Imaging prices at White River Medical Center
Batesville, AR · every code in this section with a posted price and a Medicare benchmark.
285 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 3-D radiotherapy plan dose-volume histograms (77295) | $2,382.75 | $3,177 | 1.9× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$168.75–$225 | $225–$300 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $746.25 | $995 | 2.1× |
| Angio internal mammary (75756) | $6,150 | $8,200 | 2.1× |
| Angio pulmonary bilat (75743) | $5,343.75 | $7,125 | 1.9× |
| Angiography extremity bilateral rs&i (75716) | $5,343.75 | $7,125 | 1.9× |
| Angiography extremity unilateral rs&i (75710) | $5,343.75 | $7,125 | 1.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,493.75 | $7,325 | 1.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $5,493.75 | $7,325 | 1.9× |
| Ankle 2 views (73600) range across 5 matching MRF lines |
$40.50–$161.25 | $54–$215 | varies |
| Aortography thoracic serialography rs&i (75605) | $9,157.50 | $12,210 | 1.8× |
| Artery X-Rays Abdomen (75726) | $8,861.25 | $11,815 | 1.7× |
| Artery X-Rays Pelvis (75736) | $8,861.25 | $11,815 | 1.7× |
| Artery X-Rays Spine (75705) | $9,153.75 | $12,205 | 1.8× |
| Arthrogram ankle (73615) | $772.50 | $1,030 | 2.4× |
| Arthrogram hip (73525) | $772.50 | $1,030 | 2.4× |
| Arthrogram Wrist (73115) | $772.50 | $1,030 | 2.4× |
| Basic radiation dosimetry calculation (77300) | $252 | $336 | 2.1× |
| Bone age studies (77072) | $225 | $300 | 2.4× |
| Bone Imaging 3 Phase (78315) | $1,328.25 | $1,771 | 3.6× |
| Bone Imaging Limited Area (78300) | $746.25 | $995 | 2.1× |
| Bone Imaging Whole Body (78306) | $746.25 | $995 | 2.1× |
| Bone marrow imaging; multiple areas (78103) | $746.25 | $995 | 2.1× |
| Bone survey infant (77076) | $225 | $300 | 2.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $810 | $1,080 | 2.5× |
| Cat Scan Follow-Up Study (76380) | $161.25 | $215 | 2.0× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$135–$180 | $180–$240 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$149.25–$198.75 | $199–$265 | varies |
| Chest 4 or more views (71048) | $225 | $300 | 2.4× |
| Clavicle complete (73000) range across 5 matching MRF lines |
$40.50–$161.25 | $54–$215 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$161.25–$194.25 | $215–$259 | varies |
| Continuing medical physics consltj pr wk (77336) | $252 | $336 | 2.1× |
| Contrast Exam Abdominl Aorta (75625) | $5,663.25 | $7,551 | 2.0× |
| Contrast X-Ray Bladder (74430) | $772.50 | $1,030 | 2.4× |
| Contrast X-Ray Of Elbow (73085) | $772.50 | $1,030 | 2.4× |
| Contrast X-Ray Of Knee Joint (73580) | $772.50 | $1,030 | 2.4× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$532.50–$810 | $710–$1,080 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$480–$566.25 | $640–$755 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$352.50–$367.50 | $470–$490 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$405–$414.75 | $540–$553 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$225–$276.75 | $300–$369 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$772.50–$829.50 | $1,030–$1,106 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$232.50–$405 | $310–$540 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$405–$498.75 | $540–$665 | varies |
| CT angio hrt w/3d image (75574) | $367.50 | $490 | 1.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$348–$405 | $464–$540 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$405–$498.75 | $540–$665 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $405 | $540 | 2.5× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$232.50–$772.50 | $310–$1,030 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$225–$1,375.50 | $300–$1,834 | varies |
| CT cervical spine w/wo cont (72127) | $405 | $540 | 2.5× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$367.50–$382.50 | $490–$510 | varies |
| CT chest w/wo contrast (71270) | $405 | $540 | 2.5× |
| CT head/brain with contrast (70460) | $367.50 | $490 | 2.3× |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$345.75–$405 | $461–$540 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $367.50 | $490 | 1.2× |
| CT heart no contrast quant eval coronry calcium (75571) | $161.25 | $215 | 2.0× |
| CT iac w contrast (70481) | $367.50 | $490 | 2.3× |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$290.25–$405 | $387–$540 | varies |
| CT lower ext w/o (73700) range across 3 matching MRF lines |
$225–$265.50 | $300–$354 | varies |
| CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
$332.25–$367.50 | $443–$490 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$273.75–$772.50 | $365–$1,030 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$225–$318.75 | $300–$425 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$276.75–$367.50 | $369–$490 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$225–$231 | $300–$308 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$382.50–$405 | $510–$540 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$345.75–$405 | $461–$540 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$225–$281.25 | $300–$375 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$390–$405 | $520–$540 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$225–$289.50 | $300–$386 | varies |
| CT scan of leg combo (73702) range across 3 matching MRF lines |
$318.75–$405 | $425–$540 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$382.50–$405 | $510–$540 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$307.50–$367.50 | $410–$490 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$225–$231 | $300–$308 | varies |
| CT thoracic spine w contrast (72129) | $367.50 | $490 | 2.3× |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$221.25–$225 | $295–$300 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$330–$405 | $440–$540 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$225–$307.50 | $300–$410 | varies |
| CT upper ext wo (73200) range across 3 matching MRF lines |
$225–$264.75 | $300–$353 | varies |
| CT upper extremity w/o & w/contrast material (73202) | $405 | $540 | 2.5× |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$286.50–$772.50 | $382–$1,030 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$367.50–$750.75 | $490–$1,001 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$390–$405 | $520–$540 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) | $722.25 | $963 | 2.3× |
| CTA pelvis (72191) | $405 | $540 | 2.5× |
| Discography Cerv/Thor Spine (72285) | $3,480 | $4,640 | 2.0× |
| Dxa Bone Density Axial (77080) | $221.25 | $295 | 2.3× |
| Echo exam uterus (76831) | $450 | $600 | 2.1× |
| Echo Guide For Artery Repair (76936) | $510 | $680 | 2.6× |
| Esophagram (74220) | $371.25 | $495 | 2.3× |
| Fetal Biophys Profile W/Nst (76818) | $182.25 | $243 | 1.9× |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$19.50–$450 | $26–$600 | varies |
| Follow-Up Angiography (75898) | $18,238.50 | $24,318 | 6.3× |
| Foot 2 views (73620) range across 4 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$40.50–$174.75 | $54–$233 | varies |
| Gastric emptying imaging study (78264) | $746.25 | $995 | 2.1× |
| Gated Heart Planar Single (78472) | $746.25 | $995 | 2.1× |
| Hand 2 views (73120) range across 5 matching MRF lines |
$56.25–$225 | $75–$300 | varies |
| Hepatobil Syst Image W/Drug (78227) | $956.25 | $1,275 | 1.9× |
| Hysterosalpingogram (74740) | $472.50 | $630 | 2.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $180 | $240 | 2.3× |
| Infant hip ultrasound, limited static exam (76886) | $161.25 | $215 | 2.0× |
| K Flow/Funct Image Multiple (78709) | $968.25 | $1,291 | 2.0× |
| K Flow/Funct Image W/Drug (78708) | $956.25 | $1,275 | 1.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $746.25 | $995 | 2.1× |
| Knee 3 Views (73562) range across 6 matching MRF lines |
$45–$180 | $60–$240 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $746.25 | $995 | 2.1× |
| Lung Perf&Ventilat Diferentl (78598) | $956.25 | $1,275 | 1.9× |
| Lung Ventilat&Perfus Imaging (78582) | $956.25 | $1,275 | 1.9× |
| Lymph System Imaging (78195) | $956.25 | $1,275 | 1.9× |
| Magnetic Image Jaw Joint (70336) | $472.50 | $630 | 2.2× |
| Mlc imrt design & construction per imrt plan (77338) | $648.75 | $865 | 1.9× |
| Mra Head W/O & W/Contrast Material (70546) | $772.50 | $1,030 | 2.4× |
| MRA head w/o contrast (70544) | $472.50 | $630 | 2.2× |
| Mra Neck W/O &W/Contrast Material (70549) | $772.50 | $1,030 | 2.4× |
| MRA neck w/o contrast (70547) | $472.50 | $630 | 2.2× |
| MRI abdomen w/o contrast (74181) | $472.50 | $630 | 2.2× |
| MRI any jt lower extrem w/contrast material (73722) | $1,380 | $1,840 | 1.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $810 | $1,080 | 2.5× |
| MRI any jt upper extremity w/contrast matrl (73222) | $1,380 | $1,840 | 1.9× |
| MRI Breast W/O Contrast Bilateral (77047) | $472.50 | $630 | 2.2× |
| MRI Breast Without Contrast Material Unilateral (77046) | $472.50 | $630 | 2.2× |
| MRI cardiac w/o contrast (75557) | $472.50 | $630 | 2.2× |
| MRI cervical spine w/o cont (72141) | $472.50 | $630 | 2.2× |
| MRI chest w/o contrast (71550) | $472.50 | $630 | 2.2× |
| MRI chest with contrast (71551) | $1,380 | $1,840 | 1.9× |
| MRI chest wo w contrast (71552) | $810 | $1,080 | 2.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $772.50 | $1,030 | 2.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $810 | $1,080 | 2.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $472.50 | $630 | 2.2× |
| MRI lumbar spine w contrast (72149) | $772.50 | $1,030 | 2.4× |
| Mri Neck Spine W/O & W/Dye (72156) | $810 | $1,080 | 2.5× |
| MRI orbit face &/neck w/o contrast (70540) | $472.50 | $630 | 2.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $772.50 | $1,030 | 2.4× |
| MRI pelvis w/o & w contrast (72197) | $810 | $1,080 | 2.5× |
| MRI pelvis w/o contrast (72195) | $472.50 | $630 | 2.2× |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$170.25–$735 | $227–$980 | varies |
| MRI thoracic spine w/o contrast (72146) | $472.50 | $630 | 2.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) | $2,105.25 | $2,807 | 6.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $472.50 | $630 | 2.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $810 | $1,080 | 2.5× |
| MRI, abdomen, combo (74183) | $810 | $1,080 | 2.5× |
| MRI, dorsal spine combo (72157) | $772.50 | $1,030 | 2.4× |
| MRI, dorsal spine contrast (72147) | $772.50 | $1,030 | 2.4× |
| MRI, joint upper extrem (73221) | $472.50 | $630 | 2.2× |
| MRI, joint upper extrem combo (73223) | $810 | $1,080 | 2.5× |
| MRI, lumbar spine combo (72158) | $810 | $1,080 | 2.5× |
| Myocardial Spect Multiple Studies (78452) | $2,576.25 | $3,435 | 2.2× |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Nonvascular Shunt X-Ray (75809) | $204.75 | $273 | 2.2× |
| Ntsty modul radthx pln dose-vol histos (77301) | $2,382.75 | $3,177 | 1.9× |
| Nuclear Rx Oral Admin (79005) | $480 | $640 | 2.3× |
| Ob us nuchal meas 1 gest (76813) | $183.75 | $245 | 1.9× |
| Parathyroid Planar Imaging (78070) | $746.25 | $995 | 2.1× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$56.25–$225 | $75–$300 | varies |
| Pet Image W/Ct Lmtd (78814) | $2,921.25 | $3,895 | 2.2× |
| PET image w/CT, full body (78816) | $2,921.25 | $3,895 | 2.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 15 matching MRF lines |
$2,694–$3,018.75 | $3,592–$4,025 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) | $746.25 | $995 | 2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$168.75–$225 | $225–$300 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $930 | $1,240 | 1.9× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$52.50–$180 | $70–$240 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 5 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Radex elbow complete minimum 3 views (73080) range across 5 matching MRF lines |
$135–$180 | $180–$240 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$168.75–$225 | $225–$300 | varies |
| Radex fingr minimum 2 views (73140) range across 7 matching MRF lines |
$40.50–$243.75 | $54–$325 | varies |
| Radex foot complete minimum 3 views (73630) range across 4 matching MRF lines |
$135–$180 | $180–$240 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$52.50–$243.75 | $70–$325 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 4 matching MRF lines |
$168.75–$225 | $225–$300 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Radex Ribs Unilateral 2 Views (71100) | $161.25 | $215 | 2.0× |
| Radex shoulder complete minimum 2 views (73030) range across 6 matching MRF lines |
$45–$180 | $60–$240 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$364.50–$486 | $486–$648 | varies |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$45–$180 | $60–$240 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $15,030 | $20,040 | 2.2× |
| Radiation treatment delivery level 1 (77402) | $211.50 | $282 | 2.3× |
| Radiation treatment delivery level 2 (77407) | $798 | $1,064 | 2.3× |
| Radiation treatment delivery level 3 (77412) range across 4 matching MRF lines |
$464.25–$1,143.75 | $619–$1,525 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$168.75–$225 | $225–$300 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $390 | $520 | 2.4× |
| Radiologic exam knee complete 4/more views (73564) range across 6 matching MRF lines |
$56.25–$225 | $75–$300 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$183–$243.75 | $244–$325 | varies |
| Radiologic exam swallow function contrast study (74230) | $371.25 | $495 | 2.3× |
| Radiologic exam upr gi trc double contrast study (74246) | $390 | $520 | 2.4× |
| Radiologic examination femur minimum 2 views (73552) range across 5 matching MRF lines |
$40.50–$174.75 | $54–$233 | varies |
| Radiologic examination knee 1/2 views (73560) range across 6 matching MRF lines |
$40.50–$174.75 | $54–$233 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$168.75–$225 | $225–$300 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 5 matching MRF lines |
$40.50–$161.25 | $54–$215 | varies |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$183–$243.75 | $244–$325 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $746.25 | $995 | 2.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$2,568.75–$2,576.25 | $3,425–$3,435 | varies |
| Scapula (73010) range across 4 matching MRF lines |
$168.75–$225 | $225–$300 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$52.50–$67.50 | $70–$90 | varies |
| Sella turcica (70240) range across 2 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Shoulder Arthrography (73040) | $772.50 | $1,030 | 2.4× |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$135–$225 | $180–$300 | varies |
| Special dosimetry (77331) | $252 | $336 | 2.1× |
| Special Physics Consult (77370) | $252 | $336 | 2.1× |
| Special teletherapy port plan (77321) | $648.75 | $865 | 1.9× |
| Special treatment procedure (77470) | $1,101 | $1,468 | 2.2× |
| Spleen Imaging (78185) | $746.25 | $995 | 2.1× |
| Stereotactic Body Radiation Delivery (77373) | $3,346.50 | $4,462 | 2.1× |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) | $211.50 | $282 | 2.3× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) | $211.50 | $282 | 2.3× |
| Surf radj ther supfc/orthvlt treatment planning (77436) | $78 | $104 | 2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $681.75 | $909 | 2.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $648.75 | $865 | 1.9× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$201.75–$693 | $269–$924 | varies |
| Ther rad simulaj-aided field setting simple (77280) | $252 | $336 | 2.1× |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$56.25–$225 | $75–$300 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$61.50–$243.75 | $82–$325 | varies |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) | $187.50 | $250 | 0.5× |
| Thyroid Imaging With Vascular Flow (78013) | $797.25 | $1,063 | 2.2× |
| Thyroid Met Imaging Body (78018) | $956.25 | $1,275 | 1.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $746.25 | $995 | 2.1× |
| Tx Devices Design & Construction Complex (77334) | $648.75 | $865 | 1.9× |
| Ultrasound Breast Limited (76642) | $217.50 | $290 | 2.7× |
| Ultrasound Exam Aaa Screen (76706) | $217.50 | $290 | 2.3× |
| Ultrasound, abdomen limited (76705) | $217.50 | $290 | 2.3× |
| Upper gi w/o kub (74240) | $371.25 | $495 | 2.3× |
| Urethrocystogram voiding (74455) | $472.50 | $630 | 2.2× |
| Urethrocystography retrograde (74450) | $450 | $600 | 2.1× |
| Us chest (76604) | $217.50 | $290 | 2.3× |
| Us exam, pelvic, limited (76857) | $73.50 | $98 | 0.8× |
| Us head (76506) | $217.50 | $290 | 2.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $225 | $300 | 2.4× |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$260.38–$472.50 | $347.17–$630 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$126–$225 | $168–$300 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$217.50–$225 | $290–$300 | varies |
| Us pelvic non ob complete (76856) | $162 | $216 | 1.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$169.58–$217.50 | $226.11–$290 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$217.50–$370.50 | $290–$494 | varies |
| Us retroperitoneal complete (76770) | $144 | $192 | 1.5× |
| Us retroperitoneal limited (76775) range across 4 matching MRF lines |
$217.50–$354 | $290–$472 | varies |
| Us scrotum and contents (76870) | $144 | $192 | 1.5× |
| Us thyroid (76536) range across 3 matching MRF lines |
$118.50–$217.50 | $158–$290 | varies |
| Us transrectal (76872) | $168.75 | $225 | 1.8× |
| Vein X-Ray Chest (75827) | $1,215 | $1,620 | 0.8× |
| Venogram Sinus/Jugular (75860) | $6,374.25 | $8,499 | 2.2× |
| Venography caval inferior serialography rs&i (75825) | $4,378.50 | $5,838 | 1.5× |
| Venography extremity bilateral rs&i (75822) | $3,146.25 | $4,195 | 2.2× |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$818.25–$2,846.25 | $1,091–$3,795 | varies |
| Venography Renal Bilateral (75833) | $4,303.50 | $5,738 | 1.5× |
| Wrist 2 views (73100) range across 6 matching MRF lines |
$40.50–$161.25 | $54–$215 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| X-ray antegrade pyelogram tube (74425) | $772.50 | $1,030 | 2.4× |
| X-Ray Aorta Leg Arteries (75630) | $5,663.25 | $7,551 | 2.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 5 matching MRF lines |
$40.50–$174.75 | $54–$233 | varies |
| X-Ray Exam Breast Specimen (76098) | $975 | $1,300 | 2.0× |
| X-Ray Exam Entire Spi 1 Vw (72081) | $161.25 | $215 | 2.0× |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 6 matching MRF lines |
$45–$180 | $60–$240 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 5 matching MRF lines |
$52.50–$210 | $70–$280 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$168.75–$225 | $225–$300 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$168.75–$225 | $225–$300 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$40.50–$161.25 | $54–$215 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $243.75 | $325 | 2.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $225 | $300 | 2.4× |
| X-ray eye for foreign body (70030) range across 4 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| X-ray humerus (73060) range across 5 matching MRF lines |
$40.50–$161.25 | $54–$215 | varies |
| X-ray IV pyelogram (ivp) (74400) | $371.25 | $495 | 2.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 3 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$40.50–$161.25 | $54–$215 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$56.25–$225 | $75–$300 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$183–$243.75 | $244–$325 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$168.75–$225 | $225–$300 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$120.75–$161.25 | $161–$215 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $180 | $240 | 2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$183–$243.75 | $244–$325 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$197.25–$262.50 | $263–$350 | varies |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$168.75–$225 | $225–$300 | varies |
| X-Rays Bone Survey Complete (77075) range across 3 matching MRF lines |
$168.75–$225 | $225–$300 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$56.25–$225 | $75–$300 | varies |
| Xr facial bones less than 3 views (70140) | $161.25 | $215 | 2.0× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$168.75–$225 | $225–$300 | 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.