76873) $179.57 $641.30 2.0×
Esophagram (74220) $186.01 $664.29 1.2×
Fetal Biophys Profile W/Nst (76818) $174.49 $623.15 1.9×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $132.81 $474.32 1.5×
Fluoroscopy up to 1 hr (76000) $162.63 $580.80 0.8×
Follow-Up Angiography (75898) $215.14 $768.35 0.1×
Foot 2 views (73620)
range across 3 matching MRF lines
$62.68–$83.69 $223.85–$298.87 varies
Forearm 2 views (73090) $125.36 $447.70 1.7×
Gastric emptying imaging study (78264) $534.97 $1,910.59 1.6×
Gastroesophageal Reflux Exam (78262) $238.18 $850.63 0.7×
Gated Heart Planar Single (78472) $556.99 $1,989.24 1.6×
Hand 2 views (73120)
range across 3 matching MRF lines
$96.56–$128.75 $344.85–$459.80 varies
Heart Image (Pet) Multiple (78492) $1,398.91 $4,996.09 1.1×
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $1,256.95 $4,489.10 0.5×
Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) $957.45 $3,419.46 0.4×
Hepatobil Syst Image W/Drug (78227) $560.04 $2,000.13 1.2×
Hepatobiliary System Imaging (78226) $370.65 $1,323.74 1.1×
Ht Muscle Image Spect Sing (78451) $986.25 $3,522.31 0.9×
Hysterosalpingogram (74740) $180.92 $646.14 0.9×
Infant hip ultrasound with hip movement (dynamic) (76885) $150.43 $537.24 2.0×
Joint Survey Single View (77077) $87.08 $310.97 1.0×
K Flow/Funct Image Multiple (78709) $360.49 $1,287.44 0.8×
K Flow/Funct Image W/Drug (78708) $548.18 $1,957.78 1.2×
K Flow/Funct Image W/O Drug (78707) $535.31 $1,911.80 1.1×
Kidney Imaging Morphoogy W/Vascular Flow (78701) $177.87 $635.25 0.5×
Knee 3 Views (73562)
range across 3 matching MRF lines
$114.86–$153.14 $410.19–$546.92 varies
Leveen/Shunt Patency Exam (78291) $202.27 $722.37 0.6×
Liver & Spleen Imaging Static Only (78215) $451.29 $1,611.72 1.3×
Lung Perf&Ventilat Diferentl (78598) $450.61 $1,609.30 1.0×
Lung perfusion differential (78597) $427.91 $1,528.23 1.2×
Lung Ventilat&Perfus Imaging (78582) $602.73 $2,152.59 1.3×
Lung Ventilation Imaging (78579) $343.55 $1,226.94 1.0×
Lymph System Imaging (78195) $274.77 $981.31 0.6×
Lymphangiography Extremity Only Bilateral Rs&I (75803) $215.14 $768.35 0.2×
Lymphangiography extremity only unilateral rs&i (75801) $141.62 $505.78 0.3×
Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) $875.13 $3,125.43 0.3×
Lymphangiography, pelvic/abdominal, unilateral (75805) $215.14 $768.35 0.1×
Magnetic Image Jaw Joint (70336) $837.18 $2,989.91 4.1×
Meckels Divert Exam (78290) $431.30 $1,540.33 1.3×
Mra Head W/O & W/Contrast Material (70546)
range across 2 matching MRF lines
$862.93–$1,160.06 $3,081.87–$4,143.04 varies
MRA head w/o contrast (70544) $835.49 $2,983.86 4.1×
MRA head with contrast (70545) $790.09 $2,821.72 2.6×
MRA neck w contrast (70548) $525.82 $1,877.92 1.7×
Mra Neck W/O &W/Contrast Material (70549) $803.98 $2,871.33 2.7×
MRA neck w/o contrast (70547) $535.99 $1,914.22 2.6×
MRI abdomen w contrast (74182) $1,202.74 $4,295.50 4.0×
MRI abdomen w/o contrast (74181) $1,067.22 $3,811.50 5.2×
MRI any jt lower extrem w/contrast material (73722)
range across 3 matching MRF lines
$1,151.92–$1,490.72 $4,114–$5,324 varies
MRI any jt lower extrem w/o & w/contrast matrl (73723)
range across 3 matching MRF lines
$1,321.32–$2,061.26 $4,719–$7,361.64 varies
MRI any jt upper extremity w/contrast matrl (73222)
range across 3 matching MRF lines
$656.60–$1,461.93 $2,344.98–$5,221.15 varies
MRI cardiac w/o contrast (75557) $1,029.28 $3,675.98 5.0×
MRI cervical spine w contrast (72142) $1,132.95 $4,046.24 3.8×
MRI cervical spine w/o cont (72141) $493.98 $1,764.18 2.4×
MRI chest w/o contrast (71550) $1,046.56 $3,737.69 5.1×
MRI chest with contrast (71551) $692.17 $2,472.03 1.0×
MRI chest wo w contrast (71552) $1,344.70 $4,802.49 4.5×
MRI lower extrem oth/thn jt w/contrast matrl (73719)
range across 3 matching MRF lines
$1,156.33–$1,635.39 $4,129.73–$5,840.67 varies
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 3 matching MRF lines
$1,324.71–$1,595.75 $4,731.10–$5,699.10 varies
MRI lower extrem oth/thn jt w/o contr matrl (73718)
range across 3 matching MRF lines
$987.61–$1,495.13 $3,527.15–$5,339.73 varies
MRI lumbar spine w contrast (72149) $1,048.93 $3,746.16 3.5×
Mri Neck Spine W/O & W/Dye (72156) $1,347.07 $4,810.96 4.5×
MRI orbit face &/neck w/o contrast (70540) $982.19 $3,507.79 4.8×
MRI orbit face neck w contrast (70542) $1,041.14 $3,718.33 3.5×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $1,396.88 $4,988.83 4.6×
MRI pelvis w contrast (72196) $1,000.48 $3,573.13 3.3×
MRI pelvis w/o & w contrast (72197)
range across 2 matching MRF lines
$1,342.67–$1,344.70 $4,795.23–$4,802.49 varies
MRI pelvis w/o contrast (72195)
range across 2 matching MRF lines
$1,000.82–$1,067.22 $3,574.34–$3,811.50 varies
MRI spectroscopy (76390) $693.87 $2,478.08 9.2×
MRI thoracic spine w/o contrast (72146) $1,067.22 $3,811.50 5.2×
MRI upper extremity oth than jt w/contr matrl (73219)
range across 3 matching MRF lines
$985.91–$1,416.87 $3,521.10–$5,060.22 varies
MRI upper extremity oth than jt w/o contr matrl (73218)
range across 3 matching MRF lines
$930.69–$1,269.49 $3,323.87–$4,533.87 varies
Mri Uppr Extremity W/O&W/Dye (73220)
range across 3 matching MRF lines
$1,334.54–$1,707.90 $4,766.19–$6,099.61 varies
MRI, abdomen, combo (74183) $1,344.70 $4,802.49 4.5×
MRI, dorsal spine combo (72157) $1,348.09 $4,814.59 4.5×
MRI, dorsal spine contrast (72147) $1,106.53 $3,951.86 3.7×
MRI, joint upper extrem (73221)
range across 3 matching MRF lines
$1,067.22–$1,423.98 $3,811.50–$5,085.63 varies
MRI, joint upper extrem combo (73223)
range across 3 matching MRF lines
$1,344.70–$1,683.50 $4,802.49–$6,012.49 varies
MRI, lumbar spine combo (72158) $1,343.01 $4,796.44 4.5×
Myelogram cervical (72240) $532.60 $1,902.12 0.8×
Myocardial Perfusion Planar 1 Study Rest/Stress (78453) $175.50 $626.78 0.2×
Myocardial Spect Multiple Studies (78452) $356.76 $1,274.13 0.3×
Neck soft tissue (70360) $100.63 $359.37 1.3×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $203.28 $726 0.6×
Nm csf leak detection (78650) $467.21 $1,668.59 0.4×
Nonvascular Shunt X-Ray (75809) $281.89 $1,006.72 3.1×
Nuclear Rx Oral Admin (79005) $340.16 $1,214.84 1.7×
Panoramic X-ray of jaws (70355) $54.89 $196.02 0.7×
Parathyroid imaging w/tomographic spect & CT (78072) $340.16 $1,214.84 0.7×
Parathyroid Planar Imaging (78070) $425.20 $1,518.55 1.2×
Parathyroid planar imaging w/wo subtraction (78071) $340.16 $1,214.84 1.0×
Pelvis 1 or 2 views (72170) $102.32 $365.42 1.1×
Peritoneogram Rs&I (74190) $183.30 $654.61 0.4×
PET imaging CT attenuation skull base mid-thigh (78815) $2,101.24 $7,504.42 1.7×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $1,149.21 $4,104.32 0.4×
Pulmonary Perfusion Imaging Particulate (78580) $430.96 $1,539.12 1.3×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $198.20 $707.85 2.2×
Radex abscess/fistula/sinus tract rs&i (76080) $131.80 $470.69 0.3×
Radex Ankle Complete Minimum 3 Views (73610)
range across 3 matching MRF lines
$112.83–$150.43 $402.93–$537.24 varies
Radex Calcaneus Minimum 2 Views (73650)
range across 3 matching MRF lines
$91.82–$122.31 $327.91–$436.81 varies
Radex elbow complete minimum 3 views (73080)
range across 3 matching MRF lines
$99.61–$155.51 $355.74–$555.39 varies
Radex Facial Bones Complete Minimum 3 Views (70150) $152.13 $543.29 1.7×
Radex fingr minimum 2 views (73140)
range across 3 matching MRF lines
$105.03–$110.11 $375.10–$393.25 varies
Radex foot complete minimum 3 views (73630)
range across 3 matching MRF lines
$111.81–$149.08 $399.30–$532.40 varies
Radex Hand Minimum 3 Views (73130) $133.83 $477.95 1.8×
Radex lower extremity infant minimum 2 views (73592)
range across 3 matching MRF lines
$96.56–$128.75 $344.85–$459.80 varies
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $93.17 $332.75 1.0×
Radex Nasal Bones Complete Minimum 3 Views (70160) $120.96 $431.97 1.6×
Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) $152.46 $544.50 2.0×
Radex Ribs Unilateral 2 Views (71100) $75.90 $271.04 1.0×
Radex shoulder complete minimum 2 views (73030)
range across 3 matching MRF lines
$142.30–$189.73 $508.20–$677.60 varies
Radex Sinuses Paransl < 3 Views (70210) $50.15 $179.08 0.7×
Radex sm int w/mlt srl imges via enteroclss tube (74251) $113.50 $405.35 0.8×
Radex Spine 1 View Specify Level (72020) $48.11 $171.82 0.6×
Radex Sternum Minimum 2 Views (71120) $116.89 $417.45 1.6×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $133.83 $477.95 1.8×
Radex Toe Minimum 2 Views (73660)
range across 3 matching MRF lines
$96.56–$101.64 $344.85–$363 varies
Radex upper extremity infant minimum 2 views (73092)
range across 3 matching MRF lines
$93.17–$160.93 $332.75–$574.75 varies
Radex Wrist Complete Minimum 3 Views (73110)
range across 3 matching MRF lines
$94.53–$126.04 $337.59–$450.12 varies
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $198.20 $707.85 2.2×
Radiolog exam mandible compl minimum 4 views (70110) $148.40 $529.98 1.6×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $160.26 $572.33 1.8×
Radiologic exam colon double contrast study (74280) $330.67 $1,180.96 2.2×
Radiologic exam colon single contrast study (74270) $263.25 $940.17 1.7×
Radiologic exam knee complete 4/more views (73564)
range across 3 matching MRF lines
$126.72–$168.73 $452.54–$602.58 varies
Radiologic exam pelvis compl minimum 3 views (72190) $121.97 $435.60 1.4×
Radiologic Exam Small Int Single Contrast Study (74250) $225.65 $805.86 1.5×
Radiologic exam swallow function contrast study (74230) $196.85 $703.01 1.3×
Radiologic exam upr gi trc double contrast study (74246) $251.39 $897.82 1.7×
Radiologic examination femur 1 view (73551)
range across 3 matching MRF lines
$100.63–$134.17 $359.37–$479.16 varies
Radiologic examination femur minimum 2 views (73552)
range across 3 matching MRF lines
$133.83–$178.55 $477.95–$637.67 varies
Radiologic examination knee 1/2 views (73560)
range across 3 matching MRF lines
$62.68–$83.69 $223.85–$298.87 varies
Radiologic Examination Osseous Survey Limited (77074) $200.57 $716.32 2.2×
Radiologic examination tibia & fibula 2 views (73590)
range across 3 matching MRF lines
$109.78–$146.37 $392.04–$522.72 varies
Renal Cyst Study (74470) $141.62 $505.78 0.3×
Ribs bilateral 3 views (71110) $148.40 $529.98 1.6×
Rp loclzj tum plnr 1 area single day imaging (78800) $275.45 $983.73 0.8×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $328.98 $1,174.91 1.0×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $982.52 $3,509 2.1×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $692.17 $2,472.03 1.5×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $767.05 $2,739.44 1.6×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $767.05 $2,739.44 0.7×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $975.75 $3,484.80 0.8×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $767.05 $2,739.44 0.7×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $435.02 $1,553.64 2.2×
Rp Therapy Intravenous Administration (79101) $326.61 $1,166.44 1.6×
Scapula (73010)
range across 3 matching MRF lines
$107.07–$135.52 $382.36–$484 varies
Screening Digital Breast Tomosynthesis Bi (77063)
range across 2 matching MRF lines
$20.33–$30.50 $72.60–$108.90 varies
Shoulder 1 view (73020) $51.16 $182.71 0.7×
Sialogram (70390) $142.30 $508.20 0.7×
Skull less than 4 views (70250) $71.15 $254.10 0.8×
Sternoclavicular joints (71130) $71.15 $254.10 0.9×
Superior sagittal sinus venogram (75870) $295.78 $1,056.33 0.1×
Testicular Imaging W/Flow (78761) $192.78 $688.49 0.6×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $330.33 $1,179.75 2.2×
Thoracic spine 2 views (72070) $125.02 $446.49 1.4×
Thoracic spine 3 views (72072) $125.02 $446.49 1.4×
Thoracolumbar 2 views (72080) $123.67 $441.65 1.6×
Thyroid Carcinoma Metastases Img Lmtd Area (78015) $436.04 $1,557.27 1.3×
Thyroid Imaging With Vascular Flow (78013) $254.10 $907.50 0.7×
Thyroid Met Imaging Body (78018) $545.13 $1,946.89 1.2×
Thyroid Uptake Measurement (78012) $254.10 $907.50 0.7×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $423.50 $1,512.50 1.2×
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines
$96.90–$169.40 $346.06–$605 varies
Ultrasound Exam Aaa Screen (76706) $168.73 $602.58 1.9×
Ultrasound, abdomen limited (76705) $279.51 $998.25 3.1×
Umbilical-artery Doppler (OB) (76820) $170.42 $608.63 1.9×
Unlisted magnetic resonance procedure (76498) $489.57 $1,748.45 6.5×
Upper gi w/o kub (74240) $231.41 $826.43 1.5×
Urethrocystogram voiding (74455) $254.10 $907.50 1.2×
Urethrocystography retrograde (74450) $169.74 $606.21 0.8×
Us breast unilateral complete (76641)
range across 3 matching MRF lines
$145.69–$220.22 $520.30–$786.50 varies
Us chest (76604) $165 $589.27 1.8×
Us complete joint (76881)
range across 4 matching MRF lines
$125.70–$179.57 $448.91–$641.30 varies
Us exam, pelvic, limited (76857) $162.63 $580.80 1.8×
Us head (76506) $110.79 $395.67 1.2×
Us kidney transplant (76776) $187.02 $667.92 2.1×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 4 matching MRF lines
$71.49–$179.57 $255.31–$641.30 varies
Us ob detailed single fetus (76811) $362.52 $1,294.70 1.8×
Us ob limited 1 or more fetuses (76815) $150.43 $537.24 1.7×
Us ob transvaginal (76817)
range across 2 matching MRF lines
$150.43–$175.50 $537.24–$626.78 varies
Us pelvic non ob complete (76856) $263.93 $942.59 2.9×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $237.84 $849.42 2.6×
Us preg uterus real time f/u trnsabdl per fetus (76816) $142.30 $508.20 1.6×
Us retroperitoneal complete (76770) $304.25 $1,086.58 3.4×
Us retroperitoneal limited (76775) $226.32 $808.28 2.5×
Us scrotum and contents (76870) $237.84 $849.42 2.6×
Us spinal canal and contents (76800) $160.93 $574.75 1.8×
Us thyroid (76536) $223.61 $798.60 2.5×
Vein X-Ray Chest (75827) $672.86 $2,403.06 0.5×
Vein X-Ray Liver W/O Hemodyn (75887) $1,126.51 $4,023.25 0.4×
Vein X-Ray Skull Epidural (75872) $875.13 $3,125.43 1.6×
Venogram Sinus/Jugular (75860) $875.13 $3,125.43 0.3×
Venography Adrenal Unilateral (75840) $938.82 $3,352.91 0.3×
Venography caval inferior serialography rs&i (75825) $1,419.58 $5,069.90 0.5×
Venography extremity bilateral rs&i (75822) $761.63 $2,720.08 0.6×
Venography extremity unilateral rs&i (75820) $591.55 $2,112.66 0.4×
Venography Orbital Rs&I (75880) $875.13 $3,125.43 1.6×
Venography Renal Bilateral (75833) $1,095.35 $3,911.93 0.4×
Venography Renal Unilateral (75831) $1,005.56 $3,591.28 0.4×
Venous sampling by catheter (75893) $938.82 $3,352.91 0.2×
Venous Thrombosis Imaging Venogram Bilateral (78458) $311.70 $1,113.20 0.9×
Vertebral fracture assessment via dxa (77086) $93.17 $332.75 1.2×
Wrist 2 views (73100)
range across 3 matching MRF lines
$94.53–$115.20 $337.59–$411.40 varies
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $69.46 $248.05 0.9×
X-ray antegrade pyelogram tube (74425) $164.32 $586.85 0.5×
X-Ray Aorta Leg Arteries (75630) $1,385.70 $4,948.90 0.5×
X-Ray Bend Only L-S Spine (72120) $200.24 $715.11 2.2×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 3 matching MRF lines
$99.61–$116.89 $355.74–$417.45 varies
X-Ray Exam Breast Specimen (76098) $182.96 $653.40 0.4×
X-Ray Exam Entire Spi 1 Vw (72081) $96.56 $344.85 1.3×
X-Ray Exam Entire Spi 2/3 Vw (72082) $130.44 $465.85 1.4×
X-Ray Exam Entire Spi 4/5 Vw (72083) $164.32 $586.85 1.8×
X-Ray Exam Hip Uni 1 View (73501) $62.68 $223.85 0.8×
X-Ray Exam Hip Uni 2-3 Views (73502) $133.83 $477.95 1.8×
X-Ray Exam Hip Uni 4/> Views (73503) $162.63 $580.80 1.8×
X-Ray Exam Hips Bi 2 Views (73521) $187.70 $670.34 2.1×
X-Ray Exam Hips Bi 3-4 Views (73522) $217.85 $778.03 2.4×
X-Ray Exam Hips Bi 5/> Views (73523) $248.01 $885.72 2.8×
X-Ray Exam L-S Spine Bending (72114) $200.24 $715.11 2.2×
X-Ray Exam Neck Spine 2-3 Vw (72040) $121.97 $435.60 1.6×
X-Ray Exam Neck Spine 6/>Vws (72052) $121.97 $435.60 1.4×
X-Ray Exam Unilat Ribs/Chest (71101) $148.40 $529.98 1.6×
X-ray humerus (73060) $123.67 $441.65 1.6×
X-ray IV pyelogram (ivp) (74400) $317.80 $1,134.98 2.1×
X-ray IV pyelogram+tomography (74415) $333.72 $1,191.85 2.2×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $75.22 $268.62 1.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $96.56 $344.85 1.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $135.86 $485.21 1.5×
X-ray nose-rectum child f.b. (76010) $61.67 $220.22 0.8×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $195.83 $699.38 2.2×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $99.95 $356.95 1.1×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $92.84 $331.54 1.0×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $99.95 $356.95 1.3×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $148.40 $529.98 2.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $178.21 $636.46 2.0×
X-ray thoracic spine 4 vw (72074) $125.02 $446.49 1.4×
X-Ray Urinary Tract Exam With Contrast Material (74420) $181.60 $648.56 0.6×
X-Rays Bone Length Studies (77073) $87.42 $312.18 1.0×
X-Rays Bone Survey Complete (77075) $258.17 $922.02 2.9×
Xr c-spine 4 or 5 views (72050) $121.97 $435.60 1.4×
Xr facial bones less than 3 views (70140) $134.17 $479.16 1.8×
Xr orbits complete 4 views (70200) $75.56 $269.83 0.8×

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.