Imaging prices at Adventist Health Lodi Memorial
Lodi, CA · every code in this section with a posted price and a Medicare benchmark.
398 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) | $63.49 | $907 | 0.0× |
| Abdomen 1 View (74018) range across 3 matching MRF lines |
$26.25–$85.89 | $34–$1,227 | varies |
| Abdomen 2 views (74019) range across 3 matching MRF lines |
$94.43–$115.22 | $44–$1,646 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 3 matching MRF lines |
$442.47–$462.98 | $181–$6,614 | varies |
| Adrenal Cortex & Medulla Img (78075) | $9.66 | $138 | 0.0× |
| Angio internal mammary (75756) range across 2 matching MRF lines |
$1,129.03 | $211–$16,129 | 0.3× |
| Angio pulmonary bilat (75743) range across 2 matching MRF lines |
$1,129.03 | $298–$16,129 | 0.3× |
| Angiography extremity bilateral rs&i (75716) range across 3 matching MRF lines |
$609.35–$944.51 | $351–$13,493 | varies |
| Angiography extremity unilateral rs&i (75710) range across 4 matching MRF lines |
$568.19–$786.52 | $309–$11,236 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $16.17 | $231 | 0.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) range across 2 matching MRF lines |
$363.37 | $203–$5,191 | 0.1× |
| Ankle 2 views (73600) range across 12 matching MRF lines |
$14.84–$118.86 | $15–$1,698 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$14.28 | $204 | 0.0× |
| Aortography thoracic w/o serialography rs&i (75600) | $1,167.25 | $16,675 | 0.3× |
| Artery X-Rays Abdomen (75726) range across 3 matching MRF lines |
$843.01–$938.21 | $364–$13,403 | varies |
| Artery X-Rays Adrenal Gland (75731) | $14.91 | $213 | 0.0× |
| Artery X-Rays Pelvis (75736) range across 2 matching MRF lines |
$529.90–$821.38 | $7,570–$11,734 | varies |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$7.49–$11.20 | $107–$160 | varies |
| Arthrogram hip (73525) range across 3 matching MRF lines |
$187.46 | $109–$2,678 | 0.4× |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$7.42–$7.63 | $106–$109 | varies |
| Basic radiation dosimetry calculation (77300) | $9.24 | $132 | 0.1× |
| Bone age studies (77072) range across 3 matching MRF lines |
$18.97–$106.75 | $36–$1,525 | varies |
| Bone Imaging 3 Phase (78315) range across 3 matching MRF lines |
$389.76–$521.15 | $186–$7,445 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$295.47 | $115–$4,221 | 0.6× |
| Bone Imaging Multiple Areas (78305) | $10.71 | $153 | 0.0× |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$438.06 | $157–$6,258 | 0.8× |
| Bone marrow imaging limited area (78102) | $6.86 | $98 | 0.0× |
| Bone marrow imaging; multiple areas (78103) | $8.12 | $116 | 0.0× |
| Bone survey infant (77076) range across 3 matching MRF lines |
$9.24–$91.35 | $132–$1,305 | varies |
| Brachytx isodose complex (77318) | $42.91 | $613 | 0.1× |
| Brain Flow Imaging Only (78610) | $3.78 | $54 | 0.0× |
| Brain Image W/Flow < 4 Views (78601) range across 2 matching MRF lines |
$238.21–$476.42 | $3,403–$6,806 | varies |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) range across 3 matching MRF lines |
$374.36–$748.51 | $117–$10,693 | varies |
| Brain Imaging Pet Metabolic Evaluation (78608) | $18.90 | $270 | 0.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $33.60 | $480 | 0.1× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $38.43 | $549 | 0.0× |
| Cat Scan Follow-Up Study (76380) | $12.32 | $176 | 0.1× |
| Cerebrospinal Fluid Scan (78630) range across 2 matching MRF lines |
$340.76 | $124–$4,868 | 0.5× |
| Chest 1 view (71045) range across 6 matching MRF lines |
$6.22–$82.60 | $34–$1,180 | varies |
| Chest 2 views (71046) range across 5 matching MRF lines |
$9.73–$108.22 | $41–$1,546 | varies |
| Chest 3 views (71047) range across 3 matching MRF lines |
$62.51–$119 | $52–$1,700 | varies |
| Chest 4 or more views (71048) | $4.06 | $58 | 0.0× |
| Cholecystography Oral Contrast (74290) | $4.20 | $60 | 0.0× |
| Clavicle complete (73000) range across 11 matching MRF lines |
$14.21–$111.72 | $16–$1,596 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$14–$58.10 | $200–$830 | varies |
| Contrast Exam Abdominl Aorta (75625) range across 4 matching MRF lines |
$840–$979.23 | $254–$13,989 | varies |
| Contrast X-Ray Bladder (74430) range across 3 matching MRF lines |
$146.79–$169.61 | $59–$2,423 | varies |
| Contrast X-Ray Of Elbow (73085) range across 4 matching MRF lines |
$187.81–$375.27 | $101–$5,361 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 5 matching MRF lines |
$12.46–$238.91 | $119–$3,413 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $7.63 | $109 | 0.0× |
| CT abdomen and pelvis without and with contrast (74178) range across 4 matching MRF lines |
$26.11–$1,421.77 | $186–$20,311 | varies |
| CT abdomen and pelvis without contrast (74176) range across 3 matching MRF lines |
$22.61–$1,029.21 | $323–$14,703 | varies |
| CT abdomen w contrast (74160) range across 5 matching MRF lines |
$16.52–$687.33 | $118–$9,819 | varies |
| CT abdomen w wo contrast (74170) range across 4 matching MRF lines |
$9.03–$773.78 | $129–$11,054 | varies |
| CT abdomen w/o contrast (74150) range across 5 matching MRF lines |
$7.70–$636.23 | $110–$9,089 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 3 matching MRF lines |
$28.49–$1,048.88 | $407–$14,984 | varies |
| CT Angio Chest (71275) range across 3 matching MRF lines |
$23.66–$890.33 | $338–$12,719 | varies |
| CT Angio Head (70496) range across 3 matching MRF lines |
$22.68–$876.54 | $324–$12,522 | varies |
| CT angio hrt w/3d image (75574) | $31.08 | $444 | 0.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 6 matching MRF lines |
$24.50–$1,064.84 | $350–$15,212 | varies |
| CT Angio Neck (70498) range across 3 matching MRF lines |
$22.68–$813.26 | $324–$11,618 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 5 matching MRF lines |
$23.24–$945 | $332–$13,500 | varies |
| CT bone density (77078) | $3.22 | $46 | 0.0× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $47.81 | $683 | 0.2× |
| CT cervical spine w/ contrast (72126) range across 3 matching MRF lines |
$270.76–$856.45 | $226–$12,235 | varies |
| CT cervical spine w/o contrast (72125) range across 3 matching MRF lines |
$12.95–$682.01 | $185–$9,743 | varies |
| CT cervical spine w/wo cont (72127) range across 3 matching MRF lines |
$16.45–$816.20 | $235–$11,660 | varies |
| CT chest w contrast (71260) range across 3 matching MRF lines |
$15.19–$704.97 | $217–$10,071 | varies |
| CT chest w/wo contrast (71270) range across 3 matching MRF lines |
$16.24–$770 | $232–$11,000 | varies |
| CT colonography screening (74263) | $31.36 | $448 | 0.1× |
| CT head/brain with contrast (70460) range across 3 matching MRF lines |
$14.70–$683.06 | $210–$9,758 | varies |
| CT head/brain without and with contrast (70470) range across 3 matching MRF lines |
$16.52–$742 | $236–$10,600 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $22.54 | $322 | 0.0× |
| CT heart no contrast quant eval coronry calcium (75571) | $7.56 | $108 | 0.1× |
| CT iac w contrast (70481) range across 3 matching MRF lines |
$14.70–$622.65 | $210–$8,895 | varies |
| CT l-spine w&w/o contrast (72133) range across 3 matching MRF lines |
$16.45–$1,057.42 | $235–$15,106 | varies |
| CT lower ext w/o (73700) range across 9 matching MRF lines |
$6.51–$663.53 | $93–$9,479 | varies |
| CT lower extremity w/contrast material (73701) range across 6 matching MRF lines |
$15.05–$879.83 | $215–$12,569 | varies |
| CT lumbar spine w contrast (72132) range across 3 matching MRF lines |
$281.47–$898.87 | $226–$12,841 | varies |
| CT lumbar spine w/o contrast (72131) range across 3 matching MRF lines |
$12.95–$712.18 | $185–$10,174 | varies |
| CT maxillofacial w contrast (70487) range across 3 matching MRF lines |
$14.70–$683.76 | $210–$9,768 | varies |
| CT maxillofacial wo contrast (70486) range across 5 matching MRF lines |
$11.20–$402.50 | $160–$5,750 | varies |
| CT neck tissue combo (70492) range across 3 matching MRF lines |
$21–$687.75 | $300–$9,825 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 3 matching MRF lines |
$16.45–$754.60 | $235–$10,780 | varies |
| CT orbits w/o contrast (70480) range across 3 matching MRF lines |
$16.73–$565.32 | $239–$8,076 | varies |
| CT pelvis w&w/o contrast (72194) range across 5 matching MRF lines |
$15.82–$712.81 | $113–$10,183 | varies |
| CT pelvis w/o contrast (72192) range across 4 matching MRF lines |
$7.07–$622.16 | $101–$8,888 | varies |
| CT scan of leg combo (73702) range across 6 matching MRF lines |
$15.68–$616 | $112–$8,800 | varies |
| CT scans face/jaw combo (70488) range across 3 matching MRF lines |
$16.45–$748.16 | $235–$10,688 | varies |
| CT soft tissue neck w contrast (70491) range across 3 matching MRF lines |
$17.92–$691.46 | $256–$9,878 | varies |
| CT soft tissue neck w/o contrast (70490) range across 3 matching MRF lines |
$16.73–$597.17 | $239–$8,531 | varies |
| CT thoracic spine w contrast (72129) range across 3 matching MRF lines |
$15.89–$822.50 | $227–$11,750 | varies |
| CT thoracic spine w/o contrast (72128) range across 3 matching MRF lines |
$12.95–$711.83 | $185–$10,169 | varies |
| CT thoracic spine w/wo cont (72130) range across 3 matching MRF lines |
$16.52–$890.40 | $236–$12,720 | varies |
| CT thorax w/o contrast (71250) range across 3 matching MRF lines |
$14–$612.99 | $200–$8,757 | varies |
| CT upper ext wo (73200) range across 6 matching MRF lines |
$12.95–$418.74 | $185–$5,982 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 5 matching MRF lines |
$15.68–$647.50 | $224–$9,250 | varies |
| CT upper extremity with contrast (73201) range across 5 matching MRF lines |
$22.61–$606.97 | $215–$8,671 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 3 matching MRF lines |
$30.73–$899.22 | $439–$12,846 | varies |
| Cta Abdomen (74175) range across 3 matching MRF lines |
$23.59–$752.57 | $337–$10,751 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) range across 3 matching MRF lines |
$22.68–$876.54 | $324–$12,522 | varies |
| CTA pelvis (72191) | $23.24 | $332 | 0.1× |
| Dilation ureters/urethra rs&i (74485) range across 2 matching MRF lines |
$382.69 | $153–$5,467 | 0.1× |
| Discography Cerv/Thor Spine (72285) | $15.40 | $220 | 0.0× |
| Diskography lumbar (72295) | $10.92 | $156 | 0.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) range across 2 matching MRF lines |
$7.63–$78.89 | $109–$1,127 | varies |
| Dxa Bone Density Axial (77080) | $2.59 | $37 | 0.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) | $2.59 | $37 | 0.0× |
| Echo exam uterus (76831) | $9.52 | $136 | 0.0× |
| Echo Guide For Artery Repair (76936) range across 3 matching MRF lines |
$25.06–$73.85 | $358–$1,055 | varies |
| Echograp Trans R Pros Study (76873) | $21.14 | $302 | 0.2× |
| Esophageal Motility Study (78258) | $9.10 | $130 | 0.0× |
| Esophagram (74220) range across 3 matching MRF lines |
$119.63–$185.78 | $112–$2,654 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 6 matching MRF lines |
$13.79–$303.24 | $197–$4,332 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 6 matching MRF lines |
$10.01–$270.55 | $143–$3,865 | varies |
| Fluoroscopy up to 1 hr (76000) range across 4 matching MRF lines |
$126.91–$190.47 | $59–$2,721 | varies |
| Follow-Up Angiography (75898) range across 3 matching MRF lines |
$23.94–$426.58 | $342–$6,094 | varies |
| Foot 2 views (73620) range across 13 matching MRF lines |
$14.77–$113.61 | $14–$1,623 | varies |
| Forearm 2 views (73090) range across 13 matching MRF lines |
$15.96–$145.53 | $15–$2,079 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$427.35 | $145–$6,105 | 0.8× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) | $12.46 | $178 | 0.0× |
| Gastroesophageal Reflux Exam (78262) | $8.89 | $127 | 0.0× |
| Gated Heart Planar Single (78472) range across 3 matching MRF lines |
$347.97–$351.33 | $178–$5,019 | varies |
| Gated Heart, Multiple (78473) | $18.83 | $269 | 0.0× |
| Hand 2 views (73120) range across 12 matching MRF lines |
$17.57–$113.61 | $16–$1,623 | varies |
| Heart first pass single,planar (78481) | $12.39 | $177 | 0.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $14 | $200 | 0.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $14.14 | $202 | 0.0× |
| Hepatobil Syst Image W/Drug (78227) range across 5 matching MRF lines |
$377.51–$503.30 | $82–$7,190 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$429.52 | $135–$6,136 | 0.8× |
| Ht Musc Image Planar Mult (78454) | $17.36 | $248 | 0.0× |
| Ht Muscle Image Spect Sing (78451) range across 4 matching MRF lines |
$57.61–$735.84 | $250–$10,512 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$127.26 | $71–$1,818 | 0.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 3 matching MRF lines |
$9.66–$200.13 | $138–$2,859 | varies |
| Infant hip ultrasound, limited static exam (76886) range across 3 matching MRF lines |
$8.12–$159.46 | $116–$2,278 | varies |
| Infusion Ivp (74410) range across 2 matching MRF lines |
$84.21–$202.72 | $1,203–$2,896 | varies |
| Joint Survey Single View (77077) | $4.55 | $65 | 0.0× |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$473.76 | $254–$6,768 | 0.7× |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$451.71 | $219–$6,453 | 0.6× |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$395.57 | $173–$5,651 | 0.6× |
| Kidney Imaging Morphol (78700) range across 2 matching MRF lines |
$247.45 | $82–$3,535 | 0.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $6.37 | $91 | 0.0× |
| Knee 3 Views (73562) range across 9 matching MRF lines |
$11.83–$148.19 | $36–$2,117 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$324.10 | $90–$4,630 | 0.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) | $7.49 | $107 | 0.0× |
| Liver imaging static only (78201) | $5.53 | $79 | 0.0× |
| Liver imaging w/vascular flow (78202) | $6.51 | $93 | 0.0× |
| Lung Perf&Ventilat Diferentl (78598) range across 2 matching MRF lines |
$366.45 | $150–$5,235 | 0.5× |
| Lung perfusion differential (78597) | $9.24 | $132 | 0.0× |
| Lung Ventilat&Perfus Imaging (78582) range across 3 matching MRF lines |
$382.06–$481.18 | $194–$6,874 | varies |
| Lung Ventilation Imaging (78579) range across 3 matching MRF lines |
$205.45–$219.94 | $88–$3,142 | varies |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$499.87 | $216–$7,141 | 0.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $14.14 | $202 | 0.0× |
| Magnetic Image Jaw Joint (70336) | $19.11 | $273 | 0.1× |
| Mammary ductogram or galactogram multiple (77054) | $5.81 | $83 | 0.0× |
| Mammary ductogram or galactogram single (77053) | $4.69 | $67 | 0.0× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$294.07 | $124–$4,201 | 0.6× |
| Mlc imrt design & construction per imrt plan (77338) | $63.49 | $907 | 0.1× |
| Mra Head W/O & W/Contrast Material (70546) range across 3 matching MRF lines |
$19.18–$949.62 | $274–$13,566 | varies |
| MRA head w/o contrast (70544) range across 3 matching MRF lines |
$15.54–$784.98 | $222–$11,214 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$816.20 | $222–$11,660 | 1.8× |
| MRA neck w contrast (70548) range across 3 matching MRF lines |
$19.46–$825.16 | $278–$11,788 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 3 matching MRF lines |
$23.38–$784.98 | $334–$11,214 | varies |
| MRA neck w/o contrast (70547) range across 3 matching MRF lines |
$15.61–$784.98 | $223–$11,214 | varies |
| MRI abdomen w contrast (74182) range across 3 matching MRF lines |
$22.40–$879.27 | $320–$12,561 | varies |
| MRI abdomen w/o contrast (74181) range across 4 matching MRF lines |
$18.90–$875.84 | $135–$12,512 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 5 matching MRF lines |
$503.86–$673.68 | $302–$9,624 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 5 matching MRF lines |
$28.07–$712.67 | $401–$10,181 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 5 matching MRF lines |
$466.62–$764.96 | $302–$10,928 | varies |
| MRI Breast W/O Contrast Bilateral (77047) | $20.79 | $297 | 0.1× |
| MRI Breast Without Contrast Material Unilateral (77046) | $18.76 | $268 | 0.1× |
| MRI cardiac w/o cont stress (75559) | $37.59 | $537 | 0.1× |
| MRI cardiac w/o contrast (75557) | $30.31 | $433 | 0.1× |
| MRI cervical spine w contrast (72142) range across 3 matching MRF lines |
$23.38–$909.30 | $334–$12,990 | varies |
| MRI cervical spine w/o cont (72141) range across 3 matching MRF lines |
$19.32–$845.95 | $276–$12,085 | varies |
| MRI chest w/o contrast (71550) range across 3 matching MRF lines |
$19.04–$875.77 | $272–$12,511 | varies |
| MRI chest with contrast (71551) range across 3 matching MRF lines |
$471.03–$890.40 | $320–$12,720 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$29.40–$1,015.42 | $420–$14,506 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 5 matching MRF lines |
$21.07–$658 | $301–$9,400 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 6 matching MRF lines |
$28.07–$686 | $201–$9,800 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 7 matching MRF lines |
$17.57–$945.28 | $125–$13,504 | varies |
| MRI lumbar spine w contrast (72149) range across 3 matching MRF lines |
$23.31–$855.75 | $333–$12,225 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 3 matching MRF lines |
$29.89–$934.92 | $427–$13,356 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 3 matching MRF lines |
$17.43–$784.98 | $249–$11,214 | varies |
| MRI orbit face neck w contrast (70542) | $21.07 | $301 | 0.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 3 matching MRF lines |
$28–$949.41 | $400–$13,563 | varies |
| MRI pelvis w contrast (72196) range across 3 matching MRF lines |
$22.40–$775.18 | $320–$11,074 | varies |
| MRI pelvis w/o & w contrast (72197) range across 3 matching MRF lines |
$28.63–$851.62 | $409–$12,166 | varies |
| MRI pelvis w/o contrast (72195) range across 4 matching MRF lines |
$19.04–$712.32 | $136–$10,176 | varies |
| MRI thoracic spine w/o contrast (72146) range across 3 matching MRF lines |
$19.32–$846.79 | $276–$12,097 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
$21.07–$31.64 | $301–$452 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 5 matching MRF lines |
$17.64–$700.49 | $252–$10,007 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 5 matching MRF lines |
$28.07–$727.16 | $401–$10,388 | varies |
| MRI, abdomen, combo (74183) range across 3 matching MRF lines |
$28.63–$890.40 | $409–$12,720 | varies |
| MRI, dorsal spine combo (72157) range across 3 matching MRF lines |
$29.89–$934.92 | $427–$13,356 | varies |
| MRI, dorsal spine contrast (72147) range across 2 matching MRF lines |
$23.17–$860.72 | $331–$12,296 | varies |
| MRI, joint upper extrem (73221) range across 7 matching MRF lines |
$17.64–$945.35 | $252–$13,505 | varies |
| MRI, joint upper extrem combo (73223) range across 5 matching MRF lines |
$28.07–$786.52 | $401–$11,236 | varies |
| MRI, lumbar spine combo (72158) range across 3 matching MRF lines |
$29.89–$934.92 | $427–$13,356 | varies |
| Myelogram Lumbar (72265) | $10.99 | $157 | 0.0× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) | $8.75 | $125 | 0.0× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) | $12.67 | $181 | 0.0× |
| Myocardial Spect Multiple Studies (78452) range across 4 matching MRF lines |
$178.15–$1,076.53 | $295–$15,379 | varies |
| Neck soft tissue (70360) range across 3 matching MRF lines |
$23.10–$81.76 | $34–$1,168 | varies |
| Nm csf leak detection (78650) range across 2 matching MRF lines |
$267.19 | $142–$3,817 | 0.2× |
| Nm myocard infarct spect (78469) | $11.83 | $169 | 0.0× |
| Nonvascular Shunt X-Ray (75809) | $6.23 | $89 | 0.0× |
| Ntsty modul radthx pln dose-vol histos (77301) | $118.44 | $1,692 | 0.1× |
| Nuclear Rx Intra-Arterial (79445) | $29.75 | $425 | 0.1× |
| Nuclear Rx Oral Admin (79005) range across 2 matching MRF lines |
$23.03–$202.44 | $329–$2,892 | varies |
| Ob us nuchal meas 1 gest (76813) range across 5 matching MRF lines |
$13.37–$32.62 | $191–$466 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $8.47 | $121 | 0.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $13.65 | $195 | 0.1× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 2 matching MRF lines |
$2.10–$3.15 | $30–$45 | varies |
| Optic foramina (70190) range across 5 matching MRF lines |
$34.58–$82.67 | $42–$1,181 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$340.55 | $147–$4,865 | 0.6× |
| Parathyroid planar imaging w/wo subtraction (78071) | $15.26 | $218 | 0.0× |
| Pelvis 1 or 2 views (72170) range across 3 matching MRF lines |
$21.07–$91.70 | $33–$1,310 | varies |
| Peritoneogram Rs&I (74190) | $5.95 | $85 | 0.0× |
| Pet Image Skull-Thigh (78812) | $24.50 | $350 | 0.0× |
| Pet Image W/Ct Lmtd (78814) | $27.72 | $396 | 0.0× |
| PET image w/CT, full body (78816) | $31.29 | $447 | 0.0× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $31.01 | $443 | 0.0× |
| PET whole body (78813) | $24.92 | $356 | 0.0× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$380.31 | $135–$5,433 | 0.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 3 matching MRF lines |
$89.53–$115.50 | $60–$1,650 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 3 matching MRF lines |
$115.08–$143.85 | $96–$2,055 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 10 matching MRF lines |
$10.57–$147.84 | $33–$2,112 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 10 matching MRF lines |
$13.86–$129.50 | $15–$1,850 | varies |
| Radex elbow complete minimum 3 views (73080) range across 8 matching MRF lines |
$9.45–$152.39 | $33–$2,177 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 4 matching MRF lines |
$13.58–$124.67 | $49–$1,781 | varies |
| Radex fingr minimum 2 views (73140) range across 7 matching MRF lines |
$11.20–$81.13 | $26–$1,159 | varies |
| Radex foot complete minimum 3 views (73630) range across 7 matching MRF lines |
$14.84–$147.21 | $32–$2,103 | varies |
| Radex Hand Minimum 3 Views (73130) range across 9 matching MRF lines |
$10.85–$161.07 | $33–$2,301 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 8 matching MRF lines |
$16.59–$123.48 | $15–$1,764 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 3 matching MRF lines |
$22.33–$121.59 | $64–$1,737 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 6 matching MRF lines |
$16.10–$112.56 | $16–$1,608 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 3 matching MRF lines |
$25.62–$107.10 | $42–$1,530 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 8 matching MRF lines |
$10.08–$147 | $36–$2,100 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 3 matching MRF lines |
$27.37–$85.26 | $33–$1,218 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) range across 3 matching MRF lines |
$15.19–$167.23 | $217–$2,389 | varies |
| Radex Spine 1 View Specify Level (72020) range across 3 matching MRF lines |
$35.56–$63.70 | $30–$910 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 3 matching MRF lines |
$27.37–$109.34 | $37–$1,562 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 3 matching MRF lines |
$40.25–$108.43 | $45–$1,549 | varies |
| Radex Toe Minimum 2 Views (73660) range across 7 matching MRF lines |
$62.65–$179.97 | $25–$2,571 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 6 matching MRF lines |
$10.92–$123.48 | $15–$1,764 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 8 matching MRF lines |
$12.04–$148.47 | $33–$2,121 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) | $5.53 | $79 | 0.0× |
| Radiolog exam mandible compl minimum 4 views (70110) range across 3 matching MRF lines |
$25.97–$127.12 | $48–$1,816 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 3 matching MRF lines |
$122.08–$129.50 | $50–$1,850 | varies |
| Radiologic exam colon double contrast study (74280) range across 3 matching MRF lines |
$16.31–$250.25 | $233–$3,575 | varies |
| Radiologic exam colon single contrast study (74270) range across 5 matching MRF lines |
$13.44–$212.31 | $192–$3,033 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) | $9.10 | $130 | 0.0× |
| Radiologic exam knee complete 4/more views (73564) range across 7 matching MRF lines |
$35–$184.80 | $44–$2,640 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 4 matching MRF lines |
$31.15–$96.25 | $48–$1,375 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 3 matching MRF lines |
$10.50–$153.23 | $150–$2,189 | varies |
| Radiologic exam swallow function contrast study (74230) range across 3 matching MRF lines |
$117.32–$159.74 | $99–$2,282 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 3 matching MRF lines |
$11.62–$205.24 | $166–$2,932 | varies |
| Radiologic examination femur 1 view (73551) range across 5 matching MRF lines |
$17.08–$212.10 | $32–$3,030 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 6 matching MRF lines |
$23.03–$215.25 | $34–$3,075 | varies |
| Radiologic examination knee 1/2 views (73560) range across 7 matching MRF lines |
$22.75–$112.07 | $32–$1,601 | varies |
| Radiologic Examination Osseous Survey Limited (77074) | $5.74 | $82 | 0.0× |
| Radiologic Examination Salivary Gland Calculus (70380) range across 3 matching MRF lines |
$15.26–$74.90 | $32–$1,070 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 13 matching MRF lines |
$15.96–$172.76 | $15–$2,468 | varies |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $21.63 | $309 | 0.1× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $2.59 | $37 | 0.0× |
| Ribs bilateral 3 views (71110) range across 3 matching MRF lines |
$79.38–$128.45 | $54–$1,835 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 3 matching MRF lines |
$257.95–$515.48 | $119–$7,364 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) | $9.24 | $132 | 0.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) | $12.74 | $182 | 0.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 3 matching MRF lines |
$808.01–$1,616.09 | $145–$23,087 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$1,831.69 | $195–$26,167 | 2.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) range across 2 matching MRF lines |
$1,831.69 | $377–$26,167 | 1.0× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $18.41 | $263 | 0.0× |
| Rp Therapy Intravenous Administration (79101) | $25.55 | $365 | 0.1× |
| Salivary Gland Imaging (78230) | $5.81 | $83 | 0.0× |
| Scapula (73010) range across 7 matching MRF lines |
$21.21–$143.22 | $34–$2,046 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 2 matching MRF lines |
$3.92–$7.84 | $56–$112 | varies |
| Sella turcica (70240) | $2.52 | $36 | 0.0× |
| Shoulder 1 view (73020) range across 6 matching MRF lines |
$20.16–$74.27 | $29–$1,061 | varies |
| Shoulder Arthrography (73040) range across 4 matching MRF lines |
$11.06–$202.58 | $106–$2,894 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$4.97–$83.65 | $71–$1,195 | varies |
| Skull less than 4 views (70250) range across 3 matching MRF lines |
$24.85–$95.69 | $34–$1,367 | varies |
| Special dosimetry (77331) | $12.95 | $185 | 0.1× |
| Special teletherapy port plan (77321) | $14.07 | $201 | 0.0× |
| Special treatment procedure (77470) | $30.17 | $431 | 0.0× |
| Speech evaluation, complex (70371) range across 2 matching MRF lines |
$139.58–$269.01 | $1,994–$3,843 | varies |
| Sternoclavicular joints (71130) range across 3 matching MRF lines |
$24.78–$95.13 | $41–$1,359 | varies |
| Superior sagittal sinus venogram (75870) | $436.03 | $6,229 | 0.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) | $43.05 | $615 | 0.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $20.72 | $296 | 0.0× |
| Testicular Imaging W/Flow (78761) | $9.31 | $133 | 0.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) range across 3 matching MRF lines |
$23.17–$479.43 | $331–$6,849 | varies |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $15.89 | $227 | 0.0× |
| Ther rad simulaj-aided field setting simple (77280) | $10.57 | $151 | 0.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $27.79 | $397 | 0.1× |
| Thoracic spine 2 views (72070) range across 4 matching MRF lines |
$26.88–$147.14 | $38–$2,102 | varies |
| Thoracic spine 3 views (72072) range across 3 matching MRF lines |
$31.43–$191.66 | $42–$2,738 | varies |
| Thoracolumbar 2 views (72080) range across 3 matching MRF lines |
$35.35–$105.84 | $40–$1,512 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $8.75 | $125 | 0.0× |
| Thyroid Imaging With Vascular Flow (78013) | $4.69 | $67 | 0.0× |
| Thyroid Met Imaging Body (78018) | $10.64 | $152 | 0.0× |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$249.20 | $34–$3,560 | 0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 3 matching MRF lines |
$302.82–$526.61 | $91–$7,523 | varies |
| Tx Devices Design & Construction Complex (77334) | $17.01 | $243 | 0.0× |
| Tx devices design & construction intermediate (77333) | $11.20 | $160 | 0.1× |
| Tx devices design & construction simple (77332) | $6.72 | $96 | 0.0× |
| Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
$8.89–$239.19 | $127–$3,417 | varies |
| Ultrasound elastography first target lesion (76982) range across 2 matching MRF lines |
$67.55–$134.96 | $965–$1,928 | varies |
| Ultrasound Elastography Parenchyma (76981) range across 4 matching MRF lines |
$7.84–$134.96 | $112–$1,928 | varies |
| Ultrasound Exam Aaa Screen (76706) range across 4 matching MRF lines |
$7.07–$126.63 | $101–$1,809 | varies |
| Ultrasound, abdomen limited (76705) range across 5 matching MRF lines |
$7.63–$200.34 | $109–$2,862 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 4 matching MRF lines |
$6.51–$178.22 | $93–$2,546 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $3.50 | $50 | 0.0× |
| Unlisted us procedure (76999) range across 3 matching MRF lines |
$18.41–$68.11 | $263–$973 | varies |
| Upper gi w/o kub (74240) range across 3 matching MRF lines |
$10.50–$178.43 | $150–$2,549 | varies |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) | — | $11.06 | — |
| Ureteral Reflux Study (78740) | $7.42 | $106 | 0.0× |
| Urethrocystogram voiding (74455) range across 3 matching MRF lines |
$149.87–$273.49 | $61–$3,907 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$141.40 | $61–$2,020 | 0.4× |
| Us breast unilateral complete (76641) range across 5 matching MRF lines |
$9.59–$159.46 | $137–$2,278 | varies |
| Us chest (76604) range across 4 matching MRF lines |
$7.42–$194.95 | $106–$2,785 | varies |
| Us complete joint (76881) range across 4 matching MRF lines |
$11.83–$192.15 | $169–$2,745 | varies |
| Us exam, pelvic, limited (76857) range across 6 matching MRF lines |
$6.51–$159.53 | $93–$2,279 | varies |
| Us head (76506) range across 3 matching MRF lines |
$8.26–$192.15 | $118–$2,745 | varies |
| Us kidney transplant (76776) range across 4 matching MRF lines |
$9.87–$199.15 | $141–$2,845 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 6 matching MRF lines |
$9.03–$233.31 | $129–$3,333 | varies |
| Us ob detailed single fetus (76811) range across 5 matching MRF lines |
$24.85–$142.66 | $355–$2,038 | varies |
| Us ob limited 1 or more fetuses (76815) range across 6 matching MRF lines |
$8.47–$147.77 | $121–$2,111 | varies |
| Us ob transvaginal (76817) range across 6 matching MRF lines |
$9.80–$134.05 | $140–$1,915 | varies |
| Us pelvic non ob complete (76856) range across 4 matching MRF lines |
$8.96–$248.08 | $128–$3,544 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 6 matching MRF lines |
$10.71–$250.60 | $153–$3,580 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 5 matching MRF lines |
$10.15–$95.27 | $145–$1,361 | varies |
| Us retroperitoneal complete (76770) range across 4 matching MRF lines |
$9.59–$283.15 | $137–$4,045 | varies |
| Us retroperitoneal limited (76775) range across 5 matching MRF lines |
$7.56–$133.56 | $108–$1,908 | varies |
| Us scrotum and contents (76870) range across 4 matching MRF lines |
$8.33–$199.99 | $119–$2,857 | varies |
| Us spinal canal and contents (76800) range across 3 matching MRF lines |
$16.80–$267.68 | $240–$3,824 | varies |
| Us thyroid (76536) range across 4 matching MRF lines |
$7.35–$231.21 | $105–$3,303 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$8.89–$57.61 | $127–$823 | varies |
| Vascular Flow Imaging (78445) | $6.44 | $92 | 0.0× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$621.53 | $203–$8,879 | 0.3× |
| Vein X-Ray Skull Epidural (75872) | $139.16 | $1,988 | 0.2× |
| Vein X-Ray Spleen/Liver (75810) | $541.80 | $7,740 | 0.1× |
| Venogram Sinus/Jugular (75860) | $14.56 | $208 | 0.0× |
| Venography caval inferior serialography rs&i (75825) range across 4 matching MRF lines |
$32.27–$631.82 | $203–$9,026 | varies |
| Venography extremity bilateral rs&i (75822) range across 3 matching MRF lines |
$473.55–$868.84 | $264–$12,412 | varies |
| Venography extremity unilateral rs&i (75820) range across 3 matching MRF lines |
$234.01–$292.53 | $188–$4,179 | varies |
| Venography Orbital Rs&I (75880) | $182.14 | $2,602 | 0.2× |
| Venography Renal Bilateral (75833) | $18.48 | $264 | 0.0× |
| Venography Renal Unilateral (75831) | $13.86 | $198 | 0.0× |
| Venous sampling by catheter (75893) likely a partial charge, not the full procedure |
$6.86 | $98 | 0.0× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) | $11.76 | $168 | 0.0× |
| Vertebral fracture assessment via dxa (77086) | $2.24 | $32 | 0.0× |
| Wrist 2 views (73100) range across 11 matching MRF lines |
$13.93–$131.46 | $16–$1,878 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 4 matching MRF lines |
$30.73–$95.48 | $36–$1,364 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$203.98 | $95–$2,914 | 0.4× |
| X-Ray Aorta Leg Arteries (75630) range across 4 matching MRF lines |
$571.06–$680.82 | $357–$9,726 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 4 matching MRF lines |
$11.83–$214.76 | $42–$3,068 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 11 matching MRF lines |
$16.24–$115.29 | $16–$1,647 | varies |
| X-Ray Exam Breast Specimen (76098) range across 3 matching MRF lines |
$84.21–$95.13 | $59–$1,359 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$3.43–$35.35 | $49–$505 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 3 matching MRF lines |
$44.80–$102.97 | $59–$1,471 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$4.76–$87.01 | $68–$1,243 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 4 matching MRF lines |
$19.60–$81.76 | $36–$1,168 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 4 matching MRF lines |
$35.07–$109.55 | $42–$1,565 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 3 matching MRF lines |
$94.85–$131.74 | $52–$1,882 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 3 matching MRF lines |
$55.86–$119.42 | $42–$1,706 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$78.40 | $56–$1,120 | 0.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) | $4.13 | $59 | 0.0× |
| X-Ray Exam L-S Spine Bending (72114) range across 3 matching MRF lines |
$60.20–$214.76 | $58–$3,068 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 5 matching MRF lines |
$11.55–$147.84 | $42–$2,112 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 3 matching MRF lines |
$52.78–$214.76 | $56–$3,068 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 3 matching MRF lines |
$56.42–$117.95 | $50–$1,685 | varies |
| X-ray eye for foreign body (70030) | $2.38 | $34 | 0.0× |
| X-ray humerus (73060) range across 12 matching MRF lines |
$17.36–$143.29 | $15–$2,047 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$145.18 | $90–$2,074 | 0.6× |
| X-ray IV pyelogram+tomography (74415) range across 3 matching MRF lines |
$125.79–$303.17 | $91–$4,331 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 3 matching MRF lines |
$20.93–$106.47 | $34–$1,521 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 3 matching MRF lines |
$25.27–$94.50 | $33–$1,350 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 3 matching MRF lines |
$38.92–$151.69 | $42–$2,167 | varies |
| X-ray nose-rectum child f.b. (76010) range across 3 matching MRF lines |
$12.67–$92.75 | $34–$1,325 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 3 matching MRF lines |
$89.60–$114.52 | $60–$1,636 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 3 matching MRF lines |
$33.60–$105.91 | $42–$1,513 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 3 matching MRF lines |
$31.78–$65.87 | $33–$941 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 5 matching MRF lines |
$18.34–$96.18 | $16–$1,374 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 3 matching MRF lines |
$37.38–$124.95 | $41–$1,785 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 3 matching MRF lines |
$45.92–$156.31 | $53–$2,233 | varies |
| X-Ray Stress View (77071) | $15.54 | $222 | 0.1× |
| X-ray thoracic spine 4 vw (72074) range across 3 matching MRF lines |
$40.32–$191.66 | $46–$2,738 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$2.38–$19.25 | $34–$275 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) | $6.79 | $97 | 0.0× |
| X-Rays Bone Length Studies (77073) range across 3 matching MRF lines |
$82.95–$128.80 | $51–$1,840 | varies |
| X-Rays Bone Survey Complete (77075) range across 3 matching MRF lines |
$7.21–$275.10 | $103–$3,930 | varies |
| Xr c-spine 4 or 5 views (72050) range across 3 matching MRF lines |
$45.92–$194.39 | $52–$2,777 | varies |
| Xr facial bones less than 3 views (70140) range across 3 matching MRF lines |
$25.20–$95.34 | $38–$1,362 | varies |
| XR Mastoids < 3 Views Bilateral (70120) range across 3 matching MRF lines |
$13.58–$99.82 | $34–$1,426 | varies |
| Xr orbits complete 4 views (70200) range across 4 matching MRF lines |
$13.86–$108.64 | $53–$1,552 | varies |
| Xr Tomogram Single Plane (76100) | $7.56 | $108 | 0.1× |
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.