Imaging prices at AdventHealth Ottawa
Ottawa, KS · every code in this section with a posted price and a Medicare benchmark.
320 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) | $9,400.31 | $9,400.31 | 7.2× |
| Abdomen 1 View (74018) | $701.37 | $701.37 | 8.6× |
| Abdomen 2 views (74019) | $863.22 | $863.22 | 8.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) | $4,271.70 | $4,271.70 | 11.4× |
| Angio pulmonary bilat (75743) | $6,510.69 | $6,510.69 | 2.2× |
| Angiography extremity bilateral rs&i (75716) | $7,478.76 | $7,478.76 | 2.5× |
| Angiography extremity unilateral rs&i (75710) | $5,754.46 | $5,754.46 | 1.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) | $5,099.09 | $5,099.09 | 1.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $5,014.96 | $5,014.96 | 1.7× |
| Ankle 2 views (73600) | $374.88 | $374.88 | 4.6× |
| Aortography thoracic serialography rs&i (75605) | $6,020.76 | $6,020.76 | 1.2× |
| Artery X-Rays Abdomen (75726) | $5,844.02 | $5,844.02 | 1.1× |
| Artery X-Rays Adrenal Gland (75731) | $6,020.76 | $6,020.76 | 2.0× |
| Artery X-Rays Pelvis (75736) | $6,020.76 | $6,020.76 | 1.2× |
| Artery X-Rays Spine (75705) | $6,885.31 | $6,885.31 | 1.3× |
| Arthrogram hip (73525) | $1,277.05 | $1,277.05 | 3.9× |
| Arthrogram Wrist (73115) | $1,849.42 | $1,849.42 | 5.6× |
| Basic radiation dosimetry calculation (77300) | $1,046.40 | $1,046.40 | 8.3× |
| Bone age studies (77072) | $651.32 | $651.32 | 6.6× |
| Bone Imaging 3 Phase (78315) | $5,706.31 | $5,706.31 | 15.2× |
| Bone Imaging Limited Area (78300) | $3,480.45 | $3,480.45 | 9.3× |
| Bone Imaging Whole Body (78306) | $4,775.50 | $4,775.50 | 12.7× |
| Bone survey infant (77076) | $759.20 | $759.20 | 7.7× |
| Brachytx isodose complex (77318) | $2,651.83 | $2,651.83 | 7.5× |
| Brachytx isodose intermed (77317) | $2,651.83 | $2,651.83 | 7.5× |
| Brachytx Isodose Plan Simple (77316) | $1,000.40 | $1,000.40 | 2.8× |
| Brain Image W/Flow < 4 Views (78601) | $2,879.86 | $2,879.86 | 7.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $3,319.17 | $3,319.17 | 10.1× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $6,943.32 | $6,943.32 | 9.4× |
| Cat Scan Follow-Up Study (76380) | $2,262.51 | $2,262.51 | 27.6× |
| Chest 1 view (71045) | $767.63 | $767.63 | 9.4× |
| Chest 2 views (71046) | $1,005.96 | $1,005.96 | 12.3× |
| Chest 3 views (71047) | $1,508.97 | $1,508.97 | 18.4× |
| Clavicle complete (73000) | $714.69 | $714.69 | 8.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) | $2,035.75 | $2,035.75 | 20.7× |
| Continuing medical physics consltj pr wk (77336) | $1,047.93 | $1,047.93 | 8.3× |
| Contrast Exam Abdominl Aorta (75625) | $5,653.93 | $5,653.93 | 1.9× |
| Contrast X-Ray Bladder (74430) | $1,310.27 | $1,310.27 | 4.0× |
| Contrast X-Ray Of Elbow (73085) | $1,433.85 | $1,433.85 | 4.4× |
| Contrast X-Ray Of Knee Joint (73580) | $2,438.47 | $2,438.47 | 7.4× |
| Contrast Xray Throat/Cerv Esopha (74210) | $976.84 | $976.84 | 5.9× |
| CT abdomen and pelvis without and with contrast (74178) | $9,436.55 | $9,436.55 | 28.8× |
| CT abdomen and pelvis without contrast (74176) | $6,814.94 | $6,814.94 | 30.4× |
| CT abdomen w contrast (74160) | $5,089.63 | $5,089.63 | 30.9× |
| CT abdomen w wo contrast (74170) | $6,423.56 | $6,423.56 | 38.9× |
| CT abdomen w/o contrast (74150) | $4,653.76 | $4,653.76 | 47.3× |
| CT Angio Abdomen and Pelvis (74174) | $8,030.75 | $8,030.75 | 24.5× |
| CT Angio Chest (71275) | $5,356.30 | $5,356.30 | 32.5× |
| CT Angio Head (70496) | $5,257.18 | $5,257.18 | 31.9× |
| CT angio hrt w/3d image (75574) | $4,946.13 | $4,946.13 | 15.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) | $5,781.67 | $5,781.67 | 35.1× |
| CT Angio Neck (70498) | $5,257.18 | $5,257.18 | 31.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) | $5,781.67 | $5,781.67 | 35.1× |
| CT bone density (77078) | $2,035.75 | $2,035.75 | 24.9× |
| CT cervical spine w/ contrast (72126) | $4,885.71 | $4,885.71 | 14.9× |
| CT cervical spine w/o contrast (72125) | $4,804.27 | $4,804.27 | 48.9× |
| CT cervical spine w/wo cont (72127) | $4,965.06 | $4,965.06 | 30.1× |
| CT chest w contrast (71260) | $4,212.73 | $4,212.73 | 25.5× |
| CT chest w/wo contrast (71270) | $6,202.28 | $6,202.28 | 37.6× |
| CT head/brain with contrast (70460) | $5,549.93 | $5,549.93 | 33.6× |
| CT head/brain without and with contrast (70470) | $6,248.04 | $6,248.04 | 37.9× |
| CT heart contrast eval cardiac structure&morph (75572) | $2,482.78 | $2,482.78 | 7.6× |
| CT heart no contrast quant eval coronry calcium (75571) | $1,355.75 | $1,355.75 | 16.6× |
| CT iac w contrast (70481) | $5,341.32 | $5,341.32 | 32.4× |
| CT l-spine w&w/o contrast (72133) | $5,235.43 | $5,235.43 | 31.7× |
| CT lower ext w/o (73700) | $4,966.64 | $4,966.64 | 50.5× |
| CT lower extremity w/contrast material (73701) | $5,361.89 | $5,361.89 | 32.5× |
| CT lumbar spine w contrast (72132) | $5,034.65 | $5,034.65 | 15.3× |
| CT lumbar spine w/o contrast (72131) | $4,947.46 | $4,947.46 | 50.3× |
| CT maxillofacial w contrast (70487) | $5,341.32 | $5,341.32 | 32.4× |
| CT maxillofacial wo contrast (70486) | $4,854.76 | $4,854.76 | 49.4× |
| CT neck tissue combo (70492) | $5,243.76 | $5,243.76 | 31.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) | $7,282.73 | $7,282.73 | 44.2× |
| CT orbits w/o contrast (70480) | $4,854.76 | $4,854.76 | 49.4× |
| CT pelvis w&w/o contrast (72194) | $4,920.65 | $4,920.65 | 29.8× |
| CT pelvis w/o contrast (72192) | $3,422.59 | $3,422.59 | 34.8× |
| CT scan of leg combo (73702) | $10,437.63 | $10,437.63 | 63.3× |
| CT scans face/jaw combo (70488) | $7,282.73 | $7,282.73 | 44.2× |
| CT soft tissue neck w contrast (70491) | $4,421.83 | $4,421.83 | 26.8× |
| CT soft tissue neck w/o contrast (70490) | $3,495.03 | $3,495.03 | 35.6× |
| CT thoracic spine w contrast (72129) | $5,897.70 | $5,897.70 | 35.8× |
| CT thoracic spine w/o contrast (72128) | $4,800.46 | $4,800.46 | 48.8× |
| CT thoracic spine w/wo cont (72130) | $6,137.72 | $6,137.72 | 37.2× |
| CT thorax w/o contrast (71250) | $3,830.63 | $3,830.63 | 39.0× |
| CT upper ext wo (73200) | $4,578.88 | $4,578.88 | 46.6× |
| CT upper extremity w/o & w/contrast material (73202) | $5,560.06 | $5,560.06 | 33.7× |
| CT upper extremity with contrast (73201) | $5,331.12 | $5,331.12 | 16.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) | $2,377.84 | $2,377.84 | 14.4× |
| Cta Abdomen (74175) | $2,084.86 | $2,084.86 | 12.6× |
| CTA pelvis (72191) | $5,781.67 | $5,781.67 | 35.1× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) | $2,651.15 | $2,651.15 | 11.8× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) | $1,014.56 | $1,014.56 | 10.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $1,671.06 | $1,671.06 | 17.0× |
| Doppler Fetal Mid Cerebral Artery (76821) | $590.49 | $590.49 | 6.0× |
| Dxa Bone Density Axial (77080) | $987.10 | $987.10 | 10.0× |
| Dxa bone density study (77085) | $1,515.52 | $1,515.52 | 15.4× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $644.58 | $644.58 | 7.9× |
| Echo exam of fetal heart (76825) | $1,866.70 | $1,866.70 | 3.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) | $1,479.19 | $1,479.19 | 6.6× |
| Esophagram (74220) | $976.84 | $976.84 | 5.9× |
| Fetal Biophys Profile W/Nst (76818) | $1,209.85 | $1,209.85 | 12.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) | $870.61 | $870.61 | 8.9× |
| Fluoroscopy up to 1 hr (76000) | $2,241.91 | $2,241.91 | 10.0× |
| Foot 2 views (73620) | $785.98 | $785.98 | 9.6× |
| Forearm 2 views (73090) | $915.63 | $915.63 | 11.2× |
| Gastric emptying imaging study (78264) | $3,410.28 | $3,410.28 | 9.1× |
| Gated Heart Planar Single (78472) | $2,571.50 | $2,571.50 | 6.8× |
| Hand 2 views (73120) | $347.51 | $347.51 | 3.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) | $5,051.42 | $5,051.42 | 7.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) | $5,051.42 | $5,051.42 | 7.7× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) | $5,051.42 | $5,051.42 | 7.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $8,696.79 | $8,696.79 | 2.9× |
| Hepatobil Syst Image W/Drug (78227) | $4,461.24 | $4,461.24 | 8.7× |
| Hepatobiliary System Imaging (78226) | $3,787.97 | $3,787.97 | 10.1× |
| Ht Muscle Image Spect Sing (78451) | $5,468.36 | $5,468.36 | 4.5× |
| Hysterosalpingogram (74740) | $1,789.66 | $1,789.66 | 8.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) | $1,667.06 | $1,667.06 | 20.4× |
| Interstitial radiation source applic complex (77778) | $742.16 | $742.16 | 1.1× |
| K Flow/Funct Image W/Drug (78708) | $1,819.08 | $1,819.08 | 3.6× |
| K Flow/Funct Image W/O Drug (78707) | $1,433.22 | $1,433.22 | 2.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $749.68 | $749.68 | 2.0× |
| Knee 3 Views (73562) | $966.52 | $966.52 | 11.8× |
| Lung Perf&Ventilat Diferentl (78598) | $3,222.17 | $3,222.17 | 6.3× |
| Lung perfusion differential (78597) | $3,304.19 | $3,304.19 | 8.8× |
| Lung Ventilat&Perfus Imaging (78582) | $3,099.11 | $3,099.11 | 6.1× |
| Lymph System Imaging (78195) | $2,084.94 | $2,084.94 | 4.1× |
| Magnetic Image Jaw Joint (70336) | $4,040.07 | $4,040.07 | 18.0× |
| Meckels Divert Exam (78290) | $1,804.86 | $1,804.86 | 4.8× |
| Mlc imrt design & construction per imrt plan (77338) | $2,525.97 | $2,525.97 | 7.2× |
| Mr safety determination physician/other qhp (76016) | $243.81 | $243.81 | 3.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $68.08 | $68.08 | 2.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $255.58 | $255.58 | 2.9× |
| Mr safety implt pos&/immoblj (76019) | $162.37 | $162.37 | 2.9× |
| Mr safety med physics xm customization plng&mntr (76017) | $671.82 | $671.82 | 3.0× |
| Mra Head W/O & W/Contrast Material (70546) | $3,833.42 | $3,833.42 | 11.7× |
| MRA head w/o contrast (70544) | $2,324.13 | $2,324.13 | 10.4× |
| MRA head with contrast (70545) | $2,556.55 | $2,556.55 | 7.8× |
| Mra Neck W/O &W/Contrast Material (70549) | $5,096.60 | $5,096.60 | 15.5× |
| MRA neck w/o contrast (70547) | $3,396.82 | $3,396.82 | 15.1× |
| MRI abdomen w contrast (74182) | $4,879.79 | $4,879.79 | 14.9× |
| MRI abdomen w/o contrast (74181) | $4,040.07 | $4,040.07 | 18.0× |
| MRI any jt lower extrem w/contrast material (73722) | $4,879.79 | $4,879.79 | 6.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) | $6,651.40 | $6,651.40 | 20.3× |
| MRI any jt upper extremity w/contrast matrl (73222) | $4,444.84 | $4,444.84 | 6.0× |
| MRI Breast W/O Contrast Bilateral (77047) | $5,671.20 | $5,671.20 | 25.3× |
| MRI cardiac w/o contrast (75557) | $3,211.13 | $3,211.13 | 14.3× |
| MRI cervical spine w contrast (72142) | $4,436.20 | $4,436.20 | 13.5× |
| MRI cervical spine w/o cont (72141) | $3,665.94 | $3,665.94 | 16.3× |
| MRI chest w/o contrast (71550) | $4,435.77 | $4,435.77 | 19.8× |
| MRI chest wo w contrast (71552) | $6,651.40 | $6,651.40 | 20.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) | $5,967.81 | $5,967.81 | 18.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) | $3,747.23 | $3,747.23 | 16.7× |
| MRI lumbar spine w contrast (72149) | $4,879.79 | $4,879.79 | 14.9× |
| Mri Neck Spine W/O & W/Dye (72156) | $5,497.01 | $5,497.01 | 16.8× |
| MRI orbit face &/neck w/o contrast (70540) | $3,600.03 | $3,600.03 | 16.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) | $5,400.04 | $5,400.04 | 16.5× |
| MRI pelvis w contrast (72196) | $4,879.79 | $4,879.79 | 14.9× |
| MRI pelvis w/o & w contrast (72197) | $6,046.72 | $6,046.72 | 18.4× |
| MRI pelvis w/o contrast (72195) | $4,435.77 | $4,435.77 | 19.8× |
| MRI thoracic spine w/o contrast (72146) | $4,032.52 | $4,032.52 | 18.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) | $4,303.95 | $4,303.95 | 19.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) | $6,805.19 | $6,805.19 | 20.7× |
| MRI, abdomen, combo (74183) | $6,046.72 | $6,046.72 | 18.4× |
| MRI, dorsal spine combo (72157) | $6,046.72 | $6,046.72 | 18.4× |
| MRI, dorsal spine contrast (72147) | $4,879.79 | $4,879.79 | 14.9× |
| MRI, joint upper extrem (73221) | $3,672.79 | $3,672.79 | 16.4× |
| MRI, joint upper extrem combo (73223) | $5,877.20 | $5,877.20 | 17.9× |
| MRI, lumbar spine combo (72158) | $6,046.72 | $6,046.72 | 18.4× |
| Myelogram cervical (72240) | $4,918.89 | $4,918.89 | 6.7× |
| Myelogram Lumbar (72265) | $4,407.51 | $4,407.51 | 6.0× |
| Myelograpy 2/more regions rs&i (72270) | $9,599.03 | $9,599.03 | 13.0× |
| Myocardial Spect Multiple Studies (78452) | $6,430.18 | $6,430.18 | 5.3× |
| Neck soft tissue (70360) | $558.71 | $558.71 | 6.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) | $1,379.69 | $1,379.69 | 3.7× |
| Ntsty modul radthx pln dose-vol histos (77301) | $8,545.74 | $8,545.74 | 6.6× |
| Nuclear Rx Intra-Arterial (79445) | $6,306.72 | $6,306.72 | 28.7× |
| Nuclear Rx Oral Admin (79005) | $2,773.47 | $2,773.47 | 12.6× |
| Ob us nuchal meas 1 gest (76813) | $1,325.57 | $1,325.57 | 13.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $927.07 | $927.07 | 9.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) | $4,228.74 | $4,228.74 | 8.3× |
| Parathyroid Planar Imaging (78070) | $1,753.94 | $1,753.94 | 4.7× |
| Parathyroid planar imaging w/wo subtraction (78071) | $1,843.11 | $1,843.11 | 4.9× |
| Pelvis 1 or 2 views (72170) | $663.45 | $663.45 | 6.7× |
| PET image w/CT, full body (78816) | $9,944.17 | $9,944.17 | 7.4× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $7,232.13 | $7,232.13 | 5.4× |
| PET whole body (78813) | $10,667.32 | $10,667.32 | 7.9× |
| Pulmonary Perfusion Imaging Particulate (78580) | $2,652.14 | $2,652.14 | 7.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) | $1,213.90 | $1,213.90 | 12.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) | $1,276 | $1,276 | 2.5× |
| Radex Ankle Complete Minimum 3 Views (73610) | $412.63 | $412.63 | 5.0× |
| Radex Calcaneus Minimum 2 Views (73650) | $729.53 | $729.53 | 8.9× |
| Radex elbow complete minimum 3 views (73080) | $916.37 | $916.37 | 11.2× |
| Radex Facial Bones Complete Minimum 3 Views (70150) | $1,243.30 | $1,243.30 | 12.6× |
| Radex fingr minimum 2 views (73140) | $608.16 | $608.16 | 7.4× |
| Radex foot complete minimum 3 views (73630) | $965.52 | $965.52 | 11.8× |
| Radex Hand Minimum 3 Views (73130) | $926.42 | $926.42 | 11.3× |
| Radex lower extremity infant minimum 2 views (73592) | $539.39 | $539.39 | 6.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) | $890.01 | $890.01 | 10.9× |
| Radex Ribs Unilateral 2 Views (71100) | $926.42 | $926.42 | 11.3× |
| Radex shoulder complete minimum 2 views (73030) | $900.80 | $900.80 | 11.0× |
| Radex Sinuses Paransl < 3 Views (70210) | $838.76 | $838.76 | 10.2× |
| Radex Spine 1 View Specify Level (72020) | $691.77 | $691.77 | 8.5× |
| Radex Sternum Minimum 2 Views (71120) | $888.65 | $888.65 | 10.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) | $841.46 | $841.46 | 10.3× |
| Radex Toe Minimum 2 Views (73660) | $547.49 | $547.49 | 6.7× |
| Radex upper extremity infant minimum 2 views (73092) | $465.23 | $465.23 | 4.7× |
| Radex Wrist Complete Minimum 3 Views (73110) | $912.93 | $912.93 | 11.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $611.40 | $611.40 | 6.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) | $24,243.54 | $24,243.54 | 3.5× |
| Radiation treatment delivery level 1 (77402) | $828.95 | $828.95 | 8.6× |
| Radiation treatment delivery level 3 (77412) | $1,558.12 | $1,558.12 | 3.0× |
| Radiolog exam mandible compl minimum 4 views (70110) | $1,061.26 | $1,061.26 | 10.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) | $1,025.07 | $1,025.07 | 10.4× |
| Radiologic exam colon double contrast study (74280) | $2,999.21 | $2,999.21 | 18.2× |
| Radiologic exam colon single contrast study (74270) | $2,456.97 | $2,456.97 | 14.9× |
| Radiologic exam knee complete 4/more views (73564) | $1,219.02 | $1,219.02 | 12.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) | $663.45 | $663.45 | 6.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) | $1,079.57 | $1,079.57 | 6.5× |
| Radiologic exam swallow function contrast study (74230) | $1,220.13 | $1,220.13 | 7.4× |
| Radiologic exam upr gi trc double contrast study (74246) | $2,649.32 | $2,649.32 | 16.1× |
| Radiologic examination femur 1 view (73551) | $519.16 | $519.16 | 6.3× |
| Radiologic examination femur minimum 2 views (73552) | $1,090.93 | $1,090.93 | 13.3× |
| Radiologic examination knee 1/2 views (73560) | $928.35 | $928.35 | 11.3× |
| Radiologic Examination Osseous Survey Limited (77074) | $1,117.91 | $1,117.91 | 11.4× |
| Radiologic examination tibia & fibula 2 views (73590) | $885.39 | $885.39 | 10.8× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) | $1,353.59 | $1,353.59 | 3.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) | $1,082.87 | $1,082.87 | 3.0× |
| Ribs bilateral 3 views (71110) | $796.96 | $796.96 | 8.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) | $3,112.15 | $3,112.15 | 6.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) | $4,225.67 | $4,225.67 | 8.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $5,653.27 | $5,653.27 | 4.6× |
| Scapula (73010) | $890.01 | $890.01 | 9.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) | $170.48 | $170.48 | 7.3× |
| Shoulder 1 view (73020) | $822.59 | $822.59 | 10.1× |
| Shoulder Arthrography (73040) | $1,342.03 | $1,342.03 | 4.1× |
| Skull less than 4 views (70250) | $819.89 | $819.89 | 8.3× |
| Special teletherapy port plan (77321) | $2,525.97 | $2,525.97 | 7.2× |
| Special treatment procedure (77470) | $3,747.70 | $3,747.70 | 7.2× |
| Stereotactic Body Radiation Delivery (77373) | $8,491.48 | $8,491.48 | 5.1× |
| Sternoclavicular joints (71130) | $640.54 | $640.54 | 7.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $1,000.40 | $1,000.40 | 2.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $2,778.55 | $2,778.55 | 7.9× |
| Ther rad simulaj-aided field setting simple (77280) | $1,047.93 | $1,047.93 | 8.3× |
| Thoracic spine 2 views (72070) | $591.99 | $591.99 | 6.0× |
| Thoracic spine 3 views (72072) | $1,061.26 | $1,061.26 | 10.8× |
| Thoracolumbar 2 views (72080) | $528.60 | $528.60 | 6.5× |
| Thyroid Met Imaging Body (78018) | $4,708.78 | $4,708.78 | 9.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) | $2,229.43 | $2,229.43 | 5.9× |
| Tx Devices Design & Construction Complex (77334) | $1,926.37 | $1,926.37 | 5.5× |
| Tx devices design & construction simple (77332) | $1,751.25 | $1,751.25 | 13.9× |
| Ultrasound Breast Limited (76642) | $912.87 | $912.87 | 11.2× |
| Ultrasound Exam Aaa Screen (76706) | $666.09 | $666.09 | 6.8× |
| Ultrasound, abdomen limited (76705) | $1,151.56 | $1,151.56 | 11.7× |
| Umbilical-artery Doppler (OB) (76820) | $1,165.09 | $1,165.09 | 11.9× |
| Upper gi w/o kub (74240) | $1,731.89 | $1,731.89 | 10.5× |
| Urethrocystogram voiding (74455) | $1,571.26 | $1,571.26 | 7.0× |
| Urethrocystography retrograde (74450) | $1,355.32 | $1,355.32 | 6.0× |
| Us breast unilateral complete (76641) | $1,004.19 | $1,004.19 | 10.2× |
| Us chest (76604) | $1,493.70 | $1,493.70 | 15.2× |
| Us complete joint (76881) | $4,533.98 | $4,533.98 | 46.1× |
| Us exam, pelvic, limited (76857) | $928.68 | $928.68 | 9.4× |
| Us head (76506) | $1,667.06 | $1,667.06 | 17.0× |
| Us kidney transplant (76776) | $728.73 | $728.73 | 7.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) | $2,264 | $2,264 | 23.0× |
| Us ob detailed single fetus (76811) | $1,298.18 | $1,298.18 | 5.8× |
| Us ob limited 1 or more fetuses (76815) | $870.03 | $870.03 | 8.8× |
| Us ob transvaginal (76817) | $1,343.62 | $1,343.62 | 13.7× |
| Us pelvic non ob complete (76856) | $1,900.37 | $1,900.37 | 19.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) | $1,187.28 | $1,187.28 | 12.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) | $1,051.86 | $1,051.86 | 10.7× |
| Us retroperitoneal complete (76770) | $1,902.31 | $1,902.31 | 19.4× |
| Us retroperitoneal limited (76775) | $1,225.10 | $1,225.10 | 12.5× |
| Us scrotum and contents (76870) | $2,445.85 | $2,445.85 | 24.9× |
| Us spinal canal and contents (76800) | $1,762.88 | $1,762.88 | 17.9× |
| Us thyroid (76536) | $2,361.79 | $2,361.79 | 24.0× |
| Us transrectal (76872) | $2,262.02 | $2,262.02 | 23.0× |
| Vein X-Ray Chest (75827) | $8,368.27 | $8,368.27 | 5.7× |
| Venogram Sinus/Jugular (75860) | $11,668.57 | $11,668.57 | 3.9× |
| Venography caval inferior serialography rs&i (75825) | $7,521 | $7,521 | 2.5× |
| Venography extremity bilateral rs&i (75822) | $2,811.19 | $2,811.19 | 1.9× |
| Venography extremity unilateral rs&i (75820) | $2,588 | $2,588 | 1.7× |
| Venography Renal Bilateral (75833) | $16,635.42 | $16,635.42 | 5.6× |
| Venography Renal Unilateral (75831) | $6,020.76 | $6,020.76 | 2.0× |
| Wrist 2 views (73100) | $541.20 | $541.20 | 6.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) | $1,061.26 | $1,061.26 | 13.0× |
| X-ray antegrade pyelogram tube (74425) | $2,995.38 | $2,995.38 | 9.1× |
| X-Ray Aorta Leg Arteries (75630) | $6,831.63 | $6,831.63 | 2.3× |
| X-Ray Bend Only L-S Spine (72120) | $1,157.01 | $1,157.01 | 11.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) | $791.14 | $791.14 | 9.7× |
| X-Ray Exam Breast Specimen (76098) | $304.13 | $304.13 | 0.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) | $466.33 | $466.33 | 4.7× |
| X-Ray Exam Hip Uni 1 View (73501) | $652.67 | $652.67 | 8.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) | $982.32 | $982.32 | 12.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) | $2,094.50 | $2,094.50 | 21.3× |
| X-Ray Exam Hips Bi 2 Views (73521) | $993.42 | $993.42 | 10.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) | $1,303.86 | $1,303.86 | 13.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $1,396.99 | $1,396.99 | 14.2× |
| X-Ray Exam L-S Spine Bending (72114) | $1,237.08 | $1,237.08 | 12.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) | $680.98 | $680.98 | 8.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) | $1,641.11 | $1,641.11 | 16.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) | $1,161.06 | $1,161.06 | 11.8× |
| X-ray eye for foreign body (70030) | $980.63 | $980.63 | 12.0× |
| X-ray humerus (73060) | $486.72 | $486.72 | 5.9× |
| X-ray IV pyelogram (ivp) (74400) | $3,049.44 | $3,049.44 | 18.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) | $745.71 | $745.71 | 9.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) | $509.73 | $509.73 | 6.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) | $920.62 | $920.62 | 9.4× |
| X-ray nose-rectum child f.b. (76010) | $1,351.71 | $1,351.71 | 16.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) | $1,548.07 | $1,548.07 | 15.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) | $678.06 | $678.06 | 6.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) | $508.54 | $508.54 | 5.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) | $790.22 | $790.22 | 9.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) | $1,374.11 | $1,374.11 | 16.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) | $1,347.16 | $1,347.16 | 13.7× |
| X-ray thoracic spine 4 vw (72074) | $1,387.59 | $1,387.59 | 14.1× |
| X-Ray Tmj Unilat (70328) | $585.25 | $585.25 | 7.2× |
| X-Rays Bone Survey Complete (77075) | $2,532.06 | $2,532.06 | 25.8× |
| Xr c-spine 4 or 5 views (72050) | $1,472.56 | $1,472.56 | 15.0× |
| Xr facial bones less than 3 views (70140) | $760.55 | $760.55 | 9.3× |
| Xr orbits complete 4 views (70200) | $725.80 | $725.80 | 7.4× |