Imaging prices at West Calcasieu Cameron Hospital
Sulphur, LA · every code in this section with a posted price and a Medicare benchmark.
287 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 |
$97.65–$124.50 | $130.20–$166 | varies |
| Abdomen 2 views (74019) | $115.50 | $154 | 1.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $665.25 | $887 | 1.8× |
| Angio pulmonary bilat (75743) | $2,733.75 | $3,645 | 1.0× |
| Angiography extremity bilateral rs&i (75716) | $2,733.75 | $3,645 | 1.0× |
| Angiography extremity unilateral rs&i (75710) range across 3 matching MRF lines |
$1,166.25–$2,737.50 | $1,555–$3,650 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$1,164.75–$1,166.25 | $1,553–$1,555 | varies |
| Ankle 2 views (73600) | $97.50 | $130 | 1.2× |
| Aortography thoracic serialography rs&i (75605) | $2,733.75 | $3,645 | 0.5× |
| Aortography thoracic w/o serialography rs&i (75600) | $2,733.75 | $3,645 | 1.0× |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$2,733.75–$2,898.75 | $3,645–$3,865 | varies |
| Arthrogram ankle (73615) | $468.75 | $625 | 1.5× |
| Arthrogram hip (73525) | $468.75 | $625 | 1.5× |
| Bone age studies (77072) range across 3 matching MRF lines |
$33.53–$127.50 | $44.70–$170 | varies |
| Bone Imaging 3 Phase (78315) | $633 | $844 | 1.7× |
| Bone Imaging Limited Area (78300) | $633 | $844 | 1.7× |
| Bone Imaging Multiple Areas (78305) | $536.25 | $715 | 1.5× |
| Bone Imaging Whole Body (78306) | $633 | $844 | 1.7× |
| Bone survey infant (77076) | $195 | $260 | 2.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $693.75 | $925 | 1.4× |
| Brain Imaging Minimum 4 Static Views (78605) | $693.75 | $925 | 1.4× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$585–$1,395 | $780–$1,860 | varies |
| Chest 1 view (71045) | $115.50 | $154 | 1.5× |
| Chest 2 views (71046) | $115.50 | $154 | 1.5× |
| Chest 3 views (71047) | $115.50 | $154 | 1.5× |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$97.50–$115.50 | $130–$154 | varies |
| Cholecystography Oral Contrast (74290) | $198.75 | $265 | 1.3× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$115.50–$231 | $154–$308 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $300 | $400 | 3.2× |
| Contrast Exam Abdominl Aorta (75625) | $2,733.75 | $3,645 | 1.0× |
| Contrast X-Ray Bladder (74430) | $404.25 | $539 | 1.3× |
| Contrast X-Ray Of Knee Joint (73580) range across 4 matching MRF lines |
$228.75–$2,733.75 | $305–$3,645 | varies |
| CT abdomen and pelvis without and with contrast (74178) | $2,250 | $3,000 | 7.1× |
| CT abdomen and pelvis without contrast (74176) | $2,250 | $3,000 | 10.4× |
| CT abdomen w contrast (74160) | $1,327.50 | $1,770 | 8.4× |
| CT abdomen w wo contrast (74170) | $1,593 | $2,124 | 10.0× |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,115.25–$1,177.50 | $1,487–$1,570 | varies |
| CT Angio Abdomen and Pelvis (74174) | $2,250 | $3,000 | 7.1× |
| CT Angio Chest (71275) | $1,462.50 | $1,950 | 9.2× |
| CT Angio Head (70496) | $1,950 | $2,600 | 12.3× |
| CT angio hrt w/3d image (75574) | $1,462.50 | $1,950 | 4.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $1,950 | $2,600 | 12.3× |
| CT Angio Neck (70498) | $1,950 | $2,600 | 12.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 4 matching MRF lines |
$1,950–$2,400 | $2,600–$3,200 | varies |
| CT cervical spine w/ contrast (72126) | $1,560 | $2,080 | 4.9× |
| CT cervical spine w/o contrast (72125) | $1,540.50 | $2,054 | 16.3× |
| CT cervical spine w/wo cont (72127) | $1,950 | $2,600 | 12.3× |
| CT chest w contrast (71260) | $1,380.75 | $1,841 | 8.7× |
| CT chest w/wo contrast (71270) | $1,725.75 | $2,301 | 10.9× |
| CT head/brain with contrast (70460) | $1,500 | $2,000 | 9.4× |
| CT head/brain without and with contrast (70470) | $1,734.75 | $2,313 | 10.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $1,462.50 | $1,950 | 4.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $99 | $132 | 1.3× |
| CT hrt w/3d image congen (75573) | $1,462.50 | $1,950 | 4.6× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$945–$956.25 | $1,260–$1,275 | varies |
| CT l-spine w&w/o contrast (72133) | $2,301 | $3,068 | 14.5× |
| CT lower ext w/o (73700) range across 5 matching MRF lines |
$1,083.75–$1,500 | $1,445–$2,000 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$987–$1,181.25 | $1,316–$1,575 | varies |
| CT lumbar spine w contrast (72132) | $1,560 | $2,080 | 4.9× |
| CT lumbar spine w/o contrast (72131) | $1,540.50 | $2,054 | 16.3× |
| CT maxillofacial w contrast (70487) | $1,327.50 | $1,770 | 8.4× |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$942.75–$1,327.50 | $1,257–$1,770 | varies |
| CT neck tissue combo (70492) | $1,616.25 | $2,155 | 10.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 4 matching MRF lines |
$1,170–$1,192.50 | $1,560–$1,590 | varies |
| CT orbits w/o contrast (70480) range across 4 matching MRF lines |
$798.75–$1,125 | $1,065–$1,500 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,350–$1,593 | $1,800–$2,124 | varies |
| CT pelvis w/o contrast (72192) | $1,115.25 | $1,487 | 11.8× |
| CT scan of leg combo (73702) range across 11 matching MRF lines |
$987–$1,252.50 | $1,316–$1,670 | varies |
| CT scans face/jaw combo (70488) | $1,327.50 | $1,770 | 8.4× |
| CT soft tissue neck w contrast (70491) | $1,115.25 | $1,487 | 7.0× |
| CT soft tissue neck w/o contrast (70490) | $798.75 | $1,065 | 8.4× |
| CT thoracic spine w contrast (72129) | $1,560 | $2,080 | 9.8× |
| CT thoracic spine w/o contrast (72128) | $1,540.50 | $2,054 | 16.3× |
| CT thoracic spine w/wo cont (72130) | $1,540.50 | $2,054 | 9.7× |
| CT thorax w/o contrast (71250) | $1,150.50 | $1,534 | 12.2× |
| CT upper ext wo (73200) | $1,035 | $1,380 | 10.9× |
| CT upper extremity w/o & w/contrast material (73202) | $1,252.50 | $1,670 | 7.9× |
| CT upper extremity with contrast (73201) | $1,275 | $1,700 | 4.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,400 | $3,200 | 15.1× |
| Cta Abdomen (74175) | $2,137.50 | $2,850 | 13.5× |
| CTA pelvis (72191) | $2,137.50 | $2,850 | 13.5× |
| Discography Cerv/Thor Spine (72285) | $1,631.25 | $2,175 | 0.9× |
| Diskography lumbar (72295) | $1,634.25 | $2,179 | 0.9× |
| Dxa Bone Density Axial (77080) | $163.50 | $218 | 1.7× |
| Echo Guide For Artery Repair (76936) | $140.25 | $187 | 0.7× |
| Esophagram (74220) | $198.75 | $265 | 1.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $252.75 | $337 | 2.7× |
| Fluoroscopy up to 1 hr (76000) range across 3 matching MRF lines |
$187.50–$300 | $250–$400 | varies |
| Follow-Up Angiography (75898) | $566.25 | $755 | 0.2× |
| Foot 2 views (73620) | $97.50 | $130 | 1.2× |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$115.50–$231 | $154–$308 | varies |
| Gastric emptying imaging study (78264) | $506.25 | $675 | 1.4× |
| Gastroesophageal Reflux Exam (78262) | $506.25 | $675 | 1.4× |
| Gated Heart Planar Single (78472) | $562.50 | $750 | 1.6× |
| Heart first pass single,planar (78481) | $562.50 | $750 | 1.1× |
| Hepatobil Syst Image W/Drug (78227) | $681.75 | $909 | 1.4× |
| Hepatobiliary System Imaging (78226) | $681.75 | $909 | 1.9× |
| Hysterosalpingogram (74740) | $816.75 | $1,089 | 3.8× |
| Infusion Ivp (74410) | $342 | $456 | 2.2× |
| K Flow/Funct Image Multiple (78709) | $555 | $740 | 1.1× |
| K Flow/Funct Image W/Drug (78708) | $720.36 | $960.48 | 1.5× |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$487.58–$504.75 | $650.10–$673 | varies |
| Kidney Imaging Morphol (78700) | $491.25 | $655 | 1.4× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $504.08 | $672.10 | 1.4× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$127.50–$255 | $170–$340 | varies |
| Leveen/Shunt Patency Exam (78291) | $552 | $736 | 1.5× |
| Liver & Spleen Imaging Static Only (78215) | $681.75 | $909 | 1.9× |
| Lung Perf&Ventilat Diferentl (78598) | $900 | $1,200 | 1.8× |
| Lung perfusion differential (78597) | $450 | $600 | 1.2× |
| Lung Ventilat&Perfus Imaging (78582) | $900 | $1,200 | 1.8× |
| Lymph System Imaging (78195) | $815.25 | $1,087 | 1.7× |
| Magnetic Image Jaw Joint (70336) | $1,209 | $1,612 | 5.6× |
| Meckels Divert Exam (78290) | $506.25 | $675 | 1.4× |
| Mra Head W/O & W/Contrast Material (70546) | $1,140 | $1,520 | 3.6× |
| MRA head w/o contrast (70544) | $929.25 | $1,239 | 4.3× |
| MRA head with contrast (70545) | $881.25 | $1,175 | 2.8× |
| MRA neck w contrast (70548) | $881.25 | $1,175 | 2.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $1,140 | $1,520 | 3.6× |
| MRA neck w/o contrast (70547) | $787.50 | $1,050 | 3.6× |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$900–$1,350 | $1,200–$1,800 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 4 matching MRF lines |
$1,150.50–$1,308 | $1,534–$1,744 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $1,150.50 | $1,534 | 3.6× |
| MRI any jt upper extremity w/contrast matrl (73222) range across 6 matching MRF lines |
$1,150.50–$1,308 | $1,534–$1,744 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $1,500 | $2,000 | 6.9× |
| MRI Breast Without Contrast Material Unilateral (77046) | $1,125 | $1,500 | 5.2× |
| MRI cervical spine w contrast (72142) | $1,048.50 | $1,398 | 3.3× |
| MRI cervical spine w/o cont (72141) | $1,062 | $1,416 | 4.9× |
| MRI chest w/o contrast (71550) | $900 | $1,200 | 4.2× |
| MRI chest with contrast (71551) | $1,125 | $1,500 | 1.6× |
| MRI chest wo w contrast (71552) | $900 | $1,200 | 2.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,345.50 | $1,794 | 4.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $1,345.50 | $1,794 | 4.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $1,345.50 | $1,794 | 6.2× |
| MRI lumbar spine w contrast (72149) | $1,035 | $1,380 | 3.3× |
| Mri Neck Spine W/O & W/Dye (72156) | $1,222.50 | $1,630 | 3.9× |
| MRI orbit face &/neck w/o contrast (70540) range across 4 matching MRF lines |
$879–$1,209 | $1,172–$1,612 | varies |
| MRI orbit face neck w contrast (70542) | $1,048.50 | $1,398 | 3.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $1,209 | $1,612 | 3.8× |
| MRI pelvis w/o & w contrast (72197) | $1,200 | $1,600 | 3.8× |
| MRI pelvis w/o contrast (72195) | $1,016.25 | $1,355 | 4.7× |
| MRI thoracic spine w/o contrast (72146) | $1,062 | $1,416 | 4.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $1,345.50 | $1,794 | 4.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $1,345.50 | $1,794 | 6.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $1,345.50 | $1,794 | 4.3× |
| MRI, abdomen, combo (74183) range across 3 matching MRF lines |
$1,125–$1,575 | $1,500–$2,100 | varies |
| MRI, dorsal spine combo (72157) | $1,222.50 | $1,630 | 3.9× |
| MRI, dorsal spine contrast (72147) | $1,048.50 | $1,398 | 3.3× |
| MRI, joint upper extrem (73221) | $1,046.25 | $1,395 | 4.8× |
| MRI, joint upper extrem combo (73223) | $1,150.50 | $1,534 | 3.6× |
| MRI, lumbar spine combo (72158) | $1,418.25 | $1,891 | 4.5× |
| Myelogram cervical (72240) | $588.75 | $785 | 0.8× |
| Myelogram Lumbar (72265) | $588.75 | $785 | 0.8× |
| Myelography thoracic (72255) | $498.75 | $665 | 0.7× |
| Myelograpy 2/more regions rs&i (72270) | $713.25 | $951 | 1.0× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $562.50 | $750 | 1.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $570.75 | $761 | 0.5× |
| Myocardial Spect Multiple Studies (78452) | $2,217.75 | $2,957 | 1.9× |
| Neck soft tissue (70360) | $115.50 | $154 | 1.5× |
| Nonvascular Shunt X-Ray (75809) | $136.85 | $182.47 | 1.4× |
| Parathyroid Planar Imaging (78070) | $375 | $500 | 1.0× |
| Pelvis 1 or 2 views (72170) | $115.50 | $154 | 1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) | $450 | $600 | 1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $174.04 | $232.05 | 1.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $228.75 | $305 | 0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$115.50–$231 | $154–$308 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$115.50–$231 | $154–$308 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$115.50–$231 | $154–$308 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $115.50 | $154 | 1.2× |
| Radex fingr minimum 2 views (73140) | $115.50 | $154 | 1.5× |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$115.50–$231 | $154–$308 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$115.50–$231 | $154–$308 | varies |
| Radex lower extremity infant minimum 2 views (73592) | $115.50 | $154 | 1.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) | $97.65 | $130.20 | 1.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $115.50 | $154 | 1.5× |
| Radex Ribs Unilateral 2 Views (71100) | $115.50 | $154 | 1.5× |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$115.50–$231 | $154–$308 | varies |
| Radex Spine 1 View Specify Level (72020) | $115.50 | $154 | 1.5× |
| Radex Sternum Minimum 2 Views (71120) | $115.50 | $154 | 1.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $128.36 | $171.15 | 1.6× |
| Radex Toe Minimum 2 Views (73660) | $115.50 | $154 | 1.5× |
| Radex upper extremity infant minimum 2 views (73092) | $115.50 | $154 | 1.2× |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$115.50–$231 | $154–$308 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $231 | $308 | 2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) | $115.50 | $154 | 1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $115.50 | $154 | 1.2× |
| Radiologic exam colon double contrast study (74280) | $307.50 | $410 | 1.9× |
| Radiologic exam colon single contrast study (74270) | $198.75 | $265 | 1.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $210 | $280 | 1.3× |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$127.50–$231 | $170–$308 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) | $198.75 | $265 | 1.3× |
| Radiologic exam swallow function contrast study (74230) | $375 | $500 | 2.4× |
| Radiologic exam teeth complete full mouth (70320) | $108.75 | $145 | 0.5× |
| Radiologic exam upr gi trc double contrast study (74246) | $198.75 | $265 | 1.3× |
| Radiologic examination femur 1 view (73551) | $115.50 | $154 | 1.5× |
| Radiologic examination femur minimum 2 views (73552) | $115.50 | $154 | 1.5× |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$115.50–$231 | $154–$308 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 4 matching MRF lines |
$55.83–$168.75 | $74.44–$225 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$115.50–$231 | $154–$308 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$129–$231 | $172–$308 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $375 | $500 | 1.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $375 | $500 | 1.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $926.25 | $1,235 | 1.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $862.50 | $1,150 | 1.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $862.50 | $1,150 | 1.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $2,100 | $2,800 | 1.6× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $1,875 | $2,500 | 1.6× |
| Salivary Gland Function Study (78232) | $675 | $900 | 1.9× |
| Salivary Gland Imaging (78230) | $525 | $700 | 1.5× |
| Salivary Gland Imaging Serial Images (78231) | $600 | $800 | 1.7× |
| Scapula (73010) | $115.50 | $154 | 1.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $37.50 | $50 | 1.6× |
| Sella turcica (70240) | $97.50 | $130 | 1.2× |
| Shoulder 1 view (73020) | $115.50 | $154 | 1.5× |
| Shoulder Arthrography (73040) | $553.50 | $738 | 1.8× |
| Sialogram (70390) | $228.75 | $305 | 1.1× |
| Skull less than 4 views (70250) | $106.50 | $142 | 1.1× |
| Sternoclavicular joints (71130) | $115.50 | $154 | 1.5× |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$483.75–$491.25 | $645–$655 | varies |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $262.50 | $350 | 1.7× |
| Thoracic spine 3 views (72072) | $120 | $160 | 1.3× |
| Thyroid Imaging With Vascular Flow (78013) | $330 | $440 | 0.9× |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$555–$726 | $740–$968 | varies |
| Thyroid Uptake Measurement (78012) | $442.50 | $590 | 1.2× |
| Ultrasound Breast Limited (76642) | $216 | $288 | 2.7× |
| Ultrasound Exam Aaa Screen (76706) | $225 | $300 | 2.4× |
| Ultrasound, abdomen limited (76705) range across 6 matching MRF lines |
$243–$278.25 | $324–$371 | varies |
| Umbilical-artery Doppler (OB) (76820) | $187.50 | $250 | 2.0× |
| Unlisted Dx Radiographic Procedure (76499) | $373.50 | $498 | 4.7× |
| Unlisted us procedure (76999) | $262.50 | $350 | 3.3× |
| Upper gi w/o kub (74240) | $198.75 | $265 | 1.3× |
| Ureteral Reflux Study (78740) | $491.25 | $655 | 1.4× |
| Urethrocystogram voiding (74455) | $404.25 | $539 | 1.9× |
| Urethrocystography retrograde (74450) | $397.50 | $530 | 1.8× |
| Us chest (76604) | $235.50 | $314 | 2.5× |
| Us exam, pelvic, limited (76857) | $135 | $180 | 1.4× |
| Us head (76506) | $174 | $232 | 1.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $252.75 | $337 | 2.7× |
| Us ob limited 1 or more fetuses (76815) range across 5 matching MRF lines |
$134.25–$235.50 | $179–$314 | varies |
| Us ob transvaginal (76817) | $225 | $300 | 2.4× |
| Us pelvic non ob complete (76856) | $252.75 | $337 | 2.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $280.50 | $374 | 3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $162 | $216 | 1.7× |
| Us retroperitoneal complete (76770) | $278.25 | $371 | 2.9× |
| Us retroperitoneal limited (76775) | $278.25 | $371 | 2.9× |
| Us scrotum and contents (76870) | $278.25 | $371 | 2.9× |
| Us thyroid (76536) | $252.75 | $337 | 2.7× |
| Us transrectal (76872) | $213.75 | $285 | 2.3× |
| Vasogram (74440) | $345 | $460 | 1.6× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$843.75–$1,166.25 | $1,125–$1,555 | varies |
| Vein X-Ray Skull Epidural (75872) | $1,166.25 | $1,555 | 2.1× |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$1,166.25–$4,125 | $1,555–$5,500 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$843.75–$1,275 | $1,125–$1,700 | varies |
| Venography extremity unilateral rs&i (75820) | $1,275 | $1,700 | 0.9× |
| Venography Renal Bilateral (75833) | $1,166.25 | $1,555 | 0.4× |
| Wrist 2 views (73100) | $97.50 | $130 | 1.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$97.50–$103.50 | $130–$138 | varies |
| X-ray antegrade pyelogram tube (74425) | $337.50 | $450 | 1.1× |
| X-Ray Aorta Leg Arteries (75630) | $4,229.66 | $5,639.55 | 1.5× |
| X-Ray Bend Only L-S Spine (72120) | $115.50 | $154 | 1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $115.50 | $154 | 1.5× |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$97.50–$225 | $130–$300 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) | $115.50 | $154 | 1.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) | $231 | $308 | 2.4× |
| X-Ray Exam Hip Uni 1 View (73501) | $115.50 | $154 | 1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $115.50 | $154 | 1.5× |
| X-Ray Exam Hips Bi 2 Views (73521) range across 4 matching MRF lines |
$168.75–$231 | $225–$308 | varies |
| X-Ray Exam L-S Spine Bending (72114) | $168.75 | $225 | 1.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $115.50 | $154 | 1.5× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $199.50 | $266 | 2.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $168.75 | $225 | 1.8× |
| X-ray humerus (73060) range across 3 matching MRF lines |
$115.50–$231 | $154–$308 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$342–$404.25 | $456–$539 | varies |
| X-ray IV pyelogram+tomography (74415) | $345 | $460 | 2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $97.50 | $130 | 1.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $115.50 | $154 | 1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $115.50 | $154 | 1.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $168.75 | $225 | 1.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $115.50 | $154 | 1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $115.50 | $154 | 1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $108 | $144 | 1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $168.75 | $225 | 1.8× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $404.25 | $539 | 1.3× |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$115.50–$168.75 | $154–$225 | varies |
| X-Rays Bone Survey Complete (77075) | $278.25 | $371 | 2.9× |
| Xr c-spine 4 or 5 views (72050) | $199.50 | $266 | 2.1× |
| Xr orbits complete 4 views (70200) | $115.50 | $154 | 1.2× |
| Xr Tomogram Single Plane (76100) range across 7 matching MRF lines |
$167.25–$183.75 | $223–$245 | 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.