Imaging prices at Adventist Health Mendocino Coast
Fort Bragg, CA · every code in this section with a posted price and a Medicare benchmark.
397 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) | $598.62 | $907 | 0.3× |
| Abdomen 1 View (74018) range across 2 matching MRF lines |
$22.44–$312.18 | $34–$473 | varies |
| Abdomen 2 views (74019) range across 2 matching MRF lines |
$29.04–$447.48 | $44–$678 | varies |
| Acute Gastrointestinal Blood Loss Imaging (78278) range across 2 matching MRF lines |
$119.46–$1,445.40 | $181–$2,190 | varies |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) | $920.04 | $1,394 | 0.6× |
| Adrenal Cortex & Medulla Img (78075) | $91.08 | $138 | 0.1× |
| Angio internal mammary (75756) | $139.26 | $211 | 0.0× |
| Angio pulmonary bilat (75743) | $196.68 | $298 | 0.0× |
| Angiography extremity bilateral rs&i (75716) range across 2 matching MRF lines |
$231.66–$3,349.50 | $351–$5,075 | varies |
| Angiography extremity unilateral rs&i (75710) range across 2 matching MRF lines |
$203.94–$2,993.76 | $309–$4,536 | varies |
| Angiography pulmonary unilateral slctv rs&i (75741) | $152.46 | $231 | 0.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) | $133.98 | $203 | 0.0× |
| Ankle 2 views (73600) range across 7 matching MRF lines |
$9.90–$353.76 | $15–$536 | varies |
| Aortography thoracic serialography rs&i (75605) likely a partial charge, not the full procedure |
$134.64 | $204 | 0.0× |
| Aortography thoracic w/o serialography rs&i (75600) | $58.08 | $88 | 0.0× |
| Artery X-Rays Abdomen (75726) likely a partial charge, not the full procedure |
$240.24 | $364 | 0.0× |
| Artery X-Rays Adrenal Gland (75731) | $140.58 | $213 | 0.0× |
| Artery X-Rays Pelvis (75736) likely a partial charge, not the full procedure |
$131.34 | $199 | 0.0× |
| Arthrogram ankle (73615) range across 3 matching MRF lines |
$70.62–$252.78 | $107–$383 | varies |
| Arthrogram hip (73525) range across 2 matching MRF lines |
$71.94–$330 | $109–$500 | varies |
| Arthrogram Wrist (73115) range across 2 matching MRF lines |
$69.96–$240.90 | $106–$365 | varies |
| Basic radiation dosimetry calculation (77300) | $87.12 | $132 | 0.5× |
| Bone age studies (77072) range across 2 matching MRF lines |
$23.76–$116.82 | $36–$177 | varies |
| Bone Imaging 3 Phase (78315) range across 2 matching MRF lines |
$122.76–$1,366.86 | $186–$2,071 | varies |
| Bone Imaging Limited Area (78300) range across 2 matching MRF lines |
$75.90–$786.72 | $115–$1,192 | varies |
| Bone Imaging Multiple Areas (78305) range across 2 matching MRF lines |
$100.98–$867.24 | $153–$1,314 | varies |
| Bone Imaging Whole Body (78306) range across 2 matching MRF lines |
$103.62–$2,044.68 | $157–$3,098 | varies |
| Bone marrow imaging limited area (78102) | $64.68 | $98 | 0.1× |
| Bone marrow imaging; multiple areas (78103) range across 2 matching MRF lines |
$76.56–$650.10 | $116–$985 | varies |
| Bone survey infant (77076) range across 2 matching MRF lines |
$87.12–$242.88 | $132–$368 | varies |
| Brachytx isodose complex (77318) | $404.58 | $613 | 0.8× |
| Brain Flow Imaging Only (78610) | $35.64 | $54 | 0.1× |
| Brain Image W/Flow < 4 Views (78601) | $925.32 | $1,402 | 1.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) | $1,275.12 | $1,932 | 1.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) | $178.20 | $270 | 0.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) | $316.80 | $480 | 0.7× |
| Cardiac MRI w/w/o contrast w/stress (75563) | $362.34 | $549 | 0.4× |
| Cat Scan Follow-Up Study (76380) | $116.16 | $176 | 1.0× |
| Cerebrospinal Fluid Scan (78630) | $81.84 | $124 | 0.1× |
| Chest 1 view (71045) range across 3 matching MRF lines |
$22.44–$318.12 | $34–$482 | varies |
| Chest 2 views (71046) range across 3 matching MRF lines |
$27.06–$389.40 | $41–$590 | varies |
| Chest 3 views (71047) range across 2 matching MRF lines |
$34.32–$422.40 | $52–$640 | varies |
| Chest 4 or more views (71048) range across 2 matching MRF lines |
$38.28–$455.40 | $58–$690 | varies |
| Cholecystography Oral Contrast (74290) | $39.60 | $60 | 0.2× |
| Clavicle complete (73000) range across 7 matching MRF lines |
$10.56–$443.52 | $16–$672 | varies |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) range across 2 matching MRF lines |
$132–$439.56 | $200–$666 | varies |
| Contrast Exam Abdominl Aorta (75625) | $167.64 | $254 | 0.0× |
| Contrast X-Ray Bladder (74430) range across 2 matching MRF lines |
$38.94–$260.04 | $59–$394 | varies |
| Contrast X-Ray Of Elbow (73085) range across 2 matching MRF lines |
$66.66–$836.88 | $101–$1,268 | varies |
| Contrast X-Ray Of Knee Joint (73580) range across 3 matching MRF lines |
$78.54–$242.88 | $119–$368 | varies |
| Contrast Xray Throat/Cerv Esopha (74210) | $71.94 | $109 | 0.3× |
| CT abdomen and pelvis without and with contrast (74178) range across 3 matching MRF lines |
$122.76–$4,645.08 | $186–$7,038 | varies |
| CT abdomen and pelvis without contrast (74176) range across 2 matching MRF lines |
$213.18–$3,687.42 | $323–$5,587 | varies |
| CT abdomen w contrast (74160) range across 3 matching MRF lines |
$77.88–$2,143.68 | $118–$3,248 | varies |
| CT abdomen w wo contrast (74170) range across 3 matching MRF lines |
$85.14–$2,508 | $129–$3,800 | varies |
| CT abdomen w/o contrast (74150) range across 3 matching MRF lines |
$72.60–$1,848 | $110–$2,800 | varies |
| CT Angio Abdomen and Pelvis (74174) range across 2 matching MRF lines |
$268.62–$4,587 | $407–$6,950 | varies |
| CT Angio Chest (71275) range across 2 matching MRF lines |
$223.08–$2,420.88 | $338–$3,668 | varies |
| CT Angio Head (70496) range across 2 matching MRF lines |
$213.84–$2,845.92 | $324–$4,312 | varies |
| CT angio hrt w/3d image (75574) | $293.04 | $444 | 0.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
$231–$4,268.22 | $350–$6,467 | varies |
| CT Angio Neck (70498) range across 2 matching MRF lines |
$213.84–$2,845.92 | $324–$4,312 | varies |
| Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
$219.12–$3,116.52 | $332–$4,722 | varies |
| CT bone density (77078) | $30.36 | $46 | 0.3× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) | $450.78 | $683 | 2.0× |
| CT cervical spine w/ contrast (72126) range across 2 matching MRF lines |
$149.16–$2,032.80 | $226–$3,080 | varies |
| CT cervical spine w/o contrast (72125) range across 2 matching MRF lines |
$122.10–$1,811.04 | $185–$2,744 | varies |
| CT cervical spine w/wo cont (72127) | $155.10 | $235 | 0.7× |
| CT chest w contrast (71260) range across 2 matching MRF lines |
$143.22–$2,277 | $217–$3,450 | varies |
| CT chest w/wo contrast (71270) range across 2 matching MRF lines |
$153.12–$2,640 | $232–$4,000 | varies |
| CT colonography screening (74263) | $295.68 | $448 | 1.0× |
| CT head/brain with contrast (70460) range across 2 matching MRF lines |
$138.60–$2,131.80 | $210–$3,230 | varies |
| CT head/brain without and with contrast (70470) range across 2 matching MRF lines |
$155.76–$2,475 | $236–$3,750 | varies |
| CT heart contrast eval cardiac structure&morph (75572) | $212.52 | $322 | 0.5× |
| CT heart no contrast quant eval coronry calcium (75571) | $71.28 | $108 | 0.6× |
| CT iac w contrast (70481) range across 2 matching MRF lines |
$138.60–$1,057.98 | $210–$1,603 | varies |
| CT l-spine w&w/o contrast (72133) range across 2 matching MRF lines |
$155.10–$2,808.96 | $235–$4,256 | varies |
| CT lower ext w/o (73700) range across 5 matching MRF lines |
$61.38–$2,079 | $93–$3,150 | varies |
| CT lower extremity w/contrast material (73701) range across 4 matching MRF lines |
$141.90–$2,271.06 | $215–$3,441 | varies |
| CT lumbar spine w contrast (72132) range across 2 matching MRF lines |
$149.16–$2,298.78 | $226–$3,483 | varies |
| CT lumbar spine w/o contrast (72131) range across 2 matching MRF lines |
$122.10–$1,917.30 | $185–$2,905 | varies |
| CT maxillofacial w contrast (70487) range across 2 matching MRF lines |
$138.60–$1,518 | $210–$2,300 | varies |
| CT maxillofacial wo contrast (70486) range across 2 matching MRF lines |
$105.60–$1,286.34 | $160–$1,949 | varies |
| CT neck tissue combo (70492) range across 2 matching MRF lines |
$198–$1,452 | $300–$2,200 | varies |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) range across 2 matching MRF lines |
$155.10–$1,254 | $235–$1,900 | varies |
| CT orbits w/o contrast (70480) range across 2 matching MRF lines |
$157.74–$912.12 | $239–$1,382 | varies |
| CT pelvis w&w/o contrast (72194) range across 3 matching MRF lines |
$74.58–$2,291.52 | $113–$3,472 | varies |
| CT pelvis w/o contrast (72192) range across 3 matching MRF lines |
$66.66–$1,798.50 | $101–$2,725 | varies |
| CT scan of leg combo (73702) range across 5 matching MRF lines |
$73.92–$2,661.12 | $112–$4,032 | varies |
| CT scans face/jaw combo (70488) | $155.10 | $235 | 0.7× |
| CT soft tissue neck w contrast (70491) range across 2 matching MRF lines |
$168.96–$1,155 | $256–$1,750 | varies |
| CT soft tissue neck w/o contrast (70490) range across 2 matching MRF lines |
$157.74–$958.32 | $239–$1,452 | varies |
| CT thoracic spine w contrast (72129) range across 2 matching MRF lines |
$149.82–$1,504.14 | $227–$2,279 | varies |
| CT thoracic spine w/o contrast (72128) range across 2 matching MRF lines |
$122.10–$1,279.08 | $185–$1,938 | varies |
| CT thoracic spine w/wo cont (72130) range across 2 matching MRF lines |
$155.76–$2,209.68 | $236–$3,348 | varies |
| CT thorax w/o contrast (71250) range across 2 matching MRF lines |
$132–$2,014.32 | $200–$3,052 | varies |
| CT upper ext wo (73200) range across 4 matching MRF lines |
$122.10–$1,918.62 | $185–$2,907 | varies |
| CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
$147.84–$1,848 | $224–$2,800 | varies |
| CT upper extremity with contrast (73201) range across 3 matching MRF lines |
$141.90–$1,421.64 | $215–$2,154 | varies |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) range across 2 matching MRF lines |
$289.74–$2,413.62 | $439–$3,657 | varies |
| Cta Abdomen (74175) range across 2 matching MRF lines |
$222.42–$2,305.38 | $337–$3,493 | varies |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) range across 2 matching MRF lines |
$213.84–$2,845.92 | $324–$4,312 | varies |
| CTA pelvis (72191) range across 2 matching MRF lines |
$219.12–$1,974.72 | $332–$2,992 | varies |
| Dilation ureters/urethra rs&i (74485) | $100.98 | $153 | 0.0× |
| Discography Cerv/Thor Spine (72285) | $145.20 | $220 | 0.1× |
| Diskography lumbar (72295) | $102.96 | $156 | 0.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) | $71.94 | $109 | 0.5× |
| Dxa Bone Density Axial (77080) range across 2 matching MRF lines |
$24.42–$447.48 | $37–$678 | varies |
| Dxa bone density study 1/>sites appendiclr skel (77081) range across 2 matching MRF lines |
$24.42–$310.86 | $37–$471 | varies |
| Echo exam uterus (76831) | $89.76 | $136 | 0.3× |
| Echo Guide For Artery Repair (76936) range across 2 matching MRF lines |
$236.28–$696.30 | $358–$1,055 | varies |
| Echograp Trans R Pros Study (76873) | $199.32 | $302 | 1.5× |
| Esophageal Motility Study (78258) | $85.80 | $130 | 0.2× |
| Esophagram (74220) range across 2 matching MRF lines |
$73.92–$396 | $112–$600 | varies |
| Fetal Biophys Profile W/Nst (76818) range across 3 matching MRF lines |
$130.02–$322.74 | $197–$489 | varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 3 matching MRF lines |
$94.38–$671.22 | $143–$1,017 | varies |
| Fluoroscopy up to 1 hr (76000) range across 2 matching MRF lines |
$38.94–$525.36 | $59–$796 | varies |
| Follow-Up Angiography (75898) | $225.72 | $342 | 0.1× |
| Foot 2 views (73620) range across 8 matching MRF lines |
$9.24–$347.82 | $14–$527 | varies |
| Forearm 2 views (73090) range across 6 matching MRF lines |
$9.90–$397.98 | $15–$603 | varies |
| Gastric emptying imaging study (78264) range across 2 matching MRF lines |
$95.70–$1,597.20 | $145–$2,420 | varies |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) range across 2 matching MRF lines |
$117.48–$1,268.52 | $178–$1,922 | varies |
| Gastroesophageal Reflux Exam (78262) | $83.82 | $127 | 0.2× |
| Gated Heart Planar Single (78472) range across 2 matching MRF lines |
$117.48–$910.80 | $178–$1,380 | varies |
| Gated Heart, Multiple (78473) range across 2 matching MRF lines |
$177.54–$370.92 | $269–$562 | varies |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) | $1,585.32 | $2,402 | 2.3× |
| Hand 2 views (73120) range across 8 matching MRF lines |
$10.56–$569.58 | $16–$863 | varies |
| Heart first pass single,planar (78481) | $116.82 | $177 | 0.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) | $132 | $200 | 0.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) | $133.32 | $202 | 0.0× |
| Hepatobil Syst Image W/Drug (78227) range across 4 matching MRF lines |
$54.12–$1,463.88 | $82–$2,218 | varies |
| Hepatobiliary System Imaging (78226) range across 2 matching MRF lines |
$89.10–$1,427.58 | $135–$2,163 | varies |
| Ht Musc Image Planar Mult (78454) range across 2 matching MRF lines |
$163.68–$1,669.80 | $248–$2,530 | varies |
| Ht Muscle Image Spect Sing (78451) range across 2 matching MRF lines |
$165–$2,903.34 | $250–$4,399 | varies |
| Hysterosalpingogram (74740) range across 2 matching MRF lines |
$46.86–$324.72 | $71–$492 | varies |
| Infant hip ultrasound with hip movement (dynamic) (76885) range across 2 matching MRF lines |
$91.08–$181.50 | $138–$275 | varies |
| Infant hip ultrasound, limited static exam (76886) | $76.56 | $116 | 0.7× |
| Joint Survey Single View (77077) range across 2 matching MRF lines |
$42.90–$71.28 | $65–$108 | varies |
| K Flow/Funct Image Multiple (78709) range across 2 matching MRF lines |
$167.64–$838.86 | $254–$1,271 | varies |
| K Flow/Funct Image W/Drug (78708) range across 2 matching MRF lines |
$144.54–$516.78 | $219–$783 | varies |
| K Flow/Funct Image W/O Drug (78707) range across 2 matching MRF lines |
$114.18–$1,211.10 | $173–$1,835 | varies |
| Kidney Imaging Morphol (78700) | $54.12 | $82 | 0.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) | $60.06 | $91 | 0.1× |
| Knee 3 Views (73562) range across 6 matching MRF lines |
$23.76–$730.62 | $36–$1,107 | varies |
| Liver & Spleen Imaging Static Only (78215) range across 2 matching MRF lines |
$59.40–$677.16 | $90–$1,026 | varies |
| Liver & Spleen Imaging W/Vascular Flow (78216) range across 2 matching MRF lines |
$70.62–$1,092.30 | $107–$1,655 | varies |
| Liver imaging static only (78201) | $52.14 | $79 | 0.1× |
| Liver imaging w/vascular flow (78202) | $61.38 | $93 | 0.1× |
| Lung Perf&Ventilat Diferentl (78598) | $99 | $150 | 0.1× |
| Lung perfusion differential (78597) | $87.12 | $132 | 0.2× |
| Lung Ventilat&Perfus Imaging (78582) range across 2 matching MRF lines |
$128.04–$1,192.62 | $194–$1,807 | varies |
| Lung Ventilation Imaging (78579) | $58.08 | $88 | 0.1× |
| Lymph System Imaging (78195) range across 2 matching MRF lines |
$142.56–$1,211.10 | $216–$1,835 | varies |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) | $133.32 | $202 | 0.0× |
| Magnetic Image Jaw Joint (70336) | $180.18 | $273 | 0.6× |
| Mammary ductogram or galactogram multiple (77054) | $54.78 | $83 | 0.2× |
| Mammary ductogram or galactogram single (77053) | $44.22 | $67 | 0.1× |
| Meckels Divert Exam (78290) range across 2 matching MRF lines |
$81.84–$741.84 | $124–$1,124 | varies |
| Mlc imrt design & construction per imrt plan (77338) | $598.62 | $907 | 1.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) | $51.48 | $78 | 1.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) | $192.72 | $292 | 1.6× |
| Mra Head W/O & W/Contrast Material (70546) range across 2 matching MRF lines |
$180.84–$2,708.64 | $274–$4,104 | varies |
| MRA head w/o contrast (70544) range across 2 matching MRF lines |
$146.52–$1,785.30 | $222–$2,705 | varies |
| MRA head with contrast (70545) range across 2 matching MRF lines |
$146.52–$2,222.22 | $222–$3,367 | varies |
| MRA neck w contrast (70548) range across 2 matching MRF lines |
$183.48–$2,222.22 | $278–$3,367 | varies |
| Mra Neck W/O &W/Contrast Material (70549) range across 2 matching MRF lines |
$220.44–$3,685.44 | $334–$5,584 | varies |
| MRA neck w/o contrast (70547) range across 2 matching MRF lines |
$147.18–$1,785.30 | $223–$2,705 | varies |
| MRI abdomen w contrast (74182) range across 2 matching MRF lines |
$211.20–$2,640 | $320–$4,000 | varies |
| MRI abdomen w/o contrast (74181) range across 3 matching MRF lines |
$89.10–$1,959.54 | $135–$2,969 | varies |
| MRI any jt lower extrem w/contrast material (73722) range across 3 matching MRF lines |
$199.32–$3,300 | $302–$5,000 | varies |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 3 matching MRF lines |
$264.66–$4,374.48 | $401–$6,628 | varies |
| MRI any jt upper extremity w/contrast matrl (73222) range across 3 matching MRF lines |
$199.32–$2,997.72 | $302–$4,542 | varies |
| MRI bone marrow blood supply (77084) | $1,583.34 | $2,399 | 5.2× |
| MRI Breast W/O Contrast Bilateral (77047) | $196.02 | $297 | 0.6× |
| MRI Breast Without Contrast Material Unilateral (77046) | $176.88 | $268 | 0.6× |
| MRI cardiac w/o cont stress (75559) | $354.42 | $537 | 0.5× |
| MRI cardiac w/o contrast (75557) | $285.78 | $433 | 0.9× |
| MRI cervical spine w contrast (72142) range across 2 matching MRF lines |
$220.44–$2,917.20 | $334–$4,420 | varies |
| MRI cervical spine w/o cont (72141) range across 2 matching MRF lines |
$182.16–$2,668.38 | $276–$4,043 | varies |
| MRI chest w/o contrast (71550) range across 2 matching MRF lines |
$179.52–$1,836.12 | $272–$2,782 | varies |
| MRI chest with contrast (71551) range across 2 matching MRF lines |
$211.20–$1,995.18 | $320–$3,023 | varies |
| MRI chest wo w contrast (71552) range across 2 matching MRF lines |
$277.20–$3,309.90 | $420–$5,015 | varies |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 2 matching MRF lines |
$198.66–$298.32 | $301–$452 | varies |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 4 matching MRF lines |
$132.66–$3,525.72 | $201–$5,342 | varies |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 5 matching MRF lines |
$82.50–$3,739.56 | $125–$5,666 | varies |
| MRI lumbar spine w contrast (72149) range across 2 matching MRF lines |
$219.78–$2,917.20 | $333–$4,420 | varies |
| Mri Neck Spine W/O & W/Dye (72156) range across 2 matching MRF lines |
$281.82–$4,398.24 | $427–$6,664 | varies |
| MRI orbit face &/neck w/o contrast (70540) range across 2 matching MRF lines |
$164.34–$603.90 | $249–$915 | varies |
| MRI orbit face neck w contrast (70542) | $198.66 | $301 | 0.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) range across 2 matching MRF lines |
$264–$4,420.02 | $400–$6,697 | varies |
| MRI pelvis w contrast (72196) | $211.20 | $320 | 0.5× |
| MRI pelvis w/o & w contrast (72197) range across 2 matching MRF lines |
$269.94–$4,427.94 | $409–$6,709 | varies |
| MRI pelvis w/o contrast (72195) range across 3 matching MRF lines |
$89.76–$1,817.64 | $136–$2,754 | varies |
| MRI thoracic spine w/o contrast (72146) range across 2 matching MRF lines |
$182.16–$3,119.16 | $276–$4,726 | varies |
| MRI upper extremity oth than jt w/contr matrl (73219) range across 2 matching MRF lines |
$198.66–$298.32 | $301–$452 | varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) range across 3 matching MRF lines |
$166.32–$1,809.72 | $252–$2,742 | varies |
| Mri Uppr Extremity W/O&W/Dye (73220) range across 3 matching MRF lines |
$264.66–$3,525.06 | $401–$5,341 | varies |
| MRI, abdomen, combo (74183) range across 2 matching MRF lines |
$269.94–$4,427.94 | $409–$6,709 | varies |
| MRI, dorsal spine combo (72157) range across 2 matching MRF lines |
$281.82–$4,090.68 | $427–$6,198 | varies |
| MRI, dorsal spine contrast (72147) | $218.46 | $331 | 0.5× |
| MRI, joint upper extrem (73221) range across 4 matching MRF lines |
$166.32–$3,537.60 | $252–$5,360 | varies |
| MRI, joint upper extrem combo (73223) range across 4 matching MRF lines |
$264.66–$6,630.36 | $401–$10,046 | varies |
| MRI, lumbar spine combo (72158) range across 2 matching MRF lines |
$281.82–$4,312.44 | $427–$6,534 | varies |
| Myelogram Lumbar (72265) | $103.62 | $157 | 0.1× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) range across 2 matching MRF lines |
$82.50–$630.96 | $125–$956 | varies |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) range across 2 matching MRF lines |
$119.46–$1,455.30 | $181–$2,205 | varies |
| Myocardial Spect Multiple Studies (78452) range across 2 matching MRF lines |
$194.70–$3,711.18 | $295–$5,623 | varies |
| Neck soft tissue (70360) range across 2 matching MRF lines |
$22.44–$371.58 | $34–$563 | varies |
| Nm csf leak detection (78650) range across 2 matching MRF lines |
$93.72–$920.04 | $142–$1,394 | varies |
| Nm myocard infarct spect (78469) | $111.54 | $169 | 0.2× |
| Nonvascular Shunt X-Ray (75809) | $58.74 | $89 | 0.4× |
| Ntsty modul radthx pln dose-vol histos (77301) | $1,116.72 | $1,692 | 0.6× |
| Nuclear Rx Intra-Arterial (79445) | $280.50 | $425 | 0.9× |
| Nuclear Rx Oral Admin (79005) | $217.14 | $329 | 0.7× |
| Ob us nuchal meas 1 gest (76813) range across 2 matching MRF lines |
$145.86–$307.56 | $221–$466 | varies |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) | $79.86 | $121 | 0.6× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) | $128.70 | $195 | 1.0× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) range across 2 matching MRF lines |
$19.80–$29.70 | $30–$45 | varies |
| Optic foramina (70190) range across 3 matching MRF lines |
$27.72–$312.18 | $42–$473 | varies |
| Parathyroid Planar Imaging (78070) range across 2 matching MRF lines |
$97.02–$1,541.10 | $147–$2,335 | varies |
| Parathyroid planar imaging w/wo subtraction (78071) range across 2 matching MRF lines |
$143.88–$1,420.32 | $218–$2,152 | varies |
| Pelvis 1 or 2 views (72170) range across 2 matching MRF lines |
$21.78–$328.68 | $33–$498 | varies |
| Peritoneogram Rs&I (74190) | $56.10 | $85 | 0.1× |
| Pet Image Skull-Thigh (78812) | $231 | $350 | 0.1× |
| Pet Image W/Ct Lmtd (78814) | $261.36 | $396 | 0.1× |
| PET image w/CT, full body (78816) | $295.02 | $447 | 0.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) | $292.38 | $443 | 0.2× |
| PET whole body (78813) | $234.96 | $356 | 0.1× |
| Pulmonary Perfusion Imaging Particulate (78580) range across 2 matching MRF lines |
$89.10–$989.34 | $135–$1,499 | varies |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) range across 2 matching MRF lines |
$39.60–$447.48 | $60–$678 | varies |
| Radex abscess/fistula/sinus tract rs&i (76080) range across 2 matching MRF lines |
$63.36–$397.98 | $96–$603 | varies |
| Radex Ankle Complete Minimum 3 Views (73610) range across 5 matching MRF lines |
$21.78–$415.80 | $33–$630 | varies |
| Radex Calcaneus Minimum 2 Views (73650) range across 7 matching MRF lines |
$9.90–$516.12 | $15–$782 | varies |
| Radex elbow complete minimum 3 views (73080) range across 5 matching MRF lines |
$21.78–$506.22 | $33–$767 | varies |
| Radex Facial Bones Complete Minimum 3 Views (70150) range across 3 matching MRF lines |
$32.34–$469.92 | $49–$712 | varies |
| Radex fingr minimum 2 views (73140) range across 5 matching MRF lines |
$17.16–$520.74 | $26–$789 | varies |
| Radex foot complete minimum 3 views (73630) range across 5 matching MRF lines |
$21.12–$716.76 | $32–$1,086 | varies |
| Radex Hand Minimum 3 Views (73130) range across 5 matching MRF lines |
$21.78–$718.08 | $33–$1,088 | varies |
| Radex lower extremity infant minimum 2 views (73592) range across 4 matching MRF lines |
$9.90–$427.68 | $15–$648 | varies |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) range across 2 matching MRF lines |
$42.24–$345.84 | $64–$524 | varies |
| Radex Nasal Bones Complete Minimum 3 Views (70160) range across 4 matching MRF lines |
$10.56–$260.04 | $16–$394 | varies |
| Radex Ribs Unilateral 2 Views (71100) range across 2 matching MRF lines |
$27.72–$385.44 | $42–$584 | varies |
| Radex shoulder complete minimum 2 views (73030) range across 5 matching MRF lines |
$23.76–$749.76 | $36–$1,136 | varies |
| Radex Sinuses Paransl < 3 Views (70210) range across 2 matching MRF lines |
$21.78–$258.06 | $33–$391 | varies |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) | $143.22 | $217 | 0.6× |
| Radex Spine 1 View Specify Level (72020) range across 2 matching MRF lines |
$19.80–$232.32 | $30–$352 | varies |
| Radex Sternum Minimum 2 Views (71120) range across 2 matching MRF lines |
$24.42–$289.74 | $37–$439 | varies |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) range across 2 matching MRF lines |
$29.70–$374.88 | $45–$568 | varies |
| Radex Toe Minimum 2 Views (73660) range across 4 matching MRF lines |
$16.50–$312.18 | $25–$473 | varies |
| Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
$9.90–$132.66 | $15–$201 | varies |
| Radex Wrist Complete Minimum 3 Views (73110) range across 6 matching MRF lines |
$21.78–$718.08 | $33–$1,088 | varies |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) range across 2 matching MRF lines |
$52.14–$601.26 | $79–$911 | varies |
| Radiolog exam mandible compl minimum 4 views (70110) range across 2 matching MRF lines |
$31.68–$429.66 | $48–$651 | varies |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) range across 2 matching MRF lines |
$33–$271.26 | $50–$411 | varies |
| Radiologic exam colon double contrast study (74280) range across 2 matching MRF lines |
$153.78–$758.34 | $233–$1,149 | varies |
| Radiologic exam colon single contrast study (74270) range across 2 matching MRF lines |
$126.72–$578.82 | $192–$877 | varies |
| Radiologic Exam Esophagus Double Contrast Study (74221) range across 2 matching MRF lines |
$85.80–$480.48 | $130–$728 | varies |
| Radiologic exam knee complete 4/more views (73564) range across 4 matching MRF lines |
$29.04–$880.44 | $44–$1,334 | varies |
| Radiologic exam pelvis compl minimum 3 views (72190) range across 2 matching MRF lines |
$31.68–$363 | $48–$550 | varies |
| Radiologic Exam Small Int Single Contrast Study (74250) range across 2 matching MRF lines |
$99–$468.60 | $150–$710 | varies |
| Radiologic exam swallow function contrast study (74230) range across 2 matching MRF lines |
$65.34–$528 | $99–$800 | varies |
| Radiologic exam upr gi trc double contrast study (74246) range across 2 matching MRF lines |
$109.56–$411.84 | $166–$624 | varies |
| Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
$21.12–$252.12 | $32–$382 | varies |
| Radiologic examination femur minimum 2 views (73552) range across 4 matching MRF lines |
$22.44–$477.18 | $34–$723 | varies |
| Radiologic examination knee 1/2 views (73560) range across 4 matching MRF lines |
$21.12–$658.68 | $32–$998 | varies |
| Radiologic Examination Osseous Survey Limited (77074) range across 2 matching MRF lines |
$54.12–$442.20 | $82–$670 | varies |
| Radiologic Examination Salivary Gland Calculus (70380) range across 2 matching MRF lines |
$21.12–$149.16 | $32–$226 | varies |
| Radiologic examination tibia & fibula 2 views (73590) range across 8 matching MRF lines |
$9.90–$443.52 | $15–$672 | varies |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) | $397.98 | $603 | 0.6× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) | $203.94 | $309 | 0.7× |
| Red Cell Volume Determination Spx 1 Sampling (78120) | $24.42 | $37 | 0.0× |
| Ribs bilateral 3 views (71110) range across 2 matching MRF lines |
$35.64–$429 | $54–$650 | varies |
| Rp loclzj tum plnr 1 area single day imaging (78800) range across 2 matching MRF lines |
$78.54–$901.56 | $119–$1,366 | varies |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) range across 2 matching MRF lines |
$87.12–$1,151.70 | $132–$1,745 | varies |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) range across 2 matching MRF lines |
$120.12–$1,036.20 | $182–$1,570 | varies |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) range across 2 matching MRF lines |
$95.70–$1,291.62 | $145–$1,957 | varies |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) range across 2 matching MRF lines |
$128.70–$1,500.18 | $195–$2,273 | varies |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) | $248.82 | $377 | 0.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) | $173.58 | $263 | 0.1× |
| Rp Therapy Intravenous Administration (79101) | $240.90 | $365 | 0.8× |
| Salivary Gland Imaging (78230) | $54.78 | $83 | 0.1× |
| Scapula (73010) range across 4 matching MRF lines |
$22.44–$443.52 | $34–$672 | varies |
| Screening Digital Breast Tomosynthesis Bi (77063) range across 4 matching MRF lines |
$36.96–$179.52 | $56–$272 | varies |
| Sella turcica (70240) range across 2 matching MRF lines |
$23.76–$142.56 | $36–$216 | varies |
| Shoulder 1 view (73020) range across 4 matching MRF lines |
$19.14–$330.66 | $29–$501 | varies |
| Shoulder Arthrography (73040) range across 4 matching MRF lines |
$69.96–$718.74 | $106–$1,089 | varies |
| Sialogram (70390) range across 2 matching MRF lines |
$46.86–$415.14 | $71–$629 | varies |
| Skull less than 4 views (70250) range across 2 matching MRF lines |
$22.44–$353.10 | $34–$535 | varies |
| Special dosimetry (77331) | $122.10 | $185 | 0.7× |
| Special teletherapy port plan (77321) | $132.66 | $201 | 0.3× |
| Special treatment procedure (77470) | $284.46 | $431 | 0.4× |
| Sternoclavicular joints (71130) range across 2 matching MRF lines |
$27.06–$246.18 | $41–$373 | varies |
| Telethx isodose pln cplx w/basic dosimetry (77307) range across 2 matching MRF lines |
$405.90–$843.48 | $615–$1,278 | varies |
| Telethx isodose pln smpl w/dosimetry calculation (77306) | $195.36 | $296 | 0.4× |
| Testicular Imaging W/Flow (78761) range across 2 matching MRF lines |
$87.78–$587.40 | $133–$890 | varies |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) | $218.46 | $331 | 0.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) | $149.82 | $227 | 0.3× |
| Ther rad simulaj-aided field setting simple (77280) | $99.66 | $151 | 0.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) | $262.02 | $397 | 1.2× |
| Thoracic spine 2 views (72070) range across 2 matching MRF lines |
$25.08–$507.54 | $38–$769 | varies |
| Thoracic spine 3 views (72072) range across 2 matching MRF lines |
$27.72–$547.80 | $42–$830 | varies |
| Thoracolumbar 2 views (72080) range across 2 matching MRF lines |
$26.40–$64.02 | $40–$97 | varies |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) | $82.50 | $125 | 0.2× |
| Thyroid Imaging With Vascular Flow (78013) range across 2 matching MRF lines |
$44.22–$481.80 | $67–$730 | varies |
| Thyroid Met Imaging Body (78018) range across 2 matching MRF lines |
$100.32–$393.36 | $152–$596 | varies |
| Thyroid Uptake Measurement (78012) range across 2 matching MRF lines |
$22.44–$553.08 | $34–$838 | varies |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) range across 2 matching MRF lines |
$60.06–$897.60 | $91–$1,360 | varies |
| Tx Devices Design & Construction Complex (77334) | $160.38 | $243 | 0.3× |
| Tx devices design & construction intermediate (77333) | $105.60 | $160 | 0.6× |
| Tx devices design & construction simple (77332) | $63.36 | $96 | 0.4× |
| Ultrasound Breast Limited (76642) range across 4 matching MRF lines |
$83.82–$712.14 | $127–$1,079 | varies |
| Ultrasound Elastography Parenchyma (76981) | $73.92 | $112 | 0.5× |
| Ultrasound Exam Aaa Screen (76706) range across 3 matching MRF lines |
$66.66–$475.20 | $101–$720 | varies |
| Ultrasound, abdomen limited (76705) range across 3 matching MRF lines |
$71.94–$568.92 | $109–$862 | varies |
| Umbilical-artery Doppler (OB) (76820) range across 3 matching MRF lines |
$61.38–$237.60 | $93–$360 | varies |
| Unlisted Dx Radiographic Procedure (76499) | $33 | $50 | 0.3× |
| Unlisted us procedure (76999) range across 2 matching MRF lines |
$173.58–$642.18 | $263–$973 | varies |
| Upper gi w/o kub (74240) range across 2 matching MRF lines |
$99–$540.54 | $150–$819 | varies |
| Ureteral Reflux Study (78740) range across 2 matching MRF lines |
$69.96–$498.96 | $106–$756 | varies |
| Urethrocystogram voiding (74455) range across 2 matching MRF lines |
$40.26–$382.80 | $61–$580 | varies |
| Urethrocystography retrograde (74450) range across 2 matching MRF lines |
$40.26–$345.84 | $61–$524 | varies |
| Us breast unilateral complete (76641) range across 4 matching MRF lines |
$90.42–$918.72 | $137–$1,392 | varies |
| Us chest (76604) range across 3 matching MRF lines |
$69.96–$652.74 | $106–$989 | varies |
| Us complete joint (76881) range across 3 matching MRF lines |
$111.54–$525.36 | $169–$796 | varies |
| Us exam, pelvic, limited (76857) range across 3 matching MRF lines |
$61.38–$291.06 | $93–$441 | varies |
| Us head (76506) range across 2 matching MRF lines |
$77.88–$219.78 | $118–$333 | varies |
| Us kidney transplant (76776) range across 3 matching MRF lines |
$93.06–$401.28 | $141–$608 | varies |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 4 matching MRF lines |
$85.14–$638.88 | $129–$968 | varies |
| Us ob detailed single fetus (76811) range across 3 matching MRF lines |
$234.30–$751.74 | $355–$1,139 | varies |
| Us ob limited 1 or more fetuses (76815) range across 3 matching MRF lines |
$79.86–$350.46 | $121–$531 | varies |
| Us ob transvaginal (76817) range across 3 matching MRF lines |
$92.40–$275.22 | $140–$417 | varies |
| Us pelvic non ob complete (76856) range across 3 matching MRF lines |
$84.48–$930.60 | $128–$1,410 | varies |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) range across 3 matching MRF lines |
$122.10–$775.50 | $185–$1,175 | varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) range across 3 matching MRF lines |
$105.60–$442.20 | $160–$670 | varies |
| Us retroperitoneal complete (76770) range across 3 matching MRF lines |
$90.42–$792.66 | $137–$1,201 | varies |
| Us retroperitoneal limited (76775) range across 3 matching MRF lines |
$71.28–$531.96 | $108–$806 | varies |
| Us scrotum and contents (76870) range across 3 matching MRF lines |
$78.54–$531.96 | $119–$806 | varies |
| Us spinal canal and contents (76800) range across 2 matching MRF lines |
$158.40–$480.48 | $240–$728 | varies |
| Us thyroid (76536) range across 3 matching MRF lines |
$69.30–$702.90 | $105–$1,065 | varies |
| Us transrectal (76872) range across 2 matching MRF lines |
$83.82–$543.18 | $127–$823 | varies |
| Vascular Flow Imaging (78445) | $60.72 | $92 | 0.1× |
| Vein X-Ray Chest (75827) range across 2 matching MRF lines |
$133.98–$1,037.52 | $203–$1,572 | varies |
| Venogram Sinus/Jugular (75860) | $137.28 | $208 | 0.0× |
| Venography caval inferior serialography rs&i (75825) range across 3 matching MRF lines |
$133.98–$2,284.92 | $203–$3,462 | varies |
| Venography extremity bilateral rs&i (75822) range across 2 matching MRF lines |
$174.24–$1,037.52 | $264–$1,572 | varies |
| Venography extremity unilateral rs&i (75820) range across 2 matching MRF lines |
$124.08–$1,037.52 | $188–$1,572 | varies |
| Venography Renal Bilateral (75833) range across 2 matching MRF lines |
$174.24–$2,284.92 | $264–$3,462 | varies |
| Venography Renal Unilateral (75831) range across 2 matching MRF lines |
$130.68–$2,284.92 | $198–$3,462 | varies |
| Venous sampling by catheter (75893) | $3,924.36 | $5,946 | 0.5× |
| Venous thrombosis imaging (78457) | $550.44 | $834 | 0.8× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) range across 2 matching MRF lines |
$110.88–$825.66 | $168–$1,251 | varies |
| Vertebral fracture assessment via dxa (77086) range across 2 matching MRF lines |
$21.12–$117.48 | $32–$178 | varies |
| Wrist 2 views (73100) range across 8 matching MRF lines |
$10.56–$508.86 | $16–$771 | varies |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) range across 2 matching MRF lines |
$23.76–$285.78 | $36–$433 | varies |
| X-ray antegrade pyelogram tube (74425) range across 2 matching MRF lines |
$62.70–$299.64 | $95–$454 | varies |
| X-Ray Aorta Leg Arteries (75630) range across 2 matching MRF lines |
$32.34–$235.62 | $49–$357 | varies |
| X-Ray Bend Only L-S Spine (72120) range across 3 matching MRF lines |
$27.72–$302.28 | $42–$458 | varies |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 8 matching MRF lines |
$10.56–$397.98 | $16–$603 | varies |
| X-Ray Exam Breast Specimen (76098) range across 2 matching MRF lines |
$38.94–$397.98 | $59–$603 | varies |
| X-Ray Exam Entire Spi 1 Vw (72081) range across 2 matching MRF lines |
$32.34–$322.08 | $49–$488 | varies |
| X-Ray Exam Entire Spi 2/3 Vw (72082) range across 2 matching MRF lines |
$38.94–$374.88 | $59–$568 | varies |
| X-Ray Exam Entire Spi 4/5 Vw (72083) range across 2 matching MRF lines |
$44.88–$480.48 | $68–$728 | varies |
| X-Ray Exam Hip Uni 1 View (73501) range across 2 matching MRF lines |
$23.76–$279.18 | $36–$423 | varies |
| X-Ray Exam Hip Uni 2-3 Views (73502) range across 2 matching MRF lines |
$27.72–$373.56 | $42–$566 | varies |
| X-Ray Exam Hip Uni 4/> Views (73503) range across 2 matching MRF lines |
$34.32–$417.78 | $52–$633 | varies |
| X-Ray Exam Hips Bi 2 Views (73521) range across 2 matching MRF lines |
$27.72–$679.14 | $42–$1,029 | varies |
| X-Ray Exam Hips Bi 3-4 Views (73522) range across 2 matching MRF lines |
$36.96–$982.08 | $56–$1,488 | varies |
| X-Ray Exam Hips Bi 5/> Views (73523) range across 2 matching MRF lines |
$38.94–$1,029.60 | $59–$1,560 | varies |
| X-Ray Exam L-S Spine Bending (72114) range across 2 matching MRF lines |
$38.28–$592.02 | $58–$897 | varies |
| X-Ray Exam Neck Spine 2-3 Vw (72040) range across 3 matching MRF lines |
$27.72–$525.36 | $42–$796 | varies |
| X-Ray Exam Neck Spine 6/>Vws (72052) range across 2 matching MRF lines |
$36.96–$755.70 | $56–$1,145 | varies |
| X-Ray Exam Unilat Ribs/Chest (71101) range across 2 matching MRF lines |
$33–$490.38 | $50–$743 | varies |
| X-ray eye for foreign body (70030) range across 2 matching MRF lines |
$22.44–$446.16 | $34–$676 | varies |
| X-ray humerus (73060) range across 8 matching MRF lines |
$9.90–$526.02 | $15–$797 | varies |
| X-ray IV pyelogram (ivp) (74400) range across 2 matching MRF lines |
$59.40–$536.58 | $90–$813 | varies |
| X-ray IV pyelogram+tomography (74415) range across 2 matching MRF lines |
$60.06–$611.16 | $91–$926 | varies |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) range across 2 matching MRF lines |
$22.44–$233.64 | $34–$354 | varies |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) range across 2 matching MRF lines |
$21.78–$211.20 | $33–$320 | varies |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) range across 2 matching MRF lines |
$27.72–$505.56 | $42–$766 | varies |
| X-ray nose-rectum child f.b. (76010) range across 2 matching MRF lines |
$22.44–$124.08 | $34–$188 | varies |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) range across 2 matching MRF lines |
$39.60–$475.20 | $60–$720 | varies |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) range across 2 matching MRF lines |
$27.72–$330.66 | $42–$501 | varies |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) range across 2 matching MRF lines |
$21.78–$227.04 | $33–$344 | varies |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) range across 4 matching MRF lines |
$10.56–$301.62 | $16–$457 | varies |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) range across 2 matching MRF lines |
$27.06–$417.12 | $41–$632 | varies |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) range across 2 matching MRF lines |
$34.98–$591.36 | $53–$896 | varies |
| X-Ray Stress View (77071) range across 2 matching MRF lines |
$91.74–$146.52 | $139–$222 | varies |
| X-ray thoracic spine 4 vw (72074) range across 2 matching MRF lines |
$30.36–$576.84 | $46–$874 | varies |
| X-Ray Tmj Unilat (70328) range across 2 matching MRF lines |
$22.44–$100.98 | $34–$153 | varies |
| X-Ray Urinary Tract Exam With Contrast Material (74420) range across 2 matching MRF lines |
$64.02–$341.22 | $97–$517 | varies |
| X-Rays Bone Length Studies (77073) range across 2 matching MRF lines |
$33.66–$395.34 | $51–$599 | varies |
| X-Rays Bone Survey Complete (77075) range across 2 matching MRF lines |
$67.98–$829.62 | $103–$1,257 | varies |
| Xr c-spine 4 or 5 views (72050) range across 2 matching MRF lines |
$34.32–$591.36 | $52–$896 | varies |
| Xr facial bones less than 3 views (70140) range across 2 matching MRF lines |
$25.08–$306.90 | $38–$465 | varies |
| XR Mastoids < 3 Views Bilateral (70120) | $22.44 | $34 | 0.2× |
| Xr orbits complete 4 views (70200) range across 3 matching MRF lines |
$34.98–$605.22 | $53–$917 | varies |
| Xr Tomogram Single Plane (76100) range across 2 matching MRF lines |
$71.28–$351.78 | $108–$533 | varies |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.