Imaging prices at AdventHealth Littleton
Littleton, CO · every code in this section with a posted price and a Medicare benchmark.
435 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) | $15,779.15 | $15,779.15 | 10.8× |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$167.37–$789.73 | $167.37–$789.73 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$204.91–$1,149.40 | $204.91–$1,149.40 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $2,925.82 | $2,925.82 | 6.9× |
| Angio internal mammary (75756) | $4,776.17 | $4,776.17 | 1.4× |
| Angio pulmonary bilat (75743) | $11,434.24 | $11,434.24 | 3.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) | $14,146.17 | $14,146.17 | 4.2× |
| Angiography extremity bilateral rs&i (75716) | $12,175.63 | $12,175.63 | 3.7× |
| Angiography extremity unilateral rs&i (75710) | $6,471.49 | $6,471.49 | 1.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,774.66 | $5,774.66 | 1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $3,699.11 | $3,699.11 | 1.1× |
| Ankle 2 views (73600) range across 3 matching MRF lines |
$192.99–$1,106.01 | $192.99–$1,106.01 | varies |
| Aortography thoracic serialography rs&i (75605) | $7,824.58 | $7,824.58 | 1.3× |
| Artery X-Rays Abdomen (75726) | $9,679.81 | $9,679.81 | 1.6× |
| Artery X-Rays Adrenal Gland (75731) | $7,073.10 | $7,073.10 | 2.1× |
| Artery X-Rays Pelvis (75736) | $7,704.23 | $7,704.23 | 1.3× |
| Artery X-Rays Spine (75705) | $10,192.43 | $10,192.43 | 1.7× |
| Arthrogram ankle (73615) | $3,895.09 | $3,895.09 | 10.6× |
| Arthrogram hip (73525) | $1,350.64 | $1,350.64 | 3.7× |
| Arthrogram Wrist (73115) | $1,989.03 | $1,989.03 | 5.4× |
| Basic radiation dosimetry calculation (77300) | $2,075.38 | $2,075.38 | 14.6× |
| Bone age studies (77072) range across 3 matching MRF lines |
$173.93–$727.61 | $173.93–$727.61 | varies |
| Bone Imaging 3 Phase (78315) | $5,650.46 | $5,650.46 | 13.4× |
| Bone Imaging Limited Area (78300) | $3,446.38 | $3,446.38 | 8.2× |
| Bone Imaging Multiple Areas (78305) | $4,568.46 | $4,568.46 | 10.8× |
| Bone Imaging Whole Body (78306) | $4,728.76 | $4,728.76 | 11.2× |
| Bone marrow imaging limited area (78102) | $920.73 | $920.73 | 2.2× |
| Bone survey infant (77076) range across 2 matching MRF lines |
$301.22–$1,523.26 | $301.22–$1,523.26 | varies |
| Brachytx isodose complex (77318) | $10,067.49 | $10,067.49 | 25.5× |
| Brachytx isodose intermed (77317) | $7,805.98 | $7,805.98 | 19.8× |
| Brachytx Isodose Plan Simple (77316) | $7,213.84 | $7,213.84 | 18.3× |
| Brain Image W/Flow < 4 Views (78601) | $1,398.90 | $1,398.90 | 3.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $2,631.01 | $2,631.01 | 4.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $11,934.11 | $11,934.11 | 7.9× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) | $412.67 | $412.67 | 1.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,309.01 | $3,309.01 | 9.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $3,970.81 | $3,970.81 | 4.8× |
| Cat Scan Follow-Up Study (76380) range across 2 matching MRF lines |
$985.51–$2,956.93 | $985.51–$2,956.93 | varies |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) | $2,262.11 | $2,262.11 | 3.9× |
| Cerebrospinal Fluid Scan (78630) | $5,433.40 | $5,433.40 | 9.5× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$112.70–$900.72 | $112.70–$900.72 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$173.38–$1,006.41 | $173.38–$1,006.41 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$221.07–$1,207.07 | $221.07–$1,207.07 | varies |
| Chest 4 or more views (71048) range across 3 matching MRF lines |
$236.97–$1,413.04 | $236.97–$1,413.04 | varies |
| Cholecystography Oral Contrast (74290) range across 2 matching MRF lines |
$301.22–$940.54 | $301.22–$940.54 | varies |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) | $2,715.30 | $2,715.30 | 24.6× |
| Clavicle complete (73000) range across 3 matching MRF lines |
$178.31–$1,092.96 | $178.31–$1,092.96 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $934.98 | $934.98 | 8.5× |
| Continuing medical physics consltj pr wk (77336) | $2,531.29 | $2,531.29 | 17.9× |
| Contrast Exam Abdominl Aorta (75625) | $7,884.68 | $7,884.68 | 2.4× |
| Contrast X-Ray Bladder (74430) | $2,074.88 | $2,074.88 | 5.6× |
| Contrast X-Ray Of Elbow (73085) | $1,891.78 | $1,891.78 | 5.1× |
| Contrast X-Ray Of Knee Joint (73580) | $1,720.79 | $1,720.79 | 4.7× |
| Corpora cavernosography (74445) | $663.16 | $663.16 | 6.0× |
| CT abdomen and pelvis without and with contrast (74178) range across 2 matching MRF lines |
$1,332.71–$15,241.02 | $1,332.71–$15,241.02 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$1,157.23–$10,152.27 | $1,157.23–$10,152.27 | varies |
| CT abdomen w contrast (74160) range across 2 matching MRF lines |
$1,177.86–$6,969.87 | $1,177.86–$6,969.87 | varies |
| CT abdomen w wo contrast (74170) range across 2 matching MRF lines |
$1,289.72–$7,983.37 | $1,289.72–$7,983.37 | varies |
| CT abdomen w/o contrast (74150) range across 2 matching MRF lines |
$1,098.89–$5,339.31 | $1,098.89–$5,339.31 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$1,286.16–$15,906.51 | $1,286.16–$15,906.51 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$1,286.16–$8,146.87 | $1,286.16–$8,146.87 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$1,166.98–$7,339.78 | $1,166.98–$7,339.78 | varies |
| CT angio hrt w/3d image (75574) range across 2 matching MRF lines |
$1,286.16–$1,659.36 | $1,286.16–$1,659.36 | varies |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 2 matching MRF lines |
$1,286.16–$11,589.01 | $1,286.16–$11,589.01 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$1,166.98–$7,778.95 | $1,166.98–$7,778.95 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 2 matching MRF lines |
$1,286.16–$5,316.87 | $1,286.16–$5,316.87 | varies |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$1,103.07–$5,769.23 | $1,103.07–$5,769.23 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$903.10–$5,157.05 | $903.10–$5,157.05 | varies |
| CT cervical spine w/wo cont (72127) range across 2 matching MRF lines |
$1,148.23–$5,973.80 | $1,148.23–$5,973.80 | varies |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$1,153.82–$7,286.04 | $1,153.82–$7,286.04 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$1,231.21–$7,422.35 | $1,231.21–$7,422.35 | varies |
| CT colonography screening (74263) range across 2 matching MRF lines |
$936.80–$938.56 | $936.80–$938.56 | varies |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) range across 2 matching MRF lines |
$1,224.92–$1,565.59 | $1,224.92–$1,565.59 | varies |
| CT colonogrphy dx image postprocess w/o contrast (74261) range across 2 matching MRF lines |
$936.80–$938.56 | $936.80–$938.56 | varies |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$1,177.93–$5,822.01 | $1,177.93–$5,822.01 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$1,326.11–$6,941.56 | $1,326.11–$6,941.56 | varies |
| CT heart contrast eval cardiac structure&morph (75572) range across 2 matching MRF lines |
$1,286.16–$4,741.02 | $1,286.16–$4,741.02 | varies |
| CT heart no contrast quant eval coronry calcium (75571) range across 2 matching MRF lines |
$985.51–$5,033.88 | $985.51–$5,033.88 | varies |
| CT hrt w/3d image congen (75573) | $3,218.74 | $3,218.74 | 8.7× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$826.31–$5,613.92 | $826.31–$5,613.92 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$1,266.12–$6,273.88 | $1,266.12–$6,273.88 | varies |
| CT lower ext w/o (73700) range across 2 matching MRF lines |
$987.66–$4,816.27 | $987.66–$4,816.27 | varies |
| CT lower extremity w/contrast material (73701) range across 2 matching MRF lines |
$1,149.91–$7,513.42 | $1,149.91–$7,513.42 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$1,216.33–$6,207.41 | $1,216.33–$6,207.41 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$995.82–$5,672.28 | $995.82–$5,672.28 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$1,170.73–$6,007.76 | $1,170.73–$6,007.76 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$889.16–$4,595.21 | $889.16–$4,595.21 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$1,323.80–$7,470.77 | $1,323.80–$7,470.77 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$925.05–$6,647.09 | $925.05–$6,647.09 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$940.64–$5,306.43 | $940.64–$5,306.43 | varies |
| CT pelvis w&w/o contrast (72194) range across 2 matching MRF lines |
$1,166.36–$7,257.67 | $1,166.36–$7,257.67 | varies |
| CT pelvis w/o contrast (72192) range across 2 matching MRF lines |
$1,049.72–$4,813 | $1,049.72–$4,813 | varies |
| CT scan of leg combo (73702) range across 2 matching MRF lines |
$1,199.29–$9,016.07 | $1,199.29–$9,016.07 | varies |
| CT scans face/jaw combo (70488) range across 2 matching MRF lines |
$1,318.93–$7,209.29 | $1,318.93–$7,209.29 | varies |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$1,136.35–$6,658.08 | $1,136.35–$6,658.08 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$1,054.35–$4,972.71 | $1,054.35–$4,972.71 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$1,232.67–$6,039.22 | $1,232.67–$6,039.22 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$1,003.34–$5,800.95 | $1,003.34–$5,800.95 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$1,282.84–$7,247.08 | $1,282.84–$7,247.08 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$1,069.40–$5,171.54 | $1,069.40–$5,171.54 | varies |
| CT upper ext wo (73200) range across 2 matching MRF lines |
$994.46–$5,203.16 | $994.46–$5,203.16 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 2 matching MRF lines |
$1,207.56–$7,527.96 | $1,207.56–$7,527.96 | varies |
| CT upper extremity with contrast (73201) range across 2 matching MRF lines |
$1,157.84–$6,187.72 | $1,157.84–$6,187.72 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$1,920.90–$8,324.15 | $1,920.90–$8,324.15 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$1,286.16–$7,787.84 | $1,286.16–$7,787.84 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$1,286.16–$8,118.69 | $1,286.16–$8,118.69 | varies |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $1,058.76 | $1,058.76 | 4.2× |
| Dilation ureters/urethra rs&i (74485) | $3,019.83 | $3,019.83 | 1.4× |
| Discography Cerv/Thor Spine (72285) | $7,308.79 | $7,308.79 | 3.5× |
| Diskography lumbar (72295) | $7,308.79 | $7,308.79 | 3.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $1,842.92 | $1,842.92 | 16.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $2,403.83 | $2,403.83 | 21.8× |
| Doppler Fetal Mid Cerebral Artery (76821) range across 2 matching MRF lines |
$432.98–$1,249.57 | $432.98–$1,249.57 | varies |
| Dxa Bone Density Axial (77080) | $1,085.90 | $1,085.90 | 9.8× |
| Dxa bone density study (77085) | $1,528.69 | $1,528.69 | 13.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $1,283.97 | $1,283.97 | 14.0× |
| Echo exam of fetal heart (76825) | $5,448.65 | $5,448.65 | 9.5× |
| Echo exam uterus (76831) range across 2 matching MRF lines |
$432.98–$2,403.83 | $432.98–$2,403.83 | varies |
| Echo Guide For Artery Repair (76936) | $2,113.79 | $2,113.79 | 9.3× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $2,403.83 | $2,403.83 | 9.6× |
| Echograp Trans R Pros Study (76873) | $1,842.92 | $1,842.92 | 16.7× |
| Esophagram (74220) range across 2 matching MRF lines |
$301.22–$1,763.36 | $301.22–$1,763.36 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 2 matching MRF lines |
$432.98–$2,271.38 | $432.98–$2,271.38 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
$432.98–$1,892.81 | $432.98–$1,892.81 | varies |
| Fluoroscopy up to 1 hr (76000) | $1,705.74 | $1,705.74 | 6.8× |
| Follow-Up Angiography (75898) | $5,065.33 | $5,065.33 | 1.5× |
| Foot 2 views (73620) range across 3 matching MRF lines |
$172.06–$941.03 | $172.06–$941.03 | varies |
| Forearm 2 views (73090) range across 3 matching MRF lines |
$201.78–$967.84 | $201.78–$967.84 | varies |
| Gastric emptying imaging study (78264) | $3,729.61 | $3,729.61 | 8.8× |
| Gated Heart Planar Single (78472) | $4,404.16 | $4,404.16 | 10.4× |
| Gated Heart, Multiple (78473) | $5,284.98 | $5,284.98 | 12.5× |
| Hand 2 views (73120) range across 3 matching MRF lines |
$238.86–$966.21 | $238.86–$966.21 | varies |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $17,991.37 | $17,991.37 | 24.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $12,737.63 | $12,737.63 | 17.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $6,540.37 | $6,540.37 | 8.9× |
| Heart Image (Pet) Multiple (78492) | $9,554.09 | $9,554.09 | 6.3× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $8,065.83 | $8,065.83 | 2.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $6,721.53 | $6,721.53 | 2.0× |
| Hepatobil Syst Image W/Drug (78227) | $4,788.24 | $4,788.24 | 8.4× |
| Hepatobiliary System Imaging (78226) | $4,442.42 | $4,442.42 | 10.5× |
| Ht Muscle Image Spect Sing (78451) | $9,800.46 | $9,800.46 | 7.2× |
| Hysterosalpingogram (74740) | $2,084.80 | $2,084.80 | 8.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$432.98–$961.51 | $432.98–$961.51 | varies |
| Infant hip ultrasound, limited static exam (76886) | $961.51 | $961.51 | 10.5× |
| Interstitial radiation source applic complex (77778) | $19,681.98 | $19,681.98 | 26.8× |
| Intracavitary Radiation Source Applic Complex (77763) | $10,712.75 | $10,712.75 | 14.6× |
| Intracavitary Radiation Source Applic Intermed (77762) | $9,641.48 | $9,641.48 | 16.5× |
| Intracavitary radiation source applic simple (77761) | $8,034.57 | $8,034.57 | 13.8× |
| Intraop radiaj tx deliver xray single tx session (77424) | $12,438.79 | $12,438.79 | 1.6× |
| K Flow/Funct Image Multiple (78709) | $7,347.98 | $7,347.98 | 12.8× |
| K Flow/Funct Image W/Drug (78708) | $6,314.68 | $6,314.68 | 11.0× |
| K Flow/Funct Image W/O Drug (78707) | $4,975.20 | $4,975.20 | 8.7× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) | $1,828.21 | $1,828.21 | 4.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $2,602.41 | $2,602.41 | 6.2× |
| Knee 3 Views (73562) range across 3 matching MRF lines |
$229.95–$1,151.96 | $229.95–$1,151.96 | varies |
| Leveen/Shunt Patency Exam (78291) | $1,855.80 | $1,855.80 | 4.4× |
| Liver & Spleen Imaging Static Only (78215) | $2,591.51 | $2,591.51 | 6.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $2,591.51 | $2,591.51 | 6.1× |
| Liver imaging static only (78201) | $2,660.71 | $2,660.71 | 4.6× |
| Liver imaging w/vascular flow (78202) | $2,660.71 | $2,660.71 | 4.6× |
| Lung Perf&Ventilat Diferentl (78598) | $3,879.26 | $3,879.26 | 6.8× |
| Lung perfusion differential (78597) | $3,879.26 | $3,879.26 | 9.2× |
| Lung Ventilat&Perfus Imaging (78582) | $5,549.56 | $5,549.56 | 9.7× |
| Lung Ventilation Imaging (78579) | $3,660.50 | $3,660.50 | 8.7× |
| Lymph System Imaging (78195) | $3,833.65 | $3,833.65 | 6.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $4,684.33 | $4,684.33 | 1.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) | $3,055.72 | $3,055.72 | 0.9× |
| Magnetic Image Jaw Joint (70336) | $1,015.43 | $1,015.43 | 4.0× |
| Magnetic Resonance Elastography (76391) | $666.78 | $666.78 | 2.6× |
| Mammary ductogram or galactogram multiple (77054) | $1,879.35 | $1,879.35 | 7.5× |
| Mammary ductogram or galactogram single (77053) | $1,566.12 | $1,566.12 | 6.2× |
| Meckels Divert Exam (78290) | $2,676.23 | $2,676.23 | 6.3× |
| Mlc imrt design & construction per imrt plan (77338) | $29,991.75 | $29,991.75 | 75.9× |
| Mr safety determination physician/other qhp (76016) | $442.94 | $442.94 | 4.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $123.68 | $123.68 | 4.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $464.32 | $464.32 | 4.6× |
| Mr safety implt pos&/immoblj (76019) | $294.99 | $294.99 | 4.7× |
| Mr safety med physics xm customization plng&mntr (76017) | $1,220.54 | $1,220.54 | 4.8× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$1,268.87–$8,116.63 | $1,268.87–$8,116.63 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$1,024.85–$5,303.82 | $1,024.85–$5,303.82 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$1,024.85–$5,621.40 | $1,024.85–$5,621.40 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$1,096.92–$6,332 | $1,096.92–$6,332 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$1,310.06–$7,167.61 | $1,310.06–$7,167.61 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$873.37–$5,496.42 | $873.37–$5,496.42 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$1,021.13–$6,344.58 | $1,021.13–$6,344.58 | varies |
| MRI abdomen w/o contrast (74181) range across 2 matching MRF lines |
$865–$5,635.48 | $865–$5,635.48 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 2 matching MRF lines |
$1,201.53–$5,852.15 | $1,201.53–$5,852.15 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 2 matching MRF lines |
$1,591.51–$7,022.59 | $1,591.51–$7,022.59 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 2 matching MRF lines |
$1,215.41–$6,305.42 | $1,215.41–$6,305.42 | varies |
| MRI brain functional w/o physician admnistration (70554) | $6,456.42 | $6,456.42 | 25.7× |
| MRI brain functional w/physician admnistration (70555) range across 2 matching MRF lines |
$7,729.31–$7,962.70 | $7,729.31–$7,962.70 | varies |
| MRI Breast W/O Contrast Bilateral (77047) range across 2 matching MRF lines |
$1,457.26–$5,300.79 | $1,457.26–$5,300.79 | varies |
| MRI Breast Without Contrast Material Unilateral (77046) range across 2 matching MRF lines |
$976.37–$4,113.21 | $976.37–$4,113.21 | varies |
| MRI cardiac w/o cont stress (75559) | $2,596.97 | $2,596.97 | 4.5× |
| MRI cardiac w/o contrast (75557) | $2,164.14 | $2,164.14 | 8.6× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$1,192.75–$6,266.04 | $1,192.75–$6,266.04 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$984.49–$5,728.06 | $984.49–$5,728.06 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$904.69–$4,763.87 | $904.69–$4,763.87 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$1,072.38–$5,954.83 | $1,072.38–$5,954.83 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$1,398.95–$7,443.54 | $1,398.95–$7,443.54 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$1,103.13–$6,413.51 | $1,103.13–$6,413.51 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 2 matching MRF lines |
$1,462.74–$7,526.55 | $1,462.74–$7,526.55 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 2 matching MRF lines |
$918.47–$5,300.48 | $918.47–$5,300.48 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$1,179.24–$6,882.84 | $1,179.24–$6,882.84 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$1,524.08–$6,922.87 | $1,524.08–$6,922.87 | varies |
| MRI orbit face &/neck w/o contrast (70540) | $6,107.69 | $6,107.69 | 24.3× |
| MRI orbit face neck w contrast (70542) range across 2 matching MRF lines |
$971.51–$6,352.56 | $971.51–$6,352.56 | varies |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$1,288.21–$7,868 | $1,288.21–$7,868 | varies |
| MRI pelvis w contrast (72196) range across 2 matching MRF lines |
$1,039.46–$5,123.64 | $1,039.46–$5,123.64 | varies |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$1,322.95–$7,002.64 | $1,322.95–$7,002.64 | varies |
| MRI pelvis w/o contrast (72195) range across 2 matching MRF lines |
$884.83–$3,244.61 | $884.83–$3,244.61 | varies |
| MRI spectroscopy (76390) range across 2 matching MRF lines |
$1,288.21–$7,354.62 | $1,288.21–$7,354.62 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$952.42–$5,468.12 | $952.42–$5,468.12 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 6 matching MRF lines |
$1,142.17–$6,032.86 | $1,142.17–$6,032.86 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 2 matching MRF lines |
$956.82–$5,237.40 | $956.82–$5,237.40 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 2 matching MRF lines |
$1,512.88–$7,239.41 | $1,512.88–$7,239.41 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$1,299.61–$7,059.50 | $1,299.61–$7,059.50 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$1,474.42–$7,305.32 | $1,474.42–$7,305.32 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$1,144.74–$6,115.59 | $1,144.74–$6,115.59 | varies |
| MRI, joint upper extrem (73221) range across 2 matching MRF lines |
$1,013.73–$5,285.27 | $1,013.73–$5,285.27 | varies |
| MRI, joint upper extrem combo (73223) range across 2 matching MRF lines |
$1,608.16–$6,950.63 | $1,608.16–$6,950.63 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$1,512.80–$7,768.59 | $1,512.80–$7,768.59 | varies |
| Myelogram cervical (72240) | $3,197.17 | $3,197.17 | 3.9× |
| Myelogram Lumbar (72265) | $3,137.10 | $3,137.10 | 3.8× |
| Myelography thoracic (72255) | $2,460.06 | $2,460.06 | 3.0× |
| Myelograpy 2/more regions rs&i (72270) | $3,635.65 | $3,635.65 | 4.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $2,652.20 | $2,652.20 | 6.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) | $7,300.52 | $7,300.52 | 5.3× |
| Myocardial Spect Multiple Studies (78452) | $11,895.86 | $11,895.86 | 8.7× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) | $9,915.72 | $9,915.72 | 6.6× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) | $10,387.30 | $10,387.30 | 4.5× |
| N-invas est c ffr sw aly CTA (75580) | $8,882.43 | $8,882.43 | 9.8× |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$179.89–$1,003.70 | $179.89–$1,003.70 | varies |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $1,041.94 | $1,041.94 | 2.5× |
| Nm csf leak detection (78650) | $3,228.22 | $3,228.22 | 2.4× |
| Nm myocard infarct spect (78469) | $3,158.05 | $3,158.05 | 5.5× |
| Nonvascular Shunt X-Ray (75809) | $869.61 | $869.61 | 7.9× |
| Ntsty modul radthx pln dose-vol histos (77301) | $26,572.32 | $26,572.32 | 18.2× |
| Nuclear Rx Intra-Arterial (79445) | $2,654.40 | $2,654.40 | 10.8× |
| Nuclear Rx Oral Admin (79005) | $4,596.77 | $4,596.77 | 18.7× |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$432.98–$1,842.92 | $432.98–$1,842.92 | varies |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $3,525.59 | $3,525.59 | 32.0× |
| Panoramic X-ray of jaws (70355) | $808.94 | $808.94 | 8.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $8,216.02 | $8,216.02 | 14.3× |
| Parathyroid Planar Imaging (78070) | $4,117.69 | $4,117.69 | 9.8× |
| Parathyroid planar imaging w/wo subtraction (78071) | $6,280.11 | $6,280.11 | 14.9× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$204.91–$945.42 | $204.91–$945.42 | varies |
| Peritoneogram Rs&I (74190) | $3,472.30 | $3,472.30 | 6.0× |
| Pet Image Skull-Thigh (78812) | $8,062.39 | $8,062.39 | 5.3× |
| Pet Image W/Ct Lmtd (78814) | $10,907.30 | $10,907.30 | 7.2× |
| PET image w/CT, full body (78816) | $11,972.65 | $11,972.65 | 7.9× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $11,426.02 | $11,426.02 | 7.6× |
| Pet Myocardial Sngl Study (78491) | $7,643.28 | $7,643.28 | 5.1× |
| PET whole body (78813) | $8,277.07 | $8,277.07 | 5.5× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) | $2,767.56 | $2,767.56 | 2.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) | $7,793.14 | $7,793.14 | 2.3× |
| Pulmonary Perfusion Imaging Particulate (78580) | $3,047.50 | $3,047.50 | 7.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$287.81–$1,409.56 | $287.81–$1,409.56 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) | $2,277.39 | $2,277.39 | 4.0× |
| Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
$209.78–$1,202.18 | $209.78–$1,202.18 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
$173.63–$972.34 | $173.63–$972.34 | varies |
| Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
$201.78–$1,049.98 | $201.78–$1,049.98 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$267.47–$1,607.46 | $267.47–$1,607.46 | varies |
| Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
$203.34–$954.63 | $203.34–$954.63 | varies |
| Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
$187.69–$1,119.14 | $187.69–$1,119.14 | varies |
| Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
$248.81–$1,032.98 | $248.81–$1,032.98 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
$178.31–$1,859 | $178.31–$1,859 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$301.22–$1,354.89 | $301.22–$1,354.89 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 3 matching MRF lines |
$209.60–$1,239.41 | $209.60–$1,239.41 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$212.73–$1,567.63 | $212.73–$1,567.63 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
$187.69–$1,268.06 | $187.69–$1,268.06 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 4 matching MRF lines |
$192.40–$1,015.69 | $192.40–$1,015.69 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 2 matching MRF lines |
$378.54–$3,408.76 | $378.54–$3,408.76 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$142.34–$988.71 | $142.34–$988.71 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$189.27–$1,243.13 | $189.27–$1,243.13 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$301.22–$1,948.49 | $301.22–$1,948.49 | varies |
| Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
$179.89–$885.99 | $179.89–$885.99 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$178.31–$2,874.62 | $178.31–$2,874.62 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
$228.39–$1,088.28 | $228.39–$1,088.28 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 3 matching MRF lines |
$428.54–$2,061.88 | $428.54–$2,061.88 | varies |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $35,628.60 | $35,628.60 | 4.6× |
| Radiation treatment delivery level 1 (77402) | $1,304.06 | $1,304.06 | 12.1× |
| Radiation treatment delivery level 2 (77407) | $2,197 | $2,197 | 5.4× |
| Radiation treatment delivery level 3 (77412) | $3,040.63 | $3,040.63 | 5.2× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$301.22–$1,677.33 | $301.22–$1,677.33 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$239.33–$1,168.94 | $239.33–$1,168.94 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$301.22–$3,055.04 | $301.22–$3,055.04 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$301.22–$2,772.42 | $301.22–$2,772.42 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$301.22–$2,057.25 | $301.22–$2,057.25 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
$254.97–$1,617.15 | $254.97–$1,617.15 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 3 matching MRF lines |
$301.22–$1,097.25 | $301.22–$1,097.25 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$301.22–$1,898.37 | $301.22–$1,898.37 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$301.22–$2,014.84 | $301.22–$2,014.84 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$301.22–$2,105.18 | $301.22–$2,105.18 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$179.89–$301.22 | $179.89–$301.22 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
$209.60–$311.15 | $209.60–$311.15 | varies |
| Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
$198.65–$1,096.39 | $198.65–$1,096.39 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$301.22–$843.35 | $301.22–$843.35 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
$184.56–$1,061.35 | $184.56–$1,061.35 | varies |
| Red Cell Volume Determination Spx Mult Samplings (78121) | $983.57 | $983.57 | 1.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $16,541.98 | $16,541.98 | 40.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $12,773.31 | $12,773.31 | 31.4× |
| Renal Cyst Study (74470) | $2,782.86 | $2,782.86 | 4.8× |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$301.22–$2,507.92 | $301.22–$2,507.92 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) | $4,014.43 | $4,014.43 | 9.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $4,411.47 | $4,411.47 | 10.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $6,087.83 | $6,087.83 | 10.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $4,808.50 | $4,808.50 | 8.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $6,528.98 | $6,528.98 | 11.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $12,528.57 | $12,528.57 | 8.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $8,734.71 | $8,734.71 | 6.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) | $2,793.28 | $2,793.28 | 11.3× |
| Rp Therapy Intravenous Administration (79101) | $2,484.12 | $2,484.12 | 10.1× |
| Scapula (73010) range across 3 matching MRF lines |
$193.96–$1,115.86 | $193.96–$1,115.86 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$46.22–$46.33 | $46.22–$46.33 | varies |
| Sella turcica (70240) range across 3 matching MRF lines |
$301.22–$899.15 | $301.22–$899.15 | varies |
| Shoulder 1 view (73020) range across 3 matching MRF lines |
$148.60–$851.38 | $148.60–$851.38 | varies |
| Shoulder Arthrography (73040) | $1,730.05 | $1,730.05 | 4.7× |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$233.07–$1,192.14 | $233.07–$1,192.14 | varies |
| Special dosimetry (77331) | $3,113.59 | $3,113.59 | 22.0× |
| Special Physics Consult (77370) | $3,809.10 | $3,809.10 | 26.9× |
| Special teletherapy port plan (77321) | $5,771.28 | $5,771.28 | 14.6× |
| Special treatment procedure (77470) | $16,973.22 | $16,973.22 | 29.1× |
| Speech evaluation, complex (70371) | $2,106.93 | $2,106.93 | 8.4× |
| Srs Multisource (77371) | $19,147.12 | $19,147.12 | 2.5× |
| Stereotactic Body Radiation Delivery (77373) | $10,271.08 | $10,271.08 | 5.4× |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$301.22–$1,246.78 | $301.22–$1,246.78 | varies |
| Superior sagittal sinus venogram (75870) | $4,488.22 | $4,488.22 | 1.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) | $3,770.77 | $3,770.77 | 35.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $11,127.57 | $11,127.57 | 28.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $9,986.14 | $9,986.14 | 25.3× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $5,810.65 | $5,810.65 | 14.7× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $4,169.83 | $4,169.83 | 10.6× |
| Ther rad simulaj-aided field setting simple (77280) | $2,958.81 | $2,958.81 | 20.9× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) range across 2 matching MRF lines |
$301.22–$1,569.61 | $301.22–$1,569.61 | varies |
| Thoracic spine 2 views (72070) range across 3 matching MRF lines |
$218.98–$1,308.04 | $218.98–$1,308.04 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$301.22–$1,569.62 | $301.22–$1,569.62 | varies |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$195.54–$1,441.33 | $195.54–$1,441.33 | varies |
| Thyroid Imaging With Vascular Flow (78013) | $2,001.65 | $2,001.65 | 4.7× |
| Thyroid Met Imaging Body (78018) | $5,662.10 | $5,662.10 | 9.9× |
| Thyroid Uptake Measurement (78012) | $1,075.86 | $1,075.86 | 2.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $3,707.65 | $3,707.65 | 8.8× |
| Tx Devices Design & Construction Complex (77334) | $3,732.30 | $3,732.30 | 9.4× |
| Tx devices design & construction intermediate (77333) | $2,946.06 | $2,946.06 | 20.8× |
| Tx devices design & construction simple (77332) | $2,287.74 | $2,287.74 | 16.1× |
| Ultrasound Breast Limited (76642) range across 2 matching MRF lines |
$432.98–$1,923.06 | $432.98–$1,923.06 | varies |
| Ultrasound Elastography Parenchyma (76981) | $387.41 | $387.41 | 3.5× |
| Ultrasound Exam Aaa Screen (76706) range across 2 matching MRF lines |
$432.98–$1,602.55 | $432.98–$1,602.55 | varies |
| Ultrasound, abdomen limited (76705) range across 2 matching MRF lines |
$432.98–$1,714.74 | $432.98–$1,714.74 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 2 matching MRF lines |
$432.98–$1,557.54 | $432.98–$1,557.54 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $99 | $99 | 1.1× |
| Unlisted fluoroscopic procedure (76496) | $1,846.05 | $1,846.05 | 20.1× |
| Unlisted magnetic resonance procedure (76498) range across 13 matching MRF lines |
$1,288.21–$4,973.03 | $1,288.21–$4,973.03 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$301.22–$1,887.98 | $301.22–$1,887.98 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | $487.67 | $487.67 | 44.1× |
| Urea breath test c-14 isotopic analysis (78268) | $1,220.88 | $1,220.88 | 12.9× |
| Ureteral Reflux Study (78740) | $2,219.56 | $2,219.56 | 5.3× |
| Urethrocystogram voiding (74455) | $2,502.25 | $2,502.25 | 9.9× |
| Urethrocystography retrograde (74450) | $2,406.42 | $2,406.42 | 9.6× |
| Us breast unilateral complete (76641) range across 2 matching MRF lines |
$432.98–$2,063.28 | $432.98–$2,063.28 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$432.98–$1,842.92 | $432.98–$1,842.92 | varies |
| Us complete joint (76881) range across 2 matching MRF lines |
$432.98–$2,437.49 | $432.98–$2,437.49 | varies |
| Us exam, pelvic, limited (76857) range across 2 matching MRF lines |
$432.98–$1,714.74 | $432.98–$1,714.74 | varies |
| Us head (76506) range across 2 matching MRF lines |
$432.98–$1,602.55 | $432.98–$1,602.55 | varies |
| Us kidney transplant (76776) range across 2 matching MRF lines |
$432.98–$1,842.92 | $432.98–$1,842.92 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 2 matching MRF lines |
$432.98–$1,847.16 | $432.98–$1,847.16 | varies |
| Us ob detailed single fetus (76811) range across 2 matching MRF lines |
$432.98–$1,602.55 | $432.98–$1,602.55 | varies |
| Us ob limited 1 or more fetuses (76815) range across 2 matching MRF lines |
$432.98–$1,602.55 | $432.98–$1,602.55 | varies |
| Us ob transvaginal (76817) range across 2 matching MRF lines |
$432.98–$1,602.55 | $432.98–$1,602.55 | varies |
| Us pelvic non ob complete (76856) range across 2 matching MRF lines |
$432.98–$1,923.06 | $432.98–$1,923.06 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 2 matching MRF lines |
$432.98–$1,602.55 | $432.98–$1,602.55 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 2 matching MRF lines |
$432.98–$1,602.55 | $432.98–$1,602.55 | varies |
| Us retroperitoneal complete (76770) range across 2 matching MRF lines |
$432.98–$2,370.61 | $432.98–$2,370.61 | varies |
| Us retroperitoneal limited (76775) range across 2 matching MRF lines |
$432.98–$1,896.48 | $432.98–$1,896.48 | varies |
| Us scrotum and contents (76870) range across 2 matching MRF lines |
$432.98–$1,842.92 | $432.98–$1,842.92 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$432.98–$961.51 | $432.98–$961.51 | varies |
| Us thyroid (76536) range across 2 matching MRF lines |
$432.98–$1,602.55 | $432.98–$1,602.55 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$432.98–$1,602.55 | $432.98–$1,602.55 | varies |
| Vascular Flow Imaging (78445) | $939.15 | $939.15 | 2.2× |
| Vein X-Ray Chest (75827) | $6,378.63 | $6,378.63 | 3.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) | $3,255.37 | $3,255.37 | 1.0× |
| Vein X-Ray Skull Epidural (75872) | $2,849.52 | $2,849.52 | 4.3× |
| Venogram Sinus/Jugular (75860) | $31,959.13 | $31,959.13 | 9.6× |
| Venography Adrenal Unilateral (75840) | $10,370.63 | $10,370.63 | 3.1× |
| Venography caval inferior serialography rs&i (75825) | $6,392.07 | $6,392.07 | 1.9× |
| Venography extremity bilateral rs&i (75822) | $6,153.68 | $6,153.68 | 3.7× |
| Venography extremity unilateral rs&i (75820) | $3,055.72 | $3,055.72 | 1.8× |
| Venography Orbital Rs&I (75880) | $2,849.52 | $2,849.52 | 4.3× |
| Venography Renal Bilateral (75833) | $16,026.96 | $16,026.96 | 4.8× |
| Venography Renal Unilateral (75831) | $8,013.49 | $8,013.49 | 2.4× |
| Venous sampling by catheter (75893) | $7,462.18 | $7,462.18 | 1.3× |
| Vertebral fracture assessment via dxa (77086) | $177.91 | $177.91 | 1.9× |
| Wrist 2 views (73100) range across 3 matching MRF lines |
$187.69–$930.31 | $187.69–$930.31 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 3 matching MRF lines |
$228.39–$2,105.77 | $228.39–$2,105.77 | varies |
| X-ray antegrade pyelogram tube (74425) | $2,818.38 | $2,818.38 | 7.7× |
| X-Ray Aorta Leg Arteries (75630) | $10,935.52 | $10,935.52 | 3.3× |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$301.22–$2,123.53 | $301.22–$2,123.53 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
$176.76–$932.80 | $176.76–$932.80 | varies |
| X-Ray Exam Breast Specimen (76098) | $894.18 | $894.18 | 1.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 3 matching MRF lines |
$301.22–$1,193.24 | $301.22–$1,193.24 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines |
$301.22–$1,431.88 | $301.22–$1,431.88 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 3 matching MRF lines |
$428.54–$1,718.26 | $428.54–$1,718.26 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 3 matching MRF lines |
$192.40–$1,475.94 | $192.40–$1,475.94 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 3 matching MRF lines |
$267.47–$1,771.13 | $267.47–$1,771.13 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$301.22–$2,125.35 | $301.22–$2,125.35 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$254.97–$2,302.46 | $254.97–$2,302.46 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 3 matching MRF lines |
$301.22–$2,762.95 | $301.22–$2,762.95 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 3 matching MRF lines |
$364.45–$3,315.56 | $364.45–$3,315.56 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$301.22–$3,135.96 | $301.22–$3,135.96 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$212.73–$1,266.44 | $212.73–$1,266.44 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$301.22–$2,361.12 | $301.22–$2,361.12 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$239.33–$2,258.63 | $239.33–$2,258.63 | varies |
| X-ray eye for foreign body (70030) range across 3 matching MRF lines |
$178.31–$1,502.84 | $178.31–$1,502.84 | varies |
| X-ray humerus (73060) range across 3 matching MRF lines |
$187.69–$1,096.90 | $187.69–$1,096.90 | varies |
| X-ray IV pyelogram (ivp) (74400) | $603.57 | $603.57 | 3.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 3 matching MRF lines |
$301.22–$1,498.86 | $301.22–$1,498.86 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$301.22–$1,342.52 | $301.22–$1,342.52 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$225.24–$1,669.25 | $225.24–$1,669.25 | varies |
| X-ray nose-rectum child f.b. (76010) range across 3 matching MRF lines |
$301.22–$939.53 | $301.22–$939.53 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$301.22–$2,622.35 | $301.22–$2,622.35 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$301.22–$1,432.25 | $301.22–$1,432.25 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$301.22–$1,177.07 | $301.22–$1,177.07 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 3 matching MRF lines |
$179.89–$1,230.95 | $179.89–$1,230.95 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$242.45–$1,648.32 | $242.45–$1,648.32 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$294.07–$2,369.32 | $294.07–$2,369.32 | varies |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$301.22–$762.53 | $301.22–$762.53 | varies |
| X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines |
$301.22–$1,883.58 | $301.22–$1,883.58 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$301.22–$1,498.86 | $301.22–$1,498.86 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$853.01–$1,684.24 | $853.01–$1,684.24 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$292.01–$301.22 | $292.01–$301.22 | varies |
| X-Rays Bone Survey Complete (77075) range across 3 matching MRF lines |
$301.22–$2,270.99 | $301.22–$2,270.99 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$292.51–$1,927.64 | $292.51–$1,927.64 | varies |
| Xr facial bones less than 3 views (70140) range across 3 matching MRF lines |
$192.40–$1,058.76 | $192.40–$1,058.76 | varies |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$270.61–$1,859.92 | $270.61–$1,859.92 | varies |
| Xr Tomogram Single Plane (76100) | $1,706.75 | $1,706.75 | 15.5× |
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.