Imaging prices at Adena Fayette Medical Center
Washington Ch, OH · every code in this section with a posted price and a Medicare benchmark.
317 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) range across 2 matching MRF lines |
$5,755.97–$11,511.94 | $11,511.94 | varies |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$154.09–$308.18 | $308.18 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$1,235.36–$2,470.71 | $2,470.71 | varies |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$6,609.69–$13,219.37 | $13,219.37 | varies |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$5,783.53–$11,567.06 | $11,567.06 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$5,783.53–$11,567.06 | $11,567.06 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) range across 2 matching MRF lines |
$5,859.54–$11,719.07 | $11,719.07 | varies |
| Ankle 2 views (73600) range across 2 matching MRF lines |
$154.09–$308.18 | $308.18 | varies |
| Aortography thoracic serialography rs&i (75605) range across 2 matching MRF lines |
$3,103.13–$6,206.26 | $6,206.26 | varies |
| Artery X-Rays Abdomen (75726) range across 2 matching MRF lines |
$3,258.29–$6,516.57 | $6,516.57 | varies |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$3,103.13–$6,206.26 | $6,206.26 | varies |
| Arthrogram ankle (73615) range across 2 matching MRF lines |
$608.28–$1,216.56 | $1,216.56 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$624.98–$1,249.96 | $1,249.96 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$624.98–$1,249.96 | $1,249.96 | varies |
| Basic radiation dosimetry calculation (77300) range across 2 matching MRF lines |
$656.67–$1,313.34 | $1,313.34 | varies |
| Bone age studies (77072) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$1,324.31–$2,648.61 | $2,648.61 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$1,324.31–$2,648.61 | $2,648.61 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$1,324.31–$2,648.61 | $2,648.61 | varies |
| Bone marrow imaging; whole body (78104) range across 2 matching MRF lines |
$1,379.24–$2,758.47 | $2,758.47 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Brachytx isodose intermed (77317) range across 2 matching MRF lines |
$958.13–$1,916.25 | $1,916.25 | varies |
| Brachytx Isodose Plan Simple (77316) range across 2 matching MRF lines |
$937.13–$1,874.25 | $1,874.25 | varies |
| Brain Flow Imaging Only (78610) range across 2 matching MRF lines |
$440.15–$880.30 | $880.30 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 2 matching MRF lines |
$882.88–$1,765.75 | $1,765.75 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) range across 2 matching MRF lines |
$2,759.18–$5,518.36 | $5,518.36 | varies |
| Cardiac MRI w/w/o contrast & further seq (75561) range across 2 matching MRF lines |
$1,484.53–$2,969.05 | $2,969.05 | varies |
| Cardiac MRI w/w/o contrast w/stress (75563) range across 2 matching MRF lines |
$1,052–$2,103.99 | $2,103.99 | varies |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$380.95–$761.89 | $761.89 | varies |
| Chest 1 view (71045) range across 2 matching MRF lines |
$173.44–$346.87 | $346.87 | varies |
| Chest 2 views (71046) range across 2 matching MRF lines |
$173.44–$346.87 | $346.87 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$173.44–$346.87 | $346.87 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$173.37–$346.73 | $346.73 | varies |
| Clavicle complete (73000) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$223.78–$447.55 | $447.55 | varies |
| Continuing medical physics consltj pr wk (77336) range across 2 matching MRF lines |
$656.67–$1,313.34 | $1,313.34 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 2 matching MRF lines |
$5,783.53–$11,567.06 | $11,567.06 | varies |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$624.98–$1,249.96 | $1,249.96 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$624.98–$1,249.96 | $1,249.96 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 2 matching MRF lines |
$624.98–$1,249.96 | $1,249.96 | varies |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$2,390.47–$4,780.93 | $4,780.93 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$1,526.80–$3,053.60 | $3,053.60 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,008.12–$2,016.23 | $2,016.23 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,195.23–$2,390.46 | $2,390.46 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$764.32–$1,528.63 | $1,528.63 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$2,016.23–$4,032.46 | $4,032.46 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,198.89–$2,397.77 | $2,397.77 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,198.89–$2,397.77 | $2,397.77 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$1,969.30–$3,938.59 | $3,938.59 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,198.89–$2,397.77 | $2,397.77 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,198.89–$2,397.77 | $2,397.77 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,198.89–$2,397.77 | $2,397.77 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,211.47–$2,422.94 | $2,422.94 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$764.32–$1,528.63 | $1,528.63 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$1,464.25–$2,928.50 | $2,928.50 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,008.12–$2,016.23 | $2,016.23 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$1,195.23–$2,390.46 | $2,390.46 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,008.12–$2,016.23 | $2,016.23 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,195.23–$2,390.46 | $2,390.46 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$1,418.31–$2,836.61 | $2,836.61 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$177.98–$355.95 | $355.95 | varies |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$1,008.12–$2,016.23 | $2,016.23 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$1,452.44–$2,904.88 | $2,904.88 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$1,528.63–$3,057.25 | $3,057.25 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$2,016.23–$4,032.45 | $4,032.45 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,178.78–$2,357.55 | $2,357.55 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$764.32–$1,528.63 | $1,528.63 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,150–$2,300 | $2,300 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$764.75–$1,529.50 | $1,529.50 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,195.23–$2,390.46 | $2,390.46 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$1,195.23–$2,390.46 | $2,390.46 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$764.32–$1,528.63 | $1,528.63 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,195.23–$2,390.46 | $2,390.46 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$764.32–$1,528.63 | $1,528.63 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,195.23–$2,390.46 | $2,390.46 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,265–$2,530 | $2,530 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,008.12–$2,016.23 | $2,016.23 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$764.32–$1,528.63 | $1,528.63 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,196.59–$2,393.17 | $2,393.17 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$764.32–$1,528.63 | $1,528.63 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$1,509.49–$3,018.97 | $3,018.97 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$764.32–$1,528.63 | $1,528.63 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$1,529.50–$3,059 | $3,059 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,006.25–$2,012.50 | $2,012.50 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,897.50–$3,795 | $3,795 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$1,198.89–$2,397.77 | $2,397.77 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,198.89–$2,397.77 | $2,397.77 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) range across 2 matching MRF lines |
$623.76–$1,247.51 | $1,247.51 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$1,198.89–$2,397.77 | $2,397.77 | varies |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) range across 2 matching MRF lines |
$81.17–$162.34 | $162.34 | varies |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$125.42–$250.84 | $250.84 | varies |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$291.95–$583.90 | $583.90 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$154.09–$308.18 | $308.18 | varies |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$126.79–$253.58 | $253.58 | varies |
| Esophagram (74220) range across 2 matching MRF lines |
$262.09–$524.17 | $524.17 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$207.08–$414.16 | $414.16 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$423.01–$846.02 | $846.02 | varies |
| Foot 2 views (73620) range across 2 matching MRF lines |
$154.09–$308.18 | $308.18 | varies |
| Forearm 2 views (73090) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$1,337.47–$2,674.93 | $2,674.93 | varies |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$1,058.50–$2,117 | $2,117 | varies |
| Gated Heart, Multiple (78473) range across 2 matching MRF lines |
$1,395–$2,790 | $2,790 | varies |
| Hand 2 views (73120) range across 2 matching MRF lines |
$372.19–$744.38 | $744.38 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) range across 2 matching MRF lines |
$4,625.14–$9,250.28 | $9,250.28 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) range across 2 matching MRF lines |
$4,084.54–$8,169.08 | $8,169.08 | varies |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) range across 2 matching MRF lines |
$1,712.91–$3,425.82 | $3,425.82 | varies |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) range across 2 matching MRF lines |
$5,508.13–$11,016.25 | $11,016.25 | varies |
| Hepatobil Syst Image W/Drug (78227) range across 2 matching MRF lines |
$1,479.80–$2,959.59 | $2,959.59 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$969.25–$1,938.50 | $1,938.50 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$2,284.59–$4,569.18 | $4,569.18 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$541.85–$1,083.69 | $1,083.69 | varies |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$1,375–$2,750 | $2,750 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$1,366–$2,732 | $2,732 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$1,156.50–$2,313 | $2,313 | varies |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) range across 2 matching MRF lines |
$409.50–$819 | $819 | varies |
| Knee 3 Views (73562) range across 2 matching MRF lines |
$353.51–$707.02 | $707.02 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$1,581.90–$3,163.80 | $3,163.80 | varies |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$1,724.23–$3,448.46 | $3,448.46 | varies |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$2,133.44–$4,266.87 | $4,266.87 | varies |
| Lung Ventilation Imaging (78579) range across 2 matching MRF lines |
$1,414.04–$2,828.08 | $2,828.08 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$1,321.22–$2,642.43 | $2,642.43 | varies |
| Magnetic Image Jaw Joint (70336) range across 2 matching MRF lines |
$1,058.10–$2,116.20 | $2,116.20 | varies |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$703.21–$1,406.41 | $1,406.41 | varies |
| Mlc imrt design & construction per imrt plan (77338) range across 2 matching MRF lines |
$672.66–$1,345.31 | $1,345.31 | varies |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) range across 2 matching MRF lines |
$42.86–$85.72 | $85.72 | varies |
| Mr safety implt electronics prepj supvj phys/qhp (76018) range across 2 matching MRF lines |
$160.64–$321.27 | $321.27 | varies |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$1,460.50–$2,921 | $2,921 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,061.45–$2,122.90 | $2,122.90 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$1,249.77–$2,499.53 | $2,499.53 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$1,116.94–$2,233.88 | $2,233.88 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$1,293.75–$2,587.50 | $2,587.50 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$1,017.75–$2,035.50 | $2,035.50 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$1,529.50–$3,059 | $3,059 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$1,158.63–$2,317.25 | $2,317.25 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,382.61–$2,765.21 | $2,765.21 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$2,875–$5,750 | $5,750 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,382.61–$2,765.21 | $2,765.21 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$546.86–$1,093.72 | $1,093.72 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$332.07–$664.13 | $664.13 | varies |
| MRI cardiac w/o contrast (75557) range across 2 matching MRF lines |
$1,511.57–$3,023.13 | $3,023.13 | varies |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$1,156.04–$2,312.08 | $2,312.08 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$1,150.96–$2,301.92 | $2,301.92 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$848.70–$1,697.40 | $1,697.40 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$1,462.29–$2,924.57 | $2,924.57 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$1,603.68–$3,207.35 | $3,207.35 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$1,509.38–$3,018.75 | $3,018.75 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$3,047.50–$6,095 | $6,095 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$2,265.50–$4,531 | $4,531 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$1,293.75–$2,587.50 | $2,587.50 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$1,487.75–$2,975.49 | $2,975.49 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$1,165.79–$2,331.57 | $2,331.57 | varies |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$1,482.82–$2,965.64 | $2,965.64 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$1,422.29–$2,844.57 | $2,844.57 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$1,358.44–$2,716.88 | $2,716.88 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,523.75–$3,047.50 | $3,047.50 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$1,143.10–$2,286.20 | $2,286.20 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$1,155.64–$2,311.27 | $2,311.27 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$1,437.50–$2,875 | $2,875 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$1,058–$2,116 | $2,116 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,725–$3,450 | $3,450 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,575.50–$3,151 | $3,151 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,482.46–$2,964.92 | $2,964.92 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$1,192.55–$2,385.10 | $2,385.10 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,094.12–$2,188.24 | $2,188.24 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,511.03–$3,022.06 | $3,022.06 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,466.25–$2,932.50 | $2,932.50 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$3,215.63–$6,431.25 | $6,431.25 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$154.09–$308.18 | $308.18 | varies |
| Nonvascular Shunt X-Ray (75809) range across 2 matching MRF lines |
$310.85–$621.69 | $621.69 | varies |
| Ntsty modul radthx pln dose-vol histos (77301) range across 2 matching MRF lines |
$5,755.97–$11,511.94 | $11,511.94 | varies |
| Nuclear Rx Intra-Arterial (79445) range across 2 matching MRF lines |
$951.46–$1,902.92 | $1,902.92 | varies |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$1,224.52–$2,449.04 | $2,449.04 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$1,366.08–$2,732.15 | $2,732.15 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Pet Image W/Ct Lmtd (78814) range across 2 matching MRF lines |
$2,552.54–$5,105.07 | $5,105.07 | varies |
| PET image w/CT, full body (78816) range across 2 matching MRF lines |
$3,475–$6,950 | $6,950 | varies |
| PET imaging CT attenuation skull base mid-thigh (78815) range across 2 matching MRF lines |
$3,375–$6,750 | $6,750 | varies |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$1,147.17–$2,294.34 | $2,294.34 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$224.30–$448.59 | $448.59 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 2 matching MRF lines |
$353.51–$707.02 | $707.02 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| Radex elbow complete minimum 3 views (73080) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Radex fingr minimum 2 views (73140) range across 2 matching MRF lines |
$353.51–$707.02 | $707.02 | varies |
| Radex foot complete minimum 3 views (73630) range across 2 matching MRF lines |
$353.51–$707.02 | $707.02 | varies |
| Radex Hand Minimum 3 Views (73130) range across 2 matching MRF lines |
$353.51–$707.02 | $707.02 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 2 matching MRF lines |
$353.51–$707.02 | $707.02 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 2 matching MRF lines |
$353.51–$707.02 | $707.02 | varies |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| Radex Toe Minimum 2 Views (73660) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 2 matching MRF lines |
$353.51–$707.02 | $707.02 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) range across 2 matching MRF lines |
$13,633.59–$27,267.18 | $27,267.18 | varies |
| Radiation treatment delivery level 1 (77402) range across 2 matching MRF lines |
$512.45–$1,024.89 | $1,024.89 | varies |
| Radiation treatment delivery level 2 (77407) range across 2 matching MRF lines |
$1,993.60–$3,987.20 | $3,987.20 | varies |
| Radiation treatment delivery level 3 (77412) range across 2 matching MRF lines |
$2,193.97–$4,387.93 | $4,387.93 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$405.93–$811.85 | $811.85 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$311.54–$623.07 | $623.07 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$366.68–$733.36 | $733.36 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 2 matching MRF lines |
$187.12–$374.23 | $374.23 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$215.10–$430.19 | $430.19 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$311.54–$623.07 | $623.07 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$311.54–$623.07 | $623.07 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$311.54–$623.07 | $623.07 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| Radiologic examination knee 1/2 views (73560) range across 2 matching MRF lines |
$353.51–$707.02 | $707.02 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$501–$1,002 | $1,002 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$2,005–$4,010 | $4,010 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$2,284.59–$4,569.18 | $4,569.18 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$2,284.59–$4,569.18 | $4,569.18 | varies |
| Rp Therapy Intravenous Administration (79101) range across 2 matching MRF lines |
$514.41–$1,028.82 | $1,028.82 | varies |
| Scapula (73010) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$42.30–$84.59 | $84.59 | varies |
| Shoulder 1 view (73020) range across 2 matching MRF lines |
$154.09–$308.18 | $308.18 | varies |
| Shoulder Arthrography (73040) range across 2 matching MRF lines |
$624.98–$1,249.96 | $1,249.96 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$347.59–$695.18 | $695.18 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Special dosimetry (77331) range across 2 matching MRF lines |
$577.97–$1,155.93 | $1,155.93 | varies |
| Special Physics Consult (77370) range across 2 matching MRF lines |
$656.67–$1,313.34 | $1,313.34 | varies |
| Special teletherapy port plan (77321) range across 2 matching MRF lines |
$1,658.69–$3,317.37 | $3,317.37 | varies |
| Special treatment procedure (77470) range across 2 matching MRF lines |
$2,454.56–$4,909.11 | $4,909.11 | varies |
| Stereotactic Body Radiation Delivery (77373) range across 2 matching MRF lines |
$5,548.76–$11,097.51 | $11,097.51 | varies |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$1,658.69–$3,317.37 | $3,317.37 | varies |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$389.33–$778.66 | $778.66 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 2 matching MRF lines |
$1,658.69–$3,317.37 | $3,317.37 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) range across 2 matching MRF lines |
$1,280.31–$2,560.62 | $2,560.62 | varies |
| Ther rad simulaj-aided field setting simple (77280) range across 2 matching MRF lines |
$656.67–$1,313.34 | $1,313.34 | varies |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$218.50–$437 | $437 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$170.20–$340.40 | $340.40 | varies |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$1,350.61–$2,701.21 | $2,701.21 | varies |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$243.06–$486.12 | $486.12 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$919.74–$1,839.48 | $1,839.48 | varies |
| Tx Devices Design & Construction Complex (77334) range across 2 matching MRF lines |
$1,228.33–$2,456.66 | $2,456.66 | varies |
| Tx devices design & construction intermediate (77333) range across 2 matching MRF lines |
$1,169.84–$2,339.68 | $2,339.68 | varies |
| Tx devices design & construction simple (77332) range across 2 matching MRF lines |
$1,228.33–$2,456.66 | $2,456.66 | varies |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$318.85–$637.70 | $637.70 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 2 matching MRF lines |
$207.08–$414.15 | $414.15 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$409.20–$818.40 | $818.40 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$311.54–$623.07 | $623.07 | varies |
| Ureteral Reflux Study (78740) range across 2 matching MRF lines |
$353.77–$707.54 | $707.54 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$442.50–$884.99 | $884.99 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$442.50–$884.99 | $884.99 | varies |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$638.83–$1,277.66 | $1,277.66 | varies |
| Us chest (76604) range across 2 matching MRF lines |
$260.72–$521.43 | $521.43 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$409.20–$818.40 | $818.40 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$249.78–$499.56 | $499.56 | varies |
| Us head (76506) range across 2 matching MRF lines |
$260.72–$521.43 | $521.43 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$268.47–$536.93 | $536.93 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$177.50–$355 | $355 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$177.50–$355 | $355 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$409.20–$818.40 | $818.40 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$177.50–$355 | $355 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$177.50–$355 | $355 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$371.92–$743.83 | $743.83 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$347.49–$694.97 | $694.97 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$409.20–$818.40 | $818.40 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$409.20–$818.40 | $818.40 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$409.20–$818.40 | $818.40 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$328.06–$656.11 | $656.11 | varies |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$2,718.52–$5,437.04 | $5,437.04 | varies |
| Venography caval inferior serialography rs&i (75825) range across 2 matching MRF lines |
$5,508.13–$11,016.25 | $11,016.25 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$2,670.38–$5,340.76 | $5,340.76 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$2,718.52–$5,437.04 | $5,437.04 | varies |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$5,508.13–$11,016.25 | $11,016.25 | varies |
| Wrist 2 views (73100) range across 2 matching MRF lines |
$154.09–$308.18 | $308.18 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$442.50–$884.99 | $884.99 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$5,783.53–$11,567.06 | $11,567.06 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 2 matching MRF lines |
$304.14–$608.28 | $608.28 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 2 matching MRF lines |
$154.09–$308.18 | $308.18 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$959.53–$1,919.05 | $1,919.05 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$154.09–$308.18 | $308.18 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$287.50–$575 | $575 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$330.63–$661.25 | $661.25 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$304.14–$608.28 | $608.28 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$304.14–$608.28 | $608.28 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$154.09–$308.18 | $308.18 | varies |
| X-ray humerus (73060) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$442.50–$884.99 | $884.99 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$64.98–$129.95 | $129.95 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$154.09–$308.18 | $308.18 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$154.09–$308.18 | $308.18 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$304.14–$608.28 | $608.28 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$457.13–$914.25 | $914.25 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$304.14–$608.28 | $608.28 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$261.63–$523.25 | $523.25 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$624.98–$1,249.96 | $1,249.96 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$304.14–$608.28 | $608.28 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$304.14–$608.28 | $608.28 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$176.76–$353.51 | $353.51 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 2 matching MRF lines |
$174.23–$348.45 | $348.45 | varies |
| Xr orbits complete 4 views (70200) range across 2 matching MRF lines |
$186.10–$372.19 | $372.19 | 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.