Imaging prices at AdventHealth Heart of Florida
Davenport, FL · every code in this section with a posted price and a Medicare benchmark.
290 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Abdomen 2 views (74019) | $1,552.82 | $1,552.82 | 14.2× |
| Acute gi blood loss imaging (78278) | $4,448.43 | $4,448.43 | 10.7× |
| Angiography extremity bilateral rs&i (75716) | $13,361.12 | $13,361.12 | 4.1× |
| Angiography extremity unilateral rs&i (75710) | $13,361.12 | $13,361.12 | 4.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) | $12,681.09 | $12,681.09 | 2.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) | $13,361.12 | $13,361.12 | 4.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $13,361.12 | $13,361.12 | 4.1× |
| Angiography Spinal Selective Rs&I (75705) | $16,446.87 | $16,446.87 | 2.8× |
| Angiography visceral slctv/supraslctv rs&i (75726) | $22,860.26 | $22,860.26 | 3.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $7,221.44 | $7,221.44 | 2.2× |
| Ankle 2 views (73600) | $401.09 | $401.09 | 4.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) | $15,606.23 | $15,606.23 | 4.7× |
| Aortography abdominal serialography rs&i (75625) | $13,361.12 | $13,361.12 | 4.1× |
| Arthrogram hip (73525) | $3,757.33 | $3,757.33 | 10.3× |
| Arthrogram knee (73580) | $3,717.33 | $3,717.33 | 10.2× |
| Arthrogram shoulder (73040) | $3,729.79 | $3,729.79 | 10.2× |
| Bone &/Joint Imaging Limited Area (78300) | $3,000 | $3,000 | 7.2× |
| Bone &/joint imaging whole body (78306) | $4,448.43 | $4,448.43 | 10.7× |
| Bone age studies (77072) | $1,745.81 | $1,745.81 | 16.0× |
| Bone Imaging 3 Phase (78315) | $4,448.43 | $4,448.43 | 10.7× |
| Bone Marrow Imaging Limited Area (78102) | $3,634.53 | $3,634.53 | 8.7× |
| Bone survey complete (77075) | $1,662.83 | $1,662.83 | 15.2× |
| Bone survey infant (77076) | $1,650.19 | $1,650.19 | 15.1× |
| Brachytx isodose complex (77318) | $3,432.39 | $3,432.39 | 8.8× |
| Brachytx isodose intermed (77317) | $3,246.88 | $3,246.88 | 8.3× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) | $1,629.14 | $1,629.14 | 4.2× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,782.29 | $2,782.29 | 4.9× |
| Brain Imaging Vascular Flow Only (78610) | $1,073.30 | $1,073.30 | 1.9× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) | $4,448.43 | $4,448.43 | 10.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $7,095.27 | $7,095.27 | 19.5× |
| Cervical spine 2 or 3 views (72040) | $869.80 | $869.80 | 9.6× |
| Chest 1 view (71045) | $790.72 | $790.72 | 8.7× |
| Chest xray 3 views (71047) | $1,243.56 | $1,243.56 | 13.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) | $1,995.66 | $1,995.66 | 10.9× |
| Clavicle complete (73000) | $869.80 | $869.80 | 9.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $3,410.83 | $3,410.83 | 31.2× |
| Contrast Xray Throat/Cerv Esopha (74210) | $826.42 | $826.42 | 4.5× |
| CT abdomen and pelvis without and with contrast (74178) | $7,450.72 | $7,450.72 | 20.5× |
| CT abdomen and pelvis without contrast (74176) | $7,229.61 | $7,229.61 | 29.0× |
| CT abdomen w contrast (74160) | $7,450.72 | $7,450.72 | 40.7× |
| CT abdomen w wo contrast (74170) | $7,450.72 | $7,450.72 | 40.7× |
| CT abdomen w/o contrast (74150) | $3,500.71 | $3,500.71 | 32.1× |
| CT angio hrt w/3d image (75574) | $5,123.10 | $5,123.10 | 14.1× |
| CT angio lwr extr w/o&w/dye (73706) | $7,450.72 | $7,450.72 | 40.7× |
| CT angiography upper extremity lt (73206) | $7,450.72 | $7,450.72 | 40.7× |
| CT c-spine w/contrast (72126) | $13,453.87 | $13,453.87 | 36.9× |
| CT c-spine w/o contrast (72125) | $3,500.71 | $3,500.71 | 32.1× |
| CT cervical spine w&w/o contrast (72127) | $7,450.72 | $7,450.72 | 40.7× |
| CT chest w contrast (71260) | $7,450.72 | $7,450.72 | 40.7× |
| CT chest w/wo contrast (71270) | $7,450.72 | $7,450.72 | 40.7× |
| CT head/brain with contrast (70460) | $7,450.72 | $7,450.72 | 40.7× |
| CT head/brain without and with contrast (70470) | $7,450.72 | $7,450.72 | 40.7× |
| CT heart contrast eval cardiac structure&morph (75572) | $3,850.88 | $3,850.88 | 10.6× |
| CT heart w/o contrast quant eval coronary calcium (75571) | $538.07 | $538.07 | 5.9× |
| CT iac w contrast (70481) | $7,450.72 | $7,450.72 | 40.7× |
| CT limited/localized follow up study (76380) | $1,831.15 | $1,831.15 | 20.1× |
| CT lower ext w/o (73700) | $3,500.71 | $3,500.71 | 32.1× |
| CT lower extremity w wo contrast (73702) | $7,450.72 | $7,450.72 | 40.7× |
| CT lower extremity w/contrast material (73701) | $7,450.72 | $7,450.72 | 40.7× |
| CT lumbar spine w & w/o contrast (72133) | $7,450.72 | $7,450.72 | 40.7× |
| CT lumbar spine w/contrast (72132) | $13,453.87 | $13,453.87 | 36.9× |
| CT lumbar spine w/o contrast (72131) | $3,500.71 | $3,500.71 | 32.1× |
| CT maxillofacial w contrast (70487) | $7,450.72 | $7,450.72 | 40.7× |
| CT maxillofacial w/wo contrast (70488) | $7,450.72 | $7,450.72 | 40.7× |
| CT maxillofacial wo contrast (70486) | $3,500.71 | $3,500.71 | 32.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) | $7,450.72 | $7,450.72 | 40.7× |
| CT orbits w/o contrast (70480) | $3,500.71 | $3,500.71 | 32.1× |
| CT pelvis w/o contrast (72192) | $3,500.71 | $3,500.71 | 32.1× |
| CT pelvis w/wo contrast (72194) | $7,450.72 | $7,450.72 | 40.7× |
| CT scan of arm combo (73202) | $4,434.96 | $4,434.96 | 24.2× |
| CT soft tissue neck w contrast (70491) | $7,450.72 | $7,450.72 | 40.7× |
| CT soft tissue neck w/o & w/contrast material (70492) | $7,450.72 | $7,450.72 | 40.7× |
| CT soft tissue neck w/o contrast (70490) | $3,500.71 | $3,500.71 | 32.1× |
| CT thoracic spine w/contrast (72129) | $7,450.72 | $7,450.72 | 40.7× |
| CT thoracic spine w/o contrast (72128) | $3,500.71 | $3,500.71 | 32.1× |
| CT thorax w/o contrast (71250) | $3,500.71 | $3,500.71 | 32.1× |
| CT upper ext wo (73200) | $3,500.71 | $3,500.71 | 32.1× |
| CT upper extremity with contrast (73201) | $7,450.72 | $7,450.72 | 20.5× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) | $7,450.72 | $7,450.72 | 40.7× |
| Cta Abdomen (74175) | $7,450.72 | $7,450.72 | 40.7× |
| CTA abdomen pelvis (74174) | $7,450.72 | $7,450.72 | 20.5× |
| CTA chest (71275) | $7,450.72 | $7,450.72 | 40.7× |
| Cta Head (70496) | $7,450.72 | $7,450.72 | 40.7× |
| Cta Neck (70498) | $7,450.72 | $7,450.72 | 40.7× |
| Cta Pelvis (72191) | $8,966.24 | $8,966.24 | 49.0× |
| Cystography minimum 3 views rs&i (74430) | $2,628.91 | $2,628.91 | 7.2× |
| Dxa bone density study 1/> sites axial skel (77080) | $1,662.83 | $1,662.83 | 15.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $1,493.38 | $1,493.38 | 16.4× |
| Dxa bone density study axial skeleton (77085) | $510.24 | $510.24 | 4.7× |
| Esophagus (74220) | $3,189.32 | $3,189.32 | 17.4× |
| Facial bones min 3 views (70150) | $1,662.83 | $1,662.83 | 15.2× |
| Fetal biophysical profile non-stress testing (76818) | $1,511.66 | $1,511.66 | 13.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $925.47 | $925.47 | 8.5× |
| Fluoroscopy up to 1 hr (76000) | $1,511.66 | $1,511.66 | 6.1× |
| Foot 2 views (73620) | $878.85 | $878.85 | 9.7× |
| Forearm 2 views (73090) | $869.80 | $869.80 | 9.6× |
| Hand 2 views (73120) | $963.10 | $963.10 | 8.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) | $2,639.23 | $2,639.23 | 4.7× |
| Hepatobiliary syst imaging including gallbladder (78226) | $2,241.31 | $2,241.31 | 5.4× |
| Hysterosalpingogram (74740) | $2,054.73 | $2,054.73 | 8.2× |
| Intracavitary Radiation Source Applic Complex (77763) | $3,195.05 | $3,195.05 | 4.4× |
| Intracavitary Radiation Source Applic Intermed (77762) | $2,443.67 | $2,443.67 | 4.2× |
| Intracavitary Radiation Source Applic Simple (77761) | $2,443.67 | $2,443.67 | 4.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) | $5,289.95 | $5,289.95 | 9.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) | $5,617.67 | $5,617.67 | 9.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) | $4,828.35 | $4,828.35 | 8.5× |
| Knee 3 views (73562) | $443.49 | $443.49 | 4.9× |
| Liver & spleen imaging static only (78215) | $1,738.64 | $1,738.64 | 4.2× |
| Lung ventilation imaging (78579) | $1,558 | $1,558 | 3.7× |
| Lymphoscintigraphy (78195) | $5,767.76 | $5,767.76 | 10.2× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) | $9,548.36 | $9,548.36 | 11.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) | $6,187.70 | $6,187.70 | 17.0× |
| Mr safety determination physician/other qhp (76016) | $252.89 | $252.89 | 2.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $70.61 | $70.61 | 2.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $265.09 | $265.09 | 2.7× |
| Mr safety implt pos&/immoblj (76019) | $168.42 | $168.42 | 2.7× |
| Mr safety med physics xm customization plng&mntr (76017) | $696.84 | $696.84 | 2.8× |
| MRA head w & w/o contrast (70546) | $7,373.59 | $7,373.59 | 20.2× |
| MRA head w/o contrast (70544) | $3,434.06 | $3,434.06 | 13.8× |
| MRA head with contrast (70545) | $8,385.41 | $8,385.41 | 23.0× |
| MRA neck w contrast (70548) | $9,801.59 | $9,801.59 | 26.9× |
| Mra Neck W/O &W/Contrast Material (70549) | $6,390.59 | $6,390.59 | 17.5× |
| MRA neck w/o contrast (70547) | $3,434.06 | $3,434.06 | 13.8× |
| MRI abdomen w contrast (74182) | $9,657.95 | $9,657.95 | 26.5× |
| MRI abdomen w/o & w/contrast material (74183) | $6,390.59 | $6,390.59 | 17.5× |
| MRI abdomen w/o contrast (74181) | $3,434.06 | $3,434.06 | 13.8× |
| MRI any jt lower extrem w/contrast material (73722) | $9,548.36 | $9,548.36 | 11.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $6,390.59 | $6,390.59 | 17.5× |
| MRI breast w/o contrast bilateral (77047) | $10,287.23 | $10,287.23 | 41.3× |
| MRI c-spine with contrast (72142) | $6,390.59 | $6,390.59 | 17.5× |
| MRI cervical spine w/o contrast (72141) | $3,434.06 | $3,434.06 | 13.8× |
| MRI chest w/o & w/contrast material (71552) | $12,032.55 | $12,032.55 | 33.0× |
| MRI chest w/o contrast (71550) | $8,777.88 | $8,777.88 | 35.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) | $1,368.31 | $1,368.31 | 3.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $6,390.59 | $6,390.59 | 17.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,434.06 | $3,434.06 | 13.8× |
| MRI orbit face &/neck w/o contrast (70540) | $9,972.42 | $9,972.42 | 40.0× |
| MRI orbit face neck w contrast (70542) | $10,373.86 | $10,373.86 | 28.5× |
| MRI orbit/face/neck w&w/o cont (70543) | $6,390.59 | $6,390.59 | 17.5× |
| MRI pelvis w/contrast (72196) | $10,168.66 | $10,168.66 | 27.9× |
| MRI pelvis w/o & w/contrast material (72197) | $6,390.59 | $6,390.59 | 17.5× |
| MRI pelvis w/o contrast (72195) | $3,434.06 | $3,434.06 | 13.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) | $6,390.59 | $6,390.59 | 17.5× |
| MRI spinal canal lumbar w/contrast material (72149) | $6,390.59 | $6,390.59 | 17.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) | $6,390.59 | $6,390.59 | 17.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) | $6,390.59 | $6,390.59 | 17.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) | $6,390.59 | $6,390.59 | 17.5× |
| MRI thoracic spine w/o contrast (72146) | $3,434.06 | $3,434.06 | 13.8× |
| MRI up ext w/o contrast (73218) | $3,434.06 | $3,434.06 | 13.8× |
| MRI upper ext joint w/o contrast (73221) | $3,434.06 | $3,434.06 | 13.8× |
| MRI, joint upper extrem combo (73223) | $6,390.59 | $6,390.59 | 17.5× |
| Myelogram Lumbar (72265) | $4,788.90 | $4,788.90 | 5.8× |
| Myelography 2 or more regions (72270) | $5,241.86 | $5,241.86 | 6.4× |
| Myocardial Spect Multiple Studies (78452) | $15,467.57 | $15,467.57 | 11.4× |
| Myocardial spect single study at rest or stress (78451) | $9,259.97 | $9,259.97 | 6.8× |
| N-invas est c ffr sw aly CTA (75580) | $3,060.57 | $3,060.57 | 3.4× |
| Neck soft tissue (70360) | $812.26 | $812.26 | 8.9× |
| Nm cardiac blood pool multiple (78473) | $5,216.99 | $5,216.99 | 12.5× |
| Nm cisternogram (78630) | $7,109.36 | $7,109.36 | 12.5× |
| Nm gastric emptying study (78264) | $4,448.43 | $4,448.43 | 10.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $27,591.78 | $27,591.78 | 19.1× |
| Nuclear Rx Oral Admin (79005) | $3,034.79 | $3,034.79 | 12.5× |
| Osseous survey limited (77074) | $2,184.21 | $2,184.21 | 20.0× |
| Parathyrd planar w/spect&CT (78072) | $4,653.21 | $4,653.21 | 8.2× |
| Parathyroid Planar Imaging (78070) | $4,448.43 | $4,448.43 | 10.7× |
| Pelvis 1 or 2 views (72170) | $1,662.83 | $1,662.83 | 15.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $9,669.90 | $9,669.90 | 2.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $1,614.87 | $1,614.87 | 3.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) | $4,371.58 | $4,371.58 | 7.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,585.31 | $1,585.31 | 2.8× |
| Radex Ankle Compl Minimum 3 Views (73610) | $493.54 | $493.54 | 5.4× |
| Radex Calcaneus Minimum 2 Views (73650) | $869.80 | $869.80 | 9.6× |
| Radex Elbw Compl Minimum 3 Views (73080) | $869.80 | $869.80 | 9.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) | $869.80 | $869.80 | 9.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) | $1,662.83 | $1,662.83 | 15.2× |
| Radex fingr minimum 2 views (73140) | $869.80 | $869.80 | 9.6× |
| Radex Foot Compl Minimum 3 Views (73630) | $767.11 | $767.11 | 8.4× |
| Radex Hand Minimum 3 Views (73130) | $857.37 | $857.37 | 9.4× |
| Radex Hip Unilateral With Pelvis 1 View (73501) | $869.80 | $869.80 | 9.6× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) | $1,662.83 | $1,662.83 | 15.2× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) | $1,662.83 | $1,662.83 | 15.2× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) | $2,371.17 | $2,371.17 | 21.7× |
| Radex Humerus Minimum 2 Views (73060) | $869.80 | $869.80 | 9.6× |
| Radex Kne 1/2 Views (73560) | $444.76 | $444.76 | 4.9× |
| Radex Kne Compl 4/More Views (73564) | $1,662.83 | $1,662.83 | 15.2× |
| Radex Mndbl Compl Minimum 4 Views (70110) | $1,662.83 | $1,662.83 | 15.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $889.94 | $889.94 | 9.8× |
| Radex Pelvis Compl Minimum 3 Views (72190) | $2,708.06 | $2,708.06 | 24.8× |
| Radex Sho Compl Minimum 2 Views (73030) | $869.80 | $869.80 | 9.6× |
| Radex Sinuses Paransl < 3 Views (70210) | $585.18 | $585.18 | 6.4× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) | $1,527.58 | $1,527.58 | 14.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $869.80 | $869.80 | 9.6× |
| Radex Toe Minimum 2 Views (73660) | $869.80 | $869.80 | 9.6× |
| Radex upper extremity infant minimum 2 views (73092) | $1,662.83 | $1,662.83 | 15.2× |
| Radex Wrst Compl Minimum 3 Views (73110) | $796.81 | $796.81 | 8.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $875.18 | $875.18 | 8.0× |
| Radiation Delivery Stereotactic Cranial Cobalt (77371) | $26,271.41 | $26,271.41 | 3.4× |
| Radiation treatment delivery level 1 (77402) | $404.64 | $404.64 | 3.8× |
| Radiation treatment delivery level 2 (77407) | $952.60 | $952.60 | 2.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) | $266.88 | $266.88 | 2.9× |
| Radiologic exam chest 2 views (71046) | $790.72 | $790.72 | 8.7× |
| Radiologic exam colon single contrast study (74270) | $3,304.95 | $3,304.95 | 18.0× |
| Radiologic exam upr gi trc double contrast study (74246) | $3,147.57 | $3,147.57 | 17.2× |
| Radiologic exam upr gi trc single contrast study (74240) | $3,643.31 | $3,643.31 | 19.9× |
| Radiologic examination femur 1 view (73551) | $1,102.36 | $1,102.36 | 12.1× |
| Radiologic examination tibia & fibula 2 views (73590) | $869.80 | $869.80 | 9.6× |
| Radiological examination surgical specimen (76098) | $1,632.18 | $1,632.18 | 2.9× |
| Ribs bilateral 3 views (71110) | $1,662.83 | $1,662.83 | 15.2× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) | $5,256.36 | $5,256.36 | 12.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) | $5,906.93 | $5,906.93 | 10.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) | $3,590.01 | $3,590.01 | 6.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) | $4,414.25 | $4,414.25 | 3.3× |
| Sacroiliac Joints < 3 Views (72200) | $1,102.36 | $1,102.36 | 10.1× |
| Scapula (73010) | $1,662.83 | $1,662.83 | 15.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $301.02 | $301.02 | 12.9× |
| Shoulder 1 view (73020) | $869.80 | $869.80 | 9.6× |
| Small bowel series (74250) | $1,552.82 | $1,552.82 | 8.5× |
| Spine thoracic 3 views (72072) | $1,662.83 | $1,662.83 | 15.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,629.14 | $1,629.14 | 4.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $1,629.14 | $1,629.14 | 4.2× |
| Thoracolumbar 2 views (72080) | $285.78 | $285.78 | 3.1× |
| Thyroid carcinoma metastases img whole body (78018) | $4,164.65 | $4,164.65 | 7.3× |
| Thyroid uptake measurement (78012) | $2,404.33 | $2,404.33 | 5.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $1,873.02 | $1,873.02 | 4.5× |
| Tmj unilateral (70328) | $1,015.73 | $1,015.73 | 11.2× |
| Ultrasound breast complete (76641) | $636.50 | $636.50 | 5.8× |
| Ultrasound Exam Aaa Screen (76706) | $737.09 | $737.09 | 6.8× |
| Ultrasound, abdomen limited (76705) | $1,511.66 | $1,511.66 | 13.8× |
| Umbilical-artery Doppler (OB) (76820) | $990.73 | $990.73 | 9.1× |
| Urethrocystogram voiding (74455) | $3,206.88 | $3,206.88 | 12.9× |
| Urethrocystography retrograde rs&i (74450) | $2,826.80 | $2,826.80 | 11.3× |
| Us breast unilateral limited (76642) | $416.17 | $416.17 | 4.6× |
| Us chest (76604) | $1,511.66 | $1,511.66 | 13.8× |
| Us compl joint r-t w/image documentation (76881) | $1,511.66 | $1,511.66 | 13.8× |
| Us elastography parenchyma (76981) | $632.17 | $632.17 | 5.8× |
| Us encephalogram (76506) | $1,511.66 | $1,511.66 | 13.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $1,506.52 | $1,506.52 | 13.8× |
| Us ob detailed single fetus (76811) | $2,182.55 | $2,182.55 | 8.8× |
| Us ob limited (76815) | $1,286.43 | $1,286.43 | 11.8× |
| Us ob transvaginal (76817) | $1,554.74 | $1,554.74 | 14.2× |
| Us pelvic non ob complete (76856) | $1,511.66 | $1,511.66 | 13.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) | $1,511.66 | $1,511.66 | 13.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,511.66 | $1,511.66 | 13.8× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) | $1,511.66 | $1,511.66 | 13.8× |
| Us retroperitoneal complete (76770) | $3,226.25 | $3,226.25 | 29.6× |
| Us retroperitoneal limited (76775) | $1,511.66 | $1,511.66 | 13.8× |
| Us scrotum and contents (76870) | $1,511.66 | $1,511.66 | 13.8× |
| Us soft tissue head/neck (76536) | $1,511.66 | $1,511.66 | 13.8× |
| Us spinal canal and contents (76800) | $1,511.66 | $1,511.66 | 13.8× |
| Us transrectal prostate volume (76873) | $3,586.81 | $3,586.81 | 32.9× |
| Us, eye b-scan (76512) | $367.76 | $367.76 | 3.4× |
| Us,transplanted kidney, real time/ doppler (76776) | $1,511.66 | $1,511.66 | 13.8× |
| Venogram extremity bilateral (75822) | $9,580.26 | $9,580.26 | 5.8× |
| Venogram Extremity Unilateral (75820) | $7,249.50 | $7,249.50 | 4.4× |
| Venography caval inferior serialography rs&i (75825) | $13,361.12 | $13,361.12 | 4.1× |
| Venography caval superior serialography rs&i (75827) | $7,036.35 | $7,036.35 | 4.3× |
| Wrist 2 views (73100) | $869.80 | $869.80 | 9.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) | $644.10 | $644.10 | 5.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,461.57 | $1,461.57 | 16.1× |
| X-ray b.e. reductn intuss (74283) | $2,081 | $2,081 | 11.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) | $3,304.95 | $3,304.95 | 18.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $869.80 | $869.80 | 9.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $869.80 | $869.80 | 9.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $340.04 | $340.04 | 3.1× |
| X-ray exam of femur 2/> (73552) | $869.80 | $869.80 | 9.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) | $1,523.01 | $1,523.01 | 16.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $1,552.66 | $1,552.66 | 17.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $300.55 | $300.55 | 3.3× |
| X-ray leg, infant (73592) | $869.80 | $869.80 | 9.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $1,662.83 | $1,662.83 | 15.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) | $2,879.37 | $2,879.37 | 26.4× |
| X-ray nose-rectum child f.b. (76010) | $812.26 | $812.26 | 8.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) | $1,623.24 | $1,623.24 | 14.9× |
| X-ray retrograde pyelogram (74420) | $5,557.08 | $5,557.08 | 15.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) | $745.74 | $745.74 | 8.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) | $700.15 | $700.15 | 6.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,662.83 | $1,662.83 | 15.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $1,662.83 | $1,662.83 | 15.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $869.80 | $869.80 | 9.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $869.80 | $869.80 | 9.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,662.83 | $1,662.83 | 15.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) | $1,662.83 | $1,662.83 | 15.2× |
| X-Ray Spine One View - Xr Spine (72020) | $838.73 | $838.73 | 9.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) | $457.79 | $457.79 | 5.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) | $869.80 | $869.80 | 9.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) | $862.47 | $862.47 | 7.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) | $1,662.83 | $1,662.83 | 15.2× |
| Xr c-spine 4 or 5 views (72050) | $875.18 | $875.18 | 8.0× |
| Xr c-spine 6 or more views (72052) | $2,854.43 | $2,854.43 | 26.1× |
| Xr urogram antegrade (74425) | $2,506.01 | $2,506.01 | 6.9× |